MSN Writing Services

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Student Name

Capella University

NURS-FPX 6011 Evidence-Based Practice for Patient-Centered Care and Population Health

Prof. Name


Evidence-Based Population Health Improvement Plan – Type 2 Diabetes

Type-2 Diabetes Mellitus is a prevalent health problem among the adult community of Florida. It often develops in people over 45 and impacts their physical, emotional, and mental health (CDC, 2019). This chronic condition can be well-managed within the older community by implementing evidence-based interventions. In this presentation, I will discuss the environmental and epidemiological data on diabetes in the adult community of Florida and the healthcare issues they encounter. Furthermore, I will develop an ethical health improvement plan followed by a communication plan to encourage the implementation of the plan within the community. Lastly, I will explain the value and relevance of resources utilized in developing a health improvement plan and how they are appropriate to improve the community’s health.

Community Data Evaluation

Prevalence of Diabetes in FloridaAbout 2,164,009 people in Florida are diabetics, which makes up 12.5 % of the adult population. Every year, 148,613 people in Florida are diagnosed with diabetes (ADA, 2018). Type 2 diabetes accounts for 90-95 % of total diagnosed cases (Florida Department of Health, 2022). 
Costly TreatmentDiabetics have 2-3 times higher medical expenses than non-diabetics. The direct medical costs involved in treating diabetes in Florida are $19.3 million (ADA, 2018).
ComplicationsChronic kidney disease cases nationally (37 million)Vision loss cases (5,57,000)

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Environmental factors such as access to unhealthy food, poor socioeconomic status, and lack of adequate parks and recreational areas for physical activity impact the health of community residents. The population with diabetes will be unable to maintain a healthy lifestyle when they have access to processed food and a diet rich in carbohydrates. Moreover, the lack of knowledge and awareness on diabetes care and its potential consequences due to poor health literacy also contributes to poor management of diabetes, leading to secondary complications such as chronic kidney disease and vision loss.

Additionally, low socioeconomic status among community members deprives them of accessing basic medical facilities to monitor their blood glucose levels and control them by complying with prescribed medication therapy (Bodhini et al., 2023). The lack of appropriate parks also leads to a sedentary lifestyle with no physical activity, essential to maintaining a healthy lifestyle and managing diabetes. About 30.6 % of the older population above 65 has been reported to do no physical activity or exercise in Florida (America’s Health Rankings, n.d.).

Lastly, geographic disparities persist within Florida with low participation rates in the Diabetes Self-Management Education and Support (DSMES) program (Khan et al., 2021). The sources referred are reliable and validated as they were published within the last five years, showing the current studies and derived from databases like Google Scholar and Governmental websites like CDC, the Florida Department of Health, and the American Diabetes Association (ADA) and American Health Rankings.

Health Improvement Plan – Meeting Community Needs

Considering the community challenges in Florida, the health improvement plan comprises expanding the DSMES program, where people from diverse cultural backgrounds with culturally sensitive diabetes education and self-management guidelines will be provided in multiple languages to ensure the culturally diverse population of Florida equally acquires diabetes management care (Goff et al., 2020). This is done by developing diabetes education materials in culturally appropriate ways, free of stereotypes, and providing culturally competent training to healthcare providers to rule out any misunderstandings that may arise due to a lack of knowledge of different cultures. 

Furthermore, the improvement plan involves enhancing the medical coverage of diabetes self-management education and support (DSMES) by collaborating with Medicaid health insurance coverage. This will reduce health inequities experienced by people from low socioeconomic backgrounds (Powers et al., 2020). By providing diabetes self-management education and support in a culturally competent and ethically correct way, diabetics can improve their health outcomes and quality of life by acquiring healthy lifestyles and medication adherence.

