{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:31:59Z","timestamp":1765758719014,"version":"build-2065373602"},"reference-count":100,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"RYERSON","award":["NA"],"award-info":[{"award-number":["NA"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,9]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We aimed to understand how, why and in what context upskilling programmes for unregulated care providers (UCPs) to provide foot screening for systematically marginalised groups living with diabetes were implemented.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>We used realist synthesis based on Realist And Meta-narrative Evidence Syntheses: Evolving Standards guidance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data sources<\/jats:title>\n                  <jats:p>We searched the Medline, Embase, PsycINFO, CINAHL, ERIC, Web of Science Core Collection, and Scopus databases and the grey literature (Google Scholar, ProQuest Dissertations and Theses) up to November 2022.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Eligibility criteria<\/jats:title>\n                  <jats:p>We included experimental and non-experimental articles in English that either described mechanisms or discussed expected outcomes for educational interventions for patients and family caregivers or healthcare providers, both regulated and unregulated. We also included articles that evaluated the impact of foot care programmes if the UCPs\u2019 training was described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data extraction and synthesis<\/jats:title>\n                  <jats:p>The lead author extracted, annotated and coded uploaded relevant data to identify contexts, mechanisms and outcome configurations using MAXQDA (a qualitative data analysis software). We used deductive and inductive coding to structure the process. Our team members double-reviewed and appraised a random sample of 20% of articles at all stages to ensure consistency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Our search identified 52 articles. Evidence suggested the necessity of developing upskilling foot screening programmes within the context of preventive care programmes that also provide education in diabetes, and early referrals for appropriate interventions. Multidisciplinary programmes created an ideal context facilitating coordination between UCPs and their regulated counterparts. Engaging patients and community partners, using a competency-based model, and incorporating cultural competencies were determinants of success for these programmes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This review provides a realistic programme theory for the mechanisms used, the context in which these programmes were developed, and the expected outcomes to train UCPs to provide preventive foot care for systematically marginalised populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42022369208.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-081006","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T01:50:19Z","timestamp":1705974619000},"page":"e081006","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Upskilling programmes for unregulated care providers to provide diabetic foot screening for systematically marginalised populations: how, why and in what contexts do they work? A realist review"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2526-4515","authenticated-orcid":false,"given":"Samah","family":"Hassan","sequence":"first","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"Program for Health System and Technology Evaluation, Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria E","family":"Rac","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"Program for Health System and Technology Evaluation, Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management, and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN), Toronto, Ontario, Canada"},{"name":"Diabetes Action Canada, CIHR SPOR Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Hodges","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Institute of Education Research, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patti","family":"Leake","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Institute of Education Research, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saul","family":"Cobbing","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Institute