Diabetes is one of the non-communicable diseases with increasing prevalence both in the United States of America and around the world. Diabetes is associated with complications such as diabetic retinopathy, nephropathy, and neuropathy, which affect the quality of life of the patients. Nurses and other healthcare providers implement evidence-based interventions to prevent and reduce the burden associated with diabetes. Therefore, the reason for this assignment is to examine diabetes mellitus disease in the United States of America ,the state of New Jersey and also explores the application of HealthyPeople2030 and level planning interventions to diabetes.
Overview, Background and Significance of the Problem
Diabetes mellitus is a metabolic disease that occurs by the inability of the body to produce enough insulin needed for glucose transport into the cells. Insulin deficiency leads to hyperglycemia and symptoms associated with diabetes such as polyuria, polydipsia, weight loss, and impaired vision. Diabetes is associated with a range of complications. They include hyperglycemia, hypoglycemia, diabetic foot, diabetic retinopathy, nephropathy, and neuropathy. Diabetes mellitus affects the quality of life of patients and their families. This can be seen from increased care costs, decreased quality of life, increased absenteeism from work, and loss of productivity(CDC, 2022). Diabetes mellitus is preventable. Nurses and other healthcare providers can implement population-specific interventions such as health education and screening to prevent, detect, and initiate early treatments for those at risk(Ng et al., 2021). Health education on self-management of diabetes also improves treatment outcomes.
Diabetes is associated with several risk factors. They include ethnicity, family history, age, being obese or overweight, physical inactivity, and a history of gestational diabetes(CDC, 2022). Besides the above complications, diabetes has immense population impacts. For example, diabetes currently ranks the seventh leading cause of mortalities in the United States. Diabetes was considered as a cause of death in 282801 death certificates in 2019. On average, the United States spent $327 billion on diabetes in 2017. Of the cost, $237 billion was used for direct medical costs while $90 billion was incurred through reduced productivity. The statistics also show that patients with diabetes spend 2.3 times more in healthcare expenditures compared to those without diabetes(diabetesresearch.org, 2022).
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In 2019, diabetes prevalence in America was 11.3% or 37.3 million Americans. Of this number, 8.5 million Americans were undiagnosed. Diabetes new cases are estimated to be 1.4 million annually. In terms of ethnic/race prevalence, American Indians lead with 14.5%, followed by non-Hispanic blacks (12.1%), Hispanics (11.8%), Asian Americans (9.5%), and non-Hispanic whites (7.4%)(diabetes.org, 2022). About 9% or 645000 adults in New Jersey are diabetic with 34% or 2395000 adults being pre-diabetic. In terms of ethnic prevalence, Whites had a prevalence of 6.3% in 2020, 11.5% in Blacks, 13.1% in Hispanics, and 13.0% in Asian Americans(nj211.org, n.d.; www-doh.state.nj.us, n.d.).
Analysis of the Problem
Descriptive epidemiology can be applied to examine the issue of diabetes in America and New Jersey. Descriptive epidemiology examines a disease in terms of characteristics that include place, time, and person. Personal characteristics and behaviors are associated with diabetes. They include dietary habits, physical inactivity, body weight, smoking, family history of diabetes, a history of gestational diabetes, age, and ethnicity(CDC, 2022). Diabetes prevalence varies according to location. For example, the estimated percentage of people with diabetes in Atlantic is 13.7% compared to 7.9% in Bergen and 8.3% in Cape May, New Jersey(www-doh.state.nj.us, n.d.). In terms of time, diabetes rates have changed over time in the United States and New Jersey. For example, diabetes prevalence in the US in 2011 was 9.0% and rose to 10.4% in 2018, and dropped to 10.0% in 2020. On the other hand, diabetes prevalence in New Jersey in 2011 was 8.1%, rising to 10.0% in 2017, and dropping to 8.5% in 2020(www-doh.state.nj.us, n.d.).
The HealtyPeople2030 identify the characteristics of at-risk population for diabetes mellitus. They include individuals born to families with a history of diabetes due to heritability of genes associated with diabetes. They also include individual-specific factors such as overweight, obesity, physical inactivity, and unhealthy eating habits. The last characteristic is a history of gestational diabetes in an individual(health.gov, n.d.).
