Community Development for Pacific Health Promotion

Introduction

The intended purpose of this assignment is to ensure that nursing students have the ability to understand the process in which nurses deliver health promotion. The responsibility of a nurse is on patient care, safety and most importantly promoting health education. Demonstrating the effectiveness of nursing practice and how this will influence the development of the community within health promotion towards Pacific people. The first section of the assignment will be to identify and introducing a specific health concern within a chosen Pacific community with rationale. The second point of discussion will be about data collection with evidence-based statistics. The third point provides an explanation of the pathway through consultation with suitable members of the community appropriate for this project planning. In saying this, considering also the challenges and surprises that came about in locating and approaching each individual personally and culturally. The fourth part describes the process in providing a health promotion evaluation form to summarise the overall session. This will lead into the last stage of the assignment and is based on an overview of health promotion through the development of a journal article. The chosen journal for publication will be under Kai Tiaki Nursing New Zealand journal, and the name of the article is called ''Beat it, Type 2 Diabetes''. The requirements that is needed for publication within this journal will be included and attached as Appendix 1, and the evaluation form for the purpose of this health promotion project will also be attached as Appendix 2.

Health concern and Rationale

The health issue that is of concern within the chosen Pacific community, appropriate for this health promotion focuses on Type 2 Diabetes. Type 2 diabetes is a health condition that slowly progresses over time due to high blood glucose levels, and in simple terms, the body is unable to respond to insulin ( Health Navigator, 2019 ). This can lead to insulin resistance which means the body will not be able to control blood glucose level without insulin for balance ( WHO, 2019). The rationale behind the chosen health issue of type 2 diabetes is simply because a lot more of the Samoan community is affected and minimal knowledge about this specific health condition. Statistics is showing a trend of the increasing rate of mortality amongst the Samoan people continuously.

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Statistics

According to the New Zealand Society for the Study of Diabetes (2016), the overall population of New Zealand is estimated to be around 4.3 million. And within this population, 4.4% of Pacific people are likely to develop diabetes in their lifetime. Pacific people are at risk of low life expectancy rate due to increased chronic diseases with 90% of the population with type 2 diabetes, this is known to be 3 times the rate of the total New Zealand population (Pasifika futures, 2017). Statistics show strong evidence of the increasing rate for the New Zealand population with an exceeding amount of approximately 200,000 people, and amongst them is of Samoan ethnic group of more than 115,000 diagnosed with type 2 diabetes residing in New Zealand. Therefore leaves 100,000 of the New Zealand population still undiagnosed (Ministry of Health, 2014). The prevalence of type 2 diabetes between 2002-2004 survey shows the incidence rate of 370 for the Pacific population compared to 79 identified as other. It is expected that by 2020, 18% more of the Pacific population will be diagnosed with type 2 diabetes yet again, compared to the 4% of New Zealand Europeans as stated by Jowitt (2014). The data that was collected is used for awareness throughout the assignment for the Samoan community. The target audience of this health promotion is mainly the Samoan people aged 16 to 35, this is because adults are usually affected and is becoming more common in adolescents (Health quality & safety commission New Zealand, n.d). Teaching this age group will help reduce the trend of this disease because it is our role to make sure that they are being educated from a young age. This is to avoid the consequences of dealing with the complications of type 2 diabetes in their adult years. The nursing student researched and unpacked current information on statistics for the overall community on diabetes, and there is clear evidence to show that the Samoan community are badly affected. Prevention is a key factor to reducing this health disease, and in doing so the chosen age group will be well-informed with baseline knowledge to teach and educate their family and friends through basic understanding and encouragement. The World Health Organization (2017) defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. They also describe health promotion as, discipline and a process focusing on empowering people and communities in controlling their health and well-being. Whereas, from a Pacific point of view health promotion is defined as the empowering of Pasifika people to control their well-being and their future ( Hauora, 2014 ).

