What is a PHN? - Association of Public Health Nurses

NURSING PUBLIC HEALTH
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INTRODUCTION
 Type 2 diabetes tends to impact racial and
cultural subgroups at an disturbing rate in
the United States and in several nations
across the world (Sattar & Gill, 2015).
 The value of healthcare offered to these
diverse minority sections if typically
suboptimal subsequent to severe patient
related consequences as associated with the
ones in mainstreamed populaces.

AWARENESS OF WAYS IN WHICH CULTURE IMPACTS HEALTH
CONDITIONS
 Awareness of the essentiality for
cultural understanding through web-
based programs as well as
smartphone applications is the
primary step in the direction of
providing sensitive as well as
competent diabetes education
(Sapkota et al., 2015).
 It is greater than a limited knowledge
of cultural standards, ideologies,
customs, language as well as
actions.

UNDERSTANDING THE SCOPE OF DIABETES
 Diabetes tends to occur
at all age groups as well
as in all cultural groups.
It has been found in
fundamentally all parts
of the world.
 However, from a
universal perspective,
diabetes has turned into
a widespread whereby
over 150 million of adult
population across the
world suffer from,
diabetes (Abubakari et
al., 2016).

RISK FACTORS FOR ETHNICALLY DIVERSE POPULACES
 It is important that non-White populaces not only faces
augmented occurrence of Type 2 diabetes but further suffer
from more recurrent difficulties in addition to superior disease
severity.
 Studies of elder adults suffering from diabetes have explained
that Mexican Americans as well as African Americans face an
inordinate problem from diabetes in comparison to the aged
non-Hispanic Whites (López et al., 2016).

CONTINUATION
 Racial and ethnic minorities
have deprived level of health
care as evaluated to primary
subgroups.
 However, as per the Institute of
Medicine in the US , the
occurrence of important
healthcare differences amongst
racial as well as ethnic
subgroups along with the non-
Hispanic white residents
(Stojanovska, Naemiratch &
Apostolopoulos, 2017)

COMMUNITY EDUCATION REGARDING
TYPE 2 DIABETES
 Education Level
 It is important to understand by diverse
populaces that the occurrence of Type2
diabetes and CVD has been associated with
educational background.
 A study conducted in Washington has
revealed that Japanese-American male
inhabitants with advanced education
qualifications showed lower rate of
occurrence of type 2 diabetes in comparison
to the ones with technical school level
education (Janiszewski, O’Brian & Lipman,
2015).

UNDERSTANDING DIABETES-RELATED
COMPLICATIONS
 Diverse populations in the United States must
understand the identification of diabetes
complications and other factors linked to
patients.
 These factors might influence aspects of self-
management and thus calls for direct
emphasis and adequate resources.
 Patients must be involved in routine medical
treatment whereby they will be helped to
distinguish factors which influence treatment
along with related self-management plans
(Stojanovska, Naemiratch & Apostolopoulos,
2017).

KNOWING ABOUT THE BIOLOGY OF TYPE 2
DIABETES
 Inhabitants belonging to
diverse backgrounds in the
community must attain the
knowledge of pathophysiology
of type 2 diabetes.
 It is important for them to
understand that type 2
diabetes includes irregularities
at multiple organ as well as
system intensities. Studies
have claimed that insulin
sensitivity has revealed to be
lessened in diverse collections
at elevated threat for type 2
diabetes (Ferguson, Swan &
Smaldone, 2015).

CONTINUATION
 The amount, type as well
as position of body fat
tend to instigate the
threat related to type 2
diabetes as well as
associated complaints.
 Moreover, augmented
accumulation of visceral
fat typically advances to
reduced rate of insulin
sensitivity as well as
damaged endothelial
function.

CONTINUATION
 Diabetes-related sensitive suffering is also
seen as a common illness amongst patients
suffering from type 2 diabetes.
 Such emotional suffering is linked to the
psychological influence of having diabetes as
well as the necessity to track numerous
approvals on regular basis (Sherifali et al.,
2018).
 Moreover, the monotonous assessment of
diabetes-centric demonstrative distress is
extremely suggested.