Application of HealthyPeople2030
HealthPeople2030 has developed several goals and objectives related to diabetes management and prevention in the United States. They include increasing the proportion of diabetic people that get diabetes formal education, increasing the proportion of diabetics who get annual urinary albumin test, and reduce the number of diabetes cases yearly. The additional objectives include reducing the rate of hospital admissions for diabetes in older adults and reducing the rate of leg and foot amputations in adults with diabetes(health.gov, n.d.). The diabetes goals and outcomes in HP2030 are important in preventing, reducing, and eliminating the impact of diabetes on the population. For example, formal education increases awareness levels and promotes lifestyle and behavioral change among patients with and at a risk of diabetes.
Diabetes screening is achievable using several tests. They include HbA1c, fasting plasma glucose test, random plasma glucose test, and two-hour oral glucose tolerance test(Lin et al., 2021). The screening guidelines are that obese or overweight adults aged 40-70 should be screened and repeated testing every three years if the, results are within normal ranges. Patients aged 45 years and above should be screened annually for diabetes. The validity of the screening tools differs. For example, HbA1c has a high validity rate, as it can provide the risk of long-term complications compared to other methods such as fasting blood glucose(Thewjitcharoen et al., 2019). As a result, it can be used for all the populations.
Level Planning Interventions
The United States government is engaging in initiatives to address diabetes mellitus among the population. For example, it has implemented the National Diabetes Prevention Program in collaboration with private and public organizations to prevent or delay diabetes mellitus type 2. The program provides the population resources needed for them to change their lifestyles and reduce their risk of developing type 2 diabetes(CDC, 2023). The State of New Jersey also adopts interventions to address diabetes. For instance, the state supports the activities of the New Jersey Diabetes Prevention and Control Program such as granting funds to be used in public health initiatives to prevent and reduce diabetes disease burden in the population(nj.gov, n.d.). The national and state governments track data related to the above interventions using indicators such as new cases of diabetes, diabetes mortality rate, hospitalization rate, and costs incurred in diabetes management at state and national levels.
In summary, this paper has explored the issue of diabetes in America and New Jersey. Descriptive epidemiology assists understand diabetes better. State and national governments engage in activities that address diabetes. Initiatives should be population-centered to empower them to embrace the desired changes to prevent and delay diabetes.
CDC. (2022, April 5). Diabetes Risk Factors. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/risk-factors.html
CDC. (2023, August 1). National Diabetes Prevention Program | Diabetes | CDC. https://www.cdc.gov/diabetes/prevention/index.html
diabetes.org. (2022). Statistics About Diabetes | ADA. https://diabetes.org/about-us/statistics/about-diabetes
diabetesresearch.org. (2022). Diabetes Statistics. DRIF. https://diabetesresearch.org/diabetes-statistics/
health.gov. (n.d.). Diabetes: Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among People at Increased Risk—Healthy People 2030 | health.gov. Retrieved September 13, 2023, from https://health.gov/healthypeople/tools-action/browse-evidence-based-resources/diabetes-combined-diet-and-physical-activity-promotion-programs-prevent-type-2-diabetes-among-people-increased-risk
Lin, K.-Y., Hsih, W.-H., Lin, Y.-B., Wen, C.-Y., & Chang, T.-J. (2021). Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy. Journal of Diabetes Investigation, 12(8), 1322–1325. https://doi.org/10.1111/jdi.13480
Ng, A. C. T., Delgado, V., Borlaug, B. A., & Bax, J. J. (2021). Diabesity: The combined burden of obesity and diabetes on heart disease and the role of imaging. Nature Reviews Cardiology, 18(4), Article 4. https://doi.org/10.1038/s41569-020-00465-5
nj211.org. (n.d.). Diabetes Management and Prevention. NJ 211. Retrieved September 13, 2023, from https://www.nj211.org/diabetes-management-and-prevention
nj.gov. (n.d.). Department of Health | Chronic Disease Programs | Diabetes. Retrieved September 13, 2023, from https://www.nj.gov/health/fhs/chronic/diabetes/
Thewjitcharoen, Y., Jones Elizabeth, A., Butadej, S., Nakasatien, S., Chotwanvirat, P., Wanothayaroj, E., Krittiyawong, S., Himathongkam, T., & Himathongkam, T. (2019). Performance of HbA1c versus oral glucose tolerance test (OGTT) as a screening tool to diagnose dysglycemic status in high-risk Thai patients. BMC Endocrine Disorders, 19(1), 23. https://doi.org/10.1186/s12902-019-0339-6
www-doh.state.nj.us. (n.d.). NJSHAD – Health Indicator Report—Diabetes (Diagnosed) Prevalence. Retrieved September 13, 2023, from https://www-doh.state.nj.us/doh-shad/indicator/view/DiabetesPrevalence.Race.html
The concepts of epidemiology provide the framework for the study of infectious and chronic health issues/diseases, which provides a rich source of data for the analysis of trends in disease and health.This assignment will offer the learner the opportunity to explore the population health effects of a topic which will be assigned by your course faculty.
