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M59PH, Outline Project Proposal

   

Added on  2020-05-16

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M59PH - Outline Project Proposal Student Name:e-mail address:Proposed Title of Dissertation:STUDY BASED ON INTERVATIONS OF HOW TO CONTROL DIABETES TYPETWO AMONG BLACKS, ASIANS AND OTHER ETHINIC PEOPLE IN UK. Research QuestionHow effective are nutritional interventions in reducing type 2 diabetesB A M E p e o p l e i n t h e U K?Null Hypothesis(only for experimental research designs)There is a large body of evidence which link type 2 diabetes mellitus to eating habits and nutrition (Diabetes UK, 2005; Harrison, 2014). This dissertation takes the hypothesis that most cases of type 2 diabetes among BAME can be prevented or reduced througheffective nutritional intervention. There is a high prevalence of type 2diabetes mellitus with BAME people in the UK,and globally (Harrison, 2014; Public Health England, 2016). In agreement, Gatineauand Mathrani,( 2011) argue that BAME people have a high risk of developing T2DMwhich leads to physical health complications such as peripheral neuropath, limbamputations due to infected diabetic foot ulcers, blindness, renal failure as well asother cardiovascular complications associated with obesity and T2DM.Consequently, people die unnecessarily from a complication which can effectively bemanaged by diet and other lifestyle interventions (Boyington et al., 2009; Gatineauand Mathrani, 2011; Harrison, 2014). People from South Asian community have asix times risk of developing T2DM that any other ethnic group in the UK (Harrison,2014). Black people (Africans and African Caribbean) have a three-times risk ofdeveloping type 2 diabetes mellitus (Harrison, 2014; Public Health England, 2015).In addition to causing serious morbidities, T2M costs the UK government almost £4billion per year in treating complications associated with the condition (the NationalAudit Office, 2012). JoPerry/OutlineProposal/Oct2017

Most of the high cases of T2DM in BAME people is attributable to diet such as foodssaturated in fats, starchy foods, a high diet of carbohydrates (rice, chapatti, yams),butter, ghee, palm oil, maize meal, bread, and cassava (Hannif, 2015; Khunti, Kumarand Brodie 2009). Many studies have also highlighted cooking habits such asfavouring a diet of deep fried foods (meat) and overcooking vegetables (destroyingnutrients in so doing) as some of the causes of obesity and type 2 diabetes mellitusamong most BAME people (Khunti, Kumar and Brodie 2009). In addition, mostBAME people tend to eat big meals before bed-time, which results in unused energybeing stored in the body as fats (Hanif et al., 2015). Vlaar et al., (2017) argue thatlifestyle interventions which target some of these unhealthy behaviours such asphysical exercising and eating healthy foods can be effective in reducing diabetesand/or reducing onset of T2DM in people at risk of developing the illness. Forexample, Vlaar et al., (2017) carried out a randomised controlled trial with 642participants from South Asian Surinamese community in the Hague to investigatethe effectiveness of these lifestyle (exercising and nutrition) on these communitieswhich were at risk of T2DM. 332 participants who were at risk of developing T2DMwere randomly assigned to receive motivational interviewing and supervisednutritional intervention and physical exercising. The control group (n-310) who hadsimilar risk of T2DM were given generic advise by Dieticians on healthy eating. Thestudy showed that participants in the intervention group managed to reduce risk ofT2DM compared to those who received generic advice in the control group (Vlaar etal., 2017). The findings from this study indicated that through diet, people fromBAME community can reduce their risk of developing T2DM, while these alreadydiagnosed with the disease can control their blood glycaemia through diet. However, there are other factors such as genetic factors, poverty, healthy literacyand cultural practices and beliefs which cannot be ignored, and which can contributeto high incidents of T2DM in BAME people. For example, most interventions whichpromote healthy eating encourage people to eat five portions of fruit and vegetablesevery day (Harrison, 2014). Without addressing poverty, these may not be affordableto most BAME people, especially those that live in deprived parts of the country, forexample, in Coventry, many BAME people live in poor areas such as Longford,Hillfields, Stoke, Henley Green, Wood End and Foleshill(Coventry City Council,2017) where most of the BAME people live. JoPerry/OutlineProposal/Oct2017

Chosen MethodologyDue to limitations in time and resources, the study will be literature based, wherebythe author will identify relevant studies from research databases and synthesize theevidence before making conclusions on whether nutritional interventions areeffective in reducing type 2 diabetes in ethnic minorities. A literature review is acomprehensive analysis of existing literature of studies carried out on a particulararea under investigation (Taylor, 2006). As a result, a literature review is not anannotated bibliography. According to Bryman (2012), a literature review allows aresearcher to identify, analyse, synthesise and summarise evidence on a particularphenomenon under investigation, before presenting it in a way which is logical. Adam et al., (2007) maintain that there are many methods of conducting literaturereviews, such as narrative or traditional literature reviews, narrative reviews, scopingreviews of systematic reviews. This dissertation will be conducted using asystematic review approach, which is a step-by-step approach of identifying andselecting relevant literature from research databases (Bryman, 2012). A systematicreview approach uses the same rigours methods of identifying secondary sources ina way that eliminate researchers’ biases, for example, as in narrative reviews wherethe researchers can identify and select literature according to what they want to find(Bryman, 2012). A systematic review approach allows a researcher to create aninventory of how they search for literature and how they select relevant material. APrisma’s flow chart (Prisma, 2009) which is a four stage process of identifying,screening, exclusion and selection of literature will be used to demonstrate how theauthor will select relevant studies for analysis. The advantages of literature reviewsin general is that they allow novice researchers to analyse studies carried out byexperienced researchers and research institutions which are well funded (Aveyard,2010; Bryman, 2012). In addition, literature reviews save time and money asopposed to empirical studies (Aveyard, 2010). In addition, conducting a primarystudy would require the author to apply for ethical approval from the relevantresearch bodies such as the NHS Research Authority or the Coventry Universitybefore carrying out the primary study. This may be time consuming and frustratingJoPerry/OutlineProposal/Oct2017

(Bryman, 2012).The disadvantages of carrying out literature reviews are that theresearchers will not report anynew findings, but will analyse and synthesise what hasalready been concluded by other researchers (Bryman, 2012). In addition,researchers who carry out literature reviews have no control over the quality of datacollected by the primary researchers (Bryman, 2012;Creswell, 2013). Ideally, apreferred methodology for this kind of study would be a randomised controlled trial(RCT), to enable the researcher to randomly assign participants into two groups(Polit and Beck, 2014), where the control group will receive nutritional advice andmonitoring, and the other group would receive treatment as usual such as Metforminand then compare the variables post-intervention. JoPerry/OutlineProposal/Oct2017

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