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Diabetes in Appalachia: providers' perspectives.
Elizabeth A Beverly1,2, Marilyn D Ritholz3,4, Karie Cook2
1Department of Family Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH45701, USA.
Primary Health Care Research & Development
|May 15, 2020
Summary
Primary care providers in Appalachian Ohio face challenges treating diabetes due to patient fatalism, psychosocial issues, and social determinants. Culturally tailored interventions are recommended to improve diabetes care.
Area of Science:
- Public Health
- Primary Care Medicine
- Health Disparities
Background:
- Southeastern Appalachian Ohio exhibits a diabetes prevalence more than double the national average.
- A significant shortage of healthcare providers exacerbates diabetes care challenges in the region.
- Limited research exists on primary care providers' experiences treating diabetes in this specific Appalachian area.
Purpose of the Study:
- To explore primary care providers' perceived barriers and facilitators in treating patients with diabetes in southeastern Appalachian Ohio.
Main Methods:
- In-depth interviews were conducted with healthcare providers treating diabetic patients in rural southeastern Ohio.
- Interviews were transcribed, coded, and analyzed using content and thematic analyses with NVivo 12 software.
Main Results:
- Four key themes emerged: patient diabetes fatalism, prevalent comorbid psychosocial issues (depression, anxiety, trauma), interconnected social determinants (access, transportation, food/housing/financial insecurity), and the importance of providers' cultural understanding.
- Providers highlighted the need for culturally attuned clinical suggestions rooted in Appalachian values.
Conclusions:
- Evidence-based interventions tailored to Appalachian culture are recommended.
- Training to enhance primary care providers' cultural competency and humility may reduce barriers to diabetes care in Appalachian Ohio.
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