Introduction
Type 2 diabetes represents a major public health issue worldwide and, in the UK, and is a propelling factor both for affected people and healthcare systems activity. Worldwide, diabetes affects about 422 million people. This number has strongly increased recently in both wealthy and poor nations, as the WHO report on it states. This is underlined by the global target of ceasing diabetes and obesity by 2025, which is a clear proof of the severity of the problem of the whole world (Abdul Basith Khan et al., 2020).
Type 2 diabetes numbers have reached a critical level within the UK and more than 5 million people are expected to be affected. These statistics, however, are conservative since only about 4.3 million people have received a formal diagnosis and 850 thousand cases remain unknown (Whicher et al., 2020). Moreover, nearly 2.4 million individuals are considered at high risk of the development of type 2 diabetes, hence, the alerting condition that these individuals may fall into if preventive methods are not implemented properly. Interestingly, it should be noted that type 2 diabetes contributes to around 90% of all cases of diabetes in the UK and thus shows clearly the leading role of this subtype in the UK health picture (Ali et al., 2022).
The assertion of type 2 diabetes being a public health problem is apparent with the different health and public health practice definitions. Health goes beyond the absence of illness when looking at various dimensions of physical, mental and social well-being, as reflected in the definition of the WHO. In type 2 diabetes, because the factors involved include lifestyle, genetics, environment, a lot is required of public health strategies that target individuals, the community, and wider societal odds. Geography wise its impact is felt across diverse populations, rural, urban, and socioeconomic strata, the higher the risk are the most vulnerable groups.
Analytical Framework
Using the Tannahill model, it is a planned analysis approach that studies the multifaceted public health problem of Type 2 diabetes. The Tannahill Model, developed by Andrew Tannahill, offers a holistic approach to health promotion, encapsulating three key practice domains: Health Promotion (HP), Individual Transformation (IC), and Community Involvement (CD) (Woodall and Cross, 2021).
Firstly, under the Tannahill Model, Health Protection focuses on certain preventive measures that minimizes the likelihood and severity of conditions such as type 2 diabetes. In this field, screening programs, vaccination campaigns, and the policy to address risks like bad eating and sedentary lifestyle form part of the strategy (Ekenedo, 2023). Through tackling environmental and behavioural factors underpinning health status, Health Protection focuses on reducing the incidences of or delaying the onset of Type 2 diabetes at the community level.
Area of Personal Change is used to empower people to change their unhealthy habits and ways of life to more useful lifestyles which can manage diabetes. This category involves measures to strengthen people’s understanding and capability of food, fitness, and adherence to medication. It entails education, behaviour change and counselling (Woodall & Freeman, 2020). The attention goes to the people who are prone or have already been diagnosed with type 2 diabetes, so personal approaches are given to the patients so that they can improve the self-management and avoid any complications linked to this condition (Sharma, 2021).
Therefore, the Community Development will make use of available local resources, create social support systems and develop areas that promote health and wellbeing. The community approach for the case of Type2 diabetes would involve interacting with local leaders, mobilizing community-based groups, and implementing policies to ensure availability of healthy foods and opportunities for physical activity (Cross and Woodall, 2023). This is accomplished by addressing social determinants of health as well as enhancing society with preventive and sustainable communities having individuals who keep their Type 2 diabetes well-managed.
The model addresses the complexity of Type 2 diabetes in its universal approach as it requires input from an individual, community as well as the society level (Darlington and Masson, 2020). Through the implementation of Health Protection, Individual Change, and Community Development methodologies; this approach gives perspective on how to analyse and tackle the multifaceted nature of the factors surrounding the Type 2 diabetes incidence and outcome (Jackson, 2021). As the ideal tool, it excels at imparting the different approaches that must be applied to deal with type 2 diabetes as a public health crisis.
Health Protection
Health Protection and the Tannahill Model
Health Protection in the Tannahill Model is the main building block in setting the public health agenda in fighting the disease Type 2 diabetes. In this context, the focus of the domain is in line with a comprehensive approach to public health that focuses on preventive strategies to minimize the disease burden and enhance population health (Farinatti, 2023). Prevention of Type 2 Diabetes is crucial in Health Protection as health outcomes are directly impacted by the interplay of individual, interpersonal, community and social factors according to the Social Ecological Model theory. Moreover, Health Protection reflects the philosophy set forth by the Ottawa Charter, which calls for the creation of positive environments and the formulation of beneficial policies (Scriven, 2023).
