Thesis (B.A. Hons.)--Murdoch University, Perth, 2001. / Title from title page (viewed on 8 Sept. 2004). Includes bibliographical references.

Aim: - This research project was a community based intervention study of the impact of increased access to exercise opportunities and kangaroo meat on diabetes and cardiovascular disease risk factors in the Aboriginal community of Woorabinda. The exercise and dietary interventions were based on principles of community development including: training of community members to conduct exercise programmes; supply of exercise equipment; training of community members to harvest kangaroos; establishment of a butcher’s apprenticeship; and establishment of the kangaroo meat processing in the community. Methodology: - The impact of the kangaroo meat and exercise interventions on diabetes and cardiovascular disease risk factors was determined by pre- and post-intervention assessment. Pre-intervention baseline data was obtained by community clinical assessment, household meat surveys,and community exercise surveys. The post-intervention assessment was a repeat of modified meat and exercise surveys. A post-intervention community clinical assessment was not conducted due to unresolved difficulties encountered in conducting the research project. The Study Population: - The study population for the community clinical assessment and exercise surveys were volunteer adults B 15 years of age. Approximately one third of the adult population participated in the community clinical screening, 29% in the pre-intervention exercise survey, and 20.2% in the post-intervention exercise survey. The meat surveys were conducted on a household basis. There was 84% household participation in the pre-intervention meat survey and 44.3% postintervention. Findings and Discussion: - It was found that the exercise and kangaroo meat interventions did not follow the planned linear trajectory but rather proceeded in an episodic and incremental manner. The community clinical assessment found a high prevalence of diabetes (18.6%; 95% CI, 13.04 – 24.36%) and impaired glucose tolerance (13.2%; 95% CI, 8.3 – 18.1%) comparable to that found in other Indigenous communities. There was a low prevalence of hypercholesterolaemia (30.9%; 95% CI, 24.2 – 37.6%) and hypertension (19.7%; 95% CI, 13.9 – 25.5%). High prevalence for other diabetes and cardiovascular disease risk factors were found including: current smoking (48.3%;95% CI, 40.95 – 55.64%); and obesity as measured by body mass index (35%; 95% CI, 27.9 – 42%), waist circumference (83.7%; 95% CI, 76.5 - 90.86% in women; and 55.5%; 95% CI, 43.9 – 61.1% in men), and waist / hip ratio (75.5%; 95% CI, 66.9 – 84% in women; and 57.1%; 95% CI,46 – 68% in men). A high prevalence of abnormal ACR was found: the prevalence ACR 3.4 – 33.9g/mol was 11.7% (95% CI, -ve2.39 – 25.7%), and the prevalence ACR B 34g/mol was 7.6% (95% CI, -ve6.8 – 22%). The prevalence of proteinuria was 67.8% (95% CI, 59.3 – 76.3%). It was found that this high prevalence of renal disease indicators coincided with an escalating incidence of end-stage renal disease in the community. Analysis of the kangaroo meat surveys found evidence of positive dietary change including reduction in the amount of fat used to cook non-kangaroo meats, and a positive shift in stage of change for cooking for family health. In regard to kangaroo meat however it was found that the most common cooking method was unfavourable with the nutritional value of the meat being compromised by a significantly higher prevalence of frying than other meats. It was further found that this method for cooking kangaroo meat was unchanged by the research intervention. Evidence of positive change was also seen in analysis of the exercise surveys. It was found that at baseline, and post-intervention, that the majority of adults in the community met the recommended duration for exercise per week through activities of daily living. There was a positive shift in stage of change for exercise behaviour with a significant movement beyond the ‘precontemplation' towards the ‘action’ and ‘maintenance’ stages of change. This positive shift in thinking about exercise corresponded with a significant increase in the proportion of people exercising specifically for health and fitness. Conclusion: - Though not all the proposed intervention objectives were accomplished the research project contributed to furthering community aspirations and capacity. The community clinical assessment provided a useful overview of the health status of Woorabinda, and an opportunity of a thorough health check for community members. The community clinical assessment drew attention to future projections of disease in Woorabinda and prompted a concentrated health system response. Evidence of positive change in regard to meat consumption and exercise behaviours were found, changes however were slow and uneven. Improved infrastructure was important to increasing community capacity for kangaroo meat supply and exercise, but essential to the sustainability of community initiatives is skilled people, and on-going maintenance and support. The findings of this study indicate that simplistic assumptions around the health benefits of ‘traditional’ diet need to be reconsidered cognisant that communities such as Woorabinda are cultures in transition. Whilst limitations in the methodology require the findings to be considered with caution, this study provides useful evidence for planning future health education and health promotion initiatives for Woorabinda.

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