Empowerment Through Capacity Building And Community Action For Addressing Preventable Health Concerns: A Case Study On Type 2 Diabetes

Strategies for Engaging with a Community to Implement a Program for Addressing Type 2 Diabetes

Health concern is referred to as the clinical or the socio-economic condition of the patient or the population which tends to increase the risk of adverse health complications that needs proper intervention or monitoring. The health concern which has been selected for the assignment is the type 2 diabetes. Type 2 diabetes is considered as one of the most chronic illness frequently observed among the individual of all age group. The prevalence rate of type 2 diabetes is higher as compared to any other chronic illness, which prevents the body from utilizing the insulin in the appropriate manner giving rise to various chronic signs and symptoms. This assignment involves the identification of the preventable health concern which is type 2 diabetes (Raymond & Lovell, 2015). Three different strategies have been implemented in the assignment by using the framework of Lavarack’s ladder of community-based interaction to engage with the community members in order to address the health concern. Apart from that, the ways by which the nine core domains of the capacity building can be used to support the journey of empowerment for the community members is discussed in detail. To increase awareness regarding the chosen health concern among the community members, health belief model and different health promotion approaches such as, behavioural approaches, medical approaches and educational approach has been used in the assignment.

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Type 2 diabetes mellitus is considered a metabolic disorder that impacts more than a thousand lives every year around the globe. While it emerged as one of the major chronic health issues that become epidemic in majority of the countries worldwide, high prevalence is also observed in Australia, especially in the population with a high obesity rate (Raymond & Lovell, 2015).  In Australia, family history, age, lifestyle and tendency of becoming obese is consider as risk factors which impacted the majority of the communities which further trigger comorbid situation (Browne et al., 2016). In this context, a health promotional program involving community-based interaction would be one of the most effective preventive measures which may improve the management of the disease (McDermott et al., 2015).  Laverack’s Ladder of community-based interaction responded to the gap between the desires of the local community and government program in order to address public health concerns (Herens & Wagemakers, 2017). The ladders of community interaction indicate that community empowerment is crucial which provides a link between individual control capacity and social aspects (Matarrita-Cascante, Sene-Harper & Ruyle 2019).  In this context, three key strategies for implementing a program include community participation, leadership building, and policymaking.  

Core Domains of Capacity Building for Supporting Community Empowerment and Ownership of a Prevention Program

Community participation can be the most suitable strategy to implement a program which can empower the community and provide adequate health literacy to manage health concerns (Bath & Wakerman, 2015). Through the community participation, the community members such as individuals experiencing type two diabetes and family members who are at high risk of developing type two diabetes can be encouraged to involve in the health program. The health professionals and nutritionists and other volunteers can be involved in the community participation for assisting individuals so that community members gather necessary information regarding diabetes mellitus, management and prevention strategies such as lifestyle modification and dietary modifications (Miller et al., 2016). The second strategy is to build leadership amongst individuals which include professionals and community members.  Leadership is a fundamental element of community-based interaction in health program which supports the achievement of the desired goal through partnership and collaboration (Vita et al., 2016). In this context, the health professionals are required to develop leadership skills by encouraging communities to take part in the program, actively listening to the concerns of the community members and addressing the unique need of the communities (Vita et al., 2016). It will further assist in developing leadership amongst community members since they will be aware of their health condition, feel empowered and confident to take part in the health promotional program and acquire skills to manage the public health issue (Miller et al., 2016).  The third strategy is to develop policies that promote healthy physical and mental wellbeing. Chiapperino and Tengland (2016), highlighted that policymaking is the final step of implementing a health program where policymakers and other stakeholders can collaborate to evaluate the condition and amend policies according to it. In this context, the interest of policymaker and nation have a greater influence on policy that will be designed or amended.  In order to amend policies, local government and international bodies such as WHO and Australian federal agencies can be involved to make policies (Giles-Corti et al., 2016). The health policy such as increasing the price of junk food that triggers obesity and amendments of healthy eating and active living policy can be incorporated for improving the program. The participants can be consulted based on the amended health policies (Giles-Corti et al., 2016). The health policies should be in favour of encouraging community members and empowering them.  The proper evaluation and monitoring should be done for measuring the success of the program.

Models and Approaches of Health Promotion for Educating the Community about Type 2 Diabetes

The ownership of preventing public health issues relies on the community members. While communities have long been encouraged to participate in health programs for enhancing their health outcomes, these approaches often fail to provide little or no health benefits to the population of community when the community has not strengthened and empowered to enhance their health. In this context, it was observed that the majority of the population in the Australian community is unaware of health literacy to manage type two diabetes through proper nutrition and physical activity (Giles-Corti et al., 2016). In a few cases, the population of the communities has limited resources for proper and adequate management of type two diabetes which further increased high mortality rate or comorbid situation (Raymond & Lovell, 2015). Hence, in this current context, proper strengthening or capacity building of the community would help enhance community participation and health outcome. Liberato et al (2011),   conducted a literature review on 13 articles to identify core domains of community capacity building. There are nine comprehensive domains to assess the community capacity which include resource mobilization, networking, leadership, asset-based approach, participatory decision making, and communication, sense of community and development pathway.  

