Investigating Perceived Access to Community Resources in Patients with Diabetes

A new study found discrepancies between patients’ perceptions of accessible resources in their community to help manage their diabetes and the actual resources within Boston areas with high prevalence of diabetes.

The research, published in the CDC’s Preventing Chronic Disease, provides rich insight into patient perceptions, opportunities for diabetes education, and community assets that can be leveraged to improve population health.

The authors, led by BUSM medical students Jana Florian and Nicole St. Omer Roy, used “photovoice,” a group analysis technique in which individuals are encouraged to express their perspective by photographing scenes that highlight particular themes. They identified 11 individuals with poorly controlled diabetes living in diabetes “hot spots” within Boston and asked them to photograph their neighborhoods while considering the management of their diabetes.

The participants reflected on these photographs and the research team compared community-level themes that emerged to the available local resources such as community centers, places of worship, exercise facilities, and food stores including grocery stores, farmers’ markets, and food pantries. By using this novel approach of combining photovoice and asset mapping, Florian and colleagues showed a disconnect between participants’ perceptions of the availability of local resources and the objective reality of that environment.

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Photo credit:

Several participants, for example, described difficulty with access to healthy food although most convenience stores identified using asset mapping tools carried fresh fruit and vegetables. The authors recognized that many factors including cost, food quality, and daily travel patterns affect one’s perceptions of availability.

Florian and colleagues hope that this integration of photovoice and community asset mapping may help patients gain insight into their disease, learn about community resources, and motivate them to make positive lifestyle changes.

This project was supported by a pilot grant from the Department of Medicine at Boston Medical Center and the Boston University School of Medicine Medical Student Summer Research Program.

Submitted by Jonathan Dashkoff, MD, PhD.