Community Teaching Experience Paper

Diabetes 101

Grand Canyon University

NRS-427VN

Diabetes 101

The topic of education selected is Diabetes with the primary focus on prevention. The presentation was provided for an adult community education group in the city of Pomona. This particular topic of education is of interest for this group of participants. In this paper the epidemiological rational, a summary of the teaching plan with responses to teaching, the evaluation post teaching including the recap of the strength and areas of improvement of the presentation are provided.

“Insulin is a hormone produced by your pancreas, picture it as a key to let blood sugar into cells for energy. With prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually, the pancreas cannot sustain (keep up), blood sugar rises, setting the stage for prediabetes- and Type 2 Diabetes in the future“ (Centers for Disease Control and Prevention, 2019).

“More than 100 million U.S. adults are now living with diabetes or prediabetes, according to a new report released today by the Centers for Disease Control and Prevention (CDC). The report finds that as of 2015, 30.3 million Americans–9.4 percent of the U.S. population–have Diabetes. Another 84.1 million have prediabetes, a condition that if not treated often leads to type 2 diabetes within five years” (Centers for Disease Control and Prevention, 2019). The individual is considered prediabetic with a small degree of elevation in the glucose level but not yet in the discussed diabetic range of the Hemoglobin A1C 5.7-6.4%. The focus of healthcare providers in primary prevention is to keep Diabetes from occurring. Education is a vital and powerful point in patient education. It is important to know, that the progression of the disease is avoidable and patients with the regard of diagnosis prediabetes, are in good position to change their blood glucose levels to normal limits with the actions of losing weight, changing diet habits, and increase exercise. “A major National Institutes of Health (NIH)-supported clinical trial—the Diabetes Prevention Program (DPP) study—provided scientific evidence that the onset of diabetes could be prevented or delayed in people at high risk. In the DPP, adults with prediabetes reduced their risk of developing diabetes during the study by 58% through lifestyle changes such as: reduced fat and calorie intake.

Increased physical activity of at least 150 minutes/week (e.g., brisk walking 30 minutes a day, 5 days/week) and a loss of at least 5% to 7% of body weight. These lifestyle changes were effective in preventing or delaying diabetes in all ages and all ethnic groups in the DPP. Among people age 60 years and older, progression to type 2 diabetes is reduced by 71%. The DPP showed that moderate changes resulting in modest weight loss can make a difference” (Centers for Disease Control and Prevention, n.d.).

The chances of developing type 2 diabetes are dependent on a combination of risk factors such as an individuals’ genes and lifestyle. Although risk factors such as family history, age, or ethnicity can’t be changed, lifestyle risk factors such as physical activity, eating habits, and weight. In addition, prediabetes, previous gestational diabetes, and age over 45 play a factor in developing this disease (Centers for Disease Control and Prevention, n.d.).

To summarize the presented teaching plan, this was the presenters first community teaching presentation for the selected adult population. The presentation lasted 20 minutes with additional 5-10 discussion and questions of audience. The PowerPoint created for this project was easy to understand, with a brief but comprehensive outline of information. This served the purpose to present the information without overloading the audience with too much information. A hardcopy of the presented information was provided to participant to follow along and to take home as further reference. The selected topic engaged the audience in discussion and questions to the related topic. Questions about adequate carbohydrate and sugar intake and exercise along with questions about difference in type 1 and type 2 diabetes were topic of discussion. With the discussion of foods and proper in between snack, the presenter offered a Q&A about the provided snacks in this session and why the participants chose one over the other. Most participants have a great understanding of baseline nutrition and are able to give examples of healthy food choices but also admit to often use the easily accessible way of buying food on the go from fast food chains. The participants discussed personal stories and feedback of their own habits as well as family and friends and a couple of the participants shared stories about the devastation the disease has caused them in regards long term effect and even death. The closing statement of the presenter with the importance of primary prevention closed this teaching session.

