As the obesity pandemic continues to grow within the United States and the rest of the world at an extremely high rate, the number of persons diagnosed with Type 2 diabetes has also been increasing. Several studies have been conducted to investigate ways in which people can avoid this condition. The paper seeks to examine two previous studies on how Life Intervention Programs (LIPs) and Lifestyle-based Group Treatment (LGTs) can play significant roles in fostering short and long-term health improvement, in addition to insight into the possible prevention of Type 2 diabetes within the patients in the U.K and Swedish Healthcare systems.
Background of the Study
Type 2 diabetes (T2D) is quickly growing into a pandemic worldwide. In the United States, the condition is already at a crisis level, with approximately 30 million people suffering from it (American Diabetes Association, n.d.). As of 2015, T2D was the 7 th leading cause of death among adults in the United States. In the U.K, about 1 in every 15 players (about 4.7 million) have diabetes, with 90% of these patients suffering from T2D (Diabetes UK, 2019). The U.K experiences 500 premature deaths due to T2D related complications weekly. In 2015, $237 billion was used in the direct medical costs of diabetes in the United States (American Diabetes Association, n.d.). As the number of diagnoses continues to rise, the expenditure on T2D is expected to increase. As stakeholders in the healthcare industry continue to look for better treatment and prevention options, the study on LIPs and LGTs help to increase the knowledge of the risk factors associated with T2D and some of the most effective measures that can be applied to reduce the number of newly reported cases and, as a result, decrease the healthcare costs on the disease.
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The impact of behavior change programmes and lifestyle modification on Type 2 diabetes and cardiovascular diseases has not been fully explored. Di Battista et al. (2017), explores how the adoption of LIPs in the workplace environment can help make the prevention and management of T2D more economical. By comparing participants who maintained the behavioral change and those who relapsed, the study aimed to answer the question of how LIPs can help reduce the risk factors associated with T2D and cardiovascular diseases. Elsewhere, Ljung et al. (2012) analyze ways in which patients experience LFGs treatment in primary and secondary prevention of diabetes and cardiovascular diseases. As knowledge of the risk factors, causes, and actual cost on human and financial scale increases, it becomes harder to ignore every possible option available in the fight against T2D. Thus, the analysis of LIPs and LFGs to determine the most effective method will be beneficial to the stakeholders in the healthcare sector on a global level.
Method of Study
Qualitative analysis methods were applied in both studies to answer the research questions since they provide insights on how effective these programs are and can be on an individual level. In the study by Di Battista et al. (2017), the research was conducted in the work environment. The researchers argue that adults spend up to 60% of their day at work. Therefore, workplace stood out a useful setting to identify the high-risk individual and provide quality LIPs (Di Battista et al., 2017). The qualitative investigation used the Basic Need Theory (BNT) as a scheme to explore subjects’ opinion on workplace dietitian-led LIP. In the study, researchers interviewed participants who had previously took part in a dietician-led LIP within their workplace and examined the transcripts of the audio recordings from a Basic Need Theory (BNT) (Di Battista et al., 2017).
The researchers have used several qualitative and quantitative sources to add authority to the study. The inclusion of works by reputable institutions such as the National Institute for Health and Care Excellence (NICE) in the methodology puts more trust in the method that was used. Although some of the qualitative studies that have been cited are as old as from 2001, most of the sources used are from between 2008 and 2016. The recruitment process very inclusive selecting women and men who had completed the LIP sessions, which means that the outcome of the study can be used as a representation of the effect of employing LIPs across both genders. In addition to that, participants must have taken part in LIP sessions at least one year before the interview was conducted. Therefore, the methodology has the benefit of giving a picture of the long-term effect of LIPs on the participant, and hence laying a greater foundation of knowledge for their possible future usage and providing a better understanding of which factors led to increased success.
One notable drawback is the homogeneity of the study subjects. Di Battista et al. (2017) points out that all participants were white British with most of them being women, and thus making it difficult to generalize the outcome of the study. Besides, the time gap of 18 months between the time that the LIP sessions were conducted and when the study interviews were done may have interfered with the clarity of memory of the study subjects (Di Battista et al., 2017).
In the second study conducted by Ljung et al. (2012), the qualitative analysis was conducted based on social cognitive theory. The research in Sweden analyzed the interviews using Malterud’s systemic text condensation. The study combined both current and older references. However, the researchers did not give their opinion on how strong or weak they felt the sources were. The statistics of the study were mainly employed to justify the necessity of the current study.
