In recent decades, diabetes has become a worldwide epidemic. According to the estimations of the World Health Organization, around 8% of adults around the globe have some form of diabetes, either type I or type II (par. 1-2). Because diabetes is a serious health concern, primary attention should be paid to preventative measures. The severity of the epidemic has underpinned the need for the invention and investigation of new approaches to the prevention of diabetes. One such approach proposes viewing an individual as the combination of his or her physiological and psychological needs and concerns. Addressing them is the foundation of this holistic strategy for diabetes prevention, which argues that this complex health issue is caused by ignoring both mental and physical signals of the human body. Moreover, this form of diabetes prevention is associated with the involvement of different health care professionals as well as the patient’s family, each of which is responsible for carrying out different functions and roles. The complexity of issues pertaining to diabetes makes the disease and its treatment even more complicated and calls for a comprehensive strategy and holistic approach to diabetes prevention (Danaei 38).
The central objective of this article is to investigate the trends in existing knowledge on social media and health care aimed at lifting language barriers and combating the epidemic of diabetes in the modern world. An emphasis will be placed on holistic diabetes prevention and the steps taken to promote it and increase the level of its effectiveness. Moreover, barriers limiting access to health care services will be explored.
Materials (Theoretical Framework)
To more comprehensively approach the research topic and diminish the risk of misunderstandings related to the employed language, it is imperative to develop a theoretical framework of the article, the central concepts of which follow.
Holistic health is an approach in contemporary medicine that focuses on both the physical and spiritual aspects of human health and addresses these needs as the methods of preventing serious health concerns. The primary feature of the holistic health approach is its recognition of the unity of physiological and psychological measures of human health (Beil, Hanes, and Zwickey 115).
Holistic diabetes prevention, then, is a specific approach to diabetes prevention that incorporates both the physiological and psychological needs of an individual. This prevention strategy is based on a recognition of the complex nature of diabetes as well as the interconnected nature of physical and mental aspects of human health (Ofori and Unachukwu 167).
Social media is “any networked ICT tool or platform that derives its content and principal value from user engagement and permits those users to interact with that content as part of a larger movement in communications organized under Web 2.0” (Norman 3).
The language barrier is a gap in patient-professional communication related to an inadequate level of language knowledge. Even though patients might understand the words of heath care professionals, they fail to follow their recommendations or misunderstand their messages due to inconsistencies in verbal and non-verbal signs (Martin et al. 192).
The methodology for this article will be based on qualitative research. Specifically, a review of the existing literature on holistic diabetes prevention and language barriers in diabetes prevention or significant health concerns prevention will be conducted. This design was chosen because it is the most appropriate option for tracing changes in the perception of language barriers in holistic diabetes prevention and systematizing and generalizing the findings and accomplishments in this area of study. Furthermore, it is the perfect tool for developing recommendations for patients, professionals, and policymakers for the purpose of increasing the effectiveness of holistic diabetes prevention. The eligibility criteria, article search procedure, and analysis process were designed and documented in advance.
Articles were selected based on particular criteria. First of all, they were required to focus on ethnic minorities and social groups. Second, the conclusions drawn by the authors had to be practically applicable to the area of holistic diabetes prevention and/or reducing the impact of language barriers on health care services. Third, the articles had to be published in English-language peer-reviewed journals between 2001 and 2016. Finally, because conclusions and practical applicability were the central focus of this study, no specific attention was paid to research design. Accordingly, the exclusion criteria are the following: the articles were not published in scholarly peer-reviewed journals; the articles were published before 2001; and the language of the publication was not English.
Articles were found using search engines of online libraries and databases such as Google Scholar, ProQuest, ResearchGate, and NCBI. Search items included “holistic health,” “holistic diabetes prevention,” “language barriers in social media,” “language barriers in diabetes prevention,” “holistic diabetes prevention and language barriers,” and “holistic diabetes prevention and social media.” Only articles published between 2001 and 2016 were chosen with the aim of tracing changes in the perception of the issues of holistic diabetes prevention and language barriers. Only articles written in the English language were selected for analysis.
