Abstract
BackgroundHaving shown in a recent randomized controlled trial that evidence-based patient information (EBPI) significantly increased knowledge on primary prevention of diabetes compared to standard patient information, we now investigated interaction between socioeconomic status (SES) and the effect of an EBPI.Findings1,120 visitors (aged 40–70 years, without known diabetes) to the “Techniker Krankenkasse” and the “German Diabetes Center” websites were randomized. The intervention group received a newly developed on-line EBPI, the control group standard on-line information. The primary outcome measure was knowledge, classified as “good/average/poor”. We analyzed associations of knowledge with socioeconomic variables (education, vocational training, employment, subjective social status) combined with intervention effect including interactions, adjusted for possible confounding by knowledge before intervention, self–reported blood glucose measurements, blood pressure, blood lipid levels, age and gender. Logistic regression models were fitted to the subpopulation (n = 647) with complete values in these variables.Education (high vs. low) was significantly associated with knowledge (good vs. average/poor); however, there was no significant interaction between education and intervention. After adjustment, the other socioeconomic variables were not significantly associated with knowledge.ConclusionsSocioeconomic variables did not significantly change the effect of the intervention. There was a tendency towards a lower effect where lower educated individuals were concerned. Possibly the power was too low to detect interaction effects. Larger studies using SES-specific designs are needed to clarify the effect of SES. We suggest considering the socioeconomic status when evaluating a decision aid, e.g. an EBPI, to ensure its effectiveness not only in higher socioeconomic groups.Trial registrationCurrent Controlled Trials ISRCTN22060616 (Date assigned: 12 September 2008).
Highlights
Having shown in a recent randomized controlled trial that evidence-based patient information (EBPI) significantly increased knowledge on primary prevention of diabetes compared to standard patient information, we investigated interaction between socioeconomic status (SES) and the effect of an EBPI
Larger studies using SES-specific designs are needed to clarify the effect of SES
We suggest considering the socioeconomic status when evaluating a decision aid, e.g. an EBPI, to ensure its effectiveness in higher socioeconomic groups
Summary
Having shown in a recent randomized controlled trial that evidence-based patient information (EBPI) significantly increased knowledge on primary prevention of diabetes compared to standard patient information, we investigated interaction between socioeconomic status (SES) and the effect of an EBPI. We suggest considering the socioeconomic status when evaluating a decision aid, e.g. an EBPI, to ensure its effectiveness in higher socioeconomic groups. Few decision aids, including those providing evidence-based patient information (EBPI), have been evaluated regarding their effectiveness among people from a range of socioeconomic backgrounds [5,6], and results are conflicting.
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