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Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income Peoplescommunity intervention raised awareness of diabetes and emphasised the preventablenature of the condition. A participatory approach has been used to mobilise thecommunity and members who have been involved in the design to set up and implementcommunity initiatives (eg, walking groups, water only schools).For the remaining three years, the intervention will seek to consolidate work alreadyinitiated and to embed the intervention into all parts of the community, includingworkplaces and schools. Surveys 23 have been conducted to compare the prevalence ofinsulin resistance, impaired fasting glycaemic, impaired glucose tolerance, T2DM,cardiovascular risk factors and health behaviours, which will be used to determine theeffectiveness of the intervention. Formative and process evaluation methods arecurrently in progress; however, a final written report was unable to be obtained. Basedon information extracted from a conference presentation, 24 Ngati Porou Hauorakaiawhina (community health workers) have been a vital link between the healthprofessional/research team and the community throughout all stages of the project andalso for the implementation of the prevalence surveys.The Healthy Lifestyle Programme (HLP)THE HLP is an interagency, multidisciplinary, family-based obesity intervention based inNorthland. Rather than a culturally-specific programme, this intervention targeted Māori,which incorporated a healthy lifestyle approach (including physical activity) with an aimto decrease body mass. The programme was structured as an eight-week block of 90-minute group education and activity sessions. Following this block families were offeredoptional involvement in the Green Prescription Active Families (GRxAF) programme. Anevaluation 25 was conducted and included 57 families (seven groups) who completed thetwo-year programme. Participants were all severely obese (BMI greater than the 99 thcentile) with high rates of metabolic complications at baseline. Results from the studyshowed sustained improvements in standardised BMI scores and percentage body fat(PBF). Improvements in these outcomes were greatest for the youngest age group (
Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income Peoplesconsidered beneficial to adults' long-term health care. Research shows that GRx is aninexpensive way of increasing activity for inactive people. 27In 2004, the GRx programme was extended to better target the needs of young peopleand their families. This resulted in the GRx Active Families (GRxAF) initiative, whichnow operates in eight regions. The GRxAF programmes are designed to increasephysical activity in children and young people aged 5-18 years of age and theirwhānau/families, and are therefore more likely to appeal to Māori and Pacificcommunities. The aim of GRxAF is to decrease body mass by enabling families toembrace healthier and more active lifestyles that are sustainable, throughencouragement and education, nutritional guidance and advice, realistic goal setting andongoing support. Regular group activity sessions are held at community facilities andinclude goal setting and review, nutrition advice, a physical activity session, and workingas a group on individual goals/achievements. Physical activities include fitness circuits,modified games, sports and aquatic activities. Information and education about health,well-being and physical activity is provided.Waitemata District Health Board (WDHB) has provided funding for the development ofMāori and Pacific-specific Active Families programmes. These programmes arecoordinated respectively by Māori and Pacific providers who recruit participants anddeliver the intervention. Each culturally-specific programme is underpinned andsupported by their respective steering groups. An independent qualitative andquantitative evaluation 28 has been commissioned by SPARC and the WDHB, withresults available by December 2009.GRxAF Otara South AucklandHealth Incorporated is a not-for-profit, stand-alone organisation that has been operatingfor ten years in the Otara, South Auckland community and has been delivering GRxAFsince 2007. The programme has been modified in consultation with the Māori and Pacificcommunities and utilises a whānau approach to improve physical activity and healthynutrition. A programme evaluation, including information from focus groups with families,is due for completion in June 2009.Obesity Prevention in Communities (OPIC) and Let’s Beat Diabetes (LBD)Two large multi-component interventions (Obesity Prevention in Communities and LetsBeat Diabetes) have been implemented in NZ to reduce obesity and diabetes amongMāori and Pacific populations. While these interventions target Māori and Pacific people,they have also incorporated the development of culturally-specific physical activityinitiatives.Obesity Prevention in Communities (OPIC)The OPIC project is part of a regional collaboration involving Deakin University(Australia), Fiji School of Medicine, the Tongan Ministry of Health and the University ofAuckland. OPIC was based on a youth participation model which involved young peopleinitiating and developing interventions within their school environments to improvephysical activity and nutrition. For physical activity several initiatives were developed,including breakfast clubs in which students were able to sign-out sporting equipment foruse during lunches and recess, breakfast clubs with opportunity to practice hip-hop andplay games, and after-school dance classes. Preliminary results of the OPIC study wereavailable in July 2009.176
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