of Education Research, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catharine Marie","family":"Gray","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Bartley","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Etherington","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Institute of Education Research, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munira","family":"Abdulwasi","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Institute of Education Research, University Health Network, Toronto, Ontario, Canada"},{"name":"The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hei-Ching Kristy","family":"Cheung","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Institute of Education Research, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9786-1656","authenticated-orcid":false,"given":"Melanie","family":"Anderson","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"Library and Information Services, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole N","family":"Woods","sequence":"additional","affiliation":[{"name":"University Health Network, Toronto, Ontario, Canada"},{"name":"The Institute of Education Research, University Health Network, Toronto, Ontario, Canada"},{"name":"The Michener Institute of Education, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,22]]},"reference":[{"key":"2025101810483424000_14.1.e081006.1","unstructured":"DiabetesCanada Diabetes rates continue to climb in Canada. 2022. Available: https:\/\/www.diabetes.ca\/media-room\/press-releases\/diabetes-rates-continue-to-climb-in-canada"},{"key":"2025101810483424000_14.1.e081006.2","unstructured":"Commons H o . A DIABETES STRATEGY FOR CANADA, report of the standing committee on health. 2019."},{"key":"2025101810483424000_14.1.e081006.3","doi-asserted-by":"crossref","first-page":"306","DOI":"10.24095\/hpcdp.39.11.03","article-title":"At-a-glance-twenty years of diabetes surveillance using the Canadian chronic disease surveillance system","volume":"39","author":"LeBlanc","year":"2019","journal-title":"Health Promot Chronic Dis Prev Can"},{"key":"2025101810483424000_14.1.e081006.4","unstructured":"Whiteside C . Diabetes strategies in Canada and abroad. 2018."},{"key":"2025101810483424000_14.1.e081006.5","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jcjd.2013.04.005","article-title":"The Canadian diabetes Association 2013 clinical practice guidelines\u2014raising the bar and setting higher standards","volume":"37","author":"Cheng","year":"2013","journal-title":"Can J Diabetes"},{"issue":"Supplement","key":"2025101810483424000_14.1.e081006.6","doi-asserted-by":"crossref","DOI":"10.1097\/00003246-199501001-00425","article-title":"The effect of imipenem\/Cilastatin on acute Cyclosporin nephrotoxicity in heart\/lung transplant patients","volume":"23","author":"Ali","year":"1995","journal-title":"Critical Care Medicine"},{"key":"2025101810483424000_14.1.e081006.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-015-0687-5","article-title":"Economic burden of illness associated with diabetic foot ulcers in Canada","volume":"15","author":"Hopkins","year":"2015","journal-title":"BMC Health Serv Res"},{"key":"2025101810483424000_14.1.e081006.8","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1177\/1708538120923420","article-title":"The economic burden of inpatient diabetic foot ulcers in Toronto, Canada","volume":"28","author":"Syed","year":"2020","journal-title":"Vascular"},{"key":"2025101810483424000_14.1.e081006.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2017.10.002"},{"key":"2025101810483424000_14.1.e081006.10","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S2213-8587(20)30188-1","article-title":"Walking the path together: incorporating indigenous knowledge in diabetes research","volume":"8","author":"Maple-Brown","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025101810483424000_14.1.e081006.11","first-page":"561","article-title":"Type 2 diabetes mellitus in Canada \u201as first nations: status of an epidemic in progress","volume":"163","author":"Young","year":"2000","journal-title":"CMAJ"},{"key":"2025101810483424000_14.1.e081006.12","unstructured":"Nallathamby S . The social determinants of health related to the increased prevalence and risk of diabetes among South Asians in Canada. 2021."