University Essay: Community Health and Disease Prevention of T2DM

This essay delves into the critical aspects of community health and disease prevention concerning Type 2 Diabetes Mellitus (T2DM). It begins by outlining the prevalence of T2DM in Australia, highlighting modifiable and non-modifiable risk factors. The essay emphasizes the importance of community-based education, interactive sessions, and targeted awareness campaigns, particularly for Aboriginal populations, in line with Laverack's ladder of community-based interaction. It then explores capacity building within communities, identifying key domains like learning opportunities, resource mobilization, and leadership, essential for empowering communities to manage and prevent T2DM. The Health Belief Model is utilized to examine individual perceptions and behaviors regarding T2DM, providing a framework for motivating and educating communities. The paper also discusses the importance of community empowerment and ownership, and the use of various communication tools to enhance community engagement. The essay provides a comprehensive overview of effective strategies for T2DM prevention and management, highlighting the need for a multi-faceted approach that addresses both individual behaviors and community-level factors.

Running head: TYPE 2 DIABETES MELLITUS
Community Health and Disease Prevention: Type 2 Diabetes Mellitus
Name of the Student
Name of the University
Author Note

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TYPE 2 DIABETES MELLITUS
Introduction
According to the National Health Survey Done by the Australian Department of
Health (2016), about 85% of the people who are diagnosed with diabetes in Australia have
type 2 diabetes mellitus (T2DM) it is as estimated population of 1,002, 000 people. T2DM is
over represented among the aboriginals and Torres Strait Islanders persons. T2DM is over
represented among the aboriginals and Torres Strait Islanders persons (Australian
Government Department of Health, 2016). The following essay is based important steps that
must be taken under consideration in order to develop community health and disease
prevention in T2DM.
Part 1
T2DM is associated with both modifiable and non-modifiable risk factors. The major
risk factors that are associated with the development of T2DM that cannot be modified
include age, genetic predisposition, ethnicity and family history (Australian Government
Department of Health, 2016). However, T2DM is also with certain modifiable risk factor
behind its development and this includes obesity, sedentary life style, lack of proper
nutritional diet, poor knowledge about the health life style and lack of physical activity
(American Diabetes Association, 2015). Thus Zoungas et al. (2014) have rightly opined that
T2DM is preventable via proper amalgamation of lifestyle and pharmacological interventions
along with community based education in disease unawareness and frequent check up of
glycemic level in blood.
According to Blackberry et al. (2013), community based engagement is an effective
ways to increase the disease awareness. This kind of initiatives help to reduce the modifiable
risk factors associated with the disease development. This assist in reducing the probability of

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disease occurrence on a selected community and this kind of approach works best with
T2DM which is now regarded as a lifestyle disease. The Laverack’s ladder of community-
based interaction, is based on 8 different steps which ultimately help the communities to
move forward towards organizational and social interactions by taking informed steps to
address broader determinants of health (Arnstein, 2015).
Figure: Laverack’s ladder of Community-based Interaction
(Source: Arnstein, 2015)

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The three main steps that will be used engage with a community in order to
implement Type 2 Diabetes prevention program include:
i. Community Based Education
ii. Interactive community based session
iii. Special awareness campaign for aboriginals
Three Steps Chosen Relation with the Laverack’s ladder of community-based
interaction
1. Community Based Education
This will be done via practising active
communication skills from the health
care providers and the nursing
professionals who are the members of
the disease prevention campaigns
(Nutbeam, 2000)
Community Readiness
According to Powers et al. (2015) community, based
education not only helps to increase the disease awareness
but also increase the scope of self-management interventions
for diabetes management. This increase in awareness about
the disease along with education in self-management of the
disease increase the sense of community preparedness to
indulge into a series of stages and partnership with a third
party towards successful disease prevention program
2. Interactive Community Based
Session
Community Participation
Interactive communities about the type 2 diabetes will help
the community to actively indulge into common needs via
sharing of their own ideas and experiences in type 2 diabetes
disease progression (Wates, 2014).
Community Engagement
Interactions among the survivors of the type 2 diabetes will
help the community members to identify problem-solving
solutions to issues that are affecting their life (Wates, 2014).

