Theory Logic Model for Project

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Project context: The present study’s goal is to evaluate IF’s safety and effectiveness to those of conventional treatment for persons who have type 2 diabetes.

Problem: The prevalence of obesity, which has been on the rise for decades, is a potential contributor to the development of prediabetes and diabetes. There seems to be a strong correlation between obesity and diabetes, since the prevalence of both conditions is increasing. Ten percent of the U.S. population has type two diabetes mellitus (T2DM) ((Zang, He & Xue, 2022).

Project impact: However, it is possible to promote and safely adopt IF among persons with diabetes by adjusting their medications and engaging in self-monitoring of blood glucose levels.

Outcome: Substantial weight reduction and improvements in glucose regulation ensued with IF. In certain cases, insulin resistance may improve with IF (Vitale & Kim, 2020).

Proposed solution: Managing glucose levels in individuals with type 2 diabetes using IF.

Correlation of Intermittent Fasting (IF) to Type Two Diabetes Mellitus T2DM

Factors influencing selected strategy:

1. Insulin resistance.

2. Poor dieting.

3. Failure to adhere to scheduled eating and fasting windows.

4. Inactive lifestyle.

Evidence base supported solution: Diabetic-related problems may be effectively treated and prevented with dietary modifications, as affirmed by both clinical practice and the majority of national diabetes organizations (Zang, He & Xue, 2022). Intermittent fasting is only one of numerous nutritional therapies that may be tried. A dietary intervention that shifts the length of the overnight fast from 12 to 18 or 20 hours may be useful as an additional dietary approach in the treatment of diabetes mellitus (Vitale & Kim, 2020).

References

Vitale, R., & Kim, Y. (2020). The effects of intermittent fasting on glycemic control and body composition in adults with obesity and type 2 diabetes: a systematic review. 
Metabolic Syndrome and Related Disorders, 
18(10), 450-461.

Zang, B. Y., He, L. X., & Xue, L. (2022). Intermittent Fasting: Potential Bridge of Obesity and Diabetes to Health?. 
Nutrients, 
14(5), 981.

Correlation of Intermittent Fasting to Type 2 Diabetes Mellitus

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Correlation of Intermittent Fasting to Type 2 Diabetes Mellitus

A research project’s theoretical framework is a useful starting point since it serves as a blueprint for the whole paper. This capstone work is intended to be theoretically grounded in Dorothea Orem’s Self-care Theory. Clinically, Orem’s self-care model is one of the complete models for laying out the foundations of effective self-care and assisting patients in putting those foundations into practice (Tanaka, 2022). This idea is appropriate for the capstone since it emphasizes the person and their ability to make changes to improve their health.

Orem’s idea rests on these three tenets:

Self-care deficit: Due to incompetence or ignorance, the person cannot care for themselves.

Nursing system: The patient has the capacity to care for themselves, yet they need nursing care.

Self-care requisites: The person is capable of taking care of herself and has access to the resources she needs to do so.

Orem’s theory lends itself to the following types of empirical investigation:

Case study: This method might investigate how a person can take control of their health and improve it via deliberate behavior change.

Survey: Individuals’ attitudes and practices towards health care might benefit from this method.

Experimental: This method might be used to examine how IF improves insulin sensitivity and lowers blood insulin levels.

Both quantitative and qualitative approaches apply to the investigation of the Orem hypothesis. In order to measure the impact of IF on insulin sensitivity and blood insulin levels, quantitative methods would be most beneficial. Qualitative methodologies are warranted when investigating the person and their agency regarding their health. Experimental research would be the best choice for quantifying IF’s potential to improve insulin sensitivity and lower fasting insulin levels. This research design would make it possible to isolate the impact of the treatment on the result by reducing the influence of confounding factors (Rosman et al., 2022). Case studies and surveys are two of the best qualitative research approaches for examining a person and their capacity to take control of their health and make positive changes. These approaches would make it possible to inquire deeply into people’s attitudes and practices toward their health. When a researcher employs either of these methods, they get a more significant say over the scope of the study, the variables used, and the kinds of questions asked. As a result, the researcher will have concrete data to provide, such as the percentage of patients who stick to IF vs. those who do not and how it stacks up against the absence of provider education and teamwork in healthcare meant to lower DM readmissions (Yip, 2021).

