Health‐related behaviours in a remote Indigenous population with Type 2 diabetes: a Central Australian primary care survey in the Telehealth Eye and Associated Medical Services Network [TEAMSnet] project

Abstract

Aim There is a wealth of data concerning the health behaviours of Indigenous Australians, but the health behaviours of Indigenous Australians with diabetes are not systematically documented. At the clinical level, understanding a person's health behaviours can help identify and address barriers to diabetes care and promote good clinical outcomes. Methods We used a novel survey tool to systematically collect health behaviour data on Smoking, Nutrition, Alcohol consumption, Physical activity and Emotional well‐being (SNAPE) from Indigenous Australians with Type 2 diabetes in a remote primary care setting in Alice Springs. Results At least one of the five surveys in the SNAPE tool was completed by 210 participants: 30% male, mean age 52.6 years (range 22.9 – 87.4). Fifty per cent of men and 23% of women were current smokers (P < 0.001). None of the participants reported an adequate intake of vegetables. Only 9.6% reported an adequate fruit intake. Some 49% of men and 32% of women consumed alcohol in the past year (P = 0.022), and 46% of drinkers were considered high‐risk or likely‐dependent drinkers. On average, participants walked 10 min or more at a time 6.0 days a week and spent 4.8 h sitting on a weekday. Mean adapted Patient Health Questionnaire 9 score was 4.61, with 34% of participants having mild depressive symptoms and 11% having moderate‐severe depressive symptoms. Conclusions Our SNAPE survey tool results present a high‐risk, disadvantaged Indigenous population with Type 2 diabetes. More resources will be needed to sustainably implement interventions with the goal of improving health behaviours and subsequent long‐term health.

Health‐risk behaviours among Indigenous Australians with diabetes: A study in the integrated Diabetes Education and Eye Screening (iDEES) project

“…This study of Indigenous Australians with diabetes demonstrated that although less than half the study group consumed alcohol, high‐risk or likely dependent alcohol use or binge drinking was common amongst drinkers. The proportion of participants consuming alcohol in the past year (43%) was similar to a recent Central Australian study of adults with diabetes attending a remote primary clinic in which 38% of participants consumed alcohol, with men consuming more alcohol than Indigenous women (Xu et al, 2019) unlike the present study in which the proportion of men and women who were drinkers was similar ( p = .179). Safe alcohol use should be a routine part of diabetes assessment and education.…”

“…Despite this, based on the NHMRC Australian Dietary Guidelines, only 6% met the recommended adequate daily vegetable intake, 25% had adequate daily fruit intake, and 19% consumed the recommended fish intake of two or more servings daily (National Health & Medical Research Council, 2013). The observed low vegetable intake of participants is consistent with the low vegetable intake of the broader Australian population and for Indigenous Australians with diabetes in remote Australia (Xu et al, 2019), where food insecurity is likely to be more prevalent. As expected, fish intake was higher among study participants, surrounded by rivers and lakes, than their counterparts in remote Central Australia, surrounded by deserts and dry river beds.…”

Screening for diabetic retinopathy and reduced vision among Indigenous Australians in Top End primary care health services: a TEAMSnet sub‐study

“…Site differences in DR prevalence may also be due to differences in health behaviours of the communities. For example, in our TEAMSnet Central Australian cohort with a higher STDR prevalence, we reported suboptimal diet quality, physical activity and emotional well‐being, although smoking prevalence was lower than in the national indigenous population 21 . No comparable behavioural data are available for the Top End cohort, but it is plausible that the Top End coastal communities may have different health behaviours, for example better diet than desert communities.…”

Barriers in establishing systematic diabetic retinopathy screening through telemedicine in low- and middle-income countries

“…[ 35 ] As an asymptomatic disease, patient attitude and health-related behaviors play significant roles in the success of these programs. [ 31 36 ] Education support is required for people to want to access treatment when they are asymptomatic. Communication between the referrer and the patient needs to be improved significantly.…”