The objective of a study conducted by Olson and colleagues 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. Surveys were mailed 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.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that these findings document the need for culturally-specific self-management education to address unique cultural preferences and barriers to care.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The recommendations of the authors are important: you may need a diabetes management program tailored to your needs. Equally important, however, is that you close the gap between the skills you are taught and performance. This means that you must know and are able to take care of your feet. Self-management doesn’t work unless you perform the skills taught to you. Ask your health care provider for assistance if you find there is gap between what you know and what is occurring with your foot care.

JM Olson et al. Foot care education and self management behaviors in diverse veterans with diabetes. Patient Preference & Adherence, 2009;3:45-50.