As an example, you may be asked to identify populations at risk for oral health issues or, for instance, issues related to the frail living at home, and design a population health focused educational intervention for your target population.
In addition, you will look at what outcomes will be addressed to determine if your interventions are effective. This paper should integrate HP2030 and CDC information into your paper.
The alcohol misuse screening tool are designed to determine if you have alcohol use disorder (AUD). AUD is excessive drinking that can cause serious problems in your work and professional life as well as your health. Tan et al. (2018) includes health disease conditions as hypertension, sleep disorders, a variety of cancers and liver issues. The U.S. Preventive Services Task Force (USPSTF) endorses the use of screening tools to primary care providers (Tan et al., 2018). These screening tools that can be administered in 5 minutes or less as per Tan et al. (2018) include the following 3: the ten-question Alcohol Use Disorders Identification Test (AUDIT), the three-question AUDIT-Consumption (AUDIT-C), and single question screeners such as the National Institute on Alcohol Abuse and Alcoholism Single Question (NIAAA Single Question). According to USPSTF, the age group it targets is adults 18 years or older including pregnant women. USPSTF determined adolescents 12-17 would not benefit from use of the screening tool as the evidence was insufficient in balancing benefits and harms of the screening tools (Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions, 2018).
The screening tools have been utilized to test the groups it targets. Various screening tools have been utilized for those aged 18+ besides those recommended by the USPSTF. As this is just a questionnaire/screening tool, there is no harm in patients answering the questions. Utilizing the appropriate screening tools allow APNs to better identify patients with alcohol misuse behaviors so clinical interventions can be put into place for the patients.
To determine the test-retest reliability, predictive validity, and diagnostic accuracy of the tests Beard et al. (2019) compared the 1-item Strength of Urges to Drink (SUTD) scale with the 10-item Alcohol Use Disorders Identification Test (AUDIT). As the AUDIT measures harmful and hazardous drinking while SUTD measures the strength of urges to drink on a single day of high-risk drinkers. Beard et al. (2019) collected data on 57,341 participants in the study with 95% of those participants being high risk drinkers. Participants were asked to complete both questionnaires at start of study and 6 months later. Test-retest reliability was assessed by calculating a reliability coefficient between the scores on the first and the second testing. The predictive validity of the SUTD was assessed by inspecting the association between the SUTD scale and attempts to reduce alcohol intake, levels of alcohol consumption at follow-up and change in alcohol consumption between baseline and follow-up testing by means of a Mann–Whitney U test and linear-by-linear association chi-square test. In the study, Beard et al. (2019) assessed predictive accuracy utilizing Received Operating Characteristic (ROC) curves were calculated. Reliability values are as follows: SUTD r = 0.30 (95% CI 0.28 to 0.34), AUDIT r = 0.50, 95% CI 0.47 to 0.53 (Beard et al., 2019). Predictive validity with attempts to cut down from baseline to follow up showed a total of 767 higher risk drinkers (25.9%; 95% CI 24.3 to 27.5) reported that they had attempted to reduce their alcohol consumption between baseline and follow-up (Beard et al., 2019).
Based on the information read about the test, it would be good to utilize these tools in APN practice. Healthcare practitioners can determine problematic alcohol use and can start implementing clinical interventions into the patients plan of care. The National Institute on Alcohol Abuse and Alcoholism has noted that alcohol screening and brief intervention rank highly among effective preventive services based on their cost-effectiveness and potential to reduce clinically preventable burden (Screen and Assess: Use Quick, Effective Methods | National Institute on Alcohol Abuse and Alcoholism (NIAAA), 2023). If health care providers make screening for heavy drinking a routine part of care and use a quick tool recommended by the U.S. Preventive Services Task Force that identifies people with unhealthy alcohol consumption, they can easily and effectively perform this task for the betterment of their patients.