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Community Organization
Community based interaction creates a sense of attachment
which will help to engage the community towards type 2
diabetes prevention program via mobilizing themselves
towards shared goals (Wates, 2014).
3. Special Awareness campaign for
aboriginals
The importance behind this strategy
extracts its relevance from the reports
published by Abouzeid et al. (2013)
which states that type 2 diabetes
prevalence differs across the socio-
economic status within and between
the aboriginals. Thus in order to
increase the community engagement
of the aboriginals, who scores high in
rate of type 2 diabetes occurrence in
Australia, special awareness program
is mandate. This awareness campaign
will be designed with complementary
meals and special incentives in order
to increase the level of participation
(Panaretto et al., 2013)
Community Development
This strategy will help the Aboriginals will be more
spontaneous to participate in process (disease prevention
program) which will help them to improve their quality of
life (Arnstein, 2015)
Community Action
The designed strategy will increase a sense of ownership, the
aboriginals will not feel left out from the main Australian
aboriginals as they now have process disease education and
will help in community development among the aboriginals
and thereby helping them to take active participation in
disease prevention program (Arnstein, 2015).
Community Empowerment
The designed strategy will help to gain a control over their
decision making process and thereby helping them to
spontaneously decision to participate in the disease
prevention program (Arnstein, 2015)

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Figure: The layout of the overall community engagement strategy
Source: Created by author
Part 2
According to Liberato et al. (2011), capacity building process in a community based
interventions is paramounts in creating disease awareness and prevention. The review of
literature conducted by Liberato et al. (2011) led to the identification of different domains
which will help in comprehensive capacity building process towards community development
in health and social care improvement. These 9 main domains include “learning opportunities
and skills development”, “resource mobilization”, “partnership/linkages/networking”,
“leadership”, “participatory decision making”, “assets-based approach”, “sense of
community”, “communication”, and “development pathway” (Liberato et al., 2011).
Community empowerment and ownership is a process via which communities gain
control over the decision and resources that has direct impact on their day-today loves and
this also includes social determinants of health. The main difference between the community

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empowerment and other community based practise is the sense of prolong struggle that is
associated with the process of gaining power (Kuo & Feng, 2013). It is different from the
concept of capacity building which deals with establishment of assets of the communities that
can be used towards erecting successful community based disease prevention campaign (Kuo
& Feng, 2013).
Learning opportunities will mainly deal with education about the prognosis of type 2
diabetes mellitus and importance of good lifestyle habits towards prevention of type 2
diabetes. Skill development will encompass lifestyle modification skills like preparation of
healthy diabetes diet and daily exercise planner to fight against obesity, the main cause
behind type 2 diabetes (Grarup et al., 2014). Resource mobilization deals with comprehensive
set of activities which are used in securing additional and resources to the development of
community based approach in health care programs (Ferlie et al., 2015). This resource
mobilization will help in scanning new opportunities to explore in Type 2 Diabetes
prevention program. It will also help in risk analysis in the program and proposal for the start
up budget. Zorn, Grant & Henderson (2013) are of the opinion that development of social
media competencies for strengthening resource mobilization is helpful in achieving
community based intervention strategies in disease prevention. Partnership/ linkages/
networking will help in establishing proper synchronization with the stakeholders of the
community health and disease prevention campaign in Type 2 diabetes. This active
synchronization will in turn help in framing stringent disease awareness and disease
educational program at the community level and thereby helping to generate community
empowerment and ownership among the residents of the community (Rakodi, 2014).
Leadership is one of the main aspects behind the community empowerment (Martiskainen,
2017). Selection of the leaders will be done among the community participants and the
selected community leaders will aid in the process of voicing the expectations, learning and

