Health promotion: Lung Cancer in Smokers and Diabetes in elderly men (Due 24 hours)

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Health Promotion Program Proposal

Diabetes is a long-term disorder that causes an abnormally high amount of blood sugar, or glucose, in the bloodstream (Forouhi & Wareham, 2019). The body's ability to metabolize sugar in the blood is hampered by this disorder. As a result of a high blood sugar level, heart disease, stroke, high blood pressure, and a constriction of the blood vessels might occur (atherosclerosis). Distressed state (neuropathy). Sugar overload may produce tingling, numbness, burning, or discomfort in the toes or fingers, which progresses higher as the sugar levels rise. It is estimated that 26 million people in the United States have diabetes, yet only 19 million of them have been diagnosed, meaning millions more are not receiving treatment (Healthy People 2020, n.d.). If current trends continue, one in three American adults might get diabetes by the year 2050. (Healthy People 2020, n.d.). according to Forouhi & Wareham (2019), “In 2012, diabetes cost the global economy $245 billion in direct medical expenditures and lost productivity, comprising $176 billion in direct medical expenses and $69 billion in lost productivity due to verified cases” (p 25).

Diabetes in elderly men

Global Relevance

In the next decades, it is projected that the death toll from diabetes would continue to grow considerably. Using published and unpublished literature, mortality records, and admittance records, the Global Burden of Disease (GBD) uses an approach that is all its own in order to provide estimates for all locations (Lin et al., 2020). Diabetes and hypertension are the leading causes of death for over 8 million individuals each year (Lin et al., 2020). One of the greatest problems confronting the developing world these days is the rising incidence of obesity and overweight, which has joined underweight, malnutrition, and infectious illnesses as important contributors to the rise in diabetes cases (Lin et al., 2020). For example, the rise in diabetes may be linked to globalization and urbanization and may be maintained by socioeconomic determinants of health such as low income and inadequate knowledge and illiteracy in addition to poor access to healthcare.

National Relevance

Low- and middle-income countries have a higher prevalence of diabetes among the elderly than developed nations. Blood sugar disease is a serious health issue, but it also has a negative impact on the economy, stifling development and keeping the poorest people in poverty. Over half of all inpatient admissions and over 40% of all hospital fatalities are caused by noncommunicable illnesses like diabetes, which consumes the majority of a country's health care spending (Lin et al., 2020). In order to guide the creation of policy initiatives and programs for diabetic patient prevention, new research is needed to corroborate prior behavioral results on diabetic patients and how they connect to increased suffering, spread of diabetes and risk factors.

Local Relevance

In rural areas, diabetes is a greater issue due to the prevalence of risk factors and the availability of a wider range of services than in urban areas (Lin et al., 2020). There is a need for local action and support for promoting positive behavioral change. To prevent diabetes, health care practitioners must analyze risks, screen effectively, and educate the general population (Lin et al., 2020). In the movement towards diabetes prevention, boards of health must take the lead. A healthy lifestyle must also be promoted by the government through food policies.

Promotion Health Relevance

Local, national, and global health systems should use both general population and high-risk methods when developing measures to minimize diabetes and its consequences. In order to get the greatest outcomes, these strategies must address the wide determinants of health, including employment and working conditions, physical environment, education, and socio-economic status (Lin et al., 2020). We can greatly enhance the health of individuals with diabetes and lessen its burden by making simple modifications in their daily routines.

Health Problem

Various studies reveal a higher incidence and prevalence of type 2 diabetes among older men. Globally, the prevalence of diabetes is on the rise. In 2000, 2.8% of the world’s populace had diabetes, with an anticipated increase of 4.4%, which translates to about a 366million people come 2030. There are over 37.3 million diabetic patients (11.3% of America's populace) in America alone, for which 28.5million are adults (Cowie et al., 2018). According to Sinclar et al. (2020), Health and Nutrition Survey in America reveals that over 20% of the American population develops diabetes by age 75 and over. In addition, people with a family history of diabetes are more likely to develop diabetes at an older age.

There are various interventions to control older people's diabetes, for which most are long-term strategies, if not lifetime intervention. Therefore, this health promotion program especially aims at the ways of addressing the patient's adherence to medication and interventions for diabetes. To measure adherence to this intervention, all patients under treatment should have average blood glucose for the last three months (HbA1c level) of 48mmol/mol.

Population

There are various risk factors that expose the elderly to diabetes for not adhering to pharmacological and non-pharmacological measures. Some of these risk factors include but are not limited to obesity, cognitive dysfunction, and risk of bone fracture. Obesity is the most significant risk factor for type 2 diabetes. Obesity increases the chances of developing severe type 2 diabetes by seven-folds. Obese elderly men are likely to consume fatty diets but have low carbohydrates intakes. Failing to take medication is likely to worsen the patient's condition, leading to severe cases such as cognitive dysfunction. In worse-case scenarios, the impairment combined with depression can lead to dementia.

