Using community theater to improve diabetes education in Fiji

  • Philip SzmedraEmail author
  • Anand Chand
  • Mohit Prasad
  • Thomas DeTitta
  • Cathy Rozmus
Original Article


Diabetes afflicts upwards of 425 million people globally with 80% of that number living in the developing world. The World Health Organization has declared diabetes a global health threat. Here, we describe a Community Theater (CT) project implemented in Fiji, a nation where 30% of the adult population is diabetic. Current diabetes education methods used by the Ministry of Health in Fiji have proven to be ineffective in stemming the growing incidence of the disease. Our research hypothesis was that significant improvements would occur from baseline in the physical and psychosocial markers among a group of outpatients being treated at a diabetic clinic who were exposed to CT interventions over a 23-month period. Significant improvement in HbA1c levels occurred in the intervention group compared to a control group that was not exposed to CT. We conclude that novel educational approaches are needed, including CT, to combat the growing epidemic of diabetes that threatens Fiji and all other Pacific Island nations.


Diabetes education Community theater Fiji Pacific Islands Public health 



This research was sponsored by a grant from BRIDGES, a program of the International Diabetes Federation, and Eli Lilly Company and Lilly Diabetes.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethics approval and consent to participate

This research was approved by the Institutional Review Boards of both Georgia Southwestern State University and the University of the South Pacific. Informed consent was obtained from all individual participants included in the study.

Supplementary material

13410_2018_610_MOESM1_ESM.docx (2.6 mb)
ESM 1 (DOCX 2644 kb)


  1. 1.
    Bulletin of the WHO, Volume 88, number 7. July 2010. Accessed 20 February, 2017.Google Scholar
  2. 2.
    Kalipeni E, Kamlongera C. Popular Theatre and Health Care. Zomba: University of Malawi; 1987.Google Scholar
  3. 3.
    Keating J. Why do the world’s fattest people live on islands? Foreign Policy. 4 February 2011;Google Scholar
  4. 4.
    Kromhout D, Menotti A, Prevention BH. Of coronary heart disease. Diet, lifestyle, and risk factors in the seven countries study. New York: Kluwer Academic Publishers; 2002.CrossRefGoogle Scholar
  5. 5.
    Ministry of Health Fiji. Accessed 21 February 2017.
  6. 6.
    Pokharel, S. “Aarohan Street Theater”, Footsteps, no. 54, March 2004. Tearfund. Middlesex, UK.Google Scholar
  7. 7.
    Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, et al. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005 Mar;28(3):626–31. Scholar
  8. 8.
    Szmedra PI, Sharma KL, Rozmus CL. Differences in health promotion behavior among the chronically ill in three South Pacific Island countries. Dev Pract. 2007;17(2):291–300. Scholar
  9. 9.

Copyright information

© Research Society for Study of Diabetes in India 2018

Authors and Affiliations

  1. 1.School of Business AdministrationGeorgia Southwestern State UniversityAmericusUSA
  2. 2.Faculty of Business and EconomicsUniversity of the South PacificSuvaFiji
  3. 3.Faculty of Arts, Law, and EducationUniversity of the South PacificSuvaFiji
  4. 4.World CommunitiesAmericusUSA
  5. 5.School of NursingThe University of Texas Health Science Center at HoustonHoustonUSA

Personalised recommendations