APA format -Please use simple words -Please write a substantial well thought out reply to this peer’s discussion below: How might an advanced practice professional nurse or those engaged in advanced nursing practice effect change in practice and policy to address disparities (ethnicity, gender, racial, mental health or others)? Address this question from the perspective of your specific concentrations lens. What community health issues will you address? It is an unfortunate fact that health disparities have a great impact on the health of minority populations. This is especially prevalent in latino/hispanic patients with diabetes. Diabetes is an epidemic among all ethnic backgrounds in the United States, but certain minorites have been found to have much larger prevalence then others. According to the American Diabetes Association (2017), Hispanics/Latinos are 70% more likely to be diagnosed with diabetes then non-hispanic caucasians, and have a higher risk for complications such as kidney failure and heart disease. Spanakis and Golden (2013), stated that although the CDC estimates that 11.8% of Hispanic Americans are diagnosed with diabetes, the Hispanic Community Health Study/Study of Latinos raised that estimated prevalence to 16.7% in men and 17.2% in women. They also stated that Hispanic/Latinos are 1.5 times more likely die from diabetes (Spanakis & Golden, 2013). Considering that Hispanic/Latino Americans are the largest ethnic minority in the United States, these percentages represent a large and growing problem that needs to be addressed. These discrepancies are due to a variety of factors including biological, behavorial, social, environmental, socioeconomic, language barriers, and health care system problems. Although some contributing factors, such as biologic or genetic, are difficult to change, most studies agreed that a focused community centered approach could help mitigate many of the problems. The first steps to implementing any changes are always participation and education. To increase the amount of the Hispanic/Latino population receiving the neccesary education, the solution is to bring it to them in their commmunities. One article by King, Fleck, Estrella, and Reitz (2013), discusses the implementation of a community based diabetes self-management program by the Centers for Medicare and Medicaid Services (CMS). The program, called Every Diabetic counts, was meant to recruit providers and medicare participants, increase ordering and taking of tests, provide self-management education, and improve outcomes (King et al., 2013). The programs were community based and administered by community healthcare workers and physicians (King et al., 2013). The program was overall pretty successful, but ran into time and funding based barriers, and required a copay that could be prohibitive (King et al., 2013). Another study more specific to the Hispanic/Latino population was conducted by Castillo et al. (2010), and was another community based education plan. The program had community health care workers recruit Hispanic/Latino with type 2 diabetes and provided them with 2-hour classes over 10 weeks (Castillo et al. 2010). The results showed improvements in A1C levels, systolic blood pressure, diabetes knowledged, physical activity, diet, glucose monitoring, and medication adherence (Castillo et al. 2010). The key was bringing the education to non-clinical locations in their community, tailoring care to the individuals, and training spanishing speaking community healthcare workers to administer the education (Castillo et al. 2010). As a primary care provider, I can become part of this change in several ways both in my practice and my community. One is employing translations services through staff or translation lines to help break down communication barriers. Secondly I can provide nutritional consults for patients to tailor dietary plans to each individual. This can be accomplished through the PCP (myself), a staff nutritionist, or a referral depending on insurance and needs of the patient. Make sure my patients will be able to get the medications I am prescribing and understand the proper medication administration. I can also provide handouts with diabetes education and a list of community resources for my patients to reinforce the education I am giving them. By individualizing the care of all of my patients, hopefully I can help overcome some of the barriers to healthy outcomes. On a community level, I can become an active particpant in community diabetes education programs and advocate for continued research and policy changes. It is through the growth of participation and support for these programs, both by research and policy, that the health discrepancies in Hispanic/Latino diabetics can be decreased.