Category: Diabetes

Introduction

Qualitative research has achieved status and visibility in social science and particularly in the health care field. The goal of qualitative research is to answer questions that are not answered by quantitative research. Qualitative research helps researchers to gain a more detailed understanding of a specific phenomenon of interest (Gerrish & Lacey, 2010). It also helps one to understand and explain unusual situations that could not be identified through large-scale quantitative methods. This paper analyzes qualitative research issues in diabetes management in elderly patients.

Qualitative research methods

The qualitative research methodology aims to investigate why there are high cases of elderly people getting diabetes. It also aims to find out the causes which result from the elderly people suffering from diabetes. There are different methods of qualitative research which include:

Participatory action research

This method aims at working towards greater participation in healthcare so that people can contribute their ideas which will help the researchers to plan and take effective action. In the healthcare practice, its vital to involve a participatory approach to many of the research activities, to come up with acceptable results for both practitioners, patients, and significant others. This kind of research can involve interviewing elderly people who are in diabetes to understand the cause of the disease among them.

Discourse analysis

Discourse analysis provides an opportunity to investigate the definition in both cultural and conversational aspects, which encompasses a broad range of theories, topics and analytical explanation of language use (Grbich, 1999, p.98). Discourse analysis is more than just understanding the language concept. It is associated with social undertones in general interactions. Discourse analysis involves listening to peoples conversations and analyzing them for meaning. This is a very important part of nursing research as opinions would only be acquired through listening. It involves collecting qualitative data in the form of other peoples discourses or conversations. These conversations can be in written form and can include texts. Discourse analysis is interested in people talking and in interactions between people. It looks more specifically at conversation and the effect of culture. One of the main features is the examination of the people understand language and how it can be differently interpreted by different people in different situations (Mann, 2006).

Ethnographic study

The ethnographic study aims at understanding the culture and characteristics of patients. Interview questions will be set, focusing on how patients perceive themselves. The research method will aim at developing a story of the patients and how they can live with the disease. The ethnographic study provides the researcher with a much more comprehensive perspective. By observing the actual behavior of people in their natural setting the researcher will gain a much deeper and richer understanding of such behaviors. Ethnographic research also lends itself to research topics that are not easily quantified. Research in clinical practice is best understood when behavioral aspects of the patient are observed.

Research question

The seventh leading cause of death in elderly people is diabetes, a disease with long-term implications on the general healthcare of individuals (Pope & Mays, 2006). This condition is becoming more prevalent with age. It is one of the most common chronic diseases of elderly people. Therefore, it is inevitable that as the population ages, the number of older people with diabetes will increase. The likelihood of developing diabetes increases as one gets older. Almost 20 percent of people older than sixty-five have diabetes and this number increases to almost 40 percent of people over eighty (Sinclair, 2009). Despite the measures put down to prevent diabetes among the elderly the number has continued to increase. Therefore this research aims at finding out the causes of the disease among elderly people and how it can be prevented.

Research approach

This qualitative research will use a participatory action research study. Interviews will be conducted on elderly people with diabetes to know their behaviors. It will involve the researcher and the patients, working together to examine the problem to come up with an action for positive change. This method will help research participants to increase their knowledge and ideas about diabetes and thus more relevant solutions will be achieved. This approach is also the best because both the researcher and the aged diabetic will gain more from the research process when it attains greater sensitivity and self-awareness of the problem. A good relationship will be developed among research time, research participants, and the community. This qualitative approach will allow a humanistic approach through the involvement of everyone in solving the diabetes problem.

The researcher should identify participants in the research process. These will be elderly people suffering from diabetes. To achieve the research aim, which is to find out the causes of diabetes among elderly people, the researcher will have to organize the research team. When the participants have been identified, then the research team should be organized to serve as the governing body of the research process to oversee the remedial measures and solutions to diabetes. A timetable should be established and given to the research team and the research participants so that the task assigned to them will be accomplished within the stipulated time (Pope & Mays, 2006). The research team and the research participants should cooperate to conduct the participatory research project to find a solution to the problem.

Unlike other approaches of qualitative research, the participatory action research method emphasizes the importance of listening to different voices and versions (Pope & Mays, 2006). Truth becomes a product of a process in which people come together to share experiences through a dynamic process of action, reflection, and collective investigation. At the same time, they remain firmly rooted in participants conceptual world and interactions between them (Pope & Mays, 2006).

Ethnographic research unlike participatory action research does take a lot longer time in the fieldwork and also to analyze the material as well as write it up. The research method does not also have much breadth as compared to participatory action research. It leads to in-depth knowledge of a particular context and situation. It is also difficult to write up the research for publication for a peer-reviewed journal.

The participatory action research method is also preferred to discourse analysis (Wallen & Fraenkel, 2001). This is because discourse analysis only looks at a particular situation and so it may not be possible to repeat the study. This method also uses media as the source and the facts are often biased in the media. This method also calls for the need to use careful sampling of items to analyze, for example, if each has its own bias.

Literature review

In people with diabetes mellitus, the plasma glucose level is a continuous risk factor for all diabetes-related chronic illnesses and is a modifiable risk factor for them (Wallen & Fraenkel, 2001). As people age, many symptoms of diabetes are mistakenly accepted as normal age-related changes. Increased urination may be attributed to bladder muscle relaxation which can interfere with a persons ability to control urination. Additionally, the decrease in visual acuity and increased levels of fatigue are thought to be normal alterations in physical abilities (Wallen & Fraenkel, 2001). As a result, the vague nonspecific symptoms are dismissed as nonsignificant thus delaying the diagnosis of diabetes among elderly people.

Factors affecting the elderly patients

Studies suggest that the caring role for the elderly with diabetes can significantly affect the physical, emotional, social, and economic wellbeing of the family and those directly involved in the care process (Wallen & Fraenkel, 2001). Many of the published studies have shown that adults with type 1 diabetes have the biggest effect, as far as impact on significant others is concerned (Wallen & Fraenkel, 2001; Sinclair, 2009; Gerrish & Lacey, 2010). It, therefore, means that relatives may get worried even more than the patients themselves, with several spouses reporting marital conflicts brought about by diabetes management and disturbed sleep (Gerrish & Lacey, 2010).

