Question: Will a research-based, population specific diabetic education provided

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Question: Will a research-based, population specific diabetic education provided to the gestational diabetic women at the clinic increase the number of women who achieve an A1c less than 6 at the 90 day check compared to the number of women greater than 6 at 90 day check prior to the education development? In 500-750 words (not including the title page and reference page), apply a change model to the implementation plan. Include the following: 1. Roger's diffusion of innovation theory is a particularly good theoretical framework to apply to an EBP project. However, students may also choose to use change models, such as Duck's change curve model or the transtheoretical model of behavioral change. Other conceptual models presented such as a utilization model (Stetler's model) and EBP models (the Iowa model and ARCC model) can also be used as a framework for applying your evidence-based intervention in clinical practice. 2. Apply one of the above models and carry your implementation through each of the stages, phases, or steps identified in the chosen model. 3. In addition, create a conceptual model of the project. Although you will not be submitting the conceptual model you design in Topic 5 with the narrative

Explanation / Answer

IMPLEMENTATION PLAN BY ADOPTING TRANSTHEORETICAL MODEL:

The transtheoritical model developed by Prochaska & Diclemente describes the process of intentional behavior change which progressess through six stages: Precontemplation, contemplation, preparation, action, maintenance and termination. They believed that any change in behavior is a concious decision made by an individual after a thorogh evaluation of all aspects and people do tend to move to and fro in this process of change i.e the process of bringing a change in behavior is not a simple and unidirectional process.

The implementations for a population of gestational diabetic women throughout the stages of model are discussed below:

Precontemplation stage: This is the stage, whereby the individual is not yet thinking or planning foe a change and the most likely cause is lack of awareness. thus, this stage can be used actively for creating awareness among the gestational diabetic women by arranging health talks during their visit to clinic when they are waiting for their turn or even awareness programme like sociodrama (role play), audio-visual campaings (posters, pamphlets, leaflets and booklets) can be distributed among the women with gestational diabetes and their family members. The content of diabetic education may include the basic concepts about gestational diabetes like:-

Contemplation: In this stage the individual tries to evalute both the positive and negative aspect of changing the behavior. This is a crucial stage in the process of decision to change a behavior as the individual may take a decision to either work on the identified problematic behavior or may roll back to the dormant pre-contemplation phase. Here, the healthcare team has to play a pivotal role in educating the women about the pros and cons of a particular behavior. As excessive weight gain during pregnancy is one of the commonest cause of gestation diabetes; eduacting women about the following is essential:

It has to be made clear that the aforementioned behavior changes may prevent from execisse weight gain and thus in turn reduces the risk of gestational diabetes; on the contrary the inability to make these lifestyle changes may pose health risks for both the mother and baby.

Preparation: This is the determination phase whereby the individual decides to take the desired bevior changes and start making prepations for the same. Here the planned intervention can be to assist the women:-

It is essential to work in small steps and bringing about gradual changes, otherwise larger leaps ma also produce mental fatigue or may add on to the physical risks.

Action: This stage is the stage of following what was planned in the previous stages. The intervention in this stage will be just passively monitoring the women and provide assisstance wherever needed. Addtional attention is required in this stage as some individuals may revert back to previous stage as they may give up inbetween or may consider that they have failed in doing the required modifications owing to their high expectations. The idea is to provide constant motivation to sustain the changes. Reinforcing the positive behaviors can be included to enable the continuity of such behavior, hence the family members can be taught about reinforcement management techniques.

Maintenance: Achieving this stage means that the women was able to bring about and sustain all the behavior changes, the role of healthcare worker is to regularly monitor the A1c levels and preventing relapse by maintaining the levels <6. The women must be continually supported and encouraged for being able to maintain positive behaviors.

Termination: This the final stage and once people have been able to achieve it signifies that they were able to successfully bring about the behavior change and also not at risk of relapse. This stage may involve the comparision between the pre-intervention A1c results and post-intervention levels of A1c.

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