PUBH6006: Community Health Assignment Sample
Type 2 diabetes has been a vexing problem in many developed and developing nations.
There have been constant efforts, research and policy developments to reduce the health concerns and achieve health equity for type 2 diabetes at an individual level and community level; despite this, there have been increase on this preventable health concern burden on society and on the healthcare costs and system (Tol et al., 2015).http://PUBH6006: Community Health Assignment Sample
However, for health promotion and prevention of type 2 diabetes the community-based approach is necessary which require collaboration and participation among the professionals,
community members, government, NGO’s and their representatives to achieve for prevention and risk communication of type 2 diabetes through collective community action.
This also require co-learning, shared decision making, capacity building and long –term partnership among them to focus on health program promotion and implementation for the prevention of type 2 diabetes.
Part 1 – Identification of a preventable health concern and strategies for health program implementation based on Lavarack’s ladder
The chronic disease, type 2 diabetes is a common health concern liked to poor lifestyle choices and poor diet or eating habits that is preventable and identified to be addressed.
The Lavarack framework of ladder of community-based interaction is referred for levels initiating from the community readiness, participation, engagement, organization, to development, capacity-building, collective action and community empowerment (Lavarack, 2007) to implement health program for type 2 diabetes.
From the Lavarack’s ladder, it can be identified that community participation and community engagement are most essential and high priority for community-based interaction in type 2 diabetes health program.
Leadership style and skills are important to influence the community development, participation and link the health program with the social aspects so that it can also influence the community empowerment.
The three key strategies that may be used to engage with a community for the implementation of program to address type 2 diabetes health concerns are:
Multiple interventions: This includes combining structured health awareness/educational program and the policy making interventions for type 2 diabetes.
The awareness can include lifestyle, diet and oral therapy for their self management and the policy making can be in areas of diabetes safety (such as in hospital settings), quality of education given to diabetes patients, and access for diabetes care and glucose monitoring for diabetes community (Serrano-Gil & Jacob, 2010).http://PUBH6006: Community Health Assignment Sample
The policy makers from a government level and organization such as WHO can encourage participation of professionals and community members towards this health concern and can also support in community empowerment (Roseto, 2014).http://PUBH6006: Community Health Assignment Sample
This strategy also includes development and implementation of policy for diabetic care protocol for healthcare settings.
Thus, it can be said that exposure to the lifestyle or diet intervention programs coupled with policy intervention can be used for community engagement to promote type 2 diabetes prevention program.
Leadership building: For community development, participation and empowerment the utilization of effective, competent as well as local leaders is important to implement a health program (Rifkin, 2009) for the type 2 diabetes prevention.
Thus, leadership building can be a key strategy as for program successful implementation towards prevention of type 2 diabetes.
This is because competent leaders supports leadership building to offer insights on community diabetic needs, technology, supplies and culture and can engage the community through their participation in decision making and giving their experiences and needs in preventing this health concern.
The leadership building can be through skills training. Here, the local leaders can be trained for leadership building and can share their experiences for issues faced in implementing the diabetes prevention health program for effective leadership building training and to amend and improve this prevention program.
Community development program:
Here, a community centered diabetes prevention program that is evidence based can be developed that has focus on healthy lifestyle, eating habits and physical activity.
This program can also target on the perception of community and their knowledge of diabetes causes and prevention and monitoring (Serrano-Gil & Jacob, 2010), risk of diabetes, hindrances to change lifestyle and diet and self-regulation.
The development program can be useful to engage the community and encourage physical activity and nutritional program to have an effect on type 2 diabetes prevention (Tol et al., 2015).http://PUBH6006: Community Health Assignment Sample
This strategy will also include establishment of a local community group and appointment of a leader for community development program.
The community development program will provide an opportunity for connection with community members and diabetic patients and also can help in recruitment of new or additional leaders to take the health program forward.
Thus, it can be said that these strategies are essential for the health promotion and type 2 diabetes prevention program as it require partnership from community stakeholders which is possible through community participation and development to ensure community empowerment for the success of health implementation promotion.
