This article provides a sample solution for Implementing a Public Health Program on T2DM DSME.
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research about the ten leading causes of death in the United States. List all the diseases and select one disease. Research further on your selected disease.Based on research, create a 5- to 7-page Microsoft Word document that includes:
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Solution
Implementing a Public Health Program on T2DM DSME
Introduction
Implementation considered to be the evidence – to- practice gap entails the successful operationalization of evidence-based interventions in contemporary healthcare practices. Healthcare experts agree that if public health programs and policy interventions are not effectively implemented, the expected outcomes of improving population health and decreasing inequities in health and healthcare will not be realized (MacDonald et al., 2016). As a result, there is a need first to examine the leading causes of death to determine which public health programs would significantly impact a selected community. Consequently, this essay proposes developing a proposal for the implementation of a public health program that addresses T2DM within the African American Community with a specific focus on Montgomery County, Alabama. The top ten leading causes of death are identified to achieve the goal, and diabetes is selected as the disease to address. The proposed program also outlines the steps I will undertake to evaluate the intervention besides identifying and collecting data to evaluate the program. Furthermore, the method selected for data collection is explained, conclusions from the data and recommendations and plan to communicate the recommendations
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Top Ten Leading Causes of Death in the US
Since 1952, ranking on death causes in the US by age, sex, race, and origin has been carried out. According to Heron (2017), the cause of death ranking is a useful tool to demonstrate the comparative burden of cause-specific mortality. Medical News Today (2019) reports that almost three-quarters of death in the US often occur, whereby the leading causes of fatalities within the US remain consistent over the last five years. The newsletter cited the Centers for Disease Control and Prevention (CDC) reports of 2017 where 2. 813, 503 deaths were registered. Based on these findings, Medical News Today (2019) reported that heart disease was the leading cause of death in 2017, with over 640 000 deaths representing 23.5 % of all deaths. Cancer followed at 2 with almost 600 000 or 21% of the fatalities. Unintentional deaths came in third position with about 170 000 victims. Next was chronic lower respiratory disease accounting for 160 000 with cerebral vascular diseases closing the top five leading causes. At position six was Alzheimer’s disease, which claimed 121, 404 deaths or 4.3%, diabetes was ranked at position seven with 83, 564 fatalities equivalent to 3%, followed by influenza and pneumonia. Kidney failure and lastly, at position 10 was suicide.
Proposal for A Public Health Program to Address T2DM within the African American Community
As the disease of interest in the African American community, diabetes describes a condition where the individual’s body cannot control blood glucose leading to hyperglycemia. Though several types of diabetes exist, over 90 % of the patients suffer from Type 2 Diabetes mellitus. Inadequate control emanates from the absence of adequate healthcare practitioners’ intervention and poor management of Type 2 Diabetes Mellitus (T2DM) patients. At position seven, as a leading cause of death, diabetes is a significant health concern in the US. Diabetes control and treatment continue to present a significant challenge in the US despite the growing technology that ensures prompt diagnosis and necessary interventions. Though several types of diabetes exist, over 90 % of the patients suffer from Type 2 Diabetes mellitus. Inadequate control emanates from the absence of adequate intervention by healthcare practitioners and poor management, the Type 2 Diabetes Mellitus (T2DM) patients. Premised on the fact that a significant number of T2DM patients among the selected African American community had insufficient knowledge on a diabetes diet or self-care activities, a comprehensive diabetes diet, and self- care education (CDDSCE) intervention is proposed. The public health education program to improve T2DM patient outcomes (Adu et al., 2019). Most importantly, since initiatives comprising evidence-based practice change call for a conceptual model or theoretical framework to guide the program, the IOWA model will be used. At the same time, the Rosswurm & Larrabee’s (1999) Model for EBP Change will be utilized to implement the program.
Steps to be undertaken to evaluate the CDDSCE
After implementing the CDDSCE program, a pretest will be given to evaluate if the program will have enhanced diabetes and diabetes knowledge of prevention. First, I will present the outcome of the project to the stakeholder. The medical director will be one of the parties who will be present during the presentation. Nurses will also be present. Together with the medical director and the nurses, we shall discuss the feasibility of the project plans. The clinic will designate a champion who will oversee and monitor the program’s progress. We shall consider the aspect that could either enable or inhibit the process of implementation.