Furthermore, it will reduce the onset of diabetes-related complications and mortalities as the population with diabetes has adequately controlled their blood glucose levels. To overcome geographic disparities, integrating telehealth-based DSMES programs is another strategy for health improvement plans (Litchman et al., 2022). This will ensure the diabetic community of Florida with high diabetes prevalence rates acquires this service at home and overcomes the geographical barriers that cause geographical disparities. Implementing DSMES will consider an ethical code of conduct where patient privacy and confidentiality will be taken into account, along with informed consent and honesty in delivering patient-centered care. 

Criteria to Evaluate Achievement of Plan’s Outcomes

The criteria to evaluate the achievement of the plan’s outcomes are as follows:

  • Improved health behaviors, such as increased participation in physical activity, and improved dietary choices, such as prioritizing healthy food over unhealthy food
  • Reduction in diabetes prevalence in a community population
  • Increased cultural inclusivity and engagement
  • Enhanced access to care as geographic disparities are reduced, and health equity is improved

The proposed criteria are helpful and appropriate ways of measuring the success of our proposed plan as they directly estimate the efficacy of the health improvement plan. These criteria are directly relevant to the goals of our health improvement plan. When the plan is successfully implemented, the criteria of improved health outcomes, reduced diabetes prevalence, enhanced access to care, and cultural inclusivity will be fulfilled. 

Communication Plan

To effectively apply the strategies for communicating with community stakeholders and community members in an ethical, culturally sensitive, and inclusive way about the development and implementation of a health improvement plan for diabetics of Florida, it is essential to devise a communication plan and implement it. The communication plan is as follows: 

Identification of Key Stakeholders 

The critical stakeholders for developing and implementing this health improvement plan include the Diabetes Advisory Council of Florida’s Department of Health, community health centers, healthcare providers, physicians, pharmacists, nurses, and relevant organizations such as the Florida Diabetes Alliance. These specific stakeholders must collaborate to ensure diabetes prevalence in Florida can be diminished and health outcomes of diabetes in adults and older populations. They can effectively develop and implement the proposed plan with valuable resources and skillful expertise in managing the community health of diabetics. 

Communication Strategy

The communication strategy is so devised that it covers ethical, cultural, and community engagement aspects. This is done by stating the primary objectives and goals of the health improvement plan clearly in a way that persuades community stakeholders. The goals and objectives should be aligned with the objectives aimed by the relevant stakeholders. The communication plan must adhere to ethical principles of beneficence, justice, honesty, trust-building, and transparency. Incorporate storytelling as a communication strategy where success stories from different communities on improving diabetes health outcomes will be shared by employing similar health improvement plans.

Data Privacy Considerations

The communication plan will strictly abide by community members’ privacy and confidentiality rules when data sharing through telehealth will be processed. This will include implementing HIPAA guidelines on secure and safe exchange of patient’s protected health information (Solimini et al., 2021). This strategy will enhance buy-in from community members, and their participation will be enhanced. 

Making Complex Medical Terms and Concepts Comprehensive

The communication plan will use simple and layman’s language so that community members can conveniently comprehend the complex medical terms and show enhanced engagement. This is necessary as the health literacy of Florida communities with diabetes can be varied, and choosing medical terms may not convince community members to participate in a health improvement plan. Providing interpretations and translations on channels or brochures will help community members understand the medical terms and increase their buy-in (Noor Mohamed & Srinivasan, 2023).

Relevance and Value of Resources

Providing a culturally sensitive DSMES program is a relevant and valuable strategy used in health improvement plans and substantiated by evidence-based resources by Goff and colleagues (2020). Another resource by Powers and colleagues emphasizes the collaboration of Medicaid and Medicare insurance programs with DSMES plans to enhance its efficacy. This is required in the proposed health improvement plan to ensure health equity.

