Process Evaluation of the Intensive Diabetes Self-Management Program for Underserved Communities

Background/Objectives: This study assesses barriers to behavior change among underserved populations with type 2 diabetes enrolled in the intensive Diabetes Self-Management Education and Support (iDSMES) program. Methods: Thirteen participants (5 English speakers, 8 Spanish speakers), who had completed at least six months of the 1-year iDSMES program, were invited to join focus group discussions. Participants were asked about barriers, facilitators, and suggestions for promoting the program. Results: Barriers to effective diabetes self-management included financial constraints, lack of social support, stigma surrounding treatment, and miscommunication with healthcare providers. However, the iDSMES program’s support system emerged as a major facilitator. Participants valued the relationships they developed with others facing similar challenges, which motivated them to keep working toward their health goals. Conclusions: The iDSMES program was successful in promoting behavior changes and improving health literacy. Addressing financial barriers in underserved communities is essential for supporting long-term behavior change.