Date of Conferral



Doctor of Nursing Practice (DNP)




Janice Long


The Appalachian region of the United States has a high prevalence of diabetes, placing residents with diabetes at risk for physical, psychological, social, and financial burdens. To compound the issue, primary care providers often do not adhere to the guidelines established by the American Diabetes Association (ADA) regarding the recommended frequency of testing hemoglobin A1C in patients with diabetes. Lewin's planned change theory guided the project. The purpose of this project was to measure the knowledge of the primary care providers before and after an educational intervention covering the ADA guidelines for A1C monitoring and testing and to assess compliance with the guideline. The 12 volunteer participants were medical doctors, physician assistants and family nurse practitioners who served as primary care providers for a rural health clinic. Results of the educational presentation and the pre- and posttests indicated that providers improved in their knowledge of the ADA guidelines for prevention and management of diabetes. Providers identified 9 reasons that patients were not compliant with follow-up for A1C monitoring, including lack of provider knowledge of the guidelines, distance to travel to the clinic, delayed lab results, forgetting to keep appointments, bad weather, no transportation, lost orders for labs, fear that the A1C will be elevated, and fear of having more medications added to their treatment plan. This project has the potential to promote positive social change by raising awareness among providers of the need for regular monitoring of hemoglobin A1C and following the ADA guidelines for the treatment and management of diabetes. In so doing, the project may reduce the complications of diabetes for patients in the community.

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