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Advisor: Rickie Brawer, MPH, PhD, Family and Community Medicine, Thomas Jefferson University


Managing diabetes is complex for both patients and caregivers and requires a unique coordination of care between patients, primary care providers, specialists, and other health care services. The Camden Coalition of Healthcare Providers is an organization that seeks to improve healthcare delivery in Camden and has identified a need to improve the quality of diabetes care in Camden. The aim of this qualitative study is to identify the personal and systemic barriers to optimal diabetes management in Camden from the perspective of the healthcare workers in the region. Other aims include evaluating the impact of diabetes self-management education (DSME) classes and identifying recommendations for care improvement. One-on-one case interviews with pre-determined questions were conducted with healthcare employees of two primary care offices located in Camden. The interviews were audio-recorded and transcribed. Transcriptions were coded into themes and codes were compared and analyzed within and across interview responses. The results showed that general barriers to managing patients with diabetes included individual personal factors, such as patient knowledge and attitudes, and inadequate continuity of care, such as insufficient communication and access to specialty services. The impact of DSME classes on patients included an increase in awareness and knowledge about diabetes among patients, patient activation in self-care, and improved health outcomes. Factors enhancing diabetes care included patient motivation and readiness to learn, regular communication with follow-up care, electronic medical records, and community resources such as the Camden Coalition. Recommendations include maximizing enrollment in DSME classes, addressing patient motivation in care, increasing electronic information sharing with electronic medical records and the use of email, increasing patient social support with adult day care centers and family-included classes, increasing follow-up communication between office staff and patients, using Camden Coalition resources to access specialty services, and addressing obesity as a health issue in Camden in the future.