Following section is the findings chapter of the capstone. It will include limitations of the research on adult diabetes. Similarly, it will also include use and application of findings including 3 recommendations to promote additional research on adult diabetes. Every research paper is influenced by conditions and situations that affect or confine technique and study of research data, commonly known as limitations. Limitations can be described as inadequacies, circumstances or influences faced by the researcher which cannot be controlled and affects the research methodology and conclusions (“Develop a Research Proposal – Planning the Methodology – Limitations and Delimitations,” n.d.). The use and application of findings of a research usually include researcher’s recommendation on the research topic for the future researchers. It serves as a pathway for the future researchers to explore an area of the research topic that either requires additional data or new findings (“Research Guides: Organizing Your Social Sciences Research Paper: 7. The Results,” 2017). So, this chapter will also include use and application of findings including three recommendations to promote additional research on the topic of adult diabetes.
Time, data collection process and access to literature are some of the limitations encountered during the research of adult diabetes in this capstone.
For this research paper, time was a significant limiting factor for obtaining data related to adult diabetes. This research paper had a time constraint of 9 weeks in which the required data needed to be obtained and reviewed which was significantly challenging due to the complexity of the research topic. For example, the literature review section of the capstone project required in-depth scholarly research into topics such as a historical overview of diabetes, a prevalence of diabetes in various ethnic populations, and programs and initiatives for reducing diabetes in Illinois, within a time period of one week. Additional time for research would have assisted in obtaining further information pertaining to these topics from further scholarly resources. Since there was time restriction to do research and collect data, limited research was performed.
Data collection process
The means of data collection method can also represent a strong limitation for researchers when conducting research. For this research paper data used was not a primary data which is usually collected by the researcher based on the topic being researched, but chiefly secondary data from already existing scholarly resources such as government websites, reputed organization, educational institutions, newspapers, and online articles. For this primary reason, research data was restricted to the data which was collected and used for other research studies to meet different purposes (“Advantages and Disadvantages of Secondary Data – CourseBB,” 2017). For example, for data related to literature topic- “prevalence of diabetes in various ethnic populations”, secondary data was obtained from reputed organizations such as American Diabetes Association and Illinois Department of Health who have conducted their primary research and obtained primary data through focus groups, interviews, and surveys for other research purposes. Due to this limitation only restricted secondary data could be obtained and used for this research paper.
Lack of access to data
Since the data for the research was mainly obtained through secondary resources, the data was limited due to restricted availability and accessibility (“Advantages and Disadvantages of Secondary Data – CourseBB,” 2017). Secondary data available was not exactly relevant and appropriate to the research topic and was unable to address the research question and purpose in a proper manner. For example, there was restricted data available on “diabetes in a low-income population in Illinois.” The only secondary data that was available was through an article published by Illinois Department of Public Health called “Illinois Diabetes State Plan” which did not address this topic in an appropriate manner. There were other secondary resources available for “diabetes in low-income population” in general which do not address diabetes in the State of Illinois. To get more elaborated data and information related to this topic a primary research had to be conducted which is not feasible for this research paper and hence it was limited due to lack of access to literature.
Use and Application of Findings
The following section is a use and application findings for the given capstone research paper. It will include three relevant recommendations which may be useful in the field of Healthcare Administration. These recommendations are based on the scholarly evidence found as a result of extensive research from the literature review section of the capstone project from already existing scholarly resources from government websites such as Centers for Disease Control and Prevention and Illinois Department of Public Health, reputed organizations such as American Diabetes Association (ADA), educational institutions such as the University of Illinois at Chicago, newspapers, and online articles. In the United States, with diabetes affecting an estimated 29.1 million people and being the 7th leading cause of death, a more research study is essential for its cure and prevention (“Diabetes | Healthy People 2020,” n.d.). Based on the research performed during the extensive literature review of the scholarly resources, increasing access to healthcare for the low-income population, standardization of diabetes nutrition therapy and increasing awareness of diabetes in high-risk populations are some of the recommendations of this capstone project.
