Exercise and dieting are among essential human activities that determine their health. The diet involves including all required nutrients in a dish, such as vitamins, carbohydrates, and proteins (Fernandez, 2017). Nutrition is key in attaining a healthy life where high nutrition improves an individual’s immunity. The exercise involves increasing the human heart rate beyond resting and engaging the body in physical activity. A combination of a good diet and frequent exercise leads to a healthy lifestyle, especially for individuals with chronic illness. Most individuals do not adhere to the dieting requirements that health experts recommend, putting many individuals in developing diseases such as obesity, diabetes, and cardiac arrests. Miguel is a prediabetic patient from disadvantaged groups with terrible working conditions, which can cause obesity and sedentary life leading to prediabetes and hypertension. Prediabetes is a condition where a patients sugar levels are high or low but not enough to diagnose diabetes. Centres for Disease Control and Prevention. (2020) indicates that approximately 88 million Americans, 18 years and above, have prediabetes, with 60% of the patients being from disadvantaged groups such as immigrants, the poor and African-Americans such as Miguel, who is Hispanic. Diabetes has no cure indicating that patients have to live under medication and a healthy lifestyle. Therefore, lifestyle interventions are critical for prediabetic patients as they are affordable, have fewer side effects, and accessible. This paper focuses on lifestyle interventions for prediabetic patients, especially from disadvantaged groups such as Miguel's case, including physical activities and nutrition. In this case, the lifestyle intervention is educating and involving patients on good diets and physical activities as well as sending patients with diets daily.
Leadership and Change Management Role
The primary prediabetes management objective is to provide education on the precautionary measures to prevent patients from developing diabetes, with lifestyle being the major contributor. To achieve a lifestyle intervention and best patient outcome, good nutrition and body activities and health institution's leadership are critical. It refocuses practitioners' efforts through guidelines in formulating the lifestyle intervention ( Hood et al., 2015) . Through implementation, two leadership strategies are essential, including situational and transformational leadership; disadvantaged groups such as Miguel will be encouraged to change their lifestyles to improve their health, as Hood et al. (2015) noted. Transformation leadership in this health scenario transforms the operations of a health facility, creating inner ambitions amongst clinicians dealing with prediabetic patients. Also, it creates internal motivation in clinicians for the good of others and creating a clear vision of the leader’s aspirations to drive the practitioner’s willingness to improve for the institution's benefit. Situational leadership is where different interventions are undertaken to achieve the primary objective. It enables training for practitioners where they are enlightened on the trends arising. Through this kind of leadership and ethical conduct of physicians requiring them to act in the patient's best interest, Miguel will be recommended with proper diets and provided with the right nutrition while at the hospitals. Change management in creating lifestyle intervention measures such facilities creating gyms where patients can exercise and make follow-up strategies to know whether patients adhere to the dietary requirements. Health facilities under good leadership and change management can facilitate the creation of facilities accessible to all patients with subsidized costs to accommodate every member of the society.
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Collaboration and Communication
Good communication and collaboration between patients and clinicians greatly influence the change in lifestyle of prediabetic and obese patients by creating an environment where practitioners can educate them on the benefits of having good diets. Diabetes and obesity are often associated with poor diets and lack of exercise, mostly for people who have poor working conditions, low pays and face discrimination, such as Miguel. Miguel could have developed a sedentary behaviour due to discrimination, which could be the cause of obesity and bad diets. These patients can encounter emergencies where communication would be key through telemedicine where a caregiver can instruct the patient on what to do to stabilize their condition without having to visit a health institution ( Colberg et al., 2016) . Patient engagement enables a proper communication channel between a caregiver and a prediabetic patient. Through this, the caregiver can understand why the patient does not exercise or have good diets.
Collaboration leads to the delivery of quality services to patients regardless of their social status or ethnicity, facilitating the patient gaining trust with the facility and caregivers. Health facilities can also use telemedicine to communicate and enable patients to attend training sessions online even when at work which would advantage prediabetic obese patients such as Miguel. Using this strategy, patients will effectively collaborate and communicate with the caregivers, where creating and implementing the intervention mechanism will be simplified. Health facilities can create training programs to educate patients such as Miguel on the advantages of exercise and good nutrition on their health, either virtually or physically. A physician, through telemedicine, can create a session where they take patients through a physical exercise session twice a week and send balance diets recommendations to their phone every day. Proper communication leads to collaboration between caregivers and patients where there is input from both parties, thus a smooth implementation of the lifestyle intervention.
