Development and piloting of a community health worker-based intervention for the prevention of diabetes among New Zealand Maori in Te Wai o Rona: Diabetes Prevention Strategy

Public Health Nutr. 2008 Dec;11(12):1318-25. doi: 10.1017/S1368980008002711. Epub 2008 Jun 12.


Objective: The progression from impaired glucose tolerance (IGT)/impaired fasting glucose (IFG) to type 2 diabetes can be prevented or delayed through intensive lifestyle changes. How to translate this to implementation across whole communities remains unclear. We now describe the results to a pilot of a personal trainer (Maori Community Health Worker, MCHW) approach among Maori in New Zealand.

Design, setting and subjects: A randomised cluster-controlled trial of intensive lifestyle change was commenced among 5,240 non-pregnant Maori family members without diabetes from 106 rural and 106 urban geographical clusters. Baseline assessments included lifestyle questionnaires, anthropometric measurements and venesection. A pilot study (Vanguard Study) cohort of 160 participants were weighed before and during MCHW intervention, and compared with fifty-two participants weighed immediately before intervention and with 1,143 participants from the same geographical area. Interactions between participants and the MCHW were reported using personal digital assistants with a programmed detailed structured approach to each interview.

Results: During the Vanguard Study, participants and MCHW found the messages, toolkit and delivery approach acceptable. Those with IGT/IFG diagnosed (n 27) experienced significant weight loss after screening and during the Vanguard Study (5.2 (sd 6.6) kg, paired t test P < 0.01). Significant weight loss occurred during the Vanguard Study among all participants (-1.3 (sd 3.6) kg, P < 0.001).

Conclusions: Comparable initial weight loss was shown among those with IGT/IFG and those from existing trials. Community-wide prevention programmes are feasible among Maori and are likely to result in significant reductions in the incidence of diabetes.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anthropometry
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Cluster Analysis
  • Community Health Services / organization & administration*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diet*
  • Exercise / physiology
  • Feasibility Studies
  • Female
  • Glucose Tolerance Test
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • New Zealand
  • Pilot Projects
  • Weight Loss*


  • Blood Glucose