Additionally, we shall evaluate if program providers receive an appropriate amount of training and supervision to make sure that there will be intervention fidelity. While still evaluating the process, we shall evaluate the participants’ understanding of the program and evaluate how the program being implemented matches with the original design. The team will also evaluate the number of patients who will have converted from pre-diabetes to Type 2 diabetes from the implementation time of the project. Furthermore, the team will evaluate any unexpected outcomes which could be as a result of the program. Other than having positive outcomes of improved DMSP among the participants, there could also be adverse outcomes to be evaluated. The negative outcomes could be as a result of either implementation failure or some aspect of the program.
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An Evaluation Design for the Program
It will be essential to have a proper understanding of program results and determine a permanent practice change intervention. The plan for the evaluation project is crucial during project design. In this planning phase, how the program will be evaluated for generating the desired outcomes must be determined. I will plan a method of evaluation used by the nurses of the primary healthcare agency clinic to govern the efficacy of the type 2 deterrence program. Initially, I will form a team of nurses in the medical office. This team will oversee the evaluation process and make sure that the program’s planning and implementation align with goals and the program’s objectives. The evaluation plan will include both formative and impact evaluation (Hayman & Lewis, 2018). The informative evaluation will be a collection of information that concerns the program’s activities, characteristics, and outcomes. The evaluation team will use this formative evaluation in determining whether the intervention will meet the set goals and objectives. The team will also use the formative evaluation to evaluate whether the intervention’s timing will be acceptable and suitable for the target population. For impact evaluation, the team will use a questionnaire evaluating healthcare providers and patients’ attitudes towards the intervention The method will additionally evaluate the project’s effectiveness on short-term goals; decrease in the number of patients who convert from pre-diabetes to type 2DM. The impact evaluation will also include a review of the chart to assess the number of patients’ progress from prediabetes to type 2DM. The data collected from both pre and post-intervention questionnaires will determine the effectiveness of program evaluation.
· Identification and Collection of Data to Evaluate Your Program
Demographic data will include the age, gender, and ethnicity of participants. This information will be collected at the start of the first educational session. While gender and ethnicity will be reported as a percentage, age will be reported as a range and mean. Pie charts will be used to display percentages of both gender and ethnicity. Participants will first be notified that demographic information will be used and presented in chart format. ·
Explanation of the Method Determined For Collecting the Data
This EBP change project intends to measure self-care activities. A summary of the Diabetes Self-Care Activities (SDSCA) questionnaire will measure self-care activities before and after implementing the CDDSCE program (Bujang et al., 2016). General exercise diet and blood glucose monitoring subsets will be measured. It will be essential to evaluate demographic information and attendance percentage for not less than three classes. All five classes will be assessed to evaluate any dropout of participants and assess the likelihood of those who will be participating in completing the entire course. SDSCA questionnaire will also be used to measure self-care activities initially and on completion of CDDSCE program implementation. This questionnaire will be purchased through the Oregon Research Institute.
Moreover, we shall seek permission for the use of the questionnaire. SDSCA measure is a brief diabetes self-management questionnaire, including blood glucose monitoring, exercise, and general and specific diet. Kueh and Kuan (2018) have reviewed seven studies that use SDSCA to revise the scale. From this review, two more components (foot care and smoking habits) have been included in the questionnaire. Kueh and Kuan(2018) will also be used to review the SDSCA questionnaire in previous studies to provide valuable information on reliability and validity. Simple descriptive statistics will be used to measure Self-care activity outcomes. Percent of pre and post-intervention data will be assessed for specific subsets: blood glucose monitoring exercise and diet. Demographic information will be evaluated, and attendance percent for at least three classes. All five classes will also be assessed. Subsets will be analyzed for any necessary changes and improvements in percent and mean. Each subset’s pre and post-intervention data will be presented.
