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UKnowledge > College of Public Health > Journal of Appalachian Health > Vol. 7 (2025) > Iss. 3

 

Corresponding Author

Angela Occidental: angelajoccidental@gmail.com

Author Affiliations

  1. Angela Occidental, DNP, APRN-FNP-C: Nurse Practitioner, Duncan Medical Family Practice (West Portsmouth OH); email: angelajoccidental@gmail.com; ORCiD: https://orcid.org/009-0003-5987-3519
  2. Inga M. Zadvinskis, PhD, RN, EBP-C, FNAP: Evidence-Based Practice Nurse, Nursing Research and Excellence, OhioHealth Riverside Methodist Hospital (Columbus OH); ORCiD: https://orcid.org/ 0000-0001-9504-1056
  3. Jacqueline Hoying, PhD, RN, NBC-HWC, FNAP, FAAN: Associate Clinical Professor, College of Nursing, Ohio State University (Columbus OH); ORCiD: https://orcid.org/ 0000-0002-3034-6972

Author Area of Expertise

Angela Occidental- Family Nurse Practitioner Family Practice/Primary Care

Inga Zadvinskis- Evidence-Based Practice, Nursing Research, Health Literacy

Jacqueline Hoying- Mental Resilience, Nursing Research, Health Literacy

Abstract

Introduction: The Appalachian Region has a higher prevalence of type 2 diabetes mellitus (T2DM) and associated adverse health outcomes. Although numerous papers report best practices for diabetes care and education, a clinician-friendly, synthesized summary of best practices tailored to Appalachian cultural preferences is lacking.

Purpose: This paper uses the Melnyk & Fineout-Overholt evidence-based framework to identify the best practices for T2DM care and education for Appalachian residents.

Methods: A comprehensive literature search using the databases CINAHL, Academic Search Complete, and PubMed was guided by a PICOT question. Quality appraisals were completed for fifty-two articles; thirty papers were selected to synthesize best practices, delivery methods, lifestyle modifications, and outcomes.

Results: Best practices for T2DM education are recognizing how culture and the social determinants of health (SDOH) influence care, using a multidisciplinary team, and screening for diabetes knowledge and distress. Beneficial education topics are nutrition, weight management, medication management, stress management, health maintenance screenings, and lifestyle modification including exercise. Access to care may be increased by using digital or online formats.

Implications: T2DM is a complex chronic health issue; strategies are needed to address health disparities and SDOH in Appalachia. Future research is needed to determine the best practices for the duration and frequency of diabetes education and to determine ways to engage residents in diabetes care. Partnerships with local organizations may create a support network for diabetes management. Decision-makers can use these best practices to pursue interventions that engage the Appalachian community in better diabetes care.

DOI

https://doi.org/10.13023/jah.0703.10

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Occidental A, Zadvinskis IM, Hoying J. Evidence-based best practices for diabetes education and self-care in Appalachia: a literature review. J Appalach Health 2025;7(2/3):137-154. DOI: https://doi.org/10.13023/jah.0703.10

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