Refer to pages 139-141 in your text book and write a paper (750-1000 words) on how you would implement your intervention from Paper Part 2 and how you would evaluate that intervention.

Imagine yourself actually doing this intervention and everything you would need and need to do to complete the intervention.

Be as detailed as possible: where you would implement and why there, who your target would be, who you would interact with, how long would you be there, how many mailings/materials, where would you get the mailings/materials, who would you need to get permission from (if you need permission), specifically what would you be trying to accomplish, etc.

Problem definition
In the state of Hawaii, diabetes has been identified as the seventh primary causative agent of death because it has been approximated that more than nine hundred individuals die annually as a result of diabetes or other associated ailments. Moreover, statistics as of 2004 showed that more than one hundred thousand people had been diagnosed with the disease thus implying that this is a severe and widely common disease that warrants timely intervention in order to tame its continued existence (Hirokawa et al., 2004).
Goals and objectives for a diabetes health promotion program
Goals    Objectives    Evaluation measures
1.    Reduce the prevalence of diabetes in Hawaii.    a.    Increase the percentage proportion of Hawaiians who have access to diabetes education annually by 70%.
b.    Reduce cases of clinically diagnosed diabetes by 3%.
c.    Train more health workers in issues pertaining diabetes in order to equip them with relevant knowledge on how to create awareness within the masses.
d.    Increase the percentage of diabetic adults aged 65 years and above on medical care and examinations.
e.    Reduce cases of diabetes in individuals below 18 years by 2%.
f.    Increase the number of individuals undergoing routine care by 90%.
g.    Increase influenza and pneumonia vaccinations by 50%.      a.    Increased individual and community awareness.
b.    Change in behavioral attitudes
2.    Ensure that diabetes management strategies are effectively implemented.    a.    Increase the number of people with diabetes on medication by 99%.
b.    Increase nutrition centers and physical training facilities by 60% to defer diabetes development.
c.    Increase diabetes self-care modules by 60% in order to promote self-management.
d.    Increase percentage of individuals undergoing foot-check by 70%.
e.    Increase healthcare coverage by 70%.
f.    Increase community health surveys by 50%.
g.    Carry out diabetes awareness forums, for instance diabetes walks, quarterly.      a.    Change in attitudes and discontinuation of certain behaviors.
3.    Help families to effectively deal with life style changes that occur after diabetes diagnosis.     a.    Increase the number of educational facilities by 60%.
b.    Increase the prevalence of community based diabetes forums and participation by 50%    a.    Changes in attitudes.

