1091-P: Barrier to Clinic Attendance among Rural Appalachian Adults with Diabetes

Background: Despite disproportionate rates of diabetes among Appalachian residents, barriers to attending clinical appointments have not been fully explored. We examined the association between barriers to clinic attendance, A1c, and self-care. Methods: We report baseline cross-sectional data from an ongoing study of participants in six counties in rural Appalachia Kentucky. Barriers to clinic attendance were measured using a 25-item checklist adapted from the Chronic Care Model and self-care was measured using a summary score from Toobert’s Diabetes Self-Care Activities. Linear regression models were fit with varying levels of adjustment. Results: Most study participants (N=356) where White (n=349), women (n=230), and had health insurance (n=349). Average A1c was 7.7% (SD=1.7%). No barriers were reported by 37.4% of participants. In fully adjusted models, not being worried about diabetes was significantly associated with diabetes self-care. Inaccessible transportation and co-payment, and the belief that God (but not them) will help their diabetes were significantly associated with A1c (Table 1). Conclusions: Both logistical and cognitive barriers obstruct clinic attendance in this sample. Additional aspects or barriers to clinical attendance could be cognitive or emotional, such as social support and cultural norms. Future research should develop interventions for these logistical and cognitive barriers. Disclosure B. L. Smalls: None. M. Lacy: None. L. Hieronymus: None. P. Westgate: None. M. Azam: None. S. C. Westneat: None. N. Schoenberg: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK112136)