April 9, 2010

Translating Diabetes Prevention into Native Hawaiian and Pacific Islander Communities: The PILI ‘Ohana Pilot Project

Marjorie K. Mau, Joseph Keawe‘aimoku Kaholokula, Margaret R. West, Anne Leake, James T. Efird, Charles Rose, Donna-Marie Palakiko, Sheryl Yoshimura, Puni B. Kekauoha, and Henry Gomes

Progress of  Community Health Partnership

Native Hawaiians (NHs) and Other Pacific Islanders (OPIs) bear an excess burden of diabetes health disparities. To address this, Community-based Participatory Research (CBPR) approaches were used to: 1) culturally-adapt the Diabetes Prevention Program Lifestyle Intervention (DPP-LI) for NHOPI communities; and 2) implement and examine the effectiveness of the culturallyadapted program to promote weight loss in 5 NHOPI communities. . Methods—Informant interviews (n=15) and focus groups (n=15, 112 NHOPI participants) were completed to inform the cultural adaptation of the DPP-LI program. A team of 5 community investigators and 1 academic research team collaboratively developed and implemented the 12-week pilot study to assess the effectiveness of the culturally-adapted program. Results—A total of 127 NHOPIs participated in focus groups and informant interviews that resulted in the creation of a significantly modified version of the DPP-LI, entitled the PILI ‘Ohana Lifestyle Intervention (POLI). In the pilot study, 239 NHOPIs were enrolled and after 12 weeks (postprogram), mean weight loss was −1.5 kg (95%CI −2.0,−1.0) with 26% of participants losing ≥3% of their baseline weight. Mean weight loss among participants who completed all 8 lessons at 12 weeks was significantly higher (−1.8 kg, 95%CI −2.3, −1.3) than participants who completed less than 8 lessons (−0.70 kg, 95%CI −1.1, −0.29). Conclusion—A fully engaged CBPR approach was successful in translating an evidence based diabetes prevention program into a culturally relevant intervention for NHOPI communities. This pilot study demonstrates that weight loss in high risk minority populations can be achieved over a short period of time using CBPR approaches.

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