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The Pacific Islander Diabetes Prevention Program (PI-DPP), is a year-long, evidence-based lifestyle change program recognized and supported by the Center for Disease Control and Prevention (CDC). PI-DPP was formed through a partnership between the Association of Asian Pacific Community Health Organizations (AAPCHO) and the Pacific Islander Center for Primary Care Excellence (PI-CoPCE) as a project funded by the CDC DP17-1705 grant to scale the CDC National DPP in underserved areas. Currently, PI-DPP consists of 11 sites throughout the U.S. and U.S. Affiliated Pacific Islands (USAPI). 

Aligning with DPP success standards, participants aim for 5% body weight loss, 150 weekly physical activity minutes (PAMs), and lower HbA1C values. 

Listen in each week as we highlight PI-DPP sites. Mililani Leui, Program Manager of PI-DPP, sits down with site representatives to hear about their community stories and program impacts. 

This week we spoke with Mayleen Stephen, the Life-Style Change Program Coordinator for Chuuk Community Health Center (CCHC). CCHC is a health center located on the island of Weno, in the State of Chuuk in the Federated States of Micronesia (FSM). In this episode, Mililani and Mayleen speak about the importance of community partnerships as well as innovative strategies for conducting classes on neighboring islands.

CCHC Group Photo
Photo courtesy of CCHC

Mililani: My name is Mililani and I’m the program manager for the Pacific Islander Diabetes Prevention Program.

So, why is a program like this important for the community you serve?

Mayleen: This program is an eye-opener in my community. To many or most people who see evidence of how people are struggling with type 2 diabetes, there is one major reason we are participants in this program. It gives us a chance to fix what has been wrong in those days of people, who woke up and don’t feel well because of having diabetes. This program gives my community a chance to be a little bit more better when it comes to health. It gives a reason to be double-minded with food choices and a reason to get out of our comfortable zones and start doing a little something to the body instead of just sitting, sipping, and then feel unwell later on.

Mililani: Why is it important to tailor the program to your community’s specific needs?

Mayleen: The program’s participants come from different family backgrounds. One specific area where it’s needed to be tailored to the community’s need is the language of the curriculum. As the coaches, we must have the knowledge of how to give realistic examples or use the correct example or word of what’s really stated in the curriculum to have our participants understand. If we take things straight out of the curriculum and say, “Okay, here’s what’s needed to be done. You need 150 minutes of physical activity and slow down or stop eating rice,” no one will want to keep their time into the program. I, as the coordinator, find it hard to keep myself motivated and stay true to the program’s participants. I have to make sure I am working on my physical activity minutes as well as showing my family and friends and coworkers we all need to join this program. My community don’t need to know English to understand or to know how to prevent type 2 diabetes. All we need to do is give the participants the best explanation or the idea of when and how to start preventing type 2 diabetes before it’s too late.

CCHC 2020-2022 Impact Report
Photo Courtesy of PI-DPP

Mililani: What impact has your site had on the communities you serve?

Mayleen: The PT 2 program here in Chuuk Community Health Center, or sponsored by Chuuk Community Health Center, is called Waseoch. Waseoch is a Chuukese word that describes the healthy shape of the body because it’s being held physically active and eating healthy food. Waseoch started to operate in March 2020. In the year 2020 to 2021, the program enrolled 62 participants. At the end of the cycle, the total weight lost in pounds was 651 pounds. These 62 participants had a total of 332,615 physical activity minutes. The average weight loss for an individual was 10 pounds. In this year, 2020 to 2021 cycle, 43% of the 62 participants met their weight loss goal. In 2021 to 2022, there were 96 participants enrolled in the program. Our weight loss at the end of the cycle in pounds was 1,413 for these 96 participants. Our physical activity minutes was totaled up to 579,340 minutes.

