Therapeutic Engagement and Psychosocial Interventions
February 9, 2024
OMED 1425/6 – Formative Assessment
February 12, 2024
Executive summary
Type two diabetes is a serious health condition that can happen in the body due to improper function of the pancreas that produces insulin hormone. For this improper function glucose level in the blood increases continuously with time. In this type two diabetes condition, human health gets energy from carbohydrates and proteins, as insulin does not work properly, and sugar level rises with time after eating. This makes the pancreas tired and it starts producing less amount of insulin which increases the risk of higher sugar levels and higher blood pressure. Almost 90% of people in the UK are suffering from type 2 diabetes. It is one of the main reasons behind stroke and heart attack. Apart from that it can damage several body parts like eyes, kidneys, liver, feet, and many more. One of the prime reasons behind this disease is unhealthy habits and lifestyle and obesity. Paying attention to all these factors can decrease the risks of type 2 diabetes. It is not curable but diabetes management is possible. Eating healthy foods, physical activities, keeping a healthy weight and BMI, taking insulin, and weight loss surgery can help in minimizing the effects of this disease.
A Complete Guide To Quantitative Research Methods And Types of number
In this assignment, different factors regarding this disease are discussed. The growth of this disease and the demographics of Chesterfield are discussed in the next section. After that demographic comparison between Chesterfield and Sheffield is done properly to understand the differences. Recent reports on diabetes are explained in the next section. After that guidelines and the strategies taken by the cities to mitigate the effects of this disease are discussed in a detailed manner. In the targeted audience for the campaign section, the main targeted audiences are identified according to the demographic data received. After this section, a detailed discussion is done on the behavioral change model and its relation with the demographic data. After that comparison is done between several campaigns and a recommendation is given based on all the data received and intervention models. Increasing the rate of this disease can hurt the health of the whole world. So mitigating the factors contributing to increasing the disease is necessary.
Main Body
Population and demographic
Chesterfield is one of the popular outdoor market areas in Britain. The population here is almost 352802. There are almost 23 million people in a two-hour drive. Population density is 424 per square mile. The population health of a country can be assessed depending on factors like health conditions, health outcomes, mental health, and healthy behaviors. In this area, almost 9.8% of people do not have health insurance, the smoking rate is 15.4% and the expectancy of life is almost 77.5 years. According to the reports, 13% of adults are of fair or poor health in the country (Burchill et al. 2020). Almost 8% of the babies are born with low weight at the time of birth and the rate of teen birth is 10%. 12% of adults are with mental distress frequently, and deaths are 37.3%. In the country, primary care availability from doctors is 1.1% and bed availability in hospitals is 2.6%. Cancer incidence rate is almost 450.8 per 100k and heart disease is 5.4%. On the other hand, Sheffield is a city in the UK where life expectancy is lower than other areas of England. 21.6% of children are obese which is even worse than the country average. Here alcohol-related cases are higher and hospital admissions are 1010 per year. Recently a sharp rise has been noticed in the case of diabetes. According to the 2016-2017 report, 64% of adults in Derbyshire were obese and this is increasing the threat of type 2 diabetes.
The Dahlgren-Whitehead model is useful to explore all the factors related to social health and this also helps in connecting between an individual and their surroundings (Manson et al. 2021). According to this model, social factors have a huge impact on the lives of individuals. In the green sections life living conditions are present which are directly connected to people and their lives.
Figure 1: Dahlgren-Whitehead model
(Source: https://www.liverpool.ac.uk/research)
There in Sheffield city people’s lifestyle is low, and this is affecting the health of people. According to a report in 2015 almost 55,672 people in Derbyshire are suffering from diabetes which is 8.6% of the total population. By the year 2035, this figure will grow to 70, 717, 10 percent of the total population. Mainly diabetes people suffer from stroke and heart attack. Most of the children are obese and as a result, type 2 diabetes is increasing (Dahlgren and Whitehead, 2021). Researchers are saying that a lifestyle change can change this situation. Smoking and drinking are responsible for being overweight and it is seen that youth are more prone to smoking and drinking and for this life expectancy is decreasing.
