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Chb 502 | Health Behavior Assessment Answers

Write a report on type2 diabetes.

Answer:

Introduction

Health behavior and change have become one of the most relevant healthcare issues in Latin America over the last few decades. The changing course of lifestyle is considered a significant reason for the change in health behavior. Presently, type2 diabetes has become one of the main causes that are controlling the morbidity and mortality rate among the Latinas in terms of health behavioral change. The rate of type2 diabetes has increased among the Latinas by 24% in past ten years. Thus, there is an impactful requirement of effective intervention process to mitigate the behavioral issues in the type2 diabetes prevention from the Latina communities. The Precede and Proceed model can be considered as a most effective model that can control the behavioral change in the type2 diabetes prevention process among the Latinas. The Precede and Proceed model is a universally acknowledged health assessment structure that can locate the behavioral change. Moreover, this model is impactful in assessing, designing, implementing and evaluating the health promotions for the public health betterment. This study will unfold the effectiveness of the Precede and Proceed model to evaluate the healthcare behavioral change in the prevention techniques of type2 diabetes care in the Latin population. The concluding part will summarize the whole study and will refer an overall recommendation on the utilization of Precede and Proceed model to mitigate the risks if type2 diabetes from the Latinas.

Analysis

Problem analysis

Type2 diabetes is one of the most common diseases among the Latin population of USA. The inappropriate proportion of the distribution of healthcare insurance and the lack of type2 diabetes awareness are the key reasons for the growth of type2 diabetes (Yeoh, Choudhary, Nwokolo, Ayis & Amiel, 2015). The prevention of type2 diabetes symptoms lies in the effective implementation of the Precede and Proceed framework. This framework is capable to assess the key diabetic factors and issues and can implement effective strategies to mitigate the diabetic symptoms form the Latinas (Yeoh, Choudhary, Nwokolo, Ayis & Amiel, 2015). It is notable that 5.35% of the people ageing from 18-44, 61.3% of the people ageing from 45-64 and 71.0% of the population ageing from 65-74 have the diabetic awareness (American Diabetes Association, 2015). The behavioral analysis of precede and proceed model can enhance the capability of the intervention process.

Figure: Age-wise availability of type2 diabetes care plan

Source: https://care.type2 type2 diabetesjournals.org/content/37/8/2233

It is identified that the Latina population is one of the most deprived population in the USA in terms of getting the health insurance plan for type2 diabetes. Only 19% of the Latina population gets health insurance (American Diabetes Association, 2015). It can be considered as a vulnerable aspect for the type2 diabetes prevention plan (Raymond-Flesch, Siemons, Pourat, Jacobs & Brindis, 2014). An effective type2 diabetes prevention plan is capable to mitigate the issue. Moreover, the type2 diabetes intervention plan can be executed and implemented on the target population with the proper execution of the Precede and Proceed model (Raymond-Flesch, Siemons, Pourat, Jacobs & Brindis, 2014).

Figure: health insurance for type2 diabetes by Latinas

Source: https://www.pewhispanic.org/2008/08/13/hispanics-and-health-care-in-the-united-states-access-information-and-knowledge/

SMART plan for type2 diabetes intervention

The diabetes prevention program can be developed to support the people of Latina to mitigate the symptoms of type2 diabetes. The program includes lifestyle intervention, metformin intake and losing weight (Tovote et al., 2015).

Specific

Measurable

Attainable

Realistic

Time-bound

lifestyle intervention

It can be measured by practicing a regular checkup of the blood sugar level which is normally 63.3mg/dL for the Latinas

It can be attained by checking the lifestyle. For example- quitting smoking, drinking and sweet foods and regular exercise (Ezzati & Riboli, 2013).

It is realistic because practicing a healthy lifestyle reduces obesity level which is one of the prime reasons for type2 diabetes

It should be done within 15 days

metformin intake

It can be measured by identifying the HbA1c level. The 0.8% level of the HbA1c level is considered (Raymond-Flesch, Siemons, Pourat, Jacobs & Brindis, 2014).

It is attainable because metformin is the most conventional treatment for type2 diabetes

It is realistic because the metformin intake is capable to control the level of aA1c from 0.8% to 3.1% (Tovote et al., 2015).

The metformin intake must be provided within 20 days of identifying the type2 diabetes symptoms

losing obesity

This can be measured by analyzing the Body Mass Index (BMI) of the Latinas (Raymond-Flesch, Siemons, Pourat, Jacobs & Brindis, 2014).

It is attainable as a maintained diet and regular exercise can reduce the level of obesity

It is realistic because it has been found that losing 7% of the obesity level can reduce the symptoms of type2 diabetes by up to 15% (Tovote et al., 2015).