As type 1 diabetes generally develops in people younger than 30 years, newly diagnosed diabetes in older people is predominantly type 2. As people age and gain weight, the risk of type two diabetes increases with at least 20 percent of people older than 65 years having diabetes. Stolberg et al. (cited in Grbich, 1999, p.60) conducted a qualitative study dubbed, lived experience. The study revealed four main themes of being a close relative to an elderly with type 1 diabetes. They are; living in concern about the others health, making effort to be involved, experiencing confidence, and handling the illness (Grbich, 1999). Although many family members agreed that they accept diabetes as a normal human disease, it became apparent that they kept on worrying about how the patient felt and lived their lives.

Weight and activity

As a person ages, weight gain increases particularly around the abdomen, thereby increasing the distribution of fat to muscles which results in central obesity. Visceral fat has been identified as a more reliable indicator for the risk of diabetes than subcutaneous fat. Muscle changes such as muscle wasting, decreased muscle loss and changes in muscle fibers also contribute to increased insulin resistance. Impaired insulin resistance is further exacerbated by a decrease in physical activity (Pope & Mays, 2006). Arthritis, joint diseases, and decreased muscle mass and strength as well as changes in visual acuity can limit physical ability thereby hindering activity levels experienced at a younger age. Although aerobic exercise is beneficial to anyone with diabetes, elderly patients may not be able to participate due to physical limitations (Wallen & Fraenkel, 2001).

Changes in nutrition

Limited mobility not only affects insulin sensitivity, but it can impair the older adults ability to get fresh foods, especially if he has transportation issues. These factors may lead to the use of frozen meals, canned foods high in sodium, and other ready-to-eat meals. Malnutrition may also be affected by depression, social isolation, use of alcohol, and cognitive impairment (Wallen & Fraenkel, 2001). The death of a spouse and retirement can lead to loneliness, depression, and boredom which will, in turn, affect nutritional habits. In addition, changes in dentition can impact nutrition intake both in food choices and the amount is eaten. As teeth are lost of denture fits deteriorates, softer foods become easier to chew. In combination with a decreased ability to taste sweet, sour, sour, and bitter taste, the older adult may experience an increased desire for a higher concentration of sugar and salt which can further cause alleviation of blood sugar and blood pressure.

From the perspective of care, elderly persons with diabetes complications are likely to need more care than any other age group. It, therefore, means they place a lot of pressure on the significant others, whose responsibility increases when they worry more. A small qualitative study revealed that the development of qualitative study diabetic foot ulcers leads to patients and carers both experiencing reduced mobility, thus aggravating minimal social activities of the two parties (Gerrish & Lacey, 2010).

Neurologic changes

As patients age, they experience slower learning and processing time, have slower reactions, and increased risks of organic brain disease (Gerrish & Lacey, 2010). Memory loss, especially of more recent events, can make teaching basic day-to-day living skills a change. Sensory overload from the array of new information can lead to further inability to retain that information (Gerrish & Lacey, 2010). This in turn can lead to frustrations and irritations causing the patient to feel inferior and unable to care for himself. In addition, hyperglycemia can lead to impairment in learning and retention, deficits in concentration and attention span. Glucose regulation to near normal levels can help to maintain cognitive performance as well as improvement in learning and memory.

Conclusion

Qualitative research involves research techniques in which data is obtained from a relatively small group of respondents. It helps researchers to formulate their interpretations of the subject of their studies and give interpretations to add to a body of knowledge (Wallen & Fraenkel, 2001). This article has explained the different qualitative methodologies that a researcher can use giving the advantages and drawbacks of each. In the research problem of diabetes management among elderly patients, the researcher decided to use the participatory action research methodology as explained in the article.

Reference List

Gerrish, K. & Lacey, A. (2010). The Research Process in Nursing. London. John Wiley & Sons.

Grbich, C. (1999). Qualitative Research in Health: An Introduction. New York. Sage.

Mann, B. (2006). Selected Styles in Web-Based Educational Research. Boston. Idea Group Inc.

Pope, C., & Mays, N. (2006). Qualitative Research in Health Care. London. Wiley-Blackwell.

Sinclair, A. (2009). Diabetes in Old Age. New York. John Wiley & Sons.

Wallen, N. & Fraenkel, J. (2001). Educational Research: A Guide To The Process. London. Routledge.

Introduction

Chronic diseases are considered those diseases that are incurable for a long period of time mainly from three months onwards. They are referred to as chronic since they develop over a long period of time and in most cases they are incurable and therefore the individuals have to live with the consequence of the diseases. Some of the diseases that are considered chronic include arthritis, diabetes, asthma, hepatitis, cardiovascular complications and high blood pressure among others. Most of these diseases are prevalent in old age with 90% of the senior citizens having one or two chronic diseases (Bardana, 2007, p. 12).This paper will look at the main effects of chronic diseases in the lifestyle of the individuals and analyze the causes and the preventive measures of diabetes as a chronic disease. The paper also analyses asthma and its relations to air pollution

Consequences

Chronic diseases are a big challenge to the individuals suffering from them since they affect the normal living of the persons. The first major consequence is the cost of treatment which requires a lot of resources. The chronic illness patients need a lot of care and counseling which requires financial resources. Chronic illness also means that such individuals will have to bear the chronic pain that comes with the chronic illness. The individuals are also on medication through out their lives in order to prevent the occurrence of other complications or reduce pain. This may become very frustrated especially if the individuals do not have enough resources to cater for their medication. Fear of death is a major effect that affects the individuals psychologically (Bardana, 2007, p. 18). They are sure of no cure and some may give up and just wait for death. Most of these patients actually will suffer from depression if they lack proper care and counseling. Another effect of the chronic diseases is that in most case it leads to disability especially on reaching its advanced stages. This may cause stress to a lot of individuals who may not be able to do their normal duties as they used to do them. They result in relying and depending on other people for simple tasks. They may find this difficult to cope with as they view themselves as a burden to other individuals.

Causes of Diabetes

According to the medical fraternity the main causes of diabetes are still unknown. However there are those factors that are considered to cause the condition. One of the risk factors is the inheritance factor. If a family has a history of diabetes running in the family for many years then hereditary factors will play a big role in it developing within the individuals from that family. Another major cause is poor diet. Taking foods that contain too much carbohydrates, proteins and fats can lead to diabetes in the long run. Too much of these foods impair the pancreas from producing insulin and thus leading to diabetes. A close condition related to diet is obesity which is considered another cause of diabetes. Excess body weight normally leads to diabetes mellitus. Some conditions of diabetes can result from viral infections such as the Coxsackies B virus. This virus impairs the production of insulin and increases the level of sugar in the body. Other causes include age factors, emotional stress and also smoking (Shlomo, 2007, p. 12)

Preventive measures of the risks of diabetes

In order to prevent the risk of diabetes and its complications, individuals who are at risk should continuously take blood tests to check their sugar levels. Other conditions that should be medically monitored include the blood pressure and the cholesterol levels for those who are at risk. In this way one can be able to control their sugar levels and avoid diabetes (Schnitzer, 2004, p. 35). Another effective preventive measure of risks of diabetes is a change in diet. It is very possible for people who are at risk of getting diabetes to prevent it and delay its occurrence by taking a balanced diet. The diet should also contain very low fats. Another important factor is continuous involvement in physical exercises which helps a lot in losing body weight. These are especially useful in preventing diabetes type 2.