Community response to the provided teaching was received as overall positive. Adult participants were attentive and open to healthier food choices and change in lifestyle choices with daily exercise. The realization of long-term effects such as heart disease and stroke were received as a big motivator to lose weight and change sedentary lifestyle. Examples of healthier food choices and portion on the plate were discussed. The importance to see this choice as a long-term lifestyle change for themselves and the entire family was expressed. Through the presentation many challenges such as finding time to cook and to exercise were discussed among the participants. Suggestions were offered by the educator as well as participants. The concept of meal prepping for the entire week and to walk during a break or take stairs instead of the elevator were suggested.

The teaching plan was overall successful with the primary goal to provide understandable information to the audience. The developed plan mainly focused on diabetes prevention and the progression from prediabetes to the actual diabetes diagnosis with the primary goal to instill the understanding to the audience that this disease is preventable. Various facts from diabetes resources and statistics were provided to with the presentation and discussed. Generalized understanding was expressed by the participants. Understanding was evaluated by verbalization of the differences in prediabetes, Type 1 and Type 2 as well as the disease is preventable, and in many cases, reversible. Available community resources and national prevention programs were discussed and provided to the participants. Risk factors were verbalized by the audience through a group discussion at the end of presentation.

Areas of strength and areas of improvement: The opening of the presentation was focused on the description of the disease process and knowledge of participants. Questions and myths by the audience were shared with the group. This allowed a soft opening of the topic and to lay ground for teaching and understanding of the remaining information. Through research, Bloom’s taxonomy has a description on teaching simulations and techniques. The Bloom’s taxonomy is referring to the cognitive domain, knowledge-base. The presentation opens with sharing knowledge and basic concepts to the participants, followed by the process of comprehension. This comprehension will include to demonstrate the understating of the learned material by the means of organization, interpretation, and verbalizing main ideas. At last, application has the goal of using the learned information and apply it in everyday situations. The individual is using the application process to identify connections and relationships and to use this new information to situational processes (“Bloom’s Taxonomy of Learning”, n.d.). The method of teach back was used throughout the presentation. Once information was provided to audience, an engaging conversation of understanding was provided. Depending on the outcome of this conversation, the need for either further information or continuing with teaching was evaluated. If the audience is unable to repeat the learned material, the presenter will have to repeat and reinforce the material. Reassessment is very important to achieve the education goal for long-term purpose. This exercise can be repeated as many times as needed (American Nurse Today, n.d.). Improvement areas for the presenter are a more confident attitude towards the presentation material and own knowledge. This can be achieved with practice and experience. The presenter learned with this teaching experience, that provided information needs to be easy to understanding for a lay person and concise presented. It is important to included current, evidence-based research with the presentation and provide resources. Participants need be engaged in the presentation and given material to take notes and to take home, in order to facilitate a long-term learning effect. Feedback of the participants emphasized the need for hands on teaching and inclusion of examples. This topic has many parts to cover and unfortunately 30 min was not long enough to answer all the questions of participants. An education series would be a great resource for the community. This would allow a greater variety on topics and allows more time to absorb the information and teaching.

In conclusion, Diabetes Type 2 was a very good topic with large interest of adult learners to gain knowledge. As a large percentage of the population is at increased risk of this disease, education plays a key role in primary prevention. The individual is able to share the learned material with family and friends and can engage them to a healthier lifestyle. The long-term effects of Diabetes Type 2 are throughout the whole body and nearly affects every organ in our bodies. It is important for each individual to understand, that this disease is preventable with primary measures of education and reinforcement. The community health nurse can play a vital role in this education and outreach to many in the community. The primary prevention of disease will equal a positive and improved management and outcomes.

References:

Bloom’s Taxonomy of Learning [PDF file]. (n.d.) Retrieved from: http://www.nbna.org/files/Blooms%20Taxonomy%20of%20Learning.pdf

Centers for Disease Control and Prevention. (2019). Prediabetes. Retrieved from:

https://www.cdc.gov/diabetes/basics/prediabetes.html

Centers for Disease Control and Prevention. (n.d.). Prediabetes and Primary Prevention of Type 2 Diabetes. Retrieved from: https://www.cdc.gov/diabetes/ndep/pdfs/ppod-guide-prediabetes.pdf

American Nurse Today. (n.d.). Using teach-back for patient education and self- management. Retrieved from: https://www.americannursetoday.com/using-teach-back-for-patient-education-and-self-management/