Procedures

Letters were written to the heads of the diabetes clinics through the heads of the hospitals to seek permission for the study to be conducted on the premises. From May to June, 2015, trained research assistants visited the outpatient diabetes clinic weekly on days scheduled by the hospitals for the purposes of providing care to out-patient diabetes patients to recruit patients for the study. The research assistants approached patients while they waited for their medical consultation or after their consultation, to introduce the study to them and seek their consent to participate. Participants who agreed to participate were taken through the consent processes and subsequently given a survey to complete. Participants were advised that participation in the study was voluntary. The survey was paper-based and was self-administered to participants who could read and write in English. For those who could not read nor write in English, trained research assistants assisted them to complete the survey by translating the questions into their respective local dialects. This was observed in less than 10% of the participants. The survey took approximately 20 min to complete.

Weight, height and waist circumference were also measured by the trained research assistants after participants had completed the survey. These measurements were conducted in a secluded room at the hospital. The research was approved by the research department of the Tamale Teaching Hospital, the Ethics Committee of the School of Allied Health Sciences of the University for Development Studies and the Human Research Ethics Committee of the University of Newcastle.