Goal document
Goal setting one
Goal: Reduce the prevalence of diabetes in Hawaii by increasing the quality of services, facilities and education available to the population.
Objective: Increase the percentage proportion of Hawaiians who have access to diabetes education annually by 70% by equipping the available health facilities with effective equipment and training and equipping healthcare providers with efficient response procedures in these areas;
a.    Education
Target: 70 percent
Baseline: In 2010, 90% of the available healthcare facilities and nongovernmental health education organizations carried out a survey of diabetes incidences in Hawaii and established that the disease was more prevalent in the aging population. These healthcare facilities then educated the public on preventive measures and self-care modules in the identified cases, after which caregiving to the affected was initiated.
Target setting method: 20% improvement in new diabetes cases.
Data source: The Hawaii Behavioral Risk Factor Surveillance System Special Report (HBRFSS).
b.    Eating habits
Target: 70 percent
Baseline: Available data showed that the likelihood of all adult diabetes patients was obese as a result of lifestyle and eating habits. 90% of the healthcare facilities and the nongovernmental healthcare organizations provided healthy eating habits education to the natives in 2004.
Target setting method: 20 percent improvement.
Data source: Hawaii Diabetes Report 2004.
Goal setting two
Goal: Ensure that diabetes management strategies are effectively implemented by all concerned government agencies, healthcare facilities and interested interest groups.
Objective: Increase nutrition centers and physical training facilities by 60% to defer diabetes development by paying special attention to the following key areas:
a.    Education
Target: 80 percent.
Baseline: Available data showed that an individual’s education levels were essential in determining their understanding and application of the provided nutrition and physical undertaking education. To fill this knowledge gap 80 percent of the nutrition and physical training centers undertook a training initiative that was aimed at ensuring that the community had pertinent and updated information on diabetes and how to manage it effectively.
Target setting method: 20 percent improvement on education uptake.
Data source: Hawaii Diabetes Report 2004.
b.    Care provision
Target: 90 percent
Baseline: Available data shows that health facilities have arisen to address other ailments that are associated with diabetes thus intensifying the fight against diabetes. The present 80 percent of the nutrition centers and physical training practitioners took the population through trainings in order to equip them with knowledge on how to detect and manage cases of diabetes. Self-care and medication was stressed as a way of ensuring that individuals could self-manage the disease before seeking specialized attention from caregivers.
Target setting method: 20 percent.
Data source: Hawaii Diabetes Report 2004.
Diabetes intervention
As stated in the problem statement, diabetes is a major problem in Hawaii because a greater portion of the aging population is suffering from it. To this end, this paper will seek to address how the lifestyle change and diet and its nutritional content can be used to prevent the prevalence of type 2 diabetes. To address this issue, peer reviewed journals will be essential in data collection because they will provide me with the insight into how type 2 diabetes as a common disease can be prevented. Worldwide, type 2 diabetes has been identified as a common feature in most reported cases and thus effective and efficient interventions are required in order to adequately address it. Research shows that in 2000, approximately one hundred and fifty million people were diagnosed with type 2 diabetes. This research further asserts that by 2025, these numbers will have doubled thus pointing to the fact that stringent measures are needed to cushion the population from it (King, Aubert & Herman, 1998).
With these numbers, type 2 diabetes has been identified as one of the leading causative agents of most deaths in the world, notably in both developing and industrialized nations. Though its prevalence is alarming, encouraging trends show that there are fewer reported cases in remote areas where inhabitants are still engulfed in cultural ways of life. This piece of information is essential in coming up with effective intervention measures because a breakthrough into the factors influencing the lower numbers will inform research (Amos, McCarty & Zimmet, 1997). Due to obesity, native Hawaiians are at an increased risk of getting type 2 diabetes as compared to the other tribal groupings in Hawaii. Although the occurrence rates are greater for the natives, research has not effectively addressed the reasons behind the higher occurrence rates because obesity alone does not account for the increasing cases.
In recent peer reviewed journals; inherited traits, acculturation and standards of living have been thought to greatly contribute to the rising cases. It is projected that approximately 100,000 Hawaiians have type 2 diabetes; a number that is alarming. It is however sad to note that approximately 25,000 of the estimated total number of cases go unspotted and hence are never diagnosed thus resulting in terrible diabetes cases. In a state that also has Filipinos; the percentage of Hawaiians that have type 2 diabetes is the highest at 13%; the Filipinos come in second with 10% prevalence. For the native Hawaiians’ case the most affected ages range from thirty years and above (Furubayashi & Look, 2005).
With the increasing medical technology, research has ascertained that there are numerous risk factors that lead to the development of type 2 diabetes in the world. This common type of diabetes develops when the body fails to adequately use insulin thus resulting in an increase of blood sugar; a health condition commonly referred to as hyperglycemia. Research in this field has shown that living a sedentary lifestyle, genetic influences and obesity have been identified as some of the factors that lead to this disease. Of these risk factors, genetic influences has been found to be the most common because if type 2 diabetes runs in the family, then one has higher chances of getting the disease as compared to another individual in whose family the disease is a rarity. In lesser cases, individuals who lead a sedentary lifestyle and yet consume foods that have high calorie components are also at risk of contracting the disease. There is usually a relationship between sedentary lifestyles and obesity they resulting in the accumulation of fat tissue which easily results in diabetes type 2. Recent research has pinpointed obesity as the major risk factor of type 2 diabetes in other cases where there is no prevalence of the disease. Inadequate physical activity often plays a major role in obesity because it leads to one becoming overweight thus at risk of contracting diabetes (Furubayashi & Look, 2005).
Lifestyle change and keeping checks on the diet and its nutritional constituents have been found to be effective measures of addressing type 2 diabetes. Leading a lifestyle that is filled with physical activity has been found to be an essential aspect because it lowers risks of being diagnosed with diabetes. Moreover, ensuring the diet is rich in roughage and has lesser saturated fats has been helpful because it ensures that there are no fat deposits hence protecting one from risk factors, for instance weight gain. Putting individuals on controlled diets and increasing their physical activity has been found to be essential because it tremendously reduces cases of type 2 diabetes (Furubayashi & Look, 2005).
Lifestyle involvements, for example controlled alcohol intake, have been found to reduce type 2 diabetes as compared individuals who do not. In women, lesser alcohol consumption was found to be helpful, though in men it did little to prevent them from acquiring type 2 diabetes. Concerning alcohol consumption, I cannot fully recommend it as a preventive method because of the variance in results and thus more researches need to be conducted in order to fully ascertain alcohol applicability. I believe that changes in lifestyle and diet and nutrient intake will be essential in preventing the prevalence of type 2 diabetes because food, which can easily make one overweight, can easily be a cause and at the same time a prevention model if well employed (Furubayashi & Look, 2005).

Amos, A., McCarty, D. & Zimmet, P. (1997). The rising global burden of diabetes and its complications: estimates and projections to the year 2010. Diabetic Medicine, Vol. 14
Furubayashi, J. & Look, M. (2005). Type 2 diabetes in native Hawaiians and Pacific Islanders in Hawaii. Pacific Health Surveillance and Rescue, Vol. 12, No. 2.
Hirokawa, R., Huang, T., Pobutsky, A., Noguès, M., Salvail, F. & Nguyen, H. (2004). Hawaii Diabetes Report, 2004. Hawaii State Department of Health, Honolulu, Hawaii.
HBRFSS (2004). Adult diabetes prevalence measured from the HBRFSS. Year 2, Issue 1. Retrieved 17/3/15 from http://health.hawaii.gov/brfss/files/2013/11/AdultDiabetesPrevalence.pdf
King, H., Aubert, R. & Herman, H. (1998). Global burden of diabetes, 1995-2025: prevalence, numerical estimates and projections. Diabetes Care, Vol. 21.

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