I need a small paper done, apa format with cover page and references example paper in files
12
The Prevention and Management of Chronic Diseases in Adults
Student Name
Chamberlain University College of Nursing
Evidence Based Practice NR449
Professor Cynthia Butterman
April 15th, 2023.
The Prevention and Management of Chronic Diseases in Adults
Chronic diseases present one of the major public health concerns across the US. Today, six in every ten adults in the US have at least one chronic condition. Four in every ten adults are also diagnosed with two or more chronic conditions (Centers for Disease Control and Prevention, 2022). These chronic conditions have a significant impact on the health and well-being of individuals, the stability of families, the overall wellness of the community, and significant socioeconomic implications for the nation. For instance, a bigger percentage (up to 75%) of the annual health budget of the US ($4.1 trillion) is usually directed toward the management and treatment of chronic conditions (Centers for Disease Control and Prevention, 2022). On average, this implies each individual with a chronic condition incurs at least $5,300 in healthcare costs every year (Centers for Disease Control and Prevention, 2022).
Additionally, chronic diseases are the leading causes of mortality/death, including early and preventable mortalities in adults. These preventable and early mortalities have a significant implication on the socioeconomic status of families and households, especially where the individual with the condition is the primary income earner within that household. These socioeconomic implications range from increased levels of dependency within a household, lower household income, and higher poverty levels that may affect the academic progression of other members of the family (Bush et al., 2020). In essence, preventable mortalities and comorbidities in chronic conditions are a major influence on the existence of cyclical poverty within households, hence a significant factor in determining the socioeconomic stability of households now and into the future (Neuhouser, 2019). Notably, heart disease, stroke, cancer, diabetes, high blood pressure, arthritis, obesity, and Alzheimer’s disease are the major chronic diseases that present among adults in the US. Heart disease and stroke alone account for up to one-third of total deaths in the US, while cancer accounts for up to 600,000 every year (Centers for Disease Control and Prevention, 2022).
The comorbidities associated with these conditions have far more reaching socioeconomic implications for individuals, families, communities, and the public health system. However, a common attribute with chronic diseases among adults in the US is that they are largely influenced by modifiable risk factors such as poor dietary habits, limited physical activity/sedentary lifestyles as well as other risky habits such as excessive alcohol use and smoking. Nutritional or dietary habits stand out as a major risk factor for chronic conditions, their progression, and the emergence of additional comorbidities among US adults (Bush et al., 2020). Innovative approaches towards dietary and nutritional management are gaining fast approval and utilization due to advances in technology. These innovative approaches, if well implemented can help prevent chronic diseases, associated early mortalities, and comorbidities assure of improved quality of life among US adults.
Article Search
The PubMed database was utilized for article search. The keywords utilized for the search included chronic diseases, adults, prevention, health promotion, early mortality, comorbidities, monitoring, self-management, nutrition, diet, and risk factors. To conduct the search, the keywords were combined to develop key phrases. Boolean functions AND/OR were applied in combining the search (Houser, 2023). Some key phrases that were developed included “chronic diseases AND adults AND nutrition OR diet”, “chronic diseases AND prevention AND early mortalities”, “nutrition OR diet AND risk factors AND chronic diseases” and so on. Cumulatively, eight phrases were developed, and the corresponding eight searches generated a total of 382 articles. The search was refined for time relevance with duration since publication set to 2019 (5 years). Other criteria used to refine the search included full articles only, journal articles, and peer reviewed. This refined search generated a total of 9 articles. The selection of the required article for the task herein was left to the discretion of the researcher.
