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Introduction
The World Health Organization recently reported that about eight percent of American adults suffer from type II diabetes. Type II diabetes is a condition where the body is unable to produce enough insulin, making the blood glucose level increase. According to McFarlane (2010), medical researchers are yet to come up with a proper cure for diabetes. This means that the condition can only be controlled instead of being cured to delay a possible death of the patient. Recent studies show that there is a consistent surge in the number of people who suffer from this disease (Williams, 2003). Medical doctors have blamed the rise on the emerging lifestyle in the current society. Technology has transformed the world, and most of the physical activities that were previously done manually can now be done using machines. The improved technology has also enhanced the means of transport. The result of this improved world of technology has reduced the physical activity of many people. Limited physical activity is known to be one of the most common causes of type II diabetes. It is necessary to come up with intervention measures to help counter this problem. This research seeks to determine if lifestyle interventions may have a significant impact on diabetes to curb the rising incidences.
Opening Statement
Type II diabetes is one of the leading causes of death in the United States. According to the Center for Disease Control and Intervention, the United States has registered an increase in the number of new incidents over the past five years. This trend is very worrying. It is, therefore, necessary to find measures that can be used to address this problem. A change of lifestyle is one of the measures that many medical researchers have proposed. In this study, the researcher seeks to determine if it is possible to change the negative trend if the target population can engage in more physical activities. It will also be necessary to determine if a change in diet can help in protecting the target population from contracting the disease.
Background of the Study
According to World Health Organization (WHO), over 8% of Americans have type II diabetes. This percentage only presents what has been recorded officially in all the medical centers within the country. Center for Disease Control and Prevention (CDC) estimated that another 2% of Americans suffer from diabetes (Vora & Buse, 2012). However, they are yet to go for diagnosis either because the disease is still at its early stages or because of their ignorance. This means that 1 out of every 10 Americans suffer from diabetes. The report from these two leading health organizations is worrying. The fact that new cases are still being reported at very high rates is an indication that more needs to be done to arrest the situation. All the stakeholders including the doctors, the government, non-governmental bodies, and the public need to find a common way of addressing this problem in the best way possible. One of the ways that have been proposed by the recent scholars is a change in lifestyle. This basically involves engaging more in physical activities and maintaining healthy diets. This approach is simply and less costly. In fact it may help people to cut down on their budgets if they consider applying it. Failure to take this intervention may lead to increased cases of diabetes. This may put the lives of more Americans in danger.
Problem Statement
This study is intended to determine how a change in lifestyle may lead to reduced cases of type II diabetes in the society. However, it is important to note that the research may be affected by a number of issues that needs to be controlled in order to achieve the expected outcome. One of the main hindrances in this study is the issue of time. The time available for this study is very short, and this means that the researcher will be forced to find a way of balancing all the activities within the short deadline. Another problem is the unwillingness of some of the participants to respond to the study questions. Many leading health organizations and research centers have rich sources of information about this disease. However, it will be necessary for the researcher to go to the field and collect raw data from the respondents in order to support or even challenge existing information. When the participants are unwilling to respond to the questions about their conditions, then it may not be easy gathering the relevant data.
Purpose of the Study
As mentioned above, there has been extensive research about type II diabetes. The intensity of this disease and the recent reports indicating a rise in new cases has left many members of the society worried. In this particular study, the researcher is seeking to be part of a solution to this existing problem. The researcher intended to gather secondary sources of information and identify possible gaps that exist. The researcher will make an effort to address this gap by conducting primary research in order to enhance existing knowledge on how to deal with the problem. The main purpose of this study is to determine the relevance of change in lifestyle as a way of fighting type II diabetes. Change of lifestyle in this case involves engaging in more physical activities and eating healthy. Some of the recent studies have strongly supported this approach as a way of keeping safe from contracting the disease. In this study, the researcher also intends to find out why people are yet to embrace this approach of dealing with diabetes even though they have the right knowledge. Healthy diets and regular physical exercise is known to be one of the best ways of fighting so many diseases besides diabetes, such as coronary problems. However, many Americans are still very physically inactive. It would be necessary to find an explanation for this. With this in mind, the researcher will try to find possible ways that can make more people to become physically active. This study will benefit the public in confronting this disease by proposing simple and actionable ways that can be applied by everyone in order to have a positive change of lifestyle.