The Public Health Issue
Issues
In the last few years, reports have shown a sharp spike in the cases of Diabetes, mainly diabetes type 2 which can be life-threatening for a person. Type 2 diabetes can lead to heart attack, stroke, blindness, and many other problems (Ruxton et al. 2021). In the UK, type 2 diabetes cases are increasing with time. Of people who are affected by diabetes, only 10% of people are affected by diabetes type 1 and almost 90% of people are suffering from type 2 diabetes. Of the children, almost 85% are suffering from type 2 diabetes. So identifying the health risks associated with this is very important for this region.
Type 2 diabetes can mainly affect middle-aged people and older people. It can also be diagnosed in a child with obesity. Mainly this happens when the human body cannot produce much insulin. Lifestyle and food habits can be responsible for this disease (Nejhaddadgar et al. 2019). If one parent has this then there is a 15% chance that the child can also have this, if both parents have this, then chances increase to 75%. So it can be transmitted through the genes. Type 2 diabetes has a strong connection with obesity. In every three people, two are overweight in the UK and this is the reason behind this spike rate in diabetes type 2. Being away from exercise, a healthy lifestyle, prone to alcohol and smoking, and lower blood pressure control, and diet can lead to such health conditions (Hunt et al. 2018). Diabetes can lead to heart, kidney, limb amputation, eye disease, sexual dysfunction, neuropathy, depression, and a decrease in life expectancy and life length. Life expectancy can be reduced to almost 10 years for type 2 diabetes in an adult.
The effects of type 2 diabetes can be decreased by adopting a healthy lifestyle and healthy food habits. Losing weight, healthy habits and exercises to be fit, and blood pressure control can decrease the effects but removing sugar and other starch foods from the diet list is also important for mitigating effects (Wu et al. 2018). Insulin therapy can also help in this activity. Curing this disease completely is not always possible but mitigating the effects and saving lives from heart attack, stroke, and other incidents is possible. Healthy habits and healthy foods also can save a population from gaining such diseases which can lead them to death.
Some changes are necessary in lifestyle to mitigate the effects of this disease. These are:
Physical activity: Physical activity like brisk walking, cycling on a flat surface or terrain, water aerobics, hiking, rollerblading, jogging, swimming, football, gymnastics, and skipping such activities can help mitigate the disease risk.
Weight loss: According to NICE recommendations, being overweight can be a reason behind this disease. Weight loss is necessary for getting a healthy Body mass index (BMI). It should be between 18.5 and 24.9. Weight loss can mitigate health risks like stroke and heart attack.
Change in diet: Intake of leafy vegetables, fruits, beans, and lentils can improve health conditions. Fat intake should be reduced, having lean meats instead of red meats and taking food according to portion sizes can help in gaining healthy food habits.
Mitigating stress: Stress is one of the important factors of type 2 diabetes. Stress hormones are mainly responsible for increasing blood pressure (Trisnadewi et al. 2020). Continuous stress can make glucose control difficult. Stress management in life and maintaining a balance in life are very important for mitigating stress. These resources are required for life changes to minimize the effects of this disease.
Are You Looking For Economic Assignment Help Services in the UK?
Relevant policy, strategy, and guidelines
In Derbyshire, poverty is not a new problem. Poverty and surroundings can be a reason behind the increasing number of type 2 diabetes cases. Now with the increasing product costs, people are not able to afford different healthy products. An anti-poverty strategy was taken in Derbyshire from 2014 to 2017 to remove this poverty in people (Chepngeno-Langat et al. 2022). According to the poverty reports, almost 43% part part-time workers in the UK earn way less than a living wage, 21% of families are in poverty, 20% of employees have low pay and 18.2% of children are in poverty. Poverty helps in influencing health factors, mainly this poverty is harmful for children.
