Kapolei

Researchers are evaluating the PILI Aina project to improve the management of common diet-related cardiometabolic diseases like type 2 diabetes, hypertension, dyslipidemias, and obesity among Native Hawaiian adults. This project aims to reduce risk factors for new diet-related illnesses by promoting traditional Native Hawaiian diets and improving social cohesion. The study focuses on adapting and testing an evidence-based multilevel intervention called PILI Aina to optimize its effectiveness and sustainability. The study involves a community-level component called Ai Pono, which includes quarterly hands-on cooking demonstrations and cultural lessons held over five years, for a total of 36 events. Each 2-hour event features cooking demonstrations, tastings, and education about the cultural importance of traditional foods like sweet potato, breadfruit, and kalo. These lessons aim to improve family and community eating environments and social cohesion. Attendance is limited to 30 people per event, with priority given to new participants after the first lesson. Participants will be surveyed at each event to assess their reactions, fruit and vegetable intake, confidence in healthy eating, and feelings of community support. Additionally, random samples of households in participating homesteads will be surveyed annually to measure family environment, nutrition environment, social cohesion, diet self-efficacy, food literacy, and social support. These assessments will occur at baseline and yearly for four years, helping researchers evaluate the impact and sustainability of the intervention over time.

Researchers are studying how to improve the health and diet of Native Hawaiian adults who have overweight or obesity and at least one diet-related cardiometabolic condition such as type 2 diabetes, pre-diabetes, hypertension, or dyslipidemia. The project aims to test an intervention called PILI 0ina, which focuses on promoting traditional Native Hawaiian diets and improving social support while reducing risks for new diet-related illnesses. This group-randomized controlled trial will compare PILI 0ina to a standard Diabetes Prevention Program Lifestyle Intervention to see which better supports health at both individual and household levels. Participants will first complete a 3-month educational program based on the adapted Diabetes Prevention Program. After this, households will be randomly assigned to either the PILI 0ina intervention or a control group. Those in the PILI 0ina group will receive a 6-month program centered on using a raised-bed home garden to grow vegetables, hands-on cooking lessons with local experts, and family bonding activities. Households will be provided with all gardening supplies and seeds for fast-growing vegetables. The control group will receive monthly health education materials and links to community resources via mail or electronic messaging. All lessons are delivered by trained community health workers. Participants will attend assessments at the start, 3, 9, and 12 months to collect data on diet quality, weight, height, blood pressure, hemoglobin A1c, and lipid levels. Other adult household members can also join data collection to evaluate household effects. Researchers will monitor additional factors like food insecurity, nutrition environment, social support, medication use, physical activity, and diet self-confidence. The study runs until 2029, with ongoing data collection to understand how well the interventions work and their sustainability.