Health Promotion Program Proposal: Community Type II Diabetes Adults

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 Unites 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 woe, the same is manageable with very severe changes in lifestyle and oral medicines. This population, particularly low-income adults aged 45–64 years, is more likely to have poor access to healthcare and very 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-level income adults (> 45 years old) with type II diabetes often poorly control of diabetes w/ low health literacy, significant barriers to care access, and place-based (as opposed to non-place-based) lifestyle options that are not health-promoting.

Intervention: I Multicomponent lifestyle intervention (incorporating nutrition education, physical activity, and healthcare access).

Control : Current, usual diabetes care involving regular doctor visits and medications but without significant lifestyle change advice.

Conclusion: Decrease HbA1c, elevated health literacy, and better diabetes self-care.

Time: Six months.Vulnerable

Population

Older adults, with most likely individuals over the age of 45 in disadvantaged neighborhoods have an increased risk for developing and poor control of T2DM. Among the causes of this risk are behaviors or poor diet related to sedentary behavior and, in addition to eating deserts and financial barriers that prevent access to health services, stress associated with economic insecurity. Society is at the highest risk because of higher rates among any number of other diseases (hypertension, carcinogenic lifestyle), which only another one make it vulnerable, too. Untreated, these people are for diabetes complications in danger.

Literature Review

Paper 1: Lifestyle Interventions for Diabetes Management

In a 2014 review by Dunkley, et al. previously found in the trial that the lifestyle intervention targeted behaviour change, diet and exercise was feasible & achievable with T2DM. The assessment stated that this strong programming is around the same price and really tough to do so several low-revenue people in a area will not advantage. These data underscore the importance of affordable interventions at the community level to reach those at highest risk.

Paper 2: Diabetes Programs in the Community

In 2021, He et al. evaluated interventions stemming from low income communities. Results were much better all the way around in terms of diabetes control, health literacy and so on. Still, the short follow-up durations made it tricky to assess long-term effects. In summary, the results of this study demonstrate that community-based programs with keys characteristics are successfully tending to important unmet needs among at-risk vulnerable communities.

Theoretical Framework: Health Belief Model (HBM)

The program is based on the Health Belief Model, which says that people will take action to prevent bad health if they feel: (1) personally threatened, (2) see a benefit of taking action against this threat, and (3) can identify few psychosocial factors impeding these actions. keep scrolling down for heading 2. The program would adopt an educational model of public awareness about the danger of T2DM, making available such benefits through healthier living even more concrete and reducing obstacles to change which cost and food deserts present.

Program Design

Intervention:

· Nutrition Modules: This includes this includes diabetes-friendly meal planning with local healthy food.

· Physical Activity: Home-based twice weekly group fitness sessions held in English and other languages suitable for all fitness levels as well as cost low impact practical exercises.

· Healthcare Resources: Free HbA1c testing and monthly consultations with healthcare provider for diabetes management.

Recruitment and Retention:

Subjects will be recruited through community centers clinics and public health outreach programs. The program will offer transit vouchers linked to daycare and opportunities for flexible scheduling of workshops in an effort to lower dropout rates.

Timeline

· Month 1: Recruitment, Baseline HbA1c testing, intervention started.

· Months 2-5: Bi-weekly nutrition and exercise–themed workshops; continuous delivery of HbA1c testing.

· Month 6: final HbA1c assessment and qualitative review/briefing with group attendees.

SMART Goals

1. Specific: Lower the HbA1c level by ≥ 1.5% in at least 50% of the participants.

2. Measurable: Assessing baseline and post-program levels of HbA1c.

3. Realistic: Helping people understand what is achievable and presenting practical tips for effective training programmes → adequate resources → Adapted lifestyle.

4. Relevant: target an unmet need in diabetes care management within a vulnerable personal community.

5. Time-bound: This should happen in 6 months and will yield measurable results.

Evaluation Plan

Success throughout the program is a derivative of the initial success. The major outcome was a change from baseline to post-intervention in HbA1c levels. Secondary outcomes are health literacy, attitudes towards diabetes self-management and participant satisfaction. Surveys and qualitative interview data will explore the secondary outcomes, experience of the intervention with an emphasis on perceived barriers to action.

Barriers and Challenges

Potential Barriers:

· Transportation Problems: Transportation vouchers will be provided.

· Limited Access to Healthy Foods: Partnerships with local food banks will allow participants affordable access to healthy, nutritious food.

· Participant Dropout: This will be addressed through flexible scheduling as well as by providing incentives in the way of a small stipend in the central arm or grocery vouchers in the simplified arm.

Conclusion

The program is a community-based intervention for health promotion to improve diabetes outcomes in low-income communities with older residents suffering from increasing rates of diabetes. The program aims to lower levels of HbA1c and improve diabetes self-management by focusing on lifestyle interventions, barriers to achieving good health and well-being (e.g. access to care; cost). Health Belief Model: Behavior change is facilitated through the application of the Health Belief Model, which specifically addresses dry-cleaning exposures and limits by increasing participant recognition of their risks as well as benefits needed to improve long-term health states.

References

Champion, V. L., & Skinner, C. S. (2008). The health belief model. Health behavior and health education: Theory, research, and practice, 4th ed., 45–65.

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), 491-502.

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.

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Library Assignments

Description

Over the duration of this course you will write a scholarly paper, “Health Promotion Program Proposal,” addressing existing knowledge related to health promotion based on one practice problem (condition) that you will select from the list below. 