},{"key":"2025101810483424000_14.1.e081006.13","unstructured":"Organization, W.H . WHO competency framework for health workers\u2019 education and training on antimicrobial resistance. World Health Organization, 2018."},{"key":"2025101810483424000_14.1.e081006.14","doi-asserted-by":"publisher","DOI":"10.21815\/JDE.019.015"},{"key":"2025101810483424000_14.1.e081006.15","doi-asserted-by":"publisher","DOI":"10.1139\/h11-128"},{"key":"2025101810483424000_14.1.e081006.16","doi-asserted-by":"publisher","DOI":"10.1177\/0145721717737742"},{"key":"2025101810483424000_14.1.e081006.17","doi-asserted-by":"publisher","DOI":"10.1097\/FCH.0b013e31824651d3"},{"key":"2025101810483424000_14.1.e081006.18","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2020-010887"},{"key":"2025101810483424000_14.1.e081006.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-005466","article-title":"Understanding how appraisal of doctors produces its effects: a realist review protocol","volume":"4","author":"Brennan","year":"2014","journal-title":"BMJ Open"},{"key":"2025101810483424000_14.1.e081006.20","doi-asserted-by":"publisher","DOI":"10.1258\/1355819054308530"},{"key":"2025101810483424000_14.1.e081006.21","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-1"},{"key":"2025101810483424000_14.1.e081006.22","unstructured":"Hassan S et al . Understanding how and why an educational intervention for non-registered health care providers providing foot care for high-risk individuals works. PROSPERO 2022:CRD42022369208."},{"key":"2025101810483424000_14.1.e081006.23","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-072570","article-title":"Hodges BD, et al understanding how and why Upskilling programmes for unregulated care providers can support health equity in Underserved communities: a realist review protocol BMJ open","volume":"13","author":"Hassan","year":"2023","journal-title":"BMJ Open"},{"key":"2025101810483424000_14.1.e081006.24","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1080\/0142159X.2018.1484898","article-title":"Adaptive expertise in medical decision making","volume":"40","author":"Croskerry","year":"2018","journal-title":"Med Teach"},{"key":"2025101810483424000_14.1.e081006.25","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1007\/s10459-022-10178-8","article-title":"Combining adaptive expertise and (critically) reflective practice to support the development of knowledge, skill, and society","volume":"27","author":"Ng","year":"2022","journal-title":"Adv Health Sci Educ Theory Pract"},{"key":"2025101810483424000_14.1.e081006.26","doi-asserted-by":"publisher","DOI":"10.2337\/dci20-0053"},{"key":"2025101810483424000_14.1.e081006.27","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/medu.14707","article-title":"Optimising planned medical education strategies to develop learners' Person\u2010Centredness: A realist review","volume":"56","author":"Bansal","year":"2022","journal-title":"Med Educ"},{"key":"2025101810483424000_14.1.e081006.28","unstructured":"Pearson M et al . Intermediate care: a realist review and conceptual framework. Final Report NIHR Service Delivery and Organisation Programme 2013."},{"key":"2025101810483424000_14.1.e081006.29","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-33"},{"key":"2025101810483424000_14.1.e081006.30","doi-asserted-by":"crossref","unstructured":"Fusch P , Ness L . Are we there yet? data saturation in qualitative research. TQR 2015. doi:10.46743\/2160-3715\/2015.2281","DOI":"10.46743\/2160-3715\/2015.2281"},{"key":"2025101810483424000_14.1.e081006.31","doi-asserted-by":"crossref","first-page":"923","DOI":"10.2147\/VHRM.S13569","article-title":"Impact of a diabetic foot care education program on lower limb amputation rate","volume":"6","author":"Al-Wahbi","year":"2010","journal-title":"Vasc Health Risk Manag"},{"key":"2025101810483424000_14.1.e081006.32","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/dme.13286","article-title":"Time to question diabetes Self\u2010Management support for Arabic\u2010Speaking migrants: exploring a new model of care","volume":"34","author":"Alzubaidi","year":"2017","journal-title":"Diabet Med"},{"key":"2025101810483424000_14.1.e081006.33","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1177\/1534734620934578","article-title":"Impact of diabetes foot care education on amputation rate in the University of Abuja teaching hospital, Nigeria","volume":"21","author":"Anumah","year":"2022","journal-title":"Int J Low Extrem Wounds"},{"key":"2025101810483424000_14.1.e081006.34","doi-asserted-by":"crossref","unstructured":"Arruda C et al . Educational technology for care and prevention of diabetic foot ulcers. Ciencia, Cuidado e Saude 2021:20. doi:10.4025\/ciencuidsaude.v20i0.50115","DOI":"10.4025\/ciencuidsaude.v20i0.50115"},{"key":"2025101810483424000_14.1.e081006.35","unstructured":"Awe O . Education of Clinic Providers to Promote Improved Diabetes Management. Walden University, 2019."