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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 Leslie Garo of Mālama I Ke Ola Health Center (MIKOHC). MIKOHC is located in Maui, an island in Hawaii. In this episode, Leslie and Mililani talk about the importance of building rapport between both participants and lifestyle coaches as well as approaches to community-driven recruitment. 

PI-DPP Participants Pose for a Group Photo
Photo Courtesy of MIKOHC

Leslie: My name is Leslie Garo, and I am the program’s manager at Mālama I Ke Ola Health Center on Maui. 

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 community you serve? 

Leslie: So, for us, we are actually a community clinic, here, on our island and we serve those that are uninsured as well as insured. So, we do provide other services. But specifically for this program, I think it’s important to know that our demographic of patients are not usually educated about the health system. Let alone any healthy lifestyle advice or tips to help them with their health outcomes. And so, for us, I feel like this program definitely targets the patient population that we serve. 

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

Leslie: Yeah, that’s a good question. So, as the program coordinator, previously, I was in charge of a group prenatal program and that was actually contracted with a specific company that gave us an actual curriculum and how to outline every session, kind of like how DPP has. But, for that one, it wasn’t targeted to Pacific Islanders or even our patient population, and as a coordinator, I found myself having to re-do all of the different session topics and the curriculum to make it more user-friendly and approachable for our patients. I’ve seen the opposite end where if you don’t have something that tailors to your community’s needs, it’s not going to be as effective. It’s very fortunate for the program like DPP to show them that it’s relatable, it’s pertaining to, you know, someone like them. It’s doable also. Because if it weren’t for that, you can teach them all that you’d want to teach them, but if they’re not understanding it, it’s not going to make a difference or an impact. 

Photo Courtesy of MIKOHC

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

Leslie: A big part of this program also is not only teaching them how to live a healthy lifestyle, but it’s also creating relationships and so, usually the facilitators grow relationships with the participants and the participants grow relationships with one another, mainly for the support. With this program, we’re able to identify other needs. And so, it becomes kind of like an access point for these people in our community and if they need additional resources such as food, transportation, housing, we’re able to build that connection and help them with their needs. So, it doesn’t limit just for the program’s outcomes, but everything else in their life that affects their health. 

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

Mililani: So, what impact has your site had on the communities you serve? 

Leslie: We can go over a lot of the different statistics from each cohort, but ultimately, I think the main outcome we want our participants to have is to turn their lives into a healthy lifestyle, right? And how they’re gonna give back as well or apply what they’ve learned. I’ve had a lot of people in cohorts as participants that are now educating other people. Some of the participants that have been in other cohorts are now health educators. Some of them have also encouraged other families to be healthier and also other community members. 

Our impact obviously with numbers, in total, for one of our cohorts, they lost 1,495 lbs all together. In total, our whole center enrolled 143 participants. Aside from the great outcome with numbers, they’ve really shown that they’ve taken what they’ve learned and applied it to their lives, and then tried to share their education with others to make a difference in their lives as well.

PI-DPP cohort attends the LevelUp Classes
Photo Courtesy of MIKOHC

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

Leslie: Some of our best practices for recruitment have been utilizing our community health workers entirely and outreaching to any patient that qualifies for the program. So, they’ve been doing a lot of outreach whether it’s phone calls or in the community. As community health workers, they’re also very well connected in their communities. For example, one of our coaches is also a church leader and so, she recruited a lot of church members. 

For retention, I think it’s just enthusiasm that our coaches have and then we do highlight some incentives, of course. And when we say incentives, it’s mostly tools for them to use, so like the MyPlate, even coolers, blender bottles, things like that, that we can have them utilize as they change up their healthy habits. 

General programming, I would just say consistency. Our coaches are consistent with their sessions, and if not, the open line of communication is really important and if they can’t make it or there’s a change in something, the participants don’t have a problem reaching out to the coach and vice versa.

I think the biggest challenge would be retention only because a lot of people are excited to be a part of the program, the first half, and towards the second half, sometimes you know, life happens and it’s hard to get them back on track if they’ve been dealing with some life challenges or scheduling challenges where they can’t come to the sessions. And, they can fall off the program. 

So, that’s why it’s difficult to keep them engaged for like a whole year. So, some of our coaches have actually expressed, a year might be a little too long for them to commit just because there’s some much that happens in one’s life. That I think would be our biggest challenge just keeping them on board all the way until the very end. 

Photo Courtesy of MIKOHC

Mililani: What are some specific future projects and/or goals that your site has for advancing diabetes prevention and promoting healthy lifestyles? 

Leslie: Because a lot of our patients state that they don’t have the time or resources to exercise. And so, we want to give them both. 

Promoting these healthy lifestyles is not just through education, but also through action and giving them the resources, you know, giving them the lending hand to say, “Okay, come take this step. I’m gonna help you through it. You know, I’m gonna guide you, I’m gonna bring you to your first step in order for them to move forward in their transition to a healthy lifestyle.”

We thank Mālama I Ke Ola Health Center’s Leslie for speaking with us during this week’s segment. Please stay tuned for our next site highlight!

To learn more about Malama I Ke Ola Health Center, please visit their website at https://www.ccmaui.org/, Facebook and Instagram.

To support MIKOHC in their pursuit of diabetes prevention and promoting healthy lifestyles, please contact Leslie Garo at lgaro@ccmaui.org for more information. 

Facebook: @malamaikeolamaui

Instagram: @malamaikeolamaui