Background
Obesity in children is a risk factor in the development of Type 2 diabetes (T2DM). Most studies show that the prevalence of T2DM is directly proportional to age (Adams & Lammon, 2007). As a result, there is evidence to suggest that the development of insulin resistance disorders at an early age can potentially increase the likelihood that one will develop diabetes (Adams & Lammon, 2007). Furthermore, studies note that about 15% of children aged 6-11 years and adolescents in the age of 12-19 years in the United States are obese. Additionally, more than 80% of children with T2DM are obese (Whittemore, Bak, Melkus & Grey, 2003). Therefore, there is the need for community-based health workers to initiate primary, secondary, and tertiary intervention programs to prevent, diagnose, and control risk factors in the development of T2DM. In the subsequent discussions, we will look at the best practices for planning, managing, and evaluating various intervention programs relative to interviews involving different experts in community-based health care.
Planning for intervention programs
Most of the interviews involving community/public nurses converge on the fact that the first step towards developing an effective intervention program is to set the program objectives after identifying the target population affected by the subject disease. Here, most community/public nurses note that the programs should be aimed at preventing the risk factors in populations at risk. As a result, prevention should occur at four major levels, which include the primordial, primary, secondary, and tertiary levels. At the primordial level, all the risk factors in the development of the disease are identified and strategies are developed in order to eliminate as many risk factors as possible. Conversely, the primary level entails implementing strategies, which are aimed at preventing the disease amid the prevalence of various risk factors. Moreover, the secondary level should involve screening and diagnosing the disease at an early stage of development. Lastly, the tertiary level should culminate in controlling the disease, and preventing the development of other complications (Zeitler & Pinhas-Hamiel, 2008). Planning should also entail determining the cost and appropriate funding for the programs.
Managing the intervention programs
Evidence regarding the implementation of intervention programs shows that the process involves a multidisciplinary approach. However, the interviews seem to suggest that the community/public nurses play an imperative role in almost all aspects of the programs. Here, studies show that the community/public nurses should actively participate in program implementation in terms of recruiting and identifying the target populations, undertaking the preliminary clinical tests and evaluations, carrying out follow-ups, and making the final program evaluations. Furthermore, there is the need for nurses to observe ethical standards when implementing intervention programs, particularly in schools through becoming the negotiators, educators, and advocates of their patients (Pontius, 2010).
Evaluating the programs
Measuring the effectiveness of the intervention programs can take different dimensions. However, most community/public nurses note that before implementing the programs, the participants should be allowed to set their own goals and objectives relative to the overall program objectives. Subsequently, the nurses recommend that they should be given the opportunity to review the appropriateness of the set objectives and goals in order to help their patients in setting new goals if necessary. Furthermore, the participants should be allowed to rate the program objectives and their instructors to allow for appropriate changes if necessary (McAdams, 2010).
Conversely, the participants should be assessed on a step-by-step basis. Here, evaluation is done three months after the end of each step in order to assess the achievement of the goals and objectives. As a result, the nurses should assess the participants relative to their glycemic control, lipid control, weight control, and blood glucose levels (McAdams, 2010). Overall, there is the need for community/public nurses to review the effectiveness of the intervention programs in terms of their accessibility to the greatest percentage of the target populations, and their appropriateness in meeting the individual needs of a large proportion of the populations at risk.
Reference list
Adams, M., & Lammon, C. (2007). The presence of family history and the development of type2 diabetes mellitus risk factors in rural children. Journal of School Nursing (Allen Press Publishing Services Inc.), 23(5), 259-266.
McAdams, D. (2010). Personal interview conducted by Trinette Scott-Jennings.
Pontius, D. (2010). Personal interview conducted by Miquel Simms.
Whittemore, R., Bak, P., Melkus, G., & Grey, M. (2003). Promoting lifestyle change in the prevention and management of type 2 diabetes. Journal of the American Academy of Nurse Practitioners, 15(8), 341-349.
Zeitler, P & Pinhas-Hamel, O. (2008). Prevention and screening for type 2 diabetes in youth. Endocrine Research, 33(1-2), 73-91.