Effectiveness of Culturally Tailored Diabetes Education Among Asian Americans Term Paper

Excerpt from Term Paper :

Introduction

There are various risk factors that have been associated with the development of type 2 diabetes. These include, but they are not limited to, ethnicity and lifestyle. With regard to ethnicity, it is important to note that people of Asian descent have a higher predisposition to type 2 diabetes, in comparison to persons of European ancestry. Some of the complications associated with type 2 diabetes include cardiovascular disease, kidney damage, and nerve damage. It therefore follows that the relevance of proper control and management of type 2 diabetes cannot be overstated. For most persons with type 2 diabetes, the optimal control of the same tends to be a challenge. In that regard, therefore, there is need to assess how effective patient-specific dietary and lifestyle modifications are towards the control and management of type 2 diabetes. Towards this end, this study will chart pre-education and post-education glucose levels of 5-10 Asian Americans with an aim of assessing the effectiveness of culturally tailored diabetes education among this group, in comparison to a control group that has no access to such education.

Background of the Problem

Like any other chronic disease, diabetes calls for the active involvement of the patient in its management and treatment. This effectively means that interventions ought to be cognizant of the relevance of self-management. According to Nguyen, Nguyen, Fischer, and Tran (2015), “type 2 diabetes mellitus (T2DM) is a growing problem among Asian Americans.” The need to address this problem calls for the implementation of valid and effective intervention measures. Culturally tailored diabetes education could come in handy in seeking to halt this worrying trend. This is more so the case given that in the recent past, the cultural practices and beliefs of Asian Americans regarding diabetes and its treatment have not been sufficiently explored or probed.

Theoretical Foundations

The theoretical framework of the present study will be based on health belief model (HBM). In essence, the HBM “highlights the cognitive processes that act as barriers to taking preventive action through an emphasis on the role of subjective beliefs or expectations…” (Cousins, 1998, p. 145). This model is of great relevance to the present study as in the words of Jones, Jensen, Scherr, Brown, Christy, and Weaver (2015), it “posits that messages will achieve optimal behavior change if they successfully target perceived barriers, beliefs, self-efficacy, and threat” (566). The proper control and management of diabetes is often hampered by challenges that have a cultural bearing. As a matter of fact, various studies have in the past pointed out that the relevance of the social context of disease management cannot be overstated in seeking to improve outcomes (Chesla, Chun, and Kwan, 2009).

Review of Literature

Being a chronic condition, the optimal outcome of treatment and management of diabetes largely relies on self-management education that is ideally designed to enhance the quality of life via the promotion of certain behaviors and habits (Jake, 2007). For this reason, diabetic patient education ought to be personalized so as to achieve the desired outcomes. It is, however, important to note that the ability of persons to acquire, process, retain, and recall information and skills is affected by a wide variety of factors. Some of the more prominent factors on this end include cultural background and life experiences. According to Nguyen, Nguyen, Fischer, and Tran (2015), the very first step in seeking to ensure that diabetes education has the desired impact is cultural sensitivity. Cultural sensitivity has got to do with the awareness of not only the customs and beliefs of a certain people, but also their actions and though processes (Nguyen, Nguyen, Fischer, and Tran, 2015). This is the definition of cultural sensitivity that will be adopted in this text. According to Lopez, Ruiz, and Pattern (2017), “a record 20 million Asian Americans trace their roots to more than 20 countries in East and Southeast Asia and the Indian subcontinent, each with unique histories, cultures, languages and other characteristics.” Type 2 diabetes, as Nguyen, Nguyen, Fischer, and Tran (2015) observe, is increasingly becoming a concern in this demographic group. This effectively underlines the need for the personalization of diabetes education for the same to be deemed effective.

As Shabibi et al. (2017) acknowledge, being a chronic disease, diabetes calls for the enhancement of the appropriate self-care habits and behaviors of patients. In a study seeking to chart how educational intervention founded the Health Belief Model affects the self-care habits of patients having type 2 diabetes, Shabibi et al. (2017) came to the conclusion that “health education through HBM promotes the self-care behaviors of patients with type 2 diabetes” (5967). In basic terms, this particular model, according to Cousins (1998) “highlights the cognitive processes that act as barriers to taking preventive action through an emphasis on the role of subjective beliefs or expectations…” (145). This effectively means that when applied in this context, HBM addresses the long-standing behaviors via the adaptation of individual cognitions so as to eliminate or improve behaviors deemed as being counterproductive to the wellbeing of an individual. This is more so the case given that HBM is constructed on the basis that it is possible to avoid health conditions deemed negative; that the adoption of a recommended course of action could be of great relevance in seeking to avoid adverse health conditions; and that people can indeed embrace or adopt health behaviors that reinforce their health and wellbeing (Jones, et al., 2015). The relevance of reining in diabetes via the effective management of the same cannot be overstated – and towards this end, HBM comes in handy in seeking to further enhance our understanding and grasp of health behaviors and how to positively influence them via the application of culturally-relevant diabetes education.

