, Volume 4, Issue 2, pp 149-159,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 18 Dec 2013

Translating the Diabetes Prevention Program in Native Hawaiian and Pacific Islander communities: the PILI ‘Ohana Project

ABSTRACT

Native Hawaiians/Pacific Islanders experience a high prevalence of overweight/obesity. The Diabetes Prevention Program Lifestyle Intervention (DPP-LI) was translated into a 3-month community-based intervention to benefit these populations. The weight loss and other clinical and behavioral outcomes of the translated DPP-LI and the socio-demographic, behavioral, and biological factors associated with the weight loss were examined. A total of 239 Native Hawaiian/Pacific Islander adults completed the translated DPP-LI through four community-based organizations (CBOs). Changes from pre- to post-intervention assessments in weight, blood pressure, physical functioning, exercise frequency, and fat in diet were measured. Significant improvements on all variables were found, with differences observed across the four CBOs. CBOs with predominately Native Hawaiian and ethnically homogenous intervention groups had greater weight loss. General linear modeling indicated that larger baseline weight and CBO predicted weight loss. The translated DPP-LI can be effective for Native Hawaiians/Pacific Islanders, especially when socio-cultural, socio-economic, and CBO-related contextual factors are taken into account.

Implications

Practice: Evidence-based lifestyle interventions can be effectively translated into real-world settings when adapted to a specific ethnic population and the characteristics of community-based organizations, and they can be feasibly implemented using in place human resources.
Policy: The expeditious translation of evidence-based intervention strategies into real-world contexts is needed to address serious shortfalls in the application of scientific discoveries.
Research: More research is needed to elucidate the role of social support and networking in obesity interventions, especially for economically challenged and socially marginalized groups, such as immigrants and indigenous peoples.