Health promotion, prevention, or management need and appropriate contextual information

Health promotion, prevention, or management need and appropriate contextual information

As earlier stated, Type 2 Diabetes continues to be an underlying health burden in the state of Georgia, particularly among the elderly African American population. The leading socio-economic factors, as well as biological risk factors leading to Type 2 Diabetes, have been appropriately discussed in the chapters above, and understanding them is imperative in the disease’s health promotion, prevention, or management. Primarily, Diabetes Self-Management Education and Support (DSMES), tends to be a proven prevention plan teaching techniques of controlling blood sugar levels as well as their medication. Presumably, DSMES extensively relies upon the seven self-management behaviors. These include healthy eating, being active, blood glucose level monitoring, problem-solving, adherence to prescribed medication, finding healthy ways to cope, and the reduction of risks of complications development (Georgia Department of Public Health, 2015). Foremost, Georgia has improved diabetes and pre-diabetes surveillance system. The system gives

Accordingly, the Georgia Department of Public Health (DPH) has rolled out some initiates in its action plan for the health promotion, prevention, and management of Type 2 Diabetes among the elderly African American population. Foremost, Georgia has improved diabetes and pre-diabetes surveillance system. The system gives Georgia DPH access to both behavioral and self-reported data concerning the prevalence of diabetes and associated risk factors as well as claims data from hospitals (Georgia Department of Public Health. (2015). This set of data is particularly essential in diabetes surveillance. Secondly, Georgia has a reimbursement system for control services and evidence-based prevention for the disease. Medicare, although to a small extent, reimburses both self-management (DSMES) and prevention programs (weight loss, proper nutrition, and physical activity) for people with diabetes. Thirdly, the provision of professional education for diabetes through nurses, physicians, and public health professionals, particularly in rural Georgia, is crucial for early pre-diabetes and diabetes identification and promotion of healthy lifestyles as mitigation measures. Lastly, community-level promotion of self-management supports is critical to the management and control of the disease because of socio-economic disparities making access to clinical setting difficult (Georgia Department of Public Health, 2015).

Major components of the intervention plan for health promotion, prevention, or management need

Accordingly, an effective intervention plan for the health promotion, prevention, and management needs of patients with Type 2 Diabetes, demands some fundamental prerequisites. These prerequisites make up the major components of the intervention plan. Particularly among the elderly African American patient target populations, these primary components are specific, given their unique cultural needs and characteristics. Mainly, these principal components are underscored by the following five principles:

1. Participation and Involvement

Participation and involvement is perhaps the central component of a health intervention plan because it presents the target population with the opportunity to influence the disease intervention process. The active participation of the target group in a health intervention plan consists of the ownership and internalization of the entire process from the very beginning (Grabowski et al., 2017).

2. A Comprehensive and Positive Health Model

Accordingly, the conceptualization of this particular component of health intervention planning demands the understanding of health in broader terms than merely its perception of causing disease and death. As such, it should capture the scopes of a good life as well as the vitality of social relations (Grabowski, 2017).

3. Action and Action Competence

According to Grabowski (2017), effective diabetes intervention rallies alongside the component of action and action competence as participants in entirety are presented with different opportunities for skill-building. These skills are essential in managing their lives as well as changing the structural and conditional elements affecting their health outcomes.

4. Equity in Health

Fundamentally, this component of health promotion intervention notes that health promotion interventions take into account the disproportionate dissimilarities in equal prospects for healthy living and subsequent health outcomes as well as changing healthcare practices (Grabowski, 2017).

5. A setting Perspective

Predominantly, health promotion interventions should be perceived from a setting perspective, which influences the health outcomes of the patient population. It, therefore, means that this particular component accentuates both the structural and contextual setting where the patient population interacts through the residence, work, and life, and which influences their prospects for health outcomes (Grabowski, 2017).

The impact of cultural needs and characteristics of a target population and setting on healthcare practices

Cultural competence constitutes an essential element in quality health care delivery and promotion. Patient populations have specific cultural needs and characteristics, and elderly African Americans with Type 2 Diabetes in Georgia are no exception. These cultural needs and characteristics substantially impact healthcare practices, necessitating the need for cultural competence by healthcare practitioners and providers. This means for more cultural awareness concerning the target population’s habits, health beliefs, and subsequent explanatory models for the disease.

Accordingly, the cultural needs and characteristics of elderly African Americans with Type 2 Diabetes in Georgia are incredibly unique, impacting healthcare practices in entirely different ways compared to the mainstream population. Foremost, the nutritional culture and lifestyle among African Americans in Georgia, like in most southern regions, is highly characterized by the consumption of high cholesterol foods. As a result, the target population is prone to abdominal obesity and insulin resistance, which are underlying risk factors for the disease, leading to frequent chronic complications and ultimately increased mortality rates (Caballero, 2018).

