Planning, Designing And Evaluating Health Assignment Sample

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Introduction

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Health intervention is a type of medium to prevent or stabilise the medical conditions of individuals – replace this word throughout to ‘individuals’. This intervention plays an important role in enhancing the overall health of the patient. The longevity of individuals live is also increased by providing best treatment to them. The interventions are able to improve the quality of life as well as reduce patient suffering. The aim of an intervention is to prevent the disease. In this paper the problem of diabetes among people of the UK within 25-55 age range would be highlighted with proper justifications of the research.

The paper would discuss about the problems of diabetes among the residents of UK who are in age range of 25 to 55. 7% of UK population who are at risk of developing diabetes and along with that, approximately one million people are living with undiagnosed type 2 diabetes (ncbi, 2019).. The intervention method is aiming to prevent the severity of the disease by improving lifestyle factors that increase the risk.An effective strategic plan to reduce these diseases is also included in this paper. The ethics reveal the manners to maintain ethics at the time of intervention assessment amongAmericans. The study would discuss about the connection of age with diabetes and the other factors which trigger this disease for the entire population. The risk of having diabetes increase after the age of 45.

Rationale

White Americans are an ethnic group that is more susceptible to greeting type-2 diabetesref (Walejkoet al. 2018). 38.1 million adult had diabetes in the year 2018 and around 700 people are found to be diabetic in one day in the UK contextref (Walejkoet al. 2018). There are many reasons that contribute to this including the presence of a large number of obesity cases, generic traits, and resistance to insulin among othersref (Bradyet al. 2018). The presentation of diabetes among UK population can be said to be quite atypical and are found to be largely simulating type 1 and type 2 diabetes but their clinical course has subsequently then been indicating what is generally found in individuals suffering from diabetes of type 2 (Commodore-Mensah et al. 2018). The strategies that are culturally sensitive, implementation and incorporation of structured protocols of disease management and assisting educators of diabetes, professionals of healthcare and nurses among others can prove to be effective in this respect is improving the diabetes outcomes and reducing its occurrences among the ethnic groups. Due to the unhealthy food habits and busy life schedule, majority of the UK population are found to be obese and obesity has been considered as the trigger for this type 2 diabetesref(Bradyet al. 2018). In the UK, it has been estimated that the total number of people suffering from cases of diabetes in the country is as much as 4.9 million of which ninety per cent of the people in the UK have diabetes belonging to the type 2 category (Diabetes.org.uk, 2022).

A planning model is important when designing a health intervention and the precede-proceed model outlines key stages that justify the approach (Green, 1974). An alternative method is a simple logic model which would be used in large national campaigns which have to identify funding allocations to appropriate resources.

Phase one of the model involves an outline of how the intervention is going to improve Quality of Life: 4 sentences on why preventing diabetes will improves someone’s quality of life.

Preventing diabetes would improve the quality of life among the individuals and help them to lead a life without any diabetic complexities. Preventing this diabetes would improve quality of life because- the risk of having a stroke, blindness would decrease, and the chance of kidney failures potentially reduces as well. On the other hand, with controlling diabetes, blood sugar can be controlledas well. Diabetes can cause hardening of the arteries and by preventing the risk, quality of the life can be maintained throughout. With accurate self-care, foot problems can be managed as well that is most likely to happen due to diabetes.

Phase two of model involves an outline of epidemiological data which indicates adults at greater risk of diabetes. Use link to say increased family risk, ethnicity and statistic about lifestyle – physical activity.

It is predicted that nearly 5.5 million people across the UK will have type 2 diabetes by the end of 2030 if necessary protections are not taken. Around 90% people with diabetes are having type 2 diabetes and it indicates towards the severer rate of this disease. The adults are at a greater risk of developing diabetes, although thechildren are at risk too.

