{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T03:15:02Z","timestamp":1769829302060,"version":"3.49.0"},"update-to":[{"DOI":"10.12688\/f1000research.146943.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000}},{"DOI":"10.12688\/f1000research.146943.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000}},{"DOI":"10.12688\/f1000research.146943.3","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000}}],"reference-count":40,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Background Insufficient awareness of foot self-care among diabetic individuals results in diabetic foot ulcers especially in the Indian population considering its varied ethnicity and lifestyle practices. The management of diabetes and diabetic foot ulcers therefore demands a well-coordinated approach that involves multiple healthcare providers (HCPs). The present study aims to develop and validate an interprofessional collaborative (IPC) educational program involving HCPs to efficiently oversee and instruct the public on appropriate strategies for self-managing diabetic foot health in the Indian population. Methods The research group worked on creating an educational module titled \u2018An Interprofessional Collaborative Educational Module on Self-Management of Foot for Individuals with Type II Diabetes Mellitus.\u2019 The objective of this module was to promote the adoption of proper practices in self-managing foot health for individuals with type 2 diabetes mellitus. A panel of 13 experts participated in a two-stage validation process using the Delphi method to assess the module and its educational resources. Subsequently, the module was tested on a group of 30 participants, <ns4:italic>i.e.<\/ns4:italic>, individuals with diabetes, with its efficacy evaluated through conversation analysis and in-depth interviews. Results The three-month-long module included three sessions 1: Diabetes and its health implications 2: Diabetic foot and self-management 3: Interprofessional education in diabetic foot care The mode of content delivery was via Whatsapp, and the educational resources, in the form of pamphlets, flowcharts, handouts, case-based cartoons, and videos on diabetes, including diabetic foot, its risks, and self-management, were shared regularly. All participating experts consensually validated the module and educational resources. Analysis of in-depth interviews revealed that the module immensely benefitted the participants and helped them improve their knowledge and practices of foot care in diabetes. Conclusions The study highlights the importance of developing and validating IPC educational modules tailored to diabetic foot care. It can aid in enhancing adherence to proper diabetic foot care practices.<\/ns4:p>","DOI":"10.12688\/f1000research.146943.4","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T16:30:07Z","timestamp":1738686607000},"page":"386","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development and validation of an interprofessional collaborative educational module on the self-management of foot for individuals with type II diabetes mellitus in India"],"prefix":"10.12688","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0271-3568","authenticated-orcid":false,"given":"Sushma","family":"Prabhath","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harihara Prakash","family":"Ramanathan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2439-6068","authenticated-orcid":false,"given":"M Ganesh","family":"Kamath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1977-2716","authenticated-orcid":false,"given":"Gagana","family":"Karkada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ganesh","family":"Handady","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciraj Ali","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun G.","family":"Maiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"123-131","DOI":"10.15605\/jafes.032.02.05","article-title":"Knowledge and Practice of Diabetic Foot Care in Patients with Diabetes at Chinese General Hospital and Medical Center.","volume":"32","author":"E Magbanua","year":"2017","journal-title":"J. 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It was a pleasure to read through your insights. We value the positive and appreciative lines provided by you. About the recommendations provided by you, your suggestions are well taken and we are planning to scale up the current study to a larger population (in the near future) wherein the points provided shall be duly considered in our future steps:  \n<b>Recommendations:<\/b> 1. Quantitative Evaluation: Consider incorporating quantitative measures, such as pre- and post-intervention assessments, to complement the qualitative findings and provide a more robust evaluation of the module's impact. \n<b>Response to reviewer's comments: <\/b>We value your suggestion and shall definitely consider incorporating quantitative measures in our future attempts (future-ongoing research) complementing the qualitative findings to provide&nbsp;a more robust evaluation of the module's impact. Based on the current study findings, we are also aiming to refine and redefine the module to meet the requirements of the diverse population (i.e., individuals with diabetes).  