European Journal of Education Studies
ISSN: 2501 - 1111
ISSN-L: 2501 - 1111
Available on-line at: www.oapub.org/edu
10.5281/zenodo.155070
Volume 2│Issue 4│2016
EFFECTIVENESS OF ONLINE DIABETES EDUCATION
THROUGH WEB BASED INSTRUCTION
M. Arunasalam1, N. Balasubramanian2i
Research Scholar, (Ph.D., Education), Research and Development Centre,
1
Bharathiar University, Coimbatore, Tamilnadu, India
Dr., Deputy Vice Chancellor, DMI-St.Eugene University,
2
Lusaka, Zambia, South Africa
Abstract:
Education involves the teaching-learning process wherein the paradigm shift has been
from teaching to learning. This study provides a model for online Diabetes Education. It
evaluates the effectiveness of online education through web based instruction. This
study is conducted in order to create awareness about diabetes. The assessment is based
on the pre-test, post-test and criterion referenced test. This single group experimental
method is conducted for 30 respondents through online. Data collected were analysed
using Descriptive and Inferential analysis. Results revealed that there is significant
difference in the scores of pre-test and post-test. It is proved that the six modules
prepared for creating diabetes education is very effective. This study concluded that the
use of these modules increases the awareness and reduces the risk of diabetes.
Keywords: web based instruction, online diabetes education, pathophysiology of
diabetes, educational modules
Introduction
Educational Technology is intended to make both learning and teaching processes
effective as well as efficient. In view of the unprecedented explosion of knowledge in
various disciplines and fields of education it is found necessary to make teaching as
well as learning less time consuming and less laborious. It is also felt imperative on the
part of educators to make the teaching-learning process motivating, interesting and
Copyright © The Author(s). All Rights Reserved
Published by Open Access Publishing Group ©2015.
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M. Arunasalam, N. Balasubramanian EFFECTIVENESS OF ONLINE DIABETES EDUCATION THROUGH WEB BASED INSTRUCTION
exciting. Diabetes is a disease in which the body is unable to properly use and store
glucose (a form of sugar). Glucose backs up in the bloodstream, causing one’s blood
glucose (sometimes referred to as blood sugar) to rise too high. Diabetes is a complex
disease that requires daily self-management - making healthy food choices, staying
physically active, monitoring the blood sugar and taking medications as prescribed.
Successful self-management will help the people to feel better and can reduce the
chance of developing complications including heart disease, dental disease, eye
disorders, kidney disease, nerve damage and lower leg amputation.
Diabetes Mellitus
Diabetes mellitus, or simply diabetes, is a chronic disease that occurs when the pancreas
is no longer able to make insulin, or when the body cannot make good use of the insulin
it produces. Insulin is a hormone made by the pancreas, that acts like a key to
let glucose from the food the people eat pass from the blood stream into the cells in the
body to produce energy. All carbohydrate foods are broken down into glucose in the
blood. Insulin helps glucose get into the cells. The position of not being able to produce
insulin or use it effectively leads to raised glucose levels in the blood (known as
hyperglycaemia). Over the long-term high glucose levels are associated with damage to
the body and failure of various organs and tissues.
Types of Diabetes
There are two major types of diabetes. They are
∑
∑
Type I Diabetes
Type II Diabetes
In Type I (formerly called juvenile-onset or insulin-dependent) diabetes, the
body completely stops producing any insulin, a hormone that enables the body to use
glucose found in foods for energy. People with Type I diabetes must take daily insulin
injections to survive. This form of diabetes usually develops in children or young
adults, but can occur at any age. Type 2 (formerly called adult-onset or non insulindependent) diabetes results when the body doesn’t produce enough insulin and/or is
unable to use insulin properly (insulin resistance). This form of diabetes usually occurs
in people who are over 40, overweight, and have a family history of diabetes, although
today it is increasingly occurring in younger people, particularly adolescents.