The studies for analysis were selected manually by the author of this article by taking into consideration their titles, abstracts, and conclusions. The analytical framework consisted of several steps. First, the author selected ten articles meeting the eligibility criteria. Second, the conclusions of the individual research studies were summarized and systematized. Finally, a conclusion focusing on a generalization of the trends and methods for reducing language barriers in holistic diabetes prevention was drawn.
The author selected ten articles meeting the initially determined eligibility criteria in order to reach the research objectives. The chosen articles described both qualitative and quantitative research. The areas of interest covered by the studies were the following: language barriers in health care, language barriers in diabetes prevention, barriers to holistic diabetes prevention, and the role of social media in holistic diabetes prevention. As mentioned above, all chosen studies were written in English and published in peer-reviewed journals. Articles including duplicate information were excluded. Eight articles were qualitative studies, one was a quantitative study, and one used a mixed approach. Among the qualitative research studies, there were two systematic reviews of literature, one case study, and one review. One article was published in the United Kingdom, and the rest were published in the United States of America.
Results of the Research
The primary findings of the articles under study are provided in Table 1 below. The conclusions will be summarized with the aim of developing recommendations for lifting language barriers in holistic diabetes prevention.
Table 1. Summarizing the results of the selected articles.
|No.||Author, year||Topic Coverage||Research Design||Conclusions|
|1||Peyrot et al., 2013||The focus was on holistic care for patients with diabetes and their family members, as well as a discussion of the drivers for improving the quality of holistic diabetes prevention.||Qualitative research focusing on personal experiences and attitudes||The language barrier is not the primary challenge in holistic diabetes prevention; more threatening obstacles include the level of economic development of a country, the educational background of the patient, and the patient’s membership in an at-risk group (Peyrot et al. 182).|
|2||King et al., 2012||This article explored the needs of particular population groups suffering from diabetes (i.e., Asian Americans, Pacific Islanders, Native Hawaiians) and investigated the severity of language barriers in treating these patients.||Qualitative research based on survey analysis||Ethnic minorities are at increased risk of diabetes because their needs are not addressed properly due to language barriers, cultural differences, and an inability to communicate effectively (King et al. 1186).|
|3||Wilkinson, Randhawa, and Singh, 2014||Improvements in diabetes prevention and treatment after the implementation of the holistic approach to diabetes prevention were studied.||Qualitative research based on interviews focusing on the needs and experiences of patients||Challenges related to language barriers in holistic diabetes prevention and care include ineffective communication, support, and information. These challenges can be overcome only if the patient-centered approach is promoted and implemented (Wilkinson, Randhawa, and Singh 27).|
|4||Islam et al., 2012||The focus of this article was given to the Bangladeshi community of New York and the barriers they face in diabetes prevention and control.||Mixed method design incorporating elements of both qualitative and quantitative research based on interviews and focus groups centering on behaviors and facilitators of diabetes management||The central issue in holistic diabetes prevention among ethnic minorities is the inability to overcome cultural differences and the language gap represented by an inability to understand professionals’ recommendations and key information, resulting in an inability to navigate the health care sector effectively (Islam et al. 489).|
|5||Juckett, 2013||Primary attention was paid to health care provided to Latino populations and barriers keeping them from high-quality services.||Case study including both summaries of previous surveys and recommendations for lifting existing barriers||Ethnic minorities are exposed to risk of being misunderstood and, as a result, are often provided inadequate care or information on diabetes prevention. Only increased cultural competence and a multilingual health care environment can help resolve this problem (Juckett 54).|
|6||Nam et al., 2011||The article’s focus was on investigating current barriers in diabetes prevention and management, as well as developing strategies for lifting them.||Systematic literature review of the existing studies on diabetes prevention and management||Because diabetes prevention is closely related to cultural specificities, understanding them is the best option for increasing the effectiveness of diabetes prevention programs (Nam et al. 8).|
|7||Sachdeva et al., 2015||The article addressed cultural barriers to holistic diabetes prevention with a special emphasis on personal beliefs and cultural identification.||Qualitative research based on interviews with people suffering from diabetes and belonging to risk groups, focusing on their personal experiences and perceptions of diabetes||Diabetes prevention and care plans should be based on the cultural and ethnic background of a patient. The best way to handle the problem is through a special patient-centered approach that incorporates relevant linguistic elements of presenting health concerns and ways to prevent and treat them (Sachdeva et al. 33)|