Beard, E., Brown, J., West, R., Drummond, C., Kaner, E., & Michie, S. (2019). Predictive Validity, diagnostic Accuracy and Test-Retest Reliability of the Strength of Urges to Drink (SUTD) scale. International Journal of Environmental Research and Public Health, 16(19), 3714. https://doi.org/10.3390/ijerph16193714
Screen and assess: Use quick, effective methods | National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2023, June 29). https://www.niaaa.nih.gov/health-professionals-communities/core-resource-on-alcohol/screen-and-assess-use-quick-effective-methods#:~:text=Alcohol%20screening%20and%20brief%20intervention%20can%20reduce%20drinking%20levels%3A%20Research,effective%20in%20primary%20care%20settings.
Tan, C., Hungerford, D. W., Denny, C. H., & McKnight-Eily, L. R. (2018). Screening for alcohol misuse: Practices among U.S. primary care providers, DocStyles 2016. American Journal of Preventive Medicine, 54(2), 173–180. https://doi.org/10.1016/j.amepre.2017.11.008
Unhealthy Alcohol Use in Adolescents and Adults: Screening and Behavioral Counseling Interventions. (2018, November 13). www.uspreventiveservicestaskforce.org. Retrieved September 10, 2023, from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/unhealthy-alcohol-use-in-adolescents-and-adults-screening-and-behavioral-counseling-interventions
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
CO 3: Identify appropriate outcome measures and study designs applicable to epidemiological sub-fields such as infectious disease, chronic disease, environmental exposures, reproductive health, and genetics.
CO 6: Identify important sources of epidemiological data.
Sunday by 11:59pm MT of Week 2
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
Total Points Possible
This assignment is worth 125 points.
Preparing the Assignment
- Research Topic: Your course faculty will provide you with topic/s for this assignment. Please check the NR503 Course Announcements.
- Identify your target population (for instance, age or other demographic, aggregate population); this must be in your city or state.
- Discuss population-based health education interventions for your target population that is aimed at reducing morbidity and mortality for the problem. Be sure to review the research literature and HP2030 for interventions.
- Identify how and what data for interventions is being tracked.
- In a four (4) page paper, address the following. Refer to rubric for expanded details related to grading expectations.
- Identify the problem in the introduction section.
- Provide an overview of the problem in your state/national.
- Review of descriptive epidemiological and demographic data on mortality/morbidity and risk.
- HP2030: Present the goal, overview and objectives of Healthy People 2030 for the paper topic.
- Population level prevention and health promotion review. Describe population and/or primary health care focused interventions. Use of scholarly literature and HP2030 is required. There should be direct correlation to evidence for all strategies.
Best Practices in Preparing the Project
- Review directions and rubric through carefully.
- Follow submission requirements.
- Make sure all elements on the grading rubric are included. Organize the paper using the rubric sections and appropriate headings to match the sections.
- Rules of grammar, spelling, word usage, and punctuation are followed and consistent with formal, scientific writing.
- Title page, running head, body of paper, and reference page must follow APA guidelines as found in the current edition of the manual. This includes the use of headings for each section of the paper except for the introduction where no heading is used.
- Ideas and information that come from scholarly literature must be cited and referenced correctly.
- A minimum of three (3) scholarly literature references must be used. Not all references should be from scholarly web sites. You may use your textbook, but this will not count towards the three (3) scholarly literature references.
- Length: Papers not adhering to the page length may be returned to you for editing to meet the length guidelines.
- Adhere to the Chamberlain College of Nursing academic policy on integrity as it pertains to the submission of your own original work for assignments.
