“…Indigenous American Indian population in British Columbia (49) 105 high-risk individuals Design: quasi experimental, community-based 2 year programme targeted at the Indian population of rural Okanagan region in Canada Intervention: single intervention community matched to two comparison communities; intervention community, workers conducted interviews of individuals with or at risk for DM for 7 months (pre-intervention phase); programme used a participatory approach and included strategies to improve the environment and to change behaviour; cohorts tracked over a 16-month intervention phase; cross-sectional population surveys of DM risk factors were conducted at baseline and post intervention Results: the project yielded few changes in quantifiable outcomes, which was thought to be a result of the short planning and intervention phases and the level of penetration was too limited Pilot study in Pima Indians (3) n 95, obese, normoglycaemic, age 25-54 years Design: RCT, 12 months Aim: to determine the relative effectiveness of two interventions in altering risk factors for DM Intervention: two lifestyle Pima interventions: action (intervention group), structured activity and nutrition; pride(control group), activities emphasising Pima history, received basic printed information on healthy eating and exercise habits Results: after 12 months increased physical fitness in both groups; BP, BMI, 2 h glucose and insulin all increased significantly in action members compared with pride members Conclusion: sustaining adherence in behavioural interventions over a long term was challenging; Pima Indians may find a less-direct less-structured approach and more participative intervention more acceptable than a direct and highly-structured approach Church-based Programme (50) n 78, South Auckland, New Zealand Design: open-prospective non-RCT Aim: to evaluate the impact of a comprehensive DM-related lifestyle programme on DM knowledge, exercise habits, dietary habits and body size among a Samoan church congregation Intervention: two church congregations (one intervention and one control church), intervention congregation coordinated by a DM nurse specialist and one of two Samoan women, one as a DM fieldworker and the other as an aerobics instructor; four DM-awareness sessions held as part of a church service with the DM educator as the main presenter; also formed exercise groups that included sitting exercises, low-impact aerobics, walking and sports; sessions held weekly for the first year and twice weekly thereafter Results: reduction in waist circumference and consumption of fatty foods reduced in the intervention church; increased DM knowledge and an increase in the proportion exercising regularly Conclusion: DM risk-reduction programmes based on lifestyle change, DM awareness and empowerment of high-risk communities can significantly reduce risk factors for future type 2 DM Looma Healthy Lifestyle (51) n 199, over 4 years in Western Australia, adults aged ‡ 15 years Design: Cross-sectional risk-factor surveys Aim: To evaluate the effectiveness of a community-directed intervention programme to reduce CHD risk through dietary modification Intervention: intervention process included store management policy changes, health promotion, and nutrition education aimed at high-risk individuals; programme focused initially on a group of individuals at high risk of DM and CHD, consisted of education sessions by a DM nurse educator Results: significant reduction in the prevalence of hypercholesterolemia; significant increases in plasma concentrations of a-tocopherol, lutein and zeaxanthin, cryptoxanthin and b-carotene across the population Conclusion: the community-directed intervention programme reduced the prevalence of CHD risk factors related to diet...…”