152099 Taking Steps toward Improving Foot Care

Tuesday, November 6, 2007: 3:00 PM

Grace Chi, MS , University of Vermont College of Medicine, Burlington, VT
Andrew Wright , University of Vermont College of Medicine, Burlington, VT
John Elias , University of Vermont College of Medicine, Burlington, VT
Lorna Grant , University of Vermont College of Medicine, Burlington, VT
Heather Lesage , University of Vermont College of Medicine, Burlington, VT
Elisabeth Jannicky , University of Vermont College of Medicine, Burlington, VT
Jodi McQuillen , University of Vermont College of Medicine, Burlington, VT
Curtis Witcher , University of Vermont College of Medicine, Burlington, VT
Sarah Russell , University of Vermont College of Medicine, Burlington, VT
Alan Rubin, MD , General Internal Medicine, Fletcher Allen Health Care, Burlington, VT
Jan Carney, MD, MPH , University of Vermont College of Medicine, Burlington, VT
           
The American Diabetes Association (ADA) estimates that 20.8 million children and adults in the United States live with diabetes. The ADA recommends that persons with diabetes receive annual, comprehensive foot evaluations and self-care education. In March 2006 the Burlington Housing Authority conducted a survey to determine the health service needs of residents of South Square in Burlington, Vermont. Respondents identified foot care as their primary need. As second-year medical students at the University of Vermont College of Medicine, we conducted two foot care clinics aimed at serving that need. Our clinics included a thorough foot exam, toe nail trimming, and education on proper foot-care. Furthermore, each clinic attendee completed a pre- and post-clinic survey. The pre-clinic survey was designed to determine the demographics, foot health, and knowledge of proper foot-care of participants. The post-clinic survey tested the effectiveness of our education by repeating the foot education questions from the pre-clinic survey. Of the 18 clients, all had a primary care physician (PCP) and six were diabetic. The diabetics scored lower than those without diabetes on both the pre and post-surveys, suggesting a lower level of knowledge about foot health. Additionally, we discovered that despite visiting their PCPs multiple times a year, only 33% of the non-diabetics reported having their feet checked. This number improved to only 50% in surveyed diabetics. This finding illustrates a disconnect between national ADA guidelines and current physician practice, and highlights additional opportunities for provider and patient education to improve health care quality.

Learning Objectives:
1. Describe results of a survey of residents at the Burlington Housing Authority to assess need for health care services 2. Describe educational efforts used during foot care clinincs 3. Discuss results of pre and post-clinic survey and implications for improving health care quality

Keywords: Primary Care, Public Health Education and Health Promotion

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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