Introduction
During the last several decades, diabetes has remained a serious racially-based health problem in the United States. In addition to disproportionately affecting Blacks (11.7%), American Indians (14.7%), and Hispanics (12.5%), a higher burden of complications (11.7% of blindness and 37% of chronic kidney diseases) is commonly reported (Haw et al., 2021). Many profit and non-profit organizations continue paying attention to educating people and providing the best guidelines for preventing and managing the disease. However, not many nurses are properly educated about cooperating with representatives of different races. Healthcare providers usually use similar recommendations for all diabetic patients and diminish the role of racial factors. This policy brief focuses on the eco-social perspective of type 2 diabetes, addressing race and health behaviors. It is not enough to improve public awareness of the chosen disease but ensure that nurses are ready to work with racial minorities and specify their health and genetic characteristics. To help diabetic patients control weight loss, well-trained nurses need to promote education on healthy diets and physical activities.
The Rationale for the Action of the Problem
Diabetic patients address emergency departments with different complaints, including eye problems, kidney function failures, and cardiovascular complications. Compared to non-Hispanic Whites (7.5%), the number of cases affecting racial minorities is between 30 and 40% (Haw et al., 2021). The findings by Marcondes et al. (2021) reveal that Hispanics who have been recently diagnosed with diabetes do not gain access to guideline-directed preventive care the same way Whites do. Besides, Cheng et al. (2019) share their predictions that the number of American citizens diagnosed with diabetes could increase to 38% by 2060. It means that not all current interventions work effectively at the moment, and some improvements could be needed with time. Blacks and Native Americans can be negatively affected by knowledge gaps and poor skill management. Thus, the rationale for action is based on the necessity to predict diabetes-related complications in racial minorities by properly educating individuals and specifying the importance of healthy diets and physical activities.
Current policy failures may be related to poor awareness of nurses about how to implement their teaching skills and cooperate with racial minorities. Interactions between nurses and diabetic patients include identifying and evaluating their “soft” needs like motivation, interests, and beliefs and applying technological advancement in everyday practices (Jain et al., 2020). Black and Hispanic patients need to exercise regularly and maintain healthy diets to reduce the risks of diabetes or its complications. Nurses, in their turn, should know what environmental, physiological, and emotional details matter and organize their training sessions with available written and oral materials. Policy failures have already affected racial minorities by increasing diabetes cases and comorbidities and a low level of knowledge about healthy lifestyles in relation to diabetic risks.
Proposed Policy Option
At this moment, the main idea of the policy is to prepare nurses to cooperate with racial minorities and help them understand how to manage diabetes regarding current conditions. An educational intervention for local citizens focuses on the population’s awareness of diabetes, appropriate lifestyle changes, and the promotion of healthy diets and physical activities. The options include well-trained personnel, printed guidelines, informative flyers, books, and A1C test kits for all participants. This approach allows following clear principles for monitoring blood sugar levels, learning the main facts about diabetes, and following standard guidelines.
The evaluation of the policy is integral in this analysis because it shows what results are expected and what goals were achieved with the implementation of the intervention. In this case, the level of knowledge about diabetes among racial minorities matters. First, it is necessary to determine what participants might know about the issue before the intervention and pose several questions about diabetes symptoms, risk factors, preventive interventions, and outcomes. After participants are educated, the same examination is developed to compare the answers and find if there are any differences and positive or negative shifts. With time, the offered program should contribute to the possibility of preventing diabetes and the distribution of healthy lifestyles and diets in racial minorities.
Today, people have access to various options to treat and prevent diabetes. Despite being aware of the worth of education and knowledge, not many organizations develop special programs to support ordinary citizens and offer them credible information. Self-management education is observed mostly in patients who have already been diagnosed with diabetes and have nothing to do but prevent the growth of complications (Jain et al., 2020). Besides, the level of education of Blacks and Native Americans is usually lower than Whites (Cheng et al., 2019). Finally, lack of insurance and racial disparities result in the inability of Hispanics to obtain full guideline-directed care compared to Whites (Marcondes et al., 2021). These arguments serve as a solid background to help racial minorities examine the situation and learn why diabetes is a current threat to them.
Policy Recommendations
Population education cannot be ignored in today’s world, where people get access to various sources of information and make their decisions based on the material they find online. However, data quality is not always approved or checked, and individuals may follow poor or inappropriate recommendations, neglecting their genetic factors and personal health characteristics. The advantage of the offered policy is to educate a particular group of people, racial minorities, about a particular disease, diabetes.
The stakeholders who need to educate people must take the courses and understand how influential their guidelines can be in particular groups. The first step to strengthening the policy is pre-intervention training for educators to identify disparities in those diagnosed or predisposed to diabetes (Marcondes et al., 2021). It is not appropriate for an unprepared healthcare provider to cooperate with racial minorities and teach them how to prevent or manage diabetes. The second activity is recognizing what help is more effective for diabetic patients. Jain et al. (2020) underline the perspectives of technology-assisted self-management education. Hemoglobin A1C tests and cholesterol screening are recommended to identify the prediabetic condition (Haw et al., 2021). Free distribution of personal kits for monitoring vital signs is critical for this policy. When participants see that they can actually do something to check their health and understand a threat, they are more interested in improving their knowledge and following recommendations.
Conclusion
Eco-social perspectives in predicting and treating diabetes introduce a relatively new trend. Although diabetes has already been proven more common among African Americans, Hispanics, and other racial minorities than among Whites, not many real steps are taken to support the groups at risk. The main idea of the current policy is to show that healthcare providers know how to support Blacks, Hispanics, and Native Americans and educate them about diabetes and the importance of healthy diets and lifestyles. Population knowledge cannot be ignored but strengthened by any possible means, and this educational program is a unique opportunity for racial minorities to understand what diabetes is and how they can avoid its complications.
References
Cheng, Y. J., Kanaya, A. M., Araneta, M. R. G., Saydah, S. H., Kahn, H. S., Gregg, E. W., Fujimoto, W. Y., & Imperatore, G. (2019). Prevalence of diabetes by race and ethnicity in the United States, 2011-2016. JAMA, 322(24), 2389-2398.
Haw, J. S., Shah, M., Turbow, S., Egeolu, M., & Umpierrez, G. (2021). Diabetes complications in racial and ethnic minority populations in the USA. Current Diabetes Reports, 21(1).
Jain, S.R., Sui, Y., Ng, C.H., Chen, Z.X., Goh, L.H., & Shorey, S. (2020). Patients and healthcare professionals’ perspectives towards technology-assisted diabetes self-management education. A systematic qualitative review. PLoS ONE, 15(8).
Marcondes, F. O., Cheng, D., Alegria, M., & Haas, J. S. (2021). Are racial/ethnic minorities recently diagnosed with diabetes less likely than white individuals to receive guideline-directed diabetes preventive care? BMC Health Services Research, 21(1).