Exploring Patient’s Experiences of Diabetes Empowerment Education Programs (DEEP) Among Tenants of Publicly Subsidized Housing (PSH) in Arizona

Tenants of publicly subsidized housing (PSH) as well as the general population may choose from one of many existing diabetes education programs, such as the national Diabetes Prevention Program or choose from a smaller, more community-based program. The purpose of this study is to explore experiences of tenants of PSH who participated in a community-based Diabetes Empowerment Education Program (DEEP). This program aims to increase health literacy regarding public health concepts, such as the social determinants of health, gives participants the skills and resources for better diabetes management. From the literature review, a research gap was identified in two areas: studies evaluating participant’s experiences in diabetes education and studies using tenants of PSH for diabetes education. This study was designed using both qualitative and quantitative approaches to address the research gap. First, 5 participants were recruited and two surveys were conducted during the first and last sessions of the six-week DEEP class. The survey was created based upon the Diabetes Knowledge Questionnaire and the Summary of Diabetes Self-Care Activities Measure. From the surveys, a coding guide was created and data was coded according to the guide. In addition, the means and standard deviations of categories from within the survey were calculated. Second, to better understand lived experiences during the DEEP intervention, semi-structured interviews were conducted with 2 class participants and the class educator to gain a deeper understanding of their experiences in the class. Diabetes knowledge increased between the first and second surveys. The rate of correct replies to 26 questions on the Diabetes Knowledge Questionnaire increased from 52.8 % to 73.1% prior to and following the DEEP intervention. Overall, there was a 38.4% increase in diabetes knowledge before and after the DEEP classes. Regarding the findings from the individual interviews, social networks improved diabetics overall experience in the DEEP class and managing their diabetes. Additionally, barriers such as COVID-19, comorbidities, and cultural norms were discovered in participant’s experiences. Participants shared similar facilitators to diabetes management, such as time with diabetes increasing success at diabetes management. COVID-19 significantly limited enrollment in the DEEP classes, leading to a very small sample size which is a major limitation of this study. A critical implication of this study is highlighting the necessity of free community health education programs, such as this one, especially in publicly subsidized housing communities, to promote health equity for all.