Improving diabetes self-management and health among the Native Hawaiian population in Hawaii

Background: Native Hawaiians have a high rate of type 2 diabetes, but little is known about the programs and interventions that can support diabetes management in this unique population.

Objective: To examine the efficacy of diabetes support services on improving self-efficacy and health among the diabetic population on Oahu and specifically its Native Hawaiian residents.

Methods: The Live Healthy… Work Well project, a federally-funded randomized control study, included 190 adults (mean age = 42.5) with diabetes living on Oahu, of which 34% were part or full Native Hawaiian. Treatment participants received life coaching, medication therapy management from a pharmacist, and other diabetes supports. Health (hemoglobin A1c, weight) and self-efficacy (Diabetes Empowerment Survey) data were collected at baseline and 6 months. Change scores were calculated to quantify change over six months. T-tests were used to compare Native Hawaiians to other participants in the sample.

Results: Native Hawaiians had higher A1c (t = -2.87, p=.005) and BMI (t = -2.38, p = .02) at baseline compared to the rest of the sample. Over 6 months, race differences disappeared. At the same time, overweight and obese treatment group participants lowered their BMI (t = -2.29, p=.02) and raised their diabetes self-efficacy (t = 2.07, p=.004).

Conclusions: Findings suggest the efficacy of life coaching and diabetes support services in empowering Native Hawaiians to manage their disease. Native Hawaiian participants may have benefited from these services to a greater extent such that race disparities in diabetes health indicators disappeared.