An Assessment of the Unique Contextual Factors of Individuals with Diabetes Mellitus Type 2 Living in Rural Communities

Abstract

Diabetes Mellitus Type 2 (DMT2) is a significant financial burden on the United States (U.S.) economy. DMT2 is a burden financially, physically, and mentally to the individual. In 2022, DMT2 had an estimated cost of $412.9 billion dollars (Parker, 2023). More than 29 million individuals in the U.S. have DMT2 and over 86 million individuals have pre-diabetes (Towne, 2017). In rural communities, the prevalence of DMT2 is 17% higher than those living in non-rural communities (Lin, Y-L, 2016). Research shows links between the social determinants of health and poor health in rural communities (Feltner, 2017; Gordon, 2022; Towne, 2017; Ross, 2015). A literature review, responses from a needs-assessment, and feedback from occupational therapy practitioners were used to develop a holistic, community-based program called Take Control of Your Diabetes (TCOYD). TCOYD consists of four modules designed and implemented by occupational therapists. The modules provide education and strategies to reduce the barriers to buying foods recommended by the American Diabetes Association (ADA), decrease barriers to performing physical movement activity as recommended by the ADA, and medication management for DMT2 (ADA, 2021). The goal of the program is to improve nutrition, physical movement activity, and medication management to reduce Hemoglobin A1c (HbA1C).