ArticlePrimary health care research & development2020
Diabetes in Appalachia: providers' perspectives.
Article in Primary health care research & development, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- The current landscape of Ohio otolaryngologists and associated conditions: a state-level analysis.BMC health services research · 2026Article
- Health care access from the rural perspective: A narrative review.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Review
- Experiencing Housing Instability in Rural North America and Access to Health Care and Supportive Services: A Scoping Review.Journal of health care for the poor and underserved · 2025Article
- Randomised trial of Mentored 'Planning to be Active+Family' [MPBA+F] for Appalachian youth at risk for diabetes: virtual delivery protocol.BMJ public health · 2024Article
- Housing instability and cardiometabolic health in the United States: a narrative review of the literature.BMC public health · 2023Review
- Political views and organizational distrust affect rural residents' willingness to share personal data for COVID-19 contact tracing: A cross-sectional survey study.Journal of clinical and translational science · 2023Article
- Examination of Health Care Providers' Use of Language in Diabetes Care: A Secondary Qualitative Data Analysis.Clinical diabetes : a publication of the American Diabetes Association · 2022Article
- Social Determinants and Health Disparities Pertaining to Diabetes in Appalachia.Journal of primary care & community healthArticle
- Rural/Urban Disparities in the Availability of Diabetes Prevention Programs in US Hospitals.Journal of primary care & community healthArticle
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSoutheastern Appalachian Ohio has more than double the national average of diabetes and a critical shortage of healthcare providers. Paradoxically, there is limited research focused on primary care providers' experiences treating people with diabetes in this region. This study explored providers' perceived barriers to and facilitators for treating patients with diabetes in southeastern Appalachian Ohio.
methodsWe conducted in-depth interviews with healthcare providers who treat people with diabetes in rural southeastern Ohio. Interviews were transcribed, coded, and analyzed via content and thematic analyses using NVivo 12 software (QSR International, Chadstone, VIC, Australia).
resultsQualitative analysis revealed four themes: (1) patients' diabetes fatalism and helplessness: providers recounted story after story of patients believing that their diabetes was inevitable and that they were helpless to prevent or delay diabetes complications. (2) Comorbid psychosocial issues: providers described high rates of depression, anxiety, incest, abuse, and post-traumatic stress disorder among people with diabetes in this region. (3) Inter-connected social determinants interfering with diabetes care: providers identified major barriers including lack of access to providers, lack of access to transportation, food insecurity, housing insecurity, and financial insecurity. (4) Providers' cultural understanding and recommendations: providers emphasized the importance of understanding of the values central to Appalachian culture and gave culturally attuned clinical suggestions for how to use these values when working with this population.
conclusionsEvidence-based interventions tailored to Appalachian culture and training designed to increase the cultural competency and cultural humility of primary care providers may be effective approaches to reduce barriers to diabetes care in Appalachian Ohio.
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