To determine whether or not the program or initiative is successful, one may utilize the theoretical framework to determine how effectively it caters to the demands of the target audience (diabetic patients). We may also use the approach to evaluate the tailoring of a program or project to a specific person’s requirements. The core tenet of the Orem model is that people may take control of their health and well-being by making confident lifestyle choices. Since this theory emphasizes each person’s role in influencing their health, it is a good fit for assessing the program or initiative. Given its emphasis on one’s agency in influencing one’s health, Orem’s theory is a helpful framework for evaluating the project’s success. Due to its inability to account for non-medical contexts, such as environmental and social factors that affect health, the theory does not help assess the program’s effectiveness (Grajower & Horne, 2019).

References

Grajower, M. M., & Horne, B. D. (2019). Clinical management of intermittent fasting in patients with diabetes mellitus. 
Nutrients, 
11(4), 873.

Rosman, J., Eriksson, J. W., Martinell, M., Olinder, A. L., & Leksell, J. (2022). Protocol: Individual goal-based plan based on nursing theory for adults with type 2 diabetes and self-care deficits: a study protocol of a randomized controlled trial. 
BMJ Open, 
12(3).

Tanaka, M. (2022, May). Orem’s nursing self-care deficit theory: A theoretical analysis focusing on its philosophical and sociological foundation. In 
Nursing Forum (Vol. 57, No. 3, pp. 480–485).

Yip, J. Y. C. (2021). Theory-based advanced nursing practice: A practice update on the application of Orem’s self-care deficit nursing theory. 
SAGE Open Nursing, 
7, 23779608211011993.

Stakeholders

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Stakeholders

The capstone project explores the correlation of intermittent fasting (IF) to Type 2 Diabetes Mellitus (T2DM). The objective is to manage glucose levels in people with T2DM using IF. This paper reviews the stakeholders that will play a major part in the study. The table below identifies key stakeholders that will be interested in the project results, describes their roles, and reveals if they are supportive to the project.

Stakeholder	Roles
Alex Green: Patient with T2DM	This stakeholder will be the test subject. He will be subjected to IF to see if his glucose levels will improve. A positive result will help him live a better-quality life.
Ivy Kristie: Nutritionist	This stakeholder will be responsible for coming up with the fasting routine and identifying proper meals for the patient.
Sue Bell: Endocrinologist	This stakeholder will examine the impact of the IF on the T2DM and deduce the positive and negative impacts of the intervention.
Jason McCallister: Physician	This stakeholder will review how the intervention affects the patient’s T2DM and other unrelated health concerns.
Daisy Blue: Nurse	This stakeholder will be responsible for implementing the intervention and incorporating the input of the endocrinologist, the physician, and the patient to achieve desirable outcomes.

Promoting Stakeholder Participation

The first step is to identify the stakeholders early. This ensures that there is ample time to engage them and allow them to interact with each other. Next, each stakeholder will be sensitized on the significance of the project and how it will directly affect them. Once they understand the importance of the project, the stakeholders will be encouraged to interact with each other and provide feedback on how best to meet the objectives of the project. Through this collaboration, each stakeholder will feel valued and get the motivation to be personally involved in the project (Purvis, 2018). This way, the facilitator will ensure that there are several effective communication channels, which will be essential in promoting stakeholder participation.

Possible Concerns/Barriers from Stakeholders

For starters, there is the issue of competing priorities. Each stakeholder may have a priority that does not resonate with the others. This may result in friction where a consensus on how best to run the project is not reached. It is vital to incorporate effective conflict management strategies to mitigate this problem (Purvis, 2018). Another issue is that of resource constraints. Depending on the input of the stakeholders, it may be challenging to get all the necessary resources required to adequately cover the project goals. Hence, it is vital to cut costs by identifying the most integral aspects of the projects and foregoing the minor ones.

Strategies to Gain Support/Assistance from Stakeholders

One has to identify triggers and mitigation measures. Since each stakeholder has unique needs and will react differently to project actions, the facilitator must know how best to approach them and get them to collaborate (Harris et al., 2019). Also, it is vital for each stakeholder to have a say in the project. This makes everyone feel valued and ready to participate.

References

Harris, J., Croot, L., Thompson, J., & Springett, J. (2019). How stakeholder participation can contribute to systematic reviews of complex interventions. 
J Epidemiol Community Health, 
70(2), 207-214.

Purvis, R. L. (2018). What’s in it for me? Using expectancy theory and climate to explain stakeholder participation, its direction and intensity. 
International Journal of Project Management, 
33(1), 3-14.