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Conclusions from the Data and Justification
Changes in following a healthy eating plan, changes in blood glucose monitoring at the recommended times per day, and changes in having at least 30 minutes of physical exercise reach day post-intervention will be measured. According to Havele et al. (2018), routine blood glucose self-monitoring drives changes in lifestyle, hence improving glycemic control. Therefore, the benchmark for these data points will be based on studies that show improved blood glucose monitoring at the recommended times per day. The effectiveness of CDDSCE classes in improving self-care activities will be determined by the data collected. The collected data will also provide an idea of the number of participants who will be in attendance. The project manager will document the participants’ attendance, demographic data, pre, and post-test scores.
Recommendations for Improvements to CDDSCE
The rationale to incorporate CDDSCE emanates from the fact that over 90% of the T2DM patients receive diabetes care from primary care providers, hence increasing the number of patients in our community who have access to Diabetes-friendly nutrition self-care education. To improve the program, a nurse educator will lead the educational classes at the proposed program site. The classes will take place weekly, while new patients will have a separate class. The classes will take place every Thursday and the last 100 minutes. All patients diagnosed with T2DM will be notified of the upcoming lessons during their appointment visit. Simultaneously, an assessment of adherence will be conducted, barriers explored, and a follow-up plan established (Powers et al., 2015). The findings will be forwarded to the physician in collaboration and the manager of the healthcare agency. The findings will also be disseminated to three other primary care units, which the practice change site is expected to collaborate with. A final manuscript will be forwarded to a nursing or healthcare journal to be published and have a broader target audience.
Conclusion
It is imperative to acknowledge that diabetes and, in particular, T2DM are diseases with the potential to develop serious complications, primarily when poorly managed. Literature abounds, which support the efficacy of patient and family education on nutrition and self-care activities. Offering CDDSCE intervention as a public health program is bound to enhance T2DM outcomes while simultaneously preventing complications associated with T2DM.
References
Adu, M. D., Malabu, U. H., Malau-Aduli, A. E., & Malau-Aduli, B. S. (2019). Enablers and barriers to effective diabetes self-management: A multi-national investigation. PloS one, 14(6), e0217771.
Bujang, M. A., Ismail, M., & Bariyyah, N. (2016). Validation of the summary of diabetes self-care activities (SDSCA) in the Malay language for Malaysian adults. MJPHM, 16(3), 227-34.
Havele, S. A., Pfoh, E. R., Yan, C., Misra-Hebert, A. D., Le, P., & Rothberg, M. B. (2018). Physicians’ views of self-monitoring of blood glucose in patients with type 2 diabetes not on insulin. The Annals of Family Medicine, 16(4), 349-352.
Hayman, R., & Lewis, S. (2018). INTRAC’s experience of working with international NGOs on aid withdrawal and exit strategies from 2011 to 2016. VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations, 29(2), 361-372.
Heron, M. P. (2017). Deaths: leading causes for 2015.
Kueh, Y. C. & Kuan, G. (2018). Psychometric Properties of Malay Version of Summary of Diabetes Self-Care Activities Measures among the Malay adults with Type 2 Diabetes Mellitus in Kelantan. Malaysia. Austin Diabetes Res, 3(1), 1017.
MacDonald, M., Pauly, B., Wong, G., Schick-Makaroff, K., van Roode, T., Strosher, H. W., … & Carroll, S. (2016). Supporting successful implementation of public health interventions: protocol for a realist synthesis. Systematic reviews, 5(1), 1-11.
Medical News Today(2019) What are the leading causes of death in the US? URL: https://www.medicalnewstoday.com/articles/282929 Accessed 29/08/2020.
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., & Vivian, E. Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the academy of nutrition and dietetics. J Acad Nutr Diet. 2015; 115 (8): 1323–34.
Question
research about the ten leading causes of death in the United States. List all the diseases and select one disease. Research further on your selected disease.Based on research, create a 5- to 7-page Microsoft Word document that includes:
- A proposal for a public health program to address that disease within your community.
- An outline of the steps you will undertake to evaluate the program you have proposed.
- An evaluation design for your program.
- An identification and collection of data to evaluate your program.
- An explanation of the method determined for collecting the data.
- Conclusions from the data and justification of those conclusions.
- Recommendations for improvements to your program and a plan to communicate those recommendations.