Asthma and air pollution

Asthma is a chronic respiratory disease that normally affects the lungs. The interaction of an individual with the conditions of the air may deteriorate the effects of the disease. Air pollution will accelerate the effects of asthma in an individual. The quality of air that such individuals breathe affects the occurrence of asthma. Smoking and high polluted air from traffic increases the chances of suffering from asthma especially in children. The pollutants in the air contain a lot of particles which eventually irritate the respiratory system (Adams, 2006, p. 28). Polluted air may result to difficulties in breathing and also a lot of coughing. Asthma can be prevented by avoiding air that is polluted with a lot of dust, mold, tobacco, smoke, chemicals among other pollutants.

Conclusion

In conclusion, chronic diseases can be a big challenge to the patients suffering from them. They change the individuals lifestyle with most of them becoming disabled and have to depend on others. The live with the pain of the diseases especially when it advances to the maturity stages (Bardana, 2007, p22). They are a major cause of death especially to the senior citizens. However, these diseases can be prevented or delayed by taking the necessary precautions. Diseases such as diabetes can be prevented by ensuring proper medical checkups, proper balanced diet and physical exercises. In cases of diseases such as asthma, the quality of air breathed in may affect the prevalence and therefore one should always avoid areas which are highly polluted.

References

1. Ben-Shlomo, 2007. Diabetes: causes and prevention. McGraw-Hill publications
2. Emil J Bardana, 2007. Chronic illness and the quality of life. Prentice hall
3. Francis V. Adams, 2006. Clearing the Air: Asthma and Indoor Air Exposures. National Aca
4. Johann Georg Schnitzer, 2004. Diabetes Causes & Cure  including Cure of Later Diabetes Consequences. Sage publications.

Introduction

The number of people with diabetes in Oxfordshire has significantly increased over the years, making it one of the primary concerns in the area. The health problem is brought about by many factors including lifestyle, lack of physical activity and unhealthy eating habits. Most often the onset of diabetes 2 type starts when people are over 50 because with age the production of insulin by cells diminishes. Moreover, reports show that people who have obesity are twice as likely to get diabetes 2 type as those who keep fit. Diabetes affects all systems and can cause various complications that lead to disability and shortening of life. These complications may include nephropathy accompanied by the development of chronic renal failure, retinopathy, leading not only to a decrease in vision, but also to blindness, diabetic foot, angina pectoris and myocardial infarction. This report analyses diabetes as health issue affecting Oxfordshire population of ages from 50 to 80 and discusses what health services are available for treatment of diabetes in the area. It identifies health and social policy aimed at diabetes prevention in older generation and considers the role of the nurse in supporting people in Oxfordshire in their use of services provided. Moreover, the report offers recommendations to tackle the decease and outlines limitations in treatment options.

Background

A research conducted by the Oxfordshire Clinical Commissioning group has found that there are currently over 28,000 people registered as having diabetes in Oxfordshire and about 2,200 are newly diagnosed each year (Oxfordshire Clinical Commissioning group, 2022, para. 1). The problem is exacerbated by the fact that Oxford area has a large proportion of minotiry population, including many Afro-Americans who are more prone to developing diabetes 2 type. The costs of diabetes treatment include medication and social care costs as well as the cost of complications treatment which can go as high as about half of all expenses associated with the decease. There is a sharp need to reduce diabetes so a number of healthcare services have been established to tackle the decease. On a national level, Diabetes Research and Wellness Foundation aims to prevent the spread of the decease through research of the causes and effective treatment of diabetes 2 type. Locally, there is the Oxfordshire diabetic eye screening service (ODES) provided by Oxford University Hospitals (OUH) NHS Foundation Trust. This service is based at John Radcliffe Hospital and Windrush Medical Practice and performs eye screening for people suffering from diabetes (Oxfordshire: diabetic eye screening service). Moreover, there are many adult support groups and clinics that specialize in diabetes treatment.

Literature Review

In order to tackle diabetes in adults in Oxfordshire, a multi-sectoral approach has been developed that includes governmental and local bodies initiatives aimed at decease prevention and its effective treatment.

Lifestyle modification strategy

Galaviz et al (2018) proposed lifestyle modification strategy aimed at prevention of diabetes 2 type development. This strategy includes instituting healthy eating habits, engagement into sports activities, reduction of stress and anxiety, and regular checkups of the levels of sugar in the blood. Galaviz et al (2018) studied the results of the application of the given strategy in diverse adult communities and found that the proposed measures significantly reduce the risks of diabetes 2 development. This strategy is partially adopted at local level in Oxfordshire where public health actors develop local programs to promote healthy eating habits and dietary patterns. Moreover, regular checkup services have been established for people over 50 who are at risk of diabetes 2 development.

Improving access to sports and physical training

Physical activity makes it possible to increase the susceptibility of cells to insulin, which allows the pancreas not to produce this hormone in large quantities, and, consequently, it becomes much easier to maintain sugar levels. Scientists have found out that high intensity physical exercises increase the bodys sensitivity to insulin by 85, and with moderate  by 51 percent (Li et al., 2021). The effect, unfortunately, persists only on training days. Engaging in various types of physical activity lowers sugar levels not only in people predisposed to diabetes, but also in obese people. Being a large city Oxford has a developed infrastructure for sports and activities. Local authorities have placed emphasis on the creation of recreation centers and green spaces (Department of Health and Social Care, 2017). As a result of such policy the number of people who do physical exercises on a regular basis significantly increased.

Policy aimed at promoting water as a main source of liquor

Many drinks unlike ordinary drinking water, especially purchased ones, contain sugar, preservatives and other additives not always known to the buyer. The use of carbonated drinks increases the likelihood of developing type 2 diabetes, especially in older ages. The study on this aspect covered about 2,800 people (Sheikh et al., 2019). In people who drank two bottles of carbonated sweet juices a day, the risk of developing type 2 diabetes increased by 20, and the first by 99 percent (Sheikh et sl., 2019). It should also be taken into account that fruit juices can also become a provoking factor. Unlike other sweet and carbonated liquids, water allows keeping insulin and sugar under control.

