Community Health Social Marketing Program

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Introduction

Diabetes is a chronic disease that is characterized by high levels of sugar in the blood (NCBI, 2010). Currently, there have been increased incidences of diabetes in our communities due to the modern sedentary lifestyle that has been predisposing people to obesity and failure to exercise regularly. For example, in America, diabetes affects over 20 million people and over 40 million Americans have early type 2 diabetes (NCBI, 2010). Hence, there is great need to educate and sensitize the community about this disease and initiate measure that can be taken to reduce and control it.

An overview of the Community Health Diabetes Plan

Diabetes is a major health issue that affects over 180 million people globally, and with its prevalence increasing steadily, it is responsible for approximately five percent of all deaths globally (Massey et al, 2010). Due to this awareness, there have been increased national and international interventions by giving diabetes a high priority area in healthcare provision. These interventions have been quite difficult to implement in rural communities due to hindrances such as distance from health clinics, high rates of poverty, cultural barriers, mistrust, limited access to health insurance, and minimal exposure to diabetes education (Massey et al, 2010). These hindrances make prevention, detection, and management of diabetes in rural areas more difficulty.

The problem of diabetes is further complicated by high rates of obesity and sedentary lifestyles, with studies carried out in 2005 revealing that prevalence of obesity for rural adults was 23% compared to 20.5% for their urban counterparts (Jackson et al, 2005). With the prevalence of diabetes expected to increase rapidly especially in rural areas, it is therefore very necessary for well-planned, sustainable, and replicable interventions to be implemented in the rural areas. This paper will further discuss importance of social marketing, two specific measurable outcomes, two formative and two summative evaluation strategies to monitor success of the project. Lastly, it will explain the reasons for using those evaluation methodologies and the expected level of project success.

Role of Social Marketing in Community Health Diabetes Projects

According to Squidoo (2011), social marketing “is intended to help people change their behaviours to become healthier or to improve society or world in some way.” Social marketing mostly involves the commercial marketing approaches but with aim of improving health or social behaviours of individuals and community at large (Clark, 2008). In this case, we are trying to bring about behavioral change that can lead to improved self-management of diabetic patients in our community. An effective social marketing project will involve the following activities: first, talking and listening to the target people. Secondly, segmenting the people (pre-diabetic, diabetic, and whole community) and creating specific message for each group. The third is positioning of the product (behaviours, ideas, and attitudes), and fourthly, knowing the competing messages and behaviors that can deter the target people.

The fifth involves reaching the target audience and using different approaches such as visits, television programmes, group-sharing, and individual activities to drive the message home. The sixth is using the model that works and testing it to check the level of effectiveness on the target model. This is in addition to making strategic partnerships with key allies with an aim of working towards the same goal. The last is evaluating the project and using the results to improve it. Through this approach, social marketing for diabetes in the community can be managed by community health workers (CHWs), advance practice nurse (APN) and the community members. Funding for this program will be solicited from the Agency for Healthcare Research and Quality (AHRQ) and other community health initiatives.

Identification and description of two specific measurable outcomes

The overall objective of this program is improving self-management among patients with type 2 diabetes by involving community health workers as members of a clinical team. The specific measurable outcomes of this program include, first, to ensure that the level patients in the well controlled glycaemic group is maintained at more 80% of all diabetic patients in the state of Michigan by incorporating CHWs in the self-management program by August 2012. Secondly, by August 2012, to ensure that more than 50 percent of the patients in the uncontrolled glycaemic group move to well-controlled glycaemic group through involving CHWs in their self-management program in the state of Michigan. CHWs work closer to the people in their homes and rural settings thus they are more in touch with the diabetes patients in their usual life than other healthcare practitioners therefore they can play a significant role in diabetic interventions by providing information and assisting the patients to monitor and manage their conditions.

Identification and description of two formative and two summative evaluation strategies to monitor success of the project

The formative evaluation strategies will include initial evaluation – whereby, the CHWs first fill the information about the patients they intend to be visiting during their field trips. This information will include the glycaemic level of the patients and the self-management initiative each patient is doing. Upon establishing the first interaction with the patients and sharing with them the information about self-management, the next formative strategy will be ongoing evaluation. Ongoing evaluation will involve the CHWs monitoring and advising the patients during the field trips and filling the information about the progress of each patient in their patient cards. It provides a room for improvement as the CHWs can modify the delivery or content of the program to fit any developments or in abandoning the irrelevant features when realized. It also involves patients giving feedback about their view of involving the CHWs at the end of the program.

The summative evaluation strategies will involve retesting the patients with the original questionnaire to check the changes that have taken place since the intervention of CHWs. The last strategy will involve observational studies where medical experts will look at the patients’ records before intervention of CHWs and then make an updated examination of the patients and give their results. The above evaluation methodologies will be used because of the following reasons: first, they give room for modifying delivery or content incase some features of the program became less useful in the course of study. Secondly, the test-retest method is a well-recognized and recommended method for studies related to behaviour change. These methodologies allow for comparison with another set of data (medical experts results) in true spirit of scientific experiment were there is control group or standards for comparing with the experiment results.

Conclusion

With the CHWs facilitating the diabetes intervention program, the projected result of above 80% and 50% for the 2 measured outcomes will mostly likely be achieved. This will also benefit from the improved global and national diabetes awareness and intervention initiatives. With the success of this program, the government and local authorities will appreciate the role CHWs in diabetes intervention and will formulate policies that support involvement of CHWs in the interventions. With the prevalence rate of diabetes being expected to increase, intervention such as this and others aimed at prevention and detection should be given much priority in health interventions since diabetes also develop to other conditions such as retinopathy, cardiovascular conditions, and general poor body health.

References

Clark, M. (2008). Community health nursing: Advocacy for population health. Fifth edition. Upper Saddle River, NJ: Prentice Hall.

Jackson, J. et al. (2005). Computer and Internet use among urban African Americans with type 2 diabetes. Journal of Urban Health, Vol.82, pp575–583.

Massey, C.N, et al. (2010). Improving Diabetes Care in Rural Communities: An Overview of Current Initiatives and a Call for Renewed Efforts. Clinical Diabetes, Vol. 28 No. 1, pp 20-27.

NCBI. (2010). Diabetes. Web.

Squidoo. (2011). Social Marketing. Web.

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