Article Findings
El Khoury et al. (2019) utilize a systematic review and meta-analysis of the literature to examine the efficacy of dietary mobile applications on the nutritional outcomes among adults with chronic conditions. In an era of significant technological advancements in healthcare, mobile applications are proving to be a great asset in improving health promotion, health education, and enhancing self-care and self-management in individuals and families. El Khoury et al. (2019) identified articles from several databases including PubMed, MEDLINE, Embase, and CINAHL. A total of 18,649 articles were generated in the search. The search was limited to only articles published from January 1, 2007, until November 15, 2007. The PRISMA technique was applied in the systematic review. The key measures that were being sought included nutritional outcomes among adults using the dietary mobile apps, nutrition-focused physical findings, anthropometric measurements such as body mass index (BMI) and waist circumference, as well as relevant biochemical and clinical data related to nutrition.
The final choice of the 22 articles utilized in the systematic review was only intervention studies. The study findings based on pool estimates indicated that individuals that utilized the dietary mobile applications demonstrated a significantly greater decrease in waist circumference, weight, and energy intake compared to those in the control groups. More than three-quarters (75%) of the interventional studies utilized in the systematic review demonstrated that the use of dietary mobile applications had a positive impact or change on the users across at least one of the nutritional outcomes that were being measured. Additionally, more than 50% of the articles reported medium-level or large-level impact or effect of the dietary mobile applications on changes in the outcomes being measured. The greatest impact of the dietary mobile apps based on pool estimates was recorded on the measure of self-monitoring of dietary patterns and improvement or changes in self-care and self-management related to diet and weight loss.
The choice of article by El Khoury et al. (2019) was based on the reality that the complications of most chronic diseases such as diabetes, hypertension, heart diseases, and stroke can be managed or controlled with effective lifestyle changes, especially diet, and nutrition. However, the absence of objective real-time data to inform adult patients with these chronic conditions on their health status is usually a challenge, thus leading to a poor or untimely response. Thus, by the time actual interventions for the prevention of the progression of the condition are initiated, irreversible changes in organ function and system disruption have already occurred leading to disease progression and the associated comorbidities or early mortality. Healthcare innovations such as dietary mobile apps are filling the current gap in response and timeliness of literature while also serving to improve the knowledge of patients regarding the possible or expected changes in their nutritional status. This article describes the effectiveness of dietary mobile apps on adults with chronic conditions which aligns with the topic herein which seeks to explore better or more effective techniques for the prevention of chronic diseases and/or their progression among adults via dietary or nutritional techniques (El Khoury et al., 2019).
Evidence for Practice
Across the 22 articles utilized, nine studies utilized commercial applications available on the play store while the other studies utilized applications that had been developed for research purposes. The pooled estimates across these two groups demonstrated that whether for commercial or research purposes, mobile apps had a significant influence on the nutritional outcomes of adults with chronic conditions (El Khoury et al., 2019). For instance, in studies that reported on applications focused on diabetes and hypertension, the two categories of the applications reported significant improvements in the dietary/food history of the participants. Traditionally, the challenge of managing chronic conditions among adults has been linked to the absence of objective data to inform lifestyle changes or initiate other immediate interventions (Bush et al., 2020).
Patients have traditionally relied on healthcare providers to monitor their health status and nutritional outcomes. The limitation of the traditional approach is that healthcare providers cannot accurately monitor the behaviors or habits of individuals away from the hospital settings, especially concerning dietary and nutritional habits. However, innovations such as dietary mobile apps address the gap in monitoring behaviors and habits such as dietary choices, history, and physical activity levels that could have otherwise been determined subjectively in the past. With objective data on habits and behaviors, the patient and the healthcare provider are allowed to collaborate in developing personalized nutritional and dietary patterns that align with the dynamic health needs imposed by the condition or risk for the condition (El Khoury et al., 2019).
