¶ … Asian-Americans with newly diagnosed type 2 diabetes perceive barriers to implementing dietary and lifestyles changes to reduce A1C levels in the first 3 months after diagnosis"? Method of obtaining necessary approval(s) and securing support from your organization's leadership and fellow staff.

One of the most difficult parts of effecting meaningful change in an organizational setting is obtaining the necessary approval from top management and then achieving "buy-in" from fellow staff members. Top management may be fearful of change because of the unknowns and potential additional costs and disruption to operations that may result while fellow staff members may be highly reluctant to willingly accept any changes in their day-to-day routines. In this regard, Kerber and Buono (2008) emphasize that, "Planned change, which has become an increasingly popular approach to change management, may arise from any level in the organization but ultimately is sponsored at the top" (p. 24).

In order to secure top management support, it is vitally important to actively involve them in the planning phases to the extent they deem necessary, and to ensure that they are made aware of the key advantages and benefits that will accrue to the adoption and implementation of the change initiative (Kerber & Buono, 2008). It is also important to ensure that contingency plans are in place to avoid any disruption of critical services during the implementation stages (Kerber & Buono, 2008). As Kerber and Buono point out, "Change leaders and implementers seek involvement in and commitment to the change by making extensive use of specific actions, identified through research and experience, that mitigate the typical resistance and productivity losses associated with directed change" (p. 25). In addition, besides convincing top management of what benefits and advantages of the change initiative for the organization, it is also helpful to educate management and fellow staff members concerning any "what's-in-it-for-them" aspects of the initiative (Kerber & Buono, 2008).

2. Description of current...

Because nurses are also educators and serve on the front lines of delivering health care services, it is natural for nurses to provide these educational services to newly diagnosed Asian-Americans with type 2 diabetes to improve their adherence to changes in their dietary and lifestyle regimens. For example, Wu and Tung (2014) report that, "Diabetes is a chronic disease and is one of the common self-care diseases. Good self-care, including diet management, medication compliance, blood glucose monitoring, exercise participation and foot care, improves glycemic control and lowers the incidence and severity of diabetes complications" (p. 188). Fortunately, the majority of newly diagnosed type 2 diabetes patients readily understand that changes in their lifestyle and dietary habits are needed to manage this disease, but some patients fail to adopt the recommended changes for various reasons (Wu & Tung, 2014).
Although the reasons for poor adherence to recommended changes in lifestyle and dietary regimens vary from individual to individual, some of the overarching barriers to effective patient education identified by researchers to date has been a paucity of careful patient assessment concerning the their readiness for self-care as well as their motivational levels and precise individual management needs (Wu & Tung, 2014). These same barriers that affect the general population can also be reasonably posited to adversely affect the adherence levels among Asian-Americans who have been newly diagnosed with type 2 diabetes as well. In order to evaluate the effectiveness of a patient education initiative for this purpose, though, it will be necessary to collect benchmark data concerning the current levels of adherence of this population to prescribed changes in lifestyle…