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Question
Apply what you have learned about Health Promotion and Disease Prevention, and demonstrate the ability to develop a holistic plan of care, incorporating Telehealth, defining assessment and intervention of specific population incorporating unique attributes of populations for health promotion, wellness preservation and maintenance of function across the health-illness continuum. Directions: Develop a case study and a plan of care, incorporating current mobile App technology: Select a population. Define your population by gender, age, ethnicity, socioeconomic status, spiritual need, and healthcare need .Apply concepts learned in course to identify healthcare needs needs specific to the population and access to care (Utilize your textbook Chapters 1-25, knowledge from Med-U, and identified Websites). Describe how Telehealth could impact the delivery of care to this population. Identify PICO specific to the population you chose in #1. (apply PICOT statement developed in MSN 563) Define a plan of care. Submit your assignment via the D2L Dropbox This project is to be a total of 3 pages, typed. 12 pt font, 1” margins, Times New Roman. Include an additional cover page. Include an additional Reference page. APA, 6th edition format is to be observed. Hint: Concise, condensed information, with specifics and details about population and unique needs with plan for meeting these needs is considered. Incorporate the content you have learned in this course.
Answer
The Use of a Mobile App to Enhance Diabetes Self-management in African-American Women
Case Study
Diabetes has become a significant healthcare problem in the United States in the recent past. Type 2 diabetes mellitus is the most common type of diabetes. It is an acquired health condition that is characterized by the body’s inability to regulate the level of blood glucose properly (Murty & Rudd, 2015). Statistics by the National Diabetes Statistics in 2014 indicated that diabetes is the seventh leading cause of death in the United States. The chronic condition can be developed at any age but is usually prevalent among middle-aged and older persons (Hicklin, 2018). Individuals who are at higher risk of developing type 2 diabetes are persons aged 45 years and above, are overweight or obese, and come from a family with a history of diabetes. Research has established that African-American adults are nearly twice likely to develop type 2 diabetes compared with white adults in the United States. The racial disparity has been observed to have risen over the past 30 years (Hicklin, 2018).
Lifestyle and environment are the main causes contributing to the growing prevalence of diabetes in the United States (Murty & Rudd, 2015). Lifestyle risk factors include obesity and overweight, regular intake of refined carbohydrates, and processed foods, sedentary lifestyle, excessive alcohol use, and smoking. However, it is worth noting that diabetes does not occur equally across all segments of the population in the United States. This is because the lifestyle risk factors are more prevalent in the black population compared to the white population (Murty & Rudd, 2015). For instance, an assessment of the Monroe County population revealed that 38% of blacks had obesity but was present in 27% of the whites and 30% of the African-Americans sampled did not report any physical activity for the past 30 days but only 13% of the whites reported the same. Also, 46% of blacks consumed at least sugar-sweetened beverage per day compared to 20% of the whites (Murty & Rudd, 2015). Diabetes is highly preventable and can be managed through changes in daily habits.
Population
The population targeted in the current evidence-based practice is diabetic African-American women aged 45 years and above who present to ABC hospital for routine visits. Only patients diagnosed with type 2 diabetes and undergoing self-management to control blood glucose will be considered in the current project. Eligible women across all socioeconomic status levels will be included in the evidence-based practice.
Plan of Care
The plan of care will entail the provision of patient-specific protocols to patients on the medication regimen, restrictions on the diet, and exercise through a chronic disease management mobile app. All the African-American women aged 45 years and above with type 2 diabetes who present to ABC hospital for routine follow-up visits will be included in the evidence-based practice. The intervention group will include women who have continuous access to a smartphone that can support the chronic disease management app. The mobile app will be installed on their phones when the patients present to the hospital for follow-up visits. Guidance on how to use the application will be provided in each visit until the patients can effectively manage the app on their own. In situations where the patients are not able to use the app, immediate caregivers in their homes will be sought. The comparison group will include all eligible patients who do not have continuous access to a smartphone that can support the application. The outcomes will be determined based on the blood glucose levels, lifestyles modifications, and medication adherence during follow-up visits.
Impact of Telehealth on the Delivery of Care
Diabetic patients are required to take daily medication and make adjustments to their daily activities and diets as a means of keeping their blood glucose at safe levels. An uncontrolled rise in the level of the blood glucose in a diabetic patient can result in irreversible and long-term damage to the body system, lead to serious complications, and adversely affect the patient quality of life (Shrivastava, Shrivastava, & Ramasamy, 2013). Diabetic patients are required to make regular follow-up treatment in outpatient health care centers. Self-management is pertinent in glycaemic control. Diabetes self-management entails strict adherence to the medication regimen prescribed by the health care provider, self-monitoring of the blood glucose, modification to lifestyles such as changes in diet, regular exercises, and better body weight control (Shrivastava et al., 2013).
Telehealth is handy when it comes to self-management of diabetes. Patients who do not receive proper guidance or education may experience many complications following poor self-management. This may be due to difficulties in estimation of appropriate caloric intake, incorrect perception regarding the prevention of skin ulcers, and poor adherence to medication regime and blood glucose level self-monitoring (So & Chung, 2017). Telehealth improves self-care and patient outcomes among such patients through the use of communication and information technologies. Telehealth can help primary care providers to offer preventive education or promotion as well as disease management information for individuals diagnosed with diabetes which enhances their quality of life. A better understanding of the condition facilitated through telehealth intervention can help establish a modified lifestyle and behavior among diabetic patients ((So & Chung, 2017)). Since diabetic patients are left under out-patient follow-ups, self-management and drug compliance is crucial in preventing deterioration (Shrivastava et al., 2013). Telehealth, especially mHealth, is effective in facilitating such follow-ups which, in turn, enhance medication adherence and self-management.
PICOT
The evidence-based practice will be guided by the following PICOT questions; In African-American Women with Type 2 Diabetes (P), will the implementation of a chronic disease management app in their health care (I) versus those who receive usual care (C) improve self-management of diabetes (O) for a period of one year (T)?
References
Hicklin, T. (2018). Factors contributing to higher incidence of diabetes for black Americans. Retrieved from https://www.nih.gov/news-events/nih-research-matters/factors-contributing-higher-incidence-diabetes-black-americans
Murty, K., & Rudd, S. (2015). Culture, Health, and Justice: African Americans and diabetes. Diabetes, 601, 295. Retrieved from https://tinamurty.com/2017/01/14/culture-health-and-justice-african-americans-and-diabetes/
Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12(1),14-19. doi:10.1186/2251-6581-12-14
So, C. F., & Chung, J. W. (2017). Telehealth for diabetes self-management in primary healthcare: A systematic review and meta-analysis. Journal of Telemedicine and Telecare, 24(5), 356–364. doi:10.1177/1357633×17700552
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