2. Extended Follow-up: Conduct a longer follow-up period to assess the sustained impact of the educational module on participants' foot care practices and health outcomes. \n<b>Response to reviewer's comments: <\/b>Your suggestion is well taken and we shall aim to follow the same in our future attempts.","URL":"https:\/\/f1000research.com\/articles\/13-386\/v4#referee-comment-11996","order":1,"name":"referee-comment-11996","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.161075.r302217, Joseph Ngmenesegre Suglo, Kings College London, London, 09 Aug 2024, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/13-386\/v1#referee-response-302217","order":2,"name":"referee-response-302217","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sushma Prabhath<\/b>; \n<i>Posted: 26 Aug 2024<\/i>; Dear Reviewer,  Many thanks for reviewing our manuscript and providing your positive insights towards its improvements. Your valuable suggestions have thoroughly supported us in refining the manuscript.  \n<b>Reviewer\u2019s overview:<\/b> The authors presented a paper on an interesting and clinically relevant topic \u201cDevelopment and validation of an interprofessional collaborative educational module on the self-management of foot for individuals with type II diabetes mellitus\u201d They developed and validated an interprofessional collaborative (IPC) educational program involving HCPs to efficiently as a way of promoting healthy footcare practices. The paper however will require major revisions before it is accepted for indexing. \n<b>Response to comment:<\/b> We value your suggestions and have made all the necessary corrections and inclusions as advised. As stated, the manuscript is also language edited to enhance its readability.  \n<b>A point-to-point reply to the stated comments is mentioned below:<\/b>  \n<b>Comments\/ Suggestions<\/b> \n<b>Clarifications\/Modifications<\/b>  \n<b>1.&nbsp;<\/b>\n<b><i>Abstract<\/i><\/b> The writing style is difficult to read in places and I feel that the whole paper could do with a review by a copy editor. \n<b>Response to comment:&nbsp;<\/b>The manuscript has been subjected to language editing to enhance its readability  \n<b>2.&nbsp;<\/b>The author should be consistent in the use of Type II or type 2 diabetes. Use one throughout the manuscript. \n<b>Response to comment:&nbsp;<\/b>We have now maintained the consistency of using \u2018Type II Diabetes Mellitus\u2019 throughout the manuscript as advised.  \n<b>3.&nbsp;<\/b>The first sentence within the methods section of the abstract not required. This first line should be used to state explicitly the study design used. Avoid repetitions, the study aim has been repeated in different forms. It is seen in the background and under methods again. \n<b>Response to comment:&nbsp;<\/b>The necessary corrections are made as suggested. The first line under methods section in the abstract states about the development of the educational module followed by details of its validation. The objective of the module previously mentioned in the methods is now removed to avoid repetition (as previously mentioned as the aim of the study in the \u2018Background\u2019)  \n<b>4.&nbsp;<\/b>\n<b><i>Introduction<\/i><\/b> Many statements\/paragraphs within the manuscript require references eg The worldwide \u201coccurrence of DFUs varies between 5% and 7.5% among individuals with diabetic neuropathy\u201d (REF required). \n<b>Response to comment:&nbsp;<\/b>The references are adequately provided as advised. The statements\/paragraphs requiring referencing are suitable cited. Suitable changes are made in the reference list too.  \n<b>5.&nbsp;<\/b>\n<b><i>Design of the study:<\/i><\/b> The reporting guidelines used should be stated and cited within the methods sections of the study. I have seen the CONSORT guidelines checklist for randomised trials completed and uploaded \u2013 I am not sure if this is the appropriate guideline for this study as the study contains more qualitative elements than a randomised trial. The authors may want to assess other reporting guidelines such as the CORECQ guidelines for their suitability. \n<b>Response to comment:&nbsp;<\/b>The reporting guidelines are stated and cited appropriately within the methods section as advised. We have included the following (as found appropriate): TIDieR (Template for Intervention Description and Replication); COREQ (COnsolidated criteria for REporting Qualitative research) Checklist and CONSORT (Consolidated Standards of Reporting Trials).  TIDieR checklist for reporting the description of the educational intervention and its replication  COREQ checklist for reporting the qualitative research carried out  CONSORT checklist for reporting the usefulness of the educational intervention carried out as a clinical trial on the study participants, i.e., individuals with diabetes.   \n<b>6.&nbsp;<\/b>The study seems to use sequential multimethod to develop and evaluate the module. It is quite difficult to understand the exact design used in this study. If possible, can the authors give a summary of the design\/methods using a flow diagram or framework? Also be very coherent in presenting the various phases of the study, clearly indicating how each phase informed the next phase. \n<b>Response to comment:&nbsp;<\/b>A flowchart summarizing the methodology is now presented as figure 1. It clearly indicates how each phase leads to the next. Also a detailed explanation is provided under each phase\/step of the methodology.  \n<b>7.