Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Applied Health Research and Evaluation

Committee Chair/Advisor

Windsor Westbrook Sherrill

Committee Member

Karen Kemper

Committee Member

Lior Rennert

Committee Member

John Emerson


Diabetes has reached epidemic proportions in the United States. To address this, many organizations employ diabetes self-management education and support (DSMES) programs to aid in managing the impact of increasing prevalence. The purpose of this dissertation is to examine the impact of two Upstate South Carolina DSMES programs on several process and outcome measures for adults with diabetes, while also identifying current primary care provider DSMES knowledge and perceptions in an Upstate South Carolina health system.

This dissertation found inconclusive results on the impact of DSMES on PCP utilization, retinal exam screening, nephropathy attention, HDL, LDL, TC, and TG. DSME was found to reduce A1C and BMI over time. Additionally, providers were found to be lacking knowledge of the appropriate times to refer individuals to DSMES. Providers sought bilateral, closed-loop communication from DSMES teams.

In general, further studies should determine if these results hold with a larger sample size. Additionally, primary care providers should be further educated on how, when, and whom to refer to the service. While national DSMES programs should aim to further incorporate primary care providers in the program.



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