Education Program for (ESRD) Patients
Evaluation Plan for Education program for end-stage renal disease (ESRD) patients aged 30years and above
This week you will be working on an evaluation plan that will be attached to your EBP in Week 9. Submit your Evaluation Plan to the DB –listed as 1-2-3…
Culturally Targeted Self-Management Program for African Americans with Type 2 Diabetes: Program Evaluation
Lifestyle choices play a critical role in influencing the occurrence of lifestyle diseases, including diabetes mellitus (DM). Consequently, inadequate or lack thereof of information on the influence of lifestyle on clinical outcomes of Type 2 Diabetes (T2DM) contributes to difficulties among at-risk population. One such at-risk population is the population of African Americans (AA). A program was designed to improve understanding of the influence of lifestyle on clinical outcomes of Type 2 Diabetes among African Americans, a program which is subject to evaluation in this paper.
Program Goal
The goal of the program is to achieve an effective self-management, Church-Based Culturally Targeted (CBCT) diabetes self-management education program. It is designed to tailor self-management education for middle-aged African Americans. The program included 12 (including 10 women and 2 men) participants in urban churches aged 35 to 68 years (Collins-McNeil et al., 2013). It focuses on seven areas of concern with regards to self-management for diabetics, including healthy eating, being active, blood glucose monitoring, medication, risk reduction, and healthy coping. The program includes education and behavioral strategies, which aim at helping patients, achieve their self-management goals.
Purpose of the Evaluation
The following program evaluation is undertaken with the aim of evaluating the effectiveness of the program to the extent that it met its key objectives set out at the beginning as well as it used evidence-based approaches for diabetes education intervention.
Resources Needed by a Diabetes Education Program to Meet Its Goals
Diabetes education program’s success relies on the availability of science- and audience-based, culturally and linguistically appropriate resources and materials. The National Institute of Health (NIH, n.d) through the National Diabetes Education Program (NDEP) has, over the last two decades, developed diabetes education toolkit to help designers of diabetes education programs to tailor their programs for the best outcomes based on the population for which the intervention is aimed (Siminerio et al., 2018; Spruill, Magwood, Nemeth, & Williams, 2015). NDEP maintains a national repository of these important diabetes education tools and keeps updating them based on evidence from new study findings.
One such resource is the diabetes self-management education and support (DSMES). DSMES remains is considered a cornerstone in diabetic care and education (Siminerio et al., 2018). With a plethora of new therapies from research and the recognition of the fact that living with diabetes is increasingly associated with emotional challenges, DSMES as it is today moves beyond basic provision of knowledge to include behavioral strategies. This is evidenced by the move by the National Diabetes Prevention Program (DPP) to include in its modules the best evidence for T2D intervention through structured lifestyle changes (Siminerio et al., 2018). The evaluation will show how these resources were utilized in the program under evaluation.
Other important resources in diabetes education intervention for prevention or reduction of risk factors associated with type 2 diabetes are the measurement or assessment tools. NDEP recognizes that diabetes diagnosis is the first and foremost step in diabetes education and should be performed at the beginning and end of such education programs. Some of the important tools to measure various variables at the beginning and end of diabetes education programs include Diabetes Self-Care Practices Measurement (DSCPM) questionnaire, Self-Appraisal Diabetes Self-Management Scale (SADSM), Center for Epidemiological Studies Depression Scale (CES-D), and Spielberger State Anxiety Subscale from the Spielberger State–Trait Anxiety Inventory (STAI). The evaluation will assess how well such tools, if any, were utilized in the program to be evaluated.
Program Activities
Conducting Sessions
The program leadership adopts Diabetes Self-Management Education (DSME) modules from Adult Diabetes Education Program (ADEP) used for outpatients at the Duke University (Collins-McNeil et al., 2013). These modules are evidence-based and abide by the standards of diabetes care and education recommended by the American Diabetes Association (ADA). They are a culmination of years of research, which have been integrated into diabetes education toolkit in the NDEP website. Using evidence-based diabetes education modules would help to improve the reliability of the findings regarding the effectiveness of this intervention for diabetic patients among African Americans in Southeaster United States. Using the DSME modules, the program leaders, including a clergy and healthcare providers, conducted sessions lasting 2 hours each week for 6 weeks (Collins-McNeil et al., 2013). During these sessions, culturally written materials, videotapes as well as presentations were used. The educators included culturally written materials in an effort to tailor the materials to the needs of the population of participants. This approach was informed by the fact that cultural barriers are among some of the most difficult barriers to overcome in self-management for diabetes (Caballero, 2018). Therefore, designing an educational intervention that addressed such underlying cultural factors would promise the best outcomes in the intervention. This first phase included diabetes education.