&nbsp;<\/b>How were members of the FGD identified and by who? What criteria was use in recruiting them? Similarly, persons who carried out the validation of the module? How, and who recruited them? \n<b>Response to comment:&nbsp;<\/b>The principal investigator (first author of the study) identified and invited the following HCPs, i.e., general physician, an endocrinologist, a surgeon, a physiotherapist, a dietician, and a nursing professional to constitute an IP team. The IP team also included an anatomist experienced in health professions education. All the HCPs invited to form the IP team were involved in diabetic care of the patients in their respective workplace. They were the members who were involved in the group discussion that aimed at the development of the educational module.&nbsp;  The individuals who carried out the validation of the educational module were a team of both external and internal experts. The internal experts were the same HCPs who constituted the IP team and were previously involved in the FGD leading to the development of the educational module. The external experts involved in the validation of the educational were other HCPs cum experts in the field of medical education not related to the study. They were not involved in the constitution of IP team and the development process of the educational module.  The current study is a part of a larger project designed to develop an interprofessional educational module to educate individuals with diabetes about proper practices of diabetic foot care. Relevant reference indicating the same is already included (cited-reference number 24) in the manuscript under \u201cDevelopment of the educational module\u201d. However, to provide better clarity the sentences have been reframed as per reviewer\u2019s comment. Relevant statements of effect have been included in the manuscript wherever appropriate.  \n<b>8.&nbsp;<\/b>Participants that were interviewed, what sampling approach was used? \n<b>Response to comment:&nbsp;<\/b>\n<i>Convenient sampling was used. At the end of the implementation of the education module, i.e., sharing of the educational resources in the WhatsApp group after three months, the Participants were asked to express their willingness related to attending a telephonic interview related to the usefulness of the session. The consenting participants were telephonically approached for the interview.<\/i>  Statements of this effect are included in the manuscript.   \n<b>9.&nbsp;<\/b>The educational resources shared on whatsapp, who shared this information? Was it sent to participants on their individual phones or they were in single whatsapp group to receive the information? How did the authors assess whether participants actually read or watched the resources shared on whatsapp? This relates to participants fidelity\/adherence to the intervention? How about internet accessibility for whatsapp users? Did you provide internet data bundle or incentive to participants?  \n<b>Response to comment:&nbsp;<\/b>\n<i>The principal investigator created a WhatsApp group for the study participants and the educational resources were shared therein. The information regarding creating the WhatsApp group and sharing of educational resources was previously conveyed to the participants during the recruitment process. The participants were encouraged to regularly review the resources. To ensure whether participants read or watched the resources shared on WhatsApp, the number of views per entry was reviewed and tracked. No other measures were taken to ensure participants\u2019 fidelity\/adherence to the intervention.<\/i> \n<i>The users (participants) used their own internet data pack to access WhatsApp. No internet data bundle facilities or incentives were provided to the participants for the same by the researchers. <\/i>  Statements of this effect are included in the methodology section of the manuscript.  Issues related to participants fidelity\/adherence to the intervention are also mentioned in the study limitations.&nbsp;  \n<b>10.&nbsp;<\/b>\u201cThe educational resources were developed in English and the local language,&nbsp;\n<i>i.e.<\/i>, Kannada\u201d \u2013 Was it first developed in English and translated or the vise versa? what methods were used to ensure consistency and accuracy?  \n<b>Response to comment:&nbsp;<\/b>Yes, \n<i>the educational resources were first developed in English and later translated to the local language, i.e., Kannada. <\/i>  \n<i>To ensure consistency and accuracy of translated content, the following measures were followed:<\/i> \n<i>Back-Translation: After translating the content from English to the local language, i.e., Kannada, we had a different translator (who was not involved in the initial translation) translate the content back into English. It ensured that the translated version\u2019s accuracy and consistency reflected the original content.<\/i> \n<i>Bilingual Expert Review: We also invited bilingual experts (fluent in both English and Kannada) to review the translated content. The experts assessed the accuracy of the translation, ensuring that it captured both the technical and cultural nuances of the original material.<\/i>  Statements of this effect are included in the methodology section of the manuscript.   \n<b>11.