},{"key":"2025101810483424000_14.1.e081006.36","doi-asserted-by":"publisher","DOI":"10.1177\/1090198108325911"},{"key":"2025101810483424000_14.1.e081006.37","doi-asserted-by":"publisher","DOI":"10.1177\/0145721712459890"},{"key":"2025101810483424000_14.1.e081006.38","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1111\/jep.13033","article-title":"Evaluation of an Interprofessional continuing professional development course on comprehensive diabetes care: A Mixed\u2010Methods approach","volume":"25","author":"Beckman","year":"2019","journal-title":"J Eval Clin Pract"},{"key":"2025101810483424000_14.1.e081006.39","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1071\/AH090671","article-title":"An evaluation of community-based resources for management of diabetes-related foot disorders in an Australian population","volume":"33","author":"Bergin","year":"2009","journal-title":"Aust Health Rev"},{"key":"2025101810483424000_14.1.e081006.40","doi-asserted-by":"publisher","DOI":"10.1177\/014572179902500609"},{"key":"2025101810483424000_14.1.e081006.41","doi-asserted-by":"publisher","DOI":"10.1177\/0145721710371524"},{"key":"2025101810483424000_14.1.e081006.42","doi-asserted-by":"publisher","DOI":"10.1177\/0145721712441523"},{"key":"2025101810483424000_14.1.e081006.43","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.9.1428"},{"key":"2025101810483424000_14.1.e081006.44","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1080\/07370016.2016.1159435","article-title":"A peer-led diabetes education program in a homeless community to improve diabetes knowledge and empowerment","volume":"33","author":"Davis","year":"2016","journal-title":"J Community Health Nurs"},{"key":"2025101810483424000_14.1.e081006.45","doi-asserted-by":"publisher","DOI":"10.1177\/014572170102700607"},{"key":"2025101810483424000_14.1.e081006.46","unstructured":"Ismail MH . Improving Care for Spanish-Speaking People with Diabetes in a Free Clinic Setting. The University of North Carolina at Chapel Hill, 2019."},{"key":"2025101810483424000_14.1.e081006.47","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.12968\/bjcn.2004.9.Sup1.12504","article-title":"Evaluation of the impact of an educational initiative in diabetic foot management","volume":"9","author":"Jones","year":"2004","journal-title":"Br J Community Nurs"},{"key":"2025101810483424000_14.1.e081006.48","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jcjd.2011.08.002","article-title":"Two-year foot care program for minority patients with type 2 diabetes mellitus of Zhuang tribe in Guangxi, China","volume":"36","author":"Liang","year":"2012","journal-title":"Canadian Journal of Diabetes"},{"key":"2025101810483424000_14.1.e081006.49","doi-asserted-by":"crossref","first-page":"S6","DOI":"10.12968\/bjon.2021.30.12.S6","article-title":"Development and validation of a pocket guide for the prevention of diabetic foot ulcers","volume":"30","author":"Lucoveis","year":"2021","journal-title":"Br J Nurs"},{"key":"2025101810483424000_14.1.e081006.50","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/01.JBI.0000399629.73972.f2","article-title":"Utilization report","volume":"8","author":"Mat","year":"2011","journal-title":"PACEsetterS"},{"key":"2025101810483424000_14.1.e081006.51","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1097\/FCH.0b013e318202a852","article-title":"A community integration approach to social determinants of health in New Mexico","volume":"34 Suppl 1","author":"McCloskey","year":"2011","journal-title":"Fam Community Health"},{"key":"2025101810483424000_14.1.e081006.52","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s12913-015-0695-5","article-title":"Community health workers improve diabetes care in remote Australian indigenous communities: results of a pragmatic cluster randomized controlled trial","volume":"15","author":"McDermott","year":"2015","journal-title":"BMC Health Serv Res"},{"key":"2025101810483424000_14.1.e081006.53","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/phn.12601","article-title":"Enhancing