Objectives: Samoan people are susceptible to early onset of type 2 diabetes and have low primary care participation. We have evaluated the effectiveness of a culturally adapted, church-based intervention delivered by Samoan coaches and Peer Support Facilitators to prevent and manage type 2 diabetes in Samoans associated with 3 churches in South Western Sydney (SWS).
Methods: This pre-post study included Samoans ≥18 years and involved the delivery of 12 lifestyle messages and 10 diabetes messages. Participants completed questionnaires, the diabetes knowledge and behavior questionnaire, anthropometric measurements and provided a non-fasting blood sample (‘new’ diabetes diagnosis was defined if HbA1c or random blood glucose was ≥6.5% (48 mmol/mol) or ≥11.1mmol/l respectively). Obesity was defined using a Pacific body mass index (BMI) threshold ≥32kg/m2.
Results: One hundred participants (70%) participated with 68 (mean age 49.6±14.2 years; female 57.4%) completing data collection 3-8 months after commencing the intervention. The prevalence of obesity was 73% and diabetes was 32.8% (19.8% previously diagnosed; 13% undiagnosed). Overall, HbA1c fell from baseline to follow-up (mean±SD; 6.4±1.7% (46 mmol/mol) vs. 6.0±1.4% (42 mmol/mol); p<0.001). HbA1c reductions were greatest in participants with known diabetes (8.1±2.4% (65 mmol/mol) vs. 7.4±1.8% (57 mmol/mol); p=0.040). The number of participants engaging in moderate and vigorous activities per week increased significantly (336.7±136.3mins vs. 622.6±213.0 mins; p=0.019). Diabetes knowledge increased from baseline to follow-up (45.5±15.7% to 60.3±20.1%; p<0.001). There were no significant reductions in weight, blood pressure or waist circumference at follow-up.
Conclusion: There is a high prevalence of diabetes and its risk factors among Samoans living in SWS. A structured church-based culturally tailored lifestyle intervention showed promise in reducing their diabetes risks.
D. Ndwiga: None. F. MacMillan: None. K. McBride: None. O. Alofivae-Doorbinnia: None. J. Reath: None. P.A. Abbott: None. D. Simmons: Speaker's Bureau; Self; Sanofi-Aventis. Other Relationship; Self; Medtronic.
South Western Sydney Local Health District; South Western Sydney Primary Health Network; WentWest Health Care; Western Sydney University