Rural and Remote Health Journal photo
African section Asian section Australasian section European section International section Latin American section
current articles
information for authors
status/user profile
about us

Original Research

Developing a culturally competent, sustainable rural model for diabetes prevention

Submitted: 2 March 2014
Revised: 1 August 2014
Accepted: 7 August 2014
Published: 4 February 2015

Full text: You can view the full article, or view a printable version.
Comments: (login to access the comments on this article)

Author(s) : Johnson LK, Denham SA.

Lesli JohnsonSharon Denham

Citation: Johnson LK, Denham SA.  Developing a culturally competent, sustainable rural model for diabetes prevention. Rural and Remote Health (Internet) 2015; 15: 3031. Available: (Accessed 19 October 2017)


Introduction:  The incidence of newly diagnosed diabetes as well as the prevalence of diabetes increased dramatically beginning in the early 1990s. The Appalachian region of the USA extends across 13 eastern states and has been designated as part of the 'diabetes belt' because of the higher prevalence rates for type 2 diabetes rates compared to other regions of the nation. The cultural nature of the region and social networks, including family and community, often exert greater influence on health behaviors than do health professionals. This study assesses a community- and family-based approach to diabetes prevention and management.
Methods:  Eleven Appalachian counties across three states were invited to participate in Diabetes: A Family Matter, a family health model intervention utilizing the development of local coalitions that focused on family health and lifestyles. Culturally relevant materials, both print and online, along with regional trainings and coalition capacity development were used to empower local groups to increase awareness and knowledge about diabetes and promote healthy lifestyle behaviors.
Results:  Analysis of pre- and post-tests of knowledge show significant improvement in knowledge of diabetes and an increase in self-efficacy in terms of educating others about healthy lifestyles and diabetes prevention. Print and online materials were well received and generally viewed as culturally relevant and useful in efforts to increase awareness and promote healthy lifestyles. Further, at the end of 2 years, 8 out of the 11 coalitions had participated in training, volunteer recruitment and training and community engagement focused on diabetes awareness and the importance of lifestyle changes.
Conclusions:  Utilizing modest initial resources, the project was successful in engaging 11 rural counties in the development of diabetes prevention coalitions. Results show increased knowledge and self-efficacy on the part of participants as well as increased activity in community engagement.

Key words: Appalachia, community coalition, diabetes, Family Health Model, health prevention.

This abstract has been viewed 3098 times since 4-Feb-2015.