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Implementation Challenges

Rural communities may experience challenges when implementing diabetes prevention and management programs.

  • Poor adherence to self-management – Rural programs involving diabetes self-management approaches rely on the patient to perform monitoring and management tasks. For the program to be effective, patients must learn the skills and techniques necessary to manage diabetes at home. Rural programs can encourage adherence to diabetes self-management strategies through motivational interviewing, structured but limited goal setting, and participation in self-management education and self-efficacy programs.
  • Travel distance and lack of transportation – Many rural residents experience long travel distances or a lack of reliable transportation. This can make it difficult to access healthcare services or attend scheduled appointments or events. Coordinating transportation can help participants remain involved in the diabetes program. Holding meetings in central locations, for example local public health departments or community centers, can also help to eliminate transportation barriers. Mobile clinics can also be used to make a diabetes program more accessible.
  • Limited funding and resources – Finding adequate funding and resources to support program implementation is a common challenge in rural areas. Rural organizations can seek funding for diabetes programs through grants, partnerships, reimbursement, or existing programs. Planning is important for estimating costs to support program implementation, evaluation, and sustainability.
  • Technology barriers – Technology used to support diabetes programs, such as computers, telemedicine services, or electronic medical record systems, can be costly and require specific expertise. Supporting the ongoing costs associated with technology is a common challenge for rural communities.

For more information on challenges rural community health programs may experience, see Common Implementation Challenges in the Rural Community Health Toolkit.

Resources to Learn More

Elements of Successful Rural Diabetes Management Programs
Document
Examines how local innovations implemented by rural diabetes management programs overcame the key challenges of the rural setting and provided effective disease management.
Author(s): Fraser, R., Skinner, A.M., & Mueller, K.J.
Organization(s): Rural Policy Research Institute, RUPRI Center for Rural Health Policy Analysis
Date: 2006