Lastly, the resource by Litchman and colleagues (2022) highlights the importance of telehealth-based DSMES to overcome geographical disparities and barriers to improved health outcomes. Each piece of evidence is appropriate and informs the goal of improving the health of the Florida community where diabetics require implementing the proposed health improvement plan. The conflicting data exist in literature where only DSMES is not considered the best option for diabetes management. For instance, Alenazi et al., 2021 highlight the effectiveness of medication adherence therapy in diabetes and hold the opinion that medication adherence therapy for diabetics can control their glyemic levels better and improve their quality of life with regulated blood glucose levels. 


Florida community of adults and older people are found to have been suffering from type 2 diabetes. The epidemiological and environmental factors are explored that confirm the poor health management among adults and older communities of Florida with diabetes. Therefore, an evidence-based health improvement plan is devised that encourages DSMES program implementation in a culturally competent manner and financial assistance from Medicaid. Moreover, the plan covers the ethical aspects of providing patient-centered care with focus on privacy and respect towards cultural diversity. Lastly, the resources used are appropriate to the needs and barriers identified in the given community.


ADA. (2018). The burden of diabetes in Florida.

Alenazi, F., Bressington, D., Shrestha, M., Peddle, M., & Gray, R. (2021). Effectiveness of adherence therapy in adults with type 2 diabetes: A systematic review. International Journal of Environmental Research and Public Health, 18(9).  

America’s Health Rankings. (n.d.). Explore physical inactivity – ages 65+ in Florida | AHR. America’s Health Rankings. 

Bodhini, D., Morton, R. W., Santhakumar, V., Nakabuye, M., Pomares-Millan, H., Clemmensen, C., Fitzpatrick, S. L., Guasch-Ferre, M., Pankow, J. S., Ried-Larsen, M., Franks, P. W., Tobias, D. K., Merino, J., Mohan, V., & Loos, R. J. F. (2023). Impact of individual and environmental factors on dietary or lifestyle interventions to prevent type 2 diabetes development: A systematic review. Communications Medicine, 3(1), 1–17. 

CDC. (2019). Type 2 diabetes. Centers for Disease Control and Prevention. 

Dudley, M. Z., Squires, G., Petroske, T. M., Dawson, S., & Brewer, J. (2023). The use of narrative in science and health communication: A scoping review. Patient Education and Counseling, 112, 107752–107752. 

Florida Department of Health. (2022). Type 2 diabetes | Florida department of health. 

Goff, L. M., Moore, A., Harding, S., & Rivas, C. (2020). Providing culturally sensitive diabetes self-management education and support for black African and Caribbean communities: A qualitative exploration of the challenges experienced by healthcare practitioners in inner London. BMJ Open Diabetes Research and Care, 8(2), e001818. 

Khan, M. M., Roberson, S., Reid, K., Jordan, M., & Odoi, A. (2021). Geographic disparities and temporal changes of diabetes prevalence and diabetes self-management education program participation in Florida. PLOS ONE, 16(7), e0254579. 

NURS FPX 6011 Assessment 2 Evidence-Based Population Health Improvement Plan

Litchman, M. L., Kwan, B. M., Zittleman, L., Simonetti, J., Iacob, E., Curcija, K., Neuberger, J., Latendress, G., & Oser, T. K. (2022). A telehealth diabetes intervention for rural populations: Protocol for a randomized controlled trial. JMIR Research Protocols, 11(6), e34255. 

Noor Mohamed, S. S., & Srinivasan, K. (2023). A comprehensive interpretation for medical VQA: Datasets, techniques, and challenges. Journal of Intelligent & Fuzzy Systems, 44(4), 5803–5819. 

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes self-management education and support in adults with type 2 diabetes:

A consensus report of the american diabetes association, the association of diabetes care & education specialists, the academy of nutrition and dietetics, the american academy of family physicians.

The american academy of pas, the american association of nurse practitioners, and the american pharmacists association. Journal of the American Pharmacists Association, 60(6)., R., Busardò, F. P., Gibelli, F., Sirignano, A., & Ricci, G. (2021). Ethical and legal challenges of telemedicine in the era of the COVID-19 pandemic. Medicina, 57(12), 1314.