Mediators of lifestyle behavior change in Native Hawaiians - Initial findings from the Native Hawaiian Diabetes Intervention Program

OBJECTIVE - To examine the association of stage of change with diet and exe rcise behaviors in response to a lifestyle intervention for Native Hawaiian s (NHs). RESEARCH DESIGN AND METHODS - A family ('ohana) support lifestyle intervent ion was compared with a standard intervention in NHs with or at risk for di abetes in two rural communities in Hawaii (n = 147). Stage of change, as a hypothesized mediator of behavior change, and dietary and exercise behavior s were measured at baseline and at I year postintervention. RESULTS - Stage of change was significantly associated with positive dietar y and exercise behaviors. NHs receiving the 'ohana support (OS) interventio n were more likely to advance from pre-action to action/maintenance for fat intake and physical activity than the group who received the standard inte rvention. Participants in the OS group who advanced from pre-action to acti on/maintenance showed more improvement in fat intake and physical activity than those in the standard group. CONCLUSIONS - These initial findings suggest that Stage of change is an imp ortant factor in mediating lifestyle behavior changes in persons with or at risk for diabetes and merits further study among minority populations at h igh risk for diabetes.