|This criterion is linked to a Learning OutcomeAssignment Content Possible Points = 100 PointsIntroduction of the Problem (no heading)1. Problem is clearly stated.2. General introduction to the problem supports its importance as a population health issue with data and general statement of scope of problem.3. Focus of the paper is stated succinctly.(3 critical elements)||5 ptsExcellentAll bullet items (content) included with depth and consistent connection, validation, by evidence.4 ptsV. GoodAll content included but limited clarity or depth OR Content is missing one critical element.3 ptsSatisfactoryContent missing: 1. Two critical elements Or 2. Writing lacks clarity, depth2 ptsNeeds ImprovementContent missing: 1. Two critical elements 2. Clarity 3. Problem is unsupported 4. Writing is largely unsupported0 ptsUnsatisfactorySection missing||5 pts|
|This criterion is linked to a Learning OutcomeDiscussion: Overview, Background and Significance of the Problem1. Provide background and significance of the problem.2. This includes risks and impact of disease.3. Data: State and National: Incidence, prevalence, mortality, breakdown by gender/race/religion as appropriately related(3 critical elements)||25 ptsExcellentAll critical elements (content) included with depth and consistent connection, validation by evidence.23 ptsV. GoodAll content included but limited clarity or depth OR Content is missing one critical element.21 ptsSatisfactoryContent missing: 1. Two critical elements Or 2. Writing lacks clarity, depth12 ptsNeeds ImprovementContent missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported0 ptsUnsatisfactorySection missing||25 pts|
|This criterion is linked to a Learning OutcomeEpidemiological Analysis of the Problem1. Using descriptive epidemiology (provide description of term) analyze health problem2. Include demographic and related epidemiological data3. Include characteristics of at-risk population using HP2030 specified criteria(3 critical elements)||30 ptsExcellentAll critical elements (content) included with depth and consistent connection, validation by evidence27 ptsV. GoodAll content included but limited clarity or depth OR Content is missing one critical element.25 ptsSatisfactoryContent missing: 1. Two critical elements Or 2. Writing lacks clarity, depth15 ptsNeeds ImprovementContent missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported0 ptsUnsatisfactorySection missing||30 pts|
|This criterion is linked to a Learning OutcomeApplication of HP 20301. Identify HP2030 goals and objectives2. Relate HP2030 goals and objectives to health concern topic3. Identify guidelines and a screening method related to health concern4. Review validity (predictive power) of screening tool method to include what population the tool is applicable to use with (for instance, adult, child, culture)(4 critical elements)||20 ptsExcellentAll critical elements (content) included with depth and consistent connection, validation by evidence18 ptsV. GoodAll content included but limited clarity or depth OR Content is missing one critical element.17 ptsSatisfactoryContent missing: 1. Two critical elements Or 2. Writing lacks clarity, depth10 ptsNeeds ImprovementContent missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported0 ptsUnsatisfactorySection missing||20 pts|
|This criterion is linked to a Learning OutcomePopulation Level Planning Interventions1. Investigate what is being done at the population health level related to prevention and health promotion for the health problem at the national and state level2. Identify what and how outcomes are being tracked related to said interventions.3. Utilize HP2030, CDC, state public health department, research, etc. as resources for interventions and data.(3 critical elements)||20 ptsExcellentAll critical elements (content) included with depth and consistent connection, validation by evidence18 ptsV. GoodAll content included but limited clarity or depth OR Content is missing one critical element.17 ptsSatisfactoryContent missing: 1. Two critical elements Or 2. Writing lacks clarity, depth10 ptsNeeds ImprovementContent missing: 1. Two critical elements 2. Clarity 3. Writing is largely unsupported0 ptsUnsatisfactorySection missing||20 pts|
|This criterion is linked to a Learning OutcomeAssignment Format Possible Points = 25 PointsAPA1. All content accurately utilizes APA format for citations and table formatting per APA current edition.2. Reference list is formatted per APA current edition.Cover page, running heads, font size and type, reference list and headings per APA current ed.||15 ptsExcellentNo APA errors14 ptsV. Good1-2 APA errors12 ptsSatisfactory3-4 APA errors8 ptsNeeds Improvement5-6 APA errors0 ptsUnsatisfactory7 or more APA errors||15 pts|
|This criterion is linked to a Learning OutcomeGrammar, Syntax, Spelling1. Grammar, writing voice, and spelling are in accordance with APA current edition.2. Scientific prose/voice is consistent.3. Writing has precision and clarity4. See APA current edition, 3, Writing Clearly and Concisely||10 ptsExcellentWritten work is free of grammatical, spelling or punctuation errors.9 ptsV. GoodWritten work is largely free of grammatical, spelling or syntax errors. (Approximately 1-2).8 ptsSatisfactoryWritten work includes some grammatical, spelling or syntax errors that distract the reader. (Approximately 3-4).5 ptsNeeds ImprovementWritten work contains numerous grammatical, spelling or syntax errors that distract the reader (Approximately 5-6).0 ptsUnsatisfactory7 or more errors||10 pts|
|This criterion is linked to a Learning OutcomeLate Penalty DeductionsStudents are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.||0 ptsDeduction of points0 ptsDeduction of points||0 pts|
|Total Points: 125|
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