At the end of the first 6 weeks, participants will be asked to take part in another 6 weeks of behavioral strategies on self-management. Here, the participants will act independently, implementing what they learned during the first six weeks of intervention (Collins-McNeil et al., 2013). During the 6-weeks period, the healthcare providers will evaluate participants on the seven items identified at the beginning of the program, including healthy eating, being active, self-monitoring of blood glucose, medication adherence, risk reduction, problem solving, and healthy coping. The sessions also include emotion-focused coping modules for participants experiencing emotional stress resulting various stressors or events (Collins-McNeil et al., 2013). Equally important was spiritual coping led by the clergy and integrated into every session as this intervention as basically church-based.
Measuring Variables
The program also includes measurement of various variables among participants. At the beginning of the program implementation, healthcare providers will measure such variables at baseline. Quantitative data collection at baseline is important in assessing the effectiveness of a program by comparing such baseline data with that at collected at the end of sessions. Apart from data on racial background, medical diagnosis for T2DM, and written and verbal communication proficiency, the program also measures data on variables associated with diabetes, including socio-economic dynamics, patient perception of diabetes self-management, psychological and emotional status, and anthropometric measures.
Targeted Outputs
In this particular intervention, the educators targeted specific program outcomes, including the following:
- Improved healthy eating habits;
- Improved understanding of the underlying cultural factors in diabetes care;
- Improved emotional outcomes associated with stress, depression, and anxiety associated with diabetic conditions; and
- Generally improved perception of the effectiveness of self-management behavioral strategies;
Short-Term Patient Outcomes
From the above list of targeted outcomes, short-term patient outcomes would be associated with improved lifestyle choices, which would be assessed in various metrics. For example, by collecting data on blood glucose levels at baseline and comparing with that at the end of the program, the educators would evaluate the effectiveness of glycemic control among participants in the short-term. Furthermore, the educators also wanted to evaluate the impact of the program in medication adherence. Finally, the educators also targeted improvements in foot care adherence among patients included as participants in the program. Based on the findings reported for the program at the end of the 13-weeks period of its implementation, there were significant increases in healthy eating among participants. Such significant increases in healthy eating point to better glycemic control efforts by participants and constitute part of the short-term outcomes targeted by the program.
Long-Term On Patients
At the end of the entire program, the educators will help to leave a mark in the lives of the patients who they expected to be better equipped with information on targeted, culturally relevant diabetes self-management strategies. This is expressed in the key objective of the CBCT program stated in the introduction to this evaluation. The achievement of long-term measures could not be measured in the 12-weeks period, but perhaps through a longitudinal follow-up with the 12 participants.
Conclusion
From the preceding program evaluation, it is clear that the CBCT program was effective to the extent in which it included an evidence-based approach to diabetes patient education. The program utilized science- and audience-based strategies enshrined in the National Diabetes Education Program toolkit. It included two sections, with section one focusing in impating patients with the knowledge and section two focusing on strengthening behavioral strategies to reduce risk factors associated with type 2 diabetes. Furthermore, the program utilized culturally and linguistically relevant materials, which improve outcomes in a culturally relevant intervention.
References
Caballero, A. (2018). The “A to Z” of Managing Type 2 diabetes in culturally diverse populations. Frontiers In Endocrinology, 9(479), 1-15. doi: 10.3389/fendo.2018.00479
Collins-McNeil, J., Edwards, C. L., Batch, B. C., Benbow, D., MacDougal, C. S., et al. (2018). A Culturally Targeted Self-Management Program for African Americans with Type 2 Diabetes Mellitus. Canadian Journal of Nuesing Research, 44(4), 126-141.
