Ka Wai Ola - Office of Hawaiian Affairs, Volume 31, Number 2, 1 February 2014 — Health interventior program ready for wider release [ARTICLE]

Health interventior program ready for wider release

By Lisa Asato Apair of weight-loss and diabetes-management programs that have shown heartening results in Hawaiian eommunities are looking to expand their reaeh. The Partnership for Improving Lifestyle Intervention 'Ohana Projeet, known as PILI 'Ohana, hopes to expand statewide by disseminating the programs through organized entities sueh as Hawaiian eivie elubs and

Hawaiian homestead eommunities. "For the next three years, we're tasked to go out and spread PILI out to the mueh larger Native Hawaiian eommunity," said Puni Kekauoha, a PILI 'Ohana eo-direetor who served for eight years as PILI's eommunity investigator with the Papakōlea health and edueation nonprofit Kula no nā Po'e Hawai'i. "Our job right now is to . . . not just tell people about PILI but more importantly train faeilitators in different communities to conduct PILI 'Ohana with their own demographic location or group." Under a just-ended two-year grant from OHA, PILI field-tested its eommunity training and mentoring model. Kekauoha's team trained a group from the Wai'anae Valley Homestead Community Association, whose participants, she said, "lost a substantial amount of weight." After receiving training, homesteaders did their own outreach, including making flyers and going door-to-door. They also conducted focus groups along with baseline and three-month assessments. Because they managed their own program, they eame away with a sense of self-reliance. Kekauoha said she also saw that happen in Papakōlea, a homestead eommunity, where more than 200 people have participated in PILI since its inception in 2005 . The skills leamed in managing the program are transferrable to future projects, she said. "The power is in the people who live in the community." The project offers two programs - one nine-month program for weight loss and maintenance called the PILI Lifestyle Program, and a three-month program for managing diabetes, called Partners in Care. Participation is free. And while communities would lead their own programs, facilitators provide input and guidance along the way. On Hawai'i Island, Ke Ola Mamo, 0'ahu's Native Hawaiian Health Care System, mentored a group in Pana'ewa to implement the weight-loss and maintenance program. Ke Ola Mamo provided them with operational support, such as materials for assessments and lessons, and a motivated group of volunteers took ownership, said Donna-Marie Palakiko, programs manager at Ke Ola Mamo, a PILI 'Ohana partner. "They pulled speakers from their own community to help them (learn about) lomilomi (massage), lā'au lapa'au (traditional medicine), how to do container gardening," she said. "They were able to negotiate memberships to gyms in Hilo so members could adopt a fitness regimen." The programs ean be tailored to fit a community's needs, such as what time of day to meet and what kinds of activities to do and where. The program is flexible that way, Palakiko said. Participants in the PILI 'Ohana weight-loss program also show improved blood sugar levels, a key measurement of diabetes. For the Pearl Harbor Hawaiian Civic Club, about half of its 15 participants found they no longer qualified for the diabetes self-management program Partners in Care, because their blood sugars had improved - along with their weights - through PILI 'Ohana.

1"That's a very good sign," said Claire Hughes, a community investigator for PILI 'Ohana partner Hawai'i Maoli, a nonprofit of the Association of Hawaiian Civic Clubs. "That shows even without the specific focus on diabetes, PILI

helps." Hughes, a former chief of the nutrition branch at the state Department of Health, said the programs are "very mueh like some of the Hawaiian Diet programs I consulted with from the department . . . in that you go out into the community and people in the community actually carry out the work." The civic club participants, whieh included Kuini Pi'olani and Lāhainā civic clubs, embraced what they learned as lifestyle changes. When they went out to eat as a group, they applied what they learned about choices and portion control and tucked extra servings of ehieken into take-home containers before eating. Members also kept in touch via social media to send reminders about meetings and eheek on people's weight, blood sugar and blood pressure. The Pearl Harbor civic club, whieh appointed its own "food specialists," was especially good in learning about new

foods and food sources, and bringing information back to share, such as how to plant sprouts or where to find food products at cheaper prices. The club "instituted a more focused change on nutrition," Hughes said. "That's a lasting change." Other partners in PILI 'Ohana are the Department of Native Hawaiian Heahh at the John A. Burns School of Medicine and Kōkua Kalihi ValleyComprehensive Family Services. The three-year dissemination effort is funded by the National Institute on Minority Heahh and Heahh Disparities, whieh also funded the parent PILI 'Ohana Project. ■

HEALĪH

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How to participate The PILI 'Ohana project is interested in hearingfrom community leaders who wishtobringtheprograms into their communities. It is not as interested in hearing from individuals seeking to lose weight. To inquire, email pili.ohana. mail@gmail.com