Introduction
The Hispanic adult population in the United States has a greater prevalence and incidence of type 2 diabetes (T2D) than the public at large. In addition to a genetic predisposition to obesity and improved insulin resistance, sociocultural variables, including poorer income and restricted access to healthcare and education, are also contributing factors in this situation. The following paper’s goal is to investigate how underprivileged Latino adults with diabetes may be assisted in managing their disease within six months through therapies like education.
PICOT Question
Patient: Hispanic/Latino adult people in the US;
Intervention: Education and self-management;
Comparison: No intervention;
Outcome: Improved management of the condition;
Time: six months.
Final Question: In Latino/Hispanic adult people with type 2 diabetes, how effective is education and diabetes self-management compared to no intervention in improving the management of the condition within six months?
Background of Studies
The selected studies have various backgrounds and frameworks for the investigation. The study by Hildebrand et al. (2018) speaks about the peculiarities of type 2 diabetes among Latin populations. The authors assume that there is a high number of representatives of this cohort living with the condition, which requires a better investigation of the problem to understand the major causes of this disproportion. The primary aim of the study is to determine the facilitators and barriers to investigating the decision-making process in the Latin population and their values associated with type 2 diabetes. The authors reveal the three major themes related to the problem, such as lowering barriers to access care, language, and trust. It is vital to introduce strategies to support learning and guarantee the number of Latinos in research studies is increased. It will ensure an enhanced understanding of the existing problems and help the cohort to improve self-management activities.
The quantitative study by Smith-Miller et al. (2016) aims at describing the relations between knowledge, health-promoting behaviors, and self-management activities among Spanish-speaking individuals in the USA with type 2 diabetes. The authors assume that the Hispanic community living in the state might benefit from clinical interventions focused on promoting knowledge and specific physical activity aimed at reducing the adverse effects of the condition. The results of the investigation prove the assumption made by the authors. The statistical analysis methods show that individuals with better knowledge of type 2 diabetes self-management show better results compared to other individuals (Smith-Miller et al., 2016). In such a way, it becomes critical to create the framework for educating this group and explaining the necessity of nutrition, physical activity, and interpersonal relations in struggling against the condition.
The main goal of Morales et al. (2020) study is to ascertain how the five key factors affecting human health affect the burden of T2D on Latino households. Latino community health professionals who have received specialized training and are multilingual choose participant households and carry out study tasks. Every member of the family will yearly provide data on more than 100 distinct factors. The investigation is a cross-sectional, long-term observational cohort experiment. Based on their age and level of diabetes, participants are placed into groups. Researchers investigate the multifactorial burden of diabetes in Latino families and determine whether standard biological and genetic risk factors are not the only ones associated with cardio-metabolic illness.
In Zhang et al. (2021) study, 1,568 participants in five-year local diabetes and evidence-based treatment initiative who were enrolled from a nearby clinic underwent secondary data collection. The research is the first to examine individual and community-level SDOH in the framework of diabetes care using Bayesian multilayer spatial modeling. Findings point to the importance of community SDOH in diabetes monitoring and administration, as well as the necessity for future preventive interventions to take neighborhood and community context into consideration to enhance their overall efficacy. A fuller knowledge of diabetes management is provided by including both individual and community SDOH in the study, which may help to improve culturally appropriate, cost-effective initiatives for diabetic patients. The study’s results will be crucial in determining how to prioritize SDOH in terms of improving diabetes management for underprivileged Mexican Americans.
In contrast to no intervention for six months, the PICOT question compares the effects of education and diabetes self-management treatment on Latino community health. Hildebrand et al. (2018) offer detailed information about the positive effects of additional education and lowering barriers to accessing care and knowledge about type 2 diabetes. They also admit the importance of values and cultural aspects. The impact of five SDOHs on the prevalence of type 2 diabetes will be examined by the Molares et al. (2020) project. Besides, Zhang et al. (2021) study will assess the positions of SDOH in diabetes care training programs at the Individual and county level to suggest future interventional techniques. Speaking about the increased risks of T2D among the Hispanic population in the USA, Smith-Miller et al. (2016) assume that most individuals from this group do not manage this condition effectively. It means there is a critical need for additional education that might promote better results.
Method of Studies
The selected problem was investigated by using various approaches. Hildebrand et al. (2018) conducted an exploratory qualitative study and used one-to-one interviews to acquire an enhanced understanding of the central facilitators and barriers affecting the Latin population in the USA. Molares et al. (2020) employed cross-sectional and longitudinal techniques together with the observational cohort research methodology. Zhang et al. (2021) used a study that analyzed secondary data from a diabetic management program that treated 1568 people. The study by Smith-Miller (2016) uses a quantitative approach supported by statistical data analysis to develop an improved understanding of the effectiveness of various clinical interventions and strategies to improve self-management among the selected population.
