Engaging Underserved Community Members in Diabetes Self-Management: Evidence From the YMCA of Greater Richmond Diabetes Control Program

Author:

Allen Julie Ober1ORCID,Concha Jeannie B.2,Mejía Ruiz María José3,Rapp Ashley4,Montgomery Joshua5,Smith Jana3,Wolfson Julia A.6,Thornton William3,Mezuk Briana4

Affiliation:

1. Population Studies Center, University of Michigan Institute for Social Research, Ann Arbor, Michigan

2. Department of Public Health Sciences, University of Texas, El Paso, Texas

3. YMCA of Greater Richmond, Richmond, Virginia

4. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan

5. Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Washington, District of Columbia

6. Departments of Health Management and Policy and Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan

Abstract

Purpose The purpose of this study was to identify factors influencing participant engagement in a community-based diabetes self-management program (DSMP), with a focus on the needs of underserved groups (eg, racial/ethnic minorities, low income). Methods Focus groups were conducted with participants (n = 22) from the YMCA of Greater Richmond’s Diabetes Control Program, who were recruited using a purposeful sampling frame to capture a range of experiences. In-depth interviews were conducted with lay health coaches (n = 3). The RADaR qualitative analysis technique was used to identify themes related to factors across the continuum of engagement. Results Fear affected program enrollment and retention in complex ways. Peers and coaches were important for social support and accountability. The length of the program (12 weeks), accessible information, practical skill building, and emphasis on making small, feasible improvements in pursuit of larger goals were identified as critical for engagement and improving diabetes self-management. Health and outside obligations were the major barriers to program attendance. Conclusions Participant and coach perspectives provide important insight into existing strengths of community-based DSMPs that can be expanded on to promote engagement as well as potential opportunities for improvement. Actionable recommendations for increasing engagement of underserved groups in community-based DSMPs are provided.

Funder

National Institute on Aging

virginia commonwealth university

American Diabetes Association

Publisher

SAGE Publications

Subject

Health Professions (miscellaneous),Endocrinology, Diabetes and Metabolism

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