How Diabetes Is Epidemic in New York

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How Diabetes Is Epidemic in New York

Table of Contents

Introduction
Methodology
Study Design
A Theoretical Framework for The Intervention
The Results and Effectiveness of The Strategies
Independent And Dependent Variables
Ethical Issues Related to Diabetes Study In New York
IRB Review and Time Proposed Result Timing
Conclusion
References

Introduction

The intervention study majorly reflects on how diabetes is epidemic in New York, especially in minority communities which are the blacks and Latinos in the south Bronx. Recent studies from New York City Health suggest that about half a million adults have been diagnosed with diabetes in the past ten years, and around 250,000 people are living with diabetes and are not aware of it. Diabetes and other cardiovascular diseases are one of the leading causes of death in New York. Despite advancements in knowledge, more than half of New York adults are overweight, and a good percentage are morbidly obese, which is the highest predictor of diabetes. The New York Health Department has discovered that diabetes is the highest of blindness, lower extremity amputations in adults, and end-stage renal disease. There has been an increased number of hospitalizations due to diabetes. This intervention study focuses on determining how diabetes inappropriately affects black and Latino New Yorkers. The speculated solution to reduce diabetes in these minority communities is to regulate dietary habits and encourage them to perform regular checkups for diabetes.

Methodology

Low-income black and Latino communities demonstrate a greater prevalence of type 2 diabetes on uncontrollable levels. Most of these people live at low literacy levels since they are more likely to live at poverty levels. Interventions are more necessary to improve diabetes among low-income Latinos and whites.

Study Design

The best way to identify and conduct successful research is by conducting clinical trials. It has tested efficacy from past intervention studies since the clinical trials in New York hospitals can conduct a culturally effective self-management intervention (Agarwal et al., 2021). Participants are expected to be recruited from six community health centers in New York. The intervention is all theory-based, which involves a very intensive phase of 13 weekly sessions and continuous close follow-ups of 12 months at intervals of 4 and 12 months. The expected outcome for the follow-ups for black and Latino New Yorkers is primarily glycosylated hemoglobin, also known as HbA1c. However, self-management behaviors are also likely secondary products of the follow-ups. Latinos and black people have different self-management behaviors. However, the people recruited should be disciplined and willing to work with the study team to achieve the most effective results.

The other spectrum the study is to consider is weight, lipids, and blood pressure. These parameters are vital in determining whether an individual has a risk of diabetes or not (Agarwal et al.,.2021). The other objective of the study is to offer adequate diabetes knowledge, its potential risks, how epidemic it is in New York, and how important it is for people to take care of their diets and promote healthy living (Mayer et al. 2019). Additional outcomes include improving the quality of life by encouraging these communities to embrace therapy and reducing depression rates in New York City, which is the highest cause of poor dietary indiscipline. Around 300 participants should be selected as the sample population, 150 Black and the rest Latino (Mayer et al., 2019). They should be recruited per the design specifications and approximately 30% dropout estimation rate. The design provides a high chance of detecting changes in HbA1c between the interventions and control groups, and the difference is 0.5 to 0.6 % for Latino participants and 0.6 to 0.8% for the black community.

A Theoretical Framework for The Intervention

The interventions behavioral targets included physical activity, diet, and blood glucose self-management. Medical adherence is also included, although that is demonstrated from the first stages of the study. The dietary targets include reducing saturated fat intake while maintaining a balance in mono, polyunsaturated fats, and fiber intake by using whole grain intake of promoted fruits and vegetables. They are encouraged to reduce the intake of sodium and portion control, such as rice. Physical activities involve gradually increasing walking with the ultimate goal of 10,000 steps per day (Osorio et al., 2020). They are also encouraged to monitor their glucose two hours before breakfast to help their healthcare providers distinguish if they are hypo or hyperglycemic. Motivational interviewing is also very important. Using the social cognitive theory, which is more patient-centered counseling. The social approach has successfully collected interventional experiences with many populations, including these two communities. People chose it to identify the knowledge gaps in the sample population and help promote positive attitudes toward diabetes self-management (Osorio et al., 2020). A few of the strategies used in self-efficacy and behavioral change for the sample population were;

Giving opportunities for productive experiences through exploring skills such as cooking traditional meals together while using the healthiest cooking methods and playing games such as having walks and counting the steps.
We managed to create peer educational programs by hiring professionals who deliver the importance of improving quality of life and healthy living.
The sample population is encouraged to accept that being overweight is unhealthy and develop goal-setting habits that help them self-monitor their progress and have the ability to process feedback and self-management skills.
Some activities we did were collective shopping and supermarket tours, where we ensured they learned how to make appropriate shopping decisions.

