f David Atkinson, RCSWA Broome
Be Healthy: Implementing culturally secure programs for obesity and chronic disease prevention with remote Aboriginal communities and families
Aboriginal people from several Kimberley communities have requested support for implementing culturally secure lifestyle modification programs that foster internal motivation, enhance health knowledge, and modify health beliefs and risk perception. We codesigned, piloted and refined the ‘Be Healthy’ program with 110 Derby Aboriginal people. The 8-module program involves practical nutrition education, discussion of chronic diseases, cooking, stress management and group physical activity. Content, while consistent with the US Diabetes Prevention Program, is tailored to local culture and younger age (15-40 years), and delivered by Aboriginal facilitators in a culturally secure, supportive and enjoyable atmosphere. The pilot program demonstrated acceptability, positive behaviour changes and proof of concept in a challenging setting.
This project will empower Aboriginal people to increase exercise levels, improve nutrition and reduce obesity. It combines the power of research to drive evidence-based positive behaviour change with the wisdom, knowledge and cultural strength of Aboriginal communities, integrated with the major Kimberley healthcare providers. This community-led initiative will be adapted using a similar codesign process with other Aboriginal communities, implemented on a large scale over 5 years and evaluated. While the program will be open to all Aboriginal residents, we will particularly encourage participation of people who are 1) obese, 2) pregnant (improve outcomes for baby/child), and 3) parents (intergenerational transfer of health regarding behaviour). Through partnerships between Aboriginal organisations and academic researchers, the program will be culturally relevant, rigorously evaluated and embedded within the community for sustainability and will deliver short, medium and long-term health benefits.
- Assoc Professor Julia Marley
- Erica Spry
- Prof Lynette Henderson-Yates, DAHS
- Prof David Atkinson
- Jamilah Bin Omar
- Dr Kimberley Seear
- Ms Emma Carlin
- Dr Sarah Straw
Progression to diabetes among Aboriginal people in the Kimberley: Identifying opportunities to enhance intervention for prevention within primary health care
Regular screening for T2D is standard in the Kimberley and this process can also detect people at high risk for diabetes; that is, people with “pre-diabetes”. Large studies have demonstrated that interventions supporting healthy lifestyle behaviours for people with pre-diabetes can prevent or delay T2D. The recently-published position statement on screening and management of pre-diabetes in primary care in Australia recommended the HbA1c range 6.0–6.4% for pre-diabetes. Identified individuals should be provided with healthy lifestyle education, strategies and support within primary care, including consideration of psychosocial factors. This is particularly important in the Kimberley, where there are limited referral options and few structured prevention programs.
This study will improve understanding of the quality of screening for diabetes in the Kimberley region, and the factors influencing progression to T2D. This will enable the development and implementation of clinical guidelines for best practice for pre-diabetes in remote Aboriginal settings that emphasise both physical and psychosocial factors. The Kimberley Lead Clinicians Forum and Kimberley Aboriginal Community Controlled Health Services recognise and support the need to investigate progression to T2D regionally with a view to improved interventions for diabetes prevention and more timely diagnoses to minimise complications. Findings will also be highly relevant to other settings with a high T2D burden in Australia and internationally.
- Assoc Prof Julia Marley, RCSWA Broome / KAMS
- Prof David Atkinson, RCSWA Broome
- Dr Kim Seear, KAMS
- Erica Spry, KAMS / RCSWA Broome
- Dr Caitlyn White, KAMS
Young-onset diabetes refers to type 2 diabetes m