Program Proposal and Evaluation Plan

Program Proposal and Evaluation Plan

Title and description

Diabetes is a basically a disease that attacks an individual's metabolism structure and produces dissimilarities and inconsistencies in the glucose/sugar level in the individual's blood. The primary conductor of the diseases, particularly diabetes mellitus, is the deteriorating function of the pancreas whereby they stop producing or produce very little of hormone insulin. This in turn impacts the production levels of sugar in the blood and increases it significantly to the point that the sugar level in urine is also elevated. As a consequence, the body reacts by producing energy through the use of other minerals and nutrients in the body like fat for instance because of the failure of the metabolism structure to use sugar for energy production. This results in the production of ketones in the blood which is a devastating sign for an individual's health as it means that the individual's diabetes is getting worse. There are two primary forms of diabetes that exist: i) Type 1, or insulin-dependent diabetes mellitus (IDDM) and ii) type 2, non-insulin-dependent diabetes mellitus (NIDDM). Each form carries its own symptoms and consequences for the patient. In this paper we focus on the second form of diabetes i.e. type 2, non-insulin-dependent diabetes mellitus (NIDDM). Some of the symptoms of diabetes include the following:

Extremely low levels of energy

Fatigue

Decreasing and deteriorating weight ratios

Dehydration

Augmented urine discharge

Increased level of hunger

Some important facts to know about the Type 2 diabetes are:

It targets the age group that is mostly above 40

The pancreas don't necessarily have to fail for type 2 diabetes to take effect

The body has to be insulin-resistant for type 2 diabetes to take effect

The consequence of type 2 diabetes can be heightened if the individual is suffering from insulin-resistance coupled with obesity

Healthy diet and exercise are key elements to control the negative consequences of type 2 diabetes

Oral hypoglycemia can also be used to decrease the blood sugar level if and when needed (PROMs 2009).

The rise of diabetes as a primary health concern among the masses has been consistent for the past few years. The National Health Survey in their report for the year 2004-2005 concluded that more than 3.6% of the total population had diabetes. In a follow up report, the National Health Survey confirmed that by the end of 2008, the figure had increased to include more than 4.0% of the population. The report also showed that nearly 88% of this population was suffering from type 2 diabetes NIDDM. The table below (figure 1) was also part of the survey done and illustrates visually the overall spread of type 2 diabetes NIDDM. The diagram shows the variations and differences in rations according to the age groups, showing how the higher age groups, i.e. 45 and above, are more vulnerable to the type 2 diabetes and hence experience higher risks as opposed to those in the younger age groups, i.e. below 45.

Figure 1: National Health Survey 2007-2008

Evidence of Need:

The first step needed in any health promotion venture is the needs assessment which is basically the procedure whereby the health problem is recognized and assessed along with the sample/target group chosen for the implementation of possible helpful actions (Hawe & Hall 1990, p. 210). Other procedures following the primary process include:

A detailed account of the health care approach and plan designed for implementation

The report can have multifaceted aims including increasing knowledge, improving the overall medical policies, developing the socioeconomic stature of the society, bettering the helath status and growth, etc. (Phillips & Verhasselt 2001).

Rationale:

It wasn't long ago when the need for some form of intervention fir type 2 diabetes NIDDM was recognized globally by organizations like the World Health Organization (WHO) and the United Nations Children's Fund. Hence, they joined hands and documented report and declaration regarding the detailed healthcare program they believed would be successful. They launched this declaration at a global discussion in Alma Ata, Kazakhstan in the year 1978.

The primary objective of the health program designed by the world health organization and United Nations Children's Fund was to ensure that the health services sector in the chosen regions improved and the medical policies were complemented and supported by relevant increases in the allocation of funds and budgets for bettering the health status of populations especially in the underdeveloped and developing nations. One important aspect of this report is that its main objective was to spread a prevention strategy amongst the population by educating them about the disease and all relevant information (WHO 1978). This proved to be a successful idea and hence has increased the importance of designing the healthcare policies and programs that not only help people fight back but also educate them about the type 2 diabetes NIDDM as well as the use of healthy diet (consumption of fruits and vegetables) and exercise programs to gain and sustain control over the process of the disease.

The diagram below exhibits the increase in the prevalence of type 2 diabetes NIDDM, with the use of age breakdown, over a period of 6 years; proving that the steady increase in the prevalence of the disease is all the more reason to employ better healthcare policies and education programs focusing on the use of healthy diet (consumption of fruits and vegetables) and exercise programs to gain and sustain control over the process of the disease.

Timelines and Location:

The entire program will last six months. The first two weeks will be the enrollment process whereby we will identify the goals and hurdles of the participants, educate them on the connection between the consumption of fruit and vegetables and decreased levels of type 2 diabetes through focus groups. The fourth week will initiate different focus groups through to week 12 followed by an evaluation in week 14. This will be followed by follow up structures of group discussion in week 18, 20 and 23. The last week, i.e. week 24, will be when the final evaluations will recorded. Of ocurse data analysis and results tabulations might require another month.

