With over 38 million adults in the United States having diabetes and another 98 million adults at risk for developing the disease, diabetes management is more urgent now than ever before.1 The chronic nature of diabetes underscores the importance of diabetes selfmanagement education and support (DSMES), which equips individuals with the skills and information that is necessary to improve their quality of life (QOL). However, disparities in health literacy, cultural understanding, and access to health care resources often prevent individuals from receiving the care they need.
Diabetes care and education specialists (DCESs) know that the most effective care is tailored to the unique needs of each person with diabetes. Yet the ability to understand and apply health information is profoundly influenced by health literacy, numeracy skills, life experiences, and social support networks—factors shaped by social determinants of health (SDOH), such as cultural background, socioeconomic status, and access to care.2,3 This article addresses the existing gaps and mitigators in culturally sensitive care and health literacy by focusing on how these elements influence diabetes management and outcomes in diverse populations.
As health literacy research and practice have advanced, we have gained new insights. We now recognize that the responsibility for health literacy does not just lie with individuals but also with the organizations and professionals who create and deliver health information and services. This understanding has led to the distinction between personal and organizational health literacy.4
Personal health literacy is “the degree to which individuals can find, understand, and use information and services to inform healthrelated decisions and actions for themselves and others.”5 Besides core literacy skills such as reading and writing, making well-informed health decisions requires information seeking, cultural understanding, communication, critical thinking, and problem-solving skills.6 Quantitative skill, or numeracy, is another element of health literacy. Evidence suggests it is independently associated with disease-related knowledge, health behaviors, outcomes, and self-efficacy in diabetes and other contexts.6,7
Organizational health literacy, which extends the responsibility of addressing health literacy to organizations, is defined as “the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”5
Over one-third of English-speaking adults in the United States demonstrated basic or below basic health literacy proficiency, and only 12% demonstrated proficient skills. Proficient skills are defined as understanding medical terms.8,9 This means approximately 90 million adults in the United States cannot understand medical terms, a necessary skill to help navigate the health care system and make well-informed health care decisions. Low personal health literacy may negatively affect health status, life expectancy, chronic disease self-management, and QOL. It is more common among older adults, nonnative English speakers, individuals with limited education or limited income, and members of racial and ethnic minority groups.10-12 Furthermore, low health literacy specifically impacts diabetes management and has been associated with limited diabetes self-management skills and confidence, ineffective glucose management, and increased incidences of retinopathy.13,14
Research regarding organizational health literacy is less extensive than personal health literacy. However, recent organizational health literacy assessments have demonstrated that the demands required from health care systems tend to exceed organizational capacity, indicating there is room for improvement in the organizations’ ability to address health literacy.15,16 Organizations are negatively impacted by the association between low health literacy and increased health care utilization and costs due to higher hospitalizations and emergency department visits.17
Inadequate personal and organizational health literacy has significant implications for diabetes self-management. Health literacy can affect the ability of people with diabetes (PWD) to manage diabetes in several ways:
how PWD interpret glucose readings
how PWD calculate carbohydrate intake or insulin doses
how PWD administer insulin
how PWD understand nutrition principles and make food choices
how PWD manage other medications
how PWD problem-solve unexpected situations in diabetes management
how PWD keep up with necessary health checks.
All these implications can directly affect glucose stability and, over time, lead to diabetesrelated complications.
Determinants of Health and Health LiteracySDOH encompass a wide range of factors that collectively shape an individual’s ability to acquire, understand, and apply health information. Addressing these determinants is essential for improving health literacy and reducing health disparities.18 According to a 2024 systematic review, there are linkages between SDOH and health literacy.18 Individuals from lower socioeconomic backgrounds often have reduced access to quality education and health information, which negatively impacts their health literacy and can lead to poorer health outcomes. Attaining higher education generally correlates with better health literacy, which equips individuals with the skills they need to comprehend and use health information effectively.18 Conversely, limited education may hinder some individuals with basic health tasks, such as understanding prescriptions. Cultural factors further influence health literacy because language barriers and differing norms can impede effective communication with health care professionals (HCPs). Access to health care resources is essential; populations with limited access often face disparities in health literacy that exacerbate health inequalities.18
Research indicates that even individuals with high health literacy may experience poor health outcomes if they experience unfavorable SDOH, such as poverty, lack of access to health care, or residence in resource-challenged areas.19 This underscores the importance of SDOH and highlights the urgency of addressing them.
