Date of Conferral





Health Services


Magdeline Aagard


Type 2 diabetes impacts the lives of adults in the low-income, middle-income, and high-income brackets in the United States and globally. More research was needed on how adults 45 years and older in Marion County managed their diabetes and the care they received based on their income. This case study involved investigating how adults 45 years and older in Marion County self-managed their diabetes and the quality of care they received based on their income. The health belief model supported the conceptual framework for the study. Data were collected through face-to-face and telephone interviews with 15 purposefully selected participants. Data were analyzed using the open-coding technique to reveal categories and themes. Results of the study indicated that adults in Marion County engaged in diabetes self-care practices but lacked the collective knowledge of the importance of self-care measures. Results also revealed that individuals had access to quality care including medication therapy, diet, exercise, and blood glucose monitoring. However, results indicated that within the 3 income groups (low, middle, and high), low-income individuals saw a doctor less frequently due to cost and out-of-pocket expense. Also, social support played an important role in access to health care and self-care management. The study results could provide educators and health care providers with insight on how people in Marion County are self-managing their diabetes and empower them to implement more programs to provide the needed education to these adults with Type 2 diabetes mellitus. The positive social change because of this study includes bringing more awareness about the importance of diabetes self-care management to individuals, families, and communities.