Population Studies Center, University of Michigan Institute for Social Research, Ann Arbor, Michigan.
Department of Public Health Sciences, University of Texas, El Paso, Texas.
Diabetes Educ. 2020 Apr;46(2):169-180. doi: 10.1177/0145721720907059. Epub 2020 Mar 4.
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).
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.
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.
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.
本研究旨在确定影响参与者参与社区糖尿病自我管理计划（DSMP）的因素，重点关注服务不足群体（如少数民族、低收入群体）的需求。
采用有针对性的抽样框架，从 YMCA of Greater Richmond 的糖尿病控制计划中招募了 22 名参与者（n=22），并对他们进行了焦点小组讨论。还对 3 名非专业健康教练（n=3）进行了深入访谈。使用 RADaR 定性分析技术，确定了与参与度连续体相关的主题。
恐惧以复杂的方式影响着项目的参与和保留。同伴和教练在提供社会支持和问责方面非常重要。项目的长度（12 周）、可获得的信息、实用技能的培养，以及强调在追求更大目标的过程中进行小而可行的改进，被认为是参与和改善糖尿病自我管理的关键。健康和外部义务是参加项目的主要障碍。
参与者和教练的观点提供了社区为基础的 DSMP 现有优势的重要见解，可以在此基础上进一步提高参与度，并为改进提供潜在机会。还提供了增加社区为基础的 DSMP 中服务不足群体参与度的可行建议。
