program is to dramatically increase awareness and treatment of diabetes mellitus through creation of diabetes awareness program within Midwood, New York. Diabetes is a metabolic disordered that is characterized by hyperglycemia or extremely high glucose blood sugar levels. The World Health Organization currently defines diabetes in three categories, type I, type II and gestational diabetes. Diabetes is an extremely serious disease; the danger posed by diabetes is the long-term complications that result. Having abnormally high glucose levels will double the risk of cardiovascular disease, damage the retinal, nerve damage, and micro vascular damage, and general poor health that could lead to gangrene and in extreme cases amputation. Diabetes is doubly dangerous because there is no cure; once diabetes develops it becomes a life long problem that is treatable, but incurable.

With the dangers associated with diabetes it is imperative that there is a mechanism for which diabetes is detected and adequate treatment provided. Diagnosis within the target population of Midwood is crucial because low income families have no feasible means to discover this common disorder. Diabetes in its three types varies in susceptibility. Type I diabetes occurs when there is autoimmune destruction of the insulin producing cells, called the pancreatic beta cells. Type I diabetes has no cure, it is found in 10% of all diabetes cases. Recent research has shown that Type I diabetes is passed on genetically, and thus heredity plays an important roll. Although there is no cure for Type I diabetes, it is currently treatable with insulin shots, which must be constantly monitored. The problem with diagnosing Type I diabetes is that those afflicted are most often completely healthy in appearance and all other physical aspects. Most people affected are of a healthy weight until they are afflicted. Furthermore, diet and exercise will not help prevent Type I diabetes, and it usually begins its affects at a very young age. Type II is caused by tissue wide insulin resistance, which is brought about by a large degree through bad diets and overall poor health. The disease occurs due to a combination of defective insulin secretion and defective responses to insulin. Since Type II is not directly related to genetics, but rather impacted by diet and exercise, hyperglycemia can be controlled and reversed. Medication that improves insulin sensitivity becomes crucial for prevent long-term damage. Bad health however is the number one predicator for "adult-onset" diabetes, with 90% of all Type II patients being obese. Type 2 diabetes may go unnoticed for years in a patient before diagnosis, since the symptoms are both milder and more sporadic than Type I.

According to surveys conducted by the WHO (World Health Organization) at least 171 million people in the world suffers from diabetes. Even more alarming, the rate of diabetes is expanding exponentially with projections that the total number of afflicted would double by 2030. Although diabetes occurs throughout the world, the majority of Type II patients are from developed nations. The overall increase in diabetes is attributed by many scientists to the development of urban communities and lifestyle changes. A western-style diet which contains an excess of fats, carbohydrates and other negative impact foods. Currently however, there is little understanding of how or why diabetes continues to spread. Diabetes is considered one of the top five most pressing diseases of developed nations. 20.8 million People have diagnosed diabetes within the United States, a further 6.2 million people are believed to be undiagnosed and almost 41 million people would be considered pre-diabetic and highly susceptible.

There are currently no local awareness programs about diabetes specific to Midwood. The target community has a mixed population, with a heavy mixture of ethnicities and religious groups. Due to its proximity to Manhattan and recent trends of infrastructural improvements the community has attracted individuals of all economic and social classes; however the predominant majority of the community is low-income families. The benefit of this program is that it will teach and educate awareness of diabetes. Within low income communities, undiagnosed diabetes is a consistent concern because there are few outlets to find information about diabetes. This education program will dramatically increase the awareness of the symptoms and possible consequences of diabetes. It will provide residents of Midwood with the tools they need to find out how to deal with possible diabetes and how to receive treatment. A recent demographic report of Midwood is composed of almost a third of elderly individuals who are the most susceptible to Type II diabetes. Obesity and general overweight behavior is also visible within the community, another strong risk factor for diabetes.

Social Assessment:

The target population is the 45,287 individuals living in Midwood. The median family income for this community is a sub-par $17,172. Midwood can be considered to be an ethnic melting pot; there are a significant percentage of Indians, Syrian Orthodox Jews, African-Americans, and many other minority groups. As a result, Midwood is a danger area for diabetes risk since diabetes is a dominantly carrier within certain ethnicities. Since the community lacks any diabetes education program there are very few diagnosed cases within the community. Their low income status makes access to affordable treatment extremely difficult; all of these factors imply that the community is not in a position to cater to diabetes education and treatment without constructing an extremely strong awareness program. From these factors it is evident that Midwood is a high risk area for undiagnosed diabetes and general pre-diabetes susceptible individuals. The best way to assist the community is to create a public campaign that will cause individuals to be able to fully assess themselves and learn if they have diabetes and how to get an accurate diagnosis.

The mission statement of this diabetes awareness campaign is to conduct and support local and large scale efforts that lead to the control and treatment of diabetes. Using the tools of education, prevention and research to ensure those future generations will be free of diabetes and its complications.

The primary goal of this program is to increase awareness of diabetes and the symptoms attributed to it. Through this awareness individuals will be able to receive greater access to diagnosis mechanisms thus increasing venues of diagnosis and treatment.

Behavioral Assessment:

Behavior risks associated with diabetes within this community takes on both genetic and habit forming factors. Genetically, diabetes type I can be inherited and is especially prominent within certain ethnic groups such as Indians. The majority of American diabetes cases involve type II diabetes however; Type II is an extremely treatable and preventable disease on several levels. Since this occurs as a result of insulin resistance, such measures can be reversed. The primarily risk behavior related with Type II diabetes is overeating and habitually bad diet. 90% of all Type II diabetes cases are related to obesity. In order to decrease the risk of Type II among pre-conditioned individuals and at-risk cases, a strong program towards weight loss emphasis must be created. Such a program is hard to implement because it involves a strong psychological and physiological change. Obesity is commonly tied to "emotion eating" as well as a myriad of other problems, which means treatment must be based upon a behavior intervention model that addresses both the psychological and physical problems of food addiction associated with diabetes. On a broad level an initiative to distribute literature on the relationship between obesity and diabetes will take place. On a specific interpersonal level, counseling will be offered for those who need or want to address their specific psychological problems that cause obesity and emotional eating. Volunteers trained by the NDEP and ADA can be effective first step counselors to challenge individuals on overeating.

Implementation:

The first step towards implementing such a project is to understand both the local and national level agencies and organizations that promote diabetes awareness. The National Diabetes Education Program (NDEP) is one such organization that would be an effective partner within this program for several reasons. First, they are ideally suited from an awareness perspective as they have hands on experience with grass roots campaigns. They have a headquarter in New York City, only twelve miles from Midwood. The American Diabetes Association will be another value partner; they also have a strong mentorship program for local level campaigning in diabetes awareness. Diabetes awareness through the ADA and NDEP has increased by 35% since 1998 according to one national survey conducted through the New York Times. Local events that have been staged in Brooklyn such as the World Diabetes Benefits Concert in 2001 drew a crowd of over 300,000 from Brooklyn and surrounding areas. Implementation will comprise of three steps that will be explained in detail below.

In coordination with NDEP an ADA, a compilation of diabetes information will be created in the form of pamphlets, posters, and flyers. Specific emphasis will be given to the difference between Type I and Type II diabetes and the common symptoms experienced in both. The distribution of this material will be through multiple venues. Sinceā€¦