Proposal to Address DIABETES

Proposal to address DIABETES

ASSESSMENT

Definition of the Public Health Problem/Issue

Diabetes is considered a public health issue because it affects about 23.6 million people in the United States. It is said by Healthy People 2020 to lower life expectancy by 15 years and is known to be the 7th leading cause of death in the United States. Having Diabetes can increase a person risk of having heart disease and other chronic disease. It is also known as the leading cause of kidney failure in the United States. If Diabetes goes untreated it can cause death, stroke, diabetic neuropathy, diabetic retinotherapy and as mentioned before heart disease. Anyone could be impacted by diabetes but those who are obese and who have family members with the disease are more at risk.

Federal agencies such as National Diabetes Information and Clearinghouse and The Center of Disease Control (CDC) are involved in addressing the health issues of Diabetes. Non-profit organization such as American Association of Diabetes Educators, American Diabetes Association and National Wellness Institute are also involved in addressing the health issue on diabetes. CDC has build programs and projects such as Children and Diabetes, National Diabetes Prevention Program and National Diabetes Education Programs which NIH also contributed too to help educated the public on diabetes.

There are two types of diabetes; type 1 and type 2 diabetes. Type 1 diabetes is when no insulin is produced from the pancreas and it is more common in children and young adults. Type 2 diabetes is when there is not enough insulin produced or the cells ignore the insulin. Type 1 diabetes is caused by genetic and environmental while type 2 diabetes is caused by genetics and lifestyle factors. Type 2 Diabetes is more common in African Americans, Native Hawaiians, American Indians, Mexican Americans and Asian Americans. Men are more likely to get heart disease and diabetes than women. Also as stated earlier if individuals have a family history of diabetes they are more likely to become diagnosed with the disease.

Description of Successful Programs/ Interventions

Since genetics and environment factors are the cause of type 1 diabetes there is no programs/interventions created to educated and prevent against this type of diabetes. On the other hand Type 2 diabetes is influenced by genetics as well as lifestyle factors and is the most common type of diabetes, so organizations and agencies has developed programs and interventions to aid in prevention of the disease.

Being obese increases the risk of diabetes so informational approaches focused on increasing physical activity. Programs were developed to educate individuals on the resources needed to get fit, the risk factors of diabetes and to help motivate them in succeeding. Community-wide campaigns that are used to increase physical activity are interventions that one, involve many community sectors, two includes highly visible, broad-based multi-component strategies such as health education and social support and etc and three may also address other cardiovascular disease factors, particular diet and smoking. Studies have shown that this informational approach has helped increased people’s physical activity and their awareness on it.

Effectiveness:

• There was a 4.2% median net increase who those who reported being physically active
• There was a 16.3% median net increase in the energy expenditure
• It also increased knowledge about exercise and intentions to become active

Another program developed to help educate people on this disease is Diabetes Prevention and Control: Self Management which teaches and educates people of how to manage their diabetes. Their goal is to prevent long term and short term health issues, increase patients quality of life, while making the cost affordable and to maintain the rate of metabolism.

Effectiveness for in community gathering:

• Mean decrease of 1.9 percentage points for glycated hemoglobin
• Median decrease of 2.0 for fasting blood glucose
• Median decrease of 5.2 lbs for weight
• Inconsistent findings of cholesterol
• Blood pressure decreased in favor of intervention

Identified barriers to program success

Barriers that affected the success of increasing physical activity were individuals’ financial status, their lack of interest, how committed they were, location, schedule and their support system. Joining the gym, jogging for 30 minutes each morning or even walking a mile is hard to maintain depending if individuals work, have children or attend school. Since exercising is not seen as a must for most they tend to not make it primary part of their schedule. Also if people exercise but still eat unhealthy most likely there would be no changes in appearance. If your calorie intake does not amount to your physical activity there would be no weight loss. Eating healthy is hard because some people cannot fund a healthy diet. Many people do not have the time to cook so they turn to fast food. It is also hard to maintain a healthy diet if you are the only person in your household who wants to eat healthy. Buying two sets of groceries cost money and cooking different meals take time.

