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Aims: Diabetes-related distress stemming from the burden of managing diabetes has been measured in multiple patient populations; however, the medical management of diabetes also presents unique challenges for health care providers. The purpose of this study was to conduct a qualitative evaluation of the experiences of healthcare providers in caring for people with diabetes (PWD)., Methods: Interviews and focus groups were conducted in a sample of 22 healthcare providers. Participants were drawn from medical residency and fellowship programs, diabetes healthcare provider networks and professional organizations. Participants were queried about their experiences working with PWD., Results: Themes were extracted and discussed by the investigator team until consensus was reached. Themes included: adherence (frustration that patients don't follow recommendations), emotions associated with treating PWDs (frustration with redundancy of treatment topics, overwhelmed by social needs of patients, worry for patient outcomes), fatigue (emotionally and physically worn-out), role definition (role as supporter and perceived responsibility for medical outcomes), and work environment (limitations of time or resources to provide care)., Conclusions: Diabetes related distress was described as a component of the caregiving experience among health care providers who treat PWD. These data indicate an emotional impact that warrants further investigation and intervention., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Physical activity (PA) and fitness are critical to maintaining health and avoiding chronic disease. Limited access to fitness facilities in low-income urban areas has been identified as a contributor to low PA participation and poor fitness., Objectives: This research describes community-based fitness centers established for adults living in low-income, urban communities and characterizes a sample of its members., Methods: The community identified a need for physical fitness opportunities to improve residents' health. Three community high schools were host sites. Resources were combined to renovate and staff facilities, acquire equipment, and refer patients to exercise. The study sample included 170 members older than age 18 who completed demographic, exercise self-efficacy, and quality of life surveys and a fitness evaluation. Neighborhood-level U.S. Census data were obtained for comparison., Results: The community-based fitness centers resulted from university, public school, and hospital partnerships offering safe, accessible, and affordable exercise opportunities. The study sample mean body mass index was 35 + 7.6 kg/m(2) (class II obesity), mean age was 50 ± 12.5 years, 66% were Black, 72% were female, 66% completed some college or greater, and 71% had an annual household income of less than $25,000 and supported 2.2 dependents. Participants had moderate confidence for exercise participation and low fitness levels. When compared with census data, participants were representative of their communities., Conclusion: This observational study reveals a need for affordable fitness centers for low-income adults. We demonstrate a model where communities and organizations strategically leverage resources to address disparities in physical fitness and health.