Research Questions, Hypotheses, and Variables
According to Chawla (2014), conducting a research is a very vigorous and complex process that needs proper guidance. This scholar notes that in many cases, some researchers have swayed off from the main topic area to other unrelated issues because they lacked proper guidance. Research questions offer this guidance. When a researcher gets to the field to collect data, many unrelated but very interesting stories may be encountered. Collecting such irrelevant data may not only waste the time needed to conduct the research, but also affects the quality of the report. Research question acts as a compass that a researcher uses to collect relevant primary and secondary sources of data. Any information that does not respond to the question is always considered irrelevant. In this study, the following are some of the questions that will be used.
- What is the impact of physical exercise in fighting off type II diabetes?
- What is the impact of improved diet in fighting off type II diabetes?
- Why do many people ignore the call to change their lifestyle even though they know it may affect their health?
- What are some of the possible simple changes that one can make to improve their lifestyle?
After setting research questions, it is always important to come up with appropriate hypotheses. Research hypotheses helps to determine the expected outcome based on the current knowledge of the researcher and the information collected from secondary sources. The following are the hypotheses developed based on the set of questions.
- H1o. Physical exercise is not the best non-medical way of fighting-off type II diabetes
- H1a. Physical exercise is the best non-medical way of fighting-off type II diabetes
- H2o. Change in lifestyle is not the best way of reducing new cases of type II diabetes
- H2a. Change in lifestyle is the best way of reducing new cases of type II diabetes
The researcher seeks to reject the null hypotheses using the data collected from the field in order to accept the alternative hypotheses.
According to Narayan (2011), it is always necessary to define both dependent and independent variables in a research. In this study, the independent variables are physical exercise and healthy diet. The dependent variable is new cases of type II diabetes. This means that new cases of diabetes rely on the type and quantity of food one takes and how one engages in physical exercises.
Theoretical Framework
According to Chawla (2014), diabetes is one of the lifestyle diseases that are claiming many lives not only in the United States but in many other countries around the world. The need to find a viable solution to this problem has led to extensive research resulting in various theories. At this stage, it is necessary to discuss the theoretical framework relevant to type II diabetes management. One of the widely used theories in diabetes management is the Self-Regulation Theory. This theory focuses on personal model of diabetes and how behavioral and emotional pattern may affect the ability to manage this disease (Ekoé, 2008). This theory has five main pillars that shape the illness management and is based on self-empowerment. The first pillar is to identify the symptoms. In order to manage diabetes, it is important to start by identifying the possible symptoms the may help indicate that one is suffering from type II diabetes. The ability to correctly identify symptoms of diabetes in time may help in early intervention measures before the disease can get to advanced stages. The second pillar is the cause of the disease. It is always necessary to determine the causes in order to know how to avoid getting affected.
The best way of avoiding this disease is to find its actual causes. Having knowledge on specific issues such as diet that is related to the disease may be a form of self-empowerment. The third pillar of this theory is the timeline. In this regard, an individual should understand the timeline on how the disease advances from one stage to the other, and how this advancement can be delayed through appropriate medication and a change in the lifestyle. The next pillar is the consequence of the disease. For an individual who is yet to become diabetic, it is important for them to realize that this is a lifetime disease that changes one’s lifestyle for the worse. It is a disease that may result into a scenario where one has to live under medication in his or her lifetime. To those who are already diabetic, they need to know how they can live positively with the disease. They need to know the consequences of failing to observe the medical prescription given to them or taking foods that may worsen their conditions. The final pillar of this theory is effective medication. Once one has been confirmed to be suffering from diabetes, it is always necessary to maintain regular medication to stay healthy. Diabetes is one of the diseases that currently have no cure. For this reason, the only way of staying alive is to have a regular intake of the prescribed medicine without fail. The patient should know when and how to take the medicines, and types of food to be taken and the nature of physical activities which are necessary.
