title: Knowledge and perceptions of diabetes in an Appalachian population.
abstract: BACKGROUND
  Qualitative research on knowledge and perceptions of diabetes is limited in the Appalachian region, where social, economic, and behavioral risk factors put many individuals at high risk for diabetes. The aim of this study was to gain a culturally informed understanding of diabetes in the Appalachian region by 1) determining cultural knowledge, beliefs, and attitudes of diabetes among those who live in the region; 2) identifying concerns and barriers to care for those with diabetes; and 3) determining the barriers and facilitators to developing interventions for the prevention and early detection of diabetes in Appalachia.
  
  
  METHODS
  Thirteen focus groups were conducted in 16 counties in West Virginia in 1999. Seven of the groups were composed of persons with diabetes (n = 61), and six were composed of community members without diabetes (n = 40). Participants included 73 women and 28 men (n = 101).
  
  
  RESULTS
  Findings show that among this population there is lack of knowledge about diabetes before and after diagnosis and little perception that a risk of diabetes exists (unless there is a family history of diabetes). Social interactions are negatively affected by having diabetes, and cultural and economic barriers to early detection and care create obstacles to the early detection of diabetes and education of those diagnosed.
  
  
  CONCLUSIONS
  Public health education and community-level interventions for primary prevention of diabetes in addition to behavior change to improve the management of diabetes are needed to reduce the health disparities related to diabetes in West Virginia.
authors.affiliation: Department of Health Promotion and Risk Reduction, Community Health Initiatives, School of Nursing, West Virginia University, PO Box 6275, Morgantown, WV 26506, USA. itessaro@hsc.wvu.edu
authors.forename: Irene
authors.initials: I
authors.lastname: Tessaro
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Smith
authors.forename: Sheila
authors.initials: S
authors.lastname: Rye
mesh_terms: D003469:Culture; D003920:Diabetes Mellitus; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011634:Public Health; D036301:Qualitative Research; D012307:Risk Factors; D012424:Rural Population; D014903:West Virginia