Methods/Design, Statistical Analysis

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The evaluative criteria (Indicators or variables) to be addressed in answering each evaluation question

The success of the proposed capstone project is based on the evaluation process to determine whether an improvement is being made. The research on the effectiveness of intermittent fasting (IF) in management is guided by the evaluation criteria important in revealing the existing gaps in the IF intervention. Therefore, the evaluation criteria adopted are based on comparing the outcomes of the implementation program of IF and then compared to the baseline data before the implementation process. The two data are compared to look at the differences. The success of the implementation process is expected to reveal a positive result. In this case, the collection of baseline data and data after implementation is based on key indicators or variables (Vitale, R., & Kim, 2020). The major variables are IF (independent) and glucose levels (dependent). Other dependent variables playing a role in influencing glucose levels are cholesterol levels, weight, and sensitivity to insulin which is indicated by the HbA1c.

The research methodologies strategies to be utilized in answering each question and their suitability

The research approaches to be adopted will involve the literature review; in this case, systemic review articles will be targeted. The search for relevant articles will focus on the role of IF in managing blood glucose levels. The relevant articles will be searched using useful databases such as PubMed, Medline, Cochrane, and Embase. The search for relevant articles will also be based on the key terms (Melynk & Fineout-Overholt, 2018). The findings from the selected articles will be important in revealing the impact of the IF on the successful management of the blood sugar level. The outcomes of this study will reveal whether IF helps reduce body weight and increases insulin sensitivity.

How data will be collected concerning the evaluative criteria or indicators

The first data will be the baseline data that will be collected using patient history about the previous values of the blood glucose levels. Upon approval by the patients, information from healthcare facilities can be relied on for the data sources. Other sources of data will be from the implementation program of IF. In this case, the selected participants will have to record their daily values of blood sugar level and weight for continuous evaluation. The collection of the data will be carried out through the implementation period.

The exact data to be collected, when, and by whom

Data collection will be a collaborative work from the providers, patients, and family members or caregivers. Healthcare providers such as nurses, physicians, endocrinologists or nutritionists will work with the patients to ensure data such as the body mass index (BMI), HbA1c, blood sugar level, HDL cholesterol values, and body weight.

Data collection tools in terms of their development and suitability in responding to questions

The collection of data will be based on experimentation and observation strategies. The baseline data are collected before implementation. The collected data is then compared to the outcome of the implementation. The experimental approach is whereby the participants are involved in the IF practice to help in the achievement of the objectives. Patients will be required to adhere to a healthy diet and engage in other recommended interventions to ensure a drop or effective management of their blood sugar.

Information on validity or reliability of tools

The information collected based on observing the baseline data collected from the healthcare facilities or patient history is authentic since it is based on the healthcare providers’ values. The information collected through experimental work throughout the implementation procedure depends on the patient’s adherence to the healthcare providers’ recommendations (Grajower & Horne, 2019). However, it is expected that the data generated will be authentic since there will be a follow-up procedure.

The reason why data collection techniques are suitable to research strategy, type of data, and purpose of evaluation

The data collection methods adopted will be appropriate since they are based on tasks performed by the providers or patients under the supervision of the providers. Data collected based on observation and experiment in this scenario are based on first-hand information.

How to analyze data, including the specific test to use

The analysis of the data will be based on the quantitative method; therefore, the statistical technique to be adopted is the chi-square test. This test is important in determining whether there is a link between the key variables in the research project. The project IF is an absolute value that is expected to help in the reduction of infection rates in the facility. Using chi-square as a statistical technique allows having cross-tabulation of the IF amongst patients. The method also objectively compares the observed and expected percentages from the implementation.

References

Grajower, M. M., & Horne, B. D. (2019). Clinical management of intermittent fasting in patients with diabetes mellitus. Nutrients, 11(4), 873.

Melynk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing healthcare: A guide to best practice (4 ed.). Wolters Kluwer.

Vitale, R., & Kim, Y. (2020). The effects of intermittent fasting on glycemic control and body composition in adults with obesity and type 2 diabetes: a systematic review. Metabolic Syndrome and Related Disorders, 18(10), 450-461.

Project Interventions

Project Interventions

Project Interventions

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Evidence-based data for the proposed interventions

The evidence-based data to support the proposed intervention are based on peer-reviewed articles and experimental research. The information collected helps in the quantification of the IF’s potential to assist in the improvement of insulin sensitivity and reducing the fasting insulin levels. The research makes it easier to identify the impact of the treatment on the outcomes by causing a decrease in the influence of the confounding factors. The research findings also make it possible to determine individuals’ ability to take full control of their health and make some positive changes (Vitale & Kim, 2020). These are essential factors that play an important role in implementing intermittent fasting (IF) for successfully managing glucose levels in individuals diagnosed with type 2 diabetes.

