HOPE for diabetes prevention

The HOPE programme is a powerful grassroots initiative from Diabetes NZ’s Auckland branch. We talked to the HOPE co-ordinator Iliana Fusitua.

HOPE (formerly Healthy Options Positive Eating) is a family-centred, culturally appropriate programme, teaching about healthy eating and fun physical activities for the whole whānau, in order to prevent and manage diabetes in communities most at risk of type 2 diabetes.

The HOPE programme is changing lives across Auckland and has been since 2008. This year, HOPE coordinator Iliana Fusitua spent her first three weeks of lockdown adapting the programme so it could also be delivered online. The new online option, “HOPE@Home”, is making the programme even more accessible, especially when participants are unable or too scared to leave their homes.

COMMUNITY DRIVEN

Iliana says, “HOPE is a familybased diabetes prevention programme that’s all about giving participants more knowledge.” The HOPE programme takes four months, with four weekly sessions covering a range of topics that include what diabetes is, cultural attitudes towards food, interactive cooking demonstrations, and exercise sessions. There is a family challenge and then a one-month and three-month follow-up to check on progress.

“It's interactive – you don’t just sit and listen to lectures. Usually, we have a minimum of 15 participants and a maximum of 25, and we go beyond health. Some people share their personal journeys and problems. You have to look at it from a holistic point of view instead of just focusing on diabetes.”

The programme relies on volunteers known as HOPE Champions who are trained to deliver the HOPE programme in their communities. “HOPE Champions are our connections to the community. These are the people who will go out to their own communities, recruit participants, and deliver the programme there. The focus is on at-risk communities – Māori, Pasifika, and South Asian – so we go out to churches, temples, community organisations, and other groups like elderly groups and exercise groups.

“And because the HOPE Champions know their community well, they know how to adjust the course content to suit them – the language, the recipes, the activities.”

Iliana says it’s important that the changes people are encouraged to make fit with their lifestyles and are culturally appropriate. “Sometimes, people will say, my doctor said that I have to stop eating my taro … But we can't do that to people. I say, you don't have to stop eating your taro. It's just about controlling the portion size.

“Or, for example, we love our corned beef, and you'd normally just eat it straight from the can, but it has a lot of saturated fat in it. So when we go out and deliver the HOPE programme to Pasifika, one of our recipes is corned beef, but we cook it in a healthier way. We show them how to drain the fat off and then bulk it up with a lot of veggies. You still can have your corn beef, but you have it in a much healthier way.”

The courses are highly successful and always draw positive feedback, and Iliana says it’s not just about people feeling physically healthier. “We get lots of people saying they've changed their way of eating in their family – they’ve got more quality time with their family at meals or more bonding time through walking after work, or after school, or taking the kids to the playground.”

Over the past two years, 89% of HOPE participants attended all four sessions, with 64% reducing their servings of sugary drinks, 62% reducing their servings of takeaways, and 90% achieving their family action plan for healthy eating. In addition, 85% achieved their family action plan for physical activity. On physical measurements, 73% recorded a weight loss and 58% recorded a waist reduction, while 45% reduced their HbA1c (blood glucose level).

HOPE AT HOME

Early this year, there had been some discussion within the branch and with the HOPE Champions about the possibility of launching HOPE online, but when Covid-19 hit, it became urgent.

Iliana turned the PowerPoints that were delivered face to face into videos with voiceovers that could be put online. The programme already used Facebook, so it was just a matter of using the platform more intensively. Each HOPE@Home programme was delivered by a HOPE Champion through a closed Facebook page.

“So far, we've run about 11 HOPE@Home programmes. We miss the face-to-face interaction with our participants, but a lot of Champions work full time and find it hard to find a time to run the course face to face. With the online programme, it's easier for them to do their work full time and then come home, put the resources up, and chat with people online.”

The NZ Sikh Women's Association is one of the groups that delivers the HOPE programme.

WHO ARE THE HOPE CHAMPIONS? Once every one to two years, Iliana runs a two-day training course to bring new HOPE Champions on board. The next is planned for April or May 2021.

“The HOPE Champions are people that have already got strong networks in their communities through the work that they do. Most of them do HOPE in their own time alongside their other work. Most, but not all, are actually social workers. They’re already working with families, and they understand the health needs and education needs of their community. These are people that have a passion to make changes in their community.”

Iliana ensures there is a solid support network in place for the HOPE Champions, and four times a year they meet at the Auckland branch office. “We just catch up and talk about their programmes, any challenges that they faced, and what they need from us to improve future programmes. We're blessed to have them. If it wasn't for them, we wouldn't be able to do it.”

To find out more about having the HOPE programme delivered in your community, or to become a HOPE Champion, see www.diabetes.org.nz/hope and/or email office@diabetesauckland.org.nz.