Abstract
This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants’ perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% females; 62% diabetic; 77% had adequate health literacy); 79% of participants completed the benefits and barriers survey. Principal component analysis indicated two components representing benefits (Cronbach’s α = 0.83) and barriers (α = 0.65). The majority perceived high benefits and low barriers to program participation; benefits included helpful interaction with health coach or program leader (73%), improved lifestyle modification (65%) due to the program, and satisfaction with the program (75%). Open-ended questions confirmed themes related to benefits of program participation, suggestion for programmatic improvements as well as barriers to participation. Participant feedback could be used to guide interventions and tailor future program implementation.
Highlights
Diabetes affects 30.3 million Americans (9.4% of the population) and contributes to early morbidity and mortality [1]
53 US states and territories [3,4]. This may be due in part to the majority of the residents residing in rural areas (WV is the 3rd most rural state in the country) [5] and low socioeconomic status, considering that diabetes is highest among individuals who earn a household income of less than $15,000 per year, and that 17.9% of West Virginians are below the poverty level [6]
Both newly diagnosed and those with longer duration of diabetes were enrolled for the intervention program; the mean number of years with diabetes reported was 19 ± 13.5 years, and no significant difference was found between the two groups
Summary
Diabetes affects 30.3 million Americans (9.4% of the population) and contributes to early morbidity and mortality [1]. West Virginia (WV) has one of the highest rates of diabetes (15.3%) and pre-diabetes (35%) among the. 53 US states and territories [3,4] This may be due in part to the majority of the residents residing in rural areas (WV is the 3rd most rural state in the country) [5] and low socioeconomic status, considering that diabetes is highest among individuals who earn a household income of less than $15,000 per year, and that 17.9% of West Virginians are below the poverty level [6]. Other factors that contribute to the high rate of diagnosed and undiagnosed diabetes and pre-diabetes in WV include geography, lack of access to quality care, the aging population, and the Appalachian culture of fatalism [7]. In WV, diabetes-related diseases such as heart disease, hypertension and stroke are the number 1, 2 and 5 causes of death, respectively [4]
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