Abstract
OBJECTIVE: To investigate influences on participation in diabetes self-management education (DSME) classes in a low-income, Spanish-speaking, Latino population. METHODS: Fifteen patients from an Oregon clinic participated in semi-structured interviews designed to understand influences on their participation in DSME classes, and the authors conducted a thematic analysis. RESULTS: Four themes characterized the data: 1) limited resources, 2) culture, 3) relationship with diabetes, and 4) relationship with clinic. Barriers to class attendance included lack of time, childcare, and transportation; male participants' shame of illness and lack of interest in health; and difficulty contacting participants by telephone. Motivators of class attendance included interest in being healthy for the sake of family; interest in nutrition; knowledge of the effects of diabetes on self, friends, and family; and positive experiences with group support and self-efficacy in class. PRACTICE IMPLICATIONS AND CONCLUSION: Participation in DSME classes in this low-income, Spanish-speaking, Latino population was influenced by many factors. Understanding these factors is an important step toward creating classes that are successful in increasing attendance rates for this and similar populations. Creative, targeted approaches to designing DSME classes for low-income, Spanish-speaking, Latino patients and similar populations are needed. These may include classes that remove the barriers of shame and lack of interest for male participants; focus on family involvement, celebration of culturally appropriate foods, group support, and self-efficacy; are accessible to resource-limited participants; and use alternative methods to recruit hard-to-reach participants.