National Institute of Health. Game Plan for Preventing Type 2 Diabetes. Nih.gov. Retrieved from https://www.niddk.nih.gov/health-information/communication-programs/ndep/health-professionals/game-plan-preventing-type-2-diabetes
Siminerio, L., Albright, A., Fradkin, J., Gallivan, J., McDivitt, J., & Rodríguez, B. et al. (2018). The National Diabetes Education Program at 20 years: Lessons learned and plans for the future. Diabetes Care, 41(2), 209-218. doi: 10.2337/dc17-0976
Spruill, I., Magwood, G., Nemeth, L., & Williams, T. (2015). African Americans’ culturally specific approaches to the management of diabetes. Global Qualitative Nursing Research, 2, 1-9. doi: 10.1177/2333393614565183
Evaluation Plan for Education program for end-stage renal disease (ESRD) patients aged 30 years and above
Evaluation Plan
End-stage renal disease (ESRD) is a major health concern affecting about 50 million people in the United States. The disease is associated with significant morbidity, mortality, and health care costs. Some studies indicate that education programs have numerous benefits in improving the conditions in ESRD patients aged 30 years and above. This essay presents an evaluation plan for an education program for end-stage renal disease (ESRD) patients aged 30 years and above. The essay establishes that education programs are fruitful and bear improvement in patient outcomes when implemented effectively. Lack of information contributes to increased mortality rates and difficulties in managing end-stage renal disease among patients of 30 years and above.
Evaluation Plan Goal
The plan aims to assess the improved health outcomes for the ESRD patients aging 30 years and above achieved through education programs. Ideally, the education program is designed to provide information to the patients regarding self-management practices, which include physical exercises, healthy eating, blood glucose monitoring, and adherence to drug medication (Baumgarten & Gehr, 2011). The program also provides patients with information regarding treatment options based on various factors such as gender, responsiveness, and culture. The program also informs the patients of the practices that may complicate the disease further so that they avoid them. In this regard, the evaluation plan will investigate the outcomes or impacts of such programs and identify any weaknesses for improvement. The education program evaluated included 15 participants patients (9 women and six men) aged between 31 to 72 years.
Purpose of the Evaluation Plan
The purpose of the evaluation plan is to provide information regarding the achievements and failures of the education program. The project will also assess the factors that affect the adoption of the self-management practices offered in the education program.
Resources Needed By Evaluation Plan for Education Program
The evaluation program has various goals to meet which rely on the availability of different resources. One of the resources necessary for the evaluation programs include the incorporation of the Diabetes Self-Management Education and Support (DSMES). This is an education that provides the patients with relevant information about the best approaches to manage their condition. Diabetes is associated with numerous emotional challenges; DSMES provides behavioral strategies that patients should adopt to improve their outcomes alongside condoning to the new therapies. Studies have reported DSMES is a useful service since it is tailored to meet individual needs and life experiences based on evidence-based standards. Patients aged 30 years and above are benefited by this service because different ages may depict different needs, and hence the service enables the patients to receive tailored services. Ideally, while the service equips patients with skills to manage the disease, it has been associated with reducing medical expenses and complications and improving quality of life.
Another essential resource is the assessment tool. While education programs have their goals and objectives to be achieved, assessment tools are essential to evaluate their effectiveness and identify the weaknesses of such plans. Diagnosis of diabetes is the first step in an education program that utilizes various tools to measure the variables ranging from diagnosis, therapy, self-management, and observing progress. The tools include self-Appraisal Diabetes, Diabetes Self-Care Practices Measurement (DSCPM) questionnaire, and Self-Management Scale, which should be assessed of their impacts on patient outcomes. Such assessment allows the opportunity to identify loopholes and a basis for more research.
Program Activities
The evaluation plan will entail participation by patients and family members in an outpatient service conducted at a health facility. The dynamic health care delivery systems have prompted DSME to be incorporated into medical homes, office practices, and healthcare organizations (Powers et al., 2017). The current generation is equipped with comprehensive knowledge concerning health care systems. Hence, some activities will include availing DSME/S in alternative and convenient settings such as technology-based programs, pharmacies, and community health centers to patients to allow them to have broad access to such education (Gucciardi et al., 2016). As a result, the patients have extensive knowledge concerning diabetes and hence able to adopt various strategies in the efforts to improve outcomes. However, the evaluation plan considers the fact that the target age group comprises of both literate and illiterate individuals. While the literate patients can access information through the internet, the uneducated will rely on the information provided to them through verbal explanation or physical demonstration (Powers et al., 2017). In this regard, an educator, offers, and a patient are necessary for a clear explanation of goals. Therefore, evidence-based diabetes education is demonstrated through the active collaboration of the parties mentioned above. The health providers, educators, and the 15 participants conducted demonstration sessions for 3 hours a week for seven weeks (Mallappallil et al., 2014). During these sessions, educative materials such as manual presentations and videotapes were used. The learning materials were tailored to meet the needs of both literate and illiterate patients and ensure that information was adequately understood.
