Enhancing Hispanic Health Equity: Perceptions, Experience, and Impact of ECU’s FreshStart Program with Rural, Hispanic/Latinx Participants with Type 2 Diabetes

Abstract

Abstract Hispanic populations in rural North Carolina face disproportionately high rates of type 2 diabetes, resulting from by systemic barriers such a limited access to healthcare, language challenges, and socioeconomic disparities. To combat this, East Carolina University developed the program FreshStart, an innovative, bilingual, community-based diabetes self-management education and support intervention tailored for underinsured Hispanic adults. This program evaluation is aimed to assess the perceptions, experiences, and impact of FreshStart among Spanish-speaking participants, which account for one-third of all members. The intervention integrated group classes, culturally relevant “food is medicine,” produce prescriptions, and personalized telephone-based health coaching. Quantitative outcomes included attendance, pre/post hemoglobin A1C changes, and survey data, while qualitative insights were gathered via semi-structured interviews. Findings indicated high levels of program satisfaction, improved dietary behaviors, and increased motivation for self-management. Participants cited the program’s cultural relevance, hands-on learning approach, and practical support (e.g., fresh produce, bilingual coaches) as key to its success. This study underscores the importance of culturally tailored, holistic interventions in advancing health equity for Hispanic individuals living with diabetes in underserved rural communities.