MedPath

Household Participants

Not Applicable
Not yet recruiting
Conditions
Type 2 Diabetes
Hypertension
Dyslipidemias
Overweight and Obesity
Interventions
Behavioral: Household-level effects
Registration Number
NCT06590649
Lead Sponsor
University of Hawaii
Brief Summary

Native Hawaiians' traditional lifestyles and diets ensured the mutual health and well-being of the land and its inhabitants, which stand in stark contrast to the disproportionately high prevalence of diet-related, cardiometabolic diseases they experience today. In this project, the investigators will adapt and test an evidence-based multilevel intervention entitled PILI 'Āina to improve the self-management of prevalent cardiometabolic diseases and reduce risk factors for developing new diet-related illnesses and implement and evaluate the impact and sustainability of community-wide cooking demonstrations. The objectives of this project are to optimize the effectiveness and sustainability of PILI 'Āina, improve diet quality, cardiometabolic markers, promote traditional Native Hawaiian diets, and improve social cohesion.

Detailed Description

The investigators will conduct a group-randomized controlled trial to test the effectiveness of PILI Aina for improving diet and health at the individual and household levels compared to a Diabetes Prevention Program Lifestyle Intervention only group. The investigators will enroll 180 Native Hawaiian adults with overweight or obesity and at least 1 other diet-related cardiometabolic condition (Type 2 diabetes, pre-diabetes, hypertension, pre-hypertension, dyslipidemia). These index participants will receive the 3-month educational program and then be randomized at the household level to the 6-month PILI Aina intervention or to a control group. Data collection will occur at baseline and 3, 9, and 12 months. Other adult household members will be invited to participate in data collection at the same time to evaluate household-level effects.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
168
Inclusion Criteria
  • Current resident of the household in which an index participant lives
  • Willing to complete data collection protocols
  • Fluent in written and spoken English
Exclusion Criteria

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Household ParticipantsHousehold-level effectsThe household participants will be analyzed alongside the index participants to determine household-level effects from the intervention. Household participants must live in an index participant's household. Index participants are allowed to have up to 3 household participants.
Primary Outcome Measures
NameTimeMethod
Household Food PatternsMonth 3, Month 9, Month 12

Household food patterns will be measured by 4 questions that assess the frequency of meal planning, eating meals with household members, bringing prepared restaurant foods home, and preparing meals with household members. The responses and scores range from 1- 1 day, 2- 2-3 days, 3- 4-5 days, 4- 6 days, 5- 7 days. Higher scores indicate greater household food patterns.

Food insecurityMonth 3, Month 9, Month 12

Food insecurity will be measured by the 10-item Household Food Security Survey Module, which captures the qualitative and quantitative dimensions of household food supply, including psychological and behavioral responses of household members, and generates a binary indicator of food insecurity at the household level. The responses and scores range from 1-often true, 2-sometimes true, 3-never true. Higher scores indicate low food insecurity.

Nutrition EnvironmentMonth 3, Month 9, Month 12

The perceived 9-item nutrition environment will be measured by the Gustafson Perceived Nutrition Environment Measures questionnaire, which examines perceived access and availability of healthy foods within \~1 mile of the participant's home, and the availability and affordability of produce in the participant's primary food store. The responses and scores vary depending on the question including 0- disagree, 1-agree, and 0-not important, 1-slightly important, 2-moderately important, 3- important, 4-very important. Higher scores indicate higher perceived access and availability of food.

Physical ActivityMonth 3, Month 9, Month 12

The 3-item Physical Activity Questionnaire, which has been used with Native Hawaiians, will assess exercise frequency during the past month. It contains 3 items that assess moderate and vigorous exercise and changes in activity levels. The responses and scores vary depending on the question, including 0- rarely or never, 1- 2-3 times over the month, 2- about once a week, 3- 2-4 times a week, 4- more than 4 times a week. Higher scores indicate greater physical activity.

Secondary Outcome Measures
NameTimeMethod
Demographic Data- Date of BirthBaseline

Date of birth:

* Month

* Day

* Year

Demographic Data- Biological SexBaseline

Biological Sex:

* Female

* Male

Demographic Data- Marital statusBaseline

Marital Status:

* Never married

* Currently married

* Divorced or separated

* Widow/widower

* Domestic partnership/other

Demographic Data- EmploymentBaseline

Employment:

* Full time

* Part-time

* Unemployed

* Self-employed

* Retired

* Unable to work/other

* Household caretaker

Demographic Data- EducationBaseline

Education:

* Less than high school

* High school diploma/General Education Diploma (GED)

* Some college/technical training

* College degree

* Graduate/professional degree

Demographic Data- Ethic AncestryBaseline

Ethnic Ancestry:

* Caucasian

* Chinese

* Filipino

* Hawaiian

* Latino

* Japanese

* Korean

* Marshallese

* Micronesian (specify)

* Native American

* Portuguese

* Samoan

* Other (specify)

Demographic Data- Household incomeBaseline

Household Income:

* Under $49,999

* $50,000-$74,999

* $75,000-$99,999

* $100,000-$124,999

* Over $125,000

Household income will be classified according to the US Census Bureau's poverty threshold by using a dichotomous variable. Participation in public assistance programs (e.g., Temporary Assistance for Needy Families, Supplemental Nutrition Assistance Program) will also be recorded.

Demographic Data- Household CompositionBaseline

Household Composition:

1. Who lives in your house full-time? (50% or more time spent in-house)

* Parents

* Children

* Grandparents/great-grandparents

* Other family members

a. Of those people, what are their ages and genders?

* Male: 17 years and under, 18-29 yrs, 30-39 yrs, 40-39 yrs, 50-59 yrs, 60+ yrs

* Female: 17 years and under, 18-29 yrs, 30-39 yrs, 40-39 yrs, 50-59 yrs, 60+ yrs

* Number of other/non-binary: 17 years and under, 18-29 yrs, 30-39 yrs, 40-39 yrs, 50-59 yrs, 60+ yrs

Smoking/alcoholMonth 3, Month 9, Month 12

Tobacco and alcohol use will be measured by using a measure developed by Dr. Kaholokula for PILI 'Ohana.

Neighborhood environmentMonth 3, Month 9, Month 12

Neighborhood environment will be measured by the 17-item modified Neighborhood Level Stressors Scale, which assesses participants' perceptions of 4 neighborhood dimensions (i.e., walkability, availability of healthy food, safety, and social cohesion). The responses and scores range from 1-strongly disagree, 2-somewhat disagree, 3- neutral, 4-somewhat agree, 5-strongly agree. Higher scores indicate low neighborhood level stressors.

ComorbiditiesMonth 3, Month 9, Month 12

Existing comorbidities will be measured as whether the participant has ever been told by a healthcare professional that they have had a heart attack, heart failure, stroke, or chronic kidney disease.

Trial Locations

Locations (2)

Kula no nā Po'e Hawai'i

🇺🇸

Honolulu, Hawaii, United States

Kapolei Community Development Corporation

🇺🇸

Kapolei, Hawaii, United States

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