Community Based Diabetes Self-Management Education Health Promotion Program
This program aims to teach members of the community measures, approaches, and policies to undertake and implement in order to prevent and control diabetes as a chronic disease. The program therefore identifies and describes efficient and effective population-based interventions applicable to diverse lifestyles and populations. The aspect of diversity ensures the program assists people to take care and prevent acquiring diabetes and the complications accompanied by the chronic illness. It also helps people to change their lifestyle habits in order to prevent and control diabetes type 2. Thus, different groups of people residing in various regions undergoing diverse lifestyle issues are catered for through the program in order to ensure they prevent and control diabetes (DPCP, 2013).
The main issue associated with diabetes as a chronic disease is the fact that people lack necessary skills and knowledge to prevent and control the condition. The Community Based Diabetes Self-Management Education Health Promotion Program therefore aims at addressing the following issues. Foremost, it strives to address healthcare issues facing people paying to receive medical services allied to chronic diseases especially diabetes. These people include insurance providers, Medicare officials, and HMOs among others. Community Based Diabetes Self-Management Education Health Promotion Program also partners with public healthcare providers in order to prevent and control diabetes. Thus, it works on a public platform relying on practice and evidence based results to formulate interventions against chronic conditions. The National Center for Chronic Disease Prevention and Health Promotion comprises of four part framework plan to prevent and control chronic diseases hence, improve healthcare conditions among the masses. The framework plan therefore promotes efforts simultaneously undertaken to address and resolve issues arising from spread of chronic disease. As a result, Community Based Diabetes Self-Management Education Health Promotion Program framework has developed a plan addressing issues related to diabetes type 2. It identifies the risk factors that can be intervened in order to prevent diabetes and improve community members’ health conditions. More importantly, it addresses underlying causes if diabetes in order to develop systems and gather resources crucial in detecting and managing diabetes among other chronic conditions (Mozaffarian, Kamineni, Djousse, Mukamal & Siscovick, 2009).
Thus, the Community Based Diabetes Self-Management Education Health Promotion Program framework is divided into the following domains. Foremost, the epidemiology and surveillance domain is tasked in gathering, analyzing, and disseminating data and information. The results collected by undertaking this domain such as evaluation reports are utilized in making decisions. The decision making process ensures prioritized interventions are delivered and monitored to improve populations’ health conditions (Ryan, 2009).
The second domain involves environmental approaches. It is tasked in promoting health among members of the community. As a result, it educates, supports, and reinforces healthful behaviors community members including individuals, schools, and worksites can to prevent, control, and manage diabetes as a chronic disease. The health system intervention is required to increase and improve use of effective preventive and clinical care services. The Community Based Diabetes Self-Management Education Health Promotion Program is therefore keen in ensuring diabetes is a preventable chronic disease. In order to prevent diabetes, the domain ought to detect the onset of the chronic diabetes disease in order to implement factors aimed at reducing the risks and complications likely to arise. The last domain involves strategies to improve the link between community and clinical programs. These programs strive to support approaches, measures, and policies aimed at improving healthcare conditions among the people. Thus, they ought to cooperate and collaborate in order to formulate and implement prioritized management programs. The programs ought to address diabetes as a chronic disease. The Community Based Diabetes Self-Management Education Health Promotion Program acknowledges people seek clinical services before being referred to intervention programs. As a result, it strives to ensure the clinical and community based intervention programs support efforts towards preventing and controlling diabetes type 2 (DPCP, 2013).
The resources necessary to ensure the functions and operations undertaken by Community Based Diabetes Self-Management Education Health Promotion Program are effective and efficient are diverse. In order to identify the resources, it is vital to understand the core interventions pursued by the program. The first core intervention involves ensuring the quality of clinical care provided to community members improves. Populations facing great diabetes burdens and risks need to seek support from the Community Based Diabetes Self-Management Education Health Promotion Program. This provides the populations with skills they can utilize to improve, control, and manage healthcare and clinical issues related to diabetes. For example, the program educates the populations to control and manage cholesterol levels, blood pressure, body weight, AIC, and promote tobacco cessation. This is because; failure to address these healthcare issues promotes spread of diabetes type 2 (Mozaffarian, Kamineni, Djousse, Mukamal & Siscovick, 2009).