The primary limitation of the studies utilized is that they all relied on year-long monitoring of the participants (El Khoury et al., 2019). In reality, patients with chronic diseases require lifelong management of their lifestyle, habits, and behaviors, especially concerning diet and nutrition. The studies demonstrate the efficacy of diet mobile apps for short-term and mid-term assessment of nutritional outcomes in patients. There is limited evidence on the long-term utilization and efficacy of mobile apps, which would inform whether such apps have any relevance to the overall changes in behavior and lifestyle of individuals in the long term (El Khoury et al., 2019). Further, the studies fail to effectively report on the challenges in the utilization of mobile apps related to lacking patient knowledge of technological devices or applications. The optimal value of these applications is dependent on the patient’s knowledge of technology and the ability to apply all functionalities or modules of the applications. There is a need for further studies to establish how lacking knowledge and skill in technology could affect the utilization and efficacy of dietary mobile apps among adults with chronic conditions (El Khoury et al., 2019).
Sharing of Evidence
I would share the information with healthcare providers managing patients with chronic conditions, nutritionists, community health nurses, and patients with chronic conditions. Healthcare providers, nutritionists, and community health nurses are essential to creating awareness of such dietary mobile apps and their relevance to improving nutritional outcomes and overall quality of life among their patients. These professionals would also be useful in reviewing the applications and providing feedback on what would need to be altered, improved, integrated, or eliminated to further optimize the applications (Houser, 2023). Patients with chronic diseases would benefit from the information since they are the target group for these tools. I would consider social media groups via applications such as WhatsApp and Facebook to share information with a specific provider or patient networks or groups. I would also consider designing and producing pamphlets and brochures to distribute to relevant individuals, professionals, and stakeholders involved in chronic disease management and prevention. A smartphone installed with social media applications as well as a personal computer to design the brochures would be useful resources to enhance sharing of information. I would also require printing papers and a printer device to produce hard copies of the pamphlets and brochures to distribute to target groups or individuals.
Conclusion
Chronic diseases among adults in the US present significant health and socioeconomic implications. A majority of prevalent chronic conditions diagnosed in adults in the US are preventable while their progression and related complications can be controlled to assure these adults of a quality life amid their condition. One of the key strategies for effective prevention and control of chronic disease progression is via nutritional and dietary approaches (Neuhouser, 2019). However, patients and healthcare providers require objective data on dietary and nutritional patterns to develop personalized dietary plans for patients to limit, prevent or control chronic diseases and their comorbidities (Bush et al., 2020). Dietary mobile applications prove to be an effective strategy to provide the required objective data that can enhance the design of the desired personalized nutritional plans. Dietary mobile apps also enhance patients’ self-monitoring and effective planning of diets that align with the diagnosed chronic condition. While the short-term and mid-term efficacy of dietary mobile apps is not in doubt, there is a need to explore the long-term efficacy of the mobile apps to align with the lifelong nutritional-related prevention, management, and treatment of chronic conditions among adults (El Khoury et al., 2019).
References
Bush, C. L., Blumberg, J. B., El-Sohemy, A., Minich, D. M., Ordovás, J. M., Reed, D. G., & Behm, V. A. Y. (2020). Toward the definition of personalized nutrition: a proposal by the American Nutrition Association. Journal of the American College of Nutrition, 39(1), 5-15. https://doi.org/10.1080/07315724.2019.1685332
Centers for Disease Control and Prevention. (2022, October 14). Health and economic costs of chronic diseases. https://www.cdc.gov/chronicdisease/about/costs/index.htm
El Khoury, C. F., Karavetian, M., Halfens, R. J., Crutzen, R., Khoja, L., & Schols, J. M. (2019). The effects of dietary mobile apps on nutritional outcomes in adults with chronic diseases: a systematic review and meta-analysis. Journal of the Academy of Nutrition and Dietetics, 119(4), 626-651. https://doi.org/10.1016/j.jand.2018.11.010
Houser. (2023). Nursing research: Reading, using and creating evidence (5th ed.). Jones & Bartlett Learning.
Neuhouser, M. L. (2019). The importance of healthy dietary patterns in chronic disease prevention. Nutrition Research, 70, 3-6. https://doi.org/10.1016/j.nutres.2018.06.002