OVERCOMING CULTURAL BARRIERS OF USING
INSULIN
 Culturally diverse populations have negative
perceptions of using insulin.
 These views have instigated from the
essential cultural beliefs or ideologies which
are highly insufficient (Smith-Miller et al.,
2016).
 In that case, cultural competence on the part
of healthcare physicians is essential to
overcome these obstructions and offer a
culturally suitable plan of precaution.

OVERCOMING FEARS OF TYPE 2
DIABETES
 Fears are common in patients belonging to
diverse populations in the United States with
type 2 diabetes.
 They are typically interlinked with values as
well as health beliefs.
 Several patients belonging to ethnically
diverse populations like the African
Americans and Hispanics show apprehension
towards the increase in the type 2 diabetes
and its likely related problems (Lepard et al.,
2015).

GROUP ENGAGEMENT
 Diverse patient populations among Latinos
and African Americans must involve relatives
in medical and educational activities.
 This will facilitate patients to construct a
positive support system. At this stage, close
associates of diverse populations may
contribute to this network.

FOCUSING ON NUTRITIONAL PREFERENCES
 Diverse patient populations through education programs
must include activities.
 These activities will advance nutritional likings and must be
aligned with their cultural as well as social backgrounds.
 Patients will also receive guidance on ways of improving
food purchase behavioural patterns which can be extremely
advantageous for patients suffering from type 2 diabetes
(Caballero, 2018).

CONCLUSION
 Healthcare providers across the world have
been encountering challenge of delivering
care to number of diverse patient
populations.
 Taking consideration of patients’
perspectives, standards, principles, social
factors as well as language restrictions tends
to expedite the delivery of best care.
 It permits patients as well as providers to
attain their shared goal of general improved
health for patients.

REFERENCES
 Abubakari, A. R., Cousins, R., Thomas, C., Sharma, D.,
& Naderali, E. K. (2016). Sociodemographic and clinical
predictors of self-management among people with
poorly controlled type 1 and type 2 diabetes: the role
of illness perceptions and self-efficacy. Journal of
diabetes research, 2016.
 American Association of Diabetes Educators. (2015).
Cultural considerations in diabetes education: AADE
practice synopsis.
 Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T.,
Butcher, M. K., Condon, J. E., ... & Kolb, L. E. (2018).
2017 National standards for diabetes self-management
education and support. The Diabetes Educator, 44(1),
35-50.

REFERENCES
 Caballero, A. E. (2018). The “A to Z” of managing
type 2 diabetes in culturally diverse
populations. Frontiers in endocrinology, 9, 479.
 Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016).
Diabetes self-management education for adults
with type 2 diabetes mellitus: a systematic review
of the effect on glycemic control. Patient education
and counseling, 99(6), 926-943.
 Dobson, R., Whittaker, R., Jiang, Y., Maddison, R.,
Shepherd, M., McNamara, C., ... & Murphy, R.
(2018). Effectiveness of text message based,
diabetes self management support programme
(SMS4BG): two arm, parallel randomised controlled
trial. bmj, 361, k1959.

REFERENCES
 Ferguson, S., Swan, M., & Smaldone, A. (2015). Does
diabetes self-management education in conjunction
with primary care improve glycemic control in Hispanic
patients? A systematic review and meta-analysis. The
diabetes educator, 41(4), 472-484.
 Janiszewski, D., O’Brian, C. A., & Lipman, R. D. (2015).
Patient experience in a coordinated care model
featuring diabetes self-management education
integrated into the patient-centered medical
home. The diabetes educator, 41(4), 466-471.
 Lepard, M. G., Joseph, A. L., Agne, A. A., & Cherrington,
A. L. (2015). Diabetes self-management interventions
for adults with type 2 diabetes living in rural areas: a
systematic literature review. Current diabetes
reports, 15(6), 37.

