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Population Health Intervention Project: Diabetes
Miracle Cannon
Institutional Affiliation
Instructor
Nurs 503
Date
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Population Health Intervention Project: Diabetes
Overview of the Selected Population
The modern healthcare industry has been hit with the harsh reality of increased
prevalence of non-communicable diseases. While most of these illnesses can be attributed to
significant changes in lifestyles, some have complex causes and cannot thus be understood from
a single root. According to the CDC report, the prevalence of diabetes in the US is on the rise.
Over a hundred million people in the US are now living with the disease. Statistics indicate an
increase in the number of people with diabetes from 30.3 million living with diabetes and 80
million people in 2015 (CDC, 2018). Despite some tangible progress in the diagnosis for
diabetes, the disease remains a health problem in the US. In 2015, it was considered the seventh
leading cause of death. Furthermore, a considerable number of the population does not know
they live with the condition, thus making it more difficult to have befitting interventions. The US
government has invested significant funds to the management of the disease but these efforts do
not seem to yield substantial results since it still lags behind many countries in life expectancy
and disease-related deaths.
Diabetes can be managed through proper dieting, administration of prescribed insulin to
control body blood sugar levels, and regular physical exercise. Individuals living with the
condition risk developing other severe health complications such as stroke, kidney failure, heart
diseases, premature deaths, and limb amputations (Kreider, 2015). In the US, control of the
diabetic problem is jeopardized by high medical costs and other indirect costs such as loss of
time from work, disability, and premature deaths. There is thus an urgent need to intervene with
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proper measures and teach individuals living with the condition on the various ways of managing
blood sugar level conditions. This would significantly reduce the mortality rate stemming from
the disease.
Diabetes-Specific Data
According to a CDC report published in 2017, there was an estimated 30.3 million people
with the diabetes condition in the US. The population represented 9.4% of the total population.
Of the population, 30.2 million people were adults with 18 years, and above representing a
12.2% of the adult population in the country. Another trend that could be noted from the report is
that the number of people living with the condition increased as age increased. For example, the
increase in the percentage of people with diabetes reached a high of 25.5% among individuals
aged 65 years and above (Karter, 2015). Furthermore, the prevalence of diabetes compared
differently among different racial populations in the country. Diabetic conditions were higher
among non-Hispanic blacks Asians and Hispanic populations compared to the white
communities. There is therefore a high likelihood of an older Hispanic or black Asian having the
disease than a young white. These prevalence disparities are pivotal for the determination of
those populations that are at high risk so as to come up with the most befitting strategies to help
them out.
Pre-diabetes condition is also prevalent in the US with an estimated 33.9% of adults
having the disease. The percentage translates to approximately 80.1 million individuals across
the country. Of this population, only 11% are aware of their prediabetes conditions or remember
to have been informed by the doctors about their circumstances. A keen examination of the
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lifestyles of these groups has revealed that there are various risk factors that trigger their
worrying high levels of pre-diabetes prevalence. For instance, smoking among adults contributes
to 15.99% of the current level of the disease. Also, overweight and obesity conditions contribute
to increased risks of being diabetic. With 43.5% of population being obese, around 26.1% of the
adult diabetic population are overweight. Also, 17.8% of the diabetic population in the country is
considered to be severely diabetic. Physical inactivity contributes to 40.8% risks of being
diabetic among adults in the US while 73.6% of adults with diabetes suffer from the high blood
pressure conditions. Other risk factors include high cholesterol, with 58% risk; and high glucose
level among diabetic populations, with a risk rate of 15.6%.
Suggested Interventions
With increased prevalence of diabetes, many stakeholders in the domain of healthcare
have been forced to join forces to seek effective interventions to counter the debilitating
implications of the condition on society. There are now more treatment options. The
effectiveness of some of these approaches has also significantly improved, thanks to rapid
advancement of technology. Endotool and Glucommander, for example, are computer software
developed to help patients dealing with diabetes to make great strides toward improving their
condition (Mabrey, 2014). Glucommander is designed to deliver insulin at flexible timings and
advises on dosage (Ullal, 2016). The progress of these computerized tools so far has been
remarkable, and there is hope that in the future more tools may be available.
Other recommended intervention methods include lifestyle change prevention methods.
For instance, research indicates that weight loss is an effective intervention for individuals with a
high risk of developing diabetic conditions. A large population of Americans is either overweight
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or obese and this significantly increases the risk rates of diabetes (Glytec, 2018). Thus, physical
exercise can be a helpful intervention. Weight loss is good in many ways because it also helps
mitigate the risk of other cardiovascular.
