P106 Effect of a Cultural and Theory-Based Diabetes Education Intervention on Improving Knowledge, Health Beliefs and Lifestyle Behavior

To assess the effect of a diabetes education intervention (DEI) on improving knowledge, health beliefs, and lifestyle behavior. The Health Belief Model (HBM) constructs were used in designing the modules and activities of the DEI. The module on understanding type 2 diabetes (T2D) risk factors/symptoms focused on improving perceived susceptibility and seriousness. Modules on nutrition, physical activity, smoking, alcohol use and management of T2D focused on perceived benefits, barriers, and self-efficacy. Cues to action triggers of lessons were sent to participants via text and social media messaging. The participants were adults (18+ years) living in peri-urban communities in Nairobi, Kenya. A pretest-posttest experimental design was used, with 226 participants recruited either to the intervention group (IG) and control group (CG). The IG attended a 5-day face-to-face DEI that included 5 modules on understanding T2D, nutrition, physical activity, reducing tobacco and alcohol, and management of T2D. The CG received standard education on hygiene related to COVID-19. Diabetes knowledge was assessed using a pre-tested questionnaire and health beliefs using a validated HBM scale. Dietary intake was assessed using a culturally modified food frequency questionnaire, while physical activity was measured using the international physical activity questionnaire. Mixed effect models were used in analysis to assess the effect of the intervention. The IG significantly increased in knowledge at post intervention, compared to the CG (P < 0.000). Perceived susceptibility and benefits increased in the IG versus the CG across time (P < 0.004). Self-efficacy in dietary behaviors (P < 0.002) and alcohol use (P < 0.030) improved in IG versus CG, however self-efficacy in physical activity, and smoking, did not improve. Physical activity did not improve, however, the IG decreased daily mean intake of oils (P < 0.000), added sugars (P < 0.001) and increased fruits (P < 0.002), and starchy vegetables (P < 0.000). The findings demonstrate the importance of diabetes education in improving knowledge, perceived susceptibility, benefits, and self-efficacy and in changing dietary behavior among adults. Department of Nutritional Sciences, Texas Tech University