REFERENCES
 López, L., Tan-McGrory, A., Horner, G., &
Bethancourt, J. R. (2016). Eliminating disparities
among Latinos with type 2 diabetes: effective
eHealth strategies. Journal of Diabetes and its
Complications, 30(3), 554-560.
 Mendenhall, E. (2016). Beyond comorbidity: a
critical perspective of syndemic depression and
diabetes in cross‐cultural contexts. Medical
anthropology quarterly, 30(4), 462-478.
 Naranjo, D., D Schwartz, D., & M Delamater, A.
(2015). Diabetes in ethnically diverse youth:
disparate burden and intervention
approaches. Current diabetes reviews, 11(4), 251-
260.

REFERENCES
 Pereira, K., Phillips, B., Johnson, C., & Vorderstrasse, A.
(2015). Internet delivered diabetes self-management
education: a review. Diabetes technology &
therapeutics, 17(1), 55-63.
 Powers, M. A., Bardsley, J., Cypress, M., Duker, P.,
Funnell, M. M., Fischl, A. H., ... & Vivian, E. (2017).
Diabetes self-management education and support in
type 2 diabetes: a joint position statement of the
American Diabetes Association, the American
Association of Diabetes Educators, and the Academy
of Nutrition and Dietetics. The Diabetes
Educator, 43(1), 40-53.
 Rebolledo, J. A., & Arellano, R. (2016). Cultural
differences and considerations when initiating
insulin. Diabetes Spectrum, 29(3), 185-190.

 Rinker, J., Dickinson, J. K., Litchman, M. L., Williams, A.
S., Kolb, L. E., Cox, C., & Lipman, R. D. (2018). The 2017
diabetes educator and the diabetes self-management
education national practice survey. The Diabetes
Educator, 44(3), 260-268.
 Rollo, M. E., Aguiar, E. J., Williams, R. L., Wynne, K.,
Kriss, M., Callister, R., & Collins, C. E. (2016). eHealth
technologies to support nutrition and physical activity
behaviors in diabetes self-management. Diabetes,
metabolic syndrome and obesity: targets and
therapy, 9, 381.
 Sapkota, S., Brien, J. A., Greenfield, J., & Aslani, P.
(2015). A systematic review of interventions addressing
adherence to anti-diabetic medications in patients with
type 2 diabetes—impact on adherence. PloS one, 10(2).

 Sattar, N., & Gill, J. M. (2015). Type 2 diabetes in
migrant south Asians: mechanisms, mitigation, and
management. The lancet Diabetes &
endocrinology, 3(12), 1004-1016.
 Seol, H., Thompson, M., Kreider, K. E., & Vorderstrasse,
A. (2017). Diabetes self-management quality
improvement initiative for medically underserved
patients. Journal of nursing care quality, 32(3), 272-279.
 Sherifali, D., Berard, L. D., Gucciardi, E., MacDonald, B.,
& MacNeill, G. (2018). Self-management education and
support. Canadian journal of diabetes, 42, S36-S41.
 Sherr, D., & Lipman, R. D. (2015). The diabetes
educator and the diabetes self-management education
engagement: the 2015 National Practice Survey. The
Diabetes Educator, 41(5), 616-624.

REFERENCES
 Smith, M. L., Ory, M. G., Ahn, S., Kulinski, K.
P., Jiang, L., Horel, S., & Lorig, K. (2015).
National dissemination of chronic disease
self-management education programs: an
incremental examination of delivery
characteristics. Frontiers in public health, 2,
227.
 Smith-Miller, C. A., Berry, D. C., DeWalt, D., &
Miller, C. T. (2016). Type 2 diabetes self-
management among spanish-speaking
Hispanic immigrants. Journal of immigrant
and minority health, 18(6), 1392-1403.

REFERENCES
 Sohal, T., Sohal, P., King-Shier, K. M., & Khan,
N. A. (2015). Barriers and facilitators for type-
2 diabetes management in South Asians: a
systematic review. PloS one, 10(9).
 Stojanovska, L., Naemiratch, B., &
Apostolopoulos, V. (2017). Type 2 Diabetes in
People from Culturally and Linguistically
Diverse Backgrounds: Perspectives for
Training and Practice from Nutritional
Therapy and Dietician
Professions. prilozi, 38(1), 15-24.