10th November 2017, Volume 130 Number 1465

Margaret Williams, Simeon Cairns, David Simmons, Elaine Rush

Improving blood glucose, lipids, weight and blood pressure reduces complications among patients with type-2 diabetes mellitus.1,2 Such improvements can be realised through increased physical activity, healthy eating and appropriate pharmacological…

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Summary

In Aotearoa/New Zealand, the participation of Māori in the national Green Prescription lifestyle programme is lower than for New Zealand Europeans (Pakeha). A kaupapa Māori informed trial examined, for Māori and Pakeha people newly diagnosed with type 2 diabetes, if face-to-face or telephone delivery of the Green Prescription resulted in better engagement. Near equal participation of both Māori and Pakeha in the trial was achieved with improved health regardless of the mode of delivery, face-to-face or telephone.

Abstract

Aim

In Aotearoa/New Zealand, the proportion of Māori who participate in the national Green Prescription lifestyle programme is lower than for New Zealand Europeans. We compared the uptake and effectiveness of two modes of Green Prescription delivery: face-to-face and telephone among both Māori and New Zealand Europeans.

Method

Sixty-eight Māori and 70 New Zealand Europeans with type-2 diabetes participated in this six-month randomised trial of the two modes of delivery. Recruitment integrated an explicitly Māori culturally sensitive approach. All participants received lifestyle intervention. Anthropometry, blood lipids and glycated haemoglobin were measured before and after the intervention.

Results

The face-to-face approach (first meeting) yielded 100% uptake into the programme among both Māori and New Zealand Europeans. At six months there were overall reductions in weight (1.8; [95 CI%, 0.6, 2.9kg]), waist circumference (3.7 [2.6, 4.8cm]), and total cholesterol (0.6 [0.3, 0.9mmol/l]) and glycated haemoglobin (3.1 [-0.2, 6.7mmol/mol]). There were no significant differences by mode of delivery, ethnicity or gender.

Conclusion

The Green Prescription programme resulted in small but clinically favourable improvements in health outcomes for type-2 diabetes patients, regardless of the mode of delivery for both Māori and New Zealand Europeans.

Author Information

Margaret Williams, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland; Simeon Cairns, School of Sport and Recreation, Auckland University of Technology, Auckland; David Simmons, School of Medicine, Western Sydney University, Australia; Elaine Rush, Centre for Child Health Research, Auckland University of Technology, Auckland.

Acknowledgements

The authors wish to acknowledge Ministry of Health New Zealand for funding the delivery component of the GRx health service, and Sport Waikato for employing the GRx kaiwhakahaere (facilitators) to deliver the GRx programme.

Correspondence

Dr Margaret Williams, School of Public Health and Psychosocial Studies, Auckland University of Technology, 640 Great South Road, Manukau, Auckland 2025.

Correspondence Email

marwilli@aut.ac.nz

Competing Interests

Nil.

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