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These are some of the challenges that were identified by the FORHP grantees (see Module 3) that have implemented diabetes or prediabetes programs in rural communities.

  • Poor self-management: Strategies for addressing this challenge included motivational interviewing techniques, structured but limited goal setting, and a number of self-management and self-efficacy programs.
  • Transportation: Identifying barriers to transportation will help participants continue to stay involved throughout the entire duration of the program. Holding meetings in central locations (local health departments, local community centers) can help to eliminate some of these barriers. Mobile clinics can also widen the accessibility of a diabetes or prediabetes program.
  • Funding and resource availability Funding can come from grants or by creating local partnerships. Anticipating program needs is key to determining how much each program will cost in terms of planning, implementation, evaluation, and continued sustainability.
  • Technology barriers such as the cost of telemedicine services or introducing new electronic medical record systems were noted by many grantees as a common challenge.