Chesla, Chun, and Kwan (2009) are of the opinion that for health interventions to be appropriate among various demographic groups having strong cultural bearings; cultural humility is of great relevance. While there are many approaches that could be embraced in seeking to overcome cultural barriers in the treatment and management of diabetes amongst Asian Americans, culturally tailored diabetes education appears to be the most effective given the level of involvement of diabetes patients in their treatment and management plan. Shabibi et al. (2017) are of the opinion that diabetic educators ought to be well-versed on the customs and traditions of the ethnic formations they interact with. This means that they should also be aware of the beliefs, preferences, as well as learned behaviors of those diabetic patients so as to be able to ensure that culturally appropriate methods are utilized in the delivery of diabetes education.

Problem Statement

It is not known how effective culturally tailored diabetes education, founded on current evidence-based findings, is in the management and control of diabetes among Asian Americans. Given that type 2 diabetes is a chronic disease, self-management education remains one of the most important interventions for improved outcomes. Towards this end, there is significant evidence to suggest that patient education ought to be tailored to the specific circumstances of the diabetes patient. However, learning is often influenced by a wide range of factors including, but not limited to, an individual’s support networks and life experiences – both of which are largely controlled or governed by culture. There is need, therefore, to determine how culturally tailored diabetes education impacts the management and control of diabetes.

Purpose of the Project

The purpose of this project is to determine whether patients who receive culturally tailored diabetes education report a reduction in A1C levels, in comparison to patients who receive standard education. It was hypothesized that participants who receive diabetes education would report improved A1C levels, in comparison to participants who receive standard education. For this project, a total of 10 participants of Asian American extraction will be selected. Findings will come in handy in seeking to not only map the efficacy of culturally tailored diabetes education programs for Asian Americans, but to also inform the appropriate design and implementation modes for such programs.

Clinical Questions and Variables

Research Questions

1. Amongst Asian Americans with type 2 diabetes, does culturally tailored diabetes education to implement patient-specific dietary and lifestyle modifications reduce their A1C levels after 3 weeks?

2. What unique practices and beliefs do Asian Americans exhibit regarding diabetes treatment and management?

H1: Amongst Asian Americans with type 2 diabetes, culturally tailored diabetes education to implement patient-specific dietary and lifestyle modifications results in statistically significant reductions in their A1C levels after 3 weeks.

H0: Amongst Asian Americans with type 2 diabetes, culturally tailored diabetes education to implement patient-specific dietary and lifestyle modifications has no significant impact on their A1C levels after 3 weeks.

Significance of the Project

The present study will add to the existing body of knowledge on the relevance of culturally appropriate diabetes interventions. There are several studies that have been conducted on this particular topic in the past in relation…

Sources Used in Document:

References

Cousins, S.O. (1998). Exercise, Aging, and Health: Overcoming Barriers to an Active Old Age. Philadelphia, PA: Taylor & Francis.

Chesla, C.A., Chun, K.M. & Kwan, C.M. (2009). Cultural and Family Challenges to Managing Type 2 Diabetes in Immigrant Chinese Americans. Diabetes Care, 32(10), 1812–1816.

Jekel, J.F. (2007). Epidemiology, Biostatistics, and Preventive Medicine. Philadelphia, PA: Elsevier Health Sciences.

Jones, C.L., Jensen, J.D., Scherr, C.L., Brown, N.R., Christy, K. & Weaver, J. (2015). The Health Belief Model as an Explanatory Framework in Communication Research: Exploring Parallel, Serial, and Moderated Mediation. Health Communication, 30(6), 566-576.

Lopez, G., Ruiz, N.G. & Pattern, E. (2017). Key Facts about Asian Americans, a Diverse and Growing Population. Retrieved from http://www.pewresearch.org/fact-tank/2017/09/08/key-facts-about-asian-americans/

Metghalchi, S., Rivera, M., Beeson, L., Firek, A., Leon, M.D., Maclntyre, Z.R. & Balcazar, H. (2008). Improved Clinical Outcomes Using a Culturally Sensitive Diabetes Education Program in a Hispanic Population. Diabetes Education, 34(4), 698 – 706.

Nguyen, T.H., Nguyen, T., Fischer, T. & Tran, T.V. (2015). Type 2 Diabetes among Asian Americans: Prevalence and Prevention. World Journal of Diabetes, 6(4), 543–547.

Shabibi, P., Zavareh, M.S., Sayehmiri, K., Qorbani, M., Safari, O., Rastegarimehr, B. & Mansourian, M. (2017). Effect of Educational Intervention Based on the Health Belief Model on Promoting Self-Care Behaviors of Type-2 Diabetes Patients. Electronic Physician, 9(12), 5960–5968.

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