Sharon A. Denham, DSN, RNProfessor, Ohio University School of Nursing

Centers for Disease Control and Prevention National Diabetes Education Program

Ohio Department of Health Diabetes Prevention and Control Program

Ohio University’s Appalachian Rural Health Institute (ARHI)

Ohio University, Diabetes Research Initiative (DRI).

Ohio University’s Office of Research and Sponsored Projects Challenge Grants

Dr. Frank SchwartzChris KniselyDr. Ann Rathbun

Dr. Margaret Manoogian, Dr. Kathy Rose-Grippa, Larry Hamel-Lambert, Amelia Krales, Steve Fetsch, Joshua Ramsey, Norm Bebee, Dana Formby, Nicholas Sgouros, William Zorn, Dr. Lynn Harter, Dr. Karen Remsberg, Dr. Larry Wood, Tara O’Brien, Patricia Harris, Kallia Wright, Tammy Collier, Cara Butcher, Stacey Hartman, Jeff Negrelli, Eimi Lev, Maria Averion, Joe Bass

Dr. Jay Shubrook, Barbara Nakanishi, Suzanna Theodoras, Carole Merckle, Diabetes Center’s Diabetes Coalition, Beth Pingle, Francie Astrom, Karen Bailey, Dr. Benjamin Bates, Dr. Darlene Berryman, Ruth Dudding, Dr. Jennifer Hinton, Dr. Mary de Groot, Susan Isaac, Dr. Jane Hamel-Lambert, Dr. Bruce Martin, Dr. David Mould, Deborah Murray, Dr. Rafael Obregon, Tracey O’Dell, Dr. Brian Quick, Nancy Schell, Jane Snider, Kathy Trace, Deanna Tribe

Dr. Jane Kelly Nancy Schaefer Cheryl Branham Kathy Chapman Ellen Peterson

Kimberly Malone Michelle Malone Leslie Malone Antonio Keith

(T.J.) Teran Keith Ann Rathbun

Access High costs and affordability Lack of health care insurance Increased numbers of seniors Increases in chronic illness Electronic medical records Epidemic of diabetes & obesity

Diabetes is a growing problem in Appalachian region. Cultural uniqueness of the region. Lack targeted diabetes education and teaching

materials. Family is important in lives for Appalachian people. Lack family-focused diabetes education materials. Primary care largely inadequate for holistic needs.

Diabetes experts and other health practitioners are not readily accessible to many.

Need new approaches to address healthy lifestyle behaviors, diabetes prevention, and diabetes self-management.

Community programs and volunteers have been successful.

Excellent diabetes education materials for health professionals already exist and is available.

Diabetes educators may not be knowledgeable about: * Community or population health * Working with coalitions * Volunteer programs * Development, implementation, and evaluation of sustainable community programs.

Broadband access is not yet readily available, but availability continues to grow.

Social networking can be a valuable tool for mobilizing people and groups.

Healthy lifestyles, diabetes prevention, and diabetes self-management

Type 2 diabetes (primarily) Rural focus Program for Appalachian

communities

Family-Focused versus Medical Model Family Context (family history,

genetics, place, culture) Family Function (communication,

caregiving, story-telling) Family Routines

Lived experience and biomedical accounts Narrative competence and clinical care Diabetes as a “Family Disease” Diabetes more than individual problem

(extended kin networks, place, faith, etc.) Health legacies Reconstruct new stories (e.g., not being

“beholden to others”)

Ecological context Diversity Geography Multiple interacting sectors More than traditional ideas of health care

Low literacy and Health Literacy Cultural identification (avoid

stereotypes) Empowerment Living with diabetes

Novel approaches/innovative ideas Interdisciplinary input Web 2.0 availability Multiple types of audiences

Give local people a voice. Take personal actions to improve the

quality of life of those that live in your community.

Work with others to positively mobilize the resources available in your community to address the health of local residents.

Empowerment and active involvement of all local residents.

Train the trainer model Community coalitions SUGAR Helpers (Support to Unite

Generations in the Appalachian Region)

Diabetes Educator Manual SUGAR Helper Manual Series of brochures Posters Fotonovellas Bookmarkers Film Plays

www.diabetesfamily.net Toolkit section of website Multiple activities “Ask Me” Campaign