Nursing Practice Standards
The government and nursing practice heavily affect the formulation of a lifestyle intervention measure since it must adhere to the practice standards. The major nursing practice guiding standards are patient safety, welfare, and caregiver accountability, as provided for by Nursing Practice Act ( Huynh, 2020) . These basic principles provided legally for nursing practice guide how the lifestyle intervention is to be implemented. It is required that a caregiver act in the best interest of a patient, thus an intervention that considers the financial status, working conditions, and interests of the. The patient in this scenario has poor working conditions as he has to stand all day and possibly a low pay since he works in a gas station. For example, introducing online exercise sessions with physicians consider the working conditions and financials of Miguel. Some patients cannot afford to pay for gym sessions while others work long hours; thus, online exercise sessions allow them to work out while even at work. Prediabetic patient’s welfare and safety are ensured as they can eat healthy using recommendations from medical experts ( American Diabetes Association, 2017). Accountability ensures that the diets and physical activities recommended do not harm the patients’ health. It is the responsibility of the caregivers to ensure the society members are healthy, in this case, Miguel, an obese patient at risk of getting diabetes. As diet and exercise affect the health of prediabetic patients, such as obesity or heart attacks, the nurses must therefore mitigate the possibilities of the patients through encouraging and laying down measures to facilitate lifestyle change.
Patients Safety, Quality of Health, and Cost
Obese and Prediabetic patients need to eat healthily and get involved in physical activities at least once a week. To achieve this, they must be enlightened about the benefits of having a balanced diet and exercising for their general health. Also, they need to be involved in the exercise directly online or through gym facilities provided by the health facility. This intervention will ensure patients' safety, reduce system costs and improve the quality of their health ( Hood et al., 2015) . Lack of education as a result of Miguel's background could be the reason he doesn't exercise and used to smoke, exposing him to diabetes danger and possible lung cancer. Frequent virtual follow-up and check-ups for such patients will ensure their safety. Training programs to educate the patients are part of the intervention conducted in the hospitals, physically or online improves the quality of health for the patients as they gain knowledge on the benefits of eating healthy and what types of food are good for their health. Provision for exercising facilities in the hospital improves the quality of health as patients get specialized physical activities best for their health conditions. Cost is a primary challenge for prediabetic patients from disadvantaged group’s patients such as Miguel face during treatment (Colberg et al., 2016). Introduction of systems where patients can get recommendations for diets daily, and online exercising sessions with subsidized or no costs without having to visit the institutions or seeking professional assistance make the process affordable and accessible to most obese and prediabetic patients.
Care Coordination, Technology Innovation, and Community Resources Utilization
The world has seen some of the greatest technological advancements over the last century, not only in the health sector but also in the other sectors. The health sector has seen technological innovation, which has made some processes in health facilities easier. Major technology in this sector that help formulate and implement a lifestyle intervention include electronic health records, telemedicine, and remote monitoring tools (Morilla et al., 2017). Telemedicine, as discussed above, is very critical when dealing with patients who need close monitoring. It can help facilitate online treatment, diet training, and exercise sessions without visiting a facility. Electronic health records help record health trends of a patient who is obese, prediabetic and with high blood pressure. Patients can check their health situation and progress through self-monitoring tools without vising a health facility saving on costs. These technologies provide a platform where diet recommendations are sent to the patients electronically. Patients and caregivers coordinate strategies such as online or physical training to gain knowledge on diets and physical activities (OECD, 2020). Health facilities should collaborate with community resources such as non-government organizations dealing with nutrition and fitness organizations. Patients such as Miguel can understand diet from such organizations—a combination of the three when facilitates the best patient outcome where patients live healthy lives.
Conclusion
Diabetes is a chronic disease needing the close attention of caregivers since such patients are exposed to many risks. The primary challenge facing prediabetic patients is dietary and physical activities. Formulating a lifestyle change intervention is key for these patients as they are exposed to significant risks as poor diets and less physical exercises could lead to the development of other health complications such as asthma and heart attacks. The best way to intervene is educating the patients on the advantages of eating healthy and exercising regularly through training programs and exercising activities either physically or virtually. Patients such as Miguel from vulnerable groups in society are at greater risk due to discrimination, low pays, poor working conditions and lack of education. However, the formulation of the lifestyle change intervention is critical and is affected by several factors. Leadership and change management are critical in this process as leaders have to adjust to changes; the facility has to go through the process of accommodating the intervention. Communication and collaboration between all the stakeholders are key when formulating the intervention as it ensures that the intervention considers all parties. Statutory guidelines influence the formulation of the intervention in a patient-centred, safe manner, and the caregiver bearing the consequences of anything that might go wrong during the process: technological innovations facilitate smooth development and implementation of lifestyle changes with reduced costs for patients.
References
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Fernandez, O. E. (2017). Live Longer (and Be Healthier) by Eating the Right Foods. In The Calculus of Happiness (pp. 20-40). Princeton University Press.
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