The discussed community of adults between the ages of 45 and 64 living in Williamsbridge, Bronx has a rising problem if type 2 diabetes. The majority of interventions for this problem include educational programs that target people’s dietary choices, physical activity, and health knowledge (Powers et al., 2017). However, while these initiatives have proven to be effective in lowering people’s glucose intake and decreasing their risk of obesity, diabetes, and cardiovascular problems, they failed to acknowledge the socioeconomic barriers of some communities.
In the Bronx, many people live under the poverty line, which significantly restricts their access to healthy food and medical care. Therefore, they may feel discouraged to adhere to interventions that are not tailored to their specific problems. A program that promotes health through dietary change should address the socioeconomic specificities of communities in the Bronx by offering educational classes that provide affordable alternatives to unhealthy but cheap foods.
Evidence-Based Behavior Change
Current evidence suggests that dietary choices substantially impact people’s development and management of type 2 diabetes. According to Franz, Boucher, Rutten-Ramos, and VanWormer (2015), change in one’s nutrition should become the main focus of patients who need to delay the onset of diabetes. The authors note that diets based on calorie restriction, fasting, unbalanced consumption of lipids and carbohydrates do not have a prolonged effect on the weight of patients. Moreover, such programs do not provide individuals with nutrients necessary for healthy processes in the body.
Therefore, weight loss should not be the sole reason for dietary recommendations as it is not the cause of the problem but a possible symptom. Healthcare providers should make sure that patients understand how their food choices may affect their well-being.
Intervention
Interventions that attempt to improve the nutrition of patients often include plant-based and Mediterranean diets. Dunkley et al. (2014) find that such advice is often neglected by individuals who do not have an opportunity of changing their choice of products due to economic constraints. For example, some people may live in a food desert or have a low income that cannot be spent on expensive foods. In the Bronx, many families live under the line of poverty which means that their diet is dictated by the products that they can afford.
The proposed educational intervention uses nutritional information about foods to teach people how to create specific dietary plans that lower the glucose and lipid intake without significantly affecting one’s expenses. This plan should incorporate the research about the harm of sugary drinks and meal plans that utilize affordable products (legumes, whole grains, seasonal vegetables and fruit). The educational material should be presented in an accessible form that underlines the fact that weight loss is not the primary goal that will result in improved health.
Outcomes
The intervention that aims to educate people about nutrition is expected to improve people’s dietary choices. One of the central goals is to reduce the intake of glucose by highlighting the effects of sugary drinks and processed foods. Thus, people’s blood glucose levels (HbA1c) can be considered a measurable outcome (Chen et al., 2015). Another possible measure is people’s BMI, although it is not as directly connected to the development of type 2 diabetes as HbA1c. Other conditions (blood pressure, obesity, and cardiovascular problems) that may be viewed as comorbidities should also be analyzed as a result of this intervention. Finally, the lowered rate of type 2doabetes in the population is the central goal of the intervention plan.
Conclusion
The communities of Williamsbridge have socioeconomic constraints that render many initiatives ineffective. Thus, medical professionals should design a program that incorporates financial limitations of the people at risk and provides them with a viable plan of action. The suggested intervention uses nutritional data that improves people’s dietary choices by educating people about unhealthy drinks and foods. Moreover, it provides them with meal plans that utilize seasonal and affordable alternatives. Finally, it underlines the fact that weight loss and drastic measures do not lead to positive health outcomes, but moderation and mindful consumption may help.
References
Chen, L., Pei, J. H., Kuang, J., Chen, H. M., Chen, Z., Li, Z. W., & Yang, H. Z. (2015). Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism, 64(2), 338-347.
Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., & Khunti, K. (2014). Diabetes prevention in the real world: Effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations: A systematic review and meta-analysis. Diabetes Care, 37(4), 922-933.
Franz, M. J., Boucher, J. L., Rutten-Ramos, S., & VanWormer, J. J. (2015). Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. Journal of the Academy of Nutrition and Dietetics, 115(9), 1447-1463.
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H.,… Vivian, E. (2017). Diabetes self-management education and support in type 2 diabetes: A joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. The Diabetes Educator, 43(1), 40-53.