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networking which are core steps in niche building. Selection of leaders within the community
will help to generate a sense of ownership. This approach is particularly helpful among the
aboriginals as it will help them to generate a sense of empowerment under a culturally
competent atmosphere (Martiskainen, 2017). Participation of the end users or the target group
of the disease prevention program in the decision making process promotes empowerment
(Nikkhah & Redzuan, 2009). The participation in the decision making process will involve
the kind of physical exercise or the diet plan they are preferring towards dealing with the
modifiable risk factors in type 2 diabetes mellitus. The decision will also involve the period
gap behind glycemic check and funding behind the use of pharmacological interventions,
which will be used in association with the lifestyle modification. However, the participation
in the decision-making process will only be undertaken after effective completion of the
disease education. Assets based approach is concerned with unison of people and
communities in order to achieve positive change in disease prevention via using their own
skills, knowledge and lived experience, which they encountered during their own lives. This
incorporation of lived experience will be done via sharing of views in the interactive
community based session. This will help to generate a sense of community, which will again
promote community empowerment. Initial level of communication to generate disease
awareness in the communities will incorporate tools like local newspaper, newsletter, local
radio station, internet and social media platforms local events. This will attract community
members. The content of communication will also include the topics like what government is
doing for their community (with a special mention to aboriginals). As the communities come
to know about the programs framed exclusively for them by the government, as sense of
empowerment will grow leading to active community participation (Schulz & Nakamoto,
2013). Development of pathways will mainly cover who community participants will be
trained in order to lead a group of people towards successful diseas prevention. This will help

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to grow capacity in the community as the the development of community champions is
important. Selected champions will be well respected and invested in disease prevention
program and will be consulted throughout the change process. This will help to improve a
sense of belonging and thereby helping to increase community engagement (Pfefferbaum et
al., 2013).
Part 3
The Health Belief Model will be used to motivate and educate community towards
prevention of Type 2 Diabetes. Health Belief Model is a social cognition model that focuses
on understanding the perception of individuals about the reality rather than how to respond to
any particular situation (Abraham et al. 2008) this model is based on te concept six major
belief which shape up the individuals health-related behaviour and this six beliefs include
perceived susceptibility, perceived seriousness, perceived benefits, perceived barriers, cues to
action and health motivation (Green & Murphy 2014).
Conceptual framework of Health Belief Model
(Source: Green & Murphy 2014)

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Concept Definition
Perceived Susceptibility Personalized opinion about getting effected with
the disease
Perceived Severity Individualized opinion about the seriousness of
the disease
Perceived benefits One’s own belief about how taking actions will
help to decrease the susceptibility and severity
Perceived barriers Beliefs that are creating barriers in disease
prevention like financial
Cue to action Strategies of “readiness”. For example: treating
or addressing people who was initially though out
of the scope of disease development
Health motivation Motivating people towards healthy lifestyle
Figure: Healthy Belief Model
(Source: Gottwald & Goodman-Brown, 2012)

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Figure: Healthy Belief Model
(Source: Gottwald & Goodman-Brown, 2012)
The main advantage of this model is it helps in the understanding that people's health
choices are dependent not only on rational thought but also on their emotions, habits, social
conditioning and personal preference. This help in the elucidation of the effective social
teaching method to healthy habits planning. For instance in case of aboriginals development
of type 2 diabetes mellitus is not only related to their lack of knowledge about disease
prognosis but their typical unhealthy eating habits and unhealthy lifestyle also cast significant
effect on disease development. Lack of job opportunities among the aboriginals in Australia
creates a sense of depression and sedentary lifestyle which again promotes type 2 diabetes
mellitus (Markwick et al., 2014).

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One of the limitations of the model is, health-risk behaviours do not provide adequate
reference in understanding the social, environment and personal factors that influence health
condition. For instance, belief might influence a person’s decision to feed on deserts or sweet
dishes however, it does not provide direct evidence towards development of type 2 diabetes.
Moreover, it does not include self-efficacy which is defined as confidence in one’s personal
ability to take health actions which was later included in “extended health belief model”
(Markwick et al., 2014).
Conclusion
Thus from the above discussion it can be concluded that Proper community
participation, community engagement and application of health promotion model is important
is generating successful community based disease prevention program target towards T2DM.
Effective community participation and community engagement can be done via the
application of Laverack's community interaction ladder and domains of capacity building
identiifed by Liberato et al. (2011). Moreover, while applying health belief model effective
back plans must be nurtured in order to address "cues to action".