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Peer-led Diabetes Prevention Program for TASC in Melbourne Nabil Sulaiman

Peer-led Diabetes Prevention Program for TASC in Melbourne Nabil Sulaiman “International Congress on CDSM, Melbourne Nov 2008”. Aims of Peer-led. Develop an evidence based, culturally appropriate peer-led diabetes prevention resources and program for TASC Trial the program

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Peer-led Diabetes Prevention Program for TASC in Melbourne Nabil Sulaiman

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  1. Peer-led Diabetes Prevention Program for TASC in Melbourne Nabil Sulaiman “International Congress on CDSM, Melbourne Nov 2008”

  2. Aims of Peer-led • Develop an evidence based, culturally appropriate peer-led diabetes prevention resources and program for TASC • Trial the program • Evaluate the program

  3. Methodology- how? Design:Pre and post intervention trial (action research methods) • Advisory Group • Peer- leaders • Diabetes prevention program • Participants • Evaluation

  4. Methodology- how? • 12 peer leaders recruited from TASC • Program was developed (food, exercise, group dynamics ..etc) • 2- full days training of leaders • Each leader engage 10 people

  5. Program components • Principles of peer-led program • Role of diet, physical activity and stress • Group facilitation, engaging • Motivational techniques and chronic disease self-management • Leaders were paid for their training time, recruitment of participants and implementing the program.

  6. Outcome Indicators • Changes in knowledge and attitudes • Changes in behaviours • Changes in body weight and waist circumference

  7. Data collection • Questionnaire and interviews:knowledge, attitudes and behaviour "Three-day Food Diary" and physical activity” • Weight, waist circumference were measured • Pedometer to act as incentive for walking

  8. RESULTS (N= 94) • Gender: females (73%) • Age: 47% (40-45 y) and 25% (>55 y ) • COB: • Turkey (45%) • Iraq (39%) • Lebanon (12%) • Obesity: 50% (BMI=30+)

  9. Knowledge of risk of diabetes? • 54.8% said yes post intervention compared to 29.8% pre-intervention (p=.069).

  10. 80 72.3 71.3 68.1 70 64.9 60.6 59.6 58.5 56.4 60 54.3 51.1 48.9 48.9 50 45.7 40.4 38.3 PRE % 40 POST 28.7 30 20 11.8 8.5 10 0 Other Stress Smoking Fast Food Overweight Cholesterol Little Exercise Family member Blood pressure Why do you think you are at risk factors of DM?

  11. 79.6 80 60.9 70 60 50 39.1 40 % No Yes 20.4 30 20 10 0 PRE POST 39.1 20.4 No 60.9 79.6 Yes Have you done anything to lower risk during last 3 months (P<0.001)

  12. Lifestyle changes after program • 89% in food preparation • 79% dietary intake • 82% shopping • 81% feeling of well being • 79% physical activity • 69% body weight

  13. Mean walking time last week pre and post intervention

  14. WeightandWaist • Weight (kg): significant reduction in weight [mean weight pre=78.1, post=77.3; Z score=-3.415 (P=0.001) • Waist circumference (cm): mean pre=99.5cm, post =96.5 Z=-2.569 (P=0.010)

  15. Effectiveness of the program using 10-points scale • 68% gave 9 or 10 points • 18% gave 7 or 8 points • 2% gave 5 points (undecided) • 2% gave 3 or 4 points

  16. What are the main reasons for not taking any actions to lower your risks?

  17. What did you like? • 77% appreciated the information • 69% the skills learned • 63% the support provided • 95% learned healthy eating skills • 70% maintaining healthy weight • 75% how to loose weight • 73% value regular exercise • 48% information access and • 42% attitudinal change

  18. Source of diabetes knowledge • Doctors (92%) • Television (70%) • Friends (54%) • Nurses (35%) • Brochures (35%) • Family (36%) • Internet (29%) • Ethnic media (29%).

  19. Comparison with other studies

  20. Meta-analysis of 11 RCTs in CALD: Improved HbA1c 3m after intervention Weight Mean Difference -0.3% at 3m and 0.6% at 6m Knowledge scores improved at 3m Healthy life style improvement at 3m Hawthorne K, Robles Y, Cannings-John R, Edwards S. Culturally appropriate health education for type 2 diabetes in ethnic minority groups. Cochrane Database of Systematic Revies 2008 (3)

  21. Conclusions • Limited intervention • Administered by trained peers equipped with culturally appropriate education • Native language • Significant improvement in: • knowledge and attitudes • limited changes in lifestyle behaviour • The changes were maintained three months after the intervention.

  22. Conclusions • The peer-led DPP was effective in improving knowledge and changeing behaviour • The program could be replicated in other CALD

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