Listening Sessions Guide for Providers Who Support Peopl

OMB No. 0920-1154 Expiration date: 03/31/2026

Attachment D: Listening Sessions Guide

Diabetes Education and Support Service Providers Who Support People with Mental Health Disorders

Welcome (5 minutes)

Welcome and thank you for participating in today’s discussion. My name is ________________ and I work for FHI 360, a non-profit organization. Our discussion today is to inform the Centers for Disease Control and Prevention’s (CDC) diabetes education efforts. Everyone participating on this call today is a professional who works with people with mental health disorders who have diabetes. Mental health disorders we are referring to include, but are not limited to, major depressive disorder, bipolar disorder, schizophrenia, PTSD, anxiety disorders, borderline personality disorder, those that are related to autism.

The goals of today’s discussion are to better understand the diabetes self-management-related needs of people with mental health disorders who have diabetes, best practices to support diabetes self-management, the social determinants of health that impact their ability to manage their diabetes, and program capacity issues. The feedback we receive from you and others will assist in the development of resources for providers to implement DSMES services. This listening session is being sponsored by the CDC. We will have about 60 minutes for our discussion.

Before we begin, I would like to remind you that your participation in this discussion is voluntary, and you can choose to leave the conversation at any time for any reason. We are recording our discussion so I can write an accurate report. The recording will be destroyed no later than April 2028. I will not use any information that could identify you, like your name or other facts that point to you (such as your email address and phone number), in the report or any materials resulting from these discussion groups. The identifiable information recorded to schedule the listening session will not be provided to CDC; however, members of the CDC team may be sitting in on our listening session today. Therefore, we will only use first names and will refrain from mentioning the name of your organization. Do you have any questions?

Do you agree to participate in our discussion today? [wait for each participant’s response]

Do you give permission to be recorded today? [wait for each participant’s response]

Those who respond No to either question above will exit the Zoom session.

Public Reporting Burden Statement   

Public reporting burden of this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering, and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (09200572)

Ground Rules

Before we get going, I’d like to share a few ground rules:

• There are a few colleagues from FHI 360 and CDC observing our discussion.

• My job is to keep us on the right track and moving along so that we’re done in an hour. That means I may need to cut a discussion short to get through all our topics for today.

• There are no right or wrong answers.

• All comments, positive and negative, what you know and don’t know, are important.

• It is important to hear what everyone thinks, so please speak up and let others do the same.

• Respect each other and personal opinions; you may not always agree, but we will be respectful of each other.

• Don’t wait for me to call on you, but please speak one at a time.

• Respond to each other as well as to me.

• If you need to step away for a moment, feel free to do so, but please come back as soon as possible because all opinions are important.

• Please turn off all your mobile devices if possible.

Do you have any questions before we get started?

Warm-Up/Introductions (10 minutes)

Let’s begin by finding out a little bit about each of you. Please tell us:

• First name only

• The name of your DSMES service/organization and how long you’ve been a part of it

• Your role in your organization

• A brief overview of your DSMES services, including who you serve, where it is located, if it is in a rural or urban community, how often you convene, the duration, and a high-level summary of the DSMES activities.

1. DAP Diabetes Self-management Needs and How Service Providers Address Needs (8 minutes)

As I mentioned earlier, we are focusing on diabetes self-management and education support. This includes DSMES as well as any other education or support service, policy, or tool that you use with people with mental health disorders to help support self-management of their diabetes.

1. Think about the ways people with mental health disorders in your area need support or assistance when it comes to diabetes self-management. What are the most pressing needs that people with mental health disorders face that affect their ability to self-manage diabetes?

   1. Probe: mental health support, understanding the effects of the emotional challenges of diabetes on their mental health, accessible diabetes information & self-management skills training, basic needs (food/resource insecurity, transportation, job security, housing security, access to affordable medication or supplies), direct 1-1 outreach, access to healthcare provider, social/family support, culturally tailored services (language, cultural diets, etc.)

1. How, if at all, are the people with mental health disorders that you support impacted in unique ways by [insert need/issue] compared to other people with diabetes?

2. Now I’d like to discuss how your organization tries to address some of these needs you shared.

[Moderator selects topics and strategies based on discussion focusing on areas that people with mental health disorders are uniquely impacted by or areas of greatest need]

1. Let’s start by discussing [need]. In what ways is your organization working to address [issues related to topic] among the people with mental health disorders that you support?

   1. Probe: types of services, policies, partnerships or relationships with professionals/organizations in the mental health community, specialized staff training

2. What resources, tools, or other factors help support success with these activities you described?

   1. Probe if needed: informational materials, tools, staffing resources, funding for specific program areas, effective and supportive staff, high levels of engagement from participants, participants’ strong grasp of the content, social support, etc.

