Barriers to diabetes self-management education programs in underserved rural Arkansas: implications for program...

Area of Science:

• Public Health
• Diabetes Management
• Health Disparities

Background:

• Diabetes prevalence is epidemic, necessitating effective self-management education.
• Medically underserved rural areas, like Arkansas, face significant challenges in diabetes care delivery.
• The Arkansas Diabetes Prevention and Control Program established DSME programs in high-prevalence, underserved counties.

Purpose of the Study:

• To assess the implementation and outcomes of newly established Diabetes Self-Management Education (DSME) programs in rural Arkansas.
• To identify barriers encountered during DSME program implementation in underserved areas.

Main Methods:

• 12 DSME programs were delivered by registered nurses and dietitians, providing 10-13 hours of education.
• Data on preventive care practices (blood glucose monitoring, foot exams, BP, HbA1c) were collected at baseline, 6 months, and year-end.
• Program recognition and participant numbers were tracked over one year.

Main Results:

• 11 of 12 DSME programs achieved American Diabetes Association recognition.
• Participant numbers increased by 138% within one year.
• Significant improvements were observed in daily blood glucose monitoring (56% to 67%), daily foot examinations (63% to 84%), and a 0.5 unit average decrease in HbA1c.

Conclusions:

• DSME programs in rural Arkansas show potential benefits for patient preventive care practices and clinical outcomes.
• Implementation barriers, particularly the lack of an evaluation plan, limited the ability to fully assess program effectiveness.
• Integrating program evaluation into the planning phase is crucial for measuring the success of DSME initiatives.