Increasing wellness, health literacy, and activity levels in the diabetic population of

Roosevelt, Utah: An Occupation-Based Program

Background: The diabetic population in the United State represents an extraordinary cost to
the healthcare system and there is a significant need for improved management of diabetes to
improve medical outcomes and quality of life for diabetes patients (Centers for Disease Control,
2017). However, many diabetes patients do not have the proper health literacy and demonstrate
only moderate medical knowledge of how to manage their diabetes effectively (Alhaik,
2019).Traditional diabetes programs typically lack of hands-on learning opportunities due to the
lecture heavy emphasis of the classes and are not taught by a variety of healthcare
professionals. Because most DSME programs are medically-focused, lecture-based, and are
not client-centered, there is not a significant emphasis on psychosocial, occupational, and
kinesthetic dimensions and their contribution to well-being and health (Pelicand, 2013). Using
an occupation-based approach, a thorough understanding of a person, their environment, and
behavior is key to understanding effective management of chronic disease. Occupational
therapy intervention has been noted to significantly improve “function in activities of daily living,
functional self-efficacy, social or work function, psychological health, general health, or quality of
life” for those with chronic illness (Hand, 2011). The proposed program will address this public
health need in Roosevelt, Utah by providing a holistic and client-centered approach to diabetes
management and prevention of further health complications using an occupation-based model.

Objectives: The objectives of this program are to increase participation rates of diabetic
patients in diabetes self-management classes while changing the paradigm of the classes
themselves. The program will facilitate hands-on, healthy lifestyle modification, improved
psychosocial well-being, increased activity levels through engagement in meaningful activities,
and increased health literacy and self-care skills in order to improve the overall quality of life of
the diabetic population of Roosevelt, Utah.

Program Design: The program will be designed around two distinct parts a) education classes
for patients with diabetes led by multiple professions including a physician, nurse, dietitian,
physical therapist, and occupational therapist b) one-on-one outpatient intervention sessions
with an occupational therapist. Participants may be any person diagnosed with diabetes who
requires assistance to manage their condition and make healthy lifestyle changes.

Program Evaluation: The program will be evaluated by self-report of activity levels, the Short-
Form 36 (SF-36) assessment of quality of life, the Summary of Diabetes Self-Care Activities
Measure (SDSCA) to assess diabetes self-management, and the Newest Vital Sign (NVS)
assessment of health literacy.

Conclusions: The typical paradigm for diabetes self-management classes include lecture-
heavy classes with an emphasis on diet and exercise. The proposed program posits that this
approach is ineffective in creating lasting change. The traditional approach to diabetes
education typically does not take into account the unique characteristics of each client, the
client’s readiness-for change and psychosocial well-being, what the client views as meaningful
and valued, an in-depth assessment of the client’s habits and routines, the ability for the client to
maintain higher levels of activity through engagement in healthy and meaningful occupations,
and the value of experiencing and doing the necessary and meaningful occupations of life with
the guidance of a healthcare professional. The proposed program will target each of these vital
areas of assessment and intervention in order to foster value-based living, healthy habits, and
lasting changes in health status for the diabetic population of Roosevelt, Utah.

References

Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017.

Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and

Human Services; 2017.

Alhaik, S., Anshasi, H., Alkhawaldeh, J., Soh, K., & Naji, A. (2019). An assessment of

self-care knowledge among patients with diabetes mellitus. Diabetes & Metabolic

Syndrome: Clinical Research & Reviews, 13(1), 390-394.

Hand, Carri, Law, Mary, & McColl, Mary Ann. (2011). Occupational therapy interventions

for chronic diseases: A scoping review. AJOT: American Journal of Occupational

Therapy, 65(4), 428-436.

Pelicand, J., Fournier, C., Le Rhun, A., & Aujoulat, I. (2015). Self‐ care support in

paediatric patients with type 1 diabetes: Bridging the gap between patient education and

health promotion? A review. Health Expectations, 18(3), 303-311.