The Results and Effectiveness of The Strategies

The intervention study is effective in so many ways. It helps clinicians determine the success rate of diabetes self-management skills. The skills are behavioral diet, the influence of physical activity, the ability to monitor self-glucose, equip the sample population to identify the disease risk factors, and teach other members of society the relevance of healthy living (Osorio et al., 2020). The strategies also help determine the ability to monitor the demographic and psychological factors with self-discipline and HbA1c levels and how they could change their behaviors to fit a healthy living without feeling discriminated by other ethnic groups. The strategies help many people from both ethnic groups view diabetes as a controllable disease.

The study and the strategies implemented are meant to enable the patients and the sample population to impact their ability to manage diabetes at an individual level and reduce the cost of hospitalization. Before understanding the controlling measures, they have to view the disease control aspect as manageable. Soap operas are very popular among the groups, especially Latinos. The study aims to encourage the government public health officials and community health officers to develop adverts that could sensitize the population about the adverse effects of cardiovascular diseases such as diabetes.

In the Latino community, the intervention strategies anticipate that when a drama of a Latino woman with diabetes and her daughter with diabetes is aired, it will reinforce concepts in the community that few people think about and challenge negative attitudes (Osorio et al., 2020). Some advertisements, such as healthy foods do not taste good. Such strategies help develop ambivalence and create challenges incorporated into dilemmas associated with the prevention process. The sample group members help create values and behaviors that benefit other community members engaging in management and lifestyle change. Other members of society have to evaluate that healthy living is neither expensive nor copies the optimal self-management behaviors of the sample population (Marquez et al., 2019). The sample population offers various types of data as findings, and some of the expected conclusions of the study are not known to the low-income communities since most of them have languished in poverty and the knowledge of the kind of food to buy.

Independent And Dependent Variables

Diabetic people are identified as respondents in the sample population. Some will have fasting glucose of 126 mg per deciliter or higher (Marquez et al., 2019). HbA1c values are expected to be 6.5% or higher, and a good percentage of the selected population might be selected to get diabetes medication. People with normal hyperglycemic values are excluded. The studys independent variable is subject to individual race. Since the sample population is from both races, racial composition, poverty levels, or neighborhood composition should be factorized in the results. The poverty statistics from the federal poverty level are beneficial in the study since they offer information on the different aspects of each races ability to maintain a healthy lifestyle.

There exist a lot of other co-variables, but the more important ones that could come up in the intervention results are the age and gender variables. Most people with diabetes could have a family history of diabetes (Osorio et al., 2020). On the other hand, education and health status might also play a role. If age, education, and insurance are squared to control continuous variables, it is easy to identify why these two communities have diabetes as the number one mortality predicament.

Most black and Latino individuals are illiterate. So it could be that they might not have the appropriate knowledge on what to shop or the proper physical exercise or even lack coded health insurance, especially for individuals whose families have a controlled self-reported history of diabetes (Gary-Webb et al., 2018). The black community is expected to have higher diabetes prevalence levels closely relative to poverty levels. According to the national statistics, there are no distinctive differences in poverty levels between blacks and Latinos in New York or America.

The intervention studys most fundamental result is that adults in poorer households have the highest rates of diabetes. Still, the black community has a relatively large population of diabetic people compared to Latinos. However, that could be argued that black community individuals have a larger population than Latinos. There is a distinctive difference in epidemic diseases in terms of prevalence within these communities and white America.

The diabetes burden will likely shoot soon due to the lack of necessary primary interventions in New York. Despite the healthcare system employing technologically intensive care for complications, the public health sector also needs to cut the costs of diabetes management (Marquez et al., 2019). However, cutting the economic and social costs is not easy since many individuals with diabetes do not even know they have it. The more technological input needed, the lower the number of individuals getting diagnosed, increasing uncared-for diabetes. Ethical issues knock when not enough people in New York get access to diagnostic procedures or treatment due to increased patients than the technological pace, and many people are not able to receive appropriate medical care.

The focus of the intervention is primary interventions and clinical trials and ethical issues related to diabetic clinical trials. Ethics in clinical trials state that any patient, be it the control group, should be assured of the best diagnostic and therapeutic methods (Marquez et al., 2019). Most of the placebo-controlled clinical do not meet ethical standards and the ethical issue to be recognized is the duration that hyperglycemic trials should take. Unless it has prolonged hyperglycemia, it should not take more than six months because it might cause potential macrovascular complications that might adversely affect the quality of life, developing an ethical dilemma.

Another ethical concern is that most patients and unaware patients with diabetes from such communities have to be guided and assured that their patient data is confidential whenever they visit a healthcare center. Confidentiality helps the sample population to be accessible and able to communicate without the fear of the information they might disclose leaking to the members of the public. Most black people value privacy and personal space, and healthcare workers should help educate the members that a disease is not a condition to be ashamed of.

