Introduction
Diabetes is a serious racially-based health problem in the United States. It disproportionately affects Blacks (11.7%), American Indians (14.7%), and Hispanics (12.5%) and provokes a higher burden of complications (11.7% of blindness and 37% of chronic kidney diseases) (Haw et al., 2021). For example, in Nevada, about 14% of Blacks and 9.9% of Hispanics have diabetes compared to 11.5% of Whites (United Health Foundation, 2020). Many organizations educate people and provide the best guidelines for preventing and managing the disease. However, not many healthcare professionals are properly educated about cooperating with representatives of different races. Healthcare providers follow similar recommendations for all diabetic patients and diminish racial factors. This policy brief focuses on the eco-social perspective of type 2 diabetes and education, addressing race and health behaviors. The first option is to train healthcare professionals to cooperate with racial minorities and understand their genetic characteristics. The second option is to concentrate on diabetic patient education. The first option is preferred as it is not enough to improve public awareness but ensure that healthcare professionals are ready to work with racial minorities, specify their diets and physical activities, and control weight.
Rationale for Action of the Problem
Diabetic patients visit emergency departments with different complaints, including eye problems, kidney function failures, and cardiovascular complications. Compared to non-Hispanic Whites (7.5%), between 30 and 40% of racial minorities are disproportionately affected by similar complaints (Haw et al., 2021). Marcondes et al. (2021) reveal Hispanics who have been recently diagnosed with diabetes do not gain the same access to guideline-directed preventive care compared to their White counterparts. Additionally, Cheng et al. (2019) predict that the number of American citizens diagnosed with diabetes could increase to 38% by 2060. This indicates that current interventions are not working effectively, and improvements are necessary to prevent increased rates of diabetes. Blacks and Native Americans can be negatively affected by knowledge gaps and poor skills management. Thus, the rationale for action is based on the necessity to predict and prevent diabetes-related complications in racial minorities by properly educating individuals about healthy diets and regular physical activity.
Current policy failures may be related to poor awareness of healthcare professionals on how to educate racial minorities while providing care. Interactions between healthcare staff and diabetic patients include identifying and evaluating their “soft” needs like motivation, interests, and beliefs and applying technological advancements in everyday practices (Jain et al., 2020). Black and Hispanic patients need to incorporate regular physical exercise and maintain healthy diets to reduce the risk of developing diabetes. Therefore, healthcare professionals should identify and incorporate the environmental, physiological, and sociological aspects that matter to racial minorities in their practice. Policy failures have already disproportionately affected racial minorities in increased diabetes rates and comorbidities due to low levels of awareness and knowledge about healthy lifestyles in relation to diabetic risks.
Proposed Policy Option
There are two options to be discussed in this policy brief. The first option is to prepare healthcare professionals to cooperate with racial minorities and help them understand how to manage diabetes. An educational intervention for healthcare staff focuses on the ability to identify disparities among racial minorities diagnosed with diabetes, educate them on managing diabetes, and recommend appropriate lifestyle changes like healthy diets and physical activities.
The second option is to educate racial minority diabetic patients directly. The educational intervention should include identification of the illness, prevention of further complications, management of diabetes, and incorporation of lifestyle changes such as healthy diets and regular physical activities. This approach allows diabetic patients to monitor their blood sugar levels using a glucometer and define the most effective mediations to manage the current condition.
The evaluation criteria for the first option include the possibility of reaching more diabetic patients who need professional help and improving patient-doctor relationships in terms of managing chronic conditions and medication administration. A variety of diabetes-related issues and medication compliance challenge many people (Jain et al., 2020). The task of a nurse is to improve care and life quality by assisting patients with prescriptions and controlling activities.
The evaluation criteria for the second option are related to population knowledge about diabetes, its risks, and comorbidities. Individuals who do not have insurance or appropriate access to health care cannot recognize the threats. Their education affects how to use glucometers and take medications following proper dosage and time (Jain et al., 2020). Translators should be hired to remove the gap if language barriers prevent a learning process.
The decision to support the first option is made because of several reasons. Technological advancement is evident today, and many individuals are free to choose the most appropriate options to manage diabetes and cooperate with healthcare providers (Jain et al., 2020). Nurses have to understand that patients rely on their knowledge and help. They need to demonstrate high-level professionalism in care, listen to patients’ stories, provide emotional support, and build trusting relationships (Sørensen et al., 2020). Not many organizations have advanced nursing support and well-trained staff for racial minorities. Thus, the education of nurses is a unique opportunity to change care quality and diabetes management by addressing racial differences.
Policy Recommendations
Population education cannot be ignored in today’s world, where people get access to various sources of information to make their decisions. However, data quality is not always approved, and individuals may follow inappropriate recommendations, neglecting their genetic factors and personal health characteristics. Therefore, the policy option is to train and educate healthcare professionals on diabetes management for racial minorities. The stakeholders who need to educate people must take the courses and understand how influential their guidelines can be in particular groups. The first step is pre-intervention training for educators to identify disparities in those diagnosed or predisposed to diabetes (Marcondes et al., 2021). It is not appropriate for an unprepared healthcare provider to interact with racial minorities and teach them how to prevent or manage diabetes. The second activity is recognizing what help is more effective for diabetic patients considering their lifestyle preferences, resources, and social positions. Jain et al. (2020) underline the perspectives of technology-assisted self-management education. Hemoglobin A1C tests and cholesterol screening are recommended to identify the prediabetic condition (Haw et al., 2021). Nurses should be ready to work with racially diverse patients and recognize their specific needs.
Conclusion
Eco-social perspectives in predicting and treating diabetes introduce a relatively new trend. Although diabetes has already been proved more common among African Americans, Hispanics, and other racial minorities than in Whites, not many real steps are taken to support the groups at risk. The main objective of the selected policy is to improve healthcare providers’ knowledge on how to support racial minorities and educate them about diabetes and the importance of healthy diets and lifestyles. This educational program allows nurses to learn what treatment and support diabetic patients expect, focusing on their racial differences.
References
Cheng, Y. J., Kanaya, A. M., Araneta, M. R. G., Saydah, S. H., Kahn, H. S., Gregg, E. W., Fujimoto, W. Y., & Imperatore, G. (2019). Prevalence of diabetes by race and ethnicity in the United States, 2011-2016. JAMA, 322(24), 2389-2398.
Haw, J. S., Shah, M., Turbow, S., Egeolu, M., & Umpierrez, G. (2021). Diabetes complications in racial and ethnic minority populations in the USA. Current Diabetes Reports, 21(1).
Jain, S.R., Sui, Y., Ng, C.H., Chen, Z.X., Goh, L.H., & Shorey, S. (2020). Patients’ and healthcare professionals’ perspectives towards technology-assisted diabetes self-management education. A qualitative systematic review. PLoS ONE, 15(8).
Marcondes, F. O., Cheng, D., Alegria, M., & Haas, J. S. (2021). Are racial/ethnic minorities recently diagnosed with diabetes less likely than white individuals to receive guideline-directed diabetes preventive care? BMC Health Services Research, 21(1).
Sørensen, M., Groven, K. S., Gjelsvik, B., Almendingen, K., & Garnweidner-Holme, L. (2020). The roles of healthcare professionals in diabetes care: A qualitative study in Norwegian general practice. Scandinavian Journal of Primary Health Care, 38(1), 12-23.
United Health Foundation. (2020). Annual report: Diabetes in Nevada. America’s Health Rankings. Web.