Health Promotion Strategies for Jing's Type 2 Diabetes: A Case Study

This report presents a comprehensive analysis of a case study focusing on health promotion strategies for Jing, a 68-year-old retired individual diagnosed with type 2 diabetes. The report begins by defining health and health promotion, emphasizing their significance in healthcare. It explores the impact of Jing's lifestyle, including lack of exercise and poor diet, on his health, supported by evidence from the literature linking obesity and type 2 diabetes. The report then assesses Jing's health needs, identifying the most applicable level of health promotion as tertiary prevention. It outlines SMART goals and objectives for Jing's case, followed by a discussion of various health promotion approaches, including medical, behavior change, and educational approaches, with a focus on the behavior change and educational approaches. The report further examines the application of health promotion models, such as the Health Action Model and the Health Belief Model, to promote behavioral change and provides examples of activities and interventions, such as counseling and educational sessions. The report also addresses potential barriers to behavior change and highlights the importance of considering individual personality traits. The report concludes by emphasizing the role of community support and societal change in promoting health, and by suggesting additional resources, such as websites and community programs, to support Jing's health journey.

Running Head: HEALTH PROMOTION 0
Health promotion
JUNE 19, 2018
Hewlett-Packard

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INTRODUCTION
The assignment states about thecase study discussing the health condition of Jing, the issues
of Type 2 diabetes and the efforts of his wife towards resolving them. It states the
importance of health and health promotion and in Healthcare. Health can be defined as the
condition of being sound in the mind, body, and spirit. Healthpromotion which is very
relevant today explains theapproach that includes health education enabling people to change
and exercise control over external influences (World Health Organization 2018). It includes
the interventions at personal, social, organisational and political levels. The significance of
health promotion in health care centres contributes to their success. As it provides knowledge
and information to various individuals and communities to inculcate healthy behaviours and
acts as a combination of learning experiences, ensures equity within the health care. The
health sector includes the Department of health and The Hong Kong authority annual plan
from the last three years (Hospital Authority, 2018). They address the situation by
implementing the strategic and annual plans intended to improve the state of partnership with
the clients, customers and the community and government.
The plan focuses on the betterment of the people helping them stay healthy through the
employment of committed staff, professional services and teamwork. The authority strives to
initiate the action plans such as Patient Partnership in Action Programme (PPIA) to enhance
awareness of the HA. Another set up was the initiation of the Patient-centred care committee
formed in the year 2011, to improve the communication between the patients and their senior
managers. In this assignment, several areas will be discussed based on the scenario of the
case study. Needs assessment,different approaches, levels to health promotion and the models
areapplicable to the case (Royal College of Nursing 2016).

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The case study represents the physical state of a 68 -year- old retired person Jing, with type-2
diabetes, who lacks physical exercise and is overweight. His inactive attitude towards his
illness as he spends his day sitting at home watching television. Moreover, His wife helped
him to take care of his health and focus towards physical exercises (NIH 2018).
Evidence base
The influence diet and physical health have on an individual is complex and differs from
person to person. The study mentioned the link between obesity and HED diet. This relates to
the case scenario to be discussed in this assignment as the man lack initiative in exercising,
eating his favourite food most of the time. Also, it has been supported by various researches
that obesity is correlated with health issues like Type 2 diabetes as represented in the case
Jing had the same issue. As excessive weight gain leads numerous health issues such as heart
diseases, strokes, cancer, and diabetes if not treated well on time. If the person does not
changes his health behaviour, or poor dieting, up to a longer time, he/she tends to develop
diseases or health issues because healthy diet or healthy eating includes intake of sufficient
nutrients required to maintain health, or to gain energy (Ferrannini and DeFronzo, 2015).
Hence, good health emphasizes eight aspects of the wellbeing of a spiritual and physical.
Accordingly, the patient Jing can take steps towards improving the state of his wellbeing by
adopting healthy behaviour and by controlling over his poor diet. Also, Regular exercises
prevent one from chronic diseases and keep the body healthy.

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Needs assessment and levels of health promotion work
Health needs assessment of the individual represented in the case is essential. The
requirements of the Jing can be fulfilled by maximising his health potential and minimising
the health inequalities. The Need assessment includes the normative need, felt, expressed and
comparative needs. Normative needs are those, which are defined by professionals, and they
arise when a particular individual or group fails to fit in with the established norms and
standards. Felt needs to refer to what people actually want and how they feel about anything.
The other kind of need, which is called expressed needs identifies the demands of the people
arises when people converts want into actions. The last type of need is the comparative need
which describes the presence of two groups with same characteristics. Analysing all needs, a
normative need is only applicable in the case as with the person having type II diabetes doing
regular 60minutes exercise may improve the insulin sensitivity and helps in decreasing the
raised blood glucose level to the normal level. Therefore, Jing is advised to exercise
regularly, instead of eating unhealthy food.
After the need assessment is done, health promotion levels should be determined. Three
levels of health promotion are primary prevention focusing on prevention of illness, directed
to the healthy individuals whereas secondary aims to help people dealing with their current
problems or issues, tertiary focussing on the management of existing skills to improve the
health of the individual. Accordingly, the tertiary level of health promotion is applicable with
the case of Jing (Edelman, Mandle, and Kudzma, 2017).
Smart aim and smart objectives
SMART aim and objectives can be used for the case of Jing. The aim of this research for Jing
is to increase awareness of Jing about his excessive weight gain. Another Aim can be
introducing a Health Promotion Programme on ‘Quitting Smoke’ to help people know the