Increasing access to healthcare for the low-income population
There are wide health disparities that exist in the United States due to societal issues such as discrimination, socio-economic status, institutional racism, lack of health insurance and poor access to healthcare. These factors are increasing the burden of diabetes in specific racial and ethnic minority groups, especially those living in poverty making healthcare disparity a major focus for research. The burden of daily effective management of diabetes falls upon the patient due to its complexity. Successful diabetes management demands modified patient behavior that includes medication, daily blood glucose monitoring, record maintenance, and adjustment in lifestyle related to diet and exercise. Due to this reason, limited access to health care resources, contending survival demands and other social, economic and cultural hurdles associated to poverty status imposes a profound burden on disadvantaged populations leading to difficulty in self-management of diabetes (Vest et al., 2013).
The study conducted in Buffalo, New York with 34 diabetic patients revealed that even with activated social support and education to assist in diabetes self-management, the low-income population still faced low-income status obstacles such as lack of health insurance coverage, costly co-payments and distrust of the medical system. Low-income refugee population faced further challenges such as inadequate education, restricted knowledge of English language, lack of understanding about the US health system and preventive care. So, in order to increase access to healthcare and reduce health disparities in United States health system, these challenges need to be addressed taking into special account socio-economic challenges faced by low-income population. For efficient diabetes self-management not only individual patient behavior but also the patient’s community characteristics, cultural background and beliefs, social support networks and relationship with the health care system has to be taken into consideration (Vest et al., 2013).
Since the prevalence of diabetes is high among low-income populations providing diabetes management tools through food bank might help in effective management of diabetes. The study conducted by University of California at San Francisco (UCSF) and Feeding America (food bank) found that when low-income population diagnosed with diabetes were provided with diabetes- suitable food, primary care referral, blood sugar monitoring and self-management support, it enhanced their probability of better management of diabetes. These provisions assisted in the improved diabetes control and medication adherence and aided them in consumption of healthy food. So, food banks such as Feeding America can be used to address the growing epidemic of diabetes in low-income population as they have necessary resources to not only collect and distribute diabetes suitable food, but also provide diabetes health education as an institute (Fruth, 2016).
Various studies show that income and education are an important contributing factor in the prevalence of diabetes in certain population. So, by providing and promoting resources such as medication, daily blood glucose monitoring, record maintenance and education pertaining to adjustment in lifestyle related to diet and exercise in low-income population prevalence of diabetes can be reduced. Since unhealthy diet is a major contributing factor in developing diabetes, providing diabetes suitable diet through food banks- their main source of food, to the low-income population will make a major impact in reducing the burden of diabetes in them.
Standardization of diabetes nutrition therapy
For proper diabetes disease management, a healthy nutrition pattern, daily physical activity, and standard pharmacotherapy are major factors. Nutrition management is the biggest challenge for individuals with diabetes. According to American Diabetes Association (ADA) for effective diabetes management, there should not be a “one-size-fits-all” strategy, but nutrition therapy that is designed based on individual needs. Such personalized nutrition therapy will assist individuals diagnosed with diabetes to actively engage in self-management, education and treatment plan. There should be a standardization of diabetes nutrition therapy so that all individuals who are diagnosed with diabetes can receive customized nutrition plan which will assist them in effectively managing their diabetes in coordination with their healthcare provider. The customized nutrition plan should be based on individual and cultural inclination, health consciousness and realization, access to healthful food selection, compliance and aptitude to make behavioral modification. The primary goal of the standardized nutrition therapy should be to emphasize a range of nutrient-dense foods in suitable portion to endorse and sustain healthy eating habits in order to develop overall good health. By implementing such standardized nutrition therapy, individuals diagnosed with diabetes can reach and sustain body weight goals which will help them postpone the commencing of diabetes in high-risk population or avert complications of diabetes in diagnosed individuals (Vest et al., 2013).
Clinical effectiveness of medical nutrition therapy (MNT) in diabetes is supported by findings from experiments, investigational studies, and systematic reviews. When delivered using a systematic standardized process, MNT has been proven to have considerable effect on improving metabolic control in individuals with all types of diabetes. Providers assisting in MNT need to be familiar with evidenced-based nutrition recommendations and should use critical thinking and decision-making skills when providing care for individuals with diabetes in order for effective diabetes management. Usage of such standardized medical nutrition therapy leads to improved blood glucose levels and reduction in usage of health services and costs making healthcare more cost-effective (Ross, Boucher, O’Connell, & American Dietetic Association, 2005, p.?61).