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Risk of Diabetes Mellitus
Diabetes can occur in anyone. However, people who have close relatives with the
disease are somewhat more likely to develop it. Other risk factors include obesity, high
cholesterol, high blood pressure, and physical inactivity. The risk of developing
diabetes also increases as people grow older. People who are over 40 and overweight
are more likely to develop diabetes, although the incidence of type 2 diabetes in
adolescents is growing. Diabetes is more common among Native Americans, African
Americans, Hispanic Americans and Asian Americans/Pacific Islanders. Also, people
who develop diabetes while pregnant (a condition called gestational diabetes) are more
likely to develop full-blown diabetes later in life.
Significance of Diabetes Education
There are certain things that everyone who has diabetes, whether type 1 or type 2,
needs to do to be healthy. They need to have a meal (eating) plan. They need to pay
attention to how much physical activity they engage in, because physical activity can
help the body to use insulin better so it can convert glucose into energy for
cells. Everyone with type 1 diabetes, and some people with type 2 diabetes, also needs
to take insulin injections. Some people with type 2 diabetes take pills called "oral
agents" which help their bodies produce more insulin and/or use the insulin it is
producing, better. Some people with type 2 diabetes can manage their disease without
medication by appropriate meal planning and adequate physical activity.
Review of Literature
Marko Radovan and Mojca Perdih (2016) developed the guidelines for evaluating the
adaptation of accessible web-based learning materials information and communications
technology (ICT), which is e-learning’s main component, enables alternative means of
accessing the web-based learning materials that comprise the content of e-learning.
However, these materials can help provide a good educational experience only if they
are designed carefully, which is especially true for people that have difficulties with
learning from text or those with other learning disabilities (e.g., dyslexia). The main
obstacle to learning for such people is usually posed by the form in which web-based
learning materials are provided.
Mutahir Oluwafemi Abanikannda (2016) examined the enhancing effective
chemistry learning through hypermedia instructional mode of delivery. This study
provides a framework for the production of Hypermedia Instructional package. It also
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M. Arunasalam, N. Balasubramanian EFFECTIVENESS OF ONLINE DIABETES EDUCATION THROUGH WEB BASED INSTRUCTION
assessed the effectiveness of hypermedia instructional mode of delivery on students.
performance in Chemistry. This is with a view of improving the learning of Chemistry
which may eventually help to improve students’ performance. The developmental
study employed a pre-test, post-test control group design. The study concluded that the
use of HIP was an intervention which improved students’ performance retention and
attitude towards Chemistry.
Mehmet Fatih Baris (2015) conducted a study on the European teachers’
technological pedagogical content knowledge (TPCK) and educational use of web
technologies. The Technological Pedagogical Content Knowledge and Educational Use
of Web Technologies (TPCK-W) were analysed in addition to the self-efficacy and
attitudes of 33 teachers from eight different branches carrying out their duties in 19
countries of the European Union (EU). In this study, the Technological Pedagogical
Content Knowledge-Web (TPCK-W) Survey developed by Lee, Tsai, and Chan was
used. Moreover, participants’ general web attitudes changed positively, depending on
their web communication, web content, and pedagogical use of the web.
Henderson J.A., et al., (2012) in their article describe a randomized controlled
trial, the Lakota Oyate Wicozani Pi Kte (LOWPK) trial, which was designed to
determine whether a Web-based diabetes and nutritional intervention can improve risk
factors related to cardiovascular disease (CVD) among a group of remote reservationdwelling adult American Indian men and women with type 2 diabetes who are at high
risk for CVD.
Ferguson, et al., (2012), in their article examined designed, implemented and
evaluated a 48-hour training program for community health workers (CHWs) deployed
to diabetes care teams in community health centers (CHCs). The curriculum included
core knowledge/skills with diabetes content to assist CHWs in developing patient selfmanagement goals.
Taghdisi et al., (2012) recapitulates the problems caused by diabetes have direct
and indirect impacts on the quality of life of diabetic patients. This study was
conducted to assess the effect of the educational programme based on the precede
model in promoting quality of life of patients with type 2 diabetes.
