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Community needs and health screening initiatives.

May Akalemeaku
Purdue University Global
MN501M1 – History, Concepts, and Role Development
Dr. Michael Pfaff
10/22/2022
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Introduction

Numerous theories and models support the practice of health promotion and disease

prevention. Program planners employ these theories and models to understand and explain health

behaviors. They also help to guide the selection, development, and implementation of treatment

programs. Theories are concepts, definitions, and propositions that explain or predict events or

situations by illustrating the relationships between variables. They apply to a broad range of

situations. By nature, they are abstract and do not have a specific content or topic area. It

presents a systematic way of understanding an event or situation. Models are various theories to

better understand a problem in a specific context. Concepts are the building blocks of a theory,

while constructs are concepts developed in a certain way,

The benefits of a theory are enormous. It is a road map for problem analysis to create

appropriate interventions and evaluate the theory’s success. It helps health planners to determine

the most appropriate target audiences, change strategies and evaluate outcomes. They also

provide them with the skill needed to go beyond perception in creating and assessing health

behaviors and promotion interventions. They describe the dynamics of health behaviors,

including change processes and the influence of numerous elements, such as social and physical

environments. It directs the search for why people engage or abstain from certain health

behaviors. It answers the “wh” question of “why,” “what,” and “how” health issues should be

handled. They try to seek answers to these probing questions.

It is important to note that these theories and models help planners to understand how

communities and individuals behave the way they do. It helps them to increase the effectiveness

of the design of their programs, implementation, and evaluation. Planners may consider a

mixture of theories and models in their interventions for more success.

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For this exercise, we will be dealing with prediabetes and type II diabetes. The

predisposing factors of the illness are obesity and overweight (Sheehan & Ulchaker, 2012)

Theory or conceptual model to adopt

Three are three models for health behavior interventions: socioecological, transtheoretical

(stages of change), and health belief model. The socio-ecological model looks at behavior

change at multiple levels and considers the inter-relationships between environment and

behavior. The five levels of influence on health behavior include intrapersonal factors,

interpersonal processes, primary groups, organizational factors, community factors, and public

policies. The transtheoretical model deals with the process of behavior change and considers the

individual’s readiness to make and sustain behavior changes. It helps planners to design

programs based on individual readiness, motivation, and ability. The model consists of five

stages; pre-contemplation, contemplation, preparation, action, and maintenance. The health

belief model is very old but still relevant today. It addresses the readiness to act upon a health

behavior based on several individual beliefs. These include perceived susceptibility, perceived

severity, perceived benefits, and perceived barriers.

We will use a socio-ecological model to intervene in prediabetes and type II diabetes

screening. Our interest in this illness is based on its global prevalence. It is estimated that 425

million persons suffered from diabetes in 2017, and estimated to rise to 629 million by 2045.

(Forouhi, N. G., & Wareham, N. J. 2019).

Screening Purpose

Prediabetes is a state of increased health defined by elevated blood glucose and other

health risks, such as high blood pressure, abnormal blood cholesterol, and other obesity-related

conditions. Screening and intervention before the patient is diagnosed with type II diabetes has a
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host of benefits which include; improved population health. Cost-effectiveness, better patient

outcomes, and recognition and referral. In the US, the lifetime risk of diabetes diagnosis is 40%,

meaning two out of every five adults may be diagnosed (Gregg, E.W et al., 2014). 13.1% of the

population in San Bernadino County of California are diagnosed with diabetes.

Population

The screening targets black men between the ages of 40-55 who live in Rancho

Cucamonga in San Bernardine County, California.

Screening Activities

A glucose screening test will be administered. They will be required to drink a liquid that

contains glucose, and an hour later, a blood sample will be drawn to check their blood sugar

level. A normal result is 140mg/dl or lower. If it is higher, it shows that you are prone to

diabetes. The participants with results above 140mg/dl will be given some counseling. Also, they

will be advised to make some lifestyle changes; healthy eating, regular exercises, getting an

appropriate body max index (BMI) and reducing intake of alcohol. A record of all the results will

be kept for appropriate data analysis. It is important to note that there is a distinction between

screening and diagnostic testing. Screening is aimed at identifying asymptomatic individuals

who stand the risk of type II diabetes.

Outcome goals

The goals of this exercise include the following.

 Determine the population with type II diabetes

 Observe the trend, if increasing or decreasing

 Design and implement intervention programs

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Location

The screening will be done at the Cucamonga valley medical group. This health facility is

located in the city center and hence easily accessible to our target population, older black adults

that are upwardly mobile and engaged in a sedentary work life.

Cost

S/No Items Cost ($)

1 Office consumables 100:00

2 Medical Supplies 250:00

3 Testing kits 300:00

4 Honorarium for support staff 500:00

TOTAL 1,150:00

Summary

The results show that 30% of the population that was screened are at a risk of type II

diabetes. This is quite worrisome as statistics predict that about 20% of the population will suffer

diabetes in their lifetime. The results underscore the need to quickly begin an intervention

program to prevent the adverse effects of the ailment on the population. The preventive health

program will rely on the socio-ecological model of intervention.

Those screened and identified to have a risk of type II diabetes will be encouraged on

how to have a change in lifestyle to live more healthily. We will continue to counsel them to

build their self-confidence. There will be a need to encourage community walking groups and

exercise with their peers. Institutions within the city should be encouraged to provide work

environments that support health with gyms and healthy food options. As our target population is
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upwardly mobile and technology savvy, we will leverage social media tools to share information

on how to adapt to a healthy lifestyle. Finally, there will be a need to work with elected officials

to influence legislation toward providing an environment that encourages exercising by

providing the required amenities, walkways, parks, gyms, and others. Eating healthy foods and

exercising regularly decreases the prospect of developing type II diabetes (Centers for Disease

Control, 2019). This will be the focal point for health promotion and intervention

Conclusion

Theories and models are critical for understanding behavior and planning health

intervention programs. It also points us to the many variables that affect the behavior change

process at the individual, group, and community levels. We have discussed the three most

commonly used models; socio-ecological, transtheoretical, and health belief models. The

importance of theories is numerous, but they significantly assist planners in determining what

they need to know before developing public health programs. Public health is influenced by

diverse fields; however, epidemiology is very critical to its study. In our study on type II diabetes

in adult black males in Cucamonga city, we noticed that they are at a higher risk than the

predicted average. This necessitated the design of an intervention program. We are leveraging

the socio-ecological model for the program intervention. The overall essence is to drive

preventive care; the provision of complete interventions in a clinical setting that helps prevent

certain illnesses in patients. (Fletcher MD MSc, Robert H. et al., 2014).

References

Centers for Disease Control. (2019) Know your risk of heart disease. Retrieved from
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https://www.cdc.gov/heardisease/rosl_factprs.htm

Fletcher MD MSc, Robert H., Fletcher MD MSc, Suzanne W., & Fletcher MD MPH, Grant S.

(2014). Clinical epidemiology: The essentials (Fifth ed.) [ebook]. LWW.

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

Gregg, E. W., Zhuo, X., Cheng, Y. J., Albright, A. L., Narayan, K. M., & Thompson, T. J.

(2014). Trends in lifetime risk and years of life lost due to diabetes in the USA, 1985-

2011: a modelling study. The lancet. Diabetes & endocrinology, 2(11), 867–874.

https://doi.org/10.1016/S2213-8587(14)70161-5

Sheehan, J., & Ulchaker, M. M. (2012). Obesity and Type 2 Diabetes Mellitus. Oxford

University Press.