Dual Process Theory is another popular concept that is widely used in the management of diabetes. According to Ekoé (2008), this theory helps in guiding the processes of education and enhancing one’s knowledge about diabetes. The theory makes a clear distinction between systematic and heuristic processing. According to Somekh and Lewin (2005), patient education mainly takes the heuristic processing approach, where the patient takes a passive role. In this approach, the patient’s role is to listen to what the health experts say without necessarily engaging them in a consultative forum. This is a traditional approach of learning about a disease. The expert will provide all the information that a patient needs on how to manage the disease. However, many scholars have heavily criticized this approach as being ineffective. The approach takes away the power of managing the disease from the patient. The patient becomes over reliant on the experts and cannot think on his own. This is very dangerous, especially in cases where the expert lacks the right knowledge about the disease.
Some of the people who claim to be medical experts may actually be quarks who know very little about the disease. What the patient must realize is that any mistake made by the doctor may cost them dearly. The expert may not care much as long as he or she is paid. However, the patient will bear all the risks. This makes it necessary to use systematic learning. In this approach, a lot of emphasis is laid on patient empowerment. As a patient, it is necessary to be part of the solution to the problem of diabetes. The patient needs to have the right knowledge about the management of the disease. This includes knowing the medicines which are appropriate, the food to be avoided and those to be taken, the appropriate physical activity, and any other relevant issues that may affect the process of their condition. This does not rule of the importance of the experts in their lives. These patients will still have to visit doctors regularly. However, instead of taking instructions as a passive listener, the patient will engage the experts and share any new findings they have on how to manage their condition. The experts may help them shape their newly found idea in a better way to improve their condition. On the other hand, they are able to put to task the experts about their proposed medication processes. This way, the patients is able to be in control of their lives instead of wholly relying on the experts. Equipping patients is the best way of handing the responsibility of managing their condition to them.
Self-Determination Theory is another theory which looks at the distinction between autonomous and controlled motivation. According to Ekoé (2008), over 71% of the American population has post-high school diplomas. Another 59% of the population has college degrees in various courses. The level of illiteracy in this country according to the recent studies by Chawla (2014) is less than 5%. According to Vora and Buse (2012), most of those who suffer from diabetes in this country (over 68%) are people with diplomas or advanced diplomas and very decent jobs. The reason why this statistics is necessary is to help determine the reason why many people are not leading the right lifestyle that can help them stay healthy. From the early stages of learning through to the high school, students always learn about the importance of physical exercise and dangers of some types of food. In high school, learners are always taken through some of the causes, management approaches, and prevention measures of diabetes. When they leave high school, they have the right knowledge about how to fight diabetes. It is, therefore, worrying that people have the right knowledge but are unwilling to use them because of reasons that Narayan (2011) describes as recklessness. The Theory of Self-Determination seeks to find out how the two approaches of motivation can help encourage individuals to use their knowledge about diabetes positively.
According to Vora and Buse (2012), controlled motivation involves acting because of extrinsic reason. This is a situation where one acts because of the desire to be noticed by others. One may want to act in a given way so as to make people happy, receive a reward or avoid punishment. In this case, the person knows what should be done, but lacks the self-drive to do it. They only act in such a desirable manner when they know they are being monitored. For instance, a diabetic patient may be instructed to avoid specific types of food. Such a patient may deliberately decide to avoid such foods only when they are aware that people around them are monitoring their activities. When they know that they are on their own, then they would indulge in those foods without giving consideration some of the possible consequences to their actions. This explains why many Americans have the knowledge on how to lead lives free from diseases such as diabetes, but they fail to do so because they lack the self-drive. They know that their lifestyle may lead to serious consequences, but they do not give any serious consideration to these facts. They are empowered, but are unwilling to use their power to fight diabetes through a changed lifestyle. In contrast, autonomous motivation is a situation where one takes the initiative to stay healthy without necessarily expecting any reaction from others. They act for intrinsic reasons. They know that they have the responsibility to take care of their lives, and that what they eat and how they act may have an impact on their health. It is important to note that acting for intrinsic reasons is one of the biggest challenges, especially for those who have not be subjected to grueling experience of managing some of these diseases. Staying away from junk foods beautifully displayed in fast food stores requires a lot of discipline. Similarly, maintaining a regular workout is physically stressing, and unless one has the commitment to do so, it is very easy to give up along the way.