Ethical Dilemmas
Health Protection team members in charge of health promotion for type 2 diabetes may find themselves facing some of those ethical dilemmas. Individual’s autonomy being in conflict with the public good is one of the many ethical dilemmas facing the society (Scott, 2020). Although strategies like compulsory screening and taxation on unhealthy food could be effective in minimizing the rate of diabetes, they are often criticized on the ground of individual freedom and the right to choose.
Moreover, ethical issues emerge when allocation of resources because limited resources may force to prioritize among conflicting health interventions (Ingstad and Wille, 2023). On the other hand, equity and social justice will come up as certain groups especially from those who lack financial resources will be much more vulnerable to the disease.
The fair provision of preventive services and the addressing of the social determinants of health should be among the ethical issues considered in Health Protection practices (Bodryzlova et al., 2024). While the public health practitioners are forging their way through the ethical issues, they should adhere to the principles of beneficence, non-maleficence, justice, and respect for autonomy. Collaborative decision-making processes should involve stakeholders and communities and this will help to make sure that Type 2 diabetes control measures are done in an ethical and responsible manner (Muir, 2020).
Case Study
The NHS Diabetes Prevention Programme (NDPP) comes in as a national oriented program in the UK developed particularly for the high-risk individuals of developing type 2 diabetes (Hawkes et al., 2022). The Tannahill Model’s primary prevention is the main goal of the campaign, and its objective is to keep the disease from developing through healthy lifestyle habits. NDPP provide a nine-month lifestyle change program that is based on sound evidence and individualized to participants’ need. Participants will be able either to attend the group class which is offered face-to- face or to access the digital program that gives accessibility and flexibility (Whelan and Bell, 2022). The program focuses on three key areas: fostering nutritious eating, engaging in regular physical activity, and offering help, where necessary, with weight management. Research that was conducted to determine the efficacy of the NHS programme showed promising results. Data found that more than 50% of people who finished the program were able to have a significant weight loss of 3-3.7kg according to their body weight category (Hawkes et al., 2022). Research shows that the camp can lower the chance of type 2 diabetes by about 50%, showing that it may serve the function of disease prevention (McManus et al., 2022).
Suitability
The NHS’s Diabetes Prevention Program is an example of why Health Protection is a quality approach against Type 2 diabetes. The disease prevention program being implemented focuses on those individuals who are at high risk of developing the condition with the hopes of addressing the determinants of the condition’s onset upstream (Baum, 2021). The program will thus, demonstrate commitment to the concept of primary prevention. The integration in the model reflects the lifestyle choices such as healthy diet and physical activity which makes up the multi-faceted approach to the Health Protection element (Cross et al., 2023).
The program tools which include evidence-based practices and personalized support hence appear to be appropriate in slowing the increasing number of the Type 2 Diabetes. With the aim of helping people to adopt sustainable ways of life to prevent diabetes onset, the NHS DPP shares the experience of a healthier life for others (Weber et al., 2024). Hence, it substantiates how the NHS Diabetes Prevention Programme is an outstanding and inspiring demonstration of how public health strategies can contribute in coping with the increasing challenge of Type 2 Diabetes.
Individual Change
Individual Change and the Tannahill Model
According to the Tannahill Model, Individual Change, a core principle, strikes a chord with several strategies of public health theory, but especially in the effort of preventing or fighting against Type 2 Diabetes. The Tannahill Model acknowledges the central role of individuals in self-direction of their behavioural changes that will eventually promote their health (Woodall and Rowlands, 2020). Personal Transformation comes in line with the Health Belief Model and the Transtheoretical Model of Behaviour Change that point out the role that the person’s perception, motivation, and readiness play for the adoption of healthier behaviours.
Under Tannahill Model, Individual Change strategies cover instructing people of the information, skills and support that are significant in directing to the control and treatment of T2D (Carrier, 2020). Through their objective of modifying specific behaviours like diets, physical activity and medication adherence, these strategies are designed to facilitate good health outcomes at the individual level. This will eventually lead to improved population health (MIrsamiyazdi et al, 2021).