Diabetes and ethnicity-  According to the report of diabetes UK, it has been seen that the black people are more likely to develop diabetes before reaching to the age of 50. Similarly, people with this type 2 diabetes are two and half times more likely of being under the age of 50 than the white American people (diabetes.org.uk, 2022). Black Africans are more likely to be diagnosed with hypertension and hence the risk of having type 2 diabetes increase among them. South Asians develop diabetes five to ten years earlier than the White Europeans and rate of lower BMI can be made responsible for this. On the other hand, being physically active and having no family history contributes less chance to develop diabetes among the individuals (cdc.gov, 2022). Glucagon is produces in significant range whole beingphysicallyactive and it allows to use the sugars in blood to gather energy for body.

Diabetes statistics | Professionals | Diabetes UK

Phase three of the model involves an outline of the barriers and facilitators which indicates environmental factors

What will a community setting need to do to help adults prevent diabetes. What might be challenging about trying to improve their lifestyle

The community can encourage the individuals to take part in the diabetes prevention programme and getting help from family, friends and peers to take healthy diets and being physically active would encourage the individuals to follow the healthy practice. The community setting would further help the individuals to find out the risks associated worththeir health and their likelihood to develop diabetes in later life in that accordance (diabetes.org.uk, 2022). Diabetes UK has partnership with public health England and NHS England, which helps to reduce the risk as well by not allowing them to delay in the diagnosis process. The community would also help the individualsto find the links between the obesity and increased risk of diabetesas well.

In this scenario, some areas might be found challenging suchas motivating the individuals to take the first step in getting themselves checked for detecting the risks. The individual might not be interested in reducing the weight and eat healthy foods in this context.

The approach that has been chosen for the purpose of development of designing, planning and evaluating health interventions is the Ottawa charter significance. This approach has been found to be quite significant in the development of appropriate plans of health interventions as it facilitates prevention through an approach that is multi-sectoral and provides suitable guidance for the promotion of health. There are five areas of action and three strategies that have been covered in this approach. The Ottawa charter's significance as an approach for health intervention tools for diseases that are being experienced by specific ethnic groups has been found to be very much beneficial (Schoenthaler et al. 2018). The given research case of the entire population of the UK who are being diagnosed with increased type 2 diabetes disease can also be effectively planned with this approach. The death rate and number of individuals suffering from diabetes in the UK can be further evaluated with the help of figure 1 (Statista, 2021).

Need assessment

The approach of Needs Assessment

Introduce what is a needs assessment using this link

Population health needs assessment: a guide for 0 to 19 health visiting and school nursing services - GOV.UK (www.gov.uk)

In order to prevent diabetes from the earliest stages in the UK, there must be incorporation of the visitors of doctor’s team to look after the children and assess their risks in developing diabetes in the future (gov.uk, 2021). The needs of the concerned community group have to be properly understood in order to make sure that an appropriate health intervention plan can be developed for the community of UK residents and reduce the number of occurrences of being diagnosed with type 2 diabetes in the UK. The assessment of needs cannot be done without knowing the major factors that are contributing to this factor of increased cases of diabetes among black Americans living in the UK.  It has been seen that the risk factors are higher among the Asian and black people of UK than the white population (ncbi.nlm.nih.gov, 2022). Some of the major reason that has contributed to the current situation are mentioned below.

It has to be said that none of the factors can be treated as separate entities as all of them are linked together. The most important factor behind the increased number of diabetes cases among UK people is the greater prevalence of cases of obesity among concerned individuals due to their laid back attitude and their eating habits which generally consists of fast foods. The unhealthy eating habits and the non scheduled daily life are responsible for this. Due to obesity people develop resistance to insulin which further results in an increase of type 2 diabetes among the population of the UK.

The socio-economic condition of the people belonging to the black American ethnicities has always been poor for a large section of the population. The population was also exposed to a sustained period of famine which led to this condition of high migration (Brewer et al. 2018). It can also be argued that due to prolonged famine, their bodies developed a certain kind of fat that protected them from famine but made them more exposed to type-2 diabetes.

