PPDP - Frequently Asked Questions

What are the aims of The Pasifika Preventing Diabetes Programme?

• The Pasifika Preventing Diabetes Programme (PPDP) primarily aims to test whether a lifestyle and peer support programme delivered across churches in the Greater Western Sydney and South-Eastern Sydney Pasifika communities can improve a blood marker called HbA1c, an indicator of glucose (sugar) level in the blood. The programme also aims to improve other clinical measures such as weight, waist circumference and blood pressure, through changes in lifestyle behaviours particularly healthy eating and physical activity. Lastly, we hope our programme can help the body weight of children and adolescents in the church families. This programme is an expansion of a pilot study, Le Taeao Afua (LTA) where we delivered the same lifestyle and peer support programme through three Sydney Samoan Churches. The PPDP is a much larger trial testing the LTA intervention into 48 Sydney Pacific churches over the next 51 months.

How will it work?

• Community members (adults, children and adolescents via their parents) will be approached to take part through the church they attend as the program is designed to be delivered on a church wide basis.
• Once the church and its members have agreed to take part in the program, an initial screening session will be done with the church to measure their blood sugar levels and other physical measures like weight, waist circumference and blood pressure. Children and adolescents will only have their weight and height measured. As soon as each church has a good proportion of their members screened, they will be randomly allocated a time that the programme will start across the church (that is the waiting time will be decided by chance). All churches will have a minimum waiting period of 6 months before they start the programme. All churches must have this waiting time so we can compare how study outcomes (e.g. HbA1c , blood sugar, weight) improve when there is no program compared to when the program is actually running.
• Prior to the programme starting, individuals from each church will have their blood sugar, weight and other measures taken again so that we can see if anything has changed while the church was waiting to start the programme.
• The programme, which is designed to help individuals make long lasting changes to their diet and physical activity to improve their health, will last for different lengths of time in each church. Based on when they start the programme, some churches will have 6 months of the program with others having up to 2 and a half years.
• Once each church has finished the program, its members will have their blood sugar, weight and other measures taken for the final time so that we can see whether the program worked or not. Individuals will also be asked what they think about the program to inform future programmes
• A very important part of the programme is that by the end each church will have trained community members to continue supporting the changes made, and local health districts will have staff in place to continue supporting the community changes after the research has finished. We hope that the research will lead to a sustainable change to healthy lives into the future.

Why is this study focused on the Pasifika community?

• Our LTA pilot study showed that community-based solutions can make a big difference in the Pasifika community. Participants in that study were more active, and with their greater knowledge were more aware of how to eat more healthily, with these healthy habits shared with their families and communities. We are continuing to focus on the Pasifika community not just because of their high rates of obesity and diabetes but also because they are well placed to understand a holistic ‘health’ versus a medical approach, and the importance of community. We feel this community approach can lead the way in revolutionising approaches to health.

How will the Pasifika community be involved in and lead this program?

• Importantly, all aspects of this programme are being overseen and led, in partnership, by a community reference group, whose members include church leaders, Pasifika community representatives as well as medical practitioners from a Pasifika background. The reference group have been asked to fulfill the role of ensuring the needs of the Pasifika community are being met as they are at the heart of this program.

Is this study a case of the Pasifika community being used as ‘Guinea Pigs’?

• Absolutely not. The Pasifika community have a huge need to prevent the terrible harm being caused by diabetes with the growing demand for avoidable kidney dialysis and other diabetes complications. No one has been able to prevent this growth to date and no one really knows how to turn this epidemic around. The only way to obtain the funding now and into the future to run a prevention program ongoing is to be able to show that what is put into place works and is good value for money. PPDP is designed to be sustainable and intended to not only help those who take part but will also help others in the community and generations to come. We aim to serve the community to help address the health problems of diabetes and obesity, thus the programme is led by the community, for the community.
• To coincide with this framework, the programme will be conducted within strict ethical guidelines to avoid causing harm or distress to any member of the Pasifika community. Further, we will exercise a strict duty if care at all times, so if for example someone presents with any serious health issues when they are screened for the programme, they will be referred to appropriate medical services before they are allowed to start the programme.
• The alternative is to continue with small, unproven strategies that are unlikely to help such a huge problem.

I have heard that if you participate in this study, you won’t be able to start getting healthy until you are told to – is that true?

• It is true that we ask the churches and congregations that have signed up for the program to try to not organize any changes to lifestyles that would not have happened without the PPDP coming to their church, before the programme starts in their church.  The reason we ask this is that if participants are able to work with their community, church and researchers to follow the steps outlined in this programme, then this will allow the researchers to create a proven, long-term health program for their community and generations to come. That does not mean we discourage anyone from taking positive action to improve their health. Further, as mentioned earlier, anyone who presents with urgent health issues will be referred for appropriate care

If you have any further questions please contact the team at ppdp@westernsydney.edu.au.