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Health awareness improvement is one of the ways to predict and control diseases and their outcomes on populations. In this SLP project, the task is to create a basis for a health education program for the chosen cultural group. African Americans are highly predisposed to diabetes compared to non-Hispanic whites (13% compared to 7%) (Bullard et al., 2018; Centers for Disease Control and Prevention, 2017). The PEN-3 cultural model was used as a framework to analyze sociocultural factors of African Americans in health education (Ilunga Tshiswaka, Ibe-Lamberts, Mulunda, & Iwelunmor, 2017). The evaluation of such categories as cultural identity, relationships and expectation, and cultural empowerment helps to make final choices and understand the worth of knowledge in treating diabetes among African Americans.
A Health Education Program for Diabetic African Americans
The introduction of a theory-based and culturally relevant intervention to promote diabetes prevention in African Americans is a significant step in the elimination of diabetes disparities. The PEN-3 is a strong sociological approach that helps to recognize the most relevant perceptions, enablers, and nurturers (Scarinci, Bandura, Hidalgo, & Cherrington, 2012). In a health education program, the identification of its elements is a good chance to underline the strengths and weaknesses of African Americans in treating diabetes.
Cultural Identity
The success of the program is a possibility to combine as many elements of the PEN-3 model as possible. Many factors contribute to the emergence of diabetes and remain the responsibility of an individual. For example, eating habits and the growth of obesity-related problems increase the rates of diabetes in blacks (Northwestern University, 2018). Therefore, the intervention must be person-centered (African American adult men and women). The familial environment also plays a role in the development of diabetes (Routh, Hurt, Winham, & Lanningham-Foster, 2017). It is important to cover the aspects and make the program interesting and helpful for the extended family. Finally, King, Moreno, Coleman, and Williams (2018) underlined the worth of community-based partnerships to ensure the diabetic people’s needs and expectations. The neighborhood factor cannot be ignored in a learning process.
Relationships and Expectations
Regarding the relationships and expectations domain of the PEN-3 model, the improvement of health awareness depends on how well positive and negative perceptions, enablers, and nurturers were distinguished. The reinforcement of positive PEN factors like beliefs, attitudes, community support, and strong family relationships has to be underlined. Purcell and Cutchen (2013) paid attention to the belief that an aggressive attitude towards diabetes management in African Americans is necessary. Spouse support and religious faith may also have a positive outcome on the education program, and cooperation can be its central element. At the same time, several negative concepts prevent the achievement of high, positive rates in diabetes control. The lack of diabetes-specific knowledge in the community, poor self-management skills, and the absence of motivation challenge the promotion of healthy lifestyle behaviors (Smalls, Walker, Bonilha, Campbell, & Egede, 2015). To overcome these shortages, the program needs a strong leader and enough easy-to-access resources.
Cultural Empowerment
Cultural empowerment is another significant element in the education program that focuses on the recognition of positive, existential, and negative attributes. Gross, Story, Harvey, Allsopp, and Whitt-Glover (2017) proved the relationship between religion, culture, and health. The idea that God provides people with strengths to cope with diabetes should be integrated into a learning process. Faith healing, as an existential domain, cannot be changed but needs to be acknowledged. Racial inequalities provoke a number of discussions and concerns about service delivery available to African Americans (Karter et al., 2017). High prices on healthy food and poorly organized health care for black patients cause negative emotions, and these factors are better to overcome in the program.
Challenges in a Plan
In trying to plan and implement the health education program for African Americans who have diabetes, several challenges cannot be ignored but elaborated. For example, it is necessary to gather a good team of researchers, educators, and specialists who know how to work with minority people without focusing on their inabilities. The next problem is related to the identification of the scope of the program. Diabetes in black populations is a complex and wide-open topic, and instead of covering all the aspects of the diseases, one should expect to identify the main factors and urgent areas. Today, African Americans have access to various publicity-supported insurance programs (Karter et al., 2017). However, the lack of knowledge and understanding of diabetes threats remains a challenge for many people.
Conclusion
In general, the creation of a health education program is a complex process that requires multiple evaluations and thoughtful research. There are many examples of how the PEN-3 model may be integrated into the intervention. The idea to support African Americans in their intentions to manage diabetes has a number of positive outcomes, and one of them is to reduce the cases of diabetes-related complications. Religious beliefs, family support, and community relationships are the factors that may positively contribute to health awareness of society.
References
Bullard, K. M., Cowie, C. C., Lessem, S. E., Saydah, S. H., Menke, A., Geiss, L. S.,… Imperatore, G. (2018). Prevalence of diagnosed diabetes in adults by diabetes type – United States, 2016. Morbidity and Mortality Weekly Report, 67(12), 359-361.
Centers for Disease Control and Prevention. (2017). National diabetes statistics report, 2017. Web.
Gross, T. T., Story, C. R., Harvey, I. S., Allsopp, M., & Whitt-Glover, M. (2017). “As a community, we need to be more health vonscious”: Pastors’ perceptions on the health status of the black church and African-American communities. Journal of Racial and Ethnic Health Disparities, 5(3), 570–579. Web.
Ilunga Tshiswaka, D., Ibe-Lamberts, K. D., Mulunda, D. M., & Iwelunmor, J. (2017). Perceptions of dietary habits and risk for type 2 diabetes among Congolese immigrants. Journal of Diabetes Research, 2017. Web.
Karter, A. J., Lipska, K. J., O’Connor, P. J., Liu, J. Y., Moffet, H. H., Schroeder, E. B., … Steiner, J. F. (2017). High rates of severe hypoglycemia among African American patients with diabetes: The surveillance, prevention, and management of diabetes mellitus (SUPREME-DM) network. Journal of Diabetes and Its Complications, 31(5), 869–873. Web.
King, C. J., Moreno, J., Coleman, S. V., & Williams, J. F. (2018). Diabetes mortality rates among African Americans: A descriptive analysis pre and post Medicaid expansion. Preventive Medicine Reports, 12, 20-24. Web.
Northwestern University. (2018). Blacks’ high diabetes risk driven by obesity, not mystery.Science News. Web.
Purcell, N., & Cutchen, L. (2013). Diabetes self-management education for African Americans: Using the PEN-3 model to assess needs. American Journal of Health Education, 44(4), 203-212.
Routh, B., Hurt, T., Winham, D., & Lanningham-Foster, L. (2017). Family legacy of diabetes-related behaviors: An exploration of the experiences of African American parents and adult children. Global Qualitative Nursing Research, 6. Web.
Scarinci, I. C., Bandura, L., Hidalgo, B., & Cherrington, A. (2012). Development of a theory-based (PEN-3 and health belief model), culturally relevant intervention on cervical cancer prevention among Latina immigrants using intervention mapping. Health Promotion Practice, 13(1), 29-40.
Smalls, B. L., Walker, R. J., Bonilha, H. S., Campbell, J. A., & Egede, L. E. (2015). Community interventions to improve glycemic control in African Americans with type 2 diabetes: A systemic review. Global Journal of Health Science, 7(5), 171-182. Web.
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