Ethical Dilemmas
Practitioners of public health with the mission of bringing about individual actions on Type 2 Diabetes could be faced a number of ethical dilemmas. The ‘autonomy vs paternalism’ controversy is another problem arising from the rise of technology. While it is necessary to take individuals’ autonomy and decision-making capacity into account, there can be cases when the measures such as nudges or rewards are seen as hostile or invasive of private freedom (Woodall and Cross, 2021).
And then the equity and social justice matter will come on as some population might not be able to get resources easily or support for behaviour change (Ekenedo, 2023). Healthcare professionals should seek universal approaches that are culturally sensitive, inclusive, and adopt solutions according to the needs of the diverse population, and therefore mitigate the health inequality. Moreover, the stigma and blame around Type 2 Diabetes may raise ethical issues involved in individual change practice (Santiparp, 2021). Community health programs must consider a non-judging and empathetic approach, highlighting the support of action rather than punitive measures.
Case Study
Digital Lifestyle Coaching with Wearable Tech showcases a secondary prevention that falls within the Tannahill Model, where they mainly address the individuals that have already been diagnosed with type 2 diabetes (Staite et al., 2020). By implementing this new program, digital educational platforms and wearable technology are integrated to empower individuals to take control of their condition and achieve better health outcomes
Intervention uses digital coaching platform to deliver customized diet, exercise, and medicine reminders based on users’ preference and needs. On the top of that, wearable devices including fitness trackers or CGMs, monitor physical activity parameters (e.g., steps, heart rate) and blood sugar level in real time (Hietbrink et al., 2023). The plugging in of these technologies makes it possible for full data analysis so that the coaching platform can generate custom recommendations and track person improvements. One of the major advantages of this intervention is that it trains self-awareness at the people with type 2 diabetes (Rodriguez-León et al., 2021). The real-time feedback of blood glucose levels and of the physical activity becomes a basis for gaining deeper knowledge how the lifestyle impacts on health outcomes, which results in well-grounded decisions and self-management.
Sustainability
The Individual Change approach in the Digital Lifestyle Coaching with Wearable Tech intervention shows how the Tannahill Model is effective by targeting type 2 diabetes. Through the user empowerment to adopt person-tailored behavioural modifications and self-management skill improvement, this intervention is based on the Individual Change approach which is a promotion of health at the individual level (Hill-Briggs et al., 2021). The use of new technologies not only increases access but also engagement and effectiveness towards meeting better health outcomes and improving the quality of life among type 2 diabetes patients.
Community Development
Community Development and the Tannahill Model
Community Development is a fundamental to the Tannahill Model because of its approaches like creating safe environments, and mobilizing communities’ resources make it possible to empower people. In type 2 diabetes prevention, Community Development conforms with the Tannahill Model particularly concentrating on social determinants of health and forming collective actions that lead to healthy surroundings (Hansen and Thualagant, 2023). Community Development initiatives welcomes community members, organizations and stakeholders. The goal is to identify and address such systemic root determinants of health like restricted access to healthy food, fitness facilities which are safe, and health services (Barroso et al., 2020). It is aligned with the Tannahill Model’s assertion that the communities should be empowered in order to be able of taking ownership of their health and create environmentally sustainable changes that enhance well-being.
Ethical Dilemmas
The activities of the community development involving Type 2 Diabetes prevention may face ethical problems for which due diligence is necessary to be undertaken by the public health officers. A serious concern may arise out of the relations of power and non-engagement of the community (Darlington and Masson, 2020). Community participation is critical for the effective implementation of interventions; practitioners, on the other hand, need to give special attention to ensuring that inequity is addressed, and all the voices are heard during the decision-making processes (Jackson, 2021). The lack of meaningful inclusion of the marginalized or disadvantaged communities could, through their marginalization, give rise to inequities and health disparities.
