title: Perceived Barriers and Potential Strategies to Improve Self-Management Among Adults with Type 2 Diabetes: A Community-Engaged Research Approach.
abstract: Type 2 diabetes (T2D) is a leading cause of morbidity and mortality that disproportionately affects adults living in urban areas in the USA. Our goal was to actively engage community members in research to identify strategies to improve T2D self-management in an urban community in Baltimore, MD.
  
  
  
  We partnered with the Johns Hopkins Community Research Advisory Council to establish our stakeholder advisory board-the Diabetes Action Board (DAB). In response to input from DAB members regarding the best approaches for conducting community-centered T2D research, we conducted three 90-min focus groups of local adults living with T2D to identify ways to improve self-management. DAB members were involved in each stage of the research, including development of the protocol and materials, participant recruitment, and interpretation and dissemination of findings.
  
  
  
  In total, 24 adults with self-reported T2D (75 % participation rate; 79 % female) residing in the local area participated in focus groups. Participants reported that barriers within their daily home and work environments, inadequate neighborhood resources, and suboptimal healthcare quality hindered their self-management. Reported strategies that may help to improve self-management included social support from family members, providers, and community members; improved access to healthy food; and wide availability of free or low-cost T2D educational materials and classes within the local area.
  
  
  
  Our study demonstrates a successful mechanism for engaging community members in the design, implementation, and dissemination of T2D research. This research approach was beneficial for building a sustainable partnership to support future work in the local community.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. tpurnel1@jhmi.edu.|Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA. tpurnel1@jhmi.edu.|Center for Health Services and Outcomes Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. tpurnel1@jhmi.edu.
authors.forename: Tanjala S
authors.initials: TS
authors.lastname: Purnell
authors.affiliation: Armstrong Institute for Patient Safety and Quality, Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Lynch
authors.affiliation: Center for Health Services and Outcomes Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.|Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.|Community Research Advisory Council, Research Participant and Community Partnerships Core, Johns Hopkins Institute for Clinical and Translational Research, Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: Lee
authors.initials: L
authors.lastname: Bone
authors.affiliation: Center for Health Services and Outcomes Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.|Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Jodi B
authors.initials: JB
authors.lastname: Segal
authors.affiliation: Community Research Advisory Council, Research Participant and Community Partnerships Core, Johns Hopkins Institute for Clinical and Translational Research, Johns Hopkins School of Medicine, Baltimore, USA.
authors.forename: Crystal
authors.initials: C
authors.lastname: Evans
authors.affiliation: Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Longo
authors.affiliation: Center for Health Services and Outcomes Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.|Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
authors.forename: John F P
authors.initials: JF
authors.lastname: Bridges
mesh_terms: D055812:Community-Based Participatory Research / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000523:psychology* / Q000628:therapy*; D004777:Environment; D005190:Family; D005260:Female; D017144:Focus Groups; D005523:Food Supply; D005102:Health Expenditures; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods; D036301:Qualitative Research; D012648:Self Care / Q000191:economics / Q000523:psychology*; D012944:Social Support