Pacific peoples in Aotearoa New Zealand experience the highest rates of type 2 diabetes (T2DM), with limited culturally tailored interventions addressing this issue. This doctoral study assesses a culturally relevant lifestyle change programme, the Sia Tō’onga Mo’ui Diabetes Prevention Programme (STM-DPP), that is designed to mitigate T2DM risk among Tongans in NZ. The study's objectives were to implement the programme, which adapts the Diabetes Prevention Programme (DPP) for Tongans, and to evaluate its uptake and acceptability, as well as to identify barriers and enablers for preventing the progression from prediabetes to T2DM in adults aged 18-74.

The STM-DPP utilised a mixed-method approach in three phases. Phase 1 involved citizens' panels with community members, health experts, and representatives working together to adapt the Pacific Island DPP (PI-DPP). Phase 2 focused on programme implementation through weekly Zoom sessions that promoted improved diet and required 150 minutes of weekly physical activity, aiming for a 5% weight reduction. Clinical markers were assessed at baseline and post-programme. Phase 3 encompassed the evaluation of STM-DPP using focus groups to explore processes, benefits, cultural motivations, and practicality.

Conducted in Auckland, the study adapted to COVID-19 restrictions by conducting focus groups and PI-DPP modules online. A total of 41 Tongan participants (25 males, 16 females) were involved, with a significant majority having a BMI of ≥ 30 and a high risk for diabetes. Post-programme evaluation indicated notable improvements in participants' weight, waist-to-height ratios, physical activity levels, and blood pressure. The Tongan community well-received the programme's feasibility and acceptability, which contributed to high participation rates.

The findings support the efficacy of the culturally tailored STM-DPP as a viable intervention for T2DM prevention among Tongans in NZ, suggesting that similar adaptations could benefit other Pacific populations in the region.