In rural Georgia, traditional food practices, geographic isolation, and limited access to affordable, healthy options make standard dietary guidance difficult to follow for patients with diabetes. For many, primary care clinics, particularly health departments and Federally Qualified Health Centers (FQHCs), are the sole touchpoint for managing chronic illness. These visits represent a critical yet underutilized opportunity to provide tailored nutrition education that could prevent avoidable complications and reduce emergency department visits.

• Rural diabetes patients and families with limited transportation, low income, and reliance on under-resourced clinics (e.g., FQHCs, health departments) with limited access to specialists and support services
• Underserved racial, ethnic, and linguistic groups, especially Hispanic, African American, and migrant agricultural communities

In rural Georgia, diabetes education typically begins during a primary care visit at a local clinic, such as a health department or Federally Qualified Health Center (FQHC). Providers often introduce the core elements of diabetes management, including blood sugar monitoring, diet, physical activity, and medications, through brief conversations, sometimes supported by printed handouts.

Clinic-based efforts are often constrained by limited time, staffing, and cultural alignment. Educational materials are frequently generic, English-only, and disconnected from patients’ food traditions, financial limitations, or literacy levels. Providers may not have training in culturally responsive counseling and rarely have the capacity for follow-up, limiting the impact of these brief encounters. While some clinics offer referrals to certified diabetes educators or nutritionists, these services frequently involve travel and long wait times, making them inaccessible for many patients.

NEEDS STATEMENT:

Equip local clinics with tools and training to deliver culturally relevant, accessible diabetes nutrition education during routine visits.

REQUIREMENTS:

• Provider training should be accessible across clinical roles and focus on practical, low-burden tools that support patient engagement and integrate seamlessly into routine care.
• Recommendations include:
• Conversation prompts to guide open-ended questions that explore patients’ current eating habits and household food practices.
• Culturally relevant examples of food traditions aligned with the clinic’s patient population to build rapport and tailor guidance.
• Cues for motivational interviewing, helping providers assess readiness for change and collaborate with patients on identifying small, achievable dietary modifications.
• These resources should be available both before the patient visit for preparation and during the encounter as quick-reference tools, without interrupting the natural flow of conversation.
• Integrate culturally responsive nutrition education into clinic workflows to reinforce key messages at diagnosis and subsequent follow-up visits. Strategies may include:
• Embedding brief, multilingual modules into clinical encounters to support real-time learning across literacy levels.
• Offering quick-access guidance on affordable, balanced meal planning using foods available at local grocery and dollar stores.
• Promote healthier adaptations of cultural foods (e.g., baked chicken instead of fried chicken).
• Providing handouts and digital resources in multiple languages, designed for a range of literacy and learning styles.