Acting for intrinsic reasons is the best way of fighting diabetes both for those who are already affected and those who are free from the disease. The non-diabetic individuals must understand that diabetes is a condition that can be acquired in one’s lifetime if one fails to leady a healthy lifestyle. For this reason, they need to maintain regular exercise and avoid junk foods in order to stay healthy. On the other hand, those who are already suffering from this disease must understand that they have the power to remain alive based on what they do. They must take care of what they eat, including taking medication at the right time. This should be done without necessarily waiting for someone to give a reward or to avoid rebuke from others. It is a matter of being disciplined in all the activities that one engages in at all times. As Frankfort-Nachmias and Nachmias (2008) put it, it involves having the power and using it responsibly for one’s own well-being.
The last concept that will be looked at in this paper is the Social Learning Theory. This theory majorly focuses on how one perceives his ability to enact behaviors or policies and follow them through on his action plan. This may also be referred to as self-efficacy. According to Williams (2003), success and failure largely relies on one’s perception towards an issue. This is so because success or failure is a process based on how an individual views self against the issue at hand. For instance, when one develops a feeling that he cannot maintain a regular diet that is free from some forms of food, then this becomes a big issue that cannot be controlled even though it may appear simple. The moment the idea of impossibility sets in, then everything becomes impossible. It is common to find a situation where one sets a behavioral plan to engage regularly on physical exercise, maybe three times a day for about one hour on each day. The plan may be so good and very simple in paper, but unless one has a commitment to do what is right, they may not achieve the intended objective. Such a program would be forgotten about sooner or later because of the lack of personal commitment. In managing diabetes, one should start by working on their perception towards specific issues in their lives. They must develop confidence in themselves and develop a belief that they can make it on their own. In this regard, the experts and other family members need to find a way of improving the level of confidence among their patients who struggle to overcome some habits that may affect their conditions. One such habit is excessive intake of alcohol. The addicts may find it difficult overcoming such conditions. However, when they develop a will power, then it can be possible to overcome the situation.
Quantitative Research Design
Introduction
When conducting research, selecting an appropriate research design is critical in order to achieve success. In this study, the researcher was interested in a quantitative research method in order to respond to the research questions and empirically confirm the hypotheses set in the previous chapters.
Research topic
In this study, the researcher was interested in investigating the incidences of Type II diabetes and how it can be managed within the United States. The reports from Word Health Organist ion and Center for Disease Control and Prevention have given consistent reports which show rising cases of diabetes within the country. This has largely been blamed on the lifestyle. In this study, the researcher used mathematical methods to identify some of the best ways that can be used to address this problem.
Experimental design
According to Pedhazur (1991), experimental design refers to a systematic approach to a research where a researcher manipulates variables, measurement standards, and participants in order to achieve the desired outcome. For instance, when a researcher is interested in determining the relationship between two variables over a given time, it will be necessary to manipulate other factors in order to find the best way of conducting the experiment. Sometimes the manipulation may involve an assumption that some variables will remain constant as other undergo change. This way, it becomes easy to determine how one variable affects other variables. This way, a researcher is able to offer advice on how manipulating one variable may help avoid undesirable events from taking place or to avoid their impact. This makes it easy to test the set hypothesis even if the conditions within the environment are very dynamic. The participants may also be manipulated, by having a sample size that can fit into an experimental context.
Design of research
When selecting an appropriate research design, it is always important to into consideration factors such as feasibility, costs, time, and ethics. The design must be feasible based on the available resources and the desired outcome. The cost of the research design must be realistic based on the finances available for the study and its purpose. The time set for the research will also determine the appropriateness of the research design. Finally, ethics should not be forgotten when selecting an appropriate research design. This means that the design chosen should have the capacity to achieve the intended outcome without subjecting the participants to criticism or discrimination by allowing third parties to have access to their responses. Confidentiality should be maintained.
The design chosen for this study
In this study, the researcher decided to use the experimental randomized control design in order to assess how incidences of type II diabetes is affected by physical exercise. According to Mitchell (2010), physical exercise is very important in controlling incidence of type II diabetes. The only way of doing this is through this randomized controlled design. This means that there will be two groups when conducting the research which are the control group and the experimental group. Both groups will be given medication. However, the experimental group will be subjected to physical exercise while the control group will not. The researcher will then determine if there is consistency in the two groups in terms of the level of improvement in their condition. This will help determine if physical exercise has any impact on the incidence of type II diabetes.