While physical exercise is one of the most important lifestyle adjustment in regard to
intervention toward diabetes, eating habits are also important and should be given adequate
attention. People should embrace proper eating habits because it helps them keen fit and avoid
foods that may be counterproductive to the health of their bodies. There are various nutritional
ways that individuals may use to improve their diets without necessary reducing the amount of
food consumed. As an intervention measure, therefore, there is a need for healthcare stakeholders
to increase nutritional education and the implementation of incentive strategies to ensure people
change their diets for the betterment of their health (Karter, 2015). Motivational incentives can
help individuals to commit to lifestyle changes, hence leading to a reduction in the risks of
developing diabetes. It is obvious that the success rate of each of these interventions will vary
considerably. However, working together, they will foster a culture of health reformation and
significantly reduce the prevalence of the disease
Setting
The setting of the planned intervention that will be described in this paper will take place
in the intensive care unit of various sampled hospital. Intensive care units are the chosen case
since the records of every patient and service quality is readily available. At the same time, the
likelihood of providing false information is minimal since the process engages professionals who
document events as they occur. Since this study would settle for nothing but robust information,
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it will sample 50 hospitals for this purpose; 25 public hospitals while the private sector will
represent the remaining half. The sample will only concentrate within the U.S boundaries. The
research setting will also take into account various considerations such as culture, budgetary
needs, funding options available, and QSEN implications.
Cultural Considerations
The prevalence of diabetes among the American population differs based on various
cultural settings. The CDC reports that there is a high prevalence of the condition among groups
such as Hispanics, black Americans, Latinos, and Filipinos. Also, the incidence of diabetes
increases with age, with a large number of individuals who have diabetes aged 65 years and
above. The high prevalence of diabetic conditions in different races in the US is also associated
with economic returns per race/ethnicity. Black Americans and Hispanics tend to receive lower
income levels as compared to whites in the same education levels. Educational level is also an
important factor that triggers considerable disparities in terms of prevalence. Individuals with
lower levels of educations are more likely to develop diabetic conditions compared with those
with higher levels of education. According to Karter (2015), adults with less than high school
education are 12.6% more likely to have diabetes. On the other hand, individuals with high
schools’ education are 9.5% likely to develop diabetes. Those with education levels beyond high
school are 7.2% likely to develop diabetes. The association of diabetes with education also
indicates that women with less than high school education in the US are more likely to develop
diabetic conditions compared to other individuals with the same educational levels. These
statistical figures show that education is as important factor when it comes to reduction of
prevalence levels. Nevertheless, research still indicates regardless of education levels, there is
still a higher prevalence of diabetes among black and Hispanic populations as compared to white
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communities. This implies that the culture of Hispanics and blacks may have some practices that
are pivotal to the development of the disease. More importantly, it may be an indication these
high levels of diabetes are due to high levels of poverty among such groups.
Budgetary Needs
Government spend vast amounts of funds in the prevention and treatment of diabetes
across the country. For the current research, however, budgetary plans for the intended
intervention will be limited to the minimum. To minimize the costs of the research, a small
sample of the total population will be used. For instance, the general requirements for the study
will include targeted marketing awareness, an incentive program, participation in the research
and reporting of the findings. Twenty participants from four different locations will participate in
the research. They will include individuals from different ethnic and racial backgrounds, as well
as different genders and educational levels. Tentatively, the budget estimates are at around
$50,000. The funds will cover expenses to be used for traveling, community events, marketing
and lifestyle coaching. The budget also includes any indirect costs that may be incurred in the
process, and they are estimated not to exceed 10% of the total budget.
Possible Funding Sources
The research will require funding since it is quite costly to rely on personal savings. One
potential source that has been identified is the American Diabetes Association. This organization
funds research programs based on innovative hypotheses in relevant areas of etiology or
pathology of diabetes. The research plan holds significant promises for the prevention of the
advancement of the disease, and therefore it is anticipated that the organization will be pleased
with our proposal. Other possible sources of funding would be grants from relevant
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organizations. Various organizations in America offer large to mini-grants to volunteers willing
to assist in coping with the increasing risks of diabetes (Moses, 2015). Similarly, the federal
funding for research through the American diabetes association is likely to be the most
significant source of funding in the study. The association works with Congress and the
administration to ensure funding towards research devoted to diabetic research programs. The
CDC has funded many state and local programs dedicated to tackling the risks of diabetes. The
division of diabetes supports activities aimed at preventing or delaying the onset of the condition
across the country (Prevention, 2017). Diabetes is considered one of the chronic diseases and
falls under the four domains of chronic disease prevention: epidemiology and surveillance,
environmental approaches, healthcare system interventions and community programs linked to
clinical services. Therefore, the government is always committed when it comes to such
conditions and it is expected that the CDC will accept the proposal.
