Journal 2-2 Problem: Diabetes Program: Diabetes Prevention ✓ Solved

Journal 2-2 Problem: Diabetes Program: Diabetes Prevention L

Journal 2-2 Problem: Diabetes Program: Diabetes Prevention Lifestyle Change Programs. Diabetes is a chronic degenerative and metabolic disease with rising prevalence; approximately 30.3 million Americans are affected, with substantial underdiagnosis. African American, Native American, and Hispanic populations are disproportionately affected, and disparities are linked to education, poverty, and access to care. Prediabetes affects about 34% of the population and most are unaware. You are a Professor of Counselor Education and Supervision at a university in San Antonio, TX. In 1972 a military infantryman returned home, later committed a mass shooting at a school and city offices, killing teachers, students, councilpersons, police officers, and the mayor. Apply the Six-Step Model of Crisis Intervention for responding in this community.

Paper For Above Instructions

Introduction

This paper addresses two connected public health and community safety challenges: designing Diabetes Prevention Lifestyle Change Programs that reduce disparities and responding to a community mass-shooting crisis using the Six-Step Model of Crisis Intervention. The diabetes burden disproportionately affects racial and socioeconomic minorities, and prevention requires culturally tailored lifestyle programs and community outreach (CDC, 2017; Geiss et al., 2014). The traumatic mass-shooting event in San Antonio requires an organized mental health and social support response to stabilize survivors, families, first responders, and the broader community (Roberts, 2005).

Diabetes Prevention Lifestyle Change Program Design

Goal: Reduce incidence of type 2 diabetes through evidence-based lifestyle interventions, targeting high-risk and underserved populations.

Core Components

  • Evidence-based curriculum: Implement the Diabetes Prevention Program (DPP) lifestyle intervention emphasizing weight loss (5–7%), 150 minutes/week of physical activity, and dietary changes (Diabetes Prevention Program Research Group, 2002).
  • Cultural tailoring: Adapt materials, language, and delivery modes for African American, Native American, and Hispanic communities, addressing dietary patterns and social norms (Peek et al., 2007).
  • Access and affordability: Provide programs in community centers, churches, and schools, and offer sliding-scale or no-cost participation for low-income participants (CDC, 2017).
  • Screening and outreach: Use community screenings to identify prediabetes and refer to programs; educate primary care providers to reduce underdiagnosis (ADA, 2012).
  • Peer support and community health workers: Train community health workers to provide follow-up, navigation, and culturally congruent coaching (Beckles et al., 2016).

Implementation Strategies

Partner with local health departments, tribal health programs, and community organizations to recruit participants and deliver interventions where people live and work. Use mobile health technologies and group sessions to increase engagement and retention. Monitor outcomes (weight, HbA1c, physical activity) and evaluate disparity reductions by race, education, and income (DPP Research Group, 2002; CDC, 2017).

Integrating Crisis Preparedness into Chronic Disease Programs

Chronic disease programs can bolster community resilience by building trusted relationships, establishing communication channels, and training staff in psychological first aid. These assets are valuable when a community faces an acute traumatic event, enabling rapid mobilization of mental health resources (Everly & Mitchell, 2000).

Applying the Six-Step Model of Crisis Intervention to the 1972 San Antonio Mass Shooting

The Six-Step Model (Roberts, 2005) provides a structured framework for acute crisis response in the community after mass trauma. Below, each step is applied to the San Antonio scenario.

Step 1 — Conduct a Thorough Biopsychosocial and Lethality/Imminent Danger Assessment

Immediately assess physical safety, ongoing threats, and medical needs. Coordinate with law enforcement to confirm scene safety. Triage survivors for medical and psychiatric risk (active suicidal ideation, severe dissociation, psychosis). Establish incident command links between campus officials, city emergency operations, hospitals, and mental health teams (SAMHSA, 2017).