Consultation Process

The main goal for this health promotion is to promote health in a way that is simple and easy to understand, for the Samoan community. In saying this, it was not a difficult process in finding the appropriate person for a consultation. This individual is highly respected by the church community as well as the Samoan people. The importance of prayer plays a major role in healing physically and spiritually, and because of Catechist A. Petelo’s knowledge, I made sure I communicate with him in person to begin with. A. Petelo strongly believes that anything is possible when connecting with higher power through prayer, hence why he was chosen because of his beliefs and overall respect for the wider community. The first step was to speak with him after sunday mass and I had the chance to briefly discuss the topic around health promotion. He was very approachable which made things easier, he also agreed to continue our conversation at his home after a Sunday to’ona’i (lunch). As a Samoan descent, born and raised in Samoa I was well aware of what was to be worn on this particular day and coming from a big family I was taught the importance of culture, values and respect. It is our tradition that identifies the Samoan people in the way we walk and how we talk. Therefore I made the effort to wear a puletasi (Samoan traditional dress code for church) that covers the top and bottom. I made sure to provide a monetary gift as a gesture of a simple thank you for his availability and his overall kindness in agreeing to meet with me. In the Samoan culture, before entering the catechist’s home shoes must be placed outside the door to avoid unnecessary offence and careless behavior. I myself and the catechist greeted each other in the Samoan language and offered his blessings. I was able to discuss with him my plan and how I would go about meeting the objectives for this health promotion project. He questioned my chosen health promotion topic on Type 2 Diabetes, and I was able to provide relevant information before him. I had the chance to show him research-based statistics on Samoan people presented with type 2 diabetes and the need for education around this condition, especially for our people. The catechist was taken aback by the statistics results and was not hesitant to lend a helping hand. I had discussions with him the need for a venue for the purpose of the health promotion and surprisingly he was willing to provide chairs, tables and cutleries on the day and the event would be held at IVC hall. I then asked if the hall would be available on Saturday, 30 of March because I know that holding this health promotion on a Sunday would not be ideal or suitable because of church and family commitments. The catechist agreed to hold the event on Saturday with the given time of 5pm due to the fact that people will be available after work and school. Therefore giving a fair chance to everyone to attend on this day. Catechist A. Petelo suggested that I let the community know about this health promotion event by announcing it after church service, because the majority of our church community are a mix of ethnicities. I made sure that I would direct my announcement to the Samoan community during notices which happen every Sunday to end our church mass. I was able to print out handouts about the day of which the health promotion event would be held and a brief note on what would be included in the session. I had also asked catechist A. Petelo for permission to bring refreshments such as fruits, water and tea for the group of people that would attend and again he supported the idea. He offered to lend me some of the helpers to set up the hall. I was responsible for organizing and preparing the venue as best I could so that the people are comfortable and ensuring that it is within a safe environment. It was brought to my attention that I had not contacted a health professional about this health promotion event. On the same day after the consultation with A. Petelo, I managed to contact Broadway Health Clinic Medical Center which is a primary healthcare facility situated in Miramar. I spoke to the receptionist asking for the availability of a Samoan nurse and a suitable time to get in contact with her. The person that I spoke to suggested a time for F. Mauga to contact me on my personal mobile number so that I can ask to meet with her, but unfortunately, she was not able to meet with me before the event due to her busy schedule which was understandable. I was able to explain the purpose of my health promotion on type 2 diabetes over the phone and invited her to be my support person for this day, in return she agreed to be a part of this event and was happy to provide brochures, medications and a poster of the healthy eating pyramid to promote health.

Surprises and Challenges

The meeting with A. Petelo was very interested because, after the discussion, he also suggested that the community will be able to provide healthy snacks after the health promotion session. I had to make sure that the food is strictly promoting healthy eating, I had asked A. Petelo what his knowledge behind healthy eating and to my surprise, he was listing the types of food appropriate for this health promotion. We both made a list on food to bring such as fruits, apples, banana, oranges, kiwi fruits, and healthy crackers to serve on the day. The reason for his pick on the list of food is that he knows of someone very close to him diagnosed with type 2 diabetes and he understands the importance of maintaining a healthy lifestyle and keeping well. One of the challenges that I encountered on this particular day was finding out that the church choir was to have practice around the same time as the event and I had to respectfully tell the leader that I had a health promotion event on the same day as their choir practice. In the fa’asamoa way (traditional way) we the young generation have to respect our elders and support them in any way we can, and the challenge for me was to ask the leader of the choir group if it were possible to move their practice earlier because I wanted to use the session time with the audience. To my surprise the leader agreed and asked if they could come to the health promotion session which was very exciting because I will be able to teach and share my knowledge about type 2 diabetes.

Describing the process

I had arrived at the venue along with the helpers at 4 pm to set up the hall for this health promotion event. I made sure that everything is in place, as well as ensured that it is comfortable and welcoming. My plan for preparation was to set up 3 tables and a whiteboard. One table is mainly covered with a range of different pamphlets, leaflets, and brochures about type 2 diabetes and I made sure that each one will include different information on cholesterol level, high blood glucose levels, prevention for example, activity such as exercise and healthy eating. I also had information on treatment, medications and the signs and symptoms of type 2 diabetes so that the audience are aware of when to ask for help and support. The second table had 2 packs of water bottles, as well as the essentials to make tea with no added sugar. The third table had fruits, crackers, food pyramid poster pinned to the whiteboard, and diagrams to help me explain things in a non-complicated way for the audience. I also included a simple charted graph to show the rising rate of Pacific people with type 2 diabetes in comparison to other ethnicities. Visual aids such as diagrams, graphs and charts are important because of visual learning. I personally feel that visual aids can assist visual learners to enable them to make the link based on their condition (Vark, 2019). I also made sure that there was an extra chair available for the catechist A. Petelo. Once the hall was ready and well organized I had to double-check the restrooms and ensured that there is enough toilet tissue and soap bottles, there was no need for hand towels since the venue comes with hand dryers already in place. And making sure that the floor is clean, I used a mop and made sure I put a yellow wet sign as a precaution to prevent falls.

