None listed
Conditions
Brief summary
High rates of chronic disease persist in remote Indigenous communities in North East Arnhem Land. A community-developed and led nutrition and lifestyle program, Hope for Health (HfH), has been developed in Galiwin’ku, Elcho Island, with promising preliminary results. This trial seeks to evaluate the effectiveness and acceptability of this program and provides a wider platform to work with partners and the community towards structural changes in understanding about healthy nutrition, healthy food availability, school education and community initiatives around healthy lifestyle. Diet modification leading to even moderate weight loss drastically improves cardiometabolic risk in overweight and obese people. This study is a single arm pre and post study designed to develop an evidence base for an innovative community-developed and controlled, experiential learning program (HfH) that is based on the premise that traditional values and kinship are fundamental to physical health for Aboriginal Australians. Primary objective is to determine if the proportion of participants achieving weight loss following HfH at the end of the program in overweight and obese adults is at least 10%, as measured by achieving weight reduction from baseline of at least 5%. The study is performed in Galiwin'ku, Elcho Island, Northern Territory including 70 indigenous residents.
Interventions
The Hope for Health (HfH) lifestyle program. A holistic initiative combining traditional indigenous practices with modern approaches to health nutrition and lifestyle. Specifically, the program is divided into two parts:
1. A traditional 2-week retreat, taking people out of their home environment to stay in natural bush land, and providing culturally and linguistically effective two-way education that targets gaps in understanding of nutrition and health. The retreat involves nutrition and he
The Hope for Health (HfH) lifestyle program. A holistic initiative combining traditional indigenous practices with modern approaches to health nutrition and lifestyle. Specifically, the program is divided into two parts: 1. A traditional 2-week retreat, taking people out of their home environment to stay in natural bush land, and providing culturally and linguistically effective two-way education that targets gaps in understanding of nutrition and health. The retreat involves nutrition and health education, training in lifestyle skills, exercise, cooking and stress management. This program (Hope for Health) is a readily available program delivered by Why Warriors Org Ltd. 2. Support and Mentoring (3.5 months) includes individual case management and regular activities, provided for 14 weeks after the retreat. Participants receive support to tackle other systemic barriers that directly affect their ability to instigate lifestyle changes, such as choosing healthy food options at the store, dealing with difficulties in storing fresh produce at home, overcoming poor sleep and family stress from substance abuse and overcrowding, and seeking assistance for gambling. Importantly, dietary advice, home cooking demonstrations (usually conducted outside the house), and fitness activities are open for all household members, with the aim of imparting new knowledge and skills to a broader community. The support and mentoring will be delivered by the local members of Hope for Health team in conjunction with Miwatj Health and The Arnhem Land Progress Aboriginal Corporation nutritionists. At least weekly activities (health coach appointments) will be organised, determined through a participatory process, emphasising opportunities for peer-support discussion (yarning). Activities include grocery shopping, cooking, dance, walking, and gathering traditional foods. The Hope for Health team will provide outreach to participants households, with a focus on demonstrating preparation of health meals. One-on-one mentoring will assist with problem solving and lifestyle changes, including feedback and review of personal results. The weekly activities will be delivered through a combination of face-to-face meetings and phone meetings. The frequency of activities will occur at least once a week for a duration of 1-3 hours. Attendance at scheduled meeting with the Hope for Health coach will be monitored and recorded for active participants and visits to Miwatj Health will be recorded for controls. Significant noncompliance is defined as missing two consecutive health coach appointments. Participants who are significantly noncompliant will be visited by the Hope for Health coach to discuss barriers and challenges to attending, and options for making this easier.
Sponsors
University of Melbourne
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Additional inclusion of participants with a body mass index (BMI) greater than or equal to 25 kg/m2 or waist circumference greater than >94cm for males and >80cm for females. I.e updated Key inclusion criteria should be as following: 1. Adults greater than or equal to 18 years of age to less than or equal to 65 years of age 2. Body mass index (BMI) greater than or equal to 25 kg/m2 or waist circumference greater than 94cm for males and greater than 80cm for females 3. Residents of Elcho Island 4. Expressed interest and agreed to undertake the HfH program 5. Not expected to leave the Island for more than 2 weeks in the 4 months after enrolment 6. Provided a signed and dated informed consent form
Exclusion criteria
1. Has unstable diabetes with episodes of hypoglycaemia and/or ketoacidosis in the last 12 mo 2. Has insulin dependent diabetes 3. Has chronic renal failure that impairs daily function 4. Has cardiac failure 5. Has cirrhosis 6. Has other factors limiting ability to participate 7. Past participants on the HfH program 8. Women who are pregnant
Outcome results
None listed