{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T13:50:47Z","timestamp":1785160247955,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1179067"],"award-info":[{"award-number":["APP1179067"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2025,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact of a 4\u2010month dietary and lifestyle program co\u2010designed and led by Aboriginal and Torres Strait Islander people on weight and metabolic markers, diet, and physical activity in overweight and obese adults in a remote Indigenous community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Single arm, pre\u2013post intervention study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting, participants<\/jats:title><jats:p>Adult residents (18\u201365 years) of a remote Northern Territory community with body mass index (BMI) values of at least 25\u2009kg\/m<jats:sup>2<\/jats:sup> or waist circumferences exceeding 94\u2009cm (men) or 80\u2009cm (women).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Hope for Health, a culturally sensitive 4\u2010month program supporting self\u2010managed health improvement based on dietary and lifestyle change, 1 August to 30 November 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Weight loss of at least 5%; changes in BMI, waist circumference, other metabolic markers (blood pressure, biomarkers of metabolic health and inflammation), diet, and physical activity; participant perceptions of the program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We assessed outcomes for 55 participants who completed\u00a0weight assessments at both baseline and program end\u00a0(mean age, 42.5 years [standard deviation, 10.1 years]; 36 women [65%]). Forty participants lost and 15 gained weight; overall mean weight loss was 1.5\u2009kg (95% confidence interval [CI], 0.5\u20132.4\u2009kg), and ten participants (18%; 95% CI, 9\u201331%) achieved at least 5% weight reduction. The mean change in BMI (53 participants) was \u20130.60\u2009kg\/m<jats:sup>2<\/jats:sup> (95% CI, \u20130.93 to \u20130.27\u2009kg\/m<jats:sup>2<\/jats:sup>), in waist circumference (53 participants) \u20133.2\u2009cm (95% CI, \u20134.7 to \u20131.7\u2009cm), and in low\u2010density lipoprotein cholesterol level (37 participants) \u20130.28\u2009mmol\/L (95% CI, \u20130.47 to \u20130.08\u2009mmol\/L); the relative decline in the HbA<jats:sub>1c<\/jats:sub> level geometric mean (50 participants) was 11% (95% CI, 6\u201315%). The intake of breads and cereals (median change, \u20131.5 [95% CI, \u20132.0 to \u20131.0] serves\/day) and sugar\u2010sweetened beverages (\u20130.6 [95% CI, \u20131.4 to \u20130.1] serves\/day) declined; the amount of moderate and vigorous physical activity increased by a median of 103\u2009min\/day (95% CI, 74\u2013136\u2009min\/day; 19 participants). The program focus on integrating healthy bodies and networks of kin, healthy governance, vibrant language and ceremony, and a healthy environment were seen as central to its value and benefit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Community appreciation of the program and the improvements in cardiometabolic risk factors are encouraging, providing an example of a culturally sensitive, co\u2010designed initiative led by Indigenous people for reducing the prevalence of chronic disease in remote areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>Australian New Zealand Clinical Trials Registry (ACTRN12622000174785; prospective: 2 February 2022).<\/jats:p><\/jats:sec>","DOI":"10.5694\/mja2.52593","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T23:15:17Z","timestamp":1738278917000},"page":"183-190","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Improving cardiometabolic risk factors in Aboriginal and Torres Strait Islander people in northeast Arnhem Land: single arm trial of a co\u2010designed dietary and lifestyle program"],"prefix":"10.5694","volume":"222","author":[{"given":"Hasthi UW","family":"Dissanayake","sequence":"first","affiliation":[{"name":"