To promote water drinking local government has equipped clinics and workout zones with water coolers that stimulate people to view water as a desirable way to quench thirst. Moreover, many public and private organizations within Oxfordshire adopted this practice. Pricing policy with higher prices for carbonated drinks that contain high level of sugar has also contributed to this initiative.

Bring the weight to the optimal norm

Diabetes affects not only people with excess body weight, but they make up the vast majority. And if there is a predisposition to the disease, then fat accumulates around the liver and abdominal cavity. Its overabundance becomes the main reason that the body becomes less sensitive to insulin, which increases the risk of diabetes. To tackle the problem of obesity, the policy aimed at promoting healthy eating in Oxfordshire has been developed. To start, on a national level regulations that compel large restaurants, cafes, and takeaways joints to label the food they sell thus showing the number of calories this food contains have been adopted (Department of Health and Social Care, 2020). This initiative allows people to assess their health risks every time they go to eat out. Secondly, the UK government have banned advertising of all products that contain high levels of sugar, salt, and fat (Griffin et al. 2021). On the local level, CLAHRCs new initiative called Behaviour change: Diet and Obesity was adopted (University of Oxford, 2017). The initiative comprises research into the most effective methods of lowering weight in adult population groups.

Discussion

From the literature findings, it can be deduced that health initiatives aimed and prevention and treatment of diabetes among people over the age of fifty are developed taking into account the needs of changing individual lifestyle and timely healthcare initiatives. There are specific factors that may lead to diabetes, including obesity, poor nutrition with an abundance of carbohydrates and refined foods, chronic violation of the water balance in the body, and low physical activity. The literature outlines specific measures that can be taken to prevent diabetes development in adults and shows which initiatives have been introduced in Oxfordshire. These initiatives include improving access to sports and physical training, promotion of water drinking within the community, forming healthy eating habits, regular checkups, and establishing specific programmes such as CLAHRCs new initiative called Behaviour change: Diet and Obesity. Doubtlessly, awareness of the population and the availability of a coherent system of sanitary and hygienic education and medical and social assistance can contribute to diabetes prevention.

A huge role in the implementation of measures to improve the health of the nation belongs to nurses, whose education and experience allow them to provide high-quality nursing services. The quality of medical care is a set of characteristics confirming the compliance of the medical care provided with the available the needs of the patient (population), their expectations, the current level of medical science and technology.

As public health workers, nurses are responsible for sharing crucial information about individuals health, including health promotion information, which stimulates health awareness and the overall well-being of groups and communities. According to the Nursing and Midwifery Council (NMC) code of practice, nurses are mandated to make sure that peoples physical, social and psychological needs are assessed and responded to (NMC 2018, p 9). To ensure that this mandate is met, nurses should actively engage into promoting awareness of the patients of the cause of their decease and measures that can be taken to reduce risks of complications. Moreover, nurses are responsible for health checkups that should be done on a regular basis. In their practice, nurses should consider personal factors such as race and age that may be conducive to diabetes development and carefully assess risk group. m

Conclusion

Diabetes is a major health problem that has a significant impact on the quality and life expectancy of people over the age of fifty across the country. The increase in the number of people suffering from diabetes in recent years compels the government to take necessary steps to tackle this health issue. Considering that diabetes can lead to severe complications and significantly lower the quality of life, nurses are responsible for promoting the awareness of the problem across the country. Nurses should explain the reasons conducive to the decease development and outline the measures that can be taken to prevent diabetes.

The local government is responsible for implementing policies that can help in preventing diabetes development in Oxfordshire. The governmental policy to tackle diabetes includes measures for the early detection and treatment of diabetes as well as preventive measures  especially among people over fifty, providing them with medicines and materials for determining glucose levels. The policy also provides for informing citizens about risk factors, symptoms and complications. There is every reason to believe that the adopted policy plan will significantly help to manage diabetes in the community, prolonging peoples life through reducing the risk of complications and preventive measures aimed at increasing awareness of society of the problem.

References

Department of Health and Social Care (2017). Childhood obesity: a plan for action. [Online] GOV.UK. Web.

Department of Health and Social Care (2020). Tackling obesity: empowering adults and children to live healthier lives. [online] GOV.UK. Web.

Galaviz, K. I., Weber, M. B., Straus, A., Haw, J. S., Narayan, K. V., and Ali, M. K. (2018). Global diabetes prevention interventions: a systematic review and network meta-analysis of the real-world impact on incidence, weight, and glucose. Diabetes Care, 41(7), pp.1526-1534.

Griffin, N., Phillips, S.M., Hillier-Brown, F., Wistow, J., Fairbrother, H., Holding, E., Powell, K. and Summerbell, C., 2021. A critique of the English national policy from a social determinants of health perspective using a realist and problem representation approach: the Childhood Obesity: a plan for action(2016, 2018, 2019).BMC Public Health, 21(1), pp.1-10. Web.

Li, X., Zhou, T., Ma, H., Liang, Z., Fonseca, V. A., & Qi, L. (2021). Replacement of sedentary behavior by various daily-life physical activities and structured exercises: genetic risk and incident type 2 diabetes. Diabetes Care, 44(10), pp. 2403-2410.

NHS. Oxfordshire Clinical Commissioning group. Web.

Nursing and Midwifery Council (2018). The Code Professional Standards of Practice and Behaviour for Nurses and Midwives Nursing and Midwifery Council. [online] NMC. Nursing and Midwifery Council. Web.

Oxfordshire: diabetic eye screening service. Web.

Sheikh, M.S., Sheikh, I.S., Khan, S.M.S. et al. (2019). Prevalence of type 2 diabetes mellitus among adult population of District Srinagar. Int J Diabetes Dev Ctries 39, pp. 331339.

University of Oxford (2017) Tackling obesity in Oxfordshire: soups, smartphones and supermarket shopping. Web.

Introduction

Scientists sought to experiment that drinking coffee may have a positive implication to blood sugar levels that may lead to diabetes. This procedure had to be carefully conducted to articulate positive results that could be verified through standard experimental procedures. In a research procedure, some experiments may only be conducted on experimental animals that have a similar effect on humans. The experiment under consideration was carried out on 21 mice, which featured a control and treatment group.