1. Heart disease

2. Cancer

3. COPD

4. Obesity 

5. High blood pressure

6. Type II Diabetes

7. Depression

8. Community acquired pneumonia 

Select one. In the proposal, you will also develop a health promotion program to meet a health need of a vulnerable population in your potential concentration area or community.

The proposal must demonstrate graduate school level writing and critical analysis. The final version of your proposal is due in week 11

For this assignment you will submit Part One of your proposal in week 4, detailing a health problem that is prevalent within your community and demonstrating your research of health promotion strategies for addressing this specific health problem. 

Directions

The first page should be your introductory page. 

Second page will be your selected condition and the PICOT question. Below there are examples to guide you in developing your question: 

For an intervention/therapy:

In _______(P), what is the effect of _______(I) on ______(O) compared with _______(C) within 

Prevention:

For ________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

Prognosis/Predictions

Does __________ (I) influence ________ (O) in patients who have _______ (P) over ______ (T)?

For additional information and tools about how to create you question, please visit: https://csulb.libguides.com/nursing/pico

The PICOT question is due in week II. Bring it to class to be reviewed and approved. 

1. Introduction. Describe the health problem. Don't type "Introduction". (1 paragraph).

Using data and statistics, support your claim that the issue you selected is a problem.

What specifically will you address in your proposed health promotion program?

Be sure your proposed outcome is realistic and measurable.

1. Describe the vulnerable population. (1-2 paragraph).

What are the risk factors that make this a vulnerable population?

Use evidence to support the risk factors you have identified.

1. Provide a review of literature from scholarly journals (at least 2, one of those two should be systematic review supporting what you wish to accomplish) of evidence-based interventions that address the problem. (2 paragraph, one for each article).

After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found and how this evidence supports your ideas. 

1. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal. (1-2 paragraph).

For this assignment a conclusion paragraph is not required.

Paper Requirements

Three to five pages in length (excluding title page, references, and appendices)

Follow APA format

Cite a minimum of five research articles, including the two sources you will use as body of evidence in the literature search, in point 3. 

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home.  

Description 

This is a continuation of the health promotion program proposal, part one, which you submitted previously. Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.

Directions

You have already completed the steps 1-4. Make sure you revise this initial submission according to your instructor’s comments.

1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measurable.

2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified.

3. Provide a review of literature from scholarly journals of evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search.

4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide rationale for your selection which includes discussion of the concepts of the selected model

For this assignment add criteria 5-8 as detailed below: 

1. Propose a health promotion program using an evidence-based intervention found in your literature search to address the problem in the selected population/setting. Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role. Be certain to include a timeline. (2 to 4 paragraph. You may use bullets if appropriate).

2. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach. (1 paragraph).

3. Provide a detailed plan for evaluation for each outcome. (1 paragraph). 

4. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (1 paragraph). 

5. Conclude the paper with a Conclusion paragraph. Don’t type the word “Conclusion”. Here you will share your insights about this strategy and your expectations regarding achieving your goals. (1 paragraph). 

Paper Requirements 

Your assignment should be 7-8 pages (excluding title page, references, and appendices), following APA standards. 

Remember, your Proposal must be a scholarly paper demonstrating graduate school level writing and critical analysis of existing nursing knowledge about health promotion. 

Assignment rubric

Case study I 

[100 Points Total] 

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ASSIGNMENT RUBRIC
A. B. Project Content    90 points possible	0	1	2	3	4	Score
1.Describe the health problem. Using data and statistics, support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measureable	Did not identified the problem	Poorly identified the problem and aspect to address	Vaguely identified and discussed the problem and aspect to address	Briefly identified and discussed the problem and aspect to address	Thoroughly identified and discussed the problem and aspect to address
2.Describe the vulnerable population. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified.	Did not identified or described population supported by evidence.	Poorly identified or described population supported by evidence.	Vaguely identified or described population supported by evidence.	Briefly identified or described population supported by evidence.	Thoroughly identified or described population supported by evidence.
3.Provide a review of literature from scholarly journals of evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search.	Did not provide a review of literature from scholarly journals of evidence-based interventions that address the problem.	Poorly provided a review of literature from scholarly journals of evidence-based interventions that address the problem.	Vaguely provided a review of literature from scholarly journals of evidence-based interventions that address the problem.	Briefly provided a review of literature from scholarly journals of evidence-based interventions that address the problem.	Thoroughly provided a review of literature from scholarly journals of evidence-based interventions that address the problem.
4. Select and present an appropriate health promotion/ disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.	Did not select and present an appropriate health promotion/ disease prevention theoretical or conceptual model	Poorly selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model	Vaguely selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model	Briefly selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model	Thoroughly selected and present an appropriate health promotion/ disease prevention theoretical or conceptual model
	Total Points	___/20
	Percent Accomplished	___%
	A. Project Content Points  (___% x 90 pts)	___ pts
B. Organization and Formatting   25 points possible	0	1	2	3	4	Score
Organization
Organizes project and writes well.	No project or paper submitted.	Project was unorganized and poorly written.	Project was somewhat organized and overall writing left room for improvement.	Project was well-organized, but overall writing left room for improvement.	Project was thoroughly organized and well-written.
States ideas clearly and logically.	No project or paper submitted.	Ideas were not stated clearly or logically.	Some ideas were stated clearly and logically.	Most ideas were stated clearly and logically.	All ideas were stated clearly and logically.
Writes relevant content.	No project or paper submitted.	Project was off topic and not relevant.	Some portions of project were on topic and relevant.	Project was mostly on topic and relevant.	Project was thoroughly on topic and relevant.
Formatting