In Sheffield, the situation is even worse than in Chesterfield. Life efficacy was also less for those people (Telo et al. 2019). Diabetes type 2 is spreading even more. People in this place are more prone to smoking and drinking alcohol. As these habits have a very bad effect on human health, a joint health and well-being strategy is taken by the government for the years 2019 to 2024. This is taken to save people from these diseases. The ambition of this strategy is explained in the diagram.
Figure 2: Ambitions of health and wellbeing strategy
(Source: https://democracy.sheffield.gov.uk/documents)
The first focus of this strategy is children. If child health can be preserved then the whole system can be improved. After the children, young people are on the verge of poverty. Poverty can influence human life and surroundings in many ways. In this policy, the goal is also to save people from mental disorders (Kolomitro et al. 2020). In this strategy, children’s well-being and youth’s well-being are planned to help people. These strategies can improve poverty situations and the health of people and this can finally improve human health from the effects of diabetes type two like diseases.
Interventions designed to change the outcome
Intended audience
From the demographic data it can be found that in Chesterfield, people’s disease rate is comparatively lower than in Sheffield but in recent times it can be seen that Chesterfield has shown a high spike in the rise of type 2 disease. Mainly the child’s health is affected by poverty factors and in the youths, alcohol consumption and work stress are affecting their health. So improving child and youth health are the main factors here. As type two diabetes can grow in youth and adult bodies, they are also should be taken care of to save from this kind of disease. On the other hand, Sheffield is a city in the UK where life expectancy is lower than in other areas of England (Donovan et al. 2022). 21.6% of children are obese which is even worse than the country average. Here alcohol-related cases are higher and hospital admissions are very high in a year. Recently a sharp rise has been noticed in the case of diabetes. In the case of Sheffield, child obesity is the main reason behind diabetes type two disease. In the case of diabetes prevention programs, the main audience is the child and adults. In the campaign, the main audience will be child health and youth health.
Connection with demographic data
The UK has switched to nudge and behavior change wheel models to curb their health situations. The behavioral change model is mainly introduced to produce a change in the habits of people in their daily routines (Powell and Thomas, 2022). It promotes healthy habits and practices. It mainly comprises 19 different frameworks of behavior change combining nudge theory. There is a step-by-step procedure by which change in human behavior takes place.
Figure 3: Steps of behavioral change model
(Source: https://www.dunnhumby.com/resources)
These are the steps of the model. The first step is understanding the existing behavior, the second step is to identify intervention options and in the last step, the main task is to apply the intervention and analyze. This system offers a flexible framework in which different aspects are included. These are mentioned below. It works in different areas from a healthy diet to physical exercise to save energy. In the initial stages, it looks at the history reports and identifies the behavior of people and surroundings that are responsible for creating problems (Kim, 2021). After that quantitative and qualitative studies are done based on the collected data about behavior. Then the habits are divided and prioritized according to their frequency for understanding the pattern of behaviors. Here repetitive habits are also noted. After that changed patterns are introduced and they are implemented accordingly. After the implementation, analyzing it is very important for understanding the differences. If changes happen then the system is continued but if no changes happen then new ideas are implemented for a good change.
This model is also called the COM B model which is the green portion. This segment comprises three factors. These are capability, opportunity, and motivation. These factors are highly essential for changing behavior. Motivation can be of two types. These are: reflexive and automatic.
Figure 4: Wheel of change of behavior
(Source: https://www.dunnhumby.com/resources/blog)
In the outer section, policy categories are mentioned by which these behavioral changes can be achieved. These can be guidelines, environmental social planning, communication marketing, legislation, service provision, regulation, fiscal measures, and many more (Bennell, 2019). In the red sections, different interventions are mentioned like: Restrictions, modeling, education, training, and many more. Definitions of these interventions are explained below.
Education: Increasing understanding and knowledge.