QSEN Implications
QSEN refers to the quality and safety education for nurses. The QSEN approach
addresses the issues and challenges in the preparation of nurses for future through skills attitudes
and knowledge. In this research, there will be various QSEN involved to the nursing students for
the future skills. For instance, the study aims at improving the quality as well as the ensuring
safety informatics and teamwork (Sherwood, 2014). The research is evidence-based and will
offer the opportunity for improved collaboration in the management of chronic conditions caused
by diabetes.
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Timeline for Intervention
The research program will involve the collection and analysis of the data to come up with
viable conclusions in the prevention of diabetes in the US. Thus, the intervention program is
likely to take one year. During this period, the funding of the program will be sought out, and
locations, as well as intervention programs, will be set up.
Evaluation Method
While evaluating the participants of this study, a particular blueprint will help. It will
focus on adults aged 40 and above. Another consideration will be on how sugar level changes
within the selected age bracket, until it identifies the most exposed people. Another factor in
choosing the sample will depend on the number of times the participants is admitted on T2DM;
only those who have 4 and above experiences will qualify. Finally, one’s ethnicity will play part
since there has to be a balance in the selected group.
Literature Review
Type 2 diabetes is a lifelong condition caused by the body’s inability to turn glucose into
energy. Insulin resistance can be caused by various issues such as obesity, metabolic syndrome,
and too much glucose from the liver. It is prevalent in individuals aged 65 years and above. With
advancement in age, the disease is likely to come with other health complications. According to
Dungan (2013), older individuals with diabetes are more likely to develop other health
complications such as an increased prevalence of geriatric syndrome and comorbidity burden, as
well as vascular complications. With the increased aging in the US, there is a need for older
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adults to follow plans aimed at managing the risks of developing diabetes conditions or to help
maintain the requirements for a longer and healthier life.
The 2018 CDC report indicates that over 30 million people are affected by type 2
diabetes, while over eighty million people across the US are at risk of being affected by the
disease. Despite the increased measures put in place to prevent and manage diabetes, the US still
lags in the management of the disease compared to other developed countries. Statistics shows
that there are clear risk factors that trigger the prevalence of the disease. Therefore, all healthcare
stakeholders—the public health, healthcare, and the community—should join forces and
establish the most befitting responses toward ensuring that the rates are kept at a minimum.
Healthcare quality measures are also needed in all sectors of the country’s health system to
ensure that medical professionals are committed toward ensuring that the condition is well
managed at all care centers. Increased quality of service can be increased by changing the policy
measures as well as motivating members of society to embrace lifestyle changes.
The national census projects an increase in the older populations in America within the
next nine years, a phenomenon which will see a two-thirds of people affected by diabetes. There
is a strong connection between age, diet and insulin production. Individuals with advanced age
are at a higher risk of being affected by the disease. Diabetes forecasts by the Institute of
alternative futures (IAF) forecast a diagnosis rate of 25% by 2015 (Jun, 2015), however, this rate
has been surpassing as the current diagnosis rate is estimated at 30%. Without proper prevention
strategies and management of the diabetes conditions, the projected diabetic diagnosis in future
will be enormously necessitating the need for alternative prevention strategies.
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Diabetes in old age comes with other health complications which lead to increased
morbidity and mortality, especially among the individuals aged 65 years and above. For instance,
high diagnosis levels of diabetes in older populations comes alongside such complications as
heart diseases, stroke, acute myocardial infraction, and death. It’s estimated that 8 in 10 older
populations in the US are affected by some forms of health complications either directly or
indirectly related to diabetes (Rankin, 2016). It should be noted that these high levels of
prevalence come with extremely high levels of healthcare costs. The number of older individuals
to be diagnosed with diabetes is estimated to reach 26.7 million individuals by 2050—this can
also be translated as 55% of the older population in the US. The cost of healthcare accounted for
by the older populations amounted to $41.1 billion in institutional care. Without proper
prevention and management measures, the diabetes type 2 is likely to increase the levels of
deaths for the older populations as well as account for the increased costs of healthcare in the
county.
Diabetes contributes to increased mortality for people with advanced ages. The life
expectancy of the older population affected by diabetes is often reduced by eight years. This is
due to the anatomical and physiological changes characteristics of these individuals is accelerates
by the disease. According to (Robinson, 2018), people with ages 55 years and 65 years have a
shorter life expectancy compared to individuals without diabetic conditions. Biologically, the
certain age periods have specific programming significance. For instance, there is an extremely
large reservoir for glucose among older people as compared to younger people. It is estimated
that 50% of aged individuals with large reservoirs of glucose are likely to develop diabetes type
2. It is thus essential for policy implementers to take into consideration the crucial issues
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affecting older populations in the US so as to design the best intervention programs to curb the
condition.
