Diabetes, its risk factors and readiness to change lifestyle behaviours among Australian Samoans living in Sydney: Baseline data for church‐wide interventions

Abstract

Objectives To describe the current prevalence of type 2 diabetes (diabetes) and readiness to change diet and physical activity among Samoans associated with churches in Sydney. Methods Residents aged ≥18 years attending four Samoan churches in Sydney were invited to participate in a church‐wide lifestyle intervention. Participants completed questionnaires, anthropometric measurements, provided a non‐fasting blood sample for HbA1c and random blood glucose (RBG) measurement, and performed a 6‐minute walk test. Obesity was defined using a Pacific body mass index (BMI) threshold ≥32 kg/m2 and diabetes if HbA1c was ≥6.5%. Results In total, 131/187 (70%) of Samoans (mean age of 44.1 ± 15 years; Female 52%) participated. Diabetes was present in 33% of the population which included 20% previously diagnosed diabetes, duration 13.4 ± 6.7 years, (HbA1c 8.3 ± 2.5% and RBG 10.2 ± 4.1 mmol/L) and 13% had undiagnosed diabetes (HbA1c 8.1 ± 2.7% and RBG 10.3 ± 4.7 mmol/L). The overall baseline prevalence of obesity, high blood pressure and meeting the physical activity recommendation of ≥150 min/wk were 77%, 44% and 38% respectively. Over 90% of participants were contemplating, if not already taking action towards healthier diet choices and increasing physical activity. Conclusions Prevalence of diabetes and its risk factors were high among Samoans in Sydney with a high proportion with undiagnosed diabetes. So what? These findings highlight the need to prioritise the delivery of culturally appropriate interventions tailored to the needs of the Samoan community. The high level of healthy lifestyle contemplation suggests that the community would be receptive to such interventions.

Using Community Based Research Frameworks to Develop and Implement a Church-Based Program to Prevent Diabetes and Its Complications for Samoan Communities in South Western Sydney

“…Use of PSFs ensured the program was sustainable as community members received training to continue with the project once the project funding had stopped. Use of volunteer peers to influence healthy behaviours has been recommended and successfully used among several CALD communities [7,17,32,44,45].…”

“…Additionally, the 10 diabetes messages aimed to improve management of diabetes and reduce risk of diabetes complications. Papers reporting on the baseline characteristics of participants [7] and outcomes of a lifestyle intervention pilot study [33] from the resulting Le Taeao Afua (LTA) Samoan diabetes prevention program pilot project have already been published. To develop a culturally appropriate diabetes prevention program, a study focusing specifically on the experiences of Samoan people living with type 2 diabetes and perceptions of diabetes, including how cultural beliefs and life experiences affected diabetes outcomes was conducted [34].…”

“…Similar to other culturally and linguistically diverse (CALD) communities in Australia, Samoans experience disproportionately higher rates of chronic conditions compared to their counterparts of European descent [3,4]. Studies conducted in Samoa [5,6], Australia [7][8][9], New Zealand [10] and the USA [11,12], have found that Samoans experience poor health outcomes and high prevalence of health conditions, including diabetes and obesity. Type 2 diabetes has been identified as one of the leading causes of death among American Samoans in the USA [13] and of disability in the Independent State of Samoa [14].…”

“…Despite these existing health disparities, in Australia and beyond, Samoans are underrepresented in health research. Few studies have focussed on Samoans living in Australia, highlighting a gap in supporting a rapidly increasing population identified to be at increased risk of obesity and diabetes [7,8,17]. Community empowerment and participatory approaches to research have been recommended to help address the health inequities that exist in CALD communities [18][19][20][21][22].…”

Multiple Unhealthy Behaviors Share Equivalent Profiles of Readiness for Change in Patients with Type 2 Diabetes

“…The TTM has been used in patients with diabetes since 1993 to analyze behavior related to nutrition [ 10 , 11 ], exercise [ 12 ] and treatment adherence [ 13 ]. Despite the tendency towards multiple behaviors in adults [ 14 ], few studies considered more than one behavior at the same time, and none have focused on a Latino population [ 15 , 16 , 17 , 18 ]. The objective of this study was to determine the concurrence of four unhealthy behaviors (consumption of refined sugars, consumption of saturated fats, insufficient or no exercise, and insufficient or no tooth brushing), and to identify common cognitive factors at advanced stages of change in patients with type 2 diabetes treated in primary care.…”