Cultural sensitivity is as critical as health literacy and numeracy sensitivity. It is more than a finite knowledge of cultural values, beliefs, customs, languages, thoughts, and actions. To gain relevant cultural insights, it is necessary to develop cultural humility.20 This reflective process involves understanding one’s biases and privileges, managing power imbalances, and maintaining a stance that is open to others in relation to aspects of their cultural identity that are most important to them. Cultural humility can help develop a mutually respectful and positive relationship among individuals (with diabetes) and HCPs.
Recent estimates show that more than 38.4 million people living in the United States have diabetes (11.6% of the US population). Additionally, 97.6 million adults, or 38% of the US adult population, have prediabetes.21 This public health epidemic has occurred in tandem with a shift in the American demographic landscape toward a high minority population.22 According to census data population projections, by 2045, White people will comprise 49.7% of the population, Hispanic people 24.6%, Black people 13.1%, Asian people 7.9%, and multiracial populations 3.8%.22 In comparison, the Centers for Disease Control and Prevention reports that the percentage of US adults with diabetes is 15.1% American Indian, 8% Asian, 12.1% Hispanic, 12.7% Black, and 7.4% White, non-Hispanic.21 Minority groups are affected by diabetes at significantly higher rates compared to non-Hispanic White adults for multidimensional reasons.
Careful attention to cultural influences on self-efficacy and motivation is critical for fostering behavior changes among minority groups affected most by diabetes. These behavior changes facilitate improved clinical outcomes, health status, and QOL.2 In 2015, 22% of the deaths attributed to diabetes were in the Hispanic population. By 2030, the percentage is expected to increase to 25%.23 This underscores the need for cultural preparedness in the DCES of today and tomorrow in the areas of ethnicity, racial, and cultural sensitivity.
In type 2 diabetes (T2D), observational studies suggest that individuals with low health literacy have less knowledge of diabetes and limited glucose management skills than individuals with higher health literacy.24-27 Moreover, adults with T2D and low health literacy are more likely to have a family or friend supporter also with low health literacy.28
Additionally, a systematic review by Al Sayah et al29 found consistent evidence of a positive association between health literacy and diabetes knowledge. Similarly, lower numeracy is associated with lower perceived self-efficacy and modestly higher A1C.24,30 The impact of low health literacy can be seen in individuals under the supervision or care of another individual with low literacy, such as children with type 1 diabetes (T1D). A study looking at 200 caregivers of children with T1D found that having a low healthliterate caregiver as assessed by the Newest Vital Sign (a valid and reliable screening tool available in English and Spanish that identifies people at risk for low health literacy) resulted in significantly higher A1C.31
A systematic review of 15 randomized controlled trials suggests that health literacy-driven interventions have a positive impact on glucose levels and self-management outcomes in individuals with T2D.32 In another randomized controlled trial, participants in an intensive diabetes disease management program that included literacy-sensitive elements had better glycemic outcomes than those who received usual care.24,30 In another trial, adding literacyand numeracy-appropriate components to a diabetes education program resulted in greater improvement in A1C after 3 months compared with training that did not include those components. The difference between groups was no longer statistically significant after 6 months, which suggests that a longer literacy intervention period or ongoing support may be necessary to maintain its benefits.33,34 Trials of literacy and culture-sensitive interventions in ethnic minority groups such as Latinos have also demonstrated benefits.23 A study by Schillinger et al35 looking at 408 people with T2D found that individuals with low health literacy were 2 times more likely to have limited glucose improvement, with an A1C of 9.5% or greater. Additionally, these individuals were 2 times more likely to have retinopathy and almost 3 times more likely to have cerebrovascular disease. Although not statistically significant, there was also a positive association between having low health literacy and a higher risk of nephropathy, lower extremity amputation, and cerebrovascular disease.
From a cultural perspective, ethnic minority groups have lower insulin usage rates than White individuals.36,37 Beliefs and myths ranging from insulin implying failure or leading to more complications to lack of family support or religious obligations can all interfere with insulin usage rates.
Assessing health literacy can be challenging because a person with low health literacy learns ways to adapt or compensate. It is incumbent on DCESs to assess a person’s diabetes functional health literacy and numeracy skills because these are essential skills to understand health information and implement successful diabetes self-management.
It has been shown that health literacy is a critical component of self-management and clinical outcomes.38 Health literacy skills include functional, interactive, critical thinking, and numeracy.39 A person with diabetes encounters many health-related daily activities requiring these skills, including understanding blood glucose levels, medication administration, and food choices.
