Effectiveness of a community-directed ‘healthy lifestyle’ program in a remote Australian Aboriginal community

Abstract

Objective: To assess the sustainability and effectiveness of a community-directed program for primary and secondary prevention of obesity, diabetes and cardiovascular disease in an Aboriginal community in north-west Western Australia. Method: Evaluation of health outcomes (body mass index, glucose tolerance, and plasma insulin and triglyceride concentrations) in a cohort of high-risk individuals (n=49, followed over two years) and cross-sectional community samples (n=200 at baseline, 185 at two-year and 132 at four-year follow-ups), process (interventions and their implementation) and impact (diet and exercise behaviour).

Outreach programmes for health improvement of Traveller Communities: a synthesis of evidence

“…It has utility here, because it comes to complement Kelly et al 133 and Leeds GATE 192 in explaining how behavioural change may be achieved. The following study (Rowley 2000) 210 was sought in order to find somewhat more robust evidence that in a trusting context whereby the focus of the intervention responds to a need identified by the Community, social support resources may be sufficient to trigger behaviour change (through cognitive engagement).…”

“…Indeed, the initiative was initiated by the Community itself, who were concerned about high morbidity and mortality from diabetes; the topic is, therefore, highly relevant. Initially, a diabetes nurse educator was employed 'to assist Looma Community members in the design and implementation of appropriate and potentially sustainable physical activity and dietary modifications' (p. 137), 210 and then Aboriginal health workers were employed and became responsible for running the programme on a day-to-day basis. Therefore, it is reasonable to assume that outreach workers are known (building on close social ties, given the small size of the Community) and trusted members of Looma, although little detail is provided about them.…”

“…When the intervention was implemented in the wider Community, a strong emphasis was placed on the 'dissemination of messages about diet and physical activity to family members by those persons taking part in the high-risk intervention program' (p. 137). 210 There is, therefore, an explicit aim to build on trusting strong social ties and activate levers for behaviour change.…”

Development and piloting of a community health worker-based intervention for the prevention of diabetes among New Zealand Maori in Te Wai o Rona: Diabetes Prevention Strategy

“…Lesser degrees of weight control (reductions in weight gain), potentially of use for sustaining diabetes prevention, are possible through community-based programmes (8)(9)(10)(11) , although these are often fraught with difficulties (8,9,12,13) . Interruption of the supply of energy-dense foods in isolated communities and promotion of traditional lifestyles can also have an effect on diabetes risk (10,14) , although these are unlikely to be practical in most populations and particularly in urban areas.…”

“…Interruption of the supply of energy-dense foods in isolated communities and promotion of traditional lifestyles can also have an effect on diabetes risk (10,14) , although these are unlikely to be practical in most populations and particularly in urban areas.…”