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UKnowledge > College of Public Health > Journal of Appalachian Health > Vol. 8 (2026) > Iss. 2

 

Corresponding Author

Soghra Jarvandi, sjarvand@utk.edu

Author Affiliations

  1. Soghra Jarvandi, MD, MPH, PhD: Associate Professor, Department of Family and Consumer Sciences, University of Tennessee Knoxville (Knoxville TN); E-mail: sjarvand@utk.edu; ORCiD: https://orcid.org/0000-0003-0130-4586
  2. Lydia Hoskins, DrPH Candidate: Extension Specialist, Department of Family and Consumer Sciences, University of Tennessee Knoxville (Knoxville TN);; ORCiD: https://orcid.org/0009-0009-0905-579X
  3. Karen Carver, PhD, APRN, FNP-C: Assistant Professor,College of Nursing, East Tennessee State University (Johnson City, TN); ORCiD: https://orcid.org/0000-0000-0002-8304-9808
  4. Andrew S. May, MD, FAAFP: Regional Medical Director, Sullivan County Regional Health Department (Blountville TN)

Author Area of Expertise

Soghra Jarvandi, MD, MPH, PhD: Lifestyle behaviors and prevention and management of chronic conditions

Lydia Hoskins, DrPH Candidate: Public Health Education and Health Promotion

Karen Carver, PhD, APRN, FNP-C: Family Nurse Practitioner and Nurse Scientist with research interests in diabetes self-care.

Andrew May, MD, FAAFP: Family Medicine 

Abstract

Introduction: The burden of diabetes is an increasing public health challenge, especially in the Appalachian Region.

Purpose: This study assessed the impact of a community-based diabetes education program on glycemic control.

Methods: Health Extension for Diabetes (HED) is a 4-month diabetes education program offered by Extension educators in collaboration with clinical providers. Participants’ data were collected via phone interviews at baseline and after completing the program. Assessments included self-reported HbA1c, socio-demographics, diabetes knowledge, self-efficacy, and self-management behaviors. Data were analyzed by SAS software using paired analyses.

Results: Of the 105 participants in the program, 87 (83%) completed the post-assessment. Among the baseline respondents, 85 (81%) were female, 95 (90%) were white, and the mean age was 70 years. From pre- to post- program, HbA1c decreased significantly by 0.38% (p = 0.03). In addition, the participants’ mean scores increased for diabetes knowledge (p < .0001) and self-efficacy (p = 0002). In terms of health behaviors, a significantly greater proportion of participants increased their consumption of fruit and vegetables (p < .0001), but the increase in physical activity levels was not significant (p = 0.059).

Implications: This study provides evidence that a community-clinical partnership model improves glycemic control. The results highlight a possible avenue for health care systems and Extension offices to partner on diabetes education programs and improve diabetes care and outcomes for individuals living in rural Appalachian communities.

DOI

https://doi.org/10.13023/jah.0802.04

Creative Commons License

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

Recommended Citation

Jarvandi S, Hoskins L, Carver K, May, AS. Improving diabetes self-management through a partnership between clinical providers and community educators in Appalachian communities. J Appalach Health 2026; 8(2):53-63. DOI: https://doi.org/10.13023/jah.0802.04

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