DOI: 10.4103/jfmpc.jfmpc_1023_25 ISSN: 2249-4863

Culturally adapted diabetes education using the AADE7 framework: A quasi-experimental study in Hail, Saudi Arabia

Abdullah Mohammad Alshammari, Mohamed Hassan Elnaem, Siew Chin Ong
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BSTRACT

Background:

Type 2 diabetes mellitus (T2DM) presents a critical public health burden in Saudi Arabia, which has the highest T2DM prevalence in the Middle East and North Africa (MENA) region (18.7%). Despite this urgency, < 10% of diabetes interventions incorporate cultural adaptations. The American Association of Diabetes Educators 7 (AADE7) Self-Care Behaviors® framework, while globally recognized, lacks comprehensive adaptation and evaluation within this high-risk context.

Objective:

To evaluate the impact of a culturally adapted AADE7-based diabetes education intervention on glycemic control among adults with T2DM in Hail City, Saudi Arabia.

Methods:

A quasi-experimental controlled before-and-after study was conducted across five hospitals in Hail, involving 377 adults with T2DM. The intervention group ( n = 227) participated in a 12-week culturally and linguistically adapted education program incorporating digital and community-based support, while the control group ( n = 150) continued routine outpatient care. The primary outcome was change in HbA1c levels, analyzed using paired t-tests and analysis of covariance adjusted for baseline HbA1c and age.

Results:

The intervention group showed a significant reduction in mean HbA1c from 9.0% to 7.99% (mean change: –1.01%, 95% confidence interval: 0.97 to 1.05; P < 0.001; Cohen’s d = 3.30). No change was observed in the control group. Adjusted between-group difference in HbA1c was –1.02% ( P < 0.001), indicating a large effect and substantial clinical benefit. Subgroup analysis revealed enhanced efficacy among patients with baseline HbA1c ≥ 9%.

Conclusion:

The culturally adapted AADE7 intervention significantly improved glycemic control and demonstrated strong clinical impact among Saudi adults with T2DM. Integrating such models into national diabetes strategies can enhance patient outcomes and reduce disease burden.

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