Purpose 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). Methods 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. Results 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. Conclusions 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.

中文翻译：

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让服务不足的社区成员参与糖尿病自我管理：来自大里士满基督教青年会糖尿病控制计划的证据


目的本研究的目的是确定影响参与者参与基于社区的糖尿病自我管理计划（DSMP）的因素，重点关注服务不足群体（例如，种族/族裔、低收入）的需求。方法 焦点小组由大里士满基督教青年会糖尿病控制项目的参与者（n = 22）进行，这些参与者是使用有目的的抽样框架来招募的，以收集一系列经验。对非专业健康教练进行了深入访谈（n = 3）。 RADaR 定性分析技术用于识别与整个参与过程中的因素相关的主题。结果 恐惧以复杂的方式影响了项目的入学率和保留率。同伴和教练对于社会支持和责任感很重要。该计划的长度（12 周）、可获取的信息、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对于参与和改善糖尿病自我管理至关重要。健康和外部义务是参加计划的主要障碍。结论 参与者和教练的观点为了解基于社区的 DSMP 的现有优势提供了重要的见解，这些优势可以扩展以促进参与以及潜在的改进机会。提供了关于增加服务不足群体参与基于社区的 DSMP 的可行建议。