Issue addressed The Samoan community in Australia has one of the highest rates of diabetes in Australia. We explored the experiences and perceptions of Samoan patients living with diabetes and their family members. Methods Semi‐structured interviews were conducted with adults from a Samoan background living in Australia who had diabetes and their family members. Participants were recruited from a single general practice with a high proportion of Pacific Islander patients, through self‐response to waiting room flyers. Inductive thematic analysis was conducted using a constructivist‐grounded theory approach. This qualitative project was part of the developmental phase of a larger project aiming to promote healthy lifestyles and decrease diabetes in the Samoan community in Sydney, Australia. Results Twenty participants, aged 36–67 years, were interviewed. The majority was men (n = 13) and all were migrants to Australia. Participants reported a range of barriers to early detection and self‐management of diabetes, including dietary practices common within their culture and the role of church and religion. They identified that pride in their heritage and role within families could be a barrier to care but also provided an opportunity for health promotion. Conclusions The cultural factors which influence the risk and management of diabetes in the Samoan community in Australia can be the barriers to health change but also provide opportunities for culturally targeted diabetes education and health promotion. So what? These findings will inform the development of approaches for the prevention and management of diabetes within the Samoan‐Australian community. These include health‐promotion initiatives which take into account the role of cultural dietary practices, diabetes stigma, cultural pride and working with churches.

Objectives: Samoan people are susceptible to early onset of type 2 diabetes and have low primary care participation. We have evaluated the effectiveness of a culturally adapted, church-based intervention delivered by Samoan coaches and Peer Support Facilitators to prevent and manage type 2 diabetes in Samoans associated with 3 churches in South Western Sydney (SWS). Methods: This pre-post study included Samoans ≥18 years and involved the delivery of 12 lifestyle messages and 10 diabetes messages. Participants completed questionnaires, the diabetes knowledge and behavior questionnaire, anthropometric measurements and provided a non-fasting blood sample (‘new’ diabetes diagnosis was defined if HbA1c or random blood glucose was ≥6.5% (48 mmol/mol) or ≥11.1mmol/l respectively). Obesity was defined using a Pacific body mass index (BMI) threshold ≥32kg/m2. Results: One hundred participants (70%) participated with 68 (mean age 49.6±14.2 years; female 57.4%) completing data collection 3-8 months after commencing the intervention. The prevalence of obesity was 73% and diabetes was 32.8% (19.8% previously diagnosed; 13% undiagnosed). Overall, HbA1c fell from baseline to follow-up (mean±SD; 6.4±1.7% (46 mmol/mol) vs. 6.0±1.4% (42 mmol/mol); p<0.001). HbA1c reductions were greatest in participants with known diabetes (8.1±2.4% (65 mmol/mol) vs. 7.4±1.8% (57 mmol/mol); p=0.040). The number of participants engaging in moderate and vigorous activities per week increased significantly (336.7±136.3mins vs. 622.6±213.0 mins; p=0.019). Diabetes knowledge increased from baseline to follow-up (45.5±15.7% to 60.3±20.1%; p<0.001). There were no significant reductions in weight, blood pressure or waist circumference at follow-up. Conclusion: There is a high prevalence of diabetes and its risk factors among Samoans living in SWS. A structured church-based culturally tailored lifestyle intervention showed promise in reducing their diabetes risks. Disclosure D. Ndwiga: None. F. MacMillan: None. K. McBride: None. O. Alofivae-Doorbinnia: None. J. Reath: None. P.A. Abbott: None. D. Simmons: Speaker's Bureau; Self; Sanofi-Aventis. Other Relationship; Self; Medtronic. Funding South Western Sydney Local Health District; South Western Sydney Primary Health Network; WentWest Health Care; Western Sydney University