None listed
Conditions
Brief summary
Objectives: The objective is to develop and test a community competition-based behaviour change intervention to reduce diabetes and cardiovascular risk among Maori and Pacific adults. The aim of the study is to incentivise Maori and Pacific adults to lose weight and reduce their waist circumference through a team-based community and online competition. Study design and methodology: This is a quasi-experimental controlled pilot study that will compare an intervention group with a consecutive but separately recruited group of matched (on ethnicity, gender & age) controls. Study population: Maori people will be recruited in Northland (N=100) and Manawatu (N=100), and 100 Pacific people will be recruited in Auckland. Number of subjects: 300 Main criteria for inclusion: The eligibility criteria are: 1) who are obese (BMI of 30 or over) AND either or all of the following: 2a) at risk of developing type 2 diabetes (HbA1c of 41-49 mmol/mol) or who have been diagnosed with type 2 diabetes (HbA1c >=50 mmol/mol) or 2b) at risk of cardiovascular disease as defined by a ‘elevated cholesterol’, compared to the laboratories’ normal range, in a test blood during the last 12 months), or who have been diagnosed with cardiovascular disease AND 3) is enrolled or willing to enrol with a primary health care provider and is willing to have a blood test for HbA1c and cholesterol. Exclusion criteria: People will be excluded if they are: 1) Under 16-years old 2) Pregnant or planning a pregnancy within the next year 3) Women who have had a live baby in the past 6-months and who are still breastfeeding 4) People who self-report current smoking of tobacco or marijuana, or who use nicotine replacement products or nicotine from any other source (e.g. electronic devices). Statistical methods: Descriptive statistics will be produced. Chi-squared tests will be used for categorical variables and ANOVA tests for continuous variables. Inductive thematic analysis will be used to identify major themes in qualitative data.
Interventions
This is a quasi-experimental controlled pilot study that uses the following component to reduce weight for participants who are (pre- or) diabetic or who have (pre- or) cardiovascular disease. The intervention was conducted over 6 months.
Wehi was designed based on Maori and/or Pacific values. That is:
1) the prize was donated to participants selected charity,
2) team, rather than individual focus for competition
3) Maori and Pacific people in NZ have high participation in competition.
Based
This is a quasi-experimental controlled pilot study that uses the following component to reduce weight for participants who are (pre- or) diabetic or who have (pre- or) cardiovascular disease. The intervention was conducted over 6 months. Wehi was designed based on Maori and/or Pacific values. That is: 1) the prize was donated to participants selected charity, 2) team, rather than individual focus for competition 3) Maori and Pacific people in NZ have high participation in competition. Based upon the literature WEHI include the following components: 1) Intervention participants were provided with a list of daily challenges (see details in list below). The participants could choose to perform as many or as few of these challenges as the decide. They were required to fill in a diary of what challenges they did each day. The teams were required to submit the number of members who had done each challenge each day. That is, points were allocated to the teams, but not to the individuals. Daily challenges list was: -For 10 daily points: Sugar-free Drink Day A day without drinking sugar-sweetened soft drinks or fruit juices or cordials. 3+ Vege Day A day when at least 3 servings of vegetables were consumed. Exercise Day A day when at least half an hour continuous walking or more strenuous exercise was completed. -For 8 points: 1/4, 1/4, 1/2 dinner Day A day when the main meal is made up of ½ vegetables, ¼ protein and ¼ carbohydrates. Fast & Fried-Free Day A day without fast or fried food. Sweet Treat-free Day A day without eating sugar-sweetened biscuits, cakes, lollies, chocolate or desserts. -For 6 daily points: Stand Up Day A day when long periods of sitting down are broken up by standing for at least a minute and this is done at least 3 times (once in the morning, once in the afternoon and once in the evening). Build Me Up Day A day when at least 10 continuous minutes was spent focused on learning about or practising a new behaviour that will reduce stress, improve sleep quality or improve knowledge of nutrition. Visiting the WEHI website, reading the Tip of the Day and posting on your team page can count towards this. Water First Day A day of drinking a glass of water no more than 5 minutes before eating each of your 3 main meals (breakfast, lunch & dinner). 2)Teams were supported with team activity summary sheets and a fridge magnet as a mnemonic to remind participants of the daily challenges. The teams were supplied with a set of bathroom scales to use as they wish to track their progress. 3)WEHI participants are encouraged, through information provided on a wehi dedicated website (wehi.nz) to use whatever non-surgical methods, diets, programmes or health and fitness providers they want and can access at their own cost. No particular dietary intervention will be promoted, although Ministry of Health guidelines on healthy eating and physical activity will be followed for the development of tips and team weekly challenge activities. Furthermore, the use of supplements will be discouraged as many products are costly with no known scientific basis of efficacy. Group support WEHI participants compete in teams of seven, which boost peer social support and enable the dynamics of whanaungatanga (a relationship through familial and shared experiences) to operate. Each team will be self-directing in terms of organising their team meetings and activities. Teams can receive support from the regional intervention worker though this should be equitably provided to each of the teams to avoid advantaging one team over the others. Incentives In each region, three prizes are offered: 1) Greatest progress at 2 months - $1000 2) Greatest progress at 4 months - $1000 3) Greatest progress at 6 months - $3000 The prizes are paid out to the team’s nominated charity or community organisation. This fundraising aspect is expected to appeal to participants’ existing sense of duty to raise funds for cultural or local community events and other needs. This may provide additional motivation over and above any motivation to lose weight for their own benefit.
Sponsors
Marewa Glover
Study design
Allocation
Non-randomised trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1) who are obese (BMI of 30 or over) AND either or all of the following: 2a) at risk of developing type 2 diabetes (HbA1c of 41-49 mmol/mol) or who have been diagnosed with type 2 diabetes (HbA1c >50 mmol/mol) or 2b)at risk of cardiovascular disease as defined by a ‘elevated cholesterol’, compared to the laboratories’ normal range, in a test blood during the last 12 months), or who have been diagnosed with cardiovascular disease AND 3) is enrolled or willing to enrol with a primary health care provider and is willing to have a blood test for HbA1c and cholesterol.
Exclusion criteria
1)Under 16-years old 2)Pregnant or planning a pregnancy within the next year 3)Women who have had a live baby in the past 6-months and who are still breastfeeding 4)People who self-report current smoking of tobacco or marijuana, or who use nicotine replacement products or nicotine from any other source (e.g. electronic devices). This is because nicotine is a known appetite suppressant and could confound the results.
Outcome results
None listed