Besides, the prevalence of high socio-economic disparities among the ethnic group in Georgia leaves African Americans disproportionately disadvantaged and marked by high levels of poverty, illiteracy, inadequate access to healthcare, and limited healthcare insurance coverage (Caballero, 2018). Presumably, these socio-economic disparities substantially increase the associated risk factors for type 2 diabetes, because of lack of diabetes knowledge, limited medical insurance, challenges in medication adherence, and limited access to diabetes healthcare facilities, exposing them to the prevalence of pre-diabetes and diabetes conditions.

Accordingly, religion and faith are other cultural components impacting healthcare practices among African Americans with type 2 diabetes in Georgia. Primarily, there is a widespread perception among African Americans that diabetes is some sort of punishment from God. As a result, spirituality tends to become a significant coping mechanism because patients resort to religion to find answers and cope with the disease rather than adhere to prescribed medication (Caballero, 2018). As such, healthcare providers and practitioners are closely working with religious institutions, including churches and church leaders, to integrate healthcare into religious beliefs and make diabetes information and treatment available along with the integration of patients’ religious beliefs.

Impact of stakeholder needs, healthcare policy, regulations, and governing bodies relevant to healthcare practice

The role of stakeholder needs, regulations, healthcare policies, and governing bodies concerned in the healthcare practice of African Americans with Type 2 Diabetes is not easy to overlook. Collectively, their impact is enormously felt through the disease’s health promotion, prevention, and management among the target population in Georgia. Predominantly, the major stakeholders in type 2 diabetes healthcare practice consist of the elderly African Americans making up the patient target population, nursing practitioners, insurance companies, employers, the government, and pharmaceutical firms. Each of these players has distinctive needs that impact healthcare practice in varying ways.

Perceptively, the needs of the stakeholders, regulations, healthcare policy, and governing bodies significantly impact the planning of population health interventions. Accordingly, Golden et al. (2017) note that these factors influence the healthcare policy, multisectoral collaborations, and community clinic partnerships. Particularly, stakeholder needs impact intervention planning mainly through the access of medical insurance to African Americans with type 2 diabetes in Georgia. A multi-sectorial approach enables Medicare to advance medical insurance to patients without any form of insurance to ease their access to diabetes treatment. Similarly, Georgia has a healthcare policy in which Medicare reimburses self-management and prevention programs for type 2 diabetes to enable patient’s access to affordable healthcare (Georgia Department of Public Health, 2015). At the same time, insurance companies are continually working with employers and the state government to create insurance covers for the low income earning target population of African Americans.

Correspondingly, community-clinic partnerships are a critical feature in health interventions for elderly African Americans with type 2 diabetes in Georgia. Given their socio-economic status, the target population is significantly disadvantaged in accessing diabetes healthcare as such communities have to partner with clinics to make diabetes care accessible to the people. In that sense, inexpensive diabetes care access is made possible, enabling community-based interventions, ambulatory care interventions, and inpatient (acute) interventions (Golden et al., 2017).

Relevant ethical and legal issues related to practice and change

The very intervention planning for type 2 diabetes in itself presents severe ethical and legal issues when it comes to its health promotion, prevention, and management needs. Underlying research posits that caring for patients with chronic diseases such as Type 2 Diabetes presents caregivers with a plethora of significant ethical and legal challenges (Liu & Kohlen, 2018). Accordingly, patients demand to be equipped with pertinent information about diabetes self-management. Although such a predisposition by caregivers is highly commendable, it ultimately presents a tremendous ethical dilemma on the patient’s autonomy. Liu and Kohlen satisfy that in the dispensation of care, nurses ought to respect patients’ freedom with regards to their rights about their health (2018). Thus it often presents a challenge when nurses cannot undermine the will of the patient in handling their health management, even when they are acting in the patients’ best interest.

Accordingly, in Type 2 Diabetes intervention planning, ethical issues stem from the choice for continuous treatment of patients versus respect for the patients’ will. As seen, Liu and Kohlen (2018) postulate that nurse’s role in advocating for healthy lifestyles and healthy eating habits for their patients is perceived as exerting control and instilling fear, which presents a significant amount of difficulties to caregivers. Often the patient’s motivation is withdrawn in following through with treatment plans even when the nurses attempt to achieve the care objectives mandated by health care professionals, causing tension between the parties (Liu & Kohlen, 2018). In the long-run, such conflicting goals in authority and responsibility in healthcare delivery place nurses at a disproportionately disadvantaged position in implementing intervention plans. The stress exerted results in sub-optimal care, which substantially exposes them to a myriad of legal consequences from the patients and patient families.

