Heba Hijazi ^1,2* Rabah Al abdi ^3,4 Sawsan Abuhammad ^5,6 Wegdan Bani Issa ⁵ Alham Al-Sharman ^7,8 Nesreen Saadeh ⁹ Alounoud AlMarzooqi ¹ Fatma Ahmed ^10,5 Ahmed Hossain ¹ Hadia Radwan ¹¹ Muhammad Subu ⁵ Mohamad Alameddine ¹

• ¹ Department of Health Care Management, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
• ² Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Irbid, Jordan
• ³ Department of Electrical, Computer, and Biomedical Engineering , College of Engineering, Abu Dhabi University, Abu Dhabi, United Arab Emirates
• ⁴ Department of Biomedical Engineering, Faculty of Engineering, Jordan University of Science and Technology, Irbid, Irbid, Jordan
• ⁵ Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
• ⁶ Department of Maternal and Child Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Irbid, Jordan
• ⁷ Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
• ⁸ Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Irbid, Jordan
• ⁹ Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Irbid, Jordan
• ¹⁰ Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Alexandria, Egypt
• ¹¹ Department of Clinical Nutrition, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates

Background: Diabetic foot is a major public health issue, leading to increased morbidity and mortality among diabetic patients. This study aimed to evaluate the effectiveness of targeted health education interventions on self-efficacy and foot care practices among diabetic women in Jordan.A pretest-posttest, quasi-experimental design was used to collect data from 76 diabetic women at a tertiary hospital in northern Jordan. Participants were assigned to three groups: a control group receiving standard care; Intervention Group 1, receiving standard care with weekly text reminders and follow-up calls; and Intervention Group 2, receiving the same components as Intervention Group 1, plus small group education sessions and hands-on foot care training. Generalized Estimating Equations models were used to assess the impact of the interventions on foot care practices and self-efficacy over an 8-week period.The findings revealed that participants in Intervention Group 2 demonstrated the most significant improvements in both foot care practices and self-efficacy. For foot care practices, Intervention Group 2 had adjusted odds ratios (aORs) of 2.5 (95% CI: 1.3-5.1) and 1.7 (95% CI: 1.2-2.9) when compared to the control group and Intervention Group 1, respectively. Similarly, for self-efficacy, the aORs for Intervention Group 2 were 2.7 (95% CI: 1.4-5.2) relative to the control group, and 1.8 (95% CI: 1.1-3.2) compared to Intervention Group 1.Our study demonstrates that interactive educational approaches-featuring group discussions, real-time problem-solving, immediate feedback, and family support-can empower diabetic women to take a more active role in managing their foot health. Routine clinical care alone is insufficient to promote proactive foot care behaviors, highlighting the need for healthcare providers to incorporate educational materials tailored to the local cultural context into standard care to enhance patient outcomes.