Bringing Type 2 diabetes to theatre - Examining Appalachian audience reflections on The Sugar Plays

Oct 15, 2026

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The Sugar Plays are a family-centered health intervention designed to examine the lived experience of a Type 2 Diabetes Mellitus (T2DM) diagnosis in Appalachia. Using three qualitative methods—open-ended questionnaires, participatory sketches, and semi-structured personal interviews—the study analyzed responses from 30 audience members. Findings show that participants drew lessons from the plays, assessed character behavior, and practiced reciprocal storytelling, indicating narrative as relational and audiences as critically engaged.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages42

Reading Time1 h 46 min

AccessFree to download

Abstract

Purpose and study aim

Appalachia context and health communication challenges

Running head: THE SUGAR PLAYS Title: Bringing Type 2 diabetes to theatre: Examining Appalachian audience reflections on The Sugar Plays Author: Kallia O. Wright, Ph.D. Affiliation: Associate Professor, Department of Communication and Rhetorical Studies, Illinois College 1101 West College Avenue, Jacksonville, IL 62650 Abstract: The Sugar Plays are a family-focused health intervention. The goal of the play is to explore the experience of living with a Type 2 Diabetes Mellitus (T2DM) diagnosis in Appalachia. This present study examined audience reactions using three data-collection methods: (1) open-ended questionnaires,(2) participatory sketches and (3) semi-structured personal interviews. This qualitative analysis of 30 audience members who participated in all three methods found that they articulated lessons learned from the plays, evaluated the characters’ behaviors, and engaged in reciprocal storytelling. The audience’s reactions demonstrated that narrative telling is relational and that audiences were critically engaged in the process. The plays also helped health practitioners foster conversations about diabetes, the impact of intergenerational dietary habits, and the role of intergenerational buffers. Keywords: Appalachia, Narrative, Theatre, Type 2 Diabetes Mellitus The Sugar Plays 2 Bringing Type 2 diabetes to theatre: Examining Appalachian audience reflections on The Sugar Plays Living with Type 2 Diabetes Mellitus (T2DM) is a multi-layered experience, involving not only the management of the disease through prescribed medication, but also the management of communicative experiences influenced by the disease, such as the power dynamic between medical practitioners and patients. About 30.3 million individuals in the United States of America (9.4% of the population) have diabetes (Centers for Disease Control, 2017) . The total annual economic cost of treating diabetes is estimated at $245 billion. Medical expenditures for individuals with diabetes are estimated to be more than 2.3 times that of someone without diabetes (American Diabetes Association, 2013) . Yet, while people diagnosed with T2DM may share similar symptoms, their personal narratives about the impact of their illness—and the effect on family members who care for them—may differ. So, it is increasingly important to understand the illness experience. The rate of people being diagnosed with diabetes is expected to double by 2030 (Rowley, Bezold, Arikan, Byrne, & Krohe, 2017) . One region that experiences a high incidence of diabetes is Appalachia (Centers for Disease Control, 2017) . About 25 million individuals live in the 420 counties in the region, which includes cities such as Pittsburgh and small towns in the rolling hills of Kentucky. This 205,000 square mile area runs from southern New York to northern Mississippi; it is predominantly an economically distressed region, with 42% of the population categorized as rural (Pollard & Jacobsen, 2011) . Residents of socioeconomically distressed Appalachian counties are 33% more likely to develop and die from diabetes than members of nonAppalachian counties (Barker et al., 2010) . In Appalachian Ohio, this study’s site, the prevalence rate averages 11.3%, compared to the average state rate of 9.5%(Centers for Disease Control, The Sugar Plays 3 2015) . Diabetes-focused health interventions have been ongoing throughout the region (see work of the Center for Appalachian Philanthropy, Kentuckiana Regional Planning and Development Agency, and Live Healthy Appalachia); however, the incidence rate continues to rise. The purpose of the current study was to understand perceptions ofthe illness within a section of Appalachia, to add to our larger knowledge of how the illness is framed and what experiences may perpetuate or help reduce the development of the illness. Also, the study aims to help medical practitioners, family caregivers, and patients recognize the challenges associated with

FAQs

What is the purpose of The Sugar Plays in this study?

The plays aim to explore and reflect on the experience of living with a Type 2 Diabetes Mellitus (T2DM) diagnosis in Appalachia, focusing on communication experiences and illness impact.

How did the researchers collect and analyze audience responses?

They used three data-collection methods: open-ended questionnaires, participatory sketches, and semi-structured personal interviews, then conducted a qualitative analysis of 30 audience members who participated in all three.

What main communication themes are emphasized for T2DM in Appalachia?

The study highlights persistent intergenerational narratives about T2DM, culturally and familially rooted dietary practices, and economic factors as key sociocultural challenges relevant to audience perceptions.

Oct 15, 2026

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