Transforming Diabetes Management in Rural America: A Qualitative Exploration of a Diabetes Coaching Program Delivered via Telehealth

Diabetes disproportionately affects rural populations in the United States where prevalence and associated complications remain among the highest in the nation. Access to diabetes education and support services is often limited by geography, socioeconomic barriers, and workforce shortages. This study qualitatively explored participant experiences in a telehealth-based Diabetes Self-Management Education and Support (DSMES) program. This study uses interview techniques and takes a phenomenological approach to exploring the lived experiences of 27 program participants. Transcripts were analyzed through three cycles of coding to identify shared themes. Four themes emerged: (1) structural benefits of the program, (2) knowledge gained, (3) lifestyle changes implemented, and (4) improved quality of life. Participants consistently emphasized the value of personalized coaching, emotional encouragement, and practical nutrition education. Findings suggest that individualized telehealth coaching plays an important role in diabetes self-management, particularly in rural and underserved populations. By combining personalization with education and encouragement, programs can improve patient engagement, enhance self-efficacy, and support meaningful behavior change.