Literature Review Paper

Request to have the same Writer ID : 2014.  This Literature review paper is Part B of the research paper that is attached which was written by ID 2014.



In Part A, you described the population and quality initiative related to your PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) statement. In this assignment, you will formalize your PICOT and research process.

Use the GCU Library to perform a search for peer-reviewed research articles. Find five peer-reviewed primary source translational research articles.
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In a paper synthesize the research into a literature review. The literature review should provide an overview for the reader that illustrates the research related to your particular PICOT. Include the following:

Introduction: Describe the clinical issue or problem you are addressing.
Methods: Describe the criteria you used in choosing your articles
Synthesize the Literature: Part A: Discuss the main components of each article (subjects, methods, key findings) and provide rationale for how this supports your PICOT; Part B: Compare and contrast the articles: Discuss limitations, controversies, and similarities/differences of the studies.
Areas of Further Study: Analyze the evidence presented in your articles to identify what is known, unknown, and requires further study. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Benchmark – Part B: Literature Review

Introduction

This project is based on the PICOT question states that “Among African Americans diagnosed with Type 2 DM (P), does Continuous Blood Glucose Monitoring (I) compared to Self-Blood Glucose Monitoring (SBGM) (C) result in improved glycemic control (O) within four weeks (T)?” It focuses on the implementation of Continuous Blood Glucose Monitoring to improve glycemic control among African Americans diagnosed with Type 2 DM. Literature Review Paper.  It is anticipated that the implementation of Continuous Blood Glucose Monitoring will improve glycemic control among African Americans diagnosed with Type 2 DM within four weeks following its adoption.

Methods

Articles to be utilized in this project were obtained by searching from GCU Library. Some keywords such as “Continuous Blood Glucose Monitoring,” “Self-Blood Glucose Monitoring (SBGM),” “improved glycemic control,” and “African Americans diagnosed with Type 2 DM” guided the search process. Although so many articles were obtained during the search, the researcher was only interested in peer-reviewed studies that were published in the last five years. However, only the abstract was accessible from the library in some articles. In this case, the author used the provided link to track the full article online. After synthesizing all the available articles, the author selected five peer-reviewed primary source translational research articles to be used in this project.

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Synthesizing the Literature

Part A: The Main Components of the Selected Articles

The selected articles had various components such as subjects, methods, and key findings, which support the PICOT question. A study by Aloh et al. (2020) focuses on how socioeconomic factors, including employment status and education level, impact the quality of care experienced by the patients. The researchers used a cross-sectional design to collect data. Additionally, they administered some pre-tested structured questionnaires to patients receiving care services in the outpatient units of the selected hospitals in Nigeria. The study findings indicate that one’s employment status mainly determined overall patient experience. The patient experience was high among employed patients than unemployed ones. Additionally, the perception of waiting was primarily influenced by the level of the patient’s education. Educated patients reported a higher rating in the perception of waiting than uneducated ones. The components of this article support the PICOT question. First, the study subjects indicate that the quality of care experienced by African Americans diagnosed with Type 2 DM is mainly influenced by socioeconomic factors, especially the employment status and education level. Additionally, the experience of improvement in glycemic control among African Americans diagnosed with Type 2 DM mainly depends on socioeconomic factors. Literature Review Paper.

Secondly, an article by Jackson (2020) focuses on how Africa’s health care is influenced by its missing genomic data. This article states that health care is likely to be improved by the applications of genomic medicine. Intervention measures for a particular disease, such as earlier diagnoses and effective treatments, are influenced by understanding the role of environmental factors and genes in causing that illness. Thus, the improvement in glycemic control among African Americans diagnosed with Type 2 DM is impacted by an understanding of the role of environmental factors and genes in causing the condition.

Noonan et al. (2016) also documented reviews of the public health of African Americans. Their study focuses on how the health of African Americans can be improved in the US. The study findings indicate that various factors, including social development programs, African Americans’ involvement in decision and policy-making, investing in education, and expanding care access, lead to a positive trend in black health. These findings support the PICOT question since they reveal various factors that can improve glycemic control among African Americans diagnosed with Type 2 DM.

Furthermore, an article written by the Office of Minority Health (OMH) (2019) focuses on African Americans’ profile. The article states that African Americans were the second-largest minority group in the US by 2017. Blacks constituted approximately 1.4 million individuals representing about 12.7 percent of the total US population. Additionally, this article discussed various socioeconomic variables of African Americans that influence their health status, including insurance covers, education attainment, and economics. This ethnic population’s health is compromised by low education attainment, low economics, and the lack of insurance covers. This article supports the PICOT question since it outlines various socioeconomic variables of African Americans that are likely to hinder improvement in glycemic control among African Americans diagnosed with Type 2 DM.

Finally, a study by Robertson et al. (2020) focuses on factors hindering the large-scale adoption of Continuous Glucose Monitoring in Type 2 Diabetes. Study findings indicate that the implementation of Continuous Glucose Monitoring to support the management of Type 2 Diabetes is hindered by various factors, including lack of funds, inadequate knowledge and skills, and the lack of the required technology.  This article supports the PICOT question since it indicates that improvement in glycemic control among African Americans diagnosed with Type 2 DM is compromised by the lack of widespread adoption of Continuous Glucose Monitoring.

