Diabetes Educators in Safety-Net Practices A Qualitative Study

Purpose The purpose of this study was to explore the issues and challenges faced by certified diabetes educator (CDE) trainees in providing diabetes self-management education to patients in safety-net practices. Methods Semi-structured interviews were conducted with CDE trainees and a CDE mentor in 2 primary care practices. Transcripts were analyzed using a content-driven immersion-crystallization approach to identify major themes. Results Four major themes emerged from the qualitative interview data: (1) patient recruitment approaches, (2) patient barriers to attending diabetes education classes, (3) teaching challenges, and (4) CDE integration into the practices. Conclusions This study underscores the need for diabetes educators and other health education professionals to be creative and flexible in delivering self-management education to patients in underserved settings. The complexity of diabetes care and the self-care responsibilities placed on the patient reinforce the need for a team approach such as that proposed in the medical home model and should include certified diabetes educators.