Table 2 List of unranked and unsorted statements from the brainstorming exercise
1 | Food that is provided in shelters and community meals is not diabetic friendly |
2 | Unhealthy “comfort food” is a source of joy in an otherwise difficult day |
3 | Diabetic appropriate foods are unaffordable |
4 | Portion control and making healthy choices is hard when you don’t know where the next meal is coming from |
5 | Not having a kitchen where one can prepare healthy food |
6 | Getting out of the weather or accessing Wi-Fi requires purchase of fast food |
7 | Food available at food banks is not diabetic appropriate |
8 | Meals or food is only provided at set times in shelter |
9 | It is difficult to navigate the network of diabetes care providers (to get eye exams, blood work, urine tests, foot exams/care, etc.) |
10 | Past experiences with discrimination, racism, and/or prejudice in health care settings makes engaging in care undesirable |
11 | Not having trusting relationships with healthcare providers |
12 | It is difficult to keep track of days for attending appointments |
13 | Not having a way for doctors’ offices and diabetes care providers to get in touch (i.e. phone, consistent address, etc.) |
14 | Not having an affordable and convenient way to get to appointments |
15 | It is difficult to access health services due to lack of health insurance card or ID |
16 | Community and government social support programs are hard to navigate |
17 | Social assistance levels are insufficient |
18 | Not having enough knowledge about diabetes and its treatment |
19 | Mainstream diabetes education programs are not relevant to life circumstances |
20 | Mainstream diabetes education programs are not offered at a convenient place or time |
21 | Not having diabetes appropriate footwear |
22 | The danger of exposure to fingers and toes when sleeping outside |
23 | Not having reliable access to a bath or shower for foot care |
24 | Not having a secure place to store medications (where they won’t get stolen) |
25 | Not being able to afford medications |
26 | Having staff administer medications to patient |
27 | Keeping track of time of day for taking medications |
28 | Managing the interaction between recreational substances (alcohol/drugs) and diabetes treatment is difficult |
29 | The fear of having a low blood sugar in shelter or alone |
30 | There are too many other health concerns to deal with |
31 | There are too many non-health-related concerns to deal with (i.e. housing, relationships, money, etc.) |
32 | Mental health challenges make it hard to focus on giving diabetes the attention it requires |
33 | Addictions make it hard to focus on giving diabetes the attention it requires |
34 | Not being able to afford organized physical activities |
35 | Local weather makes it difficult to be active outdoors year-round |
36 | Testing supplies/pen tips are unaffordable |
37 | Not having a place to store diabetes supplies |
38 | Lack of privacy on the street or in shelter |
39 | Stigma, intimidation, or violence from peer community in shelter or transitional housing |
40 | Lack of family or other close personal connections, or negative influence/impact |
41 | Shelter staff and case managers don’t understand diabetes |
42 | High stress levels due to housing situation/frequent moves |
43 | Housing struggles lead to hopelessness and lack of concern about diabetes |