The global and national health problem that I address in this course is the prevention of diabetes and its consequences. This chronic disease is spreading at a high rate around the world due to lifestyle changes, unhealthy eating habits, or a lack of resources. While a part of the population cannot receive prevention due to limited access to health care services and nutritious food, another part of people increases the risk of diabetes or its complications due to their lifestyle. In their study, Mathe et al. (2017) found that “only 10% of this sample met recommendations of 150 minutes per week of “moderate-vigorous physical activity” MVPA in 10-minute bouts. Simultaneously, physical activity is one of the most helpful means of preventing diabetes and its complications (Mathe et al., 2017). Consequently, public health efforts should be directed toward promoting increased MVPA as a way to reduce the incidence of diabetes. Ford et al. (2021) investigated such a method of promoting MVPA as the participation of people with prediabetes in an educational program and received positive findings that can be used in a diabetes prevention program.
Low health literacy is one of the most common barriers to preventing and treating any disease. For this reason, Ford et al. (2021), in their study, chose an educational program for 573 individuals with prediabetes from Chennai, India, as a method of diabetes prevention. The main goal of the researchers was to measure the baseline MVPA of participants and increase their activity to the recommended 150 minutes per week through their participation in the Diabetes Community Lifestyle Improvement Program (D-CLIP) (Ford et al., 2021). The authors selected participants of different ages, gender, income, and types of prediabetes and divided them into intervention and control groups. As a result of the six-month program, most participants increased their MVPA to 150 minutes per week and more, which showed the program’s effectiveness.
Despite the high quality of the article, the authors identify some of the shortcomings and limitations of the study. First, participants used self-reports and were not blinded to treatment allocation (Ford et al., 2021). Consequently, participants may overestimate their results due to the influence of bias and the desire to show the effectiveness of their participation in the program. For this reason, the proportion of participants who have improved their MVPA may be inaccurate and must be checked to determine the effectiveness of the intervention clearly. However, even assuming a 50% margin of error, the study demonstrates that the education program had a beneficial effect on physical activity in people with prediabetes and diabetes prevention.
For this reason, some of the details and findings of the study can be used to develop and implement programs for the prevention of diabetes and its complications in the United States. First, the researchers note that D-CLIP had lessons that focused on improving physical activity, weight loss, and dietary changes, including specialist advice and personalized plans (Ford et al., 2021). In other words, the program used a comprehensive approach to diabetes prevention that should be the backbone of US education programs. Second, Ford et al. (2021) state that participants who also take medication reduce their risk of developing diabetes by 30% if diagnosed with prediabetes. This factor also needs to be considered and included in the program to ensure that people with prediabetes are fully supported with information and necessary medications. Third, the program peaked after six months, and then respondents’ activity began to decline (Ford et al., 2021). This fact demonstrates the need for longer-term support of program participants or a decrease in their duration but an increase in frequency and regularity.
Apparently, one should take the following steps to implement a program based on this study by making the following steps to help future participants improve their MVPA:
- Create a one-year course of 45-minute lessons once a week to teach people what types of physical activity and dietaries they should resort to throughout their whole life to minimize the risk of diabetes. The lessons should be conducted by professional nutritionists capable of designing personalized plans for every participant free of charge. The plan will include everyday tips on nutrition and recommendations of 150 minutes per week of “moderate-vigorous physical activity” MVPA in 10-minute bouts.
- Give special attention to participants who have prediabetes. Therefore, the chosen nutritionists should add medical therapy to their individual plan after an examination and a one-shot consultation concerning the factors that might influence the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and possible pathophysiological changes due to disease.
- Provide the opportunity for the participants to access the material used during the course of lectures. Ideally, there should be a website with sections on nutrition, physical exercises, and feedback. There can also be a section where the participants can upload their own stories about MVPA improvement.
Thus, an article by Ford et al. (2021) demonstrates that educational programs can be an effective method for preventing diabetes and its complications. Many ideas and findings of the authors can be used to implement a similar program in the United States. However, some details need to be checked to avoid the limitations presented in the research and adapt the program to the cultural context of the United States.
References
Ford, C. N., Do, W. L., Weber, M. B., Narayan, K., Ranjani, H., & Anjana, R. M. (2021). Moderate-to-vigorous physical activity changes in a diabetes prevention intervention randomized trial among South Asians with prediabetes – The D-CLIP trial.Diabetes Research and Clinical Practice, 174.
Mathe, N., Boyle, T., Al Sayah, F., Mundt, C., Vallance, J. K., Johnson, J. A., & Johnson, S. T. (2017). Correlates of accelerometer-assessed physical activity and sedentary time among adults with type 2 diabetes. Canadian Journal of Public Health, 108(4), e355–e361.