Diabetes Prevention Materials, 5 trifold pamphlets (3 in English, 2 in Spanish language). Santa Cruz, CA: Journeyworks Publishing; 2004. 50 pamphlets for $16.

INTRODUCTION

Several pamphlets have been developed for educating the public about diabetes, an important health problem in the United States and worldwide. These patient education materials are intended for distribution by health professionals, particularly those who work in programs focused on diabetes prevention and control. The pamphlets are 3.5x8.5 inches and open in the typical tri-fold manner. Three different pamphlets were examined for this review, two of which included a Spanish language edition (indicated in the list below with an asterisk). Those examined are entitled:

* Diabetes and You: 35 Things Everyone Should Know About Diabetes^*

* Preventing Type 2 Diabetes: 6 Good Ways to Lower Your Risk^*

* Get the Facts: Smoking, Diabetes, and Your Health.

DESCRIPTION

The information provided in each of the above patient education brochures consists largely of factual information about diabetes. In the case of the brochure entitled, "35 Things Everyone Should Know," the kind of information included is mostly epidemiology and pathophysiology. Examples include: "About one-third of people with diabetes do not know they have it," and "There are three main types of diabetes-type 1, type 2, and gestational." In the brochures entitled, "6 Good Ways to Lower Your Risk" and "Smoking, Diabetes, and Your Health," the information mostly consists of do's and don'ts related to self-care and the health consequences of one's actions. Examples include, "Lose weight if you need to," and "Quitting smoking may lower your risk of developing diabetes."

The appearance of these patient education materials is appealing. They have several muted colors and include drawings of a variety of people of all ages and ethnicity engaging in typical daily activities. The individuals depicted are much like normal everyday individuals, rather than those who are glamorous or excessively thin. Health care professionals of a variety of ethnicities are also depicted in all 3 brochures. The layout of the information is clear and easy to see, with borders and contrasting colors. The information is often presented in lists with checks or bullets.

DETAILED EVALUATION

Positive elements about these materials are that the content is important and has the potential to impact a large population because of the vast numbers of individuals already diagnosed and those at risk for diabetes. The information is up-to-date and consistent with recent publications and guidelines by the NIH and the American Diabetes Association. Topics addressed in the brochures about "Lower Your Risk" and "Smoking" include concise lists with specific action steps that individuals can take to prevent diabetes and/or the associated complications.

There are several important limitations to these materials. The brochure about "35 Facts" is extremely dense in information and doesn't make clear why the average person needs to know this kind of information (epidemiology and pathophysiology). Many of the words tend to be very complex and poly-syllabic, making them appropriate only for highly literate populations. Examples of complex words include "siblings" (versus "brothers and sisters"), "injections" (versus "shots"), "oral medications" (versus "pills"); simpler wording could enhance the utility of these brochures. Similarly, a high level of numerical understanding is required to interpret information about "risks" and how to lower one's risks of developing diabetes. Alternatively, useful information is presented in less dense forms such as checklists and "do's and don'ts," as in the brochure about smoking.

A final limitation is the cost. Although the materials are fairly inexpensive (50 for $16), one can obtain also many excellent quality, inexpensive materials from highly reputable sources such as the NIH/National Diabetes Education Project (NDEP) and the American Diabetes Association (ADA). Patient education materials from these two sources have been developed by health educators who know the research literature and use it as the basis of developing brochures. The NIH/NDEP and ADA often have patient education brochures in Spanish as well as other languages. The materials from these two sources also cover multiple topics related to self-care and diabetes, ranging from prevention to daily care for people with diabetes. Topics include nutrition, care of teeth and gums, keeping eyes healthy, foot care, and others. For examples and information about ordering these readily available brochures, consult the following Web sites: (1) http://catalog.niddk.nih.gov and (2) http://www.diabetes.org/for-health-professionals-and-scientists/resources.jsp.