Improving the Success of a Diabetes Prevention Intervention Program by Addressing the Needs of the Elderly Patients and Staff

Introduction

Diabetes mellitus (D.M.) is a growing global public health issue, with elderly persons being at more risk due to their age, which predisposes them to health risks. Diabetes mellitus is a chronic disease with high blood sugar and glycated hemoglobin (Mendola et al., 2018). Diabetes mellitus among the elderly is a major concern not only in developed countries but also in developing countries. The elderly comprise individuals above 65 (Mendola et al., 2018). Some statistics reveal that 8 in 10 elderly persons have Diabetes. Complications and co-morbidities as a result of Diabetes are more common among the elderly compared to the young population. Some barriers to treatment among the elderly have been reported, which include depression, memory loss, and the different types of handicaps, for instance, visual and physical (Mendola et al., 2018). The barriers necessitated the introduction of the categorization of elderly diabetic patients into the fit and independent elderly persons that are similar to the young persons and the other category referred to as the fragile or frail elderly patients.

The categorization of elderly patients allows for individualized treatment plans to ensure effectiveness. Fragile elderly patients, for instance, need individualized physical activity, diet, and treatment plans based on the cognition level and presence of other co-morbidities. The fundamental rule for elderly diabetic patients is to ‘individualize and go slowly.’ Approximately 33% of the elderly population in the United States have Diabetes. Scientifically, this population is more likely to develop Diabetes due to low immunity (Milanesi et al., 2015).

Additionally, the elderly are more prone to complications resulting from poor management of Diabetes. The most common diabetes complications are hypoglycemia, cardiovascular disease, and kidney failure. According to research by Milanesi et al. (2015), the elderly are more predisposed to Diabetes because of some factors like behavior, aging, genetic makeup, and lifestyle. The high diabetes prevalence and incidence among the elderly population necessitates the urgency of effective and efficient diabetes prevention measures. The adage goes, ‘Prevention is better than cure’. Prevention reduces the burden to individuals and also to the government. Therefore, the benefits of diabetes prevention cannot be underestimated. The purpose of this report is the successful implementation of diabetes prevention measures targeting the elderly population.

The national and state-level epidemiological information that includes prevalence and incidence rates of Diabetes Mellitus among the elderly

The prevalence and incidence of Diabetes have been continuously growing globally in all populations, though higher rates among the elderly. Approximately 38 million persons in the United States have Diabetes, which represents 11.6% of the total population (Caspersen et al., 2012). The total diabetic population is composed of both the diagnosed and undiagnosed population. About 30 million of the total diabetes cases are diagnosed cases, while 8 million are undiagnosed cases (Caspersen et al., 2012). Additionally, approximately 97 million adults have prediabetes, which makes up 38% of the adult population in the United States (Menke et al., 2015). Specifically to the elderly population, nearly 27 million older adults have prediabetes in the United States. The incidence of Diabetes among the total population was 6.9 per 1000 persons and 8.8 per 1000 elderly persons. The trend proves a higher incidence rate of Diabetes among the elderly (Menke et al., 2015).

Assessing the Economic, Political, and Organizational Foundations of the U.S. Healthcare systems and how they relate to Diabetes

Accessibility of healthcare services among diabetic elderly patients is very pivotal. Accessibility is majorly affected by economic factors, including the cost of healthcare services, insurance, and support groups (Engelgau et al., 2004). Diabetes treatment options tend to be expensive; therefore, the high treatment and treatment-related care present some limitations in the management of Diabetes. Some older adults encounter financial challenges that affect their ability to seek appropriate quality care. The economic barriers at the individual and national level hinder effective diabetes prevention efforts.

Similarly, politics play a pivotal role in the success of any intervention. Political goodwill usually goes a long way in the allocation of resources, building required infrastructure, training health professionals, and supporting health interventions such as diabetes prevention interventions (Engelgau et al., 2004). Policies play an important role in formulating policies and legislations that guide the provision of healthcare services. An example of the relevance of policies is the policy that lifted any limitation of any group suffering from any disease from getting any required healthcare service. The same policy allowed private and public insurance companies to provide services unconditionally to diabetic patients. The United States of America government has put immense resources into preventing and controlling Diabetes. Therefore, politics provide a framework and conducive environment for disease prevention programs. Organizational foundation, more so the healthcare delivery systems and health infrastructure, play a role in the success of diabetes prevention programs.

Regarding the organizational foundation, the United States of America has the state of art health facilities and well-trained health professionals. Various options for diabetic patients are appropriate and acceptable to each person. According to the Centers for Disease Control (CDC), nearly 26.7% of the adult population in the United States suffers from Diabetes (Engelgau et al., 2004).

The Quantitative (Survey) or Qualitative (Interview) Survey asks Diabetes Patients and Staff about their Needs and the success of a prevention Program.

Introduction:

I will explain the survey topic to the study participants and inform them of any benefits or risks involved in participating. Additionally, I will seek their voluntary participation and ensure their privacy and confidentiality.