The above-reported success of standardization of diabetes nutrition therapy programs advocates for more resources to be put in to implement such programs across the board in the United States. By doing so every individual diagnosed with diabetes can get an equal opportunity to necessary education and resources to fight diabetes which is becoming a pressing health issue.
Increasing awareness of diabetes in high-risk populations
In order to reduce prevalence of diabetes in high risk population such as African American, Hispanics/Latinos, and Asian Americans, Native Hawaiians and Pacific Islanders, it is essential that educational and diabetes initiative programs should be created to promote awareness and ensure that all people with diabetes receive best care and treatment to manage diabetes (“Awareness Programs,” n.d.).
According to American Diabetes Association (ADA), in African American community, diabetes is one of the most challenging health problems when compared to general population. Many programs and resources have been created by American Diabetes Association to address the growing epidemic and to raise understanding about the seriousness of diabetes and its complications among African American community (“Live Empowered/African American Programs,” n.d.). For example, to target African-American women between the ages of 35-55, “choose to live” is a diabetes awareness program created by American Diabetes Association which helps African-American women to take charge of their health and in turn take better care of families, friends and community (“Choose to Live,” n.d.). Similarly, “live empowered” is another program designed by ADA for African-American community which aims at raising the understanding of the seriousness of diabetes and stresses on the significance of making healthy lifestyle choices such as being active and eating healthier. This program was specifically developed with a focus on culturally appropriate materials and community-based activities. It enables, educates and creates considerable distinction in the prevalence of diabetes and its complication among African American community with various workshops and events (“Live Empowered/African American Programs,” n.d.).
In Latino community, diabetes is an imperative health problem as their rates of diabetes has almost doubled in comparison to non-Latino whites as per American Diabetes Association. It is essential to provide information pertaining to the seriousness of diabetes, its risks, and means to control the disease to the community (“Latino Programs,” n.d.). Most Latino population does not put their own health care ahead of their family needs as they feel guilty spending time and money on personal health. ADA through “Por tu familia” (“for your family” in English) program is trying to educate the Latino community that by taking care of their diabetes or preventing from developing it they, in turn, help their family too as they can be there for their family when they need them. Information pertaining diabetes initiatives and programs are provided to them in the form of books and brochures to get them more physically active and maintain a healthy weight (“Por tu familia,” n.d.). Other programs such as “Feria De Salud”, a community event aims at reaching thousands of local Latinos/Hispanics to educate them about the seriousness of diabetes with festive elements of a street fair which includes music, dancing cooking demonstration, nutritional information, speakers (“Feria de Salud,” n.d.).
Asian Americans, Native Hawaiians and Pacific Islanders are at increased risk for diabetes with their different Body Mass Index (BMI). Asian Americans are considered overweight and at increased risk of type 2 diabetes at a BMI of 24 whereas Pacific Islanders are considered overweight and at risk of diabetes at a BMI of 27 according to Joslin’s Asian American Diabetes Initiative. ADA has many resources listed on their website which can assist Asian Americans, Native Hawaiians and Pacific Islanders to learn about diabetes, its risks, and complications. According to ADA, unlike other ethnicities, this particular community does not have to be overweight to be at risk for diabetes but being overweight further enhances their risk of developing diabetes (“Asian Americans, Native Hawaiians and Pacific Islanders,” n.d.).
Even though there are various programs that exist to target the high-risk population, the report published by Center for Disease Control and Prevention (CDC) in 2014 shows that the number of adults diagnosed with diabetes in the United States has nearly quadrupled from 1980 through 2012. People diagnosed with diabetes have increased from 5.5 million to 21.3 million in these years with about 1.7 million new cases of diabetes being diagnosed every year. If this trend continues every 1 out of 3 adults will have diabetes by 2050 in the United States (Diabetes 2014 Report Card, 2014, p.?3). This report published by CDC proves that though there are various programs and initiatives that are put in place by associations such as ADA, more organizations as well as government agencies have to get involved and raise general awareness of seriousness of diabetes in high-risk population so that the prevalence of diabetes can be reduced (Diabetes 2014 Report Card, 2014, p.?3).