Both informal and formal methods can be used to assess an individual’s functional literacy and numeracy skills. An informal assessment may identify signs that a person has difficulty with reading and math. When asked to read or fill out forms, common responses from individuals with low literacy skills may include “I forgot my eyeglasses” or a request that an HCP review the material.
The expansion of e-health alternatives has broadened the information provided to and sought by PWD.39 Health literacy extends beyond the basic skills of reading, writing, and numeracy to social and communication skills that enable the application of health information and empower the person to participate in their care.40,41
Many rapid screening tests are available to formally assess health literacy. When selecting the tool to assess health literacy, the specialist needs to consider not only the properties of the test but also if it is disease-specific (diabetes) and how it will be administered (self-administered or interview). The specialist must also consider if it is appropriate for the person being assessed.38 Research indicates that it is more beneficial when assessing health literacy to use a context, diseasespecific tool, particularly in the case of diabetes.42 Examples of diabetes health literacy tools include the Rapid Estimate of Adult Literacy in Medicine short form43 and Brief Health Literacy and Brief Print Literacy Screen,39,44 all of which can be administered in 5 minutes or less.
Although research indicates these tools are effective for assessing health literacy, they have limitations. One key limitation is that these tools may inadvertently stigmatize individuals, particularly those who may already feel uncomfortable or embarrassed about their literacy levels.42,45 The potential for such stigmatization can create barriers, leading some individuals to withdraw or become resistant to participating in self-care education. To address this limitation, it is essential to approach using these tools with sensitivity and a person-centered mindset.45 Ensuring confidentiality, using nonjudgmental language, and integrating literacy assessments into routine care can help alleviate discomfort. Specialists should be transparent about the purpose of these assessments, framing them as an opportunity for empowerment rather than a test or judgment. Offering tools that are culturally and linguistically appropriate for the individual can also increase comfort and engagement during the assessment process.
Diabetes numeracy is defined as a person’s ability to understand and apply numbers in the context of acts of daily living and disease management. Understanding numeracy is a common challenge for PWD. It can go unidentified if it is not a part of the usual assessment. In diabetes management, numeracy is associated with a variety of daily self-care actions, including interpreting glucose monitoring results (self-monitoring and continuous glucose monitoring), medication administration, and dietary adjustments (carbohydrate and label reading. There can be difficulty with accurately calculating the carbohydrate content of a packaged snack, identifying glucose levels within range, and calculating an insulin dose based on blood glucose and carbohydrate content.46
The Diabetes Numeracy Test (DNT) is designed to assess diabetes-related numeracy skills, helping measure a person’s ability to manage daily diabetes care tasks such as calculating insulin doses and interpreting blood glucose readings. The DNT is available in a short format (5 items) and a long format (15 items), with higher scores reflecting stronger numeracy skills. In comparison, those who received care at a diabetes center and/or from a DCES were more effective at using numeracy skills in making medication adjustments according to their glucose readings than those under the care of a primary care professional.46
Despite its value in assessing these essential skills, relying on numbers and calculations can cause anxiety or frustration, particularly for individuals with low numeracy abilities. This could lead to feelings of inadequacy that may affect their confidence in managing their diabetes.47 To mitigate these concerns, DCESs must offer reassurance and emphasize that numeracy challenges are common and can be addressed through education and support.46 For individuals who struggle, personalized educational interventions can help improve both their numeracy skills and their overall diabetes management outcomes.
Improving health literacy and numeracy is associated with improved self-care and self-efficacy, empowering improved clinical outcomes.24,29 However, improving self-efficacy is directly related to improved metabolic outcomes, including A1C.41 Attempts to address health literacy may be more effective as part of a collaborative, person-centered, evidence-based treatment approach—components of which may include shared goal setting, empowerment, focusing on problem-solving, and improving self-efficacy.41,47 Compared with a more traditional didactic model of diabetes education, these approaches emphasize interactive communication between individuals with diabetes and DCESs to develop a plan of care. Accordingly, they may be especially appropriate and effective in low health literacy populations because they encourage and empower people toward improved understanding of their disease and more active participation in their self-care.
