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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 Saram Salle of the Chuuk Women’s Council (CWC). CWC is the umbrella organization for 64 individual women’s organizations in the State of Chuuk located in the Federated States of Micronesia (FSM). In this episode, Mililani and Saram speak about the importance of adjusting the program to the community’s specific needs and CWC’s hopes for bridging access to Chuuk’s municipal islands.

CWC Group Photo
Photo courtesy of CWC

Saram: My name is Saram Salle, working for the Pacific Islander Diabetes Prevention Program, as a lifestyle coach and as a data specialist and assistant to the coordinator.

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

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

Saram: Community that is in the process of changing society needs guidance to adapt to its changes, and [the] Pacific Islanders Diabetes Prevention Program is one solution that can help the community understand and apply what is being taught. A program like the prevention of type 2 diabetes has many values for the communities in Chuuk. Chuuk is known to have the highest number of NCDs, or noncommunicable diseases, in the FSM, and type 2 diabetes is the common one among our fellow Chuukese. Type 2 diabetes is one of the leading causes of death here in Chuuk, due [to] limited knowledge on healthy eating habits and the importance of exercising.

The program itself is like an eye opening technique for the communities to realize that the lifestyle we are living is the root cause of having NCDs, most especially type 2 diabetes. The program’s curriculum which the lifestyle coaches use is very informative and relatable to what most Islanders are going through in their daily lives. For example, most of us are relying on imported food, but we tend to ignore our own fresh and healthy food, eating more of the imported food that we are not familiar with the processing of it or we don’t really understand the contents on the packages. This program has helped many participants of PI-DPP get the idea to read the contents on the food packages and to know which imported food can be healthy or good for serving. This is basically why a program like this is very important to our community.

CWC Group Photo
Photo Courtesy of CWC

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

 Saram: Most things are easier if they are fixed or designed the way a community would easily recognize or be familiar with. New things tend to make it hard for people to understand, so it is important to adjust the program just to best suit the community’s specific needs. It is important to make some changes within the program because the program cannot move forward if the people do not understand what you are giving them.

For example, in the curriculum there are foods that they use as examples and we change them to something local or what they are familiar with or they have it in their community so they can know the benefits and can easily access it. That way they can stay healthy, have access and identify food in their communities and be able to achieve their goals.

Not all the communities that we go to have the same needs. Some, they need motivations and someone to guide them. Some need the right materials or equipment to get on with healthy living and some just need to start from scratch because they have no idea that there are many ways to live a healthy lifestyle. Most of our participants are home sitters and they are not really exposed to what others experience when people work or go to school. That is why it is important to adjust the program to our community’s specific needs.

Mililani: Is there any background information you would like to share to reinforce the importance of this program for your community?

Saram: So, Chuuk State is consisted of 41 municipal islands and are scattered in and outside of the lagoon. Our means of transportation is both small boats and small ships and the hospital is located on the main island, Weno. People from the other islands are not really accessible to the services. We are hoping this program would expand with more funding to take it to the other small islands that are scattered in and outside of Chuuk.

CWC 2018-2022 Impact Report
Photo Courtesy of PI-DPP

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

Saram: There are 350 screened and eligible participants, 66 of them lost 5% body weight, [and] eight reduced 4% of their weight. Then that’s 5.11% average percent of body weight loss per participant. 402 minutes average for physical activity minutes per week per participant. 54% completed and reduced risk of having diabetes. There’s a total of 421 classes delivered from this program.

CWC Diabetes Screening Event
Photo Courtesy of CWC

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

Saram: Some challenges that we have is the high turnover of staff because of personal reasons. Another challenge was the inconsistent and poor data collection and putting off participants’ information.

Another challenge is resources. Normally, we have the A1C+ blood test kit, and it made it difficult for referrals from both public health and Chuuk Community Health Center. That’s why we have low referrals from our partners, from the clinics and the hospitals.

For the best practices, I think having a lot of events going on helps the participants get active and always coming to classes because of a lot of events that we do and activities.

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

Saram: Increase home gardening or farms for the participants to have access to healthy food and create more events that help people do more physical exercises like our monthly Trash-a-thon and Walkathons and hikes.

We thank Saram from Chuuk Women’s Council for speaking with us during this week’s segment. Please stay tuned for our next site highlight!

To learn more about CWC, please visit their website at https://www.cwcfiinchuuk.org/ and Facebook. 

To support CWC in their pursuit of diabetes prevention and promoting healthy lifestyles, please contact Saram Salle at sallesaram@gmail.com and Nely Mori at nely.mori@gmail.com for more information. 

Facebook: @chuukwomenscouncil