title: Diabetes educators in safety-net practices: a qualitative study.
abstract: The purpose of this study was to explore the issues and challenges faced by certified diabetes educator (CDE) trainees in providing diabetes self-management education to patients in safety-net practices.
  
  
  
  Semi-structured interviews were conducted with CDE trainees and a CDE mentor in 2 primary care practices. Transcripts were analyzed using a content-driven immersion-crystallization approach to identify major themes.
  
  
  
  Four major themes emerged from the qualitative interview data: (1) patient recruitment approaches, (2) patient barriers to attending diabetes education classes, (3) teaching challenges, and (4) CDE integration into the practices.
  
  
  
  This study underscores the need for diabetes educators and other health education professionals to be creative and flexible in delivering self-management education to patients in underserved settings. The complexity of diabetes care and the self-care responsibilities placed on the patient reinforce the need for a team approach such as that proposed in the medical home model and should include certified diabetes educators.
authors.affiliation: Primary Care Research Institute, Department of Family Medicine, State University of New York at Buffalo
authors.forename: Linda S
authors.initials: LS
authors.lastname: Kahn
authors.affiliation: Primary Care Research Institute, Department of Family Medicine, State University of New York at Buffalo
authors.forename: Kathryn
authors.initials: K
authors.lastname: Glaser
authors.affiliation: Primary Care Research Institute, Department of Family Medicine, State University of New York at Buffalo
authors.forename: Chester H
authors.initials: CH
authors.lastname: Fox
authors.affiliation: Primary Care Research Institute, Department of Family Medicine, State University of New York at Buffalo
authors.forename: Adam
authors.initials: A
authors.lastname: Patterson
mesh_terms: D003144:Communication Barriers; D003920:Diabetes Mellitus / Q000534:rehabilitation*; D040441:Health Educators; D006297:Health Services Accessibility; D006801:Humans; D009518:New York; D010353:Patient Education as Topic; D018579:Patient Selection; D011204:Poverty Areas; D012648:Self Care