One benefit of the methodology of the Swedish study can be found in who they chose to interview and the settings in which the study took place. The group setting provided a more communal outlook on how effective the preventative measures were and gave the researchers great insight into how that setting and the accountability it provides can be utilized in the future to keep participants on-track in the long term. One drawback of the study was also the homogeneity of the Swedish population, which could lead to results that aren’t as applicable to people from other cultural and genetic backgrounds.
Result of the Study
In the study conducted in Sweden, most of the participants reported a positive experience of the treatment apart from one subject who had his view diverge radically from those of others. The participants view on LFG had broadened, and the subjects underwent self-development and deepened their understanding of the role they play in controlling their health (Ljung et al., 2012). Apart from identifying factors that could improve patients’ self-efficacy, the study pointed out several issues that could hinder the success of the process. Therefore, the nursing process, as well as activities by other stakeholders, can be adjusted to utilizes the positive factors discovered in the study and eliminate factors that might hinder the LFG process.
The UK study found twelve descriptive themes in relation to the BNT concept: autonomy, relatedness, and competence. These themes were categorized into three domains, namely intervention engagement, behavior change initiation, and behavior change maintenance. Through the analysis of these themes, the participants were grouped into those who managed to stay on track with the LIP and those who relapsed. Persons who maintained the LIP were identified as participants who have achieved a 3 kg weight loss or more (Di Battista et al., 2017). Participants reported to be attending the workplace LIP due to convenience and their desire to reduce their exposure to cardiovascular diseases and T2D. Also, the interaction between the members partaking in the LIPs was reported to be beneficial for initiating behavior change. The competence of the LIP administrators also affects the success of the behavioral change program. In short, a quality LIP environment was identified to bring out a positive result to patients who maintained with LIP.
Ethical Consideration
The Swedish research on the effect of LFG was approved by the Research Committee of the Department of Food and Nutrition, Umea University with all procedures being conducted as per the ethical guidelines of the university (Ljung et al., 2012). The information collected was treated with confidentiality with their identity remaining anonymous in all presentation. All 19 participants voluntarily took part in the study and had the chance to withdraw their participation at any stage. The study of LIP in the UK has not provided information about the ethical aspects of the study.
Conclusion
Although Type 2 diabetes is becoming a severe pandemic, the disease, along with cardiovascular conditions, is preventable. The studies on the effect on LFGs and LIP shows that while there is still progress to be made in the implementation and design of these programmes, the programs themselves can work when combined with environmental and social factors that are conducive to participants’ well-being. As for nurses, the studies explore multiple opportunities that can be employed to prevent T2D. Thus, the self-development and control that patients develop over their healthcare help to promote healthier living. Nurses, as well as other stakeholders in the healthcare sector, can analyze the effectiveness of the behavioral change programs and thus employ the positive aspects of the program to improve the current state of cardiovascular diseases and T2D prevention measures. Most importantly, the power of community has been highlighted in both studies, showing that when we all take an active interest in our health as well as the health of those within our scope of influence, positive outcomes are not just possible, they are probable.
References
American Diabetes Association. (n.d.) Statistics About Diabetes Retrieved from https://www.diabetes.org/resources/statistics/statistics-about-diabetes
Diabetes UK (2019) Facts and Figures Retrieved from https://www.diabetes.org.uk/professionals/position-statements-reports/statistics
Ljung, S., Olsson, C., Rask, M., Lindahl, B. (2012). Patient Experiences of a Theory-Based Lifestyle-Focused Group Treatment in the Prevention of Cardiovascular Diseases and Type 2 Diabetes. International Journal of Behavioral Medicine, 20: 378-384. Doi:10.1007/s12529-012-9252-3
Di Battista, E.M., Bracken, R.M., Stephens, J.W., Rice, S., Thomas, M., Williams, S.P., Mellalieu, S.D. and on behalf of the Prosiect Sir Gar Group (2017). Workplace Delivery of a Dietician-Led Cardiovascular Disease and Type-2 Diabetes Prevention Programme: A Qualitative Study of Participant’s Experiences in the Context of Basic Needs Theory. British Nutrition Foundation Nutrition Bulletin, 42: 309-320. Doi:10.1111/nbu.12292
