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Diabetes Self-Management, Education and Support (DSMES) is cost-effective, lowers risk for diabetic complications, and improves hemoglobin A1C. Yet, there is limited research on how DSMES is implemented in Appalachia, which is a critical knowledge gap especially considering barriers to care, and high prevalence rates.
The purpose of this study was to gain a better understanding of what each facility in West Virginia is providing regarding DSMES.
Study Design, Settings, Participants
A mixed-methods study design was conducted in fall of 2021. An online, 37-item survey was disseminated to identified facilities (clinics, organizations, hospitals) that managed diabetes education to assess current services, accreditation, patient population, setting format, curriculum, and evaluation methods. Interested individuals participated in semi-structured interviews to discuss barriers to diabetes education in their facility and in West Virginia.
Descriptive statistics were used to report quantitative survey results and qualitative thematic analysis was conducted guided by grounded theory to identify relevant themes.
Twenty-three organizations completed the online Qualtrics survey. Fifteen organizations designated a representative to participate in the virtual interview. Eighty-two and six-tenths percent reported providing DSMES to patients and 43.5% were not accredited by Association of Diabetes Care and Education Specialists or American Diabetes Association. Overall, 100% of organizations reported that their diabetes education covered basic diabetes knowledge, risk factors, diet/nutrition, and exercise.
The qualitative findings suggest that access, value of diabetes education among patients and organization; resources (i.e., funding and staffing); and insurance were major barriers. Strategies to overcome barriers include understanding community assets to build more effective programming, diabetes training and education to the hospital multidisciplinary team.
Our findings suggest the importance of needs assessments and training to understand and encourage value among diabetes patients and providers. Further, Diabetes Education in Appalachia would benefit from resources and support including funding, staffing, and accreditation services.
© 2022 Published by Elsevier Inc.