The second core intervention involves the program increasing accessibility to sustainable self-management education and support services. Members of the community especially facing great diabetes risks and burdens are therefore encouraged to seek help and assistance from Community Based Diabetes Self-Management Education Health Promotion Program. Consequently, the program strives to teach them to adopt lifestyle choices ensuring they prevent, control, and manage healthcare issues likely to lead to diabetes. The final core intervention involves the program encouraging increased usage of lifestyle change programs. It identifies programs that have successfully CDC recognition in order to prevent or delay diabetes type 2 from insetting. In order to meet and fulfill these interventions, the Community Based Diabetes Self-Management Education Health Promotion Program requires the following resources (DPCP, 2013).
Foremost, the program requires staffs. The Bureau of Health Promotion asserts that, hiring skilled, qualified, experienced, and dedicated staffs motivated to assist in achieving and fulfilling intervention program’s objectives is vital. Thus, Community Based Diabetes Self-Management Education Health Promotion Program hires and trains staffs as human resources tasked in assisting persons seeking support services allied to diabetes and other chronic diseases. The staffs are also required to address healthcare issues related to injuries and disabilities. The current salaried staffs comprising human resources at the Community Based Diabetes Self-Management Education Health Promotion Program are budgeted at over two hundred thousand dollars monthly (DPCP, 2013).
The second resources are allied to financial funding. Supplementing financial resources is vital. Through financial funding, the program is able to formulate and implement intervention services aimed at preventing and managing diabetes. The supplemented financial resources can also be utilized to address other chronic diseases as well as heart attacks and strokes likely to affect people at risk of diabetes type 2. The other resources are based on the needs identified at central locations undertaking measures to achieve the program’s goals and objectives. These locations include clinics that require more than sixty thousand dollars per year to continue providing supportive and interventional services against diabetes type 2. Thus, the Community Based Diabetes Self-Management Education Health Promotion Program requires human, financial, and technological resources. Technological resources include query-able software serving as a repository for clinic data related to prevention and management of diabetes (DPCP, 2013).
The feasibility of the program depends on the level of stakeholders’ engagement. Community Based Diabetes Self-Management Education Health Promotion Program engages HMOs in order to bring stakeholders together and share organizational data and practices. This is crucial as best practices related to diabetes care are identified. The stakeholders also ensure staffs are fully aware of the program’s goals and objectives, hence dedicated to achieve them effectively and efficiently. Regular face-to-face meetings to update program’s intervention services and guidelines in regulating the resources are also vital. They guarantee stakeholders and partners take part in resolving barriers, problems, and potential challenges likely to adversely affect quality improvement initiatives formulated by the program to improve populations’ healthcare conditions in relation to chronic conditions. The timeline required to ensure the program’s feasibility is achieved is six months. After every six months, program’s stakeholders and partners as well as human resources gather to evaluate the progress. The meeting identifies issues hindering the program’s goals and objectives to be achieved or fulfilled within the timeline. Consequently, participants are awarded an opportunity to provide solutions, suggestions, ideas, and opinions that can resolve the problems and barriers identified (DPCP, 2013).
The Intended Outcomes of the Community Based Diabetes Self-Management Education Health Promotion Program (SMART Goal Approach)
The program intends to teach members of the community measures, approaches and policies to undertake and implement in order to prevent and control diabetes. It also intends to identify and describes population-based interventions applicable to diverse lifestyles and populations leading to onset of diabetes. It also intends to assist people in changing lifestyle habits in order to prevent and control diabetes. For example, it aims to encourage people to engage in physical activities and nutritional eating habits to prevent and control diabetes type 2 (Chernoff, 2001).
Foremost, the program intends to motivate HMOs, insurance providers, and Medicare officials, to provide services that can prevent onset of diabetes. It also intends to identify risk factors the program can intervene to prevent diabetes and improve health conditions among the populations. Essentially, it intends to addresses causes if diabetes before developing systems and gathering resources crucial in detecting and managing diabetes. For example, it intends to affirm that, poor nutritional habits, lack of physical exercise, stress, and genetic compositions increase onset of diabetes. Thus, populations should address these causes of diabetes to prevent its onset (Mozaffarian, Kamineni, Djousse, Mukamal & Siscovick, 2009).