diabetes care through care coordination, Telemedicine, and education: evaluation of a rural pilot program","volume":"36","author":"McLendon","year":"2019","journal-title":"Public Health Nurs"},{"key":"2025101810483424000_14.1.e081006.54","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1800.2010.00508.x"},{"key":"2025101810483424000_14.1.e081006.55","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1071\/PY20241","article-title":"Implementation strategies to overcome barriers to diabetes-related Footcare delivery in primary care: a qualitative study","volume":"27","author":"Mullan","year":"2021","journal-title":"Aust J Prim Health"},{"key":"2025101810483424000_14.1.e081006.56","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/01.WON.0000347659.79722.b0","article-title":"Pressure ulcer awareness and prevention program: a quality improvement program through the Canadian Association of wound care","volume":"36","author":"Orsted","year":"2009","journal-title":"J Wound Ostomy Continence Nurs"},{"key":"2025101810483424000_14.1.e081006.57","unstructured":"Parsons C . The development of an evaluation plan for the implementation of the feet first program to rural Healthcare sites within the central regional health authority of Newfoundland and Labrador. 2016."},{"key":"2025101810483424000_14.1.e081006.58","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1017\/S1463423616000335","article-title":"Effectiveness of a community-based diabetes self-management education (DSME) program in a rural agricultural setting","volume":"18","author":"Paz-Pacheco","year":"2017","journal-title":"Prim Health Care Res Dev"},{"key":"2025101810483424000_14.1.e081006.59","doi-asserted-by":"publisher","DOI":"10.1007\/s13142-012-0125-8"},{"key":"2025101810483424000_14.1.e081006.60","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/j.1745-7599.2012.00786.x","article-title":"Improving diabetic foot care in a Nurse\u2010Managed Safety\u2010Net clinic","volume":"25","author":"Peterson","year":"2013","journal-title":"J Am Assoc Nurse Pract"},{"key":"2025101810483424000_14.1.e081006.61","doi-asserted-by":"crossref","unstructured":"Phillips A , Edmonds M , Robbie J , et al . Idf21-0049 ACT NOW a new diabetes foot educational and risk assessment tool for people with diabetes and health care professionals. Diabetes Research and Clinical Practice 2022;186. doi:10.1016\/j.diabres.2022.109415","DOI":"10.1016\/j.diabres.2022.109415"},{"key":"2025101810483424000_14.1.e081006.62","doi-asserted-by":"crossref","unstructured":"Prezio EA . Health outcomes, quality improvement and cost-effectiveness of the community diabetes education (code) program: results of a randomized controlled trial. 2013. doi:10.1177\/1062860613489165","DOI":"10.1177\/1062860613489165"},{"key":"2025101810483424000_14.1.e081006.63","doi-asserted-by":"crossref","first-page":"12619","DOI":"10.1166\/asl.2017.10830","article-title":"The effect of the foot care education program on knowledge and self-efficacy among family of diabetes mellitus patients in PKU Muhammadiyah Gamping Yogyakarta Indonesia","volume":"23","author":"Primanda","year":"2017","journal-title":"Adv Sci Lett"},{"key":"2025101810483424000_14.1.e081006.64","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1111\/dme.12450","article-title":"The Ipswich touch test: a simple and novel method to screen patients with diabetes at home for increased risk of foot ulceration","volume":"31","author":"Sharma","year":"2014","journal-title":"Diabet Med"},{"key":"2025101810483424000_14.1.e081006.65","doi-asserted-by":"publisher","DOI":"10.1177\/0145721710387308"},{"key":"2025101810483424000_14.1.e081006.66","unstructured":"Townsend E . Evaluation of the NSW indigenous diabetic foot program for health workers whose primary role is with aboriginal people in the lower mid North coast. Health Education and Training Institute 2012."