IRB Review and Time Proposed Result Timing

The time to achieve and analyze the results is after six months of clinical trials and at the end of the intervention. The sample population has been examined for the community health officials to make a complete report on each or even have an annual statistical comparison report (Mayer et al., 2019). The IRB process is known as a look ahead, where the 300 volunteers are weighed for the overweight parameter for type 2 diabetes. The long-term interventions for a lifestyle one should achieve include decreased calorie intake and increased physical activity.

The review of the study is the primary hypothesis of comparing the program of clinical trials in the intervention. The IRB process will test the planned follow-up for a year to provide results on the progress of the general health, any developing complications, quality of life, and psychological outcomes (Gary-Webb et al., 2018). The cost-effectiveness and management systems of lifestyle according to diabetes support programs are assessed. The intervention consists of 1589 members, including the members of the clinical trials, and its primary purpose is research. Its actual study start date is January 2022, beginning in June 2023. The assessment system is stopped immediately after 12 months of evaluation, and an intensive report is made.

Conclusion

The study unveils many variables on reasons for diabetes prevalence in the two communities. It could be argued that the difference between these communities and the white community is income and literacy levels. However, the blame cannot be based on who has more money than the other but on who knows the best type of food to buy and makes appropriate consumer decisions. Diabetes is a clinical condition, and clinical trials would be the best research method to determine how these communities are affected. It is accurate that poverty cuts across these communities, which is the causative agent for diabetes since the community members have fewer consumer choices and poor shopping options.

More research could be conducted to clarify the unaware individuals after the trials and program education. It will lead to more people accepting the screening systems to ensure awareness of diabetes status. Most diabetic adults do not even know, or if they did, they did not have the appropriate ways to handle it since most of them are depressed due to poor living standards and illiteracy. The communities need awareness and more civic education on the effects of type 2 diabetes and can engage in more physical exercises and healthy diets to help fight the disease.

It could be argued from the findings that the sample population could be a better representation of the whole population. The clinical trials for hyperglycemia and the hard work demonstrated by New York Health are vital in making the process work. However, the research conducted is costly, and if another strategy for approaching the issue is identified, it could be constructive. From the data, the New York Community health officials can identify the shortages in diagnostic equipment and have a better management grip on the disease. The technological equipment could now be available to service all diabetic patients and improve medical ethics in New York and the United States.

References

Agarwal, S., Schechter, C., Gonzalez, J., & Long, J. A. (2021). Racialethnic disparities in diabetes technology use among young adults with type 1 diabetes. Diabetes technology & therapeutics, 23(4), 306-313. Web.

Anderson, A., OConnell, S. S., Thomas, C., & Chimmanamada, R. (2022). Telehealth interventions to improve diabetes management among Black and Hispanic patients: A systematic review and meta-analysis. Journal of racial and ethnic health disparities, 1-12. Web.

Gary-Webb, T. L., Walker, E. A., Realmuto, L., Kamler, A., Lukin, J., Tyson, W., Carrasquillo, O., & Weiss, L. (2018). Translation of the National Diabetes Prevention Program to Engage Men in Disadvantaged Neighborhoods in New York City: A Description of Power Up for Health. American journal of mens health, 12(4), 9981006. Web.

Marquez, I., Calman, N., & Crump, C. (2019). A Framework for Addressing Diabetes-Related Disparities in US Latino Populations. Journal of community health, 44(2), 412422. Web.

Mayer, V. L., Vangeepuram, N., Fei, K., Hanlen-Rosado, E. A., Arniella, G., Negron, R., Fox, A., Lorig, K., & Horowitz, C. R. (2019). Outcomes of a Weight Loss Intervention to Prevent Diabetes Among Low-Income Residents of East Harlem, New York. Health education & behavior : the official publication of the Society for Public Health Education, 46(6), 10731082. Web.

Osorio, M., Koziatek, C. A., Gallagher, M. P., Recaii, J., Weinstein, M., Thorpe, L. E., Elbel, B., & Lee, D. C. (2020). Concordance and Discordance in the Geographic Distribution of Childhood Obesity and Pediatric Type 2 Diabetes in New York City. Academic pediatrics, 20(6), 809815. Web.

Osorio, M., Ravenell, J. E., Sevick, M. A., Ararso, Y., Young, T., Wall, S. P., & Lee, D. C. (2020). Community-Based Hemoglobin A1C Testing in Barbershops to Identify Black Men With Undiagnosed Diabetes. JAMA internal medicine, 180(4), 596597. Web.