Hypothesis

The experiment conducted was to test the adverse effects of coffee on hyperglycemia, which is articulated to the heightened sugar level in the blood. The subjects of the experiment were mice that could be exposed to conditions leading to diabetes. The experiment tested the level of blood sugar on exposure to coffee. Therefore, the hypothesis of the experiment is:

Drinking coffee may reduce the risk of contracting diabetes.

Control group

A control group can be defined as the subjects of the experiment that do not receive the treatment under consideration. In this experiment, the subjects of the experiment are mice and the control group would be the one that does not receive coffee. The group of eleven mice that were given pure water is the control group.

Treatment group

The treatment group is the ten mice who were given coffee diluted to measure the effects of coffee on blood sugar levels. This is because they lead to the conclusion of the hypothesis statement that featured coffee consumption and its influence on diabetes. They are treated with the entity (coffee) that is under consideration.

Scientific Experimental Design

Yes, they followed a scientific method because a careful procedure was conducted to articulate the result. Scientific experimental design features careful observation of the subjects under analysis after a hypothesis has been made. The procedure is then conducted on a non-bias level where a group is treated and the other left without an external entity (control group). Scientific experimental design often disapproves the hypothesis or supports that hypothesis to discern results that can be applied in a practical life setting. The experiment also applied the use of test subjects that were not the target of the articulated experiment. The effect of diabetes is not measured in mice but is an adverse effect on human health.

Problems and biases

The problems that could have been experienced lie, in the inability, to articulate accurate results due to a mix in the diet applied. However, equal subjection and conditions had been presented across the mice with similar physical results articulated. These conditions are expected to deliver accurate results with all the other conditions like diet and environmental exposure maintained at a level. However, there should be an equal number of mice in the control and treatment group, unlike in the experiment with the control group having an extra number.

Conclusion

The hypothesis, drinking coffee may reduce the risk of contracting diabetes, was supported because the control group produced a significant increase in blood sugar level compared to the treatment group that produced a decrease in the sugar level. With the 30% drop in the sugar level in mice that were exposed to coffee, the experiment confirmed that drinking coffee is beneficial in controlling diabetes.

The article on media release claims that 32,000 men were involved in the research while the peer-reviewed journal publishes 32,002 men. Further, the media release argues performing aerobic exercises for 150 minutes a week reduces disease development risk by 52 percent, and weight training for the same period resulted in a reduction of the risk by 34 percent. In contrast, the journal claims that the risk reductions are at 50 percent and 35 percent respectively. As illustrated, the media report had inconsistencies in giving the accurate figures as obtained from the study, which was conducted. These discrepancies in figures may lead to the attainment of confusion among the readers of the media report. As such, it becomes complex to understand why the media report would not provide the exact figures. However, these discrepancies could be based on the desire of the media, to attract more attention from leaders, by using figures, which the public could easily recall.

Further, the media report claimed that the results obtained from the study could be adopted at a global scene (OConnor, 2012). This was different from the publication on the peer-reviewed journal, which argued that the results would be attenuated for men above 65 years based on the power of this subgroup (Grontved et al., 2012). In this, the media was in the process of seeking stronger attention from the public on the study findings and emphasizing these findings. The journal argues that further research is needed to investigate the intensity, type, and duration of weight training, which is essential in contributing significantly towards risk reduction (Grontved et al., 2012). This was not reported in the media report since the media did not want the public to have some doubts about the study.

Moreover, the media report argued that research findings could be generalized for the other gender (women), which was not reported in the journal article. Nevertheless, there was a similarity in the identification of the media report limitations of the study and the journal article study limitations. Despite this, the media report did not provide the strengths of the research, which was conducted as the journal article provided. The journal article argues that the study had some strength since the sample size, which was used was large (Grontved et al., 2012). This resulted in the attainment of accurate and reliable data, which could be generalized for a large population. In addition, the study had the strength of biannual assessment of confounders and exposures and illustrating that there were robust associations for several sensitivity analyses.

Nevertheless, the media report results seemed to provide accurate information on the study findings despite their discrepancies in the illustration of the exact figures. As such, the media had to provide the public with accurate information about the research conducted. This resulted in encouraging people, to be involved excessively in the activities of weight training and aerobic exercises, as a means of health improvement to suppress instances of disease development.

However, the media report provided some information on Walter Willett quotes, which argued that a few minutes (ten minutes) of training in a day were adequate for the health improvement of an individual. This information is misleading since it has not been backed by scientific evidence from the study, which was conducted. As such, there is a need for research to be conducted, which would lead to proving the claim that little exercise is adequate to minimize the risk of type two diabetes.

References

Grontved, A., Rimm, E. B., Willett, W. C., Andersen, L. B., & Hu, F. B. (2012). A prospective study of weight training and risk of type two diabetes mellitus in men. Archives of Internal Medicine. Advance online publication. Web.

OConnor, A. (2012). Weight training may lower diabetes risk. The New York Times.

Extant literature demonstrates that a fundamental component of early Type 2 diabetes mellitus (T2DM) treatment is patient education, which in turn sets the foundation for effective treatment and management throughout the disease continuum (Robertson, 2012). It is reported in the nursing scholarship that, due to lack of effective education, many patients with diabetes are yet to realize their optimal care objectives and have difficulty following recommendations for effective self-management (Sperl-Hillen et al., 2013). In this light, the present paper aims to examine the Community Health Workers (CHW) intervention under the DREAM project (diabetes research, education, and action for minorities), and how it has been used to enhance management and control among Bangladeshi adults with T2DM in New York City.

In their seminal article on the DREAM project, Islam et al (2014) acknowledge that the CHW intervention is ideal for minority or marginalized groups that are disproportionally at an elevated threat for diabetes and have unique demographic, linguistic and socioeconomic characteristics that may impact access to and utilization of care, resulting in adverse health outcomes. In developing the evidence-based intervention to assist Bangladeshi adults with T2DM in New York City, Islam et al (2014) note that CHWs are generally indigenous to the community in which they work  ethnically, linguistically, socioeconomically, and experientially  providing them with a unique understanding of the norms, attitudes, values, and strengths of community members (p. 4). Consequently, the CHW intervention is informed by the urgent need to have culturally and linguistically relevant interventions for minority groups not only in the United States but also globally.

It is important to mention that the CHW model is a multi-component intervention consisting of group educational sessions done at least once per month and in a language that is understandable to diabetic patients, one-on-one visits, and phone follow-ups by professional CHWs. The educational sessions, which are guided by the Health Belief Model and Social Support Theory, cover core content areas such as nutrition, physical activity and complications of diabetes, with all materials tailored with specific cultural and religious practices in mind (Islam et al., 2014). One-on-one visits are intended to provide diabetic patients with the opportunity to discuss individualized care needs related to the management of the disease, while phone follow-ups are intended to both encourage adherence to discussed care plans, as well as to enhance retention of patients (Islam et al., 2014).