},{"key":"2025101810483424000_14.1.e081006.67","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1046\/j.1440-1584.2001.00320.x","article-title":"Diabetic foot care: developing culturally appropriate educational tools for aboriginal and Torres Strait Islander peoples in the Northern territory, Australia","volume":"9","author":"Watson","year":"2001","journal-title":"Aust J Rural Health"},{"key":"2025101810483424000_14.1.e081006.68","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1111\/iwj.12188","article-title":"Evaluation of a Peer\u2010Led Self\u2010Management education programme PEP talk: diabetes, healthy feet and you","volume":"10","author":"Woodbury","year":"2013","journal-title":"Int Wound J"},{"key":"2025101810483424000_14.1.e081006.69","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1586\/17446651.2015.1058151","article-title":"Reducing diabetic limb amputations in developing countries","volume":"10","author":"Abbas","year":"2015","journal-title":"Expert Review of Endocrinology & Metabolism"},{"key":"2025101810483424000_14.1.e081006.70","unstructured":"Force, C.P.S.T . Diabetes management: interventions engaging community health workers. In: The Community Guide. Retrieved from thecommunityguide. org\/findings\/diabetes-management-interventions-engaging-community-healthworkers, 2017."},{"key":"2025101810483424000_14.1.e081006.71","doi-asserted-by":"crossref","first-page":"804","DOI":"10.12968\/bjon.2009.18.13.43209","article-title":"Interprofessional capacity building in diabetic foot management","volume":"18","author":"Hayes","year":"2009","journal-title":"Br J Nurs"},{"key":"2025101810483424000_14.1.e081006.72","first-page":"1","article-title":"Building cultural competency for improved diabetes care","volume":"56","author":"Hsu","year":"2007","journal-title":"J Fam Pract"},{"key":"2025101810483424000_14.1.e081006.73","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1080\/10410236.2010.496841","article-title":"Diabetic foot health education and amputation prevention","volume":"25","author":"Joseph","year":"2010","journal-title":"Health Commun"},{"key":"2025101810483424000_14.1.e081006.74","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/NHH.0000000000001047","article-title":"Teaching wound care to family Caregivers: an overview of methods to use to promote wound healing","volume":"40","author":"Kirkland-Kyhn","year":"2022","journal-title":"Home Healthc Now"},{"key":"2025101810483424000_14.1.e081006.75","doi-asserted-by":"publisher","DOI":"10.1177\/193229681200600121"},{"key":"2025101810483424000_14.1.e081006.76","first-page":"109","article-title":"Multidisciplinary diabetic foot care teams: professional education","volume":"1","author":"McInnes","year":"1998","journal-title":"The Diabetic Foot"},{"key":"2025101810483424000_14.1.e081006.77","first-page":"67","article-title":"Multidisciplinary diabetic foot care teams: skills and knowledge","volume":"2","author":"McInnes","year":"1999","journal-title":"Diabetic Foot"},{"key":"2025101810483424000_14.1.e081006.78","first-page":"646","article-title":"How to do a 3-minute diabetic foot exam: this brief exam will help you to quickly detect major risks and prompt you to refer patients to appropriate specialists","volume":"63","author":"Miller","year":"2014","journal-title":"J Fam Pract"},{"key":"2025101810483424000_14.1.e081006.79","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/9007813","article-title":"Prevention and management of diabetes-related foot ulcers through informal Caregiver involvement: A systematic review","volume":"2022","author":"Suglo","year":"2022","journal-title":"J Diabetes Res"},{"key":"2025101810483424000_14.1.e081006.80","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.jcjd.2019.11.006","article-title":"Improving cultural safety of diabetes care in indigenous populations of Canada, Australia, New Zealand and the United States: a systematic rapid review","volume":"44","author":"Tremblay","year":"2020","journal-title":"Canadian Journal of Diabetes"},{"key":"2025101810483424000_14.1.e081006.81","doi-asserted-by":"crossref","first-page":"105906","DOI":"10.1016\/j.ijsu.2021.105906","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"88","author":"Page","year":"2021","journal-title":"Int J Surg"},{"key":"2025101810483424000_14.1.e081006.82","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/j.1742-481X.2006.00232.x","article-title":"Diabetic foot screening: why is it neglected","volume":"3","author":"Abu-Qamar","year":"2006","journal-title":"Int Wound J"},{"key":"2025101810483424000_14.1.e081006.83","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3273","article-title":"Guidelines on the classification of diabetic foot ulcers (IWGDF 2019)","volume":"36 Suppl 1","author":"Monteiro-Soares","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"2025101810483424000_14.1.e081006.84","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5032\/jae.2012.04001","article-title":"Aligning