Factors that can Influence the Use of the Proposed Interventions

Various factors can affect the implementation of the IF to help in the successful management of glucose. Patients themselves influence the first factors, which include the patients’ insulin resistance, failure to adhere to healthy behaviors like poor dieting and scheduled eating and fasting windows, and the participant’s inactive lifestyle. Another factor is the commitment from the stakeholders in the implementation process (Vitale & Kim, 2020). The commitment from healthcare providers and patients or participants impacts the use of the proposed intervention.

Barriers Associated with the Proposed Interventions

Various factors act as a roadblock to successfully implementing the proposed interventions. The first barrier is the lack of support from the primary care providers. These providers might resist changes, thus making it hard to achieve the objective. The other barrier is the lack of support from the management, especially concerning the provision of the required resources (Purvis, 2018). The patient’s resistance to the proposed new treatment interventions is the other challenge.

Resources Required

The first resource is the glucometer that will be used to measure fasting blood sugar. The other resource is the notebook, where the data collected will be recorded to monitor the patients’ progress in blood glucose control. A clock or a watch will also be required to guide the patients and providers on the specific time that food should be taken (Vitale & Kim, 2020). Other resources include drinking water, tea, coffee, and other non-caloric beverages.

Sequence of the events and activities to be implemented

The first step is the collection of the baseline data, i.e., the records of the blood sugar readings before implementing the IF. The collected data will guide on whether there is an improvement or positive changes made by the proposed intervention. The next step is to inform the patients and providers about the proposed intervention of the IF and how it is likely to improve blood sugar management. The providers are also informed about each role in the implementation process. This procedure is crucial since it aims to reduce the resistance level. The next step is the implementation process that involves fasting, whereby patients have fasting time and eating window. For a start, they can start with 12 hours fast, have a 12-hour eating window, and then build up to a 16:8 schedule. From there, patients then transition to a smaller eating window. During the implementation, the fasting blood sugar readings are taken and compared to the previous reading before implementation to determine whether there is a positive change or improvement.

Monitoring, Tracking, and Ongoing

The implementation process involves the relevant stakeholders, especially healthcare providers, who will guide the implementation procedure. The providers such as nutritionists, endocrinologists, physicians, and nurses will ensure that there is an adherence to the procedure. The adjustment can be made through changes in the diet and timing to ensure that the procedure heads in the right direction. Patients will be monitored on the type of meals they take rather than avoid the fasting process (Vitale & Kim, 2020). During this time, only the recommended diet are taken by the patients.

Performance of Tasks for the Implementation

Patients with type 2 diabetes will be subjected to IF to determine whether there is an improvement in their glucose levels. Positive outcomes show better quality of life. Nutritionists such as Ivy Kristie help develop the fasting routine and identify suitable meals for the patient. Sue Bell, the Endocrinologist, helps with examining the effect of IF on type 2 diabetes and deducing the positive and negative effects of the intervention. Jason McCallister, a physician, helped review how the intervention impacts type 2 diabetes of the patient and other issues. Daisy Blue, a nurse, assists with the implementation process by incorporating the inputs of other stakeholders to attain the desirable outcomes.

Strategies facilitating the Implementation of the Proposed

It is crucial to inform the stakeholders to avoid high resistance. Collaboration is necessary to ensure that each procedure or step is implemented effectively. It is crucial to gain support from the primary care providers by sharing the findings with them (Kirchner et al., 2020). Patients must understand the importance of the IF intervention in managing their type 2 diabetes condition.

Timeline

The implementation process is expected to take around three months. This time is adequate to help confirm the effectiveness of the proposed intervention of IF in managing the blood sugar level of patients.

Anticipated Outcomes

The expected outcome from the proposed intervention of the IF is attaining normal and healthy blood glucose levels. Consequently, there will be a low rate of systematic inflammation, improvement in the sensitivity to insulin, improved cholesterol levels, and reduction or successful maintenance of average healthy weight.

References

Kirchner, J. E., Smith, J. L., Powell, B. J., Waltz, T. J., & Proctor, E. K. (2020). Getting a clinical innovation into practice: an introduction to implementation strategies. 
Psychiatry Research, 283, 112467.