DSME barriers were the funding and the amount of people available to do the studies. It cost $50 more per child than the traditional care patient and studies that were to be done in schools, worksites and camps were unable to be completed because there were only few studies done which meant there were not enough sufficient results.

Specific Problem to be Addressed

The problem I am addressing is to educate individuals on diabetes, encourage them to become more physical active and maintain a healthy diet in order to prevent them from developing type 2 diabetes. Type 2 diabetes requires more lifestyle change and this we need to make individuals aware of so they can prevent becoming diagnosed with this disease.

Target Population

Since diabetes is most crucial to elder adults I am going to target young adults which include college students and graduate students. This gives them time to make changes to their lifestyle and their children’s lifestyle. If a child is made aware of the affects of diabetes they would not be able to make changes to their lifestyles if their parents are not encouraging it. By informing the parent there is a greater chance of improvement for both them and their offspring(s).

Proposed Interventions

Intervention #1 - environmental

The first intervention would be environmental. Since obesity is a major cause of Type 2 diabetes we can promote healthy diets by reducing the number of vending machines in public places, making campus food and foods offered at work more healthy and also promote physical activity. In order to promote physical activity we can offer free gym hours in community centers, on campus and at work places.

Intervention #2 - educational

The second intervention would be to educate young adults/college students on how to prevent getting diabetes and if diagnosed how to cope with the disease. Hearing the facts can be eye opening for many, so we need to make brochures, fact sheets and teach in healthy classes the risk factors of diabetes. Place brochures in the health clinic and places most utilize by students in order to gain their attention.

Healthy People Objective(s)

Reduce the annual number of new cases of diagnosed diabetes in the population

Baseline: 8.0 new cases of diabetes per 1,000 population aged 18 to 84 years occurred in the last 12 months

Target: 7.2 cases per 1,000 population aged 18 to 84

Reduce the diabetes death rates

Baseline: 73.1 deaths per 100,000 population were related to diabetes in 2007

Target: 65.8 deaths per 100.000 population

Reduce the rate of lower extremity of amputation in persons with diagnosed diabetes

Baseline: 3.5 lower extremity amputation per 1,000 persons with diagnosed diabetes occurred in 2005-07

Target: Not Applicable

Increase the proportion of persons at high risk for diabetes with prediabetes who report reducing the amount of fat or calories in their diet

Baseline: 48.5 percent of adults, age 18 years and older who were at high risk for diabetes with prediabetes reported reducing the amount of fat or calories I their diet

Target: 53.4 percent

Data Collection Plan

The following link provides information about diabetes affecting persons’ ages 18 and older and how well educated they are on this disease.

http://wonder.cdc.gov/scripts/broker.exe

Data will be collected on the interventions mentioned early by surveying young adults work and attend colleges that educate them on diabetes. Surveyors will be asked if they have learned anything beneficial from brochures and whether or not they were influenced to become physical active and eat healthier.

SUMMARY

Major Assessment Findings

As mentioned before 23.6 million Americans have been diagnosed with diabetes. Of that 23.6 million, 71, 382 deaths occurred in 2007.

After speaking with a few family members who were overweight, I was shocked to find out that they were aware of their risk for getting diabetes Many knew because of annual doctor visits and because it has been quite common within the family. When asked why they were not making effort to lose weight they exclaimed how hard it was to stay committed. One mentioned the lack of time and that she was too lazy. Two said “they are set in their ways” so it is hard for them to break the habit of eating unhealthy and to get into the habit of exercise.

Conclusions led to interventions that focused of educating people of the risk factors and prevention and environmental changes since people may not have the ability to make these changes themselves.

Two Proposed Interventions

My first intervention is to provide environmental changes to young adults in college and working environments. Have free gym hours so they can stay fit without worrying about the financial aspect. Also make cafeteria food healthier to encourage positive changes to their diets. My second intervention is to educated young adults by making brochures available in public environments and providing health classes that help individuals prevent themselves from being diagnosed with a chronic disease.

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Prepared by Daniella Gordon PCH 201-02 Wellness, Fall, 2012