|8||Scheppers et al., 2006||Ethnic minorities and the challenges they face in gaining access to health care were investigated.||Systematic review of scholarly articles on barriers to health care||Even though language barriers pose a significant problem in general, it is impossible to make generalizations regarding the barriers and challenges faced by ethnic minorities. That is why it is imperative to promote the patient-centered approach (Scheppers et al. 47).|
|9||Ofori and Unachukwu, 2014||Primary attention was paid to the family unit as the foundation for holistic diabetes prevention.||Review of holistic strategies for diabetes prevention and management||The prevention and treatment of diabetes requires a holistic approach that incorporates the physiological and psychological needs of an individual and views them within the context of the family unit for greater effectiveness (Ofori and Unachukwu 167).|
|10||Petrovski, Zivkovic, and Stratrova, 2015||The study focused on the role of social media such as Skype and Facebook in diabetes prevention and treatment.||Quantitative research aimed at estimating the effectiveness of social media for diabetes prevention and treatment among Internet users and regular groups||Social media is one of the best options for diabetes prevention and treatment because it allows care providers to focus on and address the needs of patients. These sites also offer an opportunity for active participation in diabetes management, benefiting both patients and health care professionals (Petrovski, Zivkovic, and Stratrova e52).|
According to the findings described above, most studies recognize the significance of a patient-centered approach to diabetes prevention both online and in real life (Petrovski, Zivkovic, and Stratrova e52; Sachdeva et al. 33; Scheppers et al. 47; Wilkinson, Randhawa, and Singh 27); these studies also underpin the significance of the holistic approach (Ofori and Unachukwu 167). The authors of some studies went even further and proposed a focus on family units (Ofori and Unachukwu 167) and on recognizing the importance of the patient’s educational and economic background (Peyrot et al. 182) as well as ethnic roots and cultural specificities (Juckett 54; King et al. 1186; Nam et al. 8). Nevertheless, primary attention is still paid to understanding and addressing the individual needs of the patient.
That being said, there are several popular measures currently implemented to reduce language barriers in the holistic prevention of diabetes: creating multilingual environments in health care units by employing interpreters and multilingual professionals; cooperating with relatives who have enough knowledge of the language to serve as interpreters; implementing the newest technologies; encouraging a patient-centered approach to diabetes prevention based on the cultural and linguistic needs of a patient; and promoting social media as an effective tool for drawing attention to holistic health promotion.
The primary objective of this article was to determine trends in the current knowledge of holistic diabetes prevention and the role of social media in lifting language barriers and promoting health. The findings reveal a trend toward recognizing the significance of focusing on patients’ needs and implementing individual approaches to diabetes treatment and prevention by incorporating cultural competence, language knowledge, and effective communication skills. However, this article has also pointed to the existence of a significant gap in the current knowledge of holistic diabetes prevention; indeed, the role of social media in health promotion and holistic diabetes prevention is understudied and requires further investigation through both qualitative and quantitative research designs aimed at drawing conclusions regarding the popularity, use, and effectiveness of social media in the health care sector. Future research should also focus on the ways to turn social media sites into platforms for health promotion.
This study has several significant limitations. First of all, the number of articles under analysis is not enough to develop strong recommendations. Nonetheless, these ten articles do provide enough foundation to determine preliminary recommendations and point to ideas for filling the gaps. Furthermore, only one of these ten articles investigated the role of social media in holistic diabetes prevention; moreover, the number of articles devoted to the development of holistic diabetes prevention in Europe is also limited due to the fact that the issue is understudied and this study focused on articles written in English only. Finally, most of these articles were designed as qualitative research, which is sufficient to estimate trends but limits the ability to draw compelling conclusions and recommendations.
The most effective measures for holistic diabetes prevention are the propagation of the patient-centered approach, the creation of a more multicultural and multilingual health care environment, and the use of social media for health promotion. Based on these conclusions, it is possible to develop some recommendations for patients, professionals, and policymakers. First of all, patients should be open when communicating with health care professionals and try to deliver all details regarding their own cultural specificities and perceptions of diabetes. Health care professionals should develop and implement a patient-centered approach because it has proven to be the most effective strategy for the prevention and treatment of diabetes. Finally, policymakers should make an attempt to redesign the current health care system with the aim of introducing a more multilingual environment and guaranteeing equal access to health care services to all members of society without regard to ethnic background. Moreover, launching programs aimed at promoting the use of social media as a platform for health promotion is recommended.