Need For the Study
Everyone who has diabetes should be seen at least once in every six months by a
diabetes specialist (an endocrinologist or a diabetologist). He or she should also be seen
periodically by other members of a diabetes treatment team, including a diabetes nurse
educator, and a dietician who will help develop a meal plan for the individual. Ideally,
one should also see an exercise physiologist for help in developing a physical activity
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M. Arunasalam, N. Balasubramanian EFFECTIVENESS OF ONLINE DIABETES EDUCATION THROUGH WEB BASED INSTRUCTION
plan, and, perhaps, a social worker, psychologist or other mental health professional for
help with the stresses and challenges of living with a chronic disease. Everyone who has
diabetes should have regular eye exams (once a year) by an eye doctor expert in
diabetes eye care to make sure that any eye problems associated with diabetes are
caught early and treated before they become serious. Also, people with diabetes need to
learn how to monitor their blood glucose. Daily testing will help determine how well
their meal plan, activity plan, and medication are working to keep blood glucose levels
in a normal range. Hence, the researcher has constructed six modules in Diabetes
Education viz., Pathophysiology, Complications, Prevention, Nutrition, Exercise and
Monitoring.
Objectives of the Study
1. To design and host a website for Diabetes Education which allows users to access
the information according to their unique need and interest.
2. To find out the effectiveness of the Web-Based Instruction in the context of
Online Diabetes Education with respect to different modules.
3. To find out whether there is any significant difference in the effectiveness of the
Web-Based Instructional Modules in Diabetes Education with respect to different
demographical variables.
Hypotheses of the Study
1. There is significant difference in the effectiveness of the Web-Based Instruction in
the context of Online Diabetes Education with respect to different modules.
2. There is significant difference in the effectiveness of the Web-Based Instructional
Modules in Diabetes Education with respect to different demographical variables
of the online learner’s viz. Gender, age and location of the learners.
Methodology
The researcher has selected Single Group Experimental Study Method for this study. A
website has been created in the address www.diabeteseducation.co.in for this study.
The website has content on six headings viz., Pathophysiology, Complications,
Prevention, Nutrition, Exercise and Monitoring. Each module has its own objectives,
text, and summary, FAQ, glossary, links, reference and download. Modules consist of
multimedia packages which include video, audio, graphics, animations, text and
images.
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Tools Used
The researcher has constructed a tool suitable to find out the effectiveness of the
website. 100 questions which consists 25 questions in Pathophysiology and 15 each in
other five modules were prepared to evaluate knowledge, understanding and
application of the respondents. This modules consists pre-tests and post-tests. The
criterion referenced test was prepared for immediate feedback.
Since the data collection is the online process, 30 respondents were selected for
this study. The age of respondents ranges from 21 to 48. Out of 30 respondents, 22 were
Indians, 7 from Tanzania and 1 from Uganda.
Analysis and Interpretations
Hypothesis 1
There is significant difference in the effectiveness of the Web-Based Instruction in the
context of Online Diabetes Education with respect to different modules.
Table 1: Significance of Difference between the Mean Scores in
Pre Test & Post Test of the Samples
Modules
Pathophysiology
Complications
Prevention
Nutrition
Exercise
Monitoring
Test
Mean
SD
N
Pre test
6.97
4.71
30
Post test
21.77
3.91
30
Pre test
3.93
2.53
30
Post test
12.67
2.71
30
Pre test
3.27
2.90
30
Post test
13.27
2.29
30
Pre test
3.73
3.23
30
Post test
14.10
1.03
30
Pre test
4.37
3.22
30
Post test
13.73
2.12
30
Pre test
3.63
3.12
30
Post test
13.63
1.56
30
European Journal of Education Studies - Volume 2 │ Issue 4 │ 2016
‘t’ value
Significance
2.194
Significant
5.371
Significant
4.277
Significant
6.937
Significant
3.080
Significant
2.630
Significant
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M. Arunasalam, N. Balasubramanian EFFECTIVENESS OF ONLINE DIABETES EDUCATION THROUGH WEB BASED INSTRUCTION
Table 1.1: Mean, Standard Deviation and Differences in Overall Scores of Respondents
Test
N
Mean
SD
‘t’ Value
Pre-test
30
25.9
17.43
Post-test
30
89.16
11.26
Remark
8.108
Significant
The above table reveals that the calculated t value exceeds the table value (1.96) in all
the six modules. It is concluded that there is a significant difference in the effectiveness
of the Web-Based Instruction in the context of Online Diabetes Education with respect
to different modules.
