Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program

Background/Objectives: Recruiting and retaining low-income participants in community-based diabetes interventions remains a persistent challenge, particularly in medically underserved areas. This study describes engagement strategies and lessons learned recruiting for a 12-month pilot of a community...

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Main Authors: Alexandria M. Boykins, Satya Surbhi, James E. Bailey
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diabetology
Subjects:
Online Access:https://www.mdpi.com/2673-4540/6/7/59
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author Alexandria M. Boykins
Satya Surbhi
James E. Bailey
author_facet Alexandria M. Boykins
Satya Surbhi
James E. Bailey
author_sort Alexandria M. Boykins
collection DOAJ
description Background/Objectives: Recruiting and retaining low-income participants in community-based diabetes interventions remains a persistent challenge, particularly in medically underserved areas. This study describes engagement strategies and lessons learned recruiting for a 12-month pilot of a community-based, medically tailored nutrition program for diabetes remission and weight loss. Methods: A descriptive, exploratory mixed-methods study was performed to assess the effectiveness of recruitment and engagement strategies in the HEAL Diabetes program and identify areas for improvement. Recruitment and enrollment data were tracked utilizing recruitment logs and field notes. Descriptive statistics were used to analyze recruitment activity and retention rates, while qualitative analysis of fieldnotes identified key barriers and facilitators. Results: Among 83 eligible participants, 63 (75.9%) completed the in-person screening and 35 (55.6% enrollment rate) enrolled. Retention was high, with 30 completing the study. Participants were largely African American (97.1%), female (70.6%), average age of 59.8 years, with a household income below USD 49,000 (74.3%). Recruitment cycles achieved 87.5% of the target before budget constraints halted enrollment. Recruitment was hindered by limited clinical integration, social barriers and life demands, while facilitators to recruiting included trust, flexibility, and tangible support for participation. Conclusions: Conventional recruitment methods, including registry-based approaches, were insufficient for engaging underserved populations. Participant-centric strategies, emphasizing trust, practical support, and structural and cultural relevance, can help enhance enrollment and retention. Effective engagement in community-based diabetes interventions requires multifaceted approaches that address clinical, social, and structural barriers to participation.
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spelling doaj-art-04c6ad8ca8ae4be6b7911cd1fe2b94c92025-08-20T03:58:26ZengMDPI AGDiabetology2673-45402025-07-01675910.3390/diabetology6070059Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) ProgramAlexandria M. Boykins0Satya Surbhi1James E. Bailey2Tennessee Population Health Consortium, University of Tennessee Health Science Center, Memphis, TN 38163, USATennessee Population Health Consortium, University of Tennessee Health Science Center, Memphis, TN 38163, USATennessee Population Health Consortium, University of Tennessee Health Science Center, Memphis, TN 38163, USABackground/Objectives: Recruiting and retaining low-income participants in community-based diabetes interventions remains a persistent challenge, particularly in medically underserved areas. This study describes engagement strategies and lessons learned recruiting for a 12-month pilot of a community-based, medically tailored nutrition program for diabetes remission and weight loss. Methods: A descriptive, exploratory mixed-methods study was performed to assess the effectiveness of recruitment and engagement strategies in the HEAL Diabetes program and identify areas for improvement. Recruitment and enrollment data were tracked utilizing recruitment logs and field notes. Descriptive statistics were used to analyze recruitment activity and retention rates, while qualitative analysis of fieldnotes identified key barriers and facilitators. Results: Among 83 eligible participants, 63 (75.9%) completed the in-person screening and 35 (55.6% enrollment rate) enrolled. Retention was high, with 30 completing the study. Participants were largely African American (97.1%), female (70.6%), average age of 59.8 years, with a household income below USD 49,000 (74.3%). Recruitment cycles achieved 87.5% of the target before budget constraints halted enrollment. Recruitment was hindered by limited clinical integration, social barriers and life demands, while facilitators to recruiting included trust, flexibility, and tangible support for participation. Conclusions: Conventional recruitment methods, including registry-based approaches, were insufficient for engaging underserved populations. Participant-centric strategies, emphasizing trust, practical support, and structural and cultural relevance, can help enhance enrollment and retention. Effective engagement in community-based diabetes interventions requires multifaceted approaches that address clinical, social, and structural barriers to participation.https://www.mdpi.com/2673-4540/6/7/59diabetesrecruitmentretentionminoritiescommunity-based interventionhealth equity
spellingShingle Alexandria M. Boykins
Satya Surbhi
James E. Bailey
Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program
Diabetology
diabetes
recruitment
retention
minorities
community-based intervention
health equity
title Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program
title_full Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program
title_fullStr Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program
title_full_unstemmed Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program
title_short Engaging People in Medically Underserved Areas in the Community-Based Healthy Eating and Active Living to Reverse Diabetes (HEAL Diabetes) Program
title_sort engaging people in medically underserved areas in the community based healthy eating and active living to reverse diabetes heal diabetes program
topic diabetes
recruitment
retention
minorities
community-based intervention
health equity
url https://www.mdpi.com/2673-4540/6/7/59
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