Once the reason behind the issue has been known, it is necessary to build upon the rationale to make an extensive assessment of what is actually needed by the population so that they overcome the current situation and reduce the cases of type 2 diabetes among the concerning pollution. From the need assessment, it can be said that the current situation of the black American when it comes to the increased number of diabetes cases among the UK can be listed as

• Establishment of healthcare facilities that specifically caters to the needs of racially abused and discriminated population
• Running extensive campaigns to make the concerned population aware of the importance of a healthy lifestyle
• The population needs also to be made aware of diabetes and its other involved factors so that they make informed decisions that protect them

Engagement of different stakeholders

The stakeholders that have to be engaged in this process in order to protect them from type 2 diabetes and prevent them from having the disease are:

The concerned population of black Americans who has to participate in the awareness campaign; Taking help of leaders from NGOs and other charitable organisations who would make financial investments in the campaign and make it a success; Making the people understand about the benefits of healthy life style and healthy diet in order to reduce the risk of diabetes; Educators who can raise awareness about the program, disease and healthy lifestyle among the concerned population; Doctors, nurses and other health professionals have to participate in treating the individuals in large numbers, which is what they usually do to make sure that the population gets free from the disease; Social workers and other people working for social and political causes has to run the campaigns and attract people in masses for the cause; Medical researchers who can further research find genetic reasons behind this unequal distribution of disease among the pollution and the ways in which it can be treated or mitigated

Justification of Approach

The approach taken can be completely justified as the major reason behind the unequal distribution of disease among different ethnicities and the reason why it is high among UK population is largely due to socio-economic factors rather than medical ones (Adjei Boakye et al. 2018). The reason why they have high cases of type 2 diabetes is that they were subjected to a large period of famines, which led to genetic modification in their body, and the development of tissue of fats that protected them from famine but exposed them to diabetes. They are being discriminated against around the world and are not getting the necessary standards of healthcare like the native population.

Intervention design

The intervention design for the mitigation of cases of diabetes among UK population would involve a combined approach in all the concerned aspects of: educational approach; behavioural approach and client-centred or empowerment approach. Primary prevention: In order to prevent the onset of the disease among the concerned population, the population has to be made aware of the disease and the current situation of it affecting the Black Americans more. They have to be made to change their current lifestyle in order to incorporate a healthy lifestyle and mitigate relying on junk foods, fast foods and laid back attitude in life.  The importance of excessive and physical activity has to be explained to them. Secondary prevention: Secondary prevention will be carried out by making sure that free or affordable diagnosis of the disease is offered to the black Americans so that they can avail themselves of the early treatment of their disease. This can be done by establishing testing labs or booths in the UK where people can get tested for their disease for free or at an affordable price. Tertiary prevention: The individuals who are already suffering from the disease will be given special attention in this campaign of intervention and will be provided with necessary medications such as metformin for reducing their glycemic levels and obesity, and insulin therapy to prevent deficiency of insulin in large batches for fast treatment and mitigation approach (Goff, 2019).

Behavioural Approach: This approach deals with changing the behavioural pattern of concerned or affected populations in order to reduce the number of cases among them that are present in them due to reasons that are not medical. This approach mainly adopts the persuasion method by running effective campaigns to promote healthy food and lifestyle habits by changing their behaviours and attitudes. This approach requires action to be taken from the end of concerned individuals as well and thus can be blamed for the consequences even though the cause may be out of their control.

In the given case of Black Americans, the people have been subject to racial discrimination, bad socio-economic conditions and situations of famine that were out of their control. Under this approach though they can instil healthy behaviours within them and adopt a healthy lifestyle and food habits which will be promoted through extensive health campaigns to bring behavioural change (Gary-Webb et al. 2018). s. Educational approach: This approach is aimed at providing appropriate information to the concerned population in order to make sure that they get the crucial skills, understanding and knowledge that is required for making decisions that are well informed and promote healthy behaviour.  This approach is different from the previous approach as it respects the freedom of individuals and gives them the option of making their own choices rather than motivating and persuading them. This approach is beneficial as it reduces the dependency on decision making related to health aspects by changing their attitude.