3. What else does your organization need to help [address _____ topic]?

1. In particular, what tools, materials, or guidance, or other support could CDC provide that would support your organization’s ability to provide diabetes education and support services to people with mental health disorders?

2. Tailoring Diabetes Self-Management Education and Support Services to People with Mental Health Disorders (25 minutes)

1. (Ask this question if not addressed above) What key strategies, tools or materials do you use to help educate and support people with mental health disorders in better managing their diabetes? We are particularly interested in learning about any strategies or tools that are tailored to support the needs of individuals with mental health disorders.

   1. In what ways do you feel like tailoring is effective? How could the tailoring be improved?

   2. What is the general format of the materials, resources, or tools you implement (fact sheets, videos, infographics, etc.)?

      1. What format are particularly helpful for the people with mental health disorders that you support?

      2. How do you share these materials/resources/tools with the people with mental health disorders that you support? (handouts, social media, email, etc)

   3. Probe on specific, new strategies to support people with mental health disorders. How effective is this strategy?

      1. [example if needed] Cognitive behavioral therapy (CBT) delivered by telehealth and enhanced with a CBT skills practice smartphone app

   4. Probe: What other DSMES programs tailored for people who have mental health disorders do you think work well?

2. Getting people with mental health disorders who have diabetes to join and stay engaged in diabetes education and support services is a challenge for many organizations. What do you find works best for helping identify and recruit people with mental health disorders who have diabetes to join your diabetes self-management program or use your services?

   1. Probe on: community partners, outreach strategies, messaging, tools and materials, providing other support services, or policies.

   2. What else will help motivate people with mental health disorders to join and stay in the program?

3. What are some of the key successes your organization has achieved over the last few years with people with mental health disorders?

4. What are the ways you measure the success of your diabetes education and support services?

   1. Using the measures of success you described, how successful would you say your organization is at reaching your goals and objectives? Why do you say that?

5. What are the main challenges you face when implementing the diabetes education and support services for people with mental health disorders?

   1. Probe if time permits: Getting participants to consistently show up, getting participants to understand the information, getting participants to continue learned practices after the program has ended

   2. How does your service try and overcome those challenges?

      1. Do you feel like your service is successful in overcoming those challenges?

      2. What else does your organization need to overcome these challenges?

6. (if time) How do you feel your DSMES service can improve?

   1. What are the barriers to implementing this type of improvement?

3. Social Determinants of Health / People with Mental Health Disorders (10 minutes)

1. Let’s shift our discussion to social determinants of health that particularly impact people with mental health disorders. We’ll start by discussing [key SDOH mentioned from list below]. How does [SDOH issue] impact people with mental health disorders?

Discussion will focus on the following key SDOH that were not raised in earlier discussion?

1. social or family support,

2. social inclusion

3. job security

4. housing security

5. food security,

6. access to affordable health services/supplies/medication

7. stress and coping

2. Are people with mental health disorders impacted in unique ways compared to other PWD?

3. [if participants believe it is significant issue] In what ways, if at all, is your organization working to address [issues] to help people with mental health disorders self-manage their diabetes?

Close (5 minutes)

1. (if time) What key advice would you offer to other providers of diabetes self-management and support services who are serving people with mental health disorders? What do you think is most essential for service providers to do to help support people with mental health disorders in managing their diabetes?

2. (if time) Is there anything else you would like to share with CDC about diabetes self-management and education efforts with people with mental health disorders?

The next phase of this project is to conduct focus groups with people with mental health disorders to learn about their experiences managing their diabetes and receiving support services. We would appreciate your help in identifying participants for these focus groups. Participants would receive a Visa electronic gift card as a thank you for participating. Please raise your hand if you might be able to help connect us to people with mental health disorders who have diabetes to participate in an online focus group.

[NOTETAKER: NOTE WHO IS RAISING HAND]

Pause for responses.

I have asked you all the questions that I have today. Thank you all so much for participating today. Your thoughts and opinions will be very useful in helping CDC develop resources for diabetes self-management education and support efforts. If you would like to learn more about resources available, you can visit CDC’s Diabetes Self-Management Education and Support (DSMES) Toolkit at https://www.cdc.gov/diabetes/dsmes-toolkit/. Thank you and have a good day.

Attachment D: DSMES Provider Listening Sessions Guide-Providers Who Support People with Mental Health Disorders 6

Formative Evaluation, Implementation and Rapid Evaluation (FIRE) of

Diabetes Self-Management in Disproportionately Affected Populations (DAPs)