Population Health Improvement Plan

Running head: POPULATION HEALTH IMPROVEMENT PLAN: TYPE 2 DIABETES
POPULATION HEALTH IMPROVEMENT PLAN: TYPE 2 DIABETES
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Introduction
Type 2 diabetes mellitus (T2DM) is characterized by a progressive decrease in the
efficiency of insulin in metabolizing glucose, despite its sufficient production (Mayer-Davis et
al., 2017). The following paper will hence briefly discuss on the key data components to be
considered on the nationwide prevalence of T2DM as well the application of the same in the
development of a population health improvement plan.
Discussion
Data Evaluation
The ‘National Diabetes Statistics Report, 2017’, formulated and synthesized by the
Centers of Disease Control and Prevention (CDC, 2017), provides relevant community data in
terms of the epidemiological, environmental and demographic prevalence of T2DM in the
United States. As per epidemiological data presented in this report, it has been evidenced that
approximately 30.3 million and 84.1 million individuals were reported to be inflicted with
T2DM and pre-diabetic conditions in the year 2017. A key demographic findings was observed
data associations between age and the prevalence of diabetes, where it was observed that one’s
gender and with increasing age, and rates of T2DM increased: 4% across 18 to 44 year olds, 17%
across 45 and 64 year olds and 25% across individuals in the ages of 65 and above. Likewise the
highest prevalence of T2DM was observed in men (36.6%) as compared to women (29.3%)
(CDC, 2017).
A key environmental finding was the observed associated between an individual’s
educational, culture and location and the national prevalence of diabetes. The highest prevalence
of T2DM was observed across Alaskan natives and non-Hispanic blacks, at the rate of 15.1 %

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and 12.1% respectively. Additionally, higher prevalence of T2DM was observed across
individuals with less than a high school level educational competency (12.6) as compared to
individuals with educational levels higher than high school education. Interestingly, individual
residing in the Appalachian and southern regions of the United States were reported to
demonstrate the highest nationwide prevalence of diabetes (CDC, 2017).
Data Relevance
Old age and gender are some of the epidemiological concerns for diabetes management
consider the strong association between males and an individual’s increasing age with the
prevalence of T2DM. The data also demonstrate the impact of environmental concerns like an
individual’s education, culture and residence, since it was observed that low levels of education,
indigenous and black minority cultural backgrounds and residing in Appalachian and Southern
regions were associated with the high risk of an individual’s health being affected by T2DM and
its associated long term complications (Micha et al., 2017).
Health Improvement Plan
Aim: To develop and implement person-centered and cultural competent educational,
dietary and exercise interventions for the prevention, management and treatment of T2DM,
specifically across males, elderly and minority ethnic communities.
Venue: Healthcare organization or community healthcare center situated at the locality,
preferably in T2DM regions such as the southern or Appalachian districts of the United States.
Target population: At-risk groups like families belonging to Indian and non-Hispanic
black minority communities and the elderly aged 65 years or above.

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T2DM Health Improvement Interventions: Based on the above identified data
components, the following will be the key interventions implemented for prevention and
management of T2DM and thus, ensuring long term positive public health outcomes:
1. Assessment-based Improvement Interventions: According to the CDC Report, 7.2
million diabetic adults were completed unaware of their condition. Thus, to improve
awareness, residents of the locality will be assessed based on their anthropometric
measurements and blood glucose levels for timely diagnosis of T2DM. Participants will
be interviewed with consent concerning their dietary and lifestyle habits, using exercise
and dietary recalls. This is because consumption of a high sugar with excessive processed
foods and sugary beverages have been associated with hyperglycemia and risk of T2DM
(Saslow et al., 2018).
2. Education-based Improvement Interventions: All residents of the locality or
community, especially those belonging to at-risk groups, will be handed printed resources
containing on the causes, incidences, treatment and management of T2DM in person-
centered language. This is because of incorporation of person-centered language in
healthcare promotional resource have been evidenced to be useful in teaching clients on
complex medical terms. Additionally, recruitment of bilingual interpreters can be useful
in developing educational diabetic education resources for non-English speaking
populations, which in turn, demonstrates cultural competency. Additionally, sign
language and Braille based resources can assist the education of deaf and blind diabetic
patients (Saslow et al., 2018). Likewise, community based educational workshops
disseminating this information, will be conducted. This is because low educational levels