People under this campaign will be taught about the causes, symptoms and effects of diabetes and the methods in which it can be mitigated. They will also be informed about the advantages of a healthy lifestyle and the impact that it can potentially have on one body and on mitigating the condition of increased cases of diabetes among black Americans. This approach will make the people more aware of the involved risks by increasing their initial knowledge about the disease and healthy lifestyle (Siopis et al 2021). Empowerment Approach: This approach is usually long term as it would empower the black Americans to solve their issue by themselves by establishing non-governmental organisations and charitable institutions that would empower them to take care of their finances and establish medical care facilities that are equal for all without any kind of racial discrimination (Hawkins, 2019). Therefore, it requires a lot of resources, strengths, and support from each other to remove anyexisting social barriers. The empowerment approach aims to empower the community and to do that health determining factors such as social, cultural as well as economic determinants need to be addressed. People's participation, sharing knowledge, and encouragement help others to think rationally and solve their issues. Moreover, it helps to build skills and helps build a sense of belongingness (Cislaghiet al. 2019). The empowerment approach is a sustainable strategy and it is indeed dynamic. Therefore, this empowerment approach is useful to slowly mitigate the diabetes issues faced by Black Americans communities of the UK. Social Change ApproachThe social change approach is the most complicated approach among all the discussed strategies. It does not focus on the changing individual behaviour and rather focuses on a much broader aspect, which is society (Singhal and Svenkerud, 2019). It aims to access and avail all healthcare facilities free of cost and targets to resolve core issues of the society. Excess eating of carbohydrates cannot help a person to control his uncontrolled diabetes (Mohanet al. 2018). Therefore, the government needs to take initiatives to plan and implement strategies that can provide healthy food to control high blood sugar. Therefore, this approach is quite impractical and difficult to implement and so, it is rejected from the intervention design.  

Evaluation strategy

A formative evaluation strategy will be taken here to understand whether or not the intervention objectives have been successfully implemented to achieve the long-term objectives (Kimeet al. 2020). Different Preventive approaches, including primary, secondary as well as tertiary prevention techniques have been adopted for the intervention of type 2 diabetes among Black population living in the UK (Goff, 2019). Other than that, the behavioural approach has been taken into consideration so that they adopt a healthier lifestyle which is very necessary to keep diabetes under control.

The educational approach is another useful intervention technique that creates awareness without forcing them to adopt changes. The educational approach is useful to increase knowledge regarding this disease and remove misconceptions as well (Siopis et al 2021). Other than that, an empowerment approach has been acquired which is beneficial for those who want to identify their weakness and learn skills to successfully mitigate their own issues. Society can be empowered as well with this intervention technique (Hawkins, 2019). In the end, a social approach can be taken to bring an overall change in the thinking of the society regarding this disease and choose a healthy lifestyle. Moreover, evaluation is necessary to determine whether or not these interventions could bring the desired changes.

It is not very easy to conduct an impact evaluation in order to understand the success of the above-mentioned interventions. It certainly requires evidence in every sector to claim the approaches to be certainly useful for bringing a positive change among the people belonging to this diabetic community. Surveys can be conducted to evaluate the intervention (Meringolo et al. 2019). However, it is quite expensive and time-consuming as well. Therefore, formative evaluation strategies can be adapted mostly to understand the impact of the intervention. 

Evaluation of Preventive/medical approach: affordable diagnosis planning has been adopted for the early detection of pre-diabetic or borderline diabetic individuals. Distribution of metformin can be considered, which a hypoglycaemic drug to keep diabetes under control. This can be evaluated by looking at the number of individuals who have responded to the initiatives and got themselves checked. In this regard, a group of black Americans having diabetes and getting all these benefits must be identified. Identified people must be distributed metformin like hypoglycaemic drugs A record must be kept to know whether or not they are regularly checking their blood sugar levels (Arodaet al. 2017).