The individual average weight loss was 15 pounds. In this year, [the] 2021 to 2022 cycle, 41% of the 96 participants met their weight loss goal. In addition, WASEOCH program or this PT 2 program has built awesome partnership with the following: CWC or Chuuk Women’s Council, CRE or Chuuk Research Extension which is located at the College of Micronesia at the Duke State campus. We have CRE or Chuuk Research Extensions as our partner that help us with cooking demonstrations and basic home gardening. We have been partnered with CWC or Chuuk Women’s Council ever since we started by holding or hosting activities together like pre-diabetes screening, walkathon community service that involves cleaning around our communities and our workplaces.

Participants in CCHC’s Walk-A-Thon pose for a group photo
Photo Courtesy of CCHC

We also have built a really good partnership with the two colleges here in Chuuk: The College of Micronesia Chuuk campus and the CCPI or Caroline College and Pastoral Institutes. With these colleges, we visit them at least once or twice a year to give lifestyle change educational awareness, as well as pre-diabetes and pre-hypertension screening. Another partner that I am more than proud of are the community faith-based organizations that have hosted the PT 2 classes at their churches at no cost. The following churches that we partner with ever since 2020 currently are the following: Sailo church located in Neauo Weno, Holy Family Parish in Nepukos Weno, Bethel Church in Fefen Inaka, Mesenkaw Church in Fefen Inaka. These are four faith-based organizations that have given up the spaces for the PT 2 classes to be hosted at no cost. We also hosted a PT 2 cohort with the West-Fefen Elementary School staff in the year 2021 to 2022. With all these partners mentioned above, the PT 2 program or WASEOCH, has been known in all these communities stated above.

Photo Courtesy of CCHC

Mililani: What are some of your site’s challenges and/or best practices for recruitment retention and general programming?

Mayleen: Our program has a lot of challenges. As I mentioned, our geographical location is a barrier to having the program spread to all the islands here in Chuuk.

During recruiting periods, we find it hard to spread the word of the PT 2 program due to lack of the program’s own transportation, where CHC Residential Community Health Center is always our source of everything. We recruit participants according to the availability of lifestyle coaches in the community. For example, in the southern communities we have two coaches, one for the clinic group and one for the community groups. Lifestyle coaches recruit and coach their own community for one specific reason, and that is accessibility. Lifestyle coaches recruit participants from their own community. For example, we have coaches who commute from the neighboring islands by boat to the main island for work. And an example is Fefen. Menti is by birth from Fefen living on this island, and therefore she’s the lifestyle coach for Fefen Cohorts.

CCHC Volleyball Games
Photo Courtesy of CCHC

I believe our best practice in recruiting is community accessibility. It is the method of using the community-available lifestyle coach to recruit, as well as coaching the class or cohort for the rest of the cycle. Each lifestyle coach [is] assigned to their own community, specifically for accessibility. We also have issues with our physical activity tournaments due to not having the program or the clinic’s own gym or facility where we can do all we can. When it comes to activities that involve sports, we utilize the partnership built between the program and the schools by using the school gyms. Our sports tournaments and activities like track and field day sport tournaments and our cooking sessions are some of the reasons our participants never want to give up the classes or the program. In other words, these activities [are] our best practice in terms of retention.

CCHC Staff Conducts Hypertension Screenings
Photo Courtesy of CCHC

Mililani: What future projects and/or goals does your site have for advancing diabetes prevention and promoting healthy lifestyles?

Mayleen: We plan to promote the Lifestyle Change Program to our own hypertension patients in the community health centers, and recruiting them to be our own participants in the PT 2 Program. This path already happened, we’ve already had a few hypertension patients as our participants in our previous cycles. But the goal is to have all of our hypertension patients into this PT 2 Program. This is one very effective plan that we think will have a great impact on our patients and the clinics itself.

We thank Mayleen from the Chuuk Community Health Center for speaking with us during this week’s segment. Please stay tuned for our next site highlight!

To learn more about CCHC, please visit their Facebook page!

To support CCHC in their pursuit of diabetes prevention and promoting healthy lifestyles, please contact Mayleen Stephen at stephenmayleen@gmail.com for more information. 

Facebook: @Chuukchc