According to the research findings, the CHW intervention has the capacity to (1) decrease levels of Hemoglobin Alc (HbA1c), lipid profiles, as well as systolic and diastolic blood pressure, (2) enhance access and utilization of healthcare for Bangladeshi adults (minority population) with T2DM in New York City, (3) trigger a positive impact of knowledge and practice of physical activity and healthful eating in this group of the population, (4) increase levels of perceived social support, (5) enhance perceived benefits and lower perceived barriers, and (6) facilitate higher levels of self-efficacy (Islam et al., 2014). As postulated by these authors, clinical measures include[d] HbAlc, lipid profile (cholesterol, HDL, LDL, and triglycerides), systolic and diastolic blood pressure, height, and weight (p. 8). Reinforcing measures for CHW intervention include social support, self-efficacy, social capital and religiosity, while knowledge and health behaviors include diabetes knowledge, diabetes management, dietary practices, food behavior, tobacco use, physical activity, medication adherence and mental health (Islam et al., 2014).

The discussed intervention provides useful insights into the nursing profession and practice. The major significance of the study, it seems, is demonstrating the use of the CHW intervention with the view to showing nursing professionals and other parties in the health sector the role of patient education in the management of diabetes and how it should be utilized to disparate minority populations to achieve optimal care outcomes. It is clear that nurses should have the capacity to understand the norms, attitudes, values and strengths of diabetic patients within a particular population, as well as their ethnic background, language dynamics and socioeconomic status to be able to attain positive results in the treatment and management of diabetes. As demonstrated in the findings, patient education is critical in the treatment and management of diabetes. This view is supported by Sperl-Hillen et al (2013), who argue that conventional individual diabetes education goes a long way to enhancing patient understanding and knowledge, self-efficacy, diabetes distress, and dietary practices. These implications are consistent with the view held by Robertson (2012), which elaborates patient education that underscores the unique cultural and linguistic needs of patients as a fundamental constituent of diabetes treatment and management.

Overall, it can be concluded that the CHW intervention is an important component in the fight against T2DM given the rapid growth of minority and underrepresented populations whom nursing professionals and other healthcare providers have difficulty reaching or communicating with, hence reducing health disparities as well as bridging the cultural and social barriers between underrepresented communities and the health care system. Although the discussed research article targeted Bangladeshi (minority) adults with T2DM in New York City, it is believed that the evidence-based intervention can be employed to other minority populations with the disease to attain optimal treatment and management outcomes. Consequently, the task now is for the relevant health agencies to implement the intervention so that patients may reap the benefits as illuminated in this paper.

References

Islam, N., Riley, L., Wyatt, L., Tandon, S.D., Tanner, M., Rarnam-Mukjerji, R&Trinh-Shevrin, C. (2014). Protocol for the DREAM project (diabetes research, education, and action for minorities): A randomized trial of a community health worker intervention to improve diabetic management and control among Bangladeshi adults in NYC. BMC Public Health, 14(1), 1-18.

Robertson, C. (2012). The role of the nurse practitioner in the diagnosis and early management of type 2 diabetes. Journal of the American Academy of Nurse Practitioners, 24(2), 225-233.

Sperl-Hillen, J., Beaton, S., Fernandes, O., Von Worley, A., Vazquez-Benitez, G., Hanson, A&Spain, V. (2013). Are benefits from diabetes self-management education sustained? American Journal of Managed Care, 19(2), 104-112.

I have chosen diabetes in the elderly as a topic for my community teaching project mainly because it is a very important and urgent problem in the health care systems of most countries. Its prevalence rates double every 10-15 years, and in 2015 more than 5 million deaths were attributed to diabetes (Stanhope & Lancaster, 2019, p. 68). Despite the efforts made by health care organizations around the world, the number of people with diabetes is expected to grow in the future.

Over the past decades, the age structure of the population has changed significantly. Global wars have ended, most dangerous infections have been defeated, and the quality of life in most countries has generally improved. All this led to a significant increase in life expectancy and in the share of the elderly population in the demographic structure of most developed countries. The aging population is the main reason for the increase in the number of patients with diabetes. According to the third revision of the US National Health and Nutrition Examination Survey (NHANES III), the prevalence of type 2 diabetes is 4-9% at the age of 50-60. It reaches its maximum values (20-22% in women and 14-24% in men) at the age of 60 (Selvin et al., 2017). Thus, the elderly population currently is and will continue to be at higher risk of developing diabetes.

Moreover, this problem is aggravated by difficulties in the timely diagnosis of diabetes in the elderly, because the course of the disease can be asymptomatic, and patients may not show any clinical symptoms. Often, type 2 diabetes is detected by chance during examination for other related diseases. 50-80% of elderly patients with type 2 diabetes have arterial hypertension and dyslipidemia, requiring medical treatment. These are the main reasons why I believe that it is necessary to raise awareness about the problem and inform all segments of the population about the prevention and care measures related to diabetes in the elderly.

References

Selvin, E., Feinleib, M., Zhang, L., Rohrmann, S., Rifai, N., Nelson, W. G., Dobs, A., Basaria, S., Golden, S. H., & Platz, E. A. (2017). Androgens and diabetes in men: Results from the third national health and nutrition examination survey (NHANES III). Diabetes Care, 30(2), 234-238.

Stanhope, M., & Lancaster, J. (2019). Public health nursing E-book: Population-centered health care in the community (10th ed.). Elsevier Health Sciences.

The importance of patient education to facilitate primary health care skills and knowledge in vulnerable populations has been broadly addressed in scholarly literature. Chin and Robins (2019) article under the title Teaching patients with type 2 diabetes to self-administer insulin published in the Australian Journal of General Practice, is one of the studies that provide patient teaching insights. The articles authors combine instructional narration with a case study presentation to illustrate the importance and practical side of self-administering insulin for patients with type-2 diabetes, the severe medication-dependent condition.

In the analyzed work, the severity of type-2 diabetes is emphasized by referring to its progressive chronic nature, rising prevalence rate across the world, numerous comorbidities, and high mortality rate. The goal of the researches in the article is to provide practical guidance to assist commencement of insulin (Chin & Robins, 2019, p. 251). Firstly, the authors discuss the threats associated with delays in administering insulin by health care professionals when a patient has no access to care. Secondly, the importance of skills of self-administering as a means of overcoming the most frequently observed complications associated with diabetes is introduced. Thirdly, the choice of instrumentation for insulin administration and an instructors competence is addressed to inform patients about influential issues. Fourthly, insulin therapys implications on driving, possible complications associated with improper injections, and the effective techniques of insulin administering are informatively presented. Finally, a case study of a patient with type-2 diabetes educated to self-administer insulin is analyzed.

