Introduction and Objective: The Diabetes Belt, spanning 644 counties across 15 southern states, faces disproportionately high rates of type 2 diabetes, compounded by limited health literacy and systemic inequities. This study investigates how health educators employ leadership and behavior change theories—transformational leadership, transactional leadership, the transtheoretical model, and diffusion of innovation—to design effective interventions. The objective is to explore strategies that enhance patient engagement, address literacy barriers, and improve self-management outcomes.Methods: A qualitative phenomenological approach analyzed data from semi-structured interviews with 12 diabetes health educators. The study examined how theoretical frameworks guided tailored, culturally relevant, and patient-centered interventions for underserved populations.Results: Key themes included personalized care, building trust, fostering self-efficacy, and clear expectations for diabetes management. Educators used visual aids, simplified information, and culturally relevant examples to enhance comprehension and engagement. Transformational leadership principles, such as individualized consideration, and adult learning strategies, like the teach-back method, were pivotal in building patient confidence and sustainable behavior change. Despite systemic challenges, tailored interventions improved glycemic control, medication adherence, and quality of life.Conclusion: This study underscores the role of health educators in addressing disparities through leadership-driven, patient-centered approaches. Findings highlight the importance of integrating leadership and behavior change theories to overcome literacy barriers and foster health equity. These insights offer practical recommendations for enhancing diabetes education and self-management in underserved communities.
M. Campos-Marquetti: None.
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