Hypothesis 2
There is significant difference in the effectiveness of the Web-Based Instructional
Modules in Diabetes Education with respect to different demographical variables of the
online learner’s viz. Gender, age and location of the learners.
Table 2: Significance of Difference between the Mean Scores in
Post Test of the Samples
External Independent Variables
Gender
Age
Country
N
Mean
SD
Male
17
86.294
14.114
Female
13
92.923
3.774
Up to 30 years
16
91.937
8.744
Above 30 years
14
86
13.220
Indian
22
91.409
5.828
Abroad
8
83
19.101
t value
Remarks
0.0797
Not Significant
0.1669
Not Significant
0.2578
Not Significant
The above table reveals that the calculated value is not exceeding the table value (1.96)
at 5 per cent level of significance in all the three demographical variables. However, by
analysing the mean, the researcher says that the female respondents scored better than
the male and the respondents belong to the age group of up to30 years scored high
when compared with the people above 30 years. The post test scores of Indians are
slightly high when compared the respondents from abroad.
The module wise analysis of the post test scores with respect to different
demographic variables are given below.
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Table 3: Significance of Difference between the Mean Scores in
Post Test of the Samples with Respect To Gender
Modules
Gender
Pathophysiology
Complications
Prevention
Nutrition
Exercise
Monitoring
N
Mean
SD
‘t’ value
Male
17
21.05
4.879
Female
13
22.69
1.887
Male
17
11.82
3.004
Female
13
13.76
1.832
Male
17
12.82
2.833
Female
13
13.84
1.143
Male
17
14.11
1.166
Female
13
14.07
0.862
Male
17
13.23
2.562
Female
13
14.38
1.120
Male
17
13.23
1.786
Female
13
14.15
1.068
Remarks
0.22021
Not Significant
0.03740
Not Significant
0.19028
Not Significant
0.91324
Not Significant
0.11168
Not Significant
0.09160
Not Significant
Table 4: Significance of Difference between the Mean Scores In
Post Test of the Samples with Respect to Age
Modules
Pathophysiology
Complications
Prevention
Nutrition
Exercise
Monitoring
Age
N
Mean
Sd
Up to 30 years
16
22.81
3.10
Above 30 years
14
20.57
4.48
Up to 30 years
16
13.75
1.84
Above 30 years
14
11.42
3.05
Up to 30 years
16
13.68
1.57
Above 30 years
14
11.42
3.05
Up to 30 years
16
14
1.21
Above 30 years
14
14.21
0.80
Up to 30 years
16
13.93
1.87
Above 30 years
14
13.5
2.40
Up to 30 years
16
13.75
1.39
Above 30 years
14
13.5
1.78
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‘t’ value
Remarks
0.130
Not Significant
0.022
Not Significant
0.022
Not Significant
0.568
Not Significant
0.588
Not Significant
0.675
Not Significant
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M. Arunasalam, N. Balasubramanian EFFECTIVENESS OF ONLINE DIABETES EDUCATION THROUGH WEB BASED INSTRUCTION
Table 5: Significance of Difference between the Mean Scores in
Post Test of the Samples With Respect to Location
Modules
Pathophysiology
Complications
Prevention
Nutrition
Exercise
Monitoring
Location
N
Mean
SD
Indian
22
22.545
2.344
Abroad
8
19.625
6.300
Indian
22
12.954
2.419
Abroad
8
11.875
3.440
Indian
22
13.772
1.020
Abroad
8
11.875
3.943
Indian
22
14.136
0.940
Abroad
8
14
1.309
Indian
22
14
1.603
Abroad
8
13
3.162
Indian
22
14
1.154
Abroad
8
12.625
2.133
‘t’ value
Remarks
0.237
Not Significant
1.281
Not Significant
0.218
Not Significant
0.792
Not Significant
0.416
Not Significant
0.119
Not Significant
Recommendations
1. The learner should be actively engaged and made to feel the real-life experiences
through simulation.
