Diabetes Mellitus Needs Analysis: Realist Review Approach

Running head: PROGRAM DESIGN IMPLEMENTATION AND EVALUATION 1
Program Design Implementation and Evaluation
Name:
Institution

PROGRAM DESIGN IMPLEMENTATION AND EVALUATION 2
Introduction
Diabetes is among the nine national health priorities. Diabetes consists of a group of
diseases that have got different causes but with similar manifestation. Among the common
feature is a high level of glucose within the patient’s body. This is caused by the lack of the
hormone insulin or even the incapability of a person to respond to insulin. Despite that it is
difficult to cure diabetes, it is observed that it can be clinically controlled and managed.
Additionally, there is a lot that individuals with diabetes can do to improve their personal health.
A needs analysis is part of a planning process that is used to identify and determine the gaps that
exist between the present conditions and the desired conditions. The purpose of this report is to
conduct a needs analysis on people living with diabetes mellitus through identification of the best
needs analysis approach, challenges faced during the needs analysis, conducting a SWOT
analysis, and identifying the program priorities. The realist review approach will be used in
carrying out the needs analysis.
Needs Analysis Approach
Realist review approach is among the best needs analysis approach for diabetes mellitus
control. Diabetes control should be done at the national level since the disease is an important
public health issue, and it has got negative impacts on the economy. According to the Ontario
Ministry of Health and Long-Term Care Reports, Diabetes is among the leading cause of death
globally. However, the number of deaths that are as a result of diabetes are substantially
underestimated specifically because of the methods used to record deaths (Becker, 2015). This is
because individuals who suffer from diabetes normally die due to diabetic complications that
include heart attack, which is mostly recorded as the cause of death rather than diabetes itself.

PROGRAM DESIGN IMPLEMENTATION AND EVALUATION 3
Additionally, the disease has got health system costs that translate to the increased economic
burden that is as a result of diabetes treatment and its complications.
According to Malone, et al (2012), realist analysis has become a popular approach in
reviewing and synthesizing evidence by focusing on and understanding the mechanisms by
which an intervention works or does not work. This approach entails the identification of the
underlying causal mechanisms as well as exploring how they function under what conditions.
The approach involves four stages that include defining the review’s scope, searching and
analyzing the evidence, extracting and synthesizing, along with developing the narrative (Bray &
Popkin, 2014). This needs analysis approach is thus useful in developing an explanatory or a
program theory regarding what works best and what does not work during the process of
controlling and managing diabetes mellitus and to what extents. Applying the approach, the
context-mechanism-outcome configuration can then be developed iteratively by means of data
collection, theorizing, including engaging the stakeholders (Cain, Orionzi, O’Brien & Trahan,
2017). The people that may be included in this needs analysis include the people living in the
community, a care home or even other long-term settings.
Challenges Faced during the Need Analysis
During the process of carrying out the needs analysis, multiple small obstacles were faced
and they ranged from policy, inter-disciplinary and the generic levels. These challenges have a
negative impact when conducting a needs analysis, and this may even lead to termination of the
process. At the policy level, there were restrictions as to the specific time when assessors could
get in touch with patients who were in care homes (Krämer, Green, Pollard & Tugendreich,
2013). As a result, there was a limitation to the number of diabetic patients who were involved in