Correction: Effectiveness of the Pasifika Women's Diabetes Wellness Program (PWDWP): Protocol for a Pilot Intervention and Feasibility Randomized Controlled Trial.

[This corrects the article DOI: 10.2196/55435.].

Effectiveness of the Pasifika Women's Diabetes Wellness Program (PWDWP): Protocol for a Pilot Intervention and Feasibility Randomized Controlled Trial.

BACKGROUND: Type 2 diabetes poses public health challenges for Maori and Pasifika communities in Australia. The women of these communities face a greater burden from type 2 diabetes-related mortality and comorbidities. Lifestyle modification behaviors through previous women's wellness programs have been shown to reduce the risk of developing complications in established type 2 diabetes. The Pasifika Women's Diabetes Wellness Program (PWDWP) pilot study, co-designed with Maori and Pasifika communities, was aimed at addressing late hospital presentations from diabetes-related complications. OBJECTIVE: This study (1) examines the efficacy of women with type 2 diabetes in the intervention group for improved glycated hemoglobin (HbA1c) clinical levels and diabetes self-management compared with the control group from baseline (T0) to week 12 (T1) and week 24 (T2; postintervention) and (2) assesses the cultural adaptability, acceptability, and feasibility of the pilot intervention for future studies. METHODS: This study uses a quasiexperimental design that involves a 24-week intervention. We recruited 50 Maori and Pasifika women with type 2 diabetes (25 in the intervention group from the south side of Brisbane and 25 in the control group from the north side of Brisbane) using participatory talanoa methodologies. The intervention group participated in face-to-face and virtual whanau education workshops (5 weeks) and had access to individual coaching and virtual support delivered by trained Maori and Pasifika health professionals and community health workers. The control group received usual care with their identified health provider. Both groups received copies of the PWDWP journal, fact sheets, and a health check passbook with tailored motivational text messages. An advisory committee was set up to oversee the program implementation, including protocols of engagement, health checks, and data collection in community settings. The quantitative data were collected at T0, T1, and T2 with HbA1c as the primary outcome measure. Secondary outcomes measured changes in diabetes self-care and body composition (eg, BMI, waist circumference). Qualitative data will ascertain the program's feasibility and cultural adaptability using talanoa focus groups. RESULTS: This pilot study was approved by the Queensland University of Technology Human Ethic Research Committee (5609) and began in January 2023 after participant recruitment between July 2022 and December 2022. The final data collection including the health check, focus group, and survey data was completed in November 2023, and data analysis and reporting are expected to conclude in 2024. CONCLUSIONS:  This study provides a blueprint for PWDWP. Collaborative partnerships with community organizations and stakeholders are crucial for program success and suggest a potential model for targeting diabetes management for Maori and Pasifika communities, emphasizing the need for culturally relevant interventions. The findings will have significant implications for policymakers and practitioners when developing and implementing public health initiatives, particularly for communities with unique cultural nuances. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12622001100785p; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384470&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55435.

"Food Is Our Love Language": Using Talanoa to Conceptualize Food Security for the Maori and Pasifika Diaspora in South-East Queensland, Australia.

Queensland is home to the largest diaspora of Maori and Pasifika peoples in Australia. They form an understudied population concerning experiences and challenges of food insecurity. This community co-designed research aims to explore the conceptualization of household food security by Maori and Pasifika peoples living in south-east Queensland. Participatory action research and talanoa were used to collect and analyse forty interviews with leaders representing 22 Maori and Pasifika cultural identities in south-east Queensland. Eight key themes emerged that conceptualise food security as an integral part of the culture and holistic health. These themes included: spirituality, identity, hospitality and reciprocity, stigma and shame, expectations and obligations, physical and mental health and barriers and solutions. Addressing food insecurity for collectivist cultures such as Maori and Pasifika peoples requires embracing food sovereignty approaches for improved food security through the co-design of practical solutions that impact social determinants and strengthen existing networks to produce and distribute affordable and nutritious food.

Using Talanoa in Community-Based Research with Australian Pacific Islander Women with Type 2 Diabetes.

BACKGROUND: Type 2 diabetes is a significant public health problem and Australian Pacific Islander (API) women and their communities are experiencing a higher burden of morbidity and mortality from the disease. Despite this higher burden there are few initiatives that are culturally tailored to improve prevention and management. OBJECTIVES: We used talanoa, a community-based research methodology to build capacity with API women living in Queensland and to develop culturally relevant methods of information sharing and knowledge building. METHODS: The partnership informed the co-design and conduct of research using a talanoa methodology framework. LESSONS LEARNED: Talanoa was used in negotiating the research partnership, setting up a steering committee, developing protocols for community engagement, collecting and co-constructing knowledge and disseminating community outcomes. CONCLUSIONS: The community-academia partnership and the participatory processes using talanoa facilitated dialogue and engagement to promote diabetes prevention and management for API communities.

Deconstructing type 2 diabetes self-management of Australian Pacific Islander women: Using a community participatory research and talanoa approach.

Community-based participatory research using culturally appropriate talanoa approaches provided the framework to explore diabetes self-management of Australian Pacific Islander (API) women living with type 2 diabetes in South-East Queensland. Data collection included interviews with key informants (21), in-depth interviews with API women with diabetes (10), talanoa group discussions (7) and monthly steering committee meetings. Using an interpretive-constructionist lens and the interpretations of community members, four cultural constructs in diabetes self-management emerged: self-identity, spirituality, stigma and denial, and structural factors. Self-identity connected the women to their Pacific heritage that framed their collective roles as primary caregivers in the community. This gave the women a strong sense of belonging and helped maintain cultural, family and relational connections which were important for their day-to-day management of diabetes. Although spirituality through religion supported the women to cope with their diabetes a total reliance on God resulted in disengagement with self-care. Shame associated with disclosure also prevented effective self-management. Finally, structural factors such as access to healthcare, poor health literacy and cultural barriers associated with obesogenic environments impeded women from seeking appropriate diabetes care. However, family and community were critical in ensuring women were supported with their diabetes self-management. The findings highlight the importance of engaging families in healthcare planning decisions in the development of culturally responsive models of diabetes support care for API women with type 2 diabetes.

Predicting intentions and behaviours in populations with or at-risk of diabetes: A systematic review.

PURPOSE: To systematically review the Theory of Planned Behaviour studies predicting self-care intentions and behaviours in populations with and at-risk of diabetes. METHODS: A systematic review using six electronic databases was conducted in 2013. A standardised protocol was used for appraisal. Studies eligibility included a measure of behaviour for healthy eating, physical activity, glucose monitoring, medication use (ii) the TPB variables (iii) the TPB tested in populations with diabetes or at-risk. RESULTS: Sixteen studies were appraised for testing the utility of the TPB. Studies included cross-sectional (n = 7); prospective (n = 5) and randomised control trials (n = 4). Intention (18%-76%) was the most predictive construct for all behaviours. Explained variance for intentions was similar across cross-sectional (28-76%); prospective (28-73%); and RCT studies (18-63%). RCTs (18-43%) provided slightly stronger evidence for predicting behaviour. CONCLUSIONS: Few studies tested predictability of the TPB in populations with or at-risk of diabetes. This review highlighted differences in the predictive utility of the TPB suggesting that the model is behaviour and population specific. Findings on key determinants of specific behaviours contribute to a better understanding of mechanisms of behaviour change and are useful in designing targeted behavioural interventions for different diabetes populations.