Persuasion: Communicating to make people aware of the fact and eradicating negative feelings.
Incentivization: By creating a reward and influencing people.
Coercion: Imposing a fine or cost as a punishment for a harmful behavior.
Training: Increasing skills in people regarding change of behavior.
Restriction: Using several rules to keep a person away from harmful habits and reduce all opportunities to engage in such behaviors.
Environmental restructuring: Changing the social and the physical context of a person’s behavior.
Modeling: Giving an example in front of people to motivate them.
Enablement: Reducing the barriers are increasing means of increasing capability and opportunity.
As in this assignment, the main issue is the spread of diabetes type 2 diabetes. Diabetes can lead to heart, kidney, limb amputation, eye disease, sexual dysfunction, neuropathy, depression, and a decrease in life expectancy and life length. Diabetes type 2 mainly develops from unhealthy habits and lifestyle (Padilla-Martínez et al. 2020). Losing weight, healthy habits and exercises to be fit, and blood pressure control can decrease the effects but removing sugar and other starch foods from the diet list is also important for mitigating effects. Insulin therapy can also help in this activity. To identify the behaviors of people are needed for understanding the pattern. After that, these interventions are to be applied to people to make them aware of healthy habits and implement them. Implementation of these models needs to be accepted by people for proper change (Ahmed et al. 2020). For this, a proper management system needs to be implemented.
Comparison between existing campaigns
For the prevention of diabetes type two different models are introduced to make people aware of all the factors but this model should be properly accepted by the people is very important. In this intervention model the main work is to understand the behaviors of humans then working accordingly is necessary (Eizirik et al. 2020). But there are some barriers too. With the changing lifestyle and stress pattern, behaviors are also changing with time. Making proper patterns with them is difficult. If making patterns will be difficult then planning an intervention according to that will also be affected. Before the change of the behaviors, eliminating this disease and its symptoms is necessary. The establishment of a healthy lifestyle is very important for children and adults. Mitigating stress alcohol consumption and smoking is important for mitigating this. This intervention gives examples of such people who have curbed this disease by adopting a healthy lifestyle and making people aware of the other aspects (Davies et al. 2019). Before the behavioral change, it needs to spread this campaign for public wellness. These are the main areas of difference with the existing interventions.
Conclusion and recommendation
To conclude this report is based on type 2 diabetes and aspects related to that disease. Diabetes plays an important role in a person’s life and can lead to several problems in the future from heart attack to depression and anxiety. It is seen that there are many steps taken by government organizations to start healthy strategies to curb this disease. In some way, it is also seen that diabetes comes to the children from parent genes. It is one of the problems in both national and international ways (Xuan et al. 2019). Many recommendations can be given for such a disease. Many interventions can be started which can make people aware of their unhealthy habits. Introducing healthy lifestyles can make people healthy. In this assignment, a change of behavioral model is introduced which mainly focuses on changing people’s lifestyle and unhealthy food habits. After the implementation, analyzing it is very important for understanding the differences. If changes happen then the system is continued but if no changes happen then new ideas are implemented for a good change.
There are some recommendations necessary for such interventions. It is based on the reading behaviors of people. Understanding proper patterns is important for proper intervention. If patterns are changing rapidly then intervention changing is also important. Then only people can be alerted to this disease.
Reference list
Journal
Ahmed, A., Lager, A., Fredlund, P. and Elinder, L.S., 2020. Consumption of fruit and vegetables and the risk of type 2 diabetes: a 4-year longitudinal study among Swedish adults. Journal of Nutritional Science, 9.
Burchill, A., Williams, C. and De Sabbata, S., 2020. It takes a region to raise an artist: The Derbyshire Report.
Burd, C., Gruss, S., Albright, A., Zina, A., Schumacher, P. and Alley, D., 2020. Translating knowledge into action to prevent type 2 diabetes: Medicare expansion of the National Diabetes Prevention Program lifestyle intervention. The Milbank Quarterly, 98(1), pp.172-196.
