SMART Position Paper

An estimated 97 million adults in the United States are overweight or obese (Klein 2000). “"Affecting one in five Americans – or more than 22 percent of the U.S. population – obesity is one of the most pervasive health problems in our nation right now," said George L. Blackburn, M.D., Ph.D., associate professor of surgery and associate director of the Division of Nutrition at Harvard Medical School/Beth Israel Deaconess Hospital, Boston, Massachusetts. "We need to implement steps to slow the progression of this national epidemic” (NAASO 1999). But the problem of obesity does not only affect the United States. "We now know that the growing prevalence of obesity is creating major health problems worldwide," said Dr. James O. Hill, president of the North American Association for the Study of Obesity (NAASO) and Professor of Pediatrics and Medicine at the University of Colorado Health Sciences Center. Obesity was once regarded as unique to Americans, but it is now seen as a global health risk affecting developing and underdeveloped countries (AOA 2000). Obesity is increasing at an epidemic rate in the United States - 1.3% a year for women over 20. Rates of obesity among minority populations, including African-Americans and Hispanic Americans are especially high (AOA 2000). There is also a marked increase in obesity among children.

The health disparities among the Blacks/African American is on the rise which is of being mostly affected by diabetes the United States and Maryland. Diabetes and cardiovascular diseases are connected which can lead to increase mortality among this population. In that matter, the Health Empowerment African Americans Diabetes Program proposal includes my creating awareness which will offer diabetes education as connected to other commodities and self-management and counseling. This will be done through outreach programs in the community in health classes and health fairs through health screening, blood glucose screening, A1C, exercise activities, body mass index (BMI), weight, monitoring of individual self-monitor log, and

Diabetes  is a serious health condition that is a chronic illness for the African Americans. Diabetes preventions strategies in African American community can be a tricky task to contain and prevent for several reasons I will discuss in this paper.

The rate of diabetes in the United States is one of the highest compared to other developed countries. An estimate of 9.3% of the population have diabetes, of those with diabetes 27.8% have yet to be diagnosed (Centers for Disease Control and Prevention [CDC], 2014). This means that approximately 8.1 million people are currently living with diabetes, but are unaware of it. As of 2012, 12.3% of people with diabetes were 20 years old or older, the largest population diagnosed with diabetes were adults 65 years old or older. 25.9% of this population lives with diabetes (CDC, 2014). On a national level, the CDC have launched initiatives that focus on prevention and disease management. The National Diabetes Prevention Program is an example of one such initiative. This program focuses on lifestyle changes,

According to Rural Health Information Hub (2017), the fundamental purpose of disease prevention is to keep individuals healthy. One implements health promotion interventions in an effort to promote healthy behaviors and to decrease the risks of developing chronic illnesses (RHIH, 2017). According to the ADA (2016) individuals that participate in health promotion behaviors are more likely to have better health outcomes compared to those who do not. The EBP change project has shown that educating patients with prediabetes can increase diabetes knowledge and promote an increase in health promotion behaviors. The EBP change project outcome has indicated that participants who completed the 6-week diabetes education program were able to increase their knowledge regarding type 2 diabetes. Therefore, with the positive outcome of the EBP change project, the EBP change project site can incorporate certain aspects of the diabetes education program into their patient education to increase diabetes knowledge, picking healthier food options and participants in activities that would increase physical fitness.

Obesity was significantly more prevalent amongst female African Americans in this community. With the highest rate affecting women between the ages of 45 to 64. Obesity was also higher amongst Black females who’s educational attainment was lower

The Objective for Healthy People 2020 is to significantly reduce the chances of the high risk population and the population who has the disease. The goal is try to implement a change in their lifestyle choices. Health People 2020 reports that “44.6 percent of adults aged 18 years and over who were at high risk for diabetes with prediabetes reported increasing their levels of physical activity in 2005-08.” The 2020 baseline objective in 2005-08 was at 44.6 percent and

However, due to the United States’ aging population, along with an increasing prevalence of obesity, diabetes is on the increase. Of the approximately 313 million population count in the United States, 97 million adults are overweight or obese. “Both excess body fat and physical inactivity predispose to type 2 diabetes. Several ethnic groups are particularly susceptible to Type 2 diabetes” (Scott 1134). Hispanics, blacks,

It is a known fact that excellent care and control of diabetes could aid in minimizing the risk of people: nonetheless, there are plenty of African Americans who are not really knowledgeable and informed that they are already a diabetic (Calvin, 2011). It is only after they have already experienced some of its complications that they finally realize that they already are a diabetic.

Abstract: African American people have a high percentage of obesity compared to other ethnic groups. Social determinants of obesity in African American people include low socioeconomic status, limited access to affordable and healthy food, dietary behavior and food culture, lack of nutrition knowledge, attitudes and beliefs, higher exposure of marketing of less nutritious food and limited access to safe places to physically active. This research was done to see how these social determinants affect the obesity rate in African American people. Different researches were reviewed. The effects of above mentioned social determinants were observed and some recommendations are given in order to minimize the health disparities in low income African

The current state of African American health is sickening. The manifestation of sedentary lifestyle multiplies the problem of leading to detritions of health (Sucher, Kittller, &Nelms, 2016). Although this state is real among all populations in the United

The Kansas Health Institute executive summary for Racial and Ethnic Minority Health Disparities in Kansas (2016) revealed the state findings resemble national findings for racial and ethnic health disparities. The distinct concern for the African-American population consist of an earlier death rate for those diagnosed with diabetes. However, despite the initiatives to improve minority health disparities, Kansas continues to fall short of achieving the goals for improvement in care (Kansas Health Institute, 2016). These findings are alarming given the health outcome risk associated with diabetes. Furthermore, the risk factor of obesity as the leading cause for the development of diabetes is concerning for Kansas residents, especially given that

African American women have the highest prevalence of being overweight and obese in the United States, at 82%. A primary goal of Health People 2020 is to eliminate health disparities for populations that are at higher risk of developing chronic conditions related to obesity, such as diabetes, cardiovascular disease, and certain cancers. Contributing health factors that cause obesity, such as decreased physical activity, stress, and poor nutrition, is also an area of focus. Church is a long-standing source of support for African American women and is a good place to promote faith-based healthy lifestyle programs (Kyryliuk, Baruth, &

Type 2 diabetes is a chronic disease where patient education is imperative and requires education that surpasses the primary care office. According to Cha et al. (2012) basic education and family involvement is an essential component for pre-diabetic and diabetic population to achieve glycemic control. Time management and time constraint are obstacles that are affecting the primary care provider in initiating health promotion topics and disease prevention information (Kowinsky, Greenhouse, Zombek, Rader & Reidy, 2009). Recognizing the time constraint at the EBP change project site for health promotion and patient education a culturally sensitive educational program would be created to promote healthy lifestyle behaviors targeting African Americans with prediabetes.

Carter, Barba, and Kautz (2013) report culturally tailored education can lead to significant improvements in self-care in African Americans with type 2 diabetes. Also, appropriate dieting, exercise, medical checkups and medication regimens for prevention and management show efficient improvements. The Health Belief Model is realistic and acknowledges that having a desire to change health behavior may not be enough. Therefore, two elements that may be helpful include cues to action and self-efficacy. The cues to action are external whereas, self-efficacy focuses on his or her ability to make a health-related change (Boskey, 2014).