Ngati and healthy: translating diabetes prevention evidence into community action

Tipene-Leach, David C., Coppell, Kirsten J., Abel, Sally, Pāhau, Helen L. R., Ehau, Terry and Mann, Jim I. (2013) Ngati and healthy: translating diabetes prevention evidence into community action. Ethnicity and Health, 18 4: 402-414. doi:10.1080/13557858.2012.754406

Author Tipene-Leach, David C.
Coppell, Kirsten J.
Abel, Sally
Pāhau, Helen L. R.
Ehau, Terry
Mann, Jim I.
Title Ngati and healthy: translating diabetes prevention evidence into community action
Formatted title
Ngāti and healthy: translating diabetes prevention evidence into community action
Journal name Ethnicity and Health   Check publisher's open access policy
ISSN 1355-7858
Publication date 2013-08
Sub-type Article (original research)
DOI 10.1080/13557858.2012.754406
Volume 18
Issue 4
Start page 402
End page 414
Total pages 13
Place of publication Abingdon, Oxon, United Kingdom
Publisher Routledge
Collection year 2014
Language eng
Formatted abstract
Introduction: Type 2 diabetes mellitus (T2DM) is a major health issue in New Zealand Māori. Clinical trials have demonstrated potential for the prevention of T2DM, but whether community public health programmes aiming to prevent diabetes are effective is untested.

Objective: To describe the planning and design of an intervention aiming to translate T2DM prevention clinical trial evidence into a community-wide population health intervention in a high risk predominantly Māori community.

Approach: Community concerns about the diabetes burden were heard by the local diabetes nurse, herself a tribal member, and discussed with a locally raised academic. Project planning ensued. The intervention and its evaluation were designed using a participatory community development model. The planned intervention had three components: community-wide health promotion initiatives conveying healthy lifestyle messages, community education and monitoring for identified high-risk individuals and their extended families, and a structural strategy aimed at adapting local environments to support lifestyle changes. The evaluation plan involved interrupted time series surveys coupled with formative and process evaluations rather than a randomised control trial design.

Discussion: Consulting communities, validating community concerns and prioritising cultural and ethical issues were key steps. Time spent developing good relationships amongst the health provider and academic research team members at the outset proved invaluable, as the team were united in addressing the project planning and implementation challenges, such as funding obstacles that arose because of our ethically and culturally appropriate non-randomised control trial evaluation design. The pre-intervention survey demonstrated high rates of diabetes (13%), insulin resistance (33%) and risk factors, and provided evidence for positive, as opposed to negative, lifestyle intervention messages.

Conclusion: Community-wide lifestyle interventions have the potential to reduce rates of type 2 diabetes and other chronic diseases in high-risk communities, but require a high level of commitment from the health sector and buy-in from the community. Adequate commitment, leadership, planning and resources are essential.
Keyword Indigenous community
Diabetes prevention
Population health
Community participation
Lifestyle intervention
Impaired glucose-tolerance
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
UQ Diamantina Institute Publications
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