Week 3: 1/22/19 – Angela Coaston
1. State your health outcome of interest. (It could be the one you used for week #2 or another one.) Pick two key behaviors that are important factors leading to your health outcome. Explain the importance of these behaviors either for etiology, prevention, or intervention. (If none of the behaviors in the readings are important for your health outcome, suggest another behavior that is.)
Health Access for the uninsured is one outcome of interest. Another would be chronic disease management for adults with type 2 diabetes who seek care aboard a mobile medical clinic. The two behaviors that are important factors leading to the management of type 2 diabetes include diet and exercise. Behavior changes towards improving diet choices particularly carbohydrate management and regular exercise can be both preventative and interventions for adults with type 2 diabetes. Unfortunately, for the population that I am seeking to study, most live in food deserts where there are 1:8 healthy food/unhealthy food options. Another challenge for this population is unsafe or no practical walking spaces for exercise.
2. Describe how you would study the role of one of the behaviors described for question #1 and your health outcome of interest. Incorporate a social factor (e.g. race/ethnicity, social exclusion, stress) in the study approach. I would conduct a prospective cohort study. I would study adults age >25 with diagnosis of type 2 diabetes confirmed aby Hemoglobin A1C level > 5.8 who are seeking care aboard a mobile medical clinics. I would randomize 2 groups and I would implement an evidence-based diabetes diet and exercise plan to both groups over 6 months. I would have one group cooking healthy foods for themselves and provide gym passes. The other group would need to find healthy food choices in their community and use home or community space for exercise. I would track, weight, diet, exercise weekly and hemoglobin A1C at baseline, 3 and 6 months.
3. If key health behaviors (e.g. smoking, exercise, nutritious diet) are strongly influenced by neighborhood, income, and/or education, do we need to continue to study how these behaviors influence health outcomes? Why or why not? Yes, we would need to continue to study how neighborhood and education influence diabetes health outcomes because diabetes is a chronic disease that is on the rise and is very costly for society. Discovering associations would help policy makers, city planners and health care providers plan, develop and implement policies and interventions to improve diabetes health outcomes. These data could influence city planners and developers to consider health outcome implications of healthy grocery stores and city walkable spaces for vulnerable populations.