Part B: Compare and Contrast the Articles

The five articles selected for this study have some limitations, controversies, and similarities/differences. On the limitations, the five articles are based on African Americans as the study population. Therefore, study findings are limited to this ethnic group and cannot be generalized to fit other populations in the US.

Secondly, some controversies are identified in these articles. Some articles, such as Robertson et al. (2020), specifically focuses on how the lack of widespread adoption of Continuous Glucose Monitoring in Type 2 Diabetes limits it from improving glycemic control among African Americans diagnosed with Type 2 DM. On the contrary, other articles such as OMH. (2019), Noonan et al. (2016), Oloh et al. (2020), and Jackson, C. (2020) focus on the factors influencing the overall health of African Americans. Therefore, these articles deviate from the proposed project’s primary objective, which involves assessing the effectiveness of Continuous Glucose Monitoring in improving glycemic control of African Americans diagnosed with Type 2 DM.

The five articles have captured the disparity in health care of African Americans in the US on the similarities. The health disparities of this ethnic population are associated with various factors. Oloh et al. (2020) associate health disparity among African Americans with socioeconomic factors, especially employment and education levels. Literature Review Paper. Unemployment and low education attainment are the fundamental causes of poor health care among African Americans. Additionally, in their article, OMH (2019) attributes disparities in health care among African Americans to socioeconomic variables, including low educational attainment, low economics, and the lack of insurance covers. Noonan et al. (2016) also associated socioeconomic factors with poor care services among African Americans. They pointed out to lack of social development programs, failure to involve African Americans in decision and policy-making, failure to invest in education, and limited access to care as the factors that limit the health of African Americans in the US. Finally, an article by Jackson (2020) associates poor healthcare in Africa with Africans’ missing genomic data.

On the differences, some articles, such as Robertson et al. (2020), focus on factors affecting the effectiveness of Continuous Glucose Monitoring in Type 2 Diabetes. On the other hand, some studies such as Noonan et al. (2016), Oloh et al. (2020), and OMH (2019) focus on the factors contributing to healthcare disparities among African Americans. They have mainly attributed the low quality of care among this ethnic population to socioeconomic variables such as low educational attainment, unemployment and low economics, and lack of medical covers. Another difference occurs in terms of the study population. Four articles, including Noonan et al. (2016), Robertson et al. (2020), and OMH (2019), focus on African Americans. On the contrary, Oloh et al. (2020) and Jackson (2020) have discussed factors compromising Africans’ care.

Areas of Further Study

The synthesizing of the five articles indicates that further study is required in some areas. First, the five articles are based on health disparities among African Americans. Therefore, a study should be conducted to assess differences in care quality among other minority populations such as Hispanics. Additionally, these articles have identified a lack of widespread adoption as the critical factor that limits the effectiveness of Continuous Glucose Monitoring in improving glycemic control of African Americans diagnosed with Type 2 DM. Thus, further studies should be conducted to evaluate other factors that are likely to hinder the effectiveness of Continuous Glucose Monitoring in improving glycemic control other than the lack of widespread adoption. Finally, a study can be conducted to assess the effectiveness of Continuous Glucose Monitoring in improving glycemic control in other patient populations rather than African Americans. Literature Review Paper.

References

Aloh, H. E., Onwujekwe, O. E., Aloh, O. G., Okoronkwo, I. L., & Nweke, C. J. (2020). Impact of socioeconomic status on patient experience on the quality of care for ambulatory healthcare services in tertiary hospitals in Southeast Nigeria. BMC Health Services Research, 20, 1-9.

Jackson, C. (2020). Africa’s Missing Genomic Data and Its Impact on Health Care. Genetic Engineering & Biotechnology News. https://www.genengnews.com/insights/africas-missing-genomic-data-and-its-impact-on-health-care/

Noonan, A. S., Velasco-Mondragon, H. E., & Wagner, F. A. (2016). Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public health reviews, 37(1), 1-20.

OMH. (2019). Profile: Black/African Americans. US Department of Health and Human Services Office of Minority Health. https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=61

Robertson, S. L., Shaughnessy, A. F., & Slawson, D. C. (2020). Continuous Glucose Monitoring in Type 2 Diabetes Is Not Ready for Widespread Adoption. American Family Physician, 101(11), 646-646.

Benchmark: Population Health Research and PICOT Statement

Health issues facing different ethnic groups in the US vary significantly. Literature Review Paper. This difference is associated with multiple factors, including health disparities, genetics, health coverage, lifestyle, socioeconomic status, and the level of awareness. Understanding ethnic groups health disparities are key in addressing these health issues. This paper will focus on African Americans and various factors that impact the management of the population’s health with strong emphasis on the high prevalence of Type 2 Diabetes Mellites.  It will also discuss a solution for addressing the identified health concern.

