Introduction
The social epidemiology of type 2 diabetes shows that several daily habits across society contribute to its development or regression. Such practices are subjective or individual, but classification can be made among various racial groups, which are dictated by the culture and customs of the representatives. This study aims to identify these habits and differentiate them by behavior and racial groups with the further goal of their mass prevention and, as a result, a decrease in the incidence of diabetes in Las Vegas, Nevada. It is planned to achieve this result by educating patients at risk, supplying them with equipment to monitor the necessary health indicators, and increasing awareness of methods for preventing and combating its possible development. The project’s innovativeness lies in the context of racial groups and taking into account their behavioral habits, a more differentiated approach is applied to the study. The methodology includes a pre-test and a post-test to assess knowledge and apply it to prevent type 2 diabetes, monitor health outcomes, and statistically interpret the findings for further use by stakeholders.
Specific Aims
The long-term goals of this project are to raise awareness among various racial groups in the region about good preventive habits that prevent the development of type 2 diabetes. As a result, this knowledge will contribute to a large-scale reduction in the incidence in this region. To achieve these goals, it was hypothesized that patient education contributes to an increase in preventive knowledge and behavioral habits, reducing the likelihood of developing type 2 diabetes. If the hypothesis is refuted, then this detailed study will be able to show the reasons for the failure, which can be taken into account in further studies.
The overall impact of the research will be both scientific and practical. Medical professionals will be able to take into account the identified habits and knowledge characteristic of certain racial groups, and scientists will be able to use the information in more in-depth studies of specific aspects. Patients, representing one of the main stakeholders, are primarily aimed at a positive result. Reducing the risk of morbidity in an individual case will be accompanied by important critical information for each participant, reflecting precisely the subjective aspects that contribute to or hinder the disease. At a minimum, this program will help 150 participants in the experiment to fight the disease, and at the maximum, it will achieve the most important discoveries that reduce the incidence in practice globally.
Research Strategy
Significance
This grant has the form R21 – exploratory developmental grant. This fact means that research in this area will aim to develop solutions to the existing problem by searching for new information that can be obtained in practice (Marquez, n.d.). First of all, the importance of the problem is explained by the high incidence and further mortality from type 2 diabetes globally (Barron et al., 2020). In addition, many patients are forced to fight the disease for a very long time, which accordingly affects their personal life, mental health, career success, and much more, and this effect is usually harmful or destructive. In this context, there have been no similar studies that differentiate between behavioral and racial aspects in the context of dealing with type 2 diabetes.
At the moment, the medical practice of preventing type 2 diabetes is reduced to diets and the presence of constant physical activity. To this knowledge, this study aims to add the method of monitoring the leading indicators of health: blood glucose and weight, as well as a more comprehensive description of beneficial behavioral habits, differentiating them by racial groups. Preventive measures are also applied in the treatment, where drug intervention is added. To reduce the insulin resistance of cells, the absorption of glucose in the gastrointestinal tract and its production in the liver, the use of biguanides and thiazolidinediones are allowed. If these drugs are not enough, drugs that enhance insulin activity are prescribed (Artasensi et al., 2020). The problem is confirmed by the increase in the incidence worldwide; the scientific literature shows stagnation in progressive solutions to this problem (Jin & Liu, 2021). The holistic approach of this study aims to expand traditional treatment and prevention practices to improve health education and personalized treatment practices further.
Innovation
The innovative aspect of this study lies in the integration into the critical determinants of the incidence of race, behavior, and the identification of cultural characteristics that differentiate groups. Considering the developing trends in the policy of inclusiveness, this knowledge can help medical professionals in the direct operational fight against type 2 diabetes and establish emotional and mental contact with the patient. Accordingly, according to the study results, intervention tools and preventive measures can be adjusted, which will now be differentiated by racial groups, showing varying degrees of effectiveness of the full range of techniques.
Approach
There are no fundamentally new solutions in the approach; the classical method of pre-test and post-test is used, statistical evaluation of results and monitoring of health indicators of 150 participants in the experiment, the sample consists of representatives of Afro-Americans, Hispanic and Native Americans between the ages of 18-40 in Las Vegas, N.V. To achieve the goals of the project, methods of individual assessment of each of the participants using tests will be used and official secondary incidence statistics will be monitored in the given region: city and state. An integrated approach will make it possible to identify the leading behavioral and social aspects that affect the risks of the disease and neutral factors that do not affect the course and prevention. The integration of such habits and knowledge into the daily lives of study participants will also be assessed through tests. All indicators are measurable, which simplifies their further statistical evaluation, which can be presented in the form of readable results.
Data will be collected through questionnaires; all responses will be recorded and stored. Potential difficulties can arise in two cases, the first involving the unreliability or error of data control systems. Participants will monitor their blood glucose using personal glucometers that they will receive as part of the experiment. If the instrument fails or transmits unreliable data, additional evaluation on another device will be required. Such problems will be solved on an individual basis. A potential error can be seen in the discrepancy between the dynamics of bad or good habits and, accordingly, monitoring indicators. They will be monitored in person, if possible, or by video link via Zoom or similar software. In parallel, the dynamics of morbidity in the region will be recorded. As a result, after evaluating the data received from the participants in the experiments, a particular time after the completion of the investigation, the incidence will be recorded for future evaluations. All quantitative data will be interpreted in the context of achieving or not achieving the goals set initially.
Conclusion
Since the study is associated with racial differentiation, it is essential to emphasize the ethical side of the issue. First of all, the program is aimed at the overall welfare of the region, regardless of the personal qualities of each person. Moreover, differentiation, in this case, is used solely to reduce the incidence and mortality from this type 2 diabetes disease. The choice of racial groups is due to an attempt to find progress in the close direction of medicine. Due to these factors, and social issues that may arise for caregivers and patients, this position should be voiced by the program team to avoid potential conflicts.
So far, the study’s social determinants are limited to three racial groups: Afro-Americans, Hispanic and Native Americans. This study may be extrapolated to representatives of other groups with positive results obtained in the end. Only if a correlation is found between behavioral and social determinants and the level of awareness of people and disease in the region should consideration be given to the remote application of this approach in the other areas and other racial groups. Implementing the results obtained in practice can be complicated by the purely theoretical basis for preparing tests and the poor assessment of a narrow range of health indicators. However, more severe funding is required for more extensive studies, which is much more difficult to obtain without success in the early stages of testing the method.
References
Artasensi, A., Pedretti, A., Vistoli, G., & Fumagalli, L. (2020). Type 2 diabetes mellitus: a review of multi-target drugs. Molecules, 25(8), 1987.
Barron, E., Bakhai, C., Kar, P., Weaver, A., Bradley, D., Ismail, H.,… & Valabhji, J. (2020). Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole-population study. The Lancet Diabetes & Endocrinology, 8(10), 813-822.
Jin, Z. L., & Liu, W. (2021). Progress in treatment of type 2 diabetes by bariatric surgery. World Journal of Diabetes, 12(8), 1187.
Marquez, E. (n.d.). Social Epidemiology EOH 705. Applying Social Epi Research. Web.