Thus, the summarized article uses instruction and case analysis to demonstrate the vital importance of insulin self-administering for patients with type-2 diabetes. The identified risks of delayed insulin intake and the benefits of patients ability to do this independently provide a basis for extensive dissemination of these skills. Overall, the study provides both theoretical and practical background for patients to initiate self-administering of insulin to prevent complications and manage their blood-glucose level.

Reference

Chin, G., & Robins, M. (2019). Teaching patients with type 2 diabetes to self-administer insulin. Australian Journal of General Practice, 48(5), 251-54.

Introduction

Currently, diabetes is one of the most common non-communicable diseases globally; this factor threatens the entire population of the planet. Hence, it is vital to collect precise information about the health history of the patients with diabetes to explore the full spectrum of factors that might have led to the disease and prevent its emergence among risk groups. As such, this work aims at proposing a method of collecting information associated with diabetes, such as demographics, medications used, and other data. It can be primarily gathered from the emergency room and hospitalization records. The accuracy and completeness of patient and quality-related data have important implications for individual safety and health research. Thus, this information can make treatment of diabetes evidence-based at my facility, improving the health of the population.

Data Collection Plan

Determining the details of information for the study is of particular importance. For this scientific work, it was chosen to study the population of a physicians practice. As a time frame, I would take into account within the last year any hospitalizations (namely 2021). I believe that this information can be found both in the office where my practice occurs and in the hospital admission or emergency room. I would choose to review history and physical data, progress notes, medication records, hospital discharge documents, and lab results as the documents for the review. I believe that the most useful system for me will be administrative and clinical documents, as they collect, store, and provide the most valuable information.

There are several new procedures that will be implemented in the course of data collection. Namely, a new electronic database will be created; it would be devoted primarily to the relevant information about patients with diabetes mentioned earlier. Moreover, a procedure for gaining permission for the use of the data would be provided. In this process, it is necessary to observe the life cycle of the system to manage the necessary information. The life cycle includes several related stages, similar to the process of patient care. The stages through which information passes are collection, processing, distribution, use, storage, and disposal, including destruction and deletion of data.

HIEs and national databases serve different purposes, which explains the different effects of incomplete submitted to them. An electronic HIE offers services for the safe transfer of patient information electronically through query-based, directed, and consumer-mediated exchange (Menachemi et al., 2018). National databases store anonymized patient records for public health research purposes. The submission of erroneous information to HIEs can result in patient care mistakes. Hence, the data from HIEs should be used with caution to prevent the inaccuracy of the research.

The study will require certain personnel to perform research tasks while other staff members will be expected to provide their best cooperation with the project. The individuals whose cooperation will be necessary include emergency room nursing staff and doctors, nurses within the facility, doctors, and physicians specializing in diabetes. Other staff will require managers and administrative workers who maintain health records and hospitalization data. Similarly, all health workers directly involved with treatment or medication would also be required to participate. However, the majority of the facility staff would only be required to be open to interviews and descriptions of the state of patients and the effects of the condition and the treatment.

The project will be fundamentally supported by staff members that will conduct investigative actions throughout the facility. These tasks will likely include collecting health records, communicating with other hospital staff, and analyzing gathered data. As such, these physicians or hospital staff will require either data-management training or aid in the form of specialists. The new practices and procedures could be implemented successfully if a strategy of guaranteeing rewards for participation would be employed. Moreover, the facility managers should develop a clear schedule so that the data collection process would not overlap with the average work operations. Both of these strategies would improve the progress of the research and prevent difficulties of its realization.

Data Security Plan

A practical approach for protecting PHI can be considered a transaction processing system. This type of information system is engaged in collecting, storing, and extracting patient data. Moreover, the transactional information system ensures the protection of the received personal data, which is critically important in healthcare. In addition, it maintains a stable database and reduces the risk of information loss in critical and unforeseen circumstances. Hence, the measures that should be taken by the personnel include the gain of access to the transaction processing system, transferring the data to a new diabetes database after receiving consent from the clients, and deleting the data after the research is done.

Specialized laws have been established that regulate this sphere of activity. An example would be the Health Insurance Portability and Accountability Act (HIPAA), which directly affects the staff, policies, and practices of providing medical services (Edemekong et al., 2018). It is engaged in protecting private information from unauthorized access and fighting fraud and abuse in healthcare. The HIPAA will, indeed, have an impact on health care personnel, policies, and procedures. As was mentioned, the operations would be launched only after receiving the consent of the customers of the facility. Moreover, the data would be protected by the use of the transaction processing system. The researchs central policy is the openness regarding the purpose of the data collection process; namely, the patients should be aware of what uses their health information for the clinic. Finally, inattentive and careless treatment of PHI by the personnel will be fined.

Benchmarking Plan

The primary source of national data is the Centers for Disease Control and Prevention. It could be used as a benchmark to compare with data from my facility. Namely, the source succinctly describes the statistics on the prevalence of diabetes, which could be contrasted with the data about the local patients to determine the difference in the situation and allocate the suitability of prevention methods. For assessment purposes, the 2020 HEDIS Comprehensive Diabetes Care quality measures from several types of healthcare plans could be used. Namely, the percentage of patients with type I and II diabetes who have poorly controlled diabetes, patients in the above-mentioned group with optimal blood pressure control, and patients undergoing eye exams are essential. These quality measures could be employed to compare the statistical data of my facility with the national database by presenting these standards to the medical personnel.

The factors influencing the quality measures include data accuracy and the particulars of a patients profile. Concerning accuracy, data errors are possible, and the number of excluded medical records is manifested in entities reports (NCQA, 2021). The collected data will be compared to the benchmarking and quality standards via several devices. Namely, the eye exam, blood pressure control, and HbA1c control data from five sources, including Medicaid HMOs, Medicare HMOs/PPOs, and commercial HMOs/PPOs, possess optimal compatibility. This can be ensured by looking at the datas characteristics.