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are associated with inadequate awareness on the causes, consequences and prevention
and thus, high risk of T2DM (Aguiar et al., 2016).
3. Diet-based Improvement Interventions: As a part of the community campaign,
residents of the locality, nutritionists in collaboration with linguistic interpreters as well
as ethnically diverse health workers will provide cultural competent, customized low fat,
high fiber diabetic diet plans. High fiber, low glycemic index diet has been associated
with improved blood sugar and T2DM control (O’Reilly et al., 2019).
4. Lifestyle-based Improvement Interventions: As a part of the community campaign,
residents of the locality, fitness experts in collaboration with linguistic interpreters as
well as ethnically diverse health workers will provide cultural competent, customized
aerobic and resistance training exercise plans for lifestyle management of blood glucose
levels. This is because exercise has been associated with improved insulin production and
sensitivity, glucose metabolism and thus, T2DM mitigation (Kirwan, Sacks &
Nieuwoudt, 2017).
Communication Strategy
To ensure that strategies of the given public health intervention plan are addressed in a
culturally sensitive manner, the educational resources and associated lifestyle strategies will be
developed in collaboration with culturally diverse healthcare workers belonging to the identified,
at-risk minority groups. This will ensure the incorporation of cultural competent interventions
and educational resources compliant to the cultural needs of the targeted population and
members of the community. To ensure the same is communicated to the public health workforce,
colleagues will be recruited in a cultural competency training designed in compliance to the
cultural needs of the community members. To ensure ethical compliance, colleague will be

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educated on the need to keep the identities and healthcare details of the participants private,
confidential and stored in highly secured databases or cabinets with authorized access (Page-
Reeves et al., 2017).
Conclusion
In addition to dietary, lifestyle and metabolic risk factors, an individual’s risk of diabetes
was observed to be largely associated with his or her cultural background, educational status,
increasing age and area of residence. To include, development and implement of a person
centered population health improvement plan targeting improved health literacy and cultural
sensitivity will assist in achievement of positive public health outcomes.

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References
Aguiar, E. J., Morgan, P. J., Collins, C. E., Plotnikoff, R. C., Young, M. D., & Callister, R.
(2016). Efficacy of the type 2 diabetes prevention using lifestyle education program
RCT. American journal of preventive medicine, 50(3), 353-364.
CDC. (2017). National Diabetes Statistics Report, 2017. Retrieved 31 January 2020, from
https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf.
Kirwan, J. P., Sacks, J., & Nieuwoudt, S. (2017). The essential role of exercise in the
management of type 2 diabetes. Cleveland Clinic journal of medicine, 84(7 Suppl 1),
S15.
Mayer-Davis, E. J., Lawrence, J. M., Dabelea, D., Divers, J., Isom, S., Dolan, L., ... & Pihoker,
C. (2017). Incidence trends of type 1 and type 2 diabetes among youths, 2002–2012. New
England Journal of Medicine, 376(15), 1419-1429.
Micha, R., Peñalvo, J. L., Cudhea, F., Imamura, F., Rehm, C. D., & Mozaffarian, D. (2017).
Association between dietary factors and mortality from heart disease, stroke, and type 2
diabetes in the United States. Jama, 317(9), 912-924.
O’Reilly, S., Versace, V., Mohebbi, M., Lim, S., Janus, E., & Dunbar, J. (2019). The effect of a
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Mishra, S. (2017). A comparative effectiveness study of two culturally competent models

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