2. Keeping in mind the various learning styles of students, a variety of media are
made use of to develop appropriate learning environment to achieve the desired
learning out-comes.
3. Learning experiences must reflect the needs and interests of the community.
Provisions should be made for the visitors of the web-site to react and exchange
ideas with it.
4. Incorporating new knowledge and viewpoints empower learners and encourage
critical thinking. Knowledge becomes functional when the individual creates
meaning from his experiences instead of simply accepting what others say as
true. True knowledge results from critical analysis of what one happens to learn.
5. All people with diabetes and those at risk of diabetes, no matter where they live,
have the right to learn about diabetes, how it can be prevented, how it can be
managed effectively and how to access educational and clinical resources.
6. Diabetes self-management education that integrates the clinical, behavioural and
psychosocial aspects of diabetes self-management should be available and
sustained.
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Conclusion
Web-based instruction offers learners unparalleled access to instructional resources, far
surpassing the reach of the traditional classroom. It also makes possible learning
experiences that are open, flexible, and distributed, providing opportunities for
engaging, interactive, and efficient instruction. Furthermore, cognitive-based theories of
learning have extended the design and delivery of Web-based instruction, applying the
technical nomenclature to instructional practices.
References
1. Abanikannda, M.O. (2016). Enhancing Effective Chemistry Learning Through
Hypermedia Instructional Mode of Delivery. European Journal of Educational
Research, 5(1), 27-34.
2. Agnew B, (2002). Simple steps to fitness. Nutrition for exercise. Checking your blood
sugar tells you when and if you need to alter your eating habits.
3. Andleigh Prabhat, K. (2008). Multimedia Systems Design, Dorling Kindersley
(India) Pvt. Ltd., New Delhi. Pg 1-51.
4. Ashwani Bhardwaj, Diabetes Causes, prevention & Cure Goodwill Publishing
House, New Delhi.
5. Baris, M. F. (2015). European Teachers’ Technological Pedagogical Content
Knowledge (TPCK) and Educational Use of Web Technologies. European Journal
of Educational Research, 4(4), 149-155.
6. Bhatnagar Gaurav, Shikha Mehta, Sugata Mitra, Introduction to Multimedia
Systems (2002) Elsevier, a division of Reed Elsevier India Private Limited, New
Delhi. Pg 1-8
7. Chiasson JL, Josse RG, Gomis R, Hanefeld M, Karasik A, Laakso M, (2002).
Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised
trial. Lancet.
8. Deitel Paul J., Harvey M. Deitel, (2011).Internet & World Wide Web How to
Program, Dorling Kindersley (India) Pvt. Ltd., New Delhi, Pg 1-20.
9. Dr. A. K. Sethi, (2012). Diabetes Control in your hands, V&S Publishers, New Delhi.
10. Dr. T. Mrunalini, (2015). Philosophical Foundations of Education, Neelkamal
Publications Pvt. Ltd, Hyderabad, P.64.
11. Ernest Adeghate, Hussein Saadi, Abdu Adem, Enyioma Obineche, (2010).
Diabetes Mellitus and Its Complications: Molecular Mechanisms, Epidemiology and
Clinical Medicine.
European Journal of Education Studies - Volume 2 │ Issue 4 │ 2016
130
M. Arunasalam, N. Balasubramanian EFFECTIVENESS OF ONLINE DIABETES EDUCATION THROUGH WEB BASED INSTRUCTION
12. Faas A, Schellevis FG, Van Eijk J T. (1997). The efficacy of self-monitoring of blood
glucose in NIDDM subjects. A criteria-based literature review. Diabetes Care.