Influence of Religion (Christian) Worldview on Population Health
With the increased ideology of globalization, many people and organizations have been
working together for the better good of society. The field of healthcare is one of the areas that
has received prominent collaborations from around the world. The religious framework plays an
important role the global collaboration and has had various leaders and healthcare professionals
working together for years. The Christian religious framework influences the way people
respond to health issues that can be considered detrimental to the progress of human society. For
instance, many Christian contributions to world health are based on global health. Traditionally,
countries from the west and America have been on the forefront of ensuring global health
through health missions to developing countries, however, with the increased economic growth
in the BRICS countries (De la Porte, 2016), many other countries are joining in the provision of
global healthcare based on the Christian framework of global health.
However, also, with the improvement in economic stature of developing countries, the
traditional influence performed by the Christian religion in healthcare has continued to lose its
role as the universal promoter of health. Christian ideologies are being surpassed with the
emerging global health provision methods, and the church has been criticized for being
incompetent when it comes to the development of effective interventions in such situations. It
needs to review its policies to ensure the framework of universal health is achieved without
compromising its overall mission of spreading the gospel. While many Christian scientists
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believe that infections are as a result of bacteria, they also believe that there is an underlying
spiritual aspect to every infection and thus the need for healing through prayer (Lew, 2015).
Changes in doctrines over the years, however, has seen the Christian faith increase support for
public health. Various biblical scriptures stress the importance of caring for the sick. The passage
of Good Samaritan as modeled by Jesus Christ shows that there is a need for people to care for
those in dire need. In 1 Timothy 5:8, the Bible says: “But if anyone does not provide for his
relatives, and especially for members of his household, he has denied the faith and is worse than
an unbeliever.” The implication is that society should join forces and forge measures of reducing
pain and suffering among those who need attention. The Christian faith also emphasizes the
importance of cleanliness and even equates purity being next to godliness. The Bible also
emphasizes the need to embrace peace because it leads to healthier lives: “A peaceful heart leads
to a healthy body; jealousy is like cancer in the bones” (Proverbs 14:30). Without a doubt, values
of Christianity are all aimed at improving the wellbeing of human beings, and this is pivotal to
the development of a healthy society.
Conclusion
On the whole, the worryingly high levels of diabetes demand the society to embrace
effective interventions to reduce the mortality rates and enhance the health of those who already
have the condition. Research on the planned intervention would be carried out for one year to
determine the specific measures that can be used to reduce the risks of increased diabetes across
the US. Estimates indicate an increase to over thirty million people being affected by the disease
and 80 million people with a high risk of being affected by diabetes. There are various suggested
intervention measures in the research, with the focus currently being on weight reduction and
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eating habit adjustment. Funds will be outsourced from the federal funding for research on
diabetes and grants from private organizations aimed at supporting research to prevent chronic
diseases. There is much hope that this research will yield some tangible fruits and lead to a
substantial reduction in the prevalence of the condition across the nation.
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References
CDC. (2018). Diabetes Programs & Initiatives. Retrieved from https://www.cdc.gov/diabetes/
programs/index.html
De la Porte, A. (2016). Spirituality and healthcare: Towards holistic peoplecentred healthcare in
South Africa. HTS Teologiese Studies/Theological Studies, 72(4), 1-9.
Dungan, K. M. (2013). Hyperglycemia in the intensive care unit: is insulin the only option?
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glytec. (2017). Personalized Diabetes Therapy Management. Retrieved from
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Jun, A. H. (2015). Evaluation of Diabetic Ketoacidosis/Hyperosmolar Hyperglycemic State
Protocol at an Academic Center. Critical care medicine, 43(12), 235.
Karter, A. J. (2015). Ethnic differences in geriatric conditions and diabetes complications among
older, insured adults with diabetes: the diabetes and aging study. Journal of aging and
health, 27(5), 894-918.
Kreider, K. E. (2015). Transitioning safely from intravenous to subcutaneous insulin. Current
diabetes reports, 15(5), 23.
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Mabrey, M. E. (2014). Effectively identifying the inpatient with hyperglycemia to increase
patient care and lower costs. Hospital Practice, 42(2), 7-13.
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Moses, H. M.-S. (2015). The anatomy of medical research: US and international comparisons.
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Prevention, C. f. (2017). National diabetes statistics report, 2017. Atlanta, GA: Centers for
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Rankin, P. M. (2016). A community-based lifestyle intervention targeting Type II Diabetes risk
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Robinson, D. J. (2018). Diabetes and Mental Health. Canadian journal of diabetes, 42, S130-
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Sherwood, G. (2014). A new mindset for quality and safety: the QSEN competencies redefine
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