Clear communication is essential in diabetes care and research, especially when managing complex conditions. Plain language is an established approach that reduces the complexity of medical information,3,48 helping to bridge the understanding gap between DCESs and PWD. Studies show that low health literacy is linked to lower participation in medication-taking,49 higher risks of rehospitalization,50 and poorer patient outcomes.51
In 2015, a task force was formed to discuss effective messages about diabetes and people with diabetes.52 The task force published recommendations highlighting 5 key principles for person-centered communication:
1. Neutral and factual language: Use language that is factual, focusing on actions, physiology, or biology without judgment.
2. Stigma-free language: Avoid language that carries stigma and ensure communication is respectful and supportive.
3. Strengths-based language: Emphasize the strengths and capabilities of individuals rather than their limitations. This approach promotes respect and hope.
4. Collaborative language: Foster collaboration between individuals and health care professionals through open and supportive dialogue.
5. Person-centered language: Use person-first language that prioritizes the individual over the disease, reinforcing their identity beyond diabetes.
It is important to recognize that certain words or phrases can convey bias—whether intentional or not. By consciously employing person-centered and strengths-based messages, diabetes care and education specialists can enhance communication and, ultimately, help people with diabetes achieve better health outcomes.
Using plain language simplifies communication, making educational materials easier to understand, which leads to more effective diabetes management and improved health outcomes.3 This is especially important given that 79% of US adults experience low health literacy.51,53 By using specific, clear, and accurate language, HCPs can enhance an individual’s comprehension of the science and medicine behind diabetes care, fostering better selfmanagement and overall health.53 Key factors in assessing the effectiveness of plain language include clarity, design, and readability.
The following tips are recommended strategies for clear oral and written communication:
Present the most important points first.
Keep sentences short.
Use headings and bullets to break up text and make the information less imposing.
Incorporate images to clarify meaning for individuals with limited reading skills.
DCESs should strive to communicate in a culturally appropriate manner, respecting the racial, ethnic, and generational differences that may affect how health information is interpreted.54 This includes engaging the services of an interpreter for those not fluent in English.
Studies show that people with diabetes often retain only about half of the information shared during clinical encounters. However, retention and comprehension significantly improve with the teach-back method, where individuals are asked to restate in their own words the information provided.55,56 This evidence-based health literacy intervention promotes individual engagement in diabetes management, safety, and overall care quality.55
By asking individuals to explain what they have been told, HCPs can assess understanding and correct any misunderstandings immediately, making this especially valuable when working with low-literacy groups.47 Although effective, integrating the teach-back method into busy clinical settings presents challenges, including time constraints, lack of training, and potential discomfort for patients and staff.
To overcome these barriers, clinics can implement the following strategies:
Integrate teach-back into routine practice: Make it a natural part of every patient interaction to streamline its use.
Provide focused training: Equip staff with efficient techniques for using the teach-back method and create a supportive environment to ease discomfort.
Use written and visual aids: Reinforce verbal communication with well-designed materials to support individual learning.
Addressing these challenges can make the teach-back method a more practical and effective tool in improving an individual’s understanding and participation in care plans.
When health-related communication is both accessible and culturally sensitive, individuals are better equipped to manage their diabetes, leading to improved outcomes.54 The growth of diverse populations has become a central focus in health care, prompting the expansion of the Campinha- Bacote model of care for cultural competence to include cultural sensitivity, competence, and humility.48,57 These 3 components are essential for creating tailored education and treatment plans that address individual needs. It is crucial to understand the differences between these terms because they are often used interchangeably but have distinct meanings (Table 1). By integrating all 3 attributes, HCPs can more effectively support diverse populations.
Competence refers to knowledge, humility is interpersonal behavior and openness to another person’s culture, and sensitivity refers to the dissemination of information based on factors unique to the specific person. Based on the QIAN curriculum, cultural humility emphasizes the importance of self-questioning, cultural immersion, active listening, and negotiation skills.62 The increased diversity in health care has led to a need to clarify the meaning of cultural humility and its importance in providing inclusive and optimal care.57
In addition, culture, individual beliefs, knowledge, customs, and habits influence not only a person’s behavior but also how they communicate. A person’s culture is interconnected with how they communicate and interpret health information. It is important to adapt skills that can improve cross-cultural communication, which is defined as communication between those who have differing traits, such as age, nationality, race, gender, and sexual orientation.63 It encompasses cultural variance in language, gestures, and body language. It is understanding how different cultures communicate and goes beyond speaking the language and knowing the meaning of the words; it is expanded to include situational contexts.64 The following 5 cultural attributes can influence communication:
language
cultural norms and values
stereotypes (unconscious biases)
cultural beliefs
cultural body language, eye contact, and gestures.