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harmful effects of smoking on health. The possible objectives to this case can be, first making
sure that the Jing attend more health promotion programme and health education activities
which will make him aware about the healthy habits; also by reducing the intake of food
which lacks nutrition would help him maintaining the weight within body mass index (Issel
and Wells, 2017).
Approaches
Five approaches to health promotion are the Medical approach, behaviour change approach,
educational, client- centred approach and societal change approach (Lewis, 2015). Medical or
preventive approach refers to the approach focussing on the medical intervention for the
prevention of ill health and premature death which means freedom from diseases (RHI Hub,
2018). Next, behaviour change approach aims to encourage people to adopt healthy eating
habits and behaviour towards maintaining good health. It is one of the popular approaches as
it mainly emphasizes towards enhancing the health of the individual. The objective behind
the educational approach is to provide knowledge and information about health-related
factors so that people can easily develop skills for the improvement of their choices such as
educating diabetic person specifically about healthy behaviour and importance of exercising
(Glanz, 2015). It can be done through teaching or with the help of mass media. Client centred
approach insists on facilitating client's to identify their problems or concerns and understand
their needs thereby take decisions accordingly. Lastly, the societal change approach tends to
recognise the importance of socio-economic environment on the health of being(Constand et.
al., 2014). There can be certain limitations also to this such as it is long-term in nature and
difficult to measure and people may not have necessary skills to change.
According to the case scenario given, the approaches applicable are behaviour change and
educational approach as behaviour change approach will make Jing understand the impact of
avoiding exercise on his health thus, enabling him to change his attitude towards maintaining

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good health. Also, the educational approach will create awareness and provide him necessary
information to make informed choices about his health problems, as it directs the behaviour
of the person towards improving health. For these health promoters can teach necessary skills
for the change is to be carefully used.
Activities and models to be applied in the case
In order to apply the above -mentioned approaches to health promotion, it requires health
promotion model, as they alone cannot promote behavioural change. Health action model is
used in this case. It depicts the health promotion processes in such a way so that they can be
implemented by the community members to achieve their actions (Sallis, Owen and Fisher,
2015). The Health action model is complex to use, but it carefully analyses the factors or
influences which acts asa hindrance for the behavioural change. Using this model, the
community tends to become responsible for their activities and their outcomes. There are two
characteristics of the model which are to be given importance are as follows- First feature is
the intention of the individual to focus and promote the behavioural change and secondly,
converting that mere intention into actions so that change may take place. And besides the
model, there has been an emphasis on the belief, and normative system. Since these factors
influence or affect the choices made by the people and describe whether the people identified
their problems well, translated into actions and the belief system tells us the way how well
the information provided was received and understood by the receiver. Also, motivation
system states whether a change in diet for the Jing, by his wife makes him happier. That
means it seeks their motivation for anything they perceive. Therefore in the model applied in
the above case, belief system and motivation system are interrelated. The way in which one
understands the information will affect their belief system which indirectly depends on their
motivation level.

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Other than the systems, models approaches and activities applied the personality of each
individual also affects their results. The Personality of an individual impacts him or her in
every way and includes factors such as self-concept and self-sentiment. It means a person
with high self-esteem tends to be more motivated towards making a change in their lives. For
example, If Jing has high self- esteem, then the internal will or force to stop smoking or
maintaining a healthy weight by exercising and taking a proper diet would be higher (Health
Promotion Board, 2018).
With the application of these approaches or activities to bring change, there are certain
obstacles or barriers towards it. The barriers could be any such as physical, cultural, and
socioeconomic.The activities for the case of Jing, to be applied for the improving the
situation aims at changing the behaviour and attitude by the formation of self-help groups,
teaching, group work, skills, giving advice. These act as guiding principles as a cure for the
patient with type 2 diabetes (Chatterjee, Khuntis, and Davies, 2017). Other than the Health
action model, another model can also be applied that is ‘Health belief model’ which guides
the health promotion programmes, also predict the changes made in the health behaviours of
a particular individual. It is one of the widely used models. The key elements of this model
stress on the study of individual beliefs on health conditions and their improvement (RHI
Hub, 2018). The above analysis of the information on the health of Jing, certain health
promotion activities are possibly applicable. And particularly, for the behaviour approach
applied, Jing could be provided with several counselling sessions or teaching. This would
further help him develop an understanding of these sessions for the betterment of his health
condition. Moreover, the educational approach also plays a major role in the improvement.
So, Jing can access the websites which provide detailed information about improving health,
getting a cure for his disease. Not, only this he can get easy tips or remedy for the healthy
eating. Therefore, it all contributes to gaining proper information or knowledge. In addition,
talking to people in the community would be beneficial as it will help in generating

