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Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income PeoplesLet’s Beat Diabetes (LBD)LBD is a community intervention project with a five-year plan to prevent and manageType 2 diabetes in the Counties Manukau region. A fundamental component of LBD isthe ‘whole society, whole life course-whole family/whānau’ approach to preventing andmanaging diabetes. Improving physical activity and nutrition are key components of theLBD strategy. Various aspects of LBD are currently being evaluated. 29Tongan Community Action ProgrammeThe purpose of the Tongan Community Action programme was to reduce healthinequalities of Tongan people living in Christchurch. The objectives were to reduceobesity and associated long-term health problems by improving nutrition, increasingphysical activity levels and reducing the levels of smoking among the participants. Theproject also aims to develop capacity within the community to ensure sustainability andless reliance on external support. It was coordinated and facilitated by two members ofthe Christchurch Tongan Community Association. Physical Activity sessions wereprovided throughout the 18-month intervention and were delivered by a Tongan fitnessinstructor. An evaluation of the programme 30 showed some changes in BMI and also inphysical activity participation. This approach appears to be sufficiently funded and hasextensive community and stakeholder support to ensure its sustainability.LotuMouiThe LotuMoui is a programme based within the Counties Manukau region aimed atimproving the health and well-being of Pacific peoples and communities. It is deliveredby Pacific churches. One aspect of LotuMoui is to promote increased physical activitylevels for Pacific families. An evaluation of this programme is currently in progress.Enua OlaThe Enua Ola lifestyle intervention, targeting Pacific families, is funded by HEHA andbased within the Waitemata District Health Board. A component of Enua Ola is topromote increased physical activity levels for Pacific families. An evaluation of thisprogramme is currently in progress.Kids in ActionThe Kids in Action programme is an after-school physical activity intervention targeted atoverweight Pacific and Māori children (aged 5-18 years). Participants attend twice aweek during one school term with their family/whānau. Within the sessions, children andfamily receive information about physical activity and healthy lifestyles, and participate inphysical activities and age-specific games. A mixed method evaluation 31 has beencompleted, which included interviews with children and parents, analysis of kids in actiondata, physical measures, and self-administered questionnaires. The evaluation foundthat compliance to the programme was mixed with more than half (52 percent) ofparticipants attending less than 40 percent of available sessions. While there werepositive effects on participant’s reported self-esteem and enjoyment, the assessment ofobjective outcomes such as physical fitness and physical activity were not standardised,which limits the interpretation of the effectiveness of the intervention. Drop-out rates,parents not getting involved in the activities, other competing outside influences, andlimited capacity are all factors that could potentially affect the sustainability of thisprogramme.177
Enhancing Food Security and Physical Activity for Māori, Pacific and Low-income PeoplesShake It – Beat It - Learn It Pacific Exercise ProgrammeThis multi-component intervention is targeted at Pacific People with the aims of reducingobesity, improving nutrition, reducing blood pressure, and increasing mobility andphysical activity. The Shake It component includes a regular healthy lifestyle andexercise programme for Pacific peoples, delivered by a NZ Institute of Sport personaltrainer. Participation in this programme is free. The programme has three maincomponents. Beat It involves an initial baseline fitness check of programme participants,which is repeated regularly. Learn It is aimed at improving development and capacitybuilding by allowing NZIS students to experience a Pacific setting for fitness training;assisting with recruitment of future fitness professionals from within the community; andtraining people to supervise the fitness sessions. The pilot of this programme wasimplemented in three communities: Tuvalu community, Porirua; Cook Island community,Porirua; and Lupe Fa’alele (Elderly Group), Newtown, Wellington South.A mixed method evaluation was conducted 32 and included key stakeholder interviews,interviews with programme participants, and analysis of health information collected inthe pilot. Results showed high levels of enjoyment and satisfaction for participants andsome reported increases in physical activity participation for older people; however, noquantitative data were provided. The programme logic was considered adequate;however, the programme implementation was poor, with only two of the fiveimplementation goals achieved. Other issues which hampered this intervention were therelatively low and decreasing numbers of participants in some groups; lack of workforcedevelopment; and lack of inter-sectoral collaboration, which limit the sustainability of thisapproach.Feasibility (Level of evidence of effectiveness)There is sufficient evidence nationally that it is feasible to develop culturally-specificphysical activity interventions; however, the effectiveness of these has not yet beendetermined. Many of the interventions lack a robust design and quantitative data todetermine the effectiveness of key outcomes.SustainabilityA few evaluations specifically highlighted the issues of sustainability, such as anadequate and sustained funding source; development of capacity and capability; andcontinued engagement of the target population and community. If these are adequatelyaddressed then culturally-specific physical activity interventions could be sustainable.Effect on equityThere is a wide variety of physical activity and lifestyle interventions that have beendeveloped to address cultural-specific needs or have targeted Māori or the Pacificpopulation. The continued development and refinement of these interventions are likelyto have a positive impact on equity. Culturally-specific programmes would have to beimplemented alongside other strategies that included a focus on low-income people toprevent lack of equity for this group.Acceptability to stakeholdersEvaluations have generally shown that these culturally-specific interventions have beenreceived well by participants, whānau, and the greater community.178
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