Home > Review Articles > Healthcare outcomes > Face-to-face versus telephone delivery of the Green Prescription for Māori and New Zealand Europeans with type-2 diabetes mellitus: influence on participation and health outcomes

Face-to-face versus telephone delivery of the Green Prescription for Māori and New Zealand Europeans with type-2 diabetes mellitus: influence on participation and health outcomes

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Authors:
Summary:

This kaupapa Māori-informed study randomised 68 Māori and 70 NZ Europeans newly diagnosed with type 2 diabetes to face-to-face (n=70) or telephone (n=68) delivery of the national Green Prescription lifestyle programme for 6 months. At the first face-to-face meeting (used as the Green Prescription information session), all study participants agreed to participate in the programme. Throughout the study, there were small but clinically favourable improvements in health outcomes for both Māori and NZ Europeans, regardless of the mode of delivery, face-to-face or telephone. At 6 months there were overall reductions from baseline in body weight (1.8 kg), waist circumference (3.7 cm), total cholesterol (0.6 mmol/L) and glycated haemoglobin (3.1 mmol/mol). No significant differences were observed in regard to mode of delivery, ethnicity or gender. Drop-out at 6 months was greater for Māori than for NZ Europeans (49% vs 24%; p=0.04). Overall attrition rates for the face-to-face and telephone approaches were 31% and 41%, respectively (p=0.509).

Comment:
This paper serves as a reminder that Green Prescriptions achieve clinically significant changes for all. Although a low-cost and simple intervention delivered in the community, inequities in access to the Green Rx (i.e. referrals made and follow-up) do exist. We must address the barriers such as reluctance to refer or poor follow-up, as these prevent some people from receiving evidence-based treatment.
Reference: N Z Med J. 2017;130(1465):71-9
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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