Advisor(s)
Suzanne Judd
Committee Member(s)
Jessica Chambliss
Kristen Watts
School
Joint Health Sciences (Interdisciplinary)
Document Type
Thesis
Department (new version)
Joint Health Sciences
Date of Award
9-11-2025
Abstract
Southern rural communities experience a higher prevalence of Type 2 diabetes (T2D) and associated comorbidities, which increases rates of premature mortality due to socio-environmental factors, pre-existing health conditions, and economic burden in comparison to their urban counterparts. Fifty percent of individuals with T2D experience pain or chronic pain (CP); however, individuals in rural communities disproportionately experience symptoms of CP. CP is a physically debilitating condition that can inhibit mobility and reduce quality of life. T2D and the co-occurrence of CP can limit an individual's ability to engage in self-managing behaviors. While diabetes self-management education and support (DSMES) programs, along with lifestyle behaviors, have been the cornerstone of treatment for people living with diabetes, they fail to specifically address diabetes self-management behaviors and daily tasks in the context of pain. Using a patient-centered qualitative approach, this study aims to understand the lived experiences of individuals with T2D and CP, to develop an innovative self-management intervention for diabetes and CP in rural areas. We conducted two focus group sessions (n=18 participants) to gain an in-depth understanding of how pain, psychological factors ,psychosocial factors, health policy, and socio-economic status serve as facilitators or barriers to self-management for the co-occurrence of T2D and CP. We identified pain, psychological factors, psychosocial factors, and socioeconomic status as barriers, whereas psychological factors, such as resilience, psychosocial factors, such as social support, and health policy as facilitators to T2D self-management in the context of pain. Older adults with T2D and CP, living in rural Alabama, are faced with unique health challenges that impact their ability to engage in successful T2D self-management. Findings from this study will provide a framework to develop a more equitable self-management intervention that embraces the lived experiences of living in rural communities to improve rural health outcomes.
ProQuest ID
Recommended Citation
Butler, Kennedy Nicole, "Bridging The Gap: Exploring The Facilitators And Barriers In The Self-Management Of Diabetes And Pain In Rural Southern Communities" (2025). All ETDs from UAB. 7375.
https://digitalcommons.library.uab.edu/etd-collection/7375
