Foot care education and self management behaviors in diverse veterans with diabetes

Jonathan M Olson¹, Molly T Hogan², Leonard M Pogach³, Mangala Rajan³, Gregory J Raugi⁴, Gayle E Reiber⁵

¹University of Washington School of Medicine, Seattle, WA, USA; ²Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA; ³Department of Veterans Affairs, New Jersey Healthcare System, Center for Healthcare Knowledge Management, East Orange, NJ, USA; ⁴Division of Dermatology, VA Puget Sound Healthcare System, Department of Veterans Affairs, Seattle, WA, USA; ⁵Research and Development, VA Puget Sound Healthcare System, Department of Veterans Affairs, Seattle, WA, USA

Abstract: The objective of this study was to examine differences in self-reported diabetes foot care education, self management behaviors, and barriers to good foot care among veterans with diabetes by race and ethnicity. Data was collected using the Veterans Health Administration Footcare Survey, a validated tool that assessed demographic, general health, diabetes and foot self-care information, barriers to foot self-care, receipt of professional foot care, and satisfaction with current care. We mailed surveys to a random sample of patients with diabetes from eight VA medical centers. Study participants were 81% White; 13% African American; 4% Asian, and 2% American Indian and Pacific Islanders. The majority of respondents felt that they did not know enough about foot self-care. There were large gaps between self-reported knowledge and actual foot care practices, even among those who reported “knowing enough” on a given topic. There were significant differences in self-reported foot care behaviors and education by race and ethnicity. These findings document the need for culturally-specific self-management education to address unique cultural preferences and barriers to care.

Keywords: diabetes mellitus, diabetic foot, patient self-management, ethnic groups, education