Using participatory action research to make diabetes education accessible for people with visual impairment

The three million people who have both visual impairment and diabetes (PVID) represent a large underserved population in the United States. Diabetes self-management education (DSME) is essential for effective management of diabetes. Numerous guidelines exist for making DSME fully accessible to PVID. No national diabetes organization produces basic DSME materials in accessible format, and few DSME programs are fully accessible to PVID.;This dissertation used a Participatory Action Research (PAR) approach to discover ways to increase the accessibility of the DSME materials and programs of the Diabetes Association of Greater Cleveland (DAGC) for PVID, adding access for PVID to an existing DSME program.;Five PVID (age range: 42--79; three African Americans, two European Americans; two men, three women) and four DAGC professional staff members (all European American women) met once a month as a Planning Group to plan, implement, and evaluate all phases of the project. The researcher served as a facilitator. Work accomplished in this project included: production of two sets of recorded DSME information, Diabetes: The Basics, and Living with Diabetes and Visual Impairment; production of guidelines to make DAGC's public DSME events more accessible to non-drivers and people who cannot see projected slides; presentation by the five visually impaired participants of an inservice for DAGC staff about their lives as PVID, and about common courtesies for effective communication with PVID.;The PAR process provided a setting for extended direct contact and cooperation between the four DAGC staff members and the five PVID. This contact enhanced both the products of this project and the process of discovering ways to meet the needs of PVID. All PVID and DAGC participants reported profound learning and transformation of their relationship with each other.;Major implications are: All DSME programs should ensure that their programs are fully accessible for PVID. Diabetes educators should extend empowerment beyond interactions between individuals to a community level, by using PAR processes to plan and implement DSME programs. Many of the recommendations for making DSME accessible also would make other forms of adult education accessible for visually impaired people.