PSYCH 694 Week 6 Applied Project Example

An Applied Health Psychology Project: A Family-Centered Diabetes Self-Management Group for a Rural Arizona Health Center

[Student Name]

University of Phoenix

PSYCH/694: Specialty Areas in Applied Psychology

Week 6 Assignment

[Instructor Name]

[Date]

The health center, the program and all figures are composites written for a model paper; research findings come from the sources listed.

Over six weeks, this course took me through applied specialties using problems from our health center. Health psychology is where I belong, and this project applies it to the problem I see most: patients struggling to manage type 2 diabetes.

The Problem

Our Flagstaff health center serves about 1,400 adults with type 2 diabetes. Only thirty-eight percent have an A1C below eight percent, a common measure of reasonable control, compared with a national health center benchmark near two thirds. Many patients live on the Navajo Nation or in rural towns, drive long distances, work shifts and cook for extended families. The center's existing nutrition class meets on weekday afternoons, uses generic handouts and averages four attendees.

What the Research Shows

Norris et al. (2001) systematically reviewed seventy-two randomized controlled trials of self-management training for adults with type 2 diabetes. Training improved knowledge, self-monitoring of blood glucose, dietary habits and blood sugar control at short-term follow-up, generally within six months. Effects tended to fade over longer periods unless reinforcement continued, and interventions that engaged patients collaboratively were more effective than those that simply delivered information.

Lorig et al. (2001) followed more than eight hundred participants in the Chronic Disease Self-Management Program, six weekly workshops run by trained community members, often people managing chronic conditions of their own. Two years after the program, participants reported less health distress and greater self-efficacy than at baseline and made fewer emergency department and physician visits.

Together these studies suggest that a collaborative, skills-based program helps, that peer leaders can deliver it and that ongoing contact is needed for gains to last.

Building Confidence

Bandura (2004) argued that health habits change most reliably when people come to believe they can control them, and that this belief grows chiefly through mastery, the experience of succeeding at manageable steps, along with seeing similar people succeed and receiving credible encouragement. He emphasized self-management skills, such as setting goals, monitoring progress and planning for obstacles, over warnings about risk.

This shapes every session: each participant leaves with one small, specific goal for the week and reports on it at the next session, and co-leaders who share participants' background model success.

The Program

Six weekly ninety-minute evening sessions, held at the center and at a chapter house on the reservation, each for up to twelve patients and one family member each. Topics: understanding diabetes in plain language; blood sugar monitoring; food and family meals, built around local foods; activity that fits daily life; medications and timing around shift work; and stress, mood and planning for setbacks. Each session follows the same pattern: check-in on last week's goal, a short skills segment, practice and a new goal. A light dinner is served.

Every session ends the same way, with one goal small enough that the participant will almost certainly succeed.

Cultural Adaptation

The center's community health representatives, who are Navajo and speak the language, will co-lead. Materials will use local foods, such as mutton stew and blue corn, with practical substitutions rather than banned lists. Sessions will welcome discussion of traditional healing and the value of harmony, and family participation reflects the role of extended families in daily life.

Roles

The psychologist will train co-leaders, co-lead the stress and mood session and see participants who screen positive for depression. Community health representatives will co-lead all sessions. My role, as a master's-level case manager and future program coordinator, is to organize the program, recruit participants, manage transportation vouchers, collect data and conduct the evaluation. I will not provide therapy or psychological assessment, which require licensure.

Sustaining Gains

Because effects fade without reinforcement, graduates will receive monthly phone check-ins from community health representatives for six months and an invitation to a quarterly reunion session.

Evaluation

The first two cohorts will start immediately; the next two, waitlisted for three months, provide a comparison. Outcomes: A1C at baseline, three and six months; a brief diabetes self-efficacy scale; attendance; and emergency visits from records. Success means at least seventy percent attendance and a larger drop in A1C among participants than waitlisted patients at three months.

Ethics

Participation is voluntary, with consent for data use. Group members agree to keep others' information private. Participants with severe depression or suicidal thoughts on screening will be referred immediately to the psychologist. Data will be reported only in aggregate, and the tribal health department will review the evaluation plan before it begins, respecting the community's authority over research involving its members.

Why I Chose Health Psychology

Each specialty this term offered something, but health psychology joined the parts of my job I care about most: patients' daily lives, their families and the long work of chronic illness. Clinical work interested me, but independent practice would require a doctorate I am not ready to pursue. I-O psychology fit my interest in systems but felt far from patients. In health psychology, a master's-level professional can coordinate programs, educate and evaluate, roles that make a real difference in a center short on staff.

Recruiting the Right Participants

The patients who most need the program are often the least likely to come. Recruitment will rely on personal invitations from providers during visits, calls from community health representatives who know families and announcements at chapter house meetings, rather than flyers alone. Patients with the highest A1C values will be invited first. Transportation vouchers and evening times address the two barriers patients mention most, and family members are invited by name so that participation feels like a family decision.

A Pilot Before Scaling

Before the four planned cohorts, a single pilot group of eight patients and their families will test the sessions, materials and logistics. After each pilot session, co-leaders and I will meet for fifteen minutes to note what worked and what confused participants, and at the end we will ask participants directly what to change. The pilot will also test whether the data collection plan is realistic: whether A1C values can be drawn on schedule and whether the self-efficacy scale makes sense in translation.

Cost and Sustainability

Estimated costs for four cohorts are about nine thousand dollars, covering dinners, transportation vouchers, materials and staff overtime. The center will apply for a tribal health grant and bill eligible diabetes education services to keep the program running.

Limits

The waitlist comparison is not randomized, so differences between early and later cohorts, such as season or motivation, could affect results. The program cannot address food access or work schedules directly, though it can help participants plan around them. Results from one center may not generalize to urban clinics or to other tribal communities with different foods and traditions.

Conclusion

A family-centered, culturally adapted self-management group, grounded in evidence on self-management training, peer-led programs and self-efficacy, offers our center a practical way to help patients gain control of diabetes and offers me a role in health psychology suited to my training.

References

Bandura, A. (2004). Health promotion by social cognitive means. Health Education & Behavior, 31(2), 143-164. https://doi.org/10.1177/1090198104263660

Lorig, K. R., Ritter, P., Stewart, A. L., Sobel, D. S., Brown, B. W., Jr., Bandura, A., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (2001). Chronic disease self-management program: 2-year health status and health care utilization outcomes. Medical Care, 39(11), 1217-1223. https://doi.org/10.1097/00005650-200111000-00008

Norris, S. L., Engelgau, M. M., & Narayan, K. M. V. (2001). Effectiveness of self-management training in type 2 diabetes: A systematic review of randomized controlled trials. Diabetes Care, 24(3), 561-587. https://doi.org/10.2337/diacare.24.3.561