Section 1: Demographic Characteristics

1. What is your gender?
2. Male
3. Female
4. Transgender
5. Other (state)
6. How old are you?
7. 60-65 years
8. 65-70 years
9. 70-75 years
10. Above 75 years
11. What is your religion?
12. Christian
13. Muslim
14. Hindu
15. Others (state)
16. What is your level of education?
17. Primary
18. Secondary
19. Post-secondary

Section II: Questions for Diabetes Patients

5. How would you rate your view regarding the effectiveness of the diabetes prevention program?
6. Good
7. Moderate
8. Very good
9. Excellent
10. On a scale of 1 to 5, what is your satisfaction level about implementing this program?
11. Very dissatisfied
12. Dissatisfied
13. Satisfied
14. Moderately satisfied
15. Very satisfied
16. Are there any benefits you can attribute to the program?
17. Yes
18. No
19. If yes, please state
20. Did you encounter any challenges during the period of implementation of the program?
21. Yes
22. No
23. In your opinion, are there any areas that need improvement regarding the Diabetes prevention program?
24. Yes
25. No
26. If yes, which ones?
27. Does this program impact your health positively?
28. Yes
29. No
30. If yes above, please describe

Section III: Questions for the staff

14. In your own opinion, was the program successful? If no, please state the possible challenge.
15. Please share examples of success stories attributed to the prevention program.
16. From your experience in implementing this prevention program, what are the target group’s needs, and did the program address those needs?
17. How did the program address the needs of diverse groups?
18. What were the successful strategies used in the program?
19. What are the recommendations that you would give aimed at improving future similar programs?

A Strategy to Gather My Information

I will also use the mixed method approach (both quantitative and qualitative) to get views and opinions about the prevention program. In-depth structured interviews will be utilized. Participation will be fully voluntary to allow the collection of honest responses and views. Additionally, I will involve third parties in collecting the data to ensure neutrality.

How I plan to evaluate if Patients are Satisfied and Staff have what they need

Meeting the Needs of Patients and Staff

Patient satisfaction will be evaluated by checking aspects such as behavior changes and individually reported positive health outcomes and assessing the program participation level. On the other hand, the staff will be assessed using analyzed feedback on certain areas such as resources, training, limitations, challenges, and opportunities.

Behavioural Theory and how it will be used to enhance the Current Program

The Health Belief Model is the most suitable theory for this diabetes prevention program. The theory provides in-depth considerations or potential reasons why people decline to change some behavior. The desired behaviors in preventing Diabetes include physical activity, proper nutrition, and stopping the intake of cigarettes and alcohol. And also weight management. The health belief model is a health promotion and prevention tool that is effective and yields sustainable behavior change. The model allows the prediction of one’s behavior by analyzing the elements that act as push factors in behavior change. Some of the elements used in the model include perceived threats, likely positive benefits, potential barriers, cues to action, and self-efficacy. The elements of the theory will be actualized through some strategies, such as setting individualized goals based on needs, introducing behavior reinforcement strategies, and setting peer support groups.

Role and Responsibilities of Healthcare Administrators

Healthcare administrators play an important role in determining the success of disease prevention programs through properly executing their roles. The roles of healthcare administrators include:

• Strategic planning: They develop and implement ideas geared towards the success of a program.
• Allocation of resources: They ensure equitable allocation of resources to the various aspects of the prevention program, for instance, health education and training of healthcare professionals involved in the program.
• Monitoring: They continuously check the program to identify challenges and issues.
• Communication: They provide a free communication avenue for staff, program beneficiaries, and other stakeholders.
• Policies: They participate in the formulation of policies crucial in the implementation of the prevention program.

Conclusion

In conclusion, addressing the needs of diabetes patients and staff is a move in the right direction. The health belief model provides a framework for behavior change, a prerequisite to a successful prevention program. The role of healthcare administrators in disease prevention programs must be considered.

References

Caspersen, C. J., Thomas, G. D., Boseman, L. A., Beckles, G. L., & Albright, A. L. (2012). Aging, Diabetes, and the public health system in the United States. American journal of public health, 102(8), 1482–1497.

Engelgau, M. M., Geiss, L. S., Saaddine, J. B., Boyle, J. P., Benjamin, S. M., Gregg, E. W., … & Venkat Narayan, K. M. (2004). The evolving diabetes burden in the United States. Annals of Internal Medicine, 140(11), 945–950.

Mendola, N. D., Chen, T. C., Gu, Q., Eberhardt, M. S., & Saydah, S. (2018). Prevalence of total, diagnosed, and undiagnosed diabetes among adults: United States, 2013-2016. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

Menke, A., Casagrande, S., Geiss, L., & Cowie, C. C. (2015). Prevalence of and trends in Diabetes among adults in the United States, 1988-2012. Jama, 314(10), 1021-1029.

Milanesi, Anna, and Jane E. Weinreb. “Diabetes in the Elderly.” (2015).