Chronic condition risk factor change over time in a remote Indigenous community
journal contributionposted on 19.03.2021, 03:41 by K Strate, J Brimblecombe, L Maple-Brown, J Garrngulkpuy, E Maypilama, M Scarlett, Kerin O'Dea, EL Barr
© 2020. Introduction: This study sought to determine change in chronic condition risk factors in a remote Indigenous community following a 3-year period of community-led health promotion initiatives. Methods: Data were compared between two cross-sectional surveys of Indigenous Australian community residents before and after health promotion activities, and longitudinal analysis of participants present at both surveys using multilevel mixed-effects regression. Results: At baseline, 294 (53% women; mean age 35 years) participated and 218 attended the second survey (56% women, mean age 40 years), and 87 attended both. Body composition, blood pressure and urinary albumin-to-creatinine ratio remained stable between baseline and follow-up. After adjusting for age and sex, haemoglobin A1c significantly increased (from 57 to 63 mmol/mol (7.5% to 8.1%), p=0.021) for those with diabetes. Increases were also observed for total cholesterol (from 4.4 to 4.6 mmol/L, p=0.006) and triglycerides (from 1.5 to 1.6 mmol/L, p=0.019), and high-density lipoprotein cholesterol levels improved (from 0.98 to 1.02 mmol/L, p=0.018). Self-reported smoking prevalence was high but stable between baseline (57%) and follow-up (56%). Similar results were observed in the longitudinal analysis to the cross-sectional survey comparison. Conclusion: Community-led health promotion initiatives may have had some benefits on chronic condition risk factors, including stabilisation of body composition, in this remote Indigenous community. Given that less favourable trends were observed for diabetes and total cholesterol over a short time period and smoking prevalence remained high, policy initiatives that address social and economic disadvantage are needed alongside community-led health promotion initiatives.
This work was funded by the National Health and Medical Research Council of Australia (NHMRC) (#124319) and by a grant from the Australian Health Ministers Advisory Council/States-Commonwealth Research Issues Forum (#PDR 2001/07) (MD). ELM Barr was funded by a NHMRC Training Fellowship (#APP1016612) and a National Heart Foundation postdoctoral fellowship (#101291). JB was supported by a National Heart Foundation Future Leader Fellowship (ID: 100085). LMB is supported by an NHMRC Practitioner Fellowship (#1078477). The information and opinions contained in this article are solely the responsibility of the authors and do not necessarily reflect the views or policy of the NHMRC.
JournalRural and Remote Health
Article NumberARTN 4452
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Science & TechnologyLife Sciences & BiomedicinePublic, Environmental & Occupational HealthAustraliachronic diseasehealth promotionIndigenous AustraliansCARDIOVASCULAR RISKHEALTHDETERMINANTSCHOLESTEROLDISEASEPREVALENCESMOKINGOBESITYTRENDSWOMENHumansChronic DiseaseRisk FactorsLongitudinal StudiesCross-Sectional StudiesAdultRural PopulationHealth PromotionFemaleMaleIndigenous Peoples