Summary Talk

To begin the health promotion session, the first thing I did was to ask the catechist to start our afternoon with a prayer. In the Samoan culture it is tradition to introduce myself in the Samoan language. The next thing I will be discussing is a brief outline of the main content of my health presentation, in saying this I will also give the audience a chance to say one thing that they have learned from the presentation. A simple description of type 2 diabetes and how it is different from type 1 diabetes, but mainly aiming their focus on type 2. Following this, a discussion of the evidence database on statistics will be explored thoroughly and how it is affecting the Pacific population rapidly. Furthermore, I will explain the etiology, signs and symptoms, pathophysiology, nursing interventions and common medications. I will also be using examples from medication samples of metformin and insulin by describing their effectiveness of action in the body relating to type 2 diabetes. In this way the audience will be able to familiarise themselves with their medication visually rather than knowing just the generic and trade name. The last slide on my presentation will be about nursing interventions on what are some of the ways we,the Pacific people can do for prevention. In saying this I will explain diet in a simple form for example include vegetables and fruits or utilize the food pyramid for guidance. I will make sure to include the importance of staying proactive through exercise. This can mean holding youth games once in a while and youth activities such as walking together as a group to maintain a healthy weight and ensuring that everyone is included. In my presentation I would have a structure of how I am going to present, for example, I would be talking in english due to my chosen audience. And for the parents and family that wish to attend I would translate in the Samoan language. Language is an important aspect in the Samoan community and because of the language barrier, our people struggle to access health services that are available because they are either embarrassed or do not understand. According to Compass health (2019), they provide interpreting services to help and support families who prefer a Samoan translator, to be able to provide insight of their condition and in this way prevent unnecessary misinterpretation when talking about their health in general. To end the session I will ask Catechist A. Petelo to conclude our session with a prayer and I will also make sure to encourage everyone who attended to take pamphlets and food provided on the table, as well as giving thanks to Catechist A. Petelo, Registered Nurse F. Mauga and to my lovely audience for making their time available for the session once more.

Evaluation

I was able to develop an evaluation form and handed them out to the audience to complete. The evaluation form is a summary of how they felt about the presentation, whether they were well informed or not, and any overall recommendations for improvements for future references around health promotion on type 2 diabetes.

Conclusion

Health promotion was developed for the right purposes on awareness and complications around Type 2 diabetes. This is to help the Pacific community to take responsibility for their health, although changing their perspective in leading a healthy lifestyle is deemed to be a challenge. It is still our role to teach and educate our pacific community in providing basic knowledge and understanding relating to type 2 diabetes. The prevalence of type 2 diabetes has great impact on the health of our people and with the foundation of support and determination, this disease can be controlled together, and in the Samoan saying: ‘it takes a village to raise a child.

Appendix 1

• Writing guidelines

Guidelines for writing articles for Kai Tiaki Nursing New Zealand.

We welcome articles on subjects relevant to nurses and nursing, midwives, and midwifery. These guidelines are designed to help you write an article that is accurate, clear, easily read, and interesting.

The main reason you want an article published in Kai Tiaki Nursing New Zealand is so other nurses/ midwives will read it and hopefully learn something valuable. Therefore the subject must interest nurses/ midwives and be written in a way that will appeal to them. The essence of good writing is simple, effective communication – a good story well told. Even the most complicated nursing/midwifery care scenario, theory of nursing/ midwifery practice or research study can be presented in a straightforward, logical fashion. This list should help you construct an article that will be read, understood and appreciated.

• Always remember who your reader is.

Your readers are nurses/midwives, so what you write must be relevant to and understood by nurses/midwives. The focus of your article must be what the nurse/midwife does, how the nurse/midwife behaves, what affects the nurse/midwife. If you are writing about a new technique in your practice area, explain how it changes nursing/ midwifery practice and its advantages and disadvantages to the nurse/midwife and patient/client. If you are discussing a theory of nursing/midwifery practice, link this to concrete examples of working nurses/midwives.

• Avoid using big words, complicated sentences, and technical jargon.

