Educational intervention to improve adherence to the Mediterranean diet among parents and their children aged 1-2 years. EniM clinical trial.

OBJECTIVE: The objective of the present study was to evaluate the effectiveness of an educational programme on healthy alimentation, carried out in day-care centres and aimed at the parents of children from 1 to 2 years of age, regarding the acquisition of healthy eating habits among themselves and their children. DESIGN: We performed a multicentre, multidisciplinary, randomized controlled study in a community setting. SETTING: The EniM study (nutritional intervention study among children from Mataró) was performed in twelve day-care centres in Mataró (Spain). Centres were randomized into a control group (CG) and an intervention group (IG). IG received four or five educational workshops on diet, CG did not have workshops. SUBJECTS: Children, not exclusively breast-fed, from 1 to 2 years of age, in the participating day-care centres and the persons responsible for their alimentation (mother or father). RESULTS: Thirty-five per cent of the IG did not attend the minimum of three workshops and were excluded. The CG included seventy-four children and seventy-two parents and the IG seventy-five children and sixty-seven parents. Both groups were comparable at baseline. Basal adherence to the Mediterranean diet was 56·4 % in parents (Gerber index) and 7·7 points in children (Kidmed test). At 8 months, Mediterranean diet adherence had improved in the IG by 5·8 points in the Gerber index (P=0·01) and 0·6 points in the Kidmed test (P=0·02) compared with the CG. CONCLUSIONS: This educational intervention performed in parents at the key period of incorporation of a 1-2-year-old child to the family table showed significant increases in adherence of the parents to the Mediterranean diet, suggesting future improvement in different indicators of health and an expected influence on the diet of their children.

[Medium-term effectiveness of a group educational intervention on foot care in patients with type 2 diabetes]. / Efectividad a medio plazo de una intervención educativa grupal dirigida al cuidado de los pies en pacientes con diabetes tipo 2.

AIM: To evaluate the medium-term effectiveness of a group educational intervention in primary care aimed at improving attitudes and skills in self-care of the feet in patients with type 2 diabetes, and to determine the optimal time for reintervention. METHOD: We performed a before-after intervention study with a 24-month follow-up. The sample consisted of 76 patients with type 2 diabetes who underwent two group education sessions. Sociodemographic variables and variables related to the neurovascular status of the foot and with hygiene and self-care habits were measured. To compare the results, McNemar's test for paired data was used. RESULTS: The mean age was 66 years and 51% were men. Skills performance before-after (8 months) the intervention were as follows: correct hygiene 41%-86%, good-medium hydration 80%-97%, daily foot washing 42%-68%, proper tools use 41%-79%, proper shoes 9%-33%, proper nails 26%-74% (all differences with p < 0.001). Among patients that improved due to the sessions, skills were still correct at 24 months in 76% (95% CI: 61%-90%) for hygiene, 100% for hydration, 70% for daily foot washing (95% CI: 51%-90%), 74% for proper tools use (95% CI: 58-90%), 55% for proper shoes (95% CI: 34%-77%) and 81% for proper nails (95% CI: 68%-94%). CONCLUSIONS: The intervention improved all the skills studied. The effects of the sessions were still evident after 24 months in more than 70% of patients for all the variables studied except proper shoe use. Group education favors skills improvement. We suggest repeating the intervention every 24 months.