Besides that, ethical complications might develop over the distribution of the resources and the community’s interventions priority setting (Scott, 2020). The public health workers should be able to use negotiation skills and the interventions designed should be based on the equity standpoint and should address the most acute needs of the community. Similarly, there are also concerns of cultural sensitivity and respect for community values that raise ethical issues (Bodryzlova et al., 2024). Interventions need to be adapted to the various cultural aspects and choices of communities to experience the community and ensure the sustainability of the programs.
Case Study
SAHAP is South Asia Health which is meant for the South Asian communities living in the UK who have a high rate of type 2 diabetes (Charity Commission, 2024). As part of the Tertiary Prevention of the Tannahill Model, SAHAP intends to take care of cases and prevent any situation that could lead to complications for people who have already been diagnosed with type two diabetes. SAHAP utilizes a cultural brainstorming for tackling the unique problems and obstructing factors of type 2 diabetes faced by the South Asian population.
The program utilizes a wide array of strategies, including community education workshops, peer support groups, and pushing for policy change (Leicester City Council, 2023). Education sessions in the community offer a unique opportunity to educate local people on healthy food, physical activity and diabetes control focusing on South Asian dietary habits and culture. Health-conscious dynamics groups provide a secure environment in which the type 2 diabetic patients share experiences, learn from each other and seek emotional support. Furthermore, SAHAP is involved in advocacy and initiatives for the accessibility of culturally appropriate health services and to address social determinants that can increase diabetes risk in the communities.
Suitability
South Asian Health Action Programme shows that the application of community development strategies is highly effective in treating chronic illnesses including stroke in the UK, for instance. Culturally adapted interventions that cater to the specific requirements and preferences of South Asian communities are the priority of SAHAP. Hence, it makes the community cross-empowerment and engagement an integral part of effective stroke prevention (Muir, 2020).
The accomplishment of SAHAP in teaching diabetes, autonomy, and healthy living abilities to the participants accentuate the potency of community development programs to empower a healthy lifestyle. Furthermore, the fall in HbA1c levels that occurred in the study participants is the indication of the positive effect of the community-based model on chronic illness management and reduction of the risk of a stroke (Baum, 2021).
Synthesis
To examine the three areas of Health Protection, Individual Change, and Community Development that are essential in solving Type 2 Diabetes, some strengths and weaknesses become evident. For example, health protection measures, namely, screening programs and policy initiatives are very effective means to overcome such factors and to prevent diabetes progression (Woodall and Cross, 2021).
On the flip side, they may not provide the face-to-face experience and interaction required to keep people involved in changing their behaviour in the long run. Individuals’ change programs that involve people’s improvement of lifestyles to embrace good health are effective in promoting self-management and behavioural therapy.
Nonetheless, they might fail in giving attention to the systemic causes and social determinants which are significant in health outcomes (Ekenedo, 2023). Community Development approaches, which entail using the existing community resources and create support programs, focus on the socio-cultural aspects of health. On the other hand, these platforms should be able to resolve issues of low participation numbers (Woodall and Freeman, 2020).
The practice domains have a range of disproportions in public health. Health Protection, Individual Change, and Community Development are usually focused on the outcomes that are more measurable and induced by specific interventions, while Health Protection only tackles the underlying determinants of health (Sharma, 2021). On the other hand, the most challenging is that finding a right mix of the three domains is a great challenge.
Taking into consideration the complex nature of Type 2 Diabetes, the integrated approach which is based on elements from all three practice domains will be the best approach (Van Teijlingen et al., 2021). The public health practitioners can manage Type 2 Diabetes by the integration of Health Protection strategies as risk reduction, Individual Change interventions as behaviour modification, and Community Development initiatives for systemic change.
Providing such comprehensive interventionism, however, is definitely not an easy task. This includes challenges such as internal organizational shortcomings, teamwork and communication with partners, and cultural issues (Cross and Woodall, 2023). Policies of comprehensive financial integration require partnerships across sectors and are accompanied by continuous engagement of communities and capacity building programs.
Briefly, cost-effective public health actions in combating type 2 diabetes demand the employment of integrated Health protection, individual change, and community development strategies (Darlington and Masson, 2020). Through understanding the problems and solutions of each domain and solving the difficulties of providing the comprehensive intervention, the public health workers are able to increase the efficiency and impact of interventions against Type 2 Diabetes as the main problem of authorities in health (Jackson, 2021).
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References
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