An innovative team-based weightloss competition to reduce cardiovascular and diabetes risk among Maori and Pacific people: Rationale and method for the study and its evaluation

Abstract

Background: Obesity rates for New Zealand (NZ) Pacific and Maori (NZ indigenous people) are among the highest in the world. Long-term results of weight management programmes for adults have been modest but primarily focused on individuals. This paper describes the rationale and methodology for a trial of a culturally tailored team-based weightloss competition conducted online with community level support. Methods/Design: A quasi-experimental design was used to compare an intervention and control group. Three six-month competitions with seven teams of seven Maori or Pacific people (N = 147) were run. Eligible participants were: Maori or Pacific, 16 years of age and above, obese (BMI ≥30 kg/m2) and either at risk of or already diagnosed with type 2 diabetes (HbA1c >50 mmol/mol) or cardiovascular disease. The intervention facilitated group use of an internet-based competition offering financial incentives, education and support. The primary outcome was percentage of individual weight lost at 12-months. Secondary outcomes were percentage reduced total cholesterol and glycated haemoglobin (HbA1c). Data collected at baseline, 6-months and 12-months included: height, body weight, blood lipids and HbA1c, eating and dieting habits, family support, food access, alcohol use, nutrition literacy, activity levels, perceptions of weight, stress and sleep, and, perceived contagion effect. Process evaluation tasks will inform acceptability. Discussion: An attractive, easy to understand weight change programme that effectively reduces disease risk among Maori and Pacific is desperately needed. Web-based delivered support and information to largely self-directed teams could also ease exponential rises in costs to the health system.