Health Promotion Program Proposal For Community Type II Diab

Health Promotion Program Proposal Community Type Ii Diabetes Adults Giselle Vilar Florida N

Health Promotion Program Proposal: Community Type II Diabetes Adults Giselle Vilar Florida National University NGR6619 HAN-HY01: Advanced Primary Care of Family III Dr. Moriane Joseph 09/22/2024 PICOT In patients (P) diagnosed with type II diabetes and over 45 years of age residing in low-income communities, will a community-based lifestyle intervention program targeting nutrition, physical activity and access to health care (I), compared to standard protocol management (C) reduce HbA1c levels and improve diabetes management outcomes across six months (O)? Introduction Inflammation, even though a physiological response in the human body, can become the principal component to develop non-communicable diseases NCDs and this is proven by one of such most prevalent systemic disease known as type II diabetes (T2DM) that exists globally. An estimated 11.2% of the United States population has diabetes, and approximately 90–95% of cases are type II (Centers for Disease Control and Prevention, 2020). Though it is a lifelong condition, the same is manageable with significant lifestyle modifications and oral medications. This population, particularly low-income adults aged 45–64 years, faces barriers such as poor healthcare access and limited opportunities for healthy living. The primary objective of this health promotion program is to support a community-based intervention designed to reduce complications associated with T2DM among low-income populations at the local level by promoting lifestyle modifications for preventable risk factors. The main outcome will be a reduction in HbA1c (glycated hemoglobin) levels at 6 months; other key outcomes include changes in diabetes self-management skills. Research question and problem statement Population: Low-income adults (> 45 years old) with type II diabetes often have poor glycemic control, low health literacy, significant barriers to care access, and reside in environments with limited access to healthy food options. Intervention: A multicomponent lifestyle intervention incorporating nutrition education, physical activity, and healthcare access improvements. Control: Standard care involving regular medical visits and medications but without targeted lifestyle modification support. Conclusion: The goal is to decrease HbA1c levels, improve health literacy, and enhance diabetes self-care over six months. Vulnerable Population: Older adults, especially those over 45 in disadvantaged neighborhoods, are at higher risk for developing and poorly managing T2DM due to factors like unhealthy diets, sedentary lifestyles, food deserts, financial barriers, and economic stress. These determinants increase the probability of complications such as hypertension and cardiovascular diseases if unmanaged. Literature Review Paper 1: Lifestyle Interventions for Diabetes Management A 2014 review by Dunkley et al. highlighted that behavior change programs focusing on diet and exercise can be feasible and effective for T2DM management, though these programs often face challenges related to affordability and accessibility, especially for low-income populations. The review underscores the need for community-level interventions that are economically feasible and tailored to the needs of underserved groups. Paper 2: Diabetes Programs in the Community A 2021 study by He et al. evaluated community-based interventions in low-income populations, demonstrating improvements in glycemic control, health literacy, and diabetes self-management. Nonetheless, the short duration of follow-up in these studies makes it difficult to assess long-term sustainability. Overall, effective community programs must address key social determinants to be successful among vulnerable populations. Theoretical Framework: Health Belief Model (HBM) The program is grounded in the Health Belief Model, which posits that individuals will adopt health behaviors if they perceive themselves to be at risk (perceived susceptibility), recognize the severity of their condition (perceived severity), believe that specific actions will reduce their risk (perceived benefits), and identify minimal barriers to action (perceived barriers). This model supports educational efforts aimed at increasing awareness of diabetes risks, benefits of lifestyle change, and reducing perceived obstacles such as cost, access, and knowledge gaps. Program Design Intervention: · Nutrition Modules: Providing diabetes-friendly meal planning using local healthy foods, emphasizing affordable options. · Physical Activity: Conducting home-based, bi-weekly group fitness sessions in multiple languages, including low-impact exercises suitable for all fitness levels. · Healthcare Resources: Offering free HbA1c testing and monthly consultations with healthcare providers to support ongoing diabetes management. Recruitment and Retention Strategies: Participants will be recruited via community centers, clinics, and public health outreach programs. To enhance retention, the program will provide transit vouchers, flexible scheduling, and incentives such as grocery vouchers or stipends. Timeline: · Month 1: Recruit participants, conduct baseline HbA1c assessments, initiate intervention. · Months 2-5: Deliver bi-weekly workshops focusing on nutrition and physical activity, maintain regular HbA1c testing. · Month 6: Final assessments, qualitative feedback, and program evaluation. SMART Goals: 1. Specific: Achieve a reduction of ≥1.5% in HbA1c levels in at least 50% of participants. 2. Measurable: Pre- and post-intervention HbA1c levels will be compared statistically. 3. Achievable: By providing practical lifestyle modifications and support, the goal is realistic given the population’s needs. 4. Relevant: Addresses the unmet need for effective diabetes management among vulnerable, low-income communities. 5. Time-bound: Complete within six months, with measurable improvements documented at program end. Evaluation Plan: The primary outcome will be the change in HbA1c levels from baseline to six months. Secondary outcomes include increased health literacy, better attitudes towards self-management, and participant satisfaction assessed through surveys and interviews. Qualitative data will explore perceived barriers and facilitators related to lifestyle changes. Barriers and Challenges: Potential challenges include transportation issues, limited access to healthy foods, and participant dropout. Solutions involve transportation vouchers, partnerships with local food banks, flexible scheduling, and incentives. Conclusion: This community-based health promotion program aims to improve diabetes outcomes among low-income, older adults by promoting lifestyle modifications, increasing access to healthcare, and addressing social barriers. Utilizing the Health Belief Model enhances the likelihood of sustained behavior change by increasing risk awareness, perceived benefits, and reducing obstacles. Achieving reductions in HbA1c and empowering individuals with better self-management skills can significantly decrease the risk of diabetes-related complications, ultimately improving quality of life for this vulnerable population. References Champion, V. L., & Skinner, C. S. (2008). The health belief model. In K. Glanz, B. K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (4th ed., pp. 45–65). Jossey-Bass. Centers for Disease Control and Prevention (2020). National diabetes statistics report, 2020. Dunkley, A. J., et al. (2014). Effectiveness of interventions for preventing type 2 diabetes in adults: A systematic review of systematic reviews. Diabetes Care, 37(2), 251–259. He, X., et al. (2021). A community-based intervention program for diabetes management: Results from a low-income urban population. Journal of Public Health, 43(1), 78-85. Kannan, S., et al. (2015). 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