An Aboriginal-driven program to prevent, control and manage nutrition-related "lifestyle" diseases including diabetes

Type 2 diabetes and other nutrition-related so-called "lifestyle" diseases, including obesity, and cardiovascular and chronic renal disease, are very prevalent in Australian Aboriginal people and contribute to their high rates of chronic illness and premature mortality. An Aboriginal-driven, community-based health protection, health promotion and improved disease detection, management and care program was introduced in four remote, discrete communities in the far north of Western Australia (WA) in order to attempt to prevent these disorders through community-based lifestyle modification. More energetic screening for early risk factors is involved as well as early dietary and exercise interventions and medical treatment, when indicated. Distinctive features of this program include its Aboriginal initiatives and perspectives, committed partnerships between the communities, the Unity of First People of Australia of Australia (UFPA) and its carers, the communities' health care providers, external clinical specialists, other external agencies and a locally-operated point-of-care (POC) pathology testing capability that is conducted by local and UFPA personnel. The POC component is quality managed by Flinders University. These features have ensured the viability of the program in three of the communities; the other one decided not to continue with the program despite risks of serious long-term health consequences. The pre-program prevalence of diabetes in screened adults was almost 40% and in adults aged (35 years was almost 60%. After several months of the program's operation, there have been positive changes in knowledge about food, nutrition, exercise and disease and altered attitudes and behaviours related to dietary and exercise patterns. There have also been improvements in weight control and in pathology test results relevant to the risk of subsequent development of diabetes and cardiovascular disease.