Type 1 Diabetes (T1D) is an autoimmune disease that occurs when the pancreas stops producing or does not make enough beta islet (insulin producing) cells for the body to function (CDC, 2021). While Type 1 Diabetes can be diagnosed at any age, it is mainly diagnosed among children, teens, and young adults, which is why it was previously referred to as Juvenile Diabetes (CDC, 2021). According to the Florida Department of health (2021), it was reported that 18,300 youth were living with Type 1 Diabetes in the state of Florida, with Baker county having the highest prevalence of Diabetes in the state (22.3%). According to Iqbal et al. (2020) adverse childhood experiences (ACEs) lead to poor glycemic control outcomes. People with Type 1 Diabetes are two to three times more likely to experience negative mental health outcomes (CDC, 2018). It is because of these risk factors and outcomes, that I am proposing an intervention that uses a trauma-informed approach to improve glycemic control and adherence to diabetes care regimens Among youth in Bakers County who have experienced ACEs. My proposal will have educational and mental health components that will use resilience-building strategies to help the target population. My program not only targets patients with T1D, but their families as well. This is in effort to address the burdens families face in taking care of a loved one with Type 1 Diabetes as well as strengthen the support system of the patient with T1D.
Trauma-Informed Principles
My program will incorporate four of the six trauma-informed principles. These principles include safety, trustworthiness & transparency, peer support, empowerment. The goal with the principle of safety is to create a safe and welcoming environment for participants. The program will establish protocols that uphold confidentiality to establish the principle of trustworthiness & transparency among participants and staff. The program will have a peer and family mentor component as the peer support principle. Finally, the voice & choice principle will be utilized in this program through self-advocacy training for patients and their families.
Levels of the Social Ecological Model
The program will use the McLeroy and colleagues (1988) social ecological model to structure our program. Program activities fall within the individual and interpersonal levels of the social ecological model. The program consists individual and family therapy and education sessions. Participants will have individual therapy and education sessions that focus on empowering patients to advocate for themselves for quality care. Family therapy sessions will serve as a way to strength the patient's support system.
Public Health Framework
Using the public health framework, the program uses tertiary public health prevention to empower and educate participants with the goal that participants will take what they learn from the program with them, ultimately maintaining and improving glycemic control (Oral et al., 2016). It has been shown that programs that integrate education and resilience-building strategies have the most success in improving glycemic control (Varni et al., 2018). The program will ensure longevity of impact by providing resources such as diabetes care supplies after the program and having follow-up interviews after the conclusion of the program, so that participants are not merely completing with the expectation that they are fully prepared. The program recognizes that a part of a strong support system involves not only a patient's family and friends but their community as well. That is the main goal of the program, building community for those with T1D.
References
CDC. (2023, November 13). National Diabetes Statistics Report | Diabetes | CDC. Www.cdc.gov. https://www.cdc.gov/diabetes/d...iagnosed%20Diabetes-
Centers for Disease Control And Prevention. (2018, August 6). Diabetes and Mental Health. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/m...20diabetes%20are%202
Florida Department of Health. (2021). 2021 Florida Diabetes Report. In Florida Department of Health (pp. 1–76). Florida Department of Health. https://www.floridahealth.gov/.../2021-dac-report.pdf
Iqbal, Kumar, Hansen, Heyrman, Spee, & Lteif. (2020). Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes. Children, 7(1), 8. https://doi.org/10.3390/children7010008
McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An Ecological Perspective on Health Promotion Programs. Health Education Quarterly, 15(4), 351–377. https://doi.org/10.1177/109019818801500401
Oral, R., Ramirez, M., Coohey, C., Nakada, S., Walz, A., Kuntz, A., Benoit, J., & Peek-Asa, C. (2015). Adverse childhood experiences and trauma informed care: the future of health care. Pediatric Research, 79(1-2), 227–233. https://doi.org/10.1038/pr.2015.197
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