Learning opportunities and skills development can be incorporated by encouraging community participants in the prevention program and involving them in training and workshops so that they can acquire the necessary skills for the management of diabetes (Begley & Pollard, 2016).  The subdomain can be incorporated in this domain such as community assessment so that the communities acquire skills required to meet primary needs.  The resource mobilization can be done by providing additional resources to the community for the management of type two diabetes.  The resources can be monitored and evaluated (subdomain of core domains of community capacity building) before providing to the community for improving the strength of the community.  The assets based approach can be taken in this case to mobilize the necessary resources (Bath & Wakerman, 2015). Proper networking and partnership can be done by collaborating with the health professionals and local as well as international governing bodies.  The profitable and non-profitable organizations can be involved in the partnership in order to assist the community in strengthening the capacity for health outcomes (Matarrita-Cascante, Sene-Harper & Ruyle 2019).  For example, professionals and organizations can support community members in amending their diet and lifestyle which will improve blood glucose levels and reduce the risk of becoming obese. The participatory decision making can be incorporated by involving the population in decision making which will empower participants and it can be through subdomain shared decision making and clearing goals to the population (Raymond & Lovell, 2015). The sense of community can be promoted through collaborations between health professionals and community members where leadership skills can be applied (Matarrita-Cascante, Sene-Harper & Ruyle 2019). Active communication strategies such as nonverbal and verbal communication can be established between health professionals and community members for addressing and assessing the need of community participants (Giles-Corti et al., 2016).  It is an excellent opportunity to reflect on compassion and empathy that strengthen community capacity for responding to the program (Giles-Corti et al., 2016).  It will build a therapeutic relationship amongst professionals and community participants and empower them.  An empowered environment can be created with the collaboration of health professionals and other stakeholders so that the community members feel empowered, comfortable and safe (Miller et al., 2016). Proper monitoring and evaluation of these domains and community activities with the alignment of these domains are required to do for the sustainability of the program. It will improve journey of empowerment and ownership of preventing disease.

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Health model is referred to as the health promotion framework which aims to enhance the effectiveness the health promotion. By observing the health concern, health belief model is considered as one of the most effective model to enhance awareness regarding the health concern among the community members.

Health belief model is termed to as the social psychological health behaviour change model which aims to modify the life style and health behaviour of the community members. By the aid of the health belief model, community members should be educated about the behaviour and life style that can be considered as the risk factor for the occurrence of the disease. Along with that, the community members should also be educated about the strategies to modify their health behaviour in order to increase their standard of living (Skinner, Tiro & Champion, 2015).

According to Jones et al., (2015), the strength of the model is that it addresses the cognitive theory and disseminates the individual into different categories, based on which they are motivated or educated to modify their current health behaviour.

The major limitation of the Health belief model is reported to be its unaccountability for the person’s attitude, values, beliefs and other determinants which is responsible for the modification of the health behaviour.

The health promotion approach which can be used to educate the community members regarding the adverse impact of type 2 diabetes in health and also about the risk factor behind it are education approach and behavioral change Approach.

According to (Kok et al., 2016), life style of the individual plays an essential role in maintaining the mental as well as physical health of the individual. Therefore by the aid of the behavioral change Approach, the community members are encouraged to adapt to the healthy living style.

The major advantage of the approach is that it helps the individual to modify their health behaviour whereas, the process is little time consuming which can be considered as the limitation.

Other health approach is educational approach, which is one of the most effective approaches to spread awareness among the community members. With the aid of this, the community members are educated regarding the adverse health outcome of type 2 daubes among the population (Marris, 2018).

The major advantage of this health promotion approach is that it helps in increasing health literacy among the population. However, the only major disadvantage is its time consuming aspect.

Conclusion:

From the above discussion it can be concluded that, type 2 diabetes is one of the major health concern identified among the individual of all age group. Type 2 diabetes if diagnosed in an individual it can never be cured and hence the only option in such case is to prevent the occurrence of the disease. From the above discussion, it is clear that lack of awareness and access to the primary healthcare service is considered as one of the most essential cause behind the increasing prevalence rate of diabetes which possesses negative impact on the quality of living of the individual. In the discussion, three different strategies such as, Community participation, building leadership and developing policies that promote healthy physical and mental wellbeing is incorporated which aims to address the health concern. Along with it, the nine different core domains which aim to increase the engagement of community member in the health promotion is also discussed in detail. Health belief model which is considered as one of the most commonly used health promotion model in the healthcare setting has been used in the discussion to educate the community members and along with that different health approaches such as, behavioural approaches and educational approach is also observed to be effective.

References:

Bath, J., & Wakerman, J. (2015). Impact of community participation in primary health care: what is the evidence?. Australian Journal of Primary Health, 21(1), 2-8.

Begley, A., & Pollard, C. M. (2016). Workforce capacity to address obesity: a Western Australian cross-sectional study identifies the gap between health priority and human resources needed. BMC public health, 16(1), 881.

Browne, J. L., Ventura, A. D., Mosely, K., & Speight, J. (2016). Measuring the stigma surrounding type 2 diabetes: development and validation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2). Diabetes Care, 39(12), 2141-2148.

Chiapperino, L., & Tengland, P. A. (2016). Empowerment in healthcare policy making: three domains of substantive controversy. Health Promotion Journal of Australia, 26(3), 210-215.

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Kok, G., Gottlieb, N. H., Peters, G. J. Y., Mullen, P. D., Parcel, G. S., Ruiter, R. A., … & Bartholomew, L. K. (2016). A taxonomy of behaviour change methods: an Intervention Mapping approach. Health psychology review, 10(3), 297-312.

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Vita, P., Cardona-Morrell, M., Bauman, A., Singh, M. F., Moore, M., Pennock, R., … & Colagiuri, S. (2016). Type 2 diabetes prevention in the community: 12-Month outcomes from the Sydney Diabetes Prevention Program. Diabetes research and clinical practice, 112, 13-19.