The main achievable outcome involves the program educating populations to address, control and manage factors predisposing them to onset of diabetes. Thus, the program will educate populations to control cholesterol levels. This involves eating a balanced diet and engaging in physical activities such as yoga, jogging, or running in order to control body weight. The program also educates population to control blood pressure. This involves avoiding stress and consuming diets comprising of junk and unhealthy foodstuffs likely to clog blood vessels. Consequently, the program educates populations to promote tobacco cessation and control stress levels as they prevent blood pressure and onset of diabetes (Chernoff, 2001).
Foremost, the program requires staffs skilled, qualified, experienced, dedicated, and motivated to assist in achieving and fulfilling intervention program’s outcomes. It also needs financial resources to address risk factors favoring spread of diabetes. Thus, the outcomes of the program are based on availability and supply of human and financial resources (DPCP, 2013).
The first four months define the program’s path convention. The next four months describe the program’s centralized data collection procedure. The last quarter of the year involves holding workshops across various regions to educate people on measures to undertake to control and prevent onset of diabetes. The program also schedules regular meetings twice a year. This ensures the program’s activities are being undertaken according to the schedules. The meetings also address potential and actual barriers and challenges hindering the program to achieve its annual goals and objectives (Osborn & Fisher, 2008).
- Evaluation for each Outcome
The aspects applied in evaluating the outcomes of the program include; trends in performance, variation among HMOs and health systems’ performances, and national performance comparisons. On an annual basis, data is collected and compared to national and regional averages. The program’s evaluation approach focuses on the following outcomes. Foremost, the program evaluates the rates of improvement in ensuring populations’ physical activities have increased in order to reduce cholesterol levels. This further leads to control of blood pressure. Clinical outcome data on monthly basis is also evaluated to provide a combined analysis assessing health conditions among populations risking onset of diabetes. The patient experience is also utilized to determine the baseline of the program. Positive experiences affirm the program’s services are effective. Conversely, negative responses prompt an investigation to identify statistical significant resources to implement to improve the patients’ experiences. For example, the program strives to reduce incidences of patient discrimination and bias. Consequently, the progress outcome measures actual improvements in clinical abilities to prevent and control diabetes among other chronic conditions (DPCP, 2013).
- Possible Barriers/Challenges and Strategies to address them
The main challenges are faced during implementation process. Reaching Medicaid patients is challenging due to lack of updated contacts, unreliable transport services in rural regions, and stiff competition in identifying the program’s priorities. The program also faces a possible challenge if it does not provide clinical services. This is because it focuses on educational and care coordination services. This can burden the relationship between the program and clinical facilities hindering the program to achieve its goals and objectives. It is also challenging to identify an appropriate data system encompassing disease management, diabetes education, care coordination, and quality improvement (Osborn & Fisher, 2008).
In order to address these barriers and challenges, the program ought to maintain steady and stable relationships with primary caregivers. This will ensure populations in rural areas that cannot be easily reached access supportive services from the primary caregivers. Staffs within the program can also develop a schedule to visit sites they can reach Medicaid patients and populations from rural regions in order to provide them with education-based resources to prevent and control onset of diabetes. An electronic data management system should be developed capable of documenting and managing the program’s services safely. It should document patient encounters, clinical information, correspondences, referrals, and the program’s outcomes (Osborn & Fisher, 2008).
Chernoff, R. (2001). Nutrition and Health Promotion in Older Adults. Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 56(2), 47-53.
Diabetes Prevention and Control Programs (DPCP). (2013). Effective Public Health Strategies to Prevent and Control Diabetes. United States Department of Health and Human Services, Centers for Disease Control and Prevention.
Mozaffarian, D., Kamineni, A., Djousse, L., Mukamal, K. J., & Siscovick, D. (2009). Lifestyle Risk Factors and New-Onset Diabetes Mellitus in Older Adults: The Cardiovascular Health Studies. Archives of Internal Medicine, 169(8), 798–807.
Osborn, C. Y. & Fisher, J. D. (2008). Diabetes Education: Integrating Theory, Cultural Considerations, and Individually Tailored Content. Clinical Diabetes, 26(4), 148-150.
Ryan, P. (2009). Integrated Theory of Health Behavior Change Background and Intervention Development. Clinical