&nbsp;<\/b>\n<b><i>Discussion<\/i><\/b> Thinking about creating health inequality \u2013 what happens to persons with diabetes who have no access to whatsapp supported devices? Is this mode of delivery scalable? Will the findings be generalizable? Discuss these as part of the study limitations. \n<b>Response to comment:&nbsp;<\/b>We value the reviewer\u2019s suggestions.  However, in the present study, the inclusion criteria for recruiting participants (individuals with diabetes) clearly states that \u201cThe participants comfortable in using the \u201c WhatsApp\u201d, i.e. a social media tool were preferred\u201d  Considering the issues on creating health inequality, we totally agree that the\n<i> mode of delivery of the educational module, i.e., online via WhatsApp is not scalable considering individuals who have no access to WhatsApp supported devices. Thus, the findings cannot be generalizable. One possible solution to address this issue could be involving the care givers, next to kin or family members &nbsp;of the individuals with diabetes who have access to WhatsApp supported devices to inform and educate them.<\/i>  Statements of this effect is included in the \u2018study limitations\u2019 of the manuscript to provide clarity as advised.   \n<b>12.&nbsp;<\/b>\u201cA straightforward in-person education approach proved to be successful in elevating awareness about foot care, and it demonstrated the potential to enhance motivation and induce behavioral changes among individuals with type 2 diabetes.\n<sup>35<\/sup>&nbsp;The present study has identified the same as its limitations. The participants preferred face-to-face interaction rather than receiving the resources online. This approach may, however, not be suitable while addressing a large cohort of participants and needs to be suitably managed.\u201d &nbsp;- I am not sure the message being communicated here \u2013 Do you mean participants in your study preferred face-to-face to online?  \n<b>Response to comment:&nbsp;<\/b>Yes, some of the participants in our study preferred face-to-face in comparison to online interactions.\n<b> <\/b>But this approach will be suitable during stand-alone sessions, i.e., a one-day workshop\/session and not during the implementation of an educational module of longer duration, i.e., three-months in this case. Further, the face-to face approach may not be suitable while considering many participants, wherein the issues of lack of attendance or participation may surface as the module\/program progresses. Therefore, online mode of interactions is preferable. Measures should be taken to make the online interactions more participatory to enhance participant satisfaction and learning. Statements of this effect is included in the discussion section of the manuscript to provide more clarity   \n<b>13.&nbsp;<\/b>The paper will benefit from proof reading to correct avoidable mistakes eg improvised instead of improved as stated under discussion. \u2013 \u201cThe module can be further improvised based on these suggestions before future implementation to enhance its effectiveness and acceptance\u201d \n<b>Response to comment:&nbsp;<\/b>The necessary corrections are made as suggested. A thorough proof reading of the manuscript is carried out to correct the mistakes. Further, the manuscript is also language edited to enhance its readability.   \n<b>14.&nbsp;<\/b>\n<b><i>Conclusion<\/i><\/b> The authors stated that \u201cThe IPC Educational Module proves highly effective in enhancing the knowledge and practices of self-managing diabetic foot care among individuals with Type II Diabetes mellitus\u201d \u2013 I wish they don\u2019t have to use the word \u201ceffective\u201d which carries a statistical connotation. However, inferential statistics were not part of this study to evaluate participants' knowledge and practices. This was rather done quantitatively. \n<b>Response to comment:&nbsp;<\/b>We value the reviewer\u2019s suggestion. Since inferential statistics were not part of the study to evaluate the participants knowledge and practices and the usefulness of the module was assessed only qualitatively (using personal interviews with the study participants); we have therefore replaced the statement&nbsp; \u201cproves highly effective\u2026..\u201d. It now reads as follows: The IPC Educational Module \n<b>can be useful <\/b>in enhancing the knowledge and practices of self-managing diabetic foot care among individuals with Type II Diabetes mellitus. The study participants express that the module has value and exhibits \n<b>usefulness<\/b> in improving their understanding and implementation of diabetic foot self-management.","URL":"https:\/\/f1000research.com\/articles\/13-386\/v4#referee-comment-12304","order":3,"name":"referee-comment-12304","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.176694.r358162, Anas Ababneh, Yarmouk University, Irbid, 23 Jan 2025, version 3, indexed","URL":"https:\/\/f1000research.com\/articles\/13-386\/v3#referee-response-358162","order":4,"name":"referee-response-358162","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Sushma Prabhath<\/b>; \n<i>Posted: 28 Jan 2025<\/i>; Dear Reviewer  Many thanks for your supportive comments. We have made the necessary changes in the conclusion section as advised.","URL":"https:\/\/f1000research.com\/articles\/13-386\/v4#referee-comment-13233","order":5,"name":"referee-comment-13233","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":6,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}