Buss, V.H., Leesong, S., Barr, M., Garfield, M., and Harris, M., 2020. Primary prevention of cardiovascular disease and type 2 diabetes mellitus using mobile health technology: systematic review of the literature. Journal of medical Internet research, 22(10), p.e21159.
Carr, M.J., Wright, A.K., Leelarathna, L., Thabit, H., Milne, N., Kanumilli, N., Ashcroft, D.M. and Rutter, M.K., 2022. Impact of COVID-19 restrictions on diabetes health checks and prescribing for people with type 2 diabetes: a UK-wide cohort study involving 618 161 people in primary care. BMJ Quality & Safety, 31(7), pp.503-514.
Chepngeno-Langat, G., Van Der Wielen, N., Falkingham, J. and Evandrou, M., 2022. Targeting Cash Transfers on the “Poorest of the Poor” in the Slums: How Well Did Kenya’s Older Persons Cash Transfer Programme Perform? Journal of Aging & Social Policy, pp.1-18.
Crowshoe, L., Dannenbaum, D., Green, M., Henderson, R., Hayward, M.N. and Toth, E., 2018. Type 2 diabetes and Indigenous peoples. Canadian Journal of Diabetes, 42, pp.S296-S306.
Dahlgren, G. and Whitehead, M., 2021. The Dahlgren-Whitehead model of health determinants: 30 years on and still chasing rainbows. Public Health, 199, pp.20-24.
Davies, M.J., Russell-Jones, D., Barber, T.M., Lavalle-González, F.J., Galstyan, G.R., Zhu, D., Baxter, M., Dessapt-Baradez, C. and McCrimmon, R.J., 2019. The glycaemic benefit of iGlarLixi in insulin-naive type 2 diabetes patients with high HbA1c or those with inadequate glycaemic control on two oral antihyperglycaemic drugs in the LixiLan-O randomized trial. Diabetes, Obesity and Metabolism, 21(8), pp.1967-1972.
de la Cruz, J.P.S., Morales, D.L.G., González-Castro, T.B., Tovilla-Zárate, C.A., Juárez-Rojop, I.E., López-Narváez, L., Hernández-Díaz, Y., Ble-Castillo, J.L., Pérez-Hernández, N. and Rodriguez-Perez, J.M., 2020. Quality of life of Latin-American individuals with type 2 diabetes mellitus: A systematic review. Primary care diabetes, 14(4), pp.317-334.
Donovan, G., Hall, N., Ling, J., Smith, F. and Wilkes, S., 2022. Influencing medication-taking behaviors using automated two‐way digital communication: A narrative synthesis systematic review informed by the Behavior Change Wheel. British Journal of Health Psychology.
Eizirik, D.L., Pasquali, L. and Cnop, M., 2020. Pancreatic β-cells in type 1 and type 2 diabetes mellitus: different pathways to failure. Nature Reviews Endocrinology, 16(7), pp.349-362.
Fazeli, P.K., Lee, H. and Steinhauser, M.L., 2020. Aging is a powerful risk factor for type 2 diabetes mellitus independent of body mass index. Gerontology, 66(2), p.209.
Hamdan, A., Haji Idrus, R. and Mokhtar, M.H., 2019. Effects of Nigella sativa on type-2 diabetes mellitus: a systematic review. International journal of environmental research and public health, 16(24), p.4911.
Hunt, C.W., Henderson, K. and Chapman, R., 2018. Using technology to provide diabetes education for rural communities. Online Journal of Rural Nursing and Health Care, 18(2), pp.134-151.
Kim, E.J., 2021. Development and Verification of an Alzheimer’s disease Risk Reduction Program for Korean Middle-aged adults with low education on the Behavior Change Wheel Model. Annals of the Romanian Society for Cell Biology, 25(1), pp.1500-1509.