Quality and Change Management Strategies

The data outcomes could perform quality improvement reviews and recommend evidence-based changes to policy and procedure. Namely, the statistical information about the risk groups and the effectiveness of various medications would be obtained to deliver a more precise plan of treatment. According to Harvard Business Review (2019), to facilitate the changes after the project is finished, it is necessary to obtain the required resources and support, for example, from the government. Victoria Health Department (n.d.) also emphasizes the use of the stakeholders as an implementation practice. Hence, the predicted changes are cooperation with various healthcare groups governmental organizations and receiving financing from these stakeholders.

Implementation

The data will be collected by accessing documents and records in the medical institutions visited to care for diabetes conditions. The first step would be gaining access to the PHI, which would take two months. Moreover, during this period, the medical staff of the facility would be trained for the project. Next, the data will be obtained and stored on electronic media in the course of six months. After this step, paper sources of information would be created; finally, these sources would be analyzed by the researchers to propose improved care and prevention measures. The data will be destroyed in five or ten years since it may no longer be relevant after that time.

Conclusion

The proposed project will ensure the improvement of quality care due to its precise nature and technological design. It is integral to observe changes in the severity of the condition as well as the effectiveness of current treatment. The use of a one-year record and the provision of adequate training to the involved staff is likely to introduce a detailed and accurate picture of health trends among diabetes patients in the selected age bracket.

References

Edemekong, P. F., Annamaraju, P., & Haydel, M. J. (2018). Health Insurance Portability and Accountability Act. StatPearls Publishing.

Harvard Business Review. (2019). Four ways to make evidence-based practice the norm in health care. Web.

Menachemi, N., Rahurkar, S., Harle, C. A., & Vest, J. R. (2018). The benefits of health information exchange: An updated systematic review. Journal of the American Medical Informatics Association, 25(9), 1259-1265. Web.

National Committee for Quality Assurance. (2021). Proposed retirement for HEDIS®1 MY 2022: Comprehensive diabetes care (CDC)HbA1c testing. Proposed changes to existing measure for HEDIS MY 2022: Comprehensive diabetes care (CDC). Web.

Victoria Health Department. (n.d.). Implementing evidence-based practice. Web.

The selected social media application for this task is Facebook since it is one of the most common social media platforms. Moreover, Facebook can be used to spread information across different people in various regions within a short period. Diabetes has become a significant threat to modern society. Consequently, the condition has been selected for this exercise to ensure that readers can acquire information regarding the disease.

Summaries

Olamoyegun, M. A., Raimi, T. H., Ala, O. A., & Fadare, J. O. (2020). Mobile phone ownership and willingness to receive mHealth services among patients with diabetes mellitus in South-West, Nigeria. Pan African Medical Journal, 37, 113. Web.

The article focuses on how the introduction of mobile phones has led to improved health care. For instance, the authors have revealed that many people are using mobile phone technology to access diabetes in various regions. People living with diabetes mellitus in South-West, Nigeria were examined to determine how they are willing to pay for mobile phone-based diabetic services. The services involve receiving guidelines through Facebook without having to visit the health care facilities. The global pandemic of the corona virus has also led to limited movement, increasing the demand for diabetic patients to use social media applications to acquire health education (Chittamuru, 2020). Additionally, the results of the survey show that many participants selected Facebook as the proffered application of receiving diabetic services. One can argue that the article is credible since it does not focus on any form of bias. The authors have focused on facts.

Chittamuru, D., Daniels, R., Sarkar, U., & Schillinger, D. (2020). Evaluating values-based message frames for type 2 diabetes prevention among Facebook audiences: Divergent values or common ground? Patient Education and Counseling, 103(12), 24202429. Web.

The article has analyzed how ads can be used to educate Facebook users about diabetes. According to the researchers, racial and ethnic minorities experience significant disparities in the prevalence of T2D relative to whites (Chittamuru et al., 2020). Therefore, such people can largely benefit from the Ads as they can enable them to acquire health education. Young people are also being affected by diabetes. Consequently, the approach of using Facebook to educate people about the condition can also be of great significance to the youth. The authors state that Framing can increase engagement with the message, argument strength, and persuasiveness (Chittamuru et al., 2020). Thus, the ads can be used to persuade the Facebook audience to focus on ways of preventing diabetes. An individual can analyze the credibility of the source, where one can note that the article is peer-reviewed and provides an in-depth analysis.

Gabarron, E., Larbi, D., Dorronzoro, E., Hasvold, P. E., Wynn, R., & Årsand, E. (2020). Factors Engaging Users of Diabetes Social Media Channels on Facebook, Twitter, and Instagram: Observational Study. Journal of Medical Internet Research, 22(9), e21204. Web.

The article has analyzed how social media users engage in different groups. The authors focused on diabetes patient associations and diabetes-specific patient groups around the world. Nonetheless, the article reveals that people should focus on the content shared in the groups. According to the research some of the people are least engaged in posts with content topics that involve empowerment and health education Gabarron et al., 2020). The research has also revealed that posts from the Norwegian Diabetes Association were extracted and analyzed to determine how people share and react to the posts. The research shows that health education posts did not receive many comments compared to personal stories. Nonetheless, they were shared by many people. The information provided shows that the article is credible since it is peer-reviewed and statistical data has been referenced.

Lessons from the Articles

The articles are educative and one can learn about the advantages of using social media in health care. The authors have revealed how Facebook is to provide health education to people in different regions. Besides, the current pandemic has limited movement of people, which makes use of social media in health care an essential practice. The articles also show the need for people to post health-related ideas on social media groups as they can be shared to help people learn about different health issues.

The information can apply in my health organization since it can help workers to learn different ways of improving their patient care. Patients can also be encouraged to join various social media groups that provide health education. The facility can also ensure that it offers health education using its social media platforms. For instance, the institution can post ways of preventing various conditions such as diabetes and provide health tips to educate people about health.

References

Chittamuru, D., Daniels, R., Sarkar, U., & Schillinger, D. (2020). Evaluating values-based message frames for type 2 diabetes prevention among Facebook audiences: Divergent values or common ground? Patient Education and Counseling, 103(12), 24202429. Web.

Gabarron, E., Larbi, D., Dorronzoro, E., Hasvold, P. E., Wynn, R., & Årsand, E. (2020). Factors Engaging Users of Diabetes Social Media Channels on Facebook, Twitter, and Instagram: Observational Study. Journal of Medical Internet Research, 22(9), e21204. Web.

Olamoyegun, M. A., Raimi, T. H., Ala, O. A., & Fadare, J. O. (2020). Mobile phone ownership and willingness to receive mHealth services among patients with diabetes mellitus in South-West, Nigeria. Pan African Medical Journal, 37, 113. Web.