Process evaluation of a multi-institutional community-based program for diabetes prevention among First Nations

Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA.
Health Education Research (Impact Factor: 1.66). 05/2008; 23(2):272-86. DOI: 10.1093/her/cym031
Source: PubMed


Epidemic rates of diabetes among Native North Americans demand novel solutions. Zhiiwaapenewin Akino'maagewin: Teaching to Prevent Diabetes was a community-based diabetes prevention program based in schools, food stores and health offices in seven First Nations in northwestern Ontario, Canada. Program interventions in these three institutions included implementation of Grades 3 and 4 healthy lifestyles curricula; stocking and labeling of healthier foods and healthy recipes cooking demonstrations and taste tests; and mass media efforts and community events held by health agencies. Qualitative and quantitative process data collected through surveys, logs and interviews assessed fidelity, dose, reach and context of the intervention to evaluate implementation and explain impact findings. School curricula implementation had moderate fidelity with 63% delivered as planned. Store activities had moderate fidelity: availability of all promoted foods was 70%, and appropriate shelf labels were posted 60% of the time. Cooking demonstrations were performed with 71% fidelity and high dose. A total of 156 posters were placed in community locations; radio, cable TV and newsletters were utilized. Interviews revealed that the program was culturally acceptable and relevant, and suggestions for improvement were made. These findings will be used to plan an expanded trial in several Native North American communities.

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Available from: Joel Gittelsohn, Feb 19, 2015
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    • "The BHC trial was well implemented with moderate to high dose delivered and high fidelity. Our process evaluation findings were consistent with studies conducted in other settings aimed at modifying the retail food environment [29,30,33]. BHC had a mean promoted entrée availability of 92%, which was higher than 70% seen in the First Nations retail food stores in Northwest Ontario, Canada [33] and 78% seen in Apache reservations in East-central Arizona [30]. "
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    Full-text · Article · Jul 2013 · BMC Public Health
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    • "Table 10.2: Geographic Location of Studies Location Study British Columbia Barton, Anderson, and Thommasen 2005; Buxton et al. 2007; Daniel et al. 2004; Macnab et al. 2008; Macnab et al. 2005; Panagiotopoulos et al. 2007; Reading et al. 2005; Smith et al. 2006; Thommasen et al. 2006; Thommasen and Zhang 2006; Thommasen et al. 2005; Wardman, Quantz, and Clement 2006; Wardman, Clement, and Quantz 2005 Ontario Minore et al. 2004; Saksvig et al. 2005; Sharma et al. 2008; Skinner, Hanning, and Tsuji 2006; Pollex et al. 2006, 484–491, Pollex et al. 2006, 121–129; Peressini et al. 2004, 382–382e, Peressini et al. 2004, 101–110; Rosecrans et al. 2008 "

    Full-text · Article · Jan 2013
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    • "This study is not a programme evaluation but rather a description of a pilot programme in one community. To conduct a comprehensive evaluation on interventions, such as the SLWEREI, there is a need to look at the programme and responses across multiple communities (17). "
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