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awareness about the negative effects of excessive weight gain and lack of exercising on his
health (Azcentral, 2018). The advantages of societal change approach can also be used
although not applied in this case. But advertising campaigns such as television ads or the
media will also help in creating a general awareness about healthy eating and being healthy
both mentally and physically (Getting Revising, 2018). Since the message will be conveyed
in the case to the wife of Jing, through which she can easily make changes in his diet.
Ethical issues
In health promotion, there are certainly ethical issues which should also be considered. Ethics
defines the study of morals, values and beliefs (Neese, 2017). These ethical principles guide
us in the decision making in the health promotion. Four principles of ethics are Autonomy,
non-maleficence, beneficence, and justice which can be further described as follows.
Autonomy - The term autonomy refers to the freedom to choose freely what behaviour or
lifestyle an individual actually want, therefore they are responsible for their decisions. Non-
maleficence means doing no harm, therefore promoters or physicians should not provide
ineffective treatment because these lead to risks with no benefit which means harming the
patient. Beneficence is defined as balancing the benefit of the intervention against any risks
whereas justice involves equality, fair and equal distribution of risks, benefits and the costs
(Holmes, 2016). According to the case of Jing, the possible ethical issue applicable is
autonomy as he can change his poor eating habits, and lifestyle on his own. But, being
manipulative towards him so that he can easily understand the effectiveness of maintaining
good health.
Evaluation
The successfulness and effectiveness of the activities could be evaluated by different
methods. Evaluation is considered as the last part of the health promotion program which

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helps in assessing what are the requirements and the value of policy, programs and projects.
Therefore, evaluation is the process which brings out the information how the health
promotion programme has been accomplished and whether the health promotion plan meets
out the standards defined at the initial stage (Green et. al., 2015). For prevention of disease, it
acts in a way to resolving the problems, analysing the availability of the resources and
forming the evaluation questionnaire on the basis of data collected and gathered, and
interpreting the results thereon (Windsor, 2015). The outcome can be measured by the use of
interviewing Jing’s wife and observing his behaviour. There are evaluations on the basis of
interventions done that means impact and outcome evaluation (Grembowski, 2015). Impact
evaluation can be defined as an effect which is observed after several interventions have been
done, which means it tells us whether the behaviour of the patients has been changed or not
whereas outcome evaluation emphasizes on one major change only after an intervention
(Toolkits, 2018). To gain an understanding of Jing’s perspective about exercising and healthy
eating, the common measure in the outcome evaluation is questionnaires which can be used.
Thus, this case involves the use of pre-questionnaire and post questionnaire. The use of
questionnaire will help in evaluating the daily consumption of his meals, dietary habit, and
time given to exercising and the physical activity or lifestyle. The use of more close-ended
questions because people need to choose the answer among all the given options which is
relatively easy and takes less time. On the contrary, acquiring in-depth information by the
questions is always not beneficial as they could also lead to misinterpretations and bring false
results. Therefore, it can be understood that the questionnaires prove to solve problems of the
patient, in assessing his behaviour after giving him proper education or knowledge about
health more than just taking interviews. These all are the footsteps towards initiating a change
in the minds of the people having a certain issue to change their behaviour (Salazar, Crosby,
and Diclemente, 2015).

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Conclusion
To conclude the above discussion, it can be analysed that according to the case study which
highlights about a 68 -year- old Jing being diabetic should focus on improving his health
condition. But, he avoided healthy eating and lacks exercising to maintain his health.
Therefore, the certain application of the models, activities and approaches to health
promotion are used. Also, Approaches such as educational, or behavioural contributed a lot
towards resolving the issue. Creating awareness was another solution, which had a significant
impact on improving his health. Since health depicts the physical and mental wellbeing.
Health promotion began with identification or analysis of needs which individual faces in the
different stages of life and then measuring the level of health promotion. The most significant
change towards fostering the health promotion activities can be the individual's behaviour
towards oneself, self-esteem and the personality. These changes can be further initiated or
implemented by implication of models such as health belief model or health action model.
And these models are then implemented by setting up certain SMART aim and objectives,
with respect to the case, can be applied with a proper and systematic manner to obtain
positive results.

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