They don’t make you smarter or your article better. Writing clearly and plainly is your goal. Widely used nursing/midwifery terms are acceptable, but avoid overly technical jargon. American writer, editor and teacher William Zinsser stresses the need for simplicity in writing: “We are a society strangling in unnecessary words, circular constructions, pompous frills and meaningless jargon.”1

• These questions will help you pull together all the relevant information needed for your article: Who? What? Why? When? Where? How?

Don’t assume all other nurses/midwives know the ins and outs of your particular area of practice. If you are unsure about how to express a particular idea or technique, think how you would explain it to a student nurse/midwife.

• The maximum length is 2500 words, which, with illustrations, fills three pages of Kai Tiaki Nursing New Zealand. Longer articles need to be discussed with the co-editors.
• References should be presented in APA style. Some examples:

Articles:

1. Sampson, M. (2013). Seeking consistency when managing patients’ pain. Kai Tiaki Nursing New Zealand; 19(5), 26-28. Bryant R. (2012). Nurses addressing access disparities in primary health care. International Nursing Review; 59(152). doi:10.1111/ j.14667657.2012.01003.x

Books:

1. O’Connor, M. E. (2010). Freed to Care, Proud to Nurse: 100 years of the New Zealand Nurses Organisation. Wellington: Steele Roberts.

Websites:

1. Ministry of Health. (2010). Cancer Control in New Zealand. Retrieved from http://www.moh.govt.nz/cancercontrol

• Submit your article via email (to coeditors@nzno.org.nz).

1. Type with double-spacing and wide margins and include your name, address, phone number/s, current position, and nursing qualifications.

• Photographs and illustrations are welcome.

1. They need to be high-resolution, at 300dpi, and at least 200kb or more. We prefer a jpeg format; send them as attachments to an email rather than in the email itself. Cartoons and diagrams are also welcome, and we can also use black and white or color prints. Most clinical articles are reviewed by Kai Tiaki Nursing New Zealand coeditors and two clinicians with expertise in the subject the article explores. Authors will be informed of the outcome of the review and the reasons why their article was accepted, rejected, or requires more work.

• Contributors assign copyright to NZNO.

If an article is accepted for publication, the copyright is automatically assigned to NZNO. Permission to republish material elsewhere is usually given to authors on request, but manuscripts must not be submitted simultaneously to other journals. • Reference 1) Zinsser, W. (2001). On Writing Well. The Classic Guide to Writing Nonfiction (25th-anniversary edition). New York: Harper Collins.

Appendix 2

Evaluation form

Beat it, Type 2 diabetes

Date: 30 May 2019

1. What did you find most interesting about the health promotion of Type 2 diabetes?
2. Was the health presentation relevant and useful to you?
3. Did you find the presentation simple or difficult to understand?
4. Were you able to learn anything about Type 2 diabetes?
5. Was the presentation helpful?
6. How can I do better next time ( improvements )?

Overall comment:

References

1. Health Navigator. (2019). Type 2 diabetes. Retrieved from https://www.healthnavigator.org.nz/health-a-z/d/diabetes-type-2/
2. World Health Organization. (2019). Diabetes mellitus. Retrieved from https://www.who.int/mediacentre/factsheets/fs138/en/
3. Ministry of health. (2014). About diabetes. Retrieved from https://www.health.govt.nz/our-work/diseases-and-conditions/diabetes/about-diabetes
4. New Zealand society for the study of diabetes. (2016). About diabetes. Retrieved from https://www.nzssd.org.nz/about-diabetes
5. Pasifika futures. (2017). Pasifika people in New Zealand. Retrieved from http://pasifikafutures.co.nz/wp-content/uploads/2015/06/PF_HowAreWeDoing-RD2-WEB2.pdf
6. Hauora. (2014). Defining health promotion. Retrieved from https://hauora.co.nz/defining-health-promotion/
7. Vark. (2019). Visual Strategies. Retrieved from http://vark-learn.com/strategies/visual-strategies/
8. Compass health. (2019). Pacific Health. Retrieved from http://www.compasshealth.org.nz/HealthServices/PacificHealth.aspx
9. Health quality & safety commission New Zealand. (n.d). Updated information on diabetes treatment in New Zealand. Retrieved from https://www.hqsc.govt.nz/assets/Health-Quality-Evaluation/Atlas/Diabetes/Diabetes-consumer-summary-Nov-2018.pdf
10. Jowitt, L. M. (2014). Ethnicity and Type 2 diabetes in Pacific Island adults in New Zealand. International journal of diabetes and clinical research; 1: 3. Retrieved from https://clinmedjournals.org/articles/ijdcr/ijdcr-1-014.pdf