Population Description

This ethnic group has partial or total ancestry from various groups. African Americans form the second and third largest ethnic group in the US, respectively. African Americans constituted approximately 41.4 million people in the US by 2017 (OMH, 2019). This number represents about 12.7 percent of the total US population (OMH, 2019). Additionally, 21.4% of African American adults had earned a degree or higher in 2017 (OMH, 2019). The percentage of  women who had earned at least a bachelor’s degree in 2017 was higher (23.8%) than that of African American men (18.5%) (OMH, 2019). The average household income was $40,165 in 2017. The insurance coverage of African Americans was about 55.5% in 2017 (OMH, 2019). In 2015, Census Bureau projections reported that the life expectancies for African Americans are 76.1 years. The life expectancy for women is relatively higher (78.9 years) than that of men (72.9 years) (OMH, 2019). The health concern is the high prevalence of Type 2 Diabetes Mellites. Literature Review Paper. 

Health Management

The management of African Americans’ health is affected by various factors. First, nursing science has an impact on the management of this population’s health. Nursing science involves the development of various practical concepts and theories to form evidence-based practices. Clinicians, in turn, utilize EBPs to provide quality and safe care, thus improving patient satisfaction and health outcomes. Secondly, epidemiologic has an impact on health management. In this case, health management for African Americans is affected by three key aspects of a disease, including the incidence, distribution, and control. Health determinants & socioeconomic status is another key factor that influences the management of health for this ethnic population. Five aspects of determinants of health, including genetics, environmental and physical influences, behavior, social factors, and medical care will affect the management of their health. Additionally, the management of this population’s health will be impacted by individuals’ socioeconomic status, including power, education attainment, occupation, and level of income. According to Aloh et al. (2020), individuals with higher socioeconomic status are provided with a high quality of care services than those with low status. Moreover, the health management of this ethnic group is affected by their genomic and genetic data. Genomic and genetic data of African American’s is used in development research. Nonetheless, the genomic and genetic data is limited (less than 3%) (Jackson, 2020). Literature Review Paper. Consequently, this ethnic population is underrepresented in genetic studies, which, in turn, compromises health management for African Americans globally.

Potential Solution & PICOT Statement

The proposed solution involves the implementation of Continuous Blood Glucose Monitoring to improve glycemic control among African Americans diagnosed with Type 2 DM. The PICOT question states that “Among African Americans diagnosed with Type 2 DM (P), does Continuous Blood Glucose Monitoring (I) compared to Self-Blood Glucose Monitoring (SBGM) (C) result in improved glycemic control (O) within four weeks (T)?” It is anticipated that glycemic control among African Americans diagnosed with Type 2 DM (P) will improve within four weeks following the implementation of Continuous Blood Glucose Monitoring.

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            The use of Continuous glucose monitors (CGMs) among patients with type 2 diabetes (T2D) increased significantly. According to Robertson et al. (2020), Continuous glucose monitoring provides real-time feedback to patients with type 2 diabetes. For instance, it alerts them in case one is becoming hypoglycemic particularly patients who are using insulin to control their blood glucose levels. Consequently, patients seek urgent medical attention if one is at risk of severe hypoglycemia.

The implementation of Continuous Blood Glucose Monitoring to improve glycemic control diagnosed with Type 2 DM incorporates health policies and goals that support health care equity for this ethnic group. Health policies and goals advocate for health care equity which is the least healthy ethnic group in the US (Noonan et al., 2016).Literature Review Paper.  These policies and goals focus on improving the access and quality of care provided to this group, thus reducing their high morbidity and mortality rates. Therefore, these policies and goals will be incorporated into the implementation of Continuous Blood Glucose Monitoring to improve glycemic control of individuals diagnosed with type 2 diabetes.

Overall, the prevalence of diabetes type 2 is relatively high among African Americans. The management of this ethnic group’s health is affected by various factors, including nursing science, epidemiologic, health determinants & socioeconomic status, genomic, and genetic. The implementation of Continuous Blood Glucose Monitoring will improve glycemic control among African Americans diagnosed with Type 2 Diabetes Mellites.

References

Aloh, H. E., Onwujekwe, O. E., Aloh, O. G., Okoronkwo, I. L., & Nweke, C. J. (2020). Impact of socioeconomic status on patient experience on the quality of care for ambulatory healthcare services in tertiary hospitals in Southeast Nigeria. BMC Health Services Research, 20, 1-9.

Jackson, C. (2020). Africa’s Missing Genomic Data and Its Impact on Health Care. Genetic Engineering & Biotechnology News. https://www.genengnews.com/insights/africas-missing-genomic-data-and-its-impact-on-health-care/

Noonan, A. S., Velasco-Mondragon, H. E., & Wagner, F. A. (2016). Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public health reviews, 37(1), 1-20.

OMH. (2019). Profile: Black/African Americans. US Department of Health and Human Services Office of Minority Health. https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=61

Robertson, S. L., Shaughnessy, A. F., & Slawson, D. C. (2020). Continuous Glucose Monitoring in Type 2 Diabetes Is Not Ready for Widespread Adoption. American Family Physician, 101(11), 646-646. Literature Review Paper.