Failing to adhere to pharmacological and non-pharmacological treatment can make a patient obese. Obese makes a person 20-40 times more likely to develop any type of diabetes compared to people with a healthy weight (Ibrahim et al., 2016). As such, losing about 7-10% of one’s net weight reduces the chances of developing diabetes by half. Physical exercise also helps reduce higher diabetes prevalence. LongoOlder patients who fail to follow treatment run the risk of mild cognitive dysfunction. Longo et al. (2019) established that cognitive dysfunction could lead to dementia or Alzheimer's disease. Patients with cognitive impairment are likely to suffer from depression. The combination of depression and diabetes is fatal to an elderly patient. It can lead to complete dementia. Another study by Lee et al. (2020) argues that older men who fail to take their medication are likely to fracture their bones. Type 2 diabetes in older men leads to increased bone minerals. However, this increase leads to increased chances of bone fracture.

Review of literature

There are various ways of promoting adherence to pharmacological and non-pharmacological treatment in elderly men patients with diabetes. According to Ampofo & Boateng (2020), 78.5% of Americans revealed that the main source of diabetes care included a doctor or other medical professionals. Most Americans believe that regular physical activity weight loss/management among medical interventions help manage diabetes. According to Sinclar et al. (2020), about 23.8% of diabetic Americans adhere to the average 150 minutes per week recommended physical activity. Therefore, promoting physical activity is one of the easier ways of promoting adherence to treatments.

On the other hand, a study by Ibrahim et al. (2016) found that 77.5% manage their diabetes through weight loss, and only 56.8% of all American diabetic patients, mainly men aged 40-75, preferred medical interventions such as statin therapy. These medical procedures include insulin intake, which is the most common, and the use of medications such as metformin, including the use of statins. It’s critical to note that chest therapy is the most common because it’s also the safest method. Although it has risks of radiation, they are very minimal given that the radiations produced are usually just as little or in level with natural radiations due to the sun.

Strength and one weakness

Ampofo & Boateng (2020) study was very conclusive in the analysis. It comprehensively explained that the main advantage of physical therapy as a diabetes intervention technique is that it lowers the patient’s blood sugar levels to a normal/standard level, thus better control of blood sugar levels. However, the study failed to put a disclaimer that physical exercise may not only cause damage to soft tissues but can also promote loss of vision, ketosis, and early hypoglycemia among type 2 diabetic old age people (Ampofo & Boateng, 2020). Therefore, the study may mislead readers who rely on its conclusion entirely.

The study by Sinclar et al. (2020) used extrapolation arithmetic to show the probable statistics by 2045. This statistic can form a foundation for future research in the field. However, the study failed to prove whether the source of the data was reliable. The study sourced data from various websites and organizations. There is a high likelihood of bias and misleading data. Ibrahim et al. (2016) backed their arguments with peer-reviewed sources, making them reliable and credible. It is also easy to trace their conclusions from their analysis of data. However, the study has a shortcoming of not selecting a small sample size that is representative of the population they are making inferences on.

Stages of the change model

Stages of the change model describe how an individual integrates new behavior to adapt to a new level. This model can best fit people with diabetes because diabetes patients go through various stages. Stage 1 is the insulin resistance phase, stage 2 is the pre-diabetes, stage 3 is the type 2 diabetes, and the final phase includes vascular complications. According to Sinclar et al. (2020), prevention is the critical element of the first stage of diabetes before they develop insulin resistance. There is a correlation between the stages of diabetes and the stage of changes model because individuals who have diabetes require various interventions at different levels to achieve desired health results. As such, there are various stages of change linked to diabetes.

The stages of the change model create a procedure for managing diabetes and its risk factors. This model argues that people should make a conscious decision as they transit from one stage to the other. Behavioral reforms among diabetic people begin when they realize a problem and commit to changing their lifestyle choices for better health (Sinclar et al., 2020). The final phase involves taking action, where the patient commits to regular physical exercises insulin intake, among other intervention programs as discussed below.

MAP-IT stands

Resources of a health promotion program can be mobilized through sending proposals for funding, creating community awareness about the problem of diabetes among elderly men, community meetings, and recruitment of volunteers. The mission and vision of the program are developed collaboratively by the partners involved in the project. The mission defines what the initiative wants to accomplish, while the vision outlines where the community wants to be. The partners of the health promotion program would be community leaders, community health nurses, public health officials, and dietitians.