Levels of Measurement
When conducting research, different variables will be used to define different factors. Each of the variables must have its own measurement levels in order to make sense. Variables are always measured based on their peculiar characteristics. There are four types of levels of measurement that are always used. Nominal scale is used to measure issues such as ethnicity, gender, language, or race. This scale is commonly used in qualitative research. Ordinal scale is majorly used when the variables can be ranked. It can be used when dealing with variables such as grades, or intensity of something. In this study, ordinal scale will be very important as a level of measurement. Interval level is widely used when there is need to determine the degree of differences can be determined. It is very appropriate for issues such as distance and temperature. Ratio scale measurement is always relevant when determining the ration that exists between differences of a continuous variable. In this study, the focus will be to determine the impact of physical exercise on incidence of type II diabetes. The physical exercise that the participants will be subjected to, can be measured in weeks. The incidence of type II diabetes can be evaluated through a measure of blood glucose level.
Sampling Method
When conducting research, it may not be easy to work with the entire population. In this research, the entire population is so big that the researcher may not conduct a feasible study on all of them. This makes it necessary to use a sample as a representative of the entire population. Different types of sampling may be relevant under different contexts. Some of the popular sampling methods include stratified sampling, systematic sampling, and purposive sampling, among others. Each of these sampling methods may fit in different contexts. It is necessary to identify the most appropriate sampling method based on the nature and the number of the participants.
Sampling method used in this study
The sampling method selected for this research is the purposive sampling approach. This method was selected because the desired population is clearly defined. The desired participants in this study are only those suffering from type II diabetes. In order to avoid biasness, purposive sampling would be appropriate at this stage. The researcher sampled a total of 200 diabetic patients. It is important to note that there are two groups of participants classified as either intervention or control group. In each of the groups, there will be 100 participants. Given that the population is predetermined, this method saves time and cost of the process of sampling.
Validity and Reliability of the Study
Validity
Leedy (2010) defines validity as the certainty with which a given research is considered correct. This correctness may be looked at from three perspectives which are content, construct, and empirical validity. Construct validity is achieved when relative theoretical framework supports incumbent theory. It involves evoking facts that are already established in the previous research. Content validity is the correctness of the information presented in the study. Empirical validity is the correctness achieved when comparing instruments. In this study, empirical validity will be achieved by correctly comparing level of exercise per week and the blood glucose level. Content validity will not be very applicable in this study.
Reliability
According to Glatthorn (2005), reliability is a measure of levels of authenticity of the validity. It defines how well the content of a given research can be applied under a given context. To text for reliability, split-half method is always employed. The correlation between the two halves is used to verify the validity. Alternatively, a pretest-posttest method can be used to determine the reliability of the study. This split-half method will be more appropriate for this study because the participants are already classified into two groups. The correlation between the two groups can easily be identified. One of the main advantages of this method is that it is simple to conduct.
Scale, Test, and Validity
In this study, the researcher used quantitative analysis to test the hypotheses and to determine the validity of the study. In this case, the participants’ opinions are represented by numbers (Gupta, 2002). It is also important to note that the relationship between the test, scales, population, validity, and reliability is very important. At this stage, it will be important to test the hypotheses which were set in the first chapter of this research.
- H1o. Physical exercise is not the best non-medical way of fighting-off type II diabetes
In order to test this hypothesis, the researcher will compare the level of improvement among the two participants in this study. The result obtained are presented in the graph below
As shown in the above graph, it is evident that the group of participants who were engaged in physical exercise registered higher performance than those who only relied on medication alone. This means that the null hypothesis above has been rejected. By rejecting the null hypothesis, the alternative hypothesis below is accepted
- H1a. Physical exercise is the best non-medical way of fighting-off type II diabetes
The following research hypothesis focused on a change in lifestyle, especially on the type of food taken by an individual. The researcher asked the participants to state their views on the relationship between lifestyle (specifically the diet) and incidence of type II diabetes.
- H2o. Change in lifestyle is not the best way of reducing new cases of type II diabetes
The responses obtained from the respondents are presented in the following pie-chart below.