It must be started within seven days after identifying the symptoms of type2 diabetes

 Table: SMART plan for type2 diabetes intervention for the Latinas

Source: Created by the researcher

Implementation of SMART intervention through Proceed and precede model

The intervention plans can be properly implemented with the effective utilization of Proceed and precede model. The Precede assessment is capable to analyze the adaptation and authenticity of the proposed intervention plan for the type2 diabetes care for the Latina (Viana, Gross & Azevedo, 2014). On the contrary, the Proceed part is capable to evaluate the after effects of the plan, implementation of the plan and the accessibility of the type2 diabetes intervention plan to the target population (Viana, Gross & Azevedo, 2014).

Implementation of diabetes intervention plan through Precede and Proceed model

The intervention plan for the type2 diabetes care for the Latinas can be properly executed with the effective implementation of the Precede and Proceed model. The Precede and Proceed model is a comprehensive structure to evaluate the healthcare prevention form the target population. 18.75% of the Latinas over 16 and 14.84% of the ageing 6 to 10 suffer from an acute level of type2 diabetes (American Diabetes Association, 2018). Thus, the implementation of Precede and Proceed model can be capable to mitigate the rate of type2 diabetes affected people from the Latin population (DePue et al., 2013).

Figure: Type2 type2 diabetes prevalence of Latinas according to age

Source: https://care.type2 type2 diabetesjournals.org/content/37/8/2233

The Precede assessment

The Precede assessment includes the predisposing, reinforcing, diagnosis and evaluation of the healthcare situation. This is helpful to mitigate the complexities regarding type2 diabetes among the Latinas (DePue et al., 2013). Moreover, this part is developed to locate, monitor, execute and implement the type2 diabetes intervention plan for the Latinas. The execution process can be segregated into different factors (Viana, Gross & Azevedo, 2014). The factors that promote the Precede assessment are social factors, epidemiological factors, ecological factors and administrative and policy factors (Litwak et al., 2018).

  • Social factors: This factor determines the social barriers of the identified diseases and helps to evaluate the result gathered from social assessment (Braveman & Gottlieb, 2014). The social factors have outlined the fact that overall 37.8% of the Latinas use to suffer from pre-type2 diabetes syndrome and 20.1% suffer from the acute level of type2 diabetes (American Diabetes Association, 2018). The identification of the social factors initiates the execution of the type2 diabetes intervention plan for the Latinas. The accumulation of the data of American type2 diabetes Association is impactful to plan accordingly for the further progress for the intervention
  • Epidemiological factors: The epidemiological factors are used to identify the healthcare determinants that are impactful on the identified issued prior to achieving the intervention goal. The high blood sugar is considered the most notable determinants that create the barrier to the development process of the intervention (Izzati & Riboli, 2013). Thus, blood sugar management is necessary to mitigate the diabetic syndromes of the Latinas (Izzati & Riboli, 2013). The identification of the healthcare determinants in the epidemiological factors is helpful to locate the healthcare factors of the Latinas that are promoting the diabetic symptoms among them (Viana, Gross & Azevedo, 2014). This is impactful on developing the plans to measure the intakes of medication that could be useful for the implementation of the type2 diabetes intervention plan.
  • Ecological factors: The ecological factors determine the environmental and behavioral aspects that are impactful on the prevention process of healthcare issues. The environmental and behavioral factors are relatable with the lifestyle changes (Clark, Boghani, Grullon, & Batista, 2017).The constant change of lifestyle for the Latina population has been increasing the risks associated with the type2 diabetes. The consumption of alcohol, drugs and smoking habit can be identified as the key behavioural change factors motivating type2 diabetes (Clark, Boghani, Grullon, & Batista, 2017).
  • Administrative and policy factor change: The administrative and policy factors govern the identified change in the intervention process. This process is also helpful to evaluate the implementation of the Precede model to control the rising trend of type2 diabetes from the Latina population (Clark, Boghani, Grullon, & Batista, 2017). The identification of the administrative and political factors can be helpful to address the factors that promote the strategic change of the type2 diabetes care intervention plan (Clark, Boghani, Grullon, & Batista, 2017).
The Proceed assessment
The Proceed assessment signifies the political, regulatory and educational development to mitigate the healthcare issues. This proceed assessment is impactful on developing, implementing, monitoring and reviewing the type2 diabetes intervention plan (Mayberry & Osborn, 2014). The analysis of the behavioral outcome of the type2 diabetes intervention plan is the most effective concept of Proceed assessment. The expansions of the Proceed factors align the development of the type2 diabetes care prevention form the Latina population (DePue et al., 2013). The Proceed assessment starts from where the Precede assessment ended. The factors that affect the Proceed factors are implementation, progress evaluation, impact evaluation and outcome evaluation (Koivusalo et al., 2016).