After a successful 7-week education program, the participants were allowed to exercise behavioral strategies on self-management for another five weeks. The participants acted independently in practicing the strategies learned during the seven weeks. This allows the educators to assess whether the participants understood the approaches in managing diabetes and identify the challenges faced as a result (Mallappallil et al., 2014). During this period, the health educators will also assess the implementation level of the strategies provided at the beginning of the program, which includes physical exercises, healthy eating, blood glucose monitoring, and adherence to medication. The session will also entail an assessment of the ability to cope with emotional changes and stress with varying environmental factors.
Measuring Variables
The measurement of different variables among the participants is of paramount importance. Such enables the health providers to assess the impacts of such variables in achieving the goals of the education program. Collection data at the baseline is essential to compare it with that collected at the end of the program. The comparison helps to assess the effectiveness of the program. Data collected for comparison includes proficiency in verbal and written communication, racial background, emotional status, and socio-economic dynamics. All these variables enhance the valid conclusion of a study program.
Targeted Outputs
The evaluation plan for education program had specific objectives which included the following:
- Assessing behavioral changes towards healthy eating habits.
- Adaptation to continuous physical exercises and adherence to medication
- Assessing the ability to manage stress and emotional changes associated with diabetes
- Assessing the understanding of the information provided through the education programs by various individual patients
- The general perception of self-management strategies by the target population.
Short-Term Patient Outcomes
Based on the above outcomes list, the short-term objectives include changing eating habits and adopting regular physical exercises and medication adherence. For instance, diabetic patients are required to avoid certain foods, especially those with high sugar concentration, and take in lots of fruits and drinking water (Plantinga, Tuot & Powe, 2010). The comparison of the data concerning eating habits at the beginning and end of the session should depict improved outcomes of the patients. Such practices constitute controlled blood glucose. According to the findings at the end of the 12 weeks, participants reported a significant improvement in healthy eating habits, which was part of the short-term outcomes for the evaluation plan. The findings also indicated a substantial adherence to medication whereby the participants paid attention in following the prescriptions for the drugs (Plantinga, Tuot & Powe, 2010). The participants indicated a notable eagerness to experience improvement changes in their conditions through medication. Further, the participants were keen to exercise regularly, as instructed by the educators. According to the findings, such exercises ensured that the patients remained active and hence improving outcomes.
Long-Term Patient Outcomes
The end of the evaluation plan aims to identify the impacts on the lives of the patients by the information equipped through the education program. In the course of the evaluation plan duration, the patients will depict behavioral changes that would be used for evaluation of the program’s effectiveness. However, the long-term outcomes will require continuous observation to compare results in different time durations.
Conclusion
The evaluation plan was effective in assessing the effectiveness of the education program among diabetes patients. According to the evaluation, the participants responded positively to the information gathered during education, which marked improved outcomes of the patients. The plan utilized scientific-research and evidence-based strategies to make outcome conclusions. The tools used to educate the patients proved effective by considering various factors concerning the target population, such as literacy levels, racial backgrounds, and individual preferences. Therefore, the education program is vital to the end-stage renal disease (ESRD) patients to help them adopt self-management strategies.
References
Baumgarten, M., & Gehr, T. (2011). Chronic kidney disease: detection and evaluation. American
family physician, 84(10), 1138.
Gucciardi, E., Espin, S., Morganti, A., & Dorado, L. (2016). Exploring interprofessional
collaboration during the integration of diabetes teams into primary care. BMC family practice, 17(1), 12.
Mallappallil, M., Friedman, E. A., Delano, B. G., McFarlane, S. I., & Salifu, M. O. (2014).
Chronic kidney disease in the elderly: evaluation and management. Clinical practice (London, England), 11(5), 525.
Plantinga, L. C., Tuot, D. S., & Powe, N. R. (2010). Awareness of chronic kidney disease among
patients and providers. Advances in chronic kidney disease, 17(3), 225-236.