The response received from the participants shows their strong support for a positive lifestyle. Most of the participants blamed poor lifestyle, especially poor dieting as the main reason why the contracted this disease. One participant categorically stated that she was addicted to fast foods, especially fried chicken and other sugary products. She started gaining weight very fast, but she did very little to control the situation. This response means that the null hypothesis above is resoundingly rejected. Most of the respondents feel that positive change of lifestyle is one of the best ways of dealing with diabetes. This means that the following alternative hypothesis is accepted.
- H2a. Change in lifestyle is the best way of reducing new cases of type II diabetes
The response obtained from the two hypotheses confirms that physical exercise and dieting are some of the key ways of managing diabetes. According to Goddard (2001), many experts always emphasize on physical exercise among the unaffected group as the best way of keeping type II diabetes at bay. Physical exercise burns excess blood sugar in the body, minimizing chances of becoming diabetic. On the other hand, one can regulate the amount of sugar intake. Excessive intake of sugar into the body may be a causative factor of diabetes. For those who are not suffering from type II diabetes, maintaining a regular physical exercise may be one of the best ways of staying healthy because one will be assured that excess blood sugar will be converted into energy. However, those who are unable to engage in regular physical exercise for one reason or the other should ensure that they limit their intake of sugar. It may not be necessary to completely cut out sugar intake. However, the amount can be controlled to ensure that one takes amounts that can easily be consumed by the daily activities. To do this, Creswell (2009) says that one needs to be empowered by having the right knowledge. One should know food products which have excess sugar and the ratio in which they should be taken on a daily basis. The following research question was also considered important in the study.
- What are some of the possible simple changes that one can make to improve their lifestyle?
The following chart shows some of the activities mentioned by the respondents as ways through which one can improve their lifestyle.
As shown in the graph above, there are a series of simple activities that one can engage in to improve his or her lifestyle. The respondents stated ways other than going to the gym. Many people find it challenging to maintain regular visits to fitness centers. Instead of going to the gym, one can decide to walk or cycle to work if it is possible. This will help burn excess calories. While at work or at home, one should consider using the staircases because it will not only burn calories within the body, but also strengthen the muscles in the entire body.
Conclusion
Reduction is type II diabetes requires an individual effort. One must realize that they are responsible for their own health. For this reason, they must find ways of leading healthy lifestyle. This research has confirmed that physical exercise is one of the best ways of reducing incidence of type II diabetes. Other possible ways may be regular water intake is also encouraged as per the views given by the respondents. These are tricks that may not necessarily need force one to refrain from popular habits. However, the respondents also stated that it would be better if one can avoid or reduce alcohol intake, smoking and eating of junk food. Although these are some of the habits that one may not give up easily, it is advisable to refrain from them.
References
Chawla, R. (2014). Manual of diabetes care. London: McMillan.
Creswell, J. (2009). Research design: Qualitative, quantitative, and mixed method approaches. Thousand Oaks: Sage Publication.
Ekoé, J.-M. (2008). The epidemiology of diabetes mellitus. Chichester, UK: Wiley-Blackwell.
Frankfort-Nachmias, C. & Nachmias, D. (2008). Research methods in social sciences: Cross-Sectional and Quasi-Experimental Designs. New York: Worth.
Glatthorn, A. (2005). Writing the winning thesis or dissertation: a step-by-step guide (2nd ed). Thousand Oaks. Corwin Press.
Goddard, W. (2001). Research methodology: an introduction. Lansdowne: Juta.
Gupta, p. (2002). Statistical Methods (31rd ed). New Delhi: Sultan Chand & Sons.
Leedy, P. (2010). Practical research: planning and design (9th ed). Upper Saddle River, Prentice Hall.
McFarlane, S. (2010). Diabetes and hypertension: Evaluation and management. Totowa: Humana.
Mitchell, M. (2010). Research design explained (7th ed). Belmont. Cengage Learning.
Narayan, K. M. V. (2011). Diabetes public health: From data to policy. New York. Wiley.
Pedhazur, E. (1991). Measurement, design and analysis. An integrated approach. Hillside: Lawrence Erlbaum Associates.
Somekh, B., & Lewin, C. (2005). Research methods in social sciences. London: Sage Publications.
Vora, J., & Buse, J. B. (2012). Evidence-based management of diabetes. New York: Cengage.
Williams, R. (2003). The Evidence Base for Diabetes Care. Chichester: John Wiley & Sons.
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