Diabetes education of Turkish people with low literacy skills: Results of an online survey of training practices

Introduction: For patients with diabetes mellitus, training is an essential part of therapy. There is a lack of empirical data regarding training experiences for people with a (Turkish) migration background and low literacy skills concerning the established training programmes. The objective of this research was to collect data from general practices based on their experiences in training these particular groups of patients. Methods: In a quantitative cross-sectional study design, 795 general practices throughout Germany with the additional designation of diabetology were invited via e-mail to participate in a fully structured, standardised online survey. An exploratory data analysis was performed using the statistics software IBM SPSS. Results: Out of 146 participating practices (response rate 18%), 66 (45%) estimated the proportion of patients with migration background in their practice to be more than 20%. Approximately 76% of the practices providing diabetes training (n = 119) trained patients of Turkish origin. Forty six percent of these practices estimated the ratio of patients of Turkish origin with low literacy skills to be 10 to 50%. Less than 36% of the practices were aware of suitable training programmes for this target group. Existing programmes were modified to special needs and new materials creatively developed. Additional culturally sensitive and visually enriched materials are needed. Forty two percent of the interviewed practices reported billing difficulties concerning frequently needed individual trainings. Discussion: Training was carried out in different ways due to individual addition or deletion of content elements. There is a lack of evaluated materials that are adapted to the users' cultural background and level of education. In the face of a significantly changed immigration structure, information and materials as well as interpreters for additional languages are increasingly required. Conclusion: Further development of evidence-based, multi-lingual, image-based, culturally sensitive and educationally diverse materials and training units and their scientific evaluation is needed. Learning contents adapted to the level of education and promoting cultural sensitivity in the provision of healthcare should be implemented increasingly in the training and continuous professional development of health professionals.