Kolomitro, K., Kenny, N. and Sheffield, S.L.M., 2020. A call to action: exploring and responding to educational developers’ workplace burnout and well-being in higher education. International Journal for Academic Development, 25(1), pp.5-18.
Li, Y., Schoufour, J., Wang, D.D., Dhana, K., Pan, A., Liu, X., Song, M., Liu, G., Shin, H.J., Sun, Q. and Al-Shaar, L., 2020. Healthy lifestyle and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes: prospective cohort study. BMJ, 368.
Manson, J., Gardiner, C., Taylor, P., Ghasemi, L., Westerdale-Shaw, E., Sutton, L. and Cawley, H., 2021. ‘Palliative care education in nursing homes: a qualitative evaluation of telementoring. BMJ Supportive & Palliative Care.
Nargesi, A.A., Jeyashanmugaraja, G.P., Desai, N., Lipska, K., Krumholz, H. and Khera, R., 2021. Contemporary national patterns of eligibility and use of novel cardioprotective antihyperglycemic agents in type 2 diabetes mellitus. Journal of the American Heart Association, 10(13), p.e021084.
Nejhaddadgar, N., Darabi, F., Rohban, A. and Solhi, M., 2019. The effectiveness of the self-management program for people with type 2 diabetes mellitus based on the PRECEDE-PROCEDE model. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(1), pp.440-443.
Padilla-Martínez, F., Collin, F., Kwasniewski, M. and Kretowski, A., 2020. A systematic review of polygenic risk scores for type 1 and type 2 diabetes. International Journal of Molecular Sciences, 21(5), p.1703.
Powell, A.J. and Thomas, S., 2022. Reverse Coding of a Common-Sense Physical Activity Intervention for Older Adults Using Elements of the Behaviour Change Wheel Framework. Health Promotion Practice, p.15248399221081832.
Ruxton, C.H., Derbyshire, E. and Sievenpiper, J.L., 2021. Pure 100% fruit juices–more than just a source of free sugars? A review of the evidence of their effect on the risk of cardiovascular disease, type 2 diabetes, and obesity. Nutrition Bulletin, 46(4), pp.415-431.
Telo, G.H., Cureau, F.V., Szklo, M., Bloch, K.V. and Schaan, B.D., 2019. Prevalence of type 2 diabetes among adolescents in Brazil: Findings from Study of Cardiovascular Risk in Adolescents (ERICA). Pediatric diabetes, 20(4), pp.389-396.
Trisnadewi, N.W., Adiputra, I.M.S., Oktaviani, N.P.W., Suapriyanti, P.A. and Saraswati, N.L.G.I., 2020. Correlation between stress level and family support towards fasting and postprandial glucose level in type 2 diabetes mellitus. Age (year), 25(1), pp.1-3.
Vinceti, M., Filippini, T. and Rothman, K.J., 2018. Selenium exposure and the risk of type 2 diabetes: a systematic review and meta-analysis. European Journal of Epidemiology, 33(9), pp.789-810.
Wu, H., Yang, S., Huang, Z., He, J. and Wang, X., 2018. Type 2 diabetes mellitus prediction model based on data mining. Informatics in Medicine Unlocked, 10, pp.100-107.
Xuan, Y., Gào, X., Anusruti, A., Holleczek, B., Jansen, E.H., Muhlack, D.C., Brenner, H. and Schöttker, B., 2019. Association of serum markers of oxidative stress with incident major cardiovascular events, cancer incidence, and all-cause mortality in type 2 diabetes patients: pooled results from two cohort studies. Diabetes Care, 42(8), pp.1436-1445.
Zhao, C., Yang, C., Wai, S.T.C., Zhang, Y., P. Portillo, M., Paoli, P., Wu, Y., San Cheang, W., Liu, B., Carpéné, C. and Xiao, J., 2019. Regulation of glucose metabolism by bioactive phytochemicals for the management of type 2 diabetes mellitus. Critical Reviews in Food Science and Nutrition, 59(6), pp.830-847.
