TABLE 2.

Summary of Themes From Key Informant Interviews to Evaluate the PROGRAM ACTIVE CBT Workbook Materials

Positive Comments	Suggested Changes
Workbook content is culturally sensitive and appropriate for use with an Appalachian population with type 2 diabetes.	Replace the word homework with take-home activity and worksheet with activity to reduce feelings of shame and resistance from educational experiences earlier in life.
Testimonial examples of “Ann” and “John” are easy to understand and effective in demonstrating abstract CBT principles.	Simplify and better define terms in the text (e.g., cognitive distortions, evidence table vs. proof record).
The characters of “Ann” and “John” are believable as members of an Appalachian community.	Better align graphics on each page with the meaning of the content beside the image.
The sequence of steps outlined in the workbook is detail oriented and supportive of behavior change efforts.	Add text to the “Introduction” to introduce the rationale for psychotherapy.
The tone of the materials are respectful of an audience with a range of literacy and health literacy levels.	Introduce the character of “John” earlier in Chapter 1.
Examples of diabetes self-care behaviors were relevant to the lives of people with type 2 diabetes.	Add text to explain the process of therapy for patients who are new to psychotherapy.
Examples were gender-balanced.	Provide examples of myths about therapy and information that dispels these myths.
	Provide an explanation that depression can be treated and the benefits of treatment.
	Shorten the text of selected chapters.
	Balance the graphic representations of women and men to be applicable to a wider audience.

Note. CBT = cognitive behavioral therapy.