Supporting theoretical nursing models and strategies from other disciplines to practice

The self-care theory endorsed by Orem is perhaps the most appropriate supporting conceptual nursing model in the health promotion intervention of Type 2 Diabetes among the elderly African American population. Primarily, Orem’s theory holds that Type 2 Diabetes patients are entitled to self-care interventions out of their free will and deliberation in maintaining their life, health, and wellbeing (Borji, Otaghi & Kazembeigi, 2017). In so doing, these self-care interventions are aimed at improving the patients’ quality of life (QOL). Accordingly, Type 2 Diabetes patients, more so the older patient population, are increasingly faced with depression, psychological shortcomings, and the threat of obesity, which substantially lowers their QOL (Borji, Otaghi & Kazembeigi, 2017). Besides, the lack of informed knowledge about an individual’s health considerably reduces their QOL. As such, the chronic nature of Type 2 Diabetes among varying patient populations demands a certain degree of their co-operation at each treatment phase as well as the adoption of self-care practices, which mainly border the seven steps of self-care management. The goal of treatment and self-care management is to improve and enhance the patients’ overall QOL.

Contextually, the prevalence of Type 2 Diabetes among elderly African Americans in Georgia is unprecedented in terms of its scale, spread, and severity. With the advancement in age, support systems, health status, nutritional needs, and physical and mental abilities significantly change. Besides, patients hold varying emotional and behavioral responses in coping with diabetes. Through Orem’s theory, self-care demands to tailor intervention plans alongside patients’ beliefs and values, which ultimately sustain their emotional health and wellbeing. Care providers and educators must impart patients with relevant knowledge skills and abilities for appropriate self-care management. As such, Orem’ models are critical in the disease intervention since it enables caregivers and educators to facilitate change through the application of ADA’s seven self-care management practices.

Strategies for leading, managing, and implementing professional nursing practices

Arguably, the excellent and efficient leadership of a Type 2 Diabetes intervention plan holds enormous potential in the provision of optimum care, particularly among the elderly population. Accordingly, Williams (2016) notes that among the older diabetic population in which there is inter-agency co-operation, team working holds more significant potential for leading, managing, and implementing professional practice care in diabetes for successful disease intervention. In that sense, team working holds a higher capacity in realizing patient safety, improving care, reducing resource wastage, making diabetes care services, both practical and sustainable, as well as enhancing staff retention.

Primarily, practical and functional leadership is imperative for efficient team working, and without which, groups tend to become weak and unproductive. As such, good leadership promotes some strategies for improving team working among multidisciplinary teams involved in professional practice care in diabetes intervention. Williams (2016) recommends that teams should be committed to sharing a common intervention purpose characterized by measurable goals. In so doing, it rallies the teams’ efforts towards committing to a shared vision in disease intervention. Secondly, excellent communication translates to sufficient flow and exchange of ideas vital in creating intervention measures for type 2 diabetes, particularly among the older patient population. Lastly, fostering pastoral leadership ensure the satisfaction of team members since they feel valued. As a result, it creates a good team spirit in which there is a cordial working relationship between members, enhancing team commitment and loyalty. Besides, it fosters mutual respect among team players promoting the willingness to shared learning and knowledge, as well as raising concerns.

Define an outcome and evaluation plan for determining the impact of health promotion, prevention, and management intervention plan

The assessment of health promotion, prevention, and management intervention plan is fundamentally essential in evaluating the efficacy of the intervention program, the identification of strategies for enhancing professional practice care, justification of resource utilization, as well as the identification of unexpected intervention program outcomes. Notably, among older patients with Type 2 Diabetes, defining an outcome and evaluation plan is critically beneficial for determining the impact of health promotion interventions.

Glycemic control has proven to be a significant outcome in Type 2 Diabetes health promotion interventions. Primarily, glycemic control refers to the typical blood sugar (glucose) levels among people with diabetes. Particularly among older patients, polypharmacy involving the concurrent taking of multiple diabetes medications is used as an intervention for Type 2 Diabetes. Mainly, it helps in glycemic control, which in turn reduces or increases instances of insulin tolerance that are potentially harmful or beneficial to patients (Lipska et al., 2016).

Accordingly, given glycemic control as the primary outcome in Type 2 Diabetes intervention among an older patient population, an outcome evaluation plan seems appropriate for determining the impact of the health promotion intervention of the disease. Perceptively, an outcome evaluation plan focuses on the health promotion intervention program’s results both in the short and long-run. Appropriate outcomes underscore the essential changes in the patients’ health conditions, behavior, and quality of life. In that sense, the randomized clinical trials conducted by Lipska et al. (2016) conclude that intensive glycemic control using polypharmacy extensively heightens or lowers the risk severe hypoglycemia, presenting a varying degree of harm and benefits to patients’ hemoglobin levels which impacts on their level of insulin tolerance and subsequent microvascular and macrovascular responses.