Peer-led Diabetes Prevention Program for TASC in Melbourne
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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

Peer-led Diabetes Prevention Program for TASC in Melbourne

Nabil Sulaiman

“International Congress on CDSM, Melbourne Nov 2008”


Aims of peer led
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


Methodology how
Methodology- how?

Design:Pre and post intervention trial (action research methods)

  • Advisory Group

  • Peer- leaders

  • Diabetes prevention program

  • Participants

  • Evaluation


Methodology how1
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


Program components
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.


Outcome indicators
Outcome Indicators

  • Changes in knowledge and attitudes

  • Changes in behaviours

  • Changes in body weight and waist circumference


Data collection
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


Results n 94
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+)


Knowledge of risk of diabetes
Knowledge of risk of diabetes?

  • 54.8% said yes post intervention compared to 29.8% pre-intervention (p=.069).


Peer led diabetes prevention program for tasc in melbourne nabil sulaiman

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?


Peer led diabetes prevention program for tasc in melbourne nabil sulaiman

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)


Lifestyle changes after program
Lifestyle changes after program

  • 89% in food preparation

  • 79% dietary intake

  • 82% shopping

  • 81% feeling of well being

  • 79% physical activity

  • 69% body weight



Weight and waist
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)


Effectiveness of the program using 10 points scale
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



What did you like
What did you like? lower your risks?

  • 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


Source of diabetes knowledge
Source of diabetes knowledge lower your risks?

  • Doctors (92%)

  • Television (70%)

  • Friends (54%)

  • Nurses (35%)

  • Brochures (35%)

  • Family (36%)

  • Internet (29%)

  • Ethnic media (29%).



Meta analysis of 11 rcts in cald

Meta-analysis of 11 RCTs in CALD: lower your risks?

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)


Conclusions
Conclusions lower your risks?

  • 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.


Conclusions1
Conclusions lower your risks?

  • The peer-led DPP was effective in improving knowledge and changeing behaviour

  • The program could be replicated in other CALD