Implementation: The implementation stage defines the strategic outcome of type2 diabetes intervention management. The type2 diabetes intervention plan is practically implemented on the target population under this plan. The utilization of the available resources, possibilities and requirement of the implementation program to assess the intervention progress (Koivisalo et al., 2016). The process includes measurement of blood sugar level, advice for medication, advice for sugar intake and requirement of insulin dosage (Tanaka et al., 2013). The normal level of glucose level among the Latina people is 63.3mg/dL (Patrick et al., 2013). Any further increase in the glucose level is considered to be a high level of type2 diabetes from where the implementation process would start.

  • Process evaluation: The process evaluation defines the authentication of the care planning process and its accessibility to the target population. The intervention process can be evaluated by measuring the effectiveness of the process can be evaluated by arranging free type2 diabetes care campaign among the Latina community (Aiello & DCCT/EDIC research group, 2014). The implementation of the healthcare campaign to the Latina people can be handy to identify the reach of the program planning (Tanaka et al., 2013). Type2 diabetes care campaign, free type2 diabetes care check-up, blood sugar test and glucose level among the Latina communities can be the best way evaluates the type2 diabetes intervention implementation process (Koivisto et al., 21016).
  • Impact of Evaluation: The impact of the evaluation defines the effectiveness of the prevention process to change the behavior of type2 diabetes affected people (Koivisto et al., 21016). This can be measured by rechecking the reduction of diabetic symptoms. This includes the sustainability in the normal blood sugar level, reducing the smoking and drinking habit and reduction of the level of obesity (Tanaka et al., 2013).
  • The outcome of the evaluation: This is the final stage of the Precede model where the outcome is analyzed. It is found from the evaluation that there is a consistent growth in healthcare and the symptoms of type2 diabetes (Arora, Peters, Burner, Lam, & Menchine, 2014). The intervention process has reached almost 70% of the target population. The level of obesity has decreased by 45% after practicing the type2 diabetes intervention plan to the Latina (Nathan, 2014). The HbA1c level is decreased to 0.8% of around 55% of the target population after having metformin intake (Aileo, 2014). Thus, the outcome of the evaluation has made it clear that the effective implementation of the Precede-Proceed is impactful on developing the healthcare situation of the target population.

Figure: Proceed and Precede framework

Source: https://www.publichealthnotes.com/behavioral-change-approach-precedeproceed-model/

Conclusion

The study has unfolded the effectiveness of the Precede and Proceed model to implement the type2 diabetes intervention plan focusing on the behavioral aspect. Type2 diabetes is one of the most prevalent diseases for the Latinas. Type2 diabetes and prediabetic syndromes affect around 30% of the Latinas. The behavioral and lifestyle change can also be identified as a significant part of the reasons of diabetic syndromes. Apart from that, high obesity, lack of physical exercise and poor health insurance system are also the reasons for type2 diabetes among the Latinas. Thus, the prevention from the diabetic symptoms has been identified in the study. The preventive techniques are implemented practically with the effective implementation of the Precede and Proceed model. Thus, the proper implementation of the anti-diabetic plan can be mitigated by effective type2 diabetes intervention plans with the help of the Precede and Proceed model.

References

Aiello, L. P., & DCCT/EDIC research group. (2014). Diabetic retinopathy and other ocular findings in the type2 type2 diabetes control and complications trial/epidemiology of type2 type2 diabetes interventions and complications study. Type2 type2 diabetes care, 37(1), 17-23. Link: https://care.type2 type2 diabetesjournals.org/content/diacare/37/1/17.full.pdf

American Type2 type2 diabetes Association. (2015). 2. Classification and diagnosis of type2 type2 diabetes. Type2 type2 diabetes care, 38(Supplement 1), S8-S16. Link:https://care.type2 type2 diabetesjournals.org/content/diacare/38/Supplement_1/S8.full.pdf

Arora, S., Peters, A. L., Burner, E., Lam, C. N., & Menchine, M. (2014). Trial to examine text message–based health in emergency department patients with type2 type2 diabetes (TExT-MED): A randomized controlled trial. Annals of emergency medicine, 63(6), 745-754. Link: https://agilehealth.com/wp-content/uploads/AEM_TExT-MED-Annals-3-.pdf

Braveman, P., & Gottlieb, L. (2014). The social determinants of health: it's time to consider the causes of the causes. Public health reports, 129(1_suppl2), 19-31.link: https://journals.sagepub.com/doi/pdf/10.1177/00333549141291S206

Clark, B., Boghani, S., Grullon, C., & Batista, M. (2017). The Impact of a Worksite-Based Type2 type2 diabetes Prevention Intervention: A Pilot Study. Population health management, 20(3), 233-238.link: https://www.liebertpub.com/doi/pdfplus/10.1089/pop.2016.0055