Some ways to overcome these barriers are to attempt to use similar language and gestures, learn about the culture and their norms, and ask questions such as, “What do you know?”; “How do you feel about___?”; or “What do you call the problem?” Considering cultural characteristics, including a person’s beliefs, rituals, customs, values, and family structure, is important for developing and providing culturally specific and sensitive health care.64 The ability to communicate cross-culturally is essential to providing education to diverse populations because it enables using proper verbal and nonverbal communication styles across cultures. The American Diabetes Association defines person-centered care as “care that considers an individual’s comorbidities and prognoses; is respectful of and responsive to individual preferences, needs, and values and ensures the individual’s values guide all clinical decisions.”65
The Association of Diabetes Care & Education Specialists (ADCES) has several resources to guide DCESs and other health professionals in navigating these topics so they are better equipped to provide culturally sensitive care. These resources include ongoing webinars; ADCES publications, including The Art and Science of Diabetes Care and Education; and an annual conference that regularly features diverse presentations on providing culturally sensitive care. DCESs may face challenges and barriers when attempting to provide culturally sensitive care. One major barrier could be language when communicating. For example, when attempting to provide education or have a conversation in an individual’s preferred language and being limited by the availability of a certified interpreter in that language (eg, even if using a translation service, there may not always be interpreters available in that specific language or dialect), DCESs may be limited in their ability to provide culturally sensitive care.
Despite challenges or barriers that may hinder providing culturally sensitive care, the importance of continuous professional development in cultural competence for HCPs cannot be overemphasized. Providing cultural competence training for HCPs can potentially help decrease some of the inequities found in health care.66
The availability of diabetes technology (eg, portals, smartphones, and mobile apps) offers growing opportunities to expand the reach of and followup health care for people with diabetes and related chronic conditions.65-67 This necessitates the need to evaluate SDOH and design various modes of technology for health literacy sensitivity. Literacy in health information technology is termed “eHealth literacy.”
eHealth is defined as the ability of people to use emerging information and communications technologies to improve or enable health and health care.68,69 Digital health literacy, or the ability to seek health information using digital technology, must be considered an important concept related to eHealth. In a study by Neter et al,68 individuals who categorized themselves as chronically ill had significantly lower eHealth literacy scores. Other SDOH studies have shown an association between lower digital health literacy with older age, lower income, education, and employment status.70 Not surprisingly, individuals with higher eHealth literacy reported having an increased understanding of their health status, symptoms, self-management principles, and self-care behaviors. Mackert et al71 surveyed 4974 adults, with an average age of 43.5 years, to determine the relationship between health literacy (assessed using the Newest Vital Sign) and the use of health information technology. The study concluded participants with low health literacy were less likely to use these tools, and those with greater health literacy had increased perceptions of ease of use and the usefulness of the tools. Study results indicated that health literacy is often not considered when designing technological resources and should be a focus to increase the benefit for all users.71 One study by Garner et al72 focused on the effectiveness of a culturally responsive mobile health (mHealth) educational application designed to improve diabetes health literacy. Results indicated that culturally responsive content improved T2D mHealth literacy.
Although eHealth literacy offers significant opportunities, there are considerable barriers that vary across demographic groups, including socioeconomic factors, age, education level, and cultural and linguistic challenges.72 Individuals from lower income backgrounds often lack access to technology, older adults struggle with digital interfaces,73 and those with lower educational attainment may find it difficult to seek and interpret online health information. Additionally, many digital health resources are not culturally tailored, which can alienate certain populations and create language barriers.
To address these challenges, strategies include developing culturally responsive eHealth resources, training HCPs in clear communication, enhancing accessibility features for users with disabilities, and engaging community members in resource development.74 Continuous evaluation and feedback are essential for improving the effectiveness of eHealth literacy initiatives.
Addressing these barriers is crucial for enhancing health outcomes in chronic disease management, particularly diabetes. A personcentered, culturally sensitive approach is vital, including considerations for individuals with comorbidities and ensuring materials are accessible to those with low vision or hearing difficulties.75 By using plain language and consistent messaging, we can empower individuals to take control of their health through the effective use of technology.75
Many PWD encounter significant challenges related to low health literacy, which limits their ability to understand and apply the essential self-care behaviors necessary for maintaining target glucose levels and improving overall health. DCESs must address these limitations while adopting cultural humility by using clear and empowering communication strategies that enhance the understanding of health information and ultimately improve health outcomes. Effective approaches include using plain language, the teach-back method, and collaborative, evidencebased treatment strategies that actively engage individuals in their care. The recommended tools for implementing these strategies are listed under “Practical Resources.”