13. Ferguson WJ, Lemay CA, Hargraves JL, Gorodetsky T, Calista J., “Developing
community health worker diabetes training”, Health Education Research, Vol.27,
No.4, 2012, pp.755-765.
14. Franz, M. (Ed.), (2001). Diabetes Management Therapies: A Core Curriculum for
Diabetes Education, 4th Edition. Chicago, IL: American Association of Diabetes
Educators.
15. H. Peter Chase, MD, (2006). Understanding Diabetes, 11th Edition.
16. Henderson JA, Chubak J, O'Connell J, Ramos MC, Jensen J, Jobe JB, “Design of a
randomized controlled trial of a web-based intervention to reduce cardiovascular disease
risk factors among remote reservation-dwelling American Indian adults with type 2
diabetes”, Journal of Primary Prevention, Vol.33, No.3, August 2012, pp.209-222.
17. Hope S. Warshaw R.D. (Author), Robyn Webb M.S. (2011). The Diabetes Food and
Nutrition Bible: A Complete Guide to Planning, Shopping, Cooking, and Eating.
18. Jackson Jeffrey C. (2013). Web Technologies, Dorling Kindersley (India) Pvt. Ltd.,
New Delhi, Pg 1-25.
19. Kanakamani Jeyaraman, MD,DNB (Endo), Nihal Thomas, MD,DNB(Endo),
FRACP (Endo), FRCP (Edin), Ruth Ruby Murray, B.Sc(N) RN, Sudeep, MD, Dip.
In Diab, DNB (Endo), Thomas V Paul, MD, DNB (Endo), (2010). A practical guide
to Diabetes Mellitus,
Fifth Edition, Department of Endocrinology, Diabetes and
Metabolism, Christian Medical College, Vellore, India, Published by Academa
Publishers, New Delhi.
20. Knowler WC, Hamman RF, Edelstein SL, et al, (2005). Prevention of type 2 diabetes
with troglitazone in the Diabetes Prevention Program.
21. M.M.S. Ahuja, (2011). Learning to live with Diabetes, National book Trust, New
Delhi, India.
22. Marko Radovan and Mojca Perdih (2016). Developing Guidelines for Evaluating
the Adaptation of Accessible Web-Based Learning Materials. International Review
of Research in Open and Distributed Learning, 17(4), 167-181.
23. Mehmet Fatih Baris, (2015). European Teachers’ Technological Pedagogical
Content Knowledge (TPCK) and Educational Use of Web Technologies. European
Journal of Educational Research, 4(4), 149-155.
24. Mutahir Oluwafemi Abanikannda, (2016). Enhancing Effective Chemistry
Learning Through Hypermedia Instructional Mode of Delivery. European Journal
of Educational Research, 5(1), 27-34.
25. Muthumanickam R., (2008). Educational Objectives for Effective Planning and
Teaching, Cyberland Publishers, Chidambaram, Pg 1-20.
European Journal of Education Studies - Volume 2 │ Issue 4 │ 2016
131
M. Arunasalam, N. Balasubramanian EFFECTIVENESS OF ONLINE DIABETES EDUCATION THROUGH WEB BASED INSTRUCTION
26. Oluwafemi O. Oguntibeju, (2012). Pathophysiology and Complications of Diabetes
Mellitus, InTech.
27. Richard I. G. Holt, Clive Cockram, Allan Flyvbjerg , Barry J. Goldstein, (2010).
Textbook of Diabetes, 4th Edition, Wiley-Blackwell.
28. Suzanne C. Smeltzer, Brenda Bare, (2004). Textbook of Medical – Surgical Nursing,
Tenth Edition, Lippincott Williams & Wilkins, Philadelphia.
29. Taghdisi, MH, M Borhania, M Solhi, ME Afkari and F Hosseini, “The effect of an
education program utilising PRECEDE model on the Quality of Life in patients with
type 2 diabetes”, Health Education Journal, Vol.71, No.2, March 2012, pp.229-238.
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