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The issue of diabetes prevention is extensive due to the need to choose measures for different population groups and avoid various complications. For this reason, it is more appropriate to discuss the application of translation science theory using one example of complications, namely the high risk of fractures in people living with diabetes. Therefore, this discussion will apply Everett Rogers’s theory of diffusion of innovations and a five-step innovation-decision process to prevent fractures in people with diabetes.
Such complication as the fragility of bones is a lesser-known consequence of diabetes as it is not sufficiently studied. However, as Ho-Pham and Nguyen (2019) argue, the increased risk of fracture in people living with diabetes is associated with a low trabecular bone score (TBS). Hence, healthcare professionals and patients should take steps to overcome this problem.
Everett Rogers’s theory of diffusion of innovations is relevant to this process since, according to it, the process of diffusion of innovations goes through five stages and depends on several factors. These steps are knowledge, persuasion, decision, acceptance, and confirmation (Kuang, 2018). In other words, fracture prevention should use such actions as educating professionals and patients about measures to improve TBS and fracture prevention, convincing them of the importance of these measures, their moral acceptance, practical application, and testing their effectiveness. For example, according to Borgen et al. (2020), ingestion of glucocorticoids, significant consumption of alcohol, and high body mass index are negatively associated with TBS. The DNP scholar should be innovators and early adopters, according to Roger’s classifications of groups, to implement the strategy that includes researching, finding valid evidence, and educating their colleagues and patients, who are stakeholders, about preventive measures (Kuang, 2018). In this way, the knowledge about bone fragility and preventive practice will be spread between medical professionals and people living with diabetes at higher rates.
However, the use of this theory has some challenges in practice. First, the relationship between TBS and fractures in people living with diabetes is still not well understood, which can lead to doubts among medical professionals at the decision-making step and difficulties in choosing measures to improve it. Second, since the rate of adoption of an innovation depends on the ability of the population to observe its effectiveness, fracture prevention may not be a priority for people living with diabetes (Kuang, 2018). This assumption is justified by the fact that a person must get injured to fracture a bone. Although this situation is probable, it depends on many external factors, such as physical activity and the environment.
References
Borgen, T.T., Bjørnerem, Å., Solberg, L.B., Andreasen, C., Brunborg, C., Stenbro, M.-B., Hübschle, L.M., Figved, W., Apalset, E.M., Gjertsen, J.-E., Basso, T., Lund, I., Hansen, A.K., Stutzer, J.-M., Dahl, C., Nordsletten, L., Frihagen, F., & Eriksen, E.F. (2020). Determinants of the trabecular bone score and prevalent vertebral fractures in women with fragility fractures: A cross-sectional sub-study of NoFRACT.Osteoporosis International, 31, 505–514.
Ho-Pham, L. T., & Nguyen, T. V. (2019). Association between trabecular bone score and type 2 diabetes: A quantitative update of the evidence. Osteoporosis International, 30(10), 2079–2085.
Kuang, W. (2018). Social media in China. Springer.
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