559-P: Evaluating the Feasibility and Preliminary Effectiveness of a Tailored Diabetes Education Program for Rural Residents

Background: Limited access to healthy foods, exercise facilities, and behavior modification skills in rural-dwelling individuals may impact the ability to appropriately manage type 2 diabetes (T2D). We tailored a 6-week diabetes education for a diverse rural Appalachia Kentucky population to determine the effects of the intervention on diabetes knowledge, self-care, and glycemic control.

Methods: A culturally tailored diabetes education was administered to study participants (N=18) with three- and six-month follow-up. The diabetes self-management questionnaire (DSMQ) and the Diabetes Knowledge Questionnaire (DKQ) were used to assess diabetes self-management and knowledge. DKQ scores were expressed as a sum of all 24 items, scaled to 10. A linear mixed effects model was used to measure DSMQ, DKQ, and A1c associations.

Results: Participants were majority white (72%). Mean A1c values decreased from 7.68 to 7.28 at follow-up. Mean DKQ scores increased from 10.50 to 11.25. There was a 0.06 difference between baseline and follow-up mean sum-scale DSMQ). Sum-scale DSMQ was negatively associated with A1c (β=-0.098; 95% CI: -0.356 to 0.161). DKQ scores were positively associated with A1c (β=0.009; 95% CI: -0.054 to 0.071). Six months of the intervention was negatively associated with A1c (β=-0.112, 95% CI: -0.462 to 0.237).

Conclusion: Findings from this pilot and feasibility study suggest that the tailored diabetes education improved diabetes knowledge and glycemic control in rural Appalachia residents living with T2D. A larger study using the tailored education is needed to provide further insight into the intervention's effectiveness.