Publicity/Promotion:

Media will be key for the publicity of the Friends with Diabetes program. Services of the local magazines, newspapers, radio, press releases, brochures, leaflets, TV commercials/interviews/discussions/talks shows, posters, billboards, etc. will be used to full effect to spread the use of fruits and vegetables to control the type 2 diabetes with the target audience being the age groups of 25 to 54.

Program Details:

Goal:

The primary goal of this research was to ensure that there was an increase in the consumption of fruit and vegetables, within a space of six months by both male and female patients suffering from type-two diabetes NIDDM, in the age groups 25 to 54, within the city of Onkaparinga, Australia.

Evaluation indicators and tools:

In this study I highlight how the socioeconomic stature of the populations proves to be one of the biggest hurdles that disallow people to initiate and maintain a healthy diet lifestyle. In a report by the Socio-Economic Indexes for Areas (SEIFA) the city of Onkaparinga has really low and decreasing socioeconomic levels, even more so than other areas in Australia like Walkerville. This is illustrated in the figure below. This not only shows a high level of illiterate, untrained and unskilled populace but also one that has little to no knowledge of the numerous amount of knowledge available on the type2 diabetes as well as the advantage of having a fruit-and-vegetable-based diet plan (SEIFA 2006).

If one focuses on the yearly incomes for the city of Onkaparinga, there is a whopping 40% of the populace that earns less than a total of $21,000 dollars annually. The overall salary percentage decreases further when the focus is only on the female earners in the region. The numbers are all the proof one needs why cheaper food, that is mostly unhealthy, is consumed so heavily in the region as opposed to fresh vegetable and fruit consumption which is costlier (Stats & Facts 2006). Some of the questions that will be tackled in the questionnaire will include the following:

Do you exercise at least 30 minutes daily?

How often do you eat vegetables, fruit, or berries?

Have you or any member of your family ever taken medication for high blood pressure on a regular basis?

Have you or any member of your family been diagnosed with type 2 diabetes?

Impact indicators and tools:

One of the rising concerns of many health workers and practitioners with regards to type 2 diabetes is that more than 700,000 natives suffer from diabetes. This burdens the overall social, economic, health and emotional structure of the country of Australia and needs to be dealt with as such (McCarty et al. 1996). The concerns have good support as high diabetes prevalence can lead to other problematic diseases and health concerns such as heart failure or cardiovascular dis-functioning/disease, loss of sight, kidney stones or failure, uselessness and amputation of the lower limbs, gangrene, amongst others. This in turn adds more pressures on the Australian social and economic structure, making diabetes the seventh most fatal disease in the country. The diagram below proves that fact.

Diabetes deaths, 1984-2004

Objectives:

The main objective of this research included:

An increase in the consumption of fruits and vegetables amongst the sample within the six months allotted for the program. The percentage aimed at was at least 80%

To record decrease in the overall body mass and weight of the participants within six months

To record increase in the overall physical activities of the participants within six months, either through engaging in riding or running (National Physical Activity Guidelines for Adults 1999)

To follow up on the research and make sure that the participants are doing well and still implementing what they learned in the program

Strategies for the Friends with Diabetes Program, Derived From the Ottawa Charter for Health Promotion:

To encourage the consumption of fruits and vegetables, the community services will be used as community workers, students, local forces, house owners, etc. will be recruited to help educating the masses on the various ways that blood sugar can be normalized and controlled.

Process Indicators:

The follow-up records and documentations on all questionnaires and focus groups would be thoroughly evaluated by a team of local and national experts and researchers hired specifically for this study and the fulfillment of its aims.

Proposed Program:

The proposed program in this study is Friends with Diabetes. It is a highly successful and invigorating program that is structured around the encouragement of the consumption of vegetables and fruits for men and women suffering from obesity or high body mass ratios, in the age groups of 25 to 54, within the city of Onkaparinga, who have already been diagnosed with type 2 diabetes NIDDM. The plan is mainly structured to inform and educate the nutritionists as well as the educators of diabetes so that they can initiate a change in the lifestyle of the diagnosed patients and hopefully improve their overall health. The program is primarily executed during the summer holidays but can extend to as long as six months based on the extent of the findings of the researches and the amount of new knowledge and information that is available for transference to the educators and the nutritionists.

Evaluation Design and Data Collection Methods

Speaking about this study particularly, a questionnaire will be developed to fulfill its primary purpose. This is done because the use of questionnaires is very useful in not only managing a large target group or sample but can also help us gather a large amount of information in a short amount of time. This questionnaire will be aimed to help us understand the hurdles that exist in today's healthcare structure. For this study the sample chosen will include individuals who