DePue, J. D., Dunsiger, S., Seiden, A. D., Blume, J., Rosen, R. K., Goldstein, M. G., ... & McGarvey, S. T. (2013). Nurse–community health worker team improves type2 type2 diabetes care in American Samoa: results of a randomized controlled trial. Type2 type2 diabetes Care, DC_121969. Link: https://care.type2 type2 diabetesjournals.org/content/early/2013/02/12/dc12-1969.short

Ezzati, M., & Riboli, E. (2013). Behavioural and dietary risk factors for noncommunicable diseases. New England Journal of Medicine, 369(10), 954-964. Link: https://www3.med.unipmn.it/papers/2013/NEJM/2013-09-04_nejm/nejmra1203528.pdf

Koivusalo, S. B., Rönö, K., Klemetti, M. M., Roine, R. P., Lindström, J., Erkkola, M., ... & Andersson, S. (2016). Gestational type2 type2 diabetes mellitus can be prevented by lifestyle intervention: the Finnish Gestational Type2 type2 diabetes Prevention Study (RADIEL): a randomized controlled trial. Type2 type2 diabetes care, 39(1), 24-30.link: https://care.type2 type2 diabetesjournals.org/content/diacare/39/1/24.full.pdf

Mayberry, L. S., & Osborn, C. Y. (2014). Empirical validation of the information–motivation–behavioral skills model of type2 type2 diabetes medication adherence: a framework for intervention. Type2 type2 diabetes care, DC_131828.link: https://care.type2 type2 diabetesjournals.org/content/diacare/early/2014/03/04/dc13-1828.full.pdf

Nathan, D. M., & DCCT/Edic Research Group. (2014). The type2 type2 diabetes control and complications trial/epidemiology of type2 type2 diabetes interventions and complications study at 30 years: overview. Type2 type2 diabetes care, 37(1), 9-16.link: https://care.type2 type2 diabetesjournals.org/content/diacare/37/1/9.full.pdf

Patrick, K., Norman, G. J., Davila, E. P., Calfas, K. J., Raab, F., Gottschalk, M., ... & Covin, J. R. (2013). Outcomes of a 12-month technology-based intervention to promote weight loss in adolescents at risk for type 2 type2 type2 diabetes. Journal of type2 type2 diabetes science and technology, 7(3), 759-770.link: https://journals.sagepub.com/doi/pdf/10.1177/193229681300700322

Litwak, L., Goh, S., Hussein, Z., Malek, R., Prusty, V., & Khamseh, M. (2018). Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study.

Raymond-Flesch, M., Siemons, R., Pourat, N., Jacobs, K., & Brindis, C. D. (2014). There is no help out there and if there is, it's really hard to find”: A qualitative study of the health concerns and health care access of Latino “DREAMers. Journal of Adolescent Health, 55(3), 323-328. Link: https://www.jahonline.org/article/S1054-139X(14)00235-3/pdf

Tanaka, S., Tanaka, S., Iimuro, S., Yamashita, H., Katayama, S., Akanuma, Y., ... & Ohashi, Y. (2013). Predicting macro-and microvascular complications in type 2 type2 type2 diabetes: the Japan Type2 type2 diabetes Complications Study/the Japanese Elderly Type2 type2 diabetes Intervention Trial risk engine. Type2 type2 diabetes Care, DC_120958.link: https://care.type2 type2 diabetesjournals.org/content/diacare/early/2013/02/07/dc12-0958.full.pdf

Tovote, K. A., Schroevers, M. J., Snippe, E., Sanderman, R., Links, T. P., Emmelkamp, P. M., & Fleer, J. (2015). Long-term effects of individual mindfulness-based cognitive therapy and cognitive behavior therapy for depressive symptoms in patients with type2 type2 diabetes: a randomized trial. Psychotherapy and psychosomatics, 84(3), 186-187. Link: https://www.rug.nl/research/portal/files/13708132/Complete_dissertation.pdf#page=96

Viana, L. V., Gross, J. L., & Azevedo, M. J. (2014). Dietary intervention in patients with gestational type2 type2 diabetes mellitus: a systematic review and meta-analysis of randomized clinical trials on maternal and newborn outcomes. Type2 type2 diabetes Care, 37(12), 3345-3355. Link; https://care.type2 type2 diabetesjournals.org/content/diacare/37/12/3345.full.pdf

Yeoh, E., Choudhary, P., Nwokolo, M., Ayis, S., & Amiel, S. A. (2015). Interventions that restore awareness of hypoglycemia in adults with type 1 type2 type2 diabetes: a systematic review and meta-analysis. Type2 type2 diabetes Care, 38(8), 1592-1609. Link: https://care.type2 type2 diabetesjournals.org/content/diacare/38/8/1592.full.pdf


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