Evaluation of the behavioural approach Persuasion methods for changing lifestyle, food habits, quitting alcohol, smoking, etc. have been taken as part of this approach. The success of this approach can be evaluated by messing up their weight regularly. A Behavioural approach is very useful to keep the bodyweight normal and prevent obesity which is one of the major reasons for diabetes (Soniet al. 2021). Junk food gives high calories that cause obesity among people. Alcohol provides 7.1Kcal energy which is also responsible for gaining significant weight. People belonging to the black ethnicity are mostly socio-economically backward and cannot afford good quality protein and mostly rely on carbohydrates for energy. Participative rates in health campaigns can indicate the success of the behavioural approach. Quitting consumption of junk food, alcohol and adopting a healthy lifestyle must be reflected if the target group loses significant weight. Therefore, the target group must be regularly weighed to evaluate the effectiveness of the behavioural approach (Mahdavi and Tahmasebi, 2017). The survey can be conducted as well to reveal the level of awareness among the people and to know whether or not they have incorporated healthy lifestyles to evaluate the effectiveness of this approach.

Evaluation of Educational approach This approach aims to teach about the causes of diabetes, its effects, and create awareness regarding effective management of this condition. Studies say a lot of people are not even aware of the negative consequences of long-term uncontrolled diabetes and as result, they are reluctant to change. With this approach, the American community can learn about the advantages of a healthy lifestyle and at the same time know about the risks associated with uncontrolled diabetes (Darlington et al. 2018). The success of this approach can be evaluated by taking interviews and asking them questions regarding this disease. Questions may be asked regarding the amount of fish, chicken, or protein sources they consume daily or the amount of oil they use for cooking. The answers can indicate the gap between learning and shifting towards a healthy lifestyle. In this way, the evaluation of educational approaches can be done successfully. Evaluation of empowerment approach: the group of people affected by this condition takes this approach. The empowerment approach helps to build skills and at the same time empower society to adopt healthy lifestyles. Social movements can be initiated to fight against racial discrimination to get equal opportunities in diabetes prevention/treatment campaigns. The aim is to empower themselves as well as the community and eradicate external controls. This requires financial stability and therefore it is quite difficult to implement. The evaluation of this intervention is difficult as well as it is a long-term approach (Zimmermanet al. 2018). However, survey, interview or questionnaire techniques can be used to get the people's perception regarding the empowerment approach and evaluate whether there is any scope for success in future.

Ethics: 

The health intervention has the ethical distinction to drive the focus of individuals on prevention. This intervention is mainly categorised in educational and environment. The educational changes may drive behaviour changes in individuals by changing their habits that can cause the rise of health issues whereas, environmental changes social manners of individuals to beneficial habits (Willmott et al. 2019). It is a normative concern that has to be maintained in black Americans because due to their behaviour habits, they are facing high inflation of diabetes disease in their adults. A study accounts that per 1000 people black American more than 66 of them are facing diabetes issues.  The 18 to 30 years adults are suffering more from this disease because of their biological factors. The high weight and fat are the main factors that arises this issue in black Americans. The educational intervention aware people regarding their and habits, which becomes the primary cause of their disease; a healthy habit has to be awakened in their mind by ethical manners. The environmental aspects include environmental effects on the people, due to environmental effect they are gaining weight thatled them to face diabetes in their early adulthood. Therefore, this issue can be mitigated by giving them ethical information about their environment and suggesting they adopt healthy habits that can reduce their unhealthy behaviours. The public health professional can reduce this disease arising in black Americans by insisting aware of their health and the bad effects of diabetes diseases in early adulthood. 

Conclusion 

It is concluded from above that due to biological factors black Americans are facing diabetes issues in their early adulthood. Most of the population of black American face this disease as compared to white people. Therefore, health professionals provide a health assessment intervention plan for them in this paper with a strategic plan that is enforceable. The professional gives two types of intervention changes to people to make them aware of their health. The interventions effective design is also provided in this paper that insight an easy way to implement health intervention among black Americans. Overall, this paper covers all health intervention aspects to aware health conditions among black Americans to reduce their disease of diabetes from their adult population. 

 

References

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