Part 2: Use of core domains of capacity-building for community empowerment and ownership of a prevention program for type 2 diabetes
Among the various core domains of capacity building, the domain of leadership, participatory decision-making and communication as identified by Liberator et al. (2011) can be used in the community empowerment and ownership program for the type 2 diabetes prevention program.
The leadership domain can be used to motivate the communities to increase their involvement in prevention program for the prevention goals (Baillie et al., 2009).http://PUBH6006: Community Health Assignment Sample
The leadership skills can be developed to negotiate the conflict and to deal with barriers to change.
The participatory decision-making domain can be used to identify the concerns and barrier of the community towards type 2 diabetes prevention and the decision making can facilitate to identify ways to address these community issues.
The leadership and participatory decision making domains together complement each other will contribute in empowering the community to take disease prevention decision and to find ways to manage behavioral change (Liberator et al., 2011).http://PUBH6006: Community Health Assignment Sample
The communication domain can be used for promoting awareness in the community on the risk of type 2 diabetes and its prevention based on lifestyle and dietary change interventions and empowerment based interventions for the community.
The communication will also be used to gain informational insight on the barrier to change towards prevention program (Mohamad et al., 2012) and the needs for the diabetic care access and social support so that capacity building can focus on measures to fulfill the needs to empower the community to take measure to avoid type 2 diabetes.
Communication domain can be used to communicate, for information disseminations, to understand the health actions and impact on community empowerment.
The sender of communication can be local leader, professionals and community representatives and medium can be face to face mass meetings and printed or digital brochure by diabetes prevention centers, support centers, hospitals, health care providers and NGOs.
It can be said that inadequate capacity building does not result in desired health outcomes thus, capacity building is essential to enhance the efforts of the community and to empower them for health and social improvement through effective public healthcare services and social support system.
For Type 2 diabetes, the health belief model will be used to motivate and educates the community.
This model suggest that individuals to take up suggested physical activity and adopt constructive behavior need to prevail over their perceived barriers to action and perceived disease threat for the benefits of recommended action (Orji et al., 2012).http://PUBH6006: Community Health Assignment Sample
This model can be used for type 2 diabetes as the health behavior towards this health issue is affected by perception of type 2 diabetes risk, illness severity, consequences and also there are perceived barrier to change the behavior and also difficulty to change the beliefs about the transformed behavior benefits.
Thus, application of health belief model will educate the community to believe that they are at risk of type 2 diabetes and its consequences, self-glucose testing, and in their behavior in relation to diet, physical activity and lifestyle choices can result to reduce the risk of diabetes.
This will help in motivating the community to develop healthy behavior for instance, change in dietary habits or shift to an active lifestyle. This will also help in addressing the perceived barriers to behavioral change so that the community is motivated to overcome their barriers.
The advantages of health belief model is that it address the cognitive theory as it focus on the individual role towards the belief (pessimistic views) and related motivation with disease (Jillian et al., 2014).http://PUBH6006: Community Health Assignment Sample
It also helps to distribute an individual belief for health issue under its key concepts of perceived benefits, perceived susceptibility/ risk, perceived severity of illness and perceived barriers in a holistic manner so that health promotion can focus on these to educate and motivate them.
The disadvantages associated with the use of health belief model are that it does not consider behavior that are adopted by individual for social acceptability (non-health reasons) or are habitual behavior like smoking.
It also does not consider the environmental factors and economic aspects that can encourage or discourage the suggested action.
Another disadvantage is related to its key concept of cues to action as they are not widely prevalent in motivating community towards heath actions as it does not propose strategies for shifting towards health-related actions (Jillian et al., 2014).http://PUBH6006: Community Health Assignment Sample
Thus, it can be said that this model is only useful for specific health outcome and for depending on desired health outcome this model is required to be integrated with other promotional model that consider economic and environmental context and also recommend strategies for change and health action.
In addition, the ecological approaches will also be used to motive and educate the community for type 2 diabetes as there is need for intervention across various levels so that this health concern is influenced by physical, economic and social environmental system along with family, community, workplace, and individual/ community belief, culture and tradition.
The approaches can be through intrapersonal (to influence knowledge related behavior), interpersonal (social support), community (norms to improve healthy lifestyle/ behavior), institutional (polices and rules) or through public policy (at local, regional and states level).