Kolb\u2019s experiential learning theory with a comprehensive agricultural education model","volume":"53","author":"Baker","year":"2012","journal-title":"JAE"},{"key":"2025101810483424000_14.1.e081006.85","doi-asserted-by":"publisher","DOI":"10.1177\/009155217800500302"},{"key":"2025101810483424000_14.1.e081006.86","first-page":"1","article-title":"To halve the number of major amputations in people living with Diabetes,\u201cACTNOW","volume":"22","author":"Edmonds","year":"2020","journal-title":"Diabetes & Primary Care"},{"key":"2025101810483424000_14.1.e081006.87","first-page":"431","article-title":"The impact of simulation-based education on students\u2019 knowledge and skills in diabetic foot examination","volume":"13","author":"Inkaya","year":"2020","journal-title":"Int J Caring Sci"},{"key":"2025101810483424000_14.1.e081006.88","doi-asserted-by":"publisher","DOI":"10.1177\/2150131914540917"},{"key":"2025101810483424000_14.1.e081006.89","unstructured":"Resource C . community healthcare workers cultural competency. CHW Training Community Health Workers, 2019."},{"key":"2025101810483424000_14.1.e081006.90","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1446.2008.00730.x"},{"key":"2025101810483424000_14.1.e081006.91","doi-asserted-by":"crossref","DOI":"10.3912\/OJIN.Vol16No02Man03","article-title":"Developing person-centred care: addressing Contextual challenges through practice development","volume":"16","author":"McCormack","year":"2011","journal-title":"Online J Issues Nurs"},{"key":"2025101810483424000_14.1.e081006.92","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17165856","article-title":"The social determinants of health: time to re-think","volume":"17","author":"Frank","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2025101810483424000_14.1.e081006.93","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMp2022641","article-title":"Community health workers and COVID-19\u2014addressing social determinants of health in times of crisis and beyond","volume":"383","author":"Peretz","year":"2020","journal-title":"N Engl J Med"},{"key":"2025101810483424000_14.1.e081006.94","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1002\/pdi.1495","article-title":"The 14\u2010Item Michigan diabetes knowledge test: translation and validation study of the Malaysian version","volume":"27","author":"Al\u2010Qazaz","year":"2010","journal-title":"Pract Diab Int"},{"key":"2025101810483424000_14.1.e081006.95","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.9.1403"},{"key":"2025101810483424000_14.1.e081006.96","doi-asserted-by":"crossref","first-page":"38","DOI":"10.25179\/tjem.2019-71974","article-title":"Turkish adaptation of Michigan diabetes research and training center\u2019s revised diabetes knowledge test and determination of factors affecting the knowledge level of diabetic individuals","volume":"24","author":"\u0130di\u0307z","year":"2020","journal-title":"Turk J Endocrinol Metab"},{"key":"2025101810483424000_14.1.e081006.97","doi-asserted-by":"publisher","DOI":"10.1177\/1468794106058867"},{"key":"2025101810483424000_14.1.e081006.98","doi-asserted-by":"crossref","DOI":"10.1111\/opn.12190","article-title":"The role of unregulated care providers in Canada\u2014A Scoping review","volume":"13","author":"Afzal","year":"2018","journal-title":"Int J Older People Nurs"},{"key":"2025101810483424000_14.1.e081006.99","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1111\/jonm.12613","article-title":"The role of unregulated care providers in home care: A Scoping review","volume":"26","author":"Saari","year":"2018","journal-title":"J Nurs Manag"},{"key":"2025101810483424000_14.1.e081006.100","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1136\/bmj.323.7322.1192","article-title":"Crossing the quality chasm: a new health system for the 21st century","volume":"323","author":"Baker","year":"2001","journal-title":"BMJ"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-081006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T17:48:55Z","timestamp":1760809735000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-081006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":100,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,22]]},"published-print":{"date-parts":[[2024,1]]}},"alternative-id":["10.1136\/bmjopen-2023-081006"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-081006","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}