All studies have their advantages and disadvantages that should be considered. The central advantage of the study by Hildebrand et al. (2018) is the involvement of individuals living with the investigated condition, which guarantees the increased credibility of the findings. However, the comparatively small sample size can be viewed as one of the limits of the research. The strong aspect of the article by Smith-Miller et al. (2016) is the use of statistical methods to show existing regularities, while the small sample size might also be viewed as its weak aspect. The main advantage of the study by Zhang et al. (2021) is the high-quality processing of the collected data and a comprehensive time sample, which confirms the authenticity of the data. The limitation of the work is that the data collected in the first years may become outdated. Molares et al. (2020) study the main advantage is the wide range of parameters that are analyzed; a limitation is the inadequate statistics compared with other studies.
Results of Studies
According to Hildebrand et al. (2018), reducing barriers by promoting better cooperation and understanding values might help to improve self-management practices and promote better outcomes. According to Molares et al. (2020), developing a framework for cohort studies would help promote health equality and excellence for T2D care while reducing the burden of T2D as a result of genetic, biological, behavioral, psychological, social, and environmental factors. Diabetes independent learning is an essential intervention for SDOH among the Latino community, according to Zhang et al. (2021), since the SDOH has a substantial impact on diabetes coordination and monitoring. According to Smith-Miller et al. (2016), clinical interventions implying cultivating knowledge, nutrition changes, and physical activity might help the Latino population with T2D and promote better outcomes.
Ethical Considerations
It is possible to stress written consent and privacy with regard to the examination’s ethical implications. An eminently evident illustration of the moral choices that were taken throughout the studies’ execution is the concealing of the participants’ names. To fill up any possible research gaps, ethical issues have been effectively addressed in the research done in the articles examined in the studies. The studies clearly show that no subject was coerced into taking part in the study; instead, everyone expressed their agreement. As a result, all researchers adhered to the ethical norms of confidentiality and written information.
Outcomes Comparison
The results of the PICOT inquiry were expected to reduce the total incidence of T2DM in the Latino population within six months through education and actions on diabetic self-management techniques. The health of the Latino population will not alter regardless of any effort. The PICOT question’s expected result was to use education and diabetes self-management treatments to enhance the health of the Latino population and lessen the impact of socioeconomic influences on their health on them.
The expected result predicted by PICOT was agreed upon by Hildebrand et al. (2018) and Zhang et al. (2021). They showed how active T2DM management and preventative education initiatives drastically reduce T2DM prevalence in the Latino community. They also discovered that diabetic self-management education is a crucial SDOH intervention. The results of Molares et al. (2020) match what the PICOT question was supposed to reveal. According to the researchers, the paradigm for cohort studies prevents SDOH from increasing the burden of T2DM and promotes health equality and effectiveness in T2DM management.
Evidence-Based Practice Change
The PICOT question suggests that within six months, the incidence of T2DM will be reduced with education and diabetic self-management techniques. In a similar vein, research publications have identified diabetic self-management and education initiatives as the most critical and successful therapies to reduce the burden of T2DM (Smith-Miller et al., 2016). Preventative nutrition education treatments would be seen as a traditional, evidence-based practice modification to lighten the stress of T2DM in the Latino population, in addition to education and diabetes self-management techniques.
Recommendations
Culture has a vital role in the development of diabetes in the Hispanic population. The creation of inexpensive interventions will be ensured by knowledge of Hispanic values. As an illustration, due to their crucial social position within the Hispanic society, addressing Hispanic women in a campaign that encourages nutrition counseling will have the most impact. The most effective treatments to stop T2D development are weight-reduction changes in behavior and metformin.
Conclusion
In conclusion, Latino health requires careful attention and control, particularly given the total burden of T2DM, which is a severe threat to them. This study has shown that the best strategy to overcome the drawbacks of T2DM is education and care for diabetic self-management. Future initiatives, meanwhile, must take into account how well nutritional health education has affected the incidence of T2DM in the Latino population. In order to control the incidence of T2DM in the Latino population, practice environment, research, and education should draw on the findings of this study as possible sources of evidence-based treatment strategies.
References
Qualitative Researches
Hildebrand, J. A., Billimek, J., Olshansky, E. F., Sorkin, D. H., Lee, J. A., & Evangelista, L. S. (2018). Facilitators and barriers to research participation: perspectives of Latinos with type 2 diabetes. European Journal of Cardiovascular Nursing, 17(8), 737-741.
Morales, J., Glantz, N., Larez, A., Bevier, W., Conneely, M., Fan, L., Reed, B., Alatorre, C., Paczkowski, R., Ahmed, T., Mackenzie, A., Duncan, I., & Kerr, D. (2020). Understanding the impact of five significant determinants of health (genetics, biology, behavior, psychology, society/environment) on type 2 diabetes in US Hispanic/Latino families: Mil Familias-a cohort study. BMC endocrine disorders, 20(1), 1-13.
Quantitative Researches
Smith-Miller, C. A., Berry, D. C., DeWalt, D., & Miller, C. T. (2016). Type 2 diabetes self-management among Spanish-speaking Hispanic immigrants. Journal of Immigrant and Minority health, 18(6), 1392-1403.
Zhang, K., Reininger, B., Lee, M., Xiao, Q., & Bauer, C. (2021). Individual and community social determinants of health associated with diabetes management in a Mexican American population. Frontiers in Public Health, 8(2), 6-40.