Diabetes knowledge and self-efficacy among rural women in Gujarat, India

Abstract

Introduction: Type II diabetes has risen dramatically among rural women in India, specifically in the states of Gujarat, Karnataka, Tamil Nadu and Uttar Pradesh. Recent studies suggest that rural Indian women's low level of self-efficacy, or confidence in their ability to carry out tasks, such as managing diabetes, is a key reason for this increase. Therefore, this study utilizes the Health Belief Model to analyze whether increased awareness of diabetes leads to a positive increase in levels of self-efficacy among diabetic women in two rural villages of Gujarat. Methods: A cross-sectional study of 126 known cases of women with diabetes was carried out in the villages of Rajpur and Valam in the Mehsana District in the state of Gujarat, India, to assess the relationship between diabetes knowledge and self-efficacy. The instrument was adapted from the Michigan Diabetes Research and Training Center's Diabetes Empowerment Scale-Short Form and Knowledge, Attitudes and Practices Assessment of the Indian Institute of Public Health Gandhinagar. Results: Participants' mean knowledge score was 10.77±2.86 out of a possible 24 points, for a mean percentage of 45%. The median self-efficacy score for the women was 7 with an interquartile range of 3. The age-adjusted multiple regression analysis demonstrated a significant positive correlation between knowledge and self-efficacy (p<0.001). Conclusions:The observations of this study suggest a positive correlation between diabetes knowledge and self-efficacy. Future diabetes educational interventions in India should place a greater emphasis on increasing knowledge among rural women. Specifically, these interventions should emphasize the major gaps in knowledge regarding causes of diabetes, complications and © James Cook University 2016, http://www.jcu.edu.au 2 treatment procedures. Educational interventions that are catered more towards rural women will be critical for improving their selfefficacy.

Association of socio-demographic determinants and knowledge of type-2 diabeties

“…Such findings suggest that diabetes awareness and knowledge may be better in urban regions, where information, messaging, and resources for diabetes may be more accessible. The association between higher wealth, education, and lower rurality and diabetes knowledge is consistent with other studies in India 12,13,17 , and other low-and middle-income countries, including Jordan 18 , Bangladesh 19 , Southeast Ethiopia 20 , Oman 21 , and Pakistan 21 .…”

“…Although all villages included in the study were rural by the definition as described by the Census of India, the rurality of each village was assessed as a predictor variable using a rurality index, adapted from Weinert and Boik 13 . The two variables incorporated into the rurality index were distance to the primary healthcare center (given half a positive weighted value), and the population size of each village (given a full negative weighted value).…”

“…Age was categorized into four groups -20-34, 35-49, 50-64, and ≥65 yearsbased on similar methods used by Shrivastava et al14 and Murugesan et al 13 . Type of health care typically accessed included government, private, natural (ie ayurvedic and/or other alternative medicines), and none, and each was assessed as a binary variable.…”

“…Information on school grade achieved was collected and had a range of 0-15, with anything greater than 12 indicating post-secondary education. For ease of interpretation, this variable had the categories of no schooling, primary education (grades 1-8), secondary education (grades 9-11), and graduate or post-secondary education (grades ≥12), based on similar methods used previously among Indian populations 13,14 . Knowledge on diabetes was collected using a validated questionnaire developed by Mohan et al (2005) 15 , and included questions about diabetes such as risk factors, complications, and prevention.…”