Purvis, R. L. (2018). What’s in it for me? Using expectancy theory and climate to explain stakeholder participation, its direction and intensity. 
International Journal of Project Management, 33(1), 3-14.

Vitale, R., & Kim, Y. (2020). The effects of intermittent fasting on glycemic control and body composition in adults with obesity and type 2 diabetes: a systematic review. Metabolic Syndrome and Related Disorders, 18(10), 450-461.

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Correlation of Intermittent Fasting to Diabetes Mellitus

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ABSTRACT

Low insulin production and high blood sugar levels are the markers of diabetes mellitus (Grajower & Horne, 2019). About 10% of the American population has diabetes mellitus, and many of these patients might benefit from intermittent fasting (Grajower & Horne, 2019). Managing diabetes by fasting is only one option among several that diabetic patients might choose, especially with the rise in popularity of intermittent fasting as a means to reduce weight and treat chronic illness. While dietary and lifestyle changes and antidiabetic medication may help manage diabetes, data on the efficacy of IF alone in this regard is scant. This analysis aimed to determine whether or not IF positively affects type 1 or type 2 diabetics by identifying clinically relevant human research. The PRISMA procedure was used to systematically review the relevant literature. The goal was to find studies that looked at how fasting affected individuals with type 1 and type 2 diabetes. Blood plasma glucose levels (mmol/L), hemoglobin A1C percentages (%), and total body mass (kg) were the primary outcomes of interest in this meta-analysis. For adults, we found four RCTs and one case report on the effects of fasting on diabetes. All of the trials found evidence of beneficial effects on weight, glycemic control (via antidiabetic medication with A1C and/or fasting plasma glucose), and/or fasting insulin levels. Fasting is an option that patients with diabetes may discuss with their doctors in order to better control their condition. Healthcare providers can use this and other easily accessible research to help them make suggestions and keep an eye on things in a safe way. Further research is needed to make reliable statements about IF’s long-term effects among diabetic patients.

Reference

Grajower M. M. & Horne B. D. (2019). Clinical management of intermittent fasting in patients with diabetes mellitus. 
Nutrients. https://doi.org/10.3390/nu11040873

· Implementation of research projects is very challenging

· Replacement of traditional practice with Evidence-based practice takes average of 17 years.

· Increasing access to quality care, provision of affordable prescription, and others will improve adherence to treatment of chronic diseases, reduce complications, economic burdens, and increase the quality of life of the minority populations in primary care setting, particularly Hemet California

Correlation of Intermittent Fasting to Diabetes Mellitus

(
Significance/Background
I
ntermittent
fasting, in contrast to many other dietary approaches, emphasizes timing of meals.
Increasing popularity of intermittent fasting as a means of losing weight and managing chronic diseases is evidence of the practice’s widespread success.
People with diabetes Mellitus often choose to control their condition by paying more attention to what they eat.
How IF works
Aims

of

the

Study
Using the available evidence, this review aims to provide suggestions for the safe monitoring of diabetic patients interested in IF. Animal experiments and religious fasting schedules are excluded.
)
(
Design/Methods
Articles from reputable academic journals were gathered for a comprehensive literature evaluation that was conducted with the use of online databases.
Studies were selected for inclusion in the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach.
Proposed

Interventions
I
ndividualized treatment plans
.
F
requent blood glucose checks
.
P
roper exercise and nutrition.
) (
Expected

Results/

Outcomes
Facilitates increased physical activity and reduced calorie consumption.
Weight reduction that is manageable.
Decreased levels of insulin.
Triglyceride levels, decreasing your risk of heart disease.
Reduced inflammation and free radical change.
Graphs/Tables
)
(
Anticipated

Conclusions
The purpose of this poster is to raise awareness about the significance of developing a personalized treatment plan, monitoring blood glucose levels regularly, and making healthy lifestyle choices for people with diabetes in order to reduce their risk of hypoglycemia.
Patients with diabetes may benefit greatly from fasting in terms of health and quality of life if they get the necessary guidance and supervision from their healthcare professionals.
Potential

Implications

to

Practice
Fasting may improve the health and well-being of people with diabetes, and this is especially true when individuals are supported by their healthcare professionals via education and monitoring.
Acknowledgements
Grajower M. M. & Horne B. D. (2019). Clinical management of intermittent fasting in patients with diabetes mellitus. 
Nutrients
.
https://doi.org/10.3390/nu11040873

)

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