Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive study

Objective The objective of this qualitative study was to describe the community-appropriate and culturally appropriate adaptations made by lifestyle change programme (LCP) coaches to the National Diabetes Prevention Programme curriculum for Federally Qualified Health Center (FQHC) patients in Hawaiʻ...

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Main Authors: Tetine Sentell, Catherine Pirkle, David Stupplebeen, Jermy-Leigh Domingo, Blythe Nett, L Brooke Keliikoa
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/11/e037577.full
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author Tetine Sentell
Catherine Pirkle
David Stupplebeen
Jermy-Leigh Domingo
Blythe Nett
L Brooke Keliikoa
author_facet Tetine Sentell
Catherine Pirkle
David Stupplebeen
Jermy-Leigh Domingo
Blythe Nett
L Brooke Keliikoa
author_sort Tetine Sentell
collection DOAJ
description Objective The objective of this qualitative study was to describe the community-appropriate and culturally appropriate adaptations made by lifestyle change programme (LCP) coaches to the National Diabetes Prevention Programme curriculum for Federally Qualified Health Center (FQHC) patients in Hawaiʻi, an ethnically diverse state with a high proportion of Native Hawaiians and Pacific Islanders (NHPI).Research design and methods We used a qualitative descriptive approach. First, we conducted a document review of existing programmatic notes and materials followed by video interview calls with 13 lifestyle coaches at 7 FQHCs implementing in-person LCPs. Lifestyle coaches catalogued, described and explained the rationale for adaptations. The research team counted adaptations if they met a specific adaptation definition derived from several sources. Community and cultural relevancy of adaptations were analysed using an existing framework for weight loss and diabetes prevention for NHPIs.Results The average number of adaptations per FQHC was 8.61 (range: 4–16). Adaptations fell into 11 broad categories such as off-site community field trips, food-related and nutrition-related activities, and physical activity opportunities. Novel adaptations included goal setting with motivational interviewing and dyadic recruitment. Field trips and in-class food demonstrations addressed the most constructs related to weight loss and diabetes prevention for NHPI, including social and community barriers, familial barriers and barriers to self-efficacy.Conclusions Lifestyle coaches were culturally attuned to the needs of LCP participants, particularly from NHPI communities. Policy-makers should recognise the extra work that LCP coaches do in order to increase enrollment and retention in these types of programmes.
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spelling doaj-art-21b1c76db6dc46b1be10b1a9b965fbf22024-11-25T15:15:09ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-037577Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive studyTetine Sentell0Catherine Pirkle1David Stupplebeen2Jermy-Leigh Domingo3Blythe Nett4L Brooke Keliikoa55 Thompson School of Social Work and Public Health, University of Hawai`i at Manoa, Honolulu, Hawaii, USAOffice of Public Health Studies, University of Hawai`i at Mānoa, Honolulu, Hawaii, USAOffice of Public Health Studies, University of Hawai`i at Mānoa, Honolulu, Hawaii, USAHawaii Primary Care Association, Honolulu, Hawaii, USAHawaii State Department of Health, Honolulu, Hawaii, USAOffice of Public Health Studies, University of Hawai`i at Mānoa, Honolulu, Hawaii, USAObjective The objective of this qualitative study was to describe the community-appropriate and culturally appropriate adaptations made by lifestyle change programme (LCP) coaches to the National Diabetes Prevention Programme curriculum for Federally Qualified Health Center (FQHC) patients in Hawaiʻi, an ethnically diverse state with a high proportion of Native Hawaiians and Pacific Islanders (NHPI).Research design and methods We used a qualitative descriptive approach. First, we conducted a document review of existing programmatic notes and materials followed by video interview calls with 13 lifestyle coaches at 7 FQHCs implementing in-person LCPs. Lifestyle coaches catalogued, described and explained the rationale for adaptations. The research team counted adaptations if they met a specific adaptation definition derived from several sources. Community and cultural relevancy of adaptations were analysed using an existing framework for weight loss and diabetes prevention for NHPIs.Results The average number of adaptations per FQHC was 8.61 (range: 4–16). Adaptations fell into 11 broad categories such as off-site community field trips, food-related and nutrition-related activities, and physical activity opportunities. Novel adaptations included goal setting with motivational interviewing and dyadic recruitment. Field trips and in-class food demonstrations addressed the most constructs related to weight loss and diabetes prevention for NHPI, including social and community barriers, familial barriers and barriers to self-efficacy.Conclusions Lifestyle coaches were culturally attuned to the needs of LCP participants, particularly from NHPI communities. Policy-makers should recognise the extra work that LCP coaches do in order to increase enrollment and retention in these types of programmes.https://bmjopen.bmj.com/content/10/11/e037577.full
spellingShingle Tetine Sentell
Catherine Pirkle
David Stupplebeen
Jermy-Leigh Domingo
Blythe Nett
L Brooke Keliikoa
Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive study
BMJ Open
title Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive study
title_full Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive study
title_fullStr Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive study
title_full_unstemmed Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive study
title_short Adaptions to the National Diabetes Prevention Programme lifestyle change curriculum by Hawai‘i Federally Qualified Health Centers: a qualitative descriptive study
title_sort adaptions to the national diabetes prevention programme lifestyle change curriculum by hawai i federally qualified health centers a qualitative descriptive study
url https://bmjopen.bmj.com/content/10/11/e037577.full
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