A community-based lifestyle intervention program addressing non-communicable disease in islands of the South Pacific

Using the Reflect community empowerment methodology to deliver a Pacific Island contextualised version of the Complete Health Improvement Program which addresses the domains of diet, physical activity, substance use, stress and positive psychology. The CHIP intervention has shown benefits for the management and reversal of chronic diseases in adults of all ages and has been described by the American College of Lifestyle Medicine as “achieving some of the most impressive clinical outcomes published in the literature”. The clinical effectiveness of CHIP has been documented in over 25 peer-reviewed publications in medical and scientific academic journals. CHIP programs have been conducted in the Solomon Islands and Fiji, however, the effectiveness of CHIP in these South Pacific countries has not been examined. the CHIP program contains sessions on the prevalence of chronic disease, lifestyle medicine, the common denominators of chronic disease, evidence for lifestyle changes, benefit of a plant-based diet, importance of fibre, exercise, social support, forgiveness, dealing with anger and fostering positive emotions. Reflect is an innovative approach to adult literacy and social changes, which fuses the theories of Brazilian educator Paulo Freire with participatory methodologies. It was developed in the 1990s through pilot projects in Bangladesh, Uganda and El Salvador and is now used by over 500 organisations in over 70 countries worldwide. It is used by local, national and international non-government organisations, by social movements, people’s organisations, district and regional governments. The approach is highly recognised, and programs using Reflect won UNESCO literacy prizes in 2003, 2005, 2007, 2008 and 2010. This methodology uses small group work that is unisex or gender specific when dealing with gender related issues to do with social change in a Pacific context. The program is delivered by facilitators sourced from the local village who can speak and read English and have completed at least year 12 of high school. The material for each session is pre-prepared so that the facilitators only need to follow a script. This program will contextualise CHIP for rural/semi-rural areas of Fiji and Vanuatu using the Reflect methodology to deliver the CHIP content. The program will be delivered over 6 months, intensive for the first month at 3 x one-hour sessions per week followed by 1 x one-hour session per week for remaining 5 months of the program. Adherence will be measured by a questionnaire administered at baseline, one month, 3 months and 6 months.,