Building Sustainable Rural Community Support for Diabetes Self-Management: Lessons Learned

Objective:   Type 2 diabetes affects almost 10% of Missourians.  The prevalence of diabetes is 17% in higher in rural Missouri communities than in cities.  We will describe a  3-year intervention project conducted by University of Missouri, Department of Family and Community Medicine (funded by Missouri Foundation for Health) using a community-based participatory approach and a primary care practice partnership component aimed at improving diabetes self-management in two rural mid-Missouri counties.

Methods: The intervention developed and implemented a strategic plan for diabetes self-management community support that built community partnerships with public assistance agencies, local comunity businesses and volunteers in diverse communities with a long history of poor cooperation between different ethnic communities.

Results: The project has successfully implemented the strategic plan and maintained sustainable community partnerships in one county in which patients from participating practices took leadership but has been unable to achieve the same results in the other county where such patients were uninvolved.

Conclusion:  Patient advice and participation in project planning and implementation is critical for self-care behavior change programs.