Step 2 — Make Psychological Contact and Establish Rapport

Deploy trained crisis counselors, chaplains, and community leaders to engage survivors, families, staff, and first responders. Use calm, empathetic approaches, introduce oneself, explain role and available supports, and obtain permission to assist. Leverage the university’s counseling center and local community organizations to reach affected groups (Roberts, 2005).

Step 3 — Identify the Major Problems

Determine immediate needs: emergency medical care, reunification with family, shelter, legal/process information, and communication. Identify acute psychological reactions: shock, grief, anger, guilt, and traumatic stress. Prioritize problems that impair basic functioning (sleep, eating, safety) and escalate care when necessary (referral for psychiatric evaluation) (James & Gilliland, 2017).

Step 4 — Encourage Exploration of Feelings and Provide Emotional Support

Allow survivors and community members to express grief and fear in safe settings. Provide psychological first aid and normalize reactions to trauma. Use culturally sensitive practices that honor diverse mourning traditions among affected racial and ethnic groups in San Antonio (e.g., Hispanic and Native American protocols) to foster communal healing (NASW, 2014).

Step 5 — Generate and Explore Alternatives and Coping Strategies, Create an Action Plan

Work collaboratively to identify practical next steps: immediate family support, legal assistance, memorial planning, academic accommodations, and short-term counseling. Connect people to ongoing resources—support groups, primary care, chronic disease programs for those with comorbidities (e.g., diabetes)—to address stress-related health impacts. Develop coping strategies (sleep hygiene, grounding techniques, peer support) and concrete plans for re-establishing routine (work, school) when safe (Roberts, 2005; Everly & Mitchell, 2000).

Step 6 — Restore Functioning and Plan Follow-Up

Coordinate long-term mental health care, monitor for PTSD, complicated grief, and depression, and provide referrals. Establish a follow-up schedule for survivors, families, and first responders. Integrate public health messaging to address community-wide anxiety and to communicate available services. Evaluate the response and revise community emergency and mental health plans to improve future preparedness (SAMHSA, 2017).

Conclusion

Preventing diabetes and responding to acute community trauma both demand coordinated, culturally informed, and resource-sensitive approaches. Effective Diabetes Prevention Lifestyle Change Programs reduce long-term morbidity and disparities when they are accessible, community-driven, and tailored. In the event of a mass shooting, employing the Six-Step Model of Crisis Intervention ensures immediate stabilization, culturally sensitive emotional support, practical problem-solving, and sustained follow-up to restore individual and community functioning (DPP Research Group, 2002; Roberts, 2005).

References

  • American Diabetes Association. (2012). The cost of diabetes. Retrieved from https://www.diabetes.org
  • Beckles, G. L., Chiu-Fang, C., & Chou, C. (2016). Disparities in the Prevalence of Diagnosed Diabetes - United States. MMWR Morb Mortal Wkly Rep, 65(45).
  • Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393–403.
  • Everly, G. S., & Mitchell, J. T. (2000). The Critical Incident Stress Management (CISM) approach. International Journal of Emergency Mental Health.
  • Geiss, L., Wang, J., Cheng, Y., et al. (2014). Prevalence and incidence trends for diagnosed diabetes among adults, United States, 1980–2012. JAMA, 312(10), 1218–1226.
  • James, R. K., & Gilliland, B. E. (2017). Crisis Intervention Strategies (8th ed.). Cengage Learning.
  • National Association of Social Workers (NASW). (2014). Guidelines for culturally competent practice. NASW Press.
  • Peek, M., Cargill, A., & Huang, E. (2007). Diabetes Health Disparities. Agency for Healthcare Research and Quality.
  • Roberts, A. R. (2005). Crisis Intervention Handbook: Assessment, Treatment, and Research (3rd ed.). Oxford University Press.
  • Substance Abuse and Mental Health Services Administration (SAMHSA). (2017). TIP 57: Trauma-Informed Care in Behavioral Health Services. SAMHSA Publications.

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