Call to ActionDCESs must prioritize health literacy and cultural sensitivity in diabetes management by actively integrating these communication strategies into daily practice. Developing ongoing training and resources to support this initiative is imperative to ensure health care teams are equipped to deliver clear, person-centered care. By doing so, DCESs can empower people with diabetes to better navigate their health journeys and achieve optimal disease management.
Future Research DirectionsThere is a pressing need for further studies to evaluate the long-term impact of these communication strategies on health outcomes. Additionally, research should explore innovative tools and methods to enhance health literacy among diverse patient populations. Advancing these efforts can contribute to a health care landscape that promotes understanding and supports sustained self-management and improved QOL for people with diabetes.
Association of Diabetes Care & Education Specialists (ADCES): ADCES offers online courses and webinars that help health care professionals enhance their cultural competency. ADCES publishes professional diabetes publications, including The Art and Science of Diabetes Care and Education, ADCES Diabetes Care and Education Curriculum, Review Guide for the Certified Diabetes Care and Education Specialist Exam, and Quick Guide to Medications. Each year, the ADCES Annual Conference welcomes health professionals from around the world to share ideas and participate in multiple sessions dedicated to this important topic. Visit: adces.org/practice/tools---resources.
Vanderbilt University Center for Diabetes Translation Research: Resources include the Diabetes Literacy and Numeracy Education Toolkit (DLNET), a comprehensive diabetes education guide designed for use with low health literacy. The DLNET includes 24 distinct modules covering different facets of diabetes self-management education, any of which can be used independently to support the learning needs of individuals. Visit: labnodes.vanderbilt.edu/resource/view/id/10654/communityid/1136.
Agency for Healthcare Research and Quality (AHRQ): Provides a systematic review examining the effects of literacy on health outcomes. It includes examples of interventions that have been tried to improve those outcomes. AHRQ also publishes the Health Literacy Universal Precautions Toolkit. Visit: www.ahrq.gov/health-literacy/improve/precautions/index.html.
Centers for Medicare and Medicaid Services—Training & Education: Find toolkits, training materials, and guidelines/tutorials on how to create written documents suitable for low-literacy audiences. Visit: cms.gov/training-education/learn/find-tools-to-help-you-help-others.
National Network of Libraries of Medicine: A listing of resources about the prevalence of health literacy-related problems and their impact on health and economic outcomes. Includes links to a variety of resources for addressing health literacy-related problems. Visit: nnlm.gov/initiatives/topics/health-literacy.
ADCES’s Speaking the Language of Diabetes: Language guidance for diabetes-related conversations, research, education, and publications. Visit: www.adces.org/docs/default-source/handouts/culturalcompetency/handout_hcp_cc_diabeteslanguage.pdf?sfvrsn=4a3a6359_25.
Diabetes self-management education and support (DSMES) toolkit: Comprehensive resources DCESs can use to enhance their delivery of DSMES. The toolkit offers multiple resources, visuals, and reminders for delivering DSMES to populations and individuals with different levels of health literacy and English-language proficiency. Visit: cdc.gov/diabetes-toolkit/php/patient-referral-process/index.html.
DSMES Promotion Playbook: Provides a cohesive and recognizable way of addressing DSMES. The DSMES Promotion Playbook consists of plain language descriptions of resources; a library of 150 images; templates for flyers, postcards, posters, and digital advertisements; and ideas for recruitment support and outreach. Visit: cdc.gov/diabetes-toolkit/php/marketing-resources/promotion-playbook-overview.html.
National Diabetes Prevention Program (DPP): Provides an overview of the National DPP lifestyle change program for individuals at risk of type 2 diabetes. Visit: cdc.gov/diabetes-prevention/index.html.
Path 2 Prevention: An interactive resource for individuals at risk for type 2 diabetes. Interactive activities include videos, games, and personalized information to reduce the risks of type 2 diabetes. Visit: diabetespath2prevention.cdc.gov/.
Diabetes Kickstart video series: Short, animated videos focusing on the ADCES7 Self-Care Behaviors for optimal diabetes management. Visit: cdc.gov/diabetes/diabetes-tv/diabetes-kickstart.html.
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