Beil, Kurt, Douglas Hanes, and Heather Zwickey. “Environmental Influence on Holistic Health Measures.” EXPLORE: The Journal of Science and Healing 10.2 (2014): 115-117. Print.
Danaei, Goodarz. “National, Regional, and Global Trends in Fasting Plasma Glucose and Diabetes Prevalence since 1980: Systematic Analysis of Health Examination Surveys and Epidemiological Studies with 370 Country-Years and 2·7 Million Participants.” The Lancet 378.9785 (2011): 31-40. Print.
Islam, Nadia, Darius Tandon, Runi Mukherji, Michael Tanner, Krittika Ghosh, Gulnamar Alam, Mamnunal Haq, Mariano Rey, and Chau Trinh-Shevrin. “Understanding Barriers to and Facilitators of Diabetes Control and Prevention in the New York City Bangladeshi Community: A Mixed-Methods Approach.” American Journal of Public Health 102.3 (2012): 486-490. Print.
Juckett, Gregory. “Caring for Latino Patients.” American Family Physician 87.1 (2013): 48-54. Print.
King, George, Marguerite McNeely, Lorna Thorpe, Marjorie Mau, Jocelyn Ko, Lenna Liu, Angela Sun, William Hsu, and Edward Chow. “Understanding and Addressing Unique Needs of Diabetes in Asian Americans, Native Hawaiians, and Pacific Islanders.” Diabetes Care 35.5 (2012): 1181-1188. Print.
Martin, Leslie, Summer R. Williams, Kelly B. Haskard, and M. Robin DiMatteo. “The Challenge of Patient Adherence.” Therapeutics and Clinical Risk Management 1.2 (2005): 189-199. Print.
Nam, Soohyun, Catherine Chesla, Nancy Stotts, and Susan Janson. “Barriers to Diabetes Management: Patient and Provider Factors.” Diabetes Research and Clinical Practice 93.1 (2011): 1-9. Print.
Norman, Cameron D. “Social Media and Health Promotion.” Global health Promotion 19.4 (2012): 3-6. Print.
Ofori, Sandra, and Chioma Unachukwu. “Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting.” Diabetes, Metabolic Syndrome, and Obesity: Targets and Therapy 2014.7 (2014): 159-168. Print.
Petrovski, Goran, Marija Zivkovic, and Slavica Stratrova. “Social Media and Diabetes: Can Facebook and Skype Improve Glucose Control in Patients With Type 1 Diabetes on Pump Therapy? One-Year Experience.” Diabetes Care 38.4 (2015): e51-e52. Print.
Peyrot, Mark, Katharina Burns, Melanie Davies, Angus Forbes, Norbert Hermanns, Richard Holt, Sanjay Kalra, Antonio Nicolucci, Johan Wens, and Ingrid Willaing. “Diabetes Attitudes Wishes and Needs 2 (DAWN2): A Multinational, Multi-Stakeholder Study of Psychosocial Issues in Diabetes and Person-Centred Diabetes Care.” Diabetes Research and Clinical Practice 99.2 (2013): 174-184. Print.
Sachdeva, Sandeep, Najam Khalique, Athar Ansari, Zulfia Khan, and Gaurav Sharma. “Cultural Determinants: Addressing Barriers to Holistic Diabetes Care.” Journal of Social Health and Diabetes 3.1 (2015): 33-38. Print.
Scheppers, Emmanuel, Els van Dongen, Jos Dekker, Jan Geertzen, and Joost Dekker. “Potential Barriers to the Use of Health Services Among Ethnic Minorities: A Review.” Family Practice 23.3 (2006): 325-348. Print.
Wilkinson, Emma, Gurch Randhawa, and Maninder Singh. “Quality Improvements in Diabetes Care, How Holistic Have They Been? A Case-Study from the United Kingdom.” International Journal for Equity in Health 13 (2014): 20-29. Print.
World Health Organization. Diabetes: Fact Sheet. 2016. Web.