Diabetes is a major problem among men, which can be addressed by educating the community about a healthy lifestyle. Lifestyle changes are among the key interventions used in the management of diabetes (Galaviz et al., 2018). The long-term goal is to improve the quality of life of men with diabetes and reduce the mortality rate by 30% within three years. High-level of community engagement is associated with improved outcomes (Haldane, V., Chuah et al., 2019). Data can be collected through public health officials since they have community health data.

The objective of the program would include evaluating the lifestyles of men in the community, improving the knowledge of the community about healthy lifestyles, and improving the number of people in the community eating healthy and living active lives. The progress of the initiative would be measured by the number of people who would participate in the activities of the program, the number of people to participate in diabetes screening, the contribution of stakeholders, and the people who would intend to act after receiving the knowledge. Health literacy skills can be used to measure the progress of health promotion initiatives (Nutbeam et al., 2018).

The work plan would include a calendar of events that would be conducted during the program implementation. The community health nurses would lead the training of community members about the benefits of healthy eating and active living. Public health officials would provide statistical data on the prevalence of the problem in the community, while community leaders will help mobilize the people for community gatherings in social halls. The meetings will take 2 hours with a break of 10 minutes. The focus of the program would be elderly men with diabetes. The participants would be required to state what they have learned at the end of each session to rate their understanding. The communication plan would include verbal communication as well as written strategies to guide the health educators and other stakeholders.

Regular evaluations of the progress would be conducted through an evaluation sheet that will be filled by the participants to evaluate the knowledge, willingness to alter their lifestyles and the lifestyle changes that have already been made. To ensure the quality of self-reported data, the participants would be assured of their anonymity, and their information would not be shared with others. The questions will be simple and easily understandable.

SMART goal:

Elderly men patients diagnosed with diabetes should have HbA1c level is 48mmol/mol (6.5%)(Measurable) or below (Specific) during the next two months (Timely) to identify adherence to pharmacological and non-pharmacological treatment (Actionable and Realistic)

References

Ampofo, A. G., & Boateng, E. B. (2020). Beyond 2020: Modeling obesity and diabetes prevalence. Diabetes research and clinical practice, 167, 108362. https://doi.og/10.1016/j.diabres.2020.108362

Cowie, C. C., Catherine, C., Casagrande, S. S., Menke, A., Cissell, M. A., Ebenhardnt, M. S., Meigs, J. B., … & Fradkin, J. E. (2018). Diabetes in America. Pdf

Forouhi, N. G., & Wareham, N. J. (2019). Epidemiology of diabetes. Medicine, 47(1), 22-27.

Galaviz, K. I., Narayan, K., Lobelo, F., & Weber, M. B. (2018). Lifestyle and the prevention of type 2 diabetes: A Status Report. American Journal of Lifestyle Medicine, 12(1), 4–20. https://doi.org/10.1177/1559827615619159

Haldane, V., Chuah, F., Srivastava, A., Singh, S. R., Koh, G., Seng, C. K., & Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PloS one, 14(5), e0216112. https://doi.org/10.1371/journal.pone.0216112

Healthy People 2020. (n.d.). Diabetes | Retrieved January 19, 2022, from https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes

Ibrahim, M., Toumilehto, J., Aschner, P., Beseler, L., Cahn, A., Eckel, R. H., … & Umpierrez, G. E. (2016). Global status of diabetes prevention and prospects for action: a consensus statement. Diabetes/metabolism research and reviews, 34(6), e3021. https://doi.org/10.1002/dmrr.3021

Lee, R. H., Sloane, R., Pieper, C., Lyles, K. W., Adler, R. A., Van Houtven, C., ... & Colón‐Emeric, C. (2019). Glycemic control and insulin treatment alter fracture risk in older men with type 2 diabetes mellitus. Journal of Bone and Mineral Research, 34(11), 2045-2051. https://doi.org/10.1002/jbmr.3826

Lin, X., Xu, Y., Pan, X., Xu, J., Ding, Y., Sun, X., ... & Shan, P. F. (2020). Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Scientific reports, 10(1), 1-11.

Longo, M., Bellastella, G., Maiorino, M. I., Meier, J. J., Esposito, K., & Giugliano, D. (2019). Diabetes and aging: from treatment goals to pharmacologic therapy. Frontiers in Endocrinology, 45. https://doi.org/10.3389/fendo.2019.00045

Nutbeam, D., McGill, B., & Premkumar, P. (2018). Improving health literacy in community populations: a review of progress. Health Promotion International, 33(5), 901-911. https://doi.org/10.1093/heapro/dax015

Sinclar, A., Saeedi, P., Kaundal, A., Karuranga, S., Malanda, B., & Williams, R. (2020). Diabetes and global ageing among 65-99-years-old adults: Findings from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice, 162, 108078. https://doi.org/10.1016/j.diabres.2020.108078