Abstract
This study reports on integrating community perspectives to adapt a family-focused, culturally appropriate behavioural intervention program to prevent diabetes among Aboriginal children (6–11 years) in Central Australia. A participatory action research approach was used to engage a range of service providers, cultural advisors, and family groups. Appropriateness, acceptability, content, and delivery of a prevention program within the Central Australian context were discussed through a series of workshops with twenty-five service providers and seven family groups separately. The data obtained were deductively coded for thematic analysis. Main findings included: (i) the strong need for a diabetes prevention program that is community owned, (ii) a flexible and culturally appropriate program delivered by upskilling community members as program facilitators, and (iii) consideration of social and environmental factors when implementing the program. It is recommended that a trial of the adapted prevention program for effectiveness and implementation is led by an Aboriginal community-controlled health service.
Highlights
Being a local community member, S.M. was passionate about the proposed diabetes prevention program and her involvement was instrumental in providing a safe space for families and other community members to share their views and stories
“working with the settings—with the stores, with the hostels, the food supply” to enhance uptake of behaviours promoted by the adapted program. This consultation project informed the adaptation of the Tribal Turning Point (TTP) program for Aboriginal children and their families in Central Australia
The review highlighted the need for an appropriate evaluation methodology to further strengthen the evidence for program effectiveness [44]. These findings align with the suggestions raised by the cultural advisors who participated in our study, who advocated for a thorough evaluation plan of the proposed diabetes prevention program
Summary
T2DM and obesity in children and adolescents are escalating global concerns [1]. Obesity is a key risk factor for T2DM, with other contributing factors observed including intergenerational factors (maternal overweight/obesity and in utero exposure to hyperglycaemia) as well as social determinants of health [2,3,4,5]. In Australia, the incidence rates of T2DM are 18 times higher among Aboriginal and Torres Strait Islander children and adolescents compared to non-Aboriginal youth [6,7,8]. The recent national Aboriginal and Torres Strait Islander Health Survey reports a significant rise in the proportion of children aged 2–14 years old affected by overweight or obesity from 30% in 2012–2013 [9] to 37%
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