This can be applied for an effective interaction of among the community and the environment to contribute towards health promotion for diabetes as according to Sharma (2016) there is a mutual influence in community when they are their environment and so they also affect the sub system of the environment.
The ecological for health promotion can motivate community to change behavior under supportive environment. This approach will also be useful to target the social and cultural environment to promote health.
The advantage of the ecological approach is that it focuses on both individual and environmental interventions so its effective for the health promotion and it also considers the reciprocal influence of community on environment and vise versa (Schwartz et al. 2011) thus, useful to know the reason and factors for the specific community behavior adoption towards type 2 diabetes disease and its prevention.
The disadvantage associated with the ecological approach is that it does not provide insight on how much community is getting influenced by the physical and social environment (Golden & Earp, 2012).http://PUBH6006: Community Health Assignment Sample
Thus, it is difficult to analyze that on what aspects or sub-systems the promotion needs to focus on to promote change in behavior or towards lifestyle interventions for positive action or behavior to promote disease awareness and health to make a change in the environment to influence the community.
It can be concluded that type 2 diabetes requires acceptance of change in behavior, lifestyle and diet through health promotion for its awareness, treatment and preventive measures.
There is a significant link among the capacity building and community empowerment where it was identified that domain of leadership, communication and participatory decision-making can be used to empower community.
The Health Belief Model can be used to understanding health behaviors, predict related changes and guide health promotion and prevention programs for type 2 diabetes.
The ecological approach was also recognized to be used in this health concern to understand the influence on health behavior due to interaction between community and physical and socio-cultural environments.
Baillie, E., Bjarnholt, C., Gruber, M., & Hughes, R. (2009). A capacity-building conceptual framework for public health nutrition practice. Public Health Nutrition, 12(8), 1031-1038.
Golden, S. D., & Earp, J. A. L. (2012). Social ecological approaches to individuals and their contexts: twenty years of health education & behavior health promotion interventions. Health Education & Behavior, 39(3), 364-372.
Jalilian, F., Motlagh, F. Z., Solhi, M., & Gharibnavaz, H. (2014). Effectiveness of self-management promotion educational program among diabetic patients based on health belief model. Journal of education and health promotion, 3.
Laverack, G. (2007). Health promotion practice: building empowered communities. London, UK: McGraw-Hill Education.
Liberato, S. C., Brimblecombe, J., Ritchie, J., Ferguson, M., & Coveney, J. (2011). Measuring capacity building in communities: a review of the literature. BMC public health, 11(1), 850.
Mohamad, N. A., Abu Talib, N. B., Bin Ahmad, M. F., Shah, M., Ishak, B., Leong, F. A., & Shakil Ahmad, M. (2012). Role Of Community Capacity Building Construct In Community Development. International Journal of Academic Research, 4(1).
Orji, R., Vassileva, J., & Mandryk, R. (2012). Towards an effective health interventions design: an extension of the health belief model. Online journal of public health informatics, 4(3).
Rifkin, S. B. (2009). Lessons from community participation in health programmes: a review of the post Alma-Ata experience. International Health, 1(1), 31-36.
Rosato, M. (2014). A framework and methodology for differentiating community intervention forms in global health. Community Development Journal, 50(2), 244-263.
Schwartz, L. A., Tuchman, L. K., Hobbie, W. L., & Ginsberg, J. P. (2011). A social‐ecological model of readiness for transition to adult‐oriented care for adolescents and young adults with chronic health conditions. Child: care, health and development, 37(6), 883-895.
Serrano-Gil, M., & Jacob, S. (2010). Engaging and empowering patients to manage their type 2 diabetes, Part I: a knowledge, attitude, and practice gap?. Advances in therapy, 27(6), 321-333.
Sharma, M., 2016. Theoretical foundations of health education and health promotion. US: Jones & Bartlett Publishers.
Tol, A., Alhani, F., Shojaeazadeh, D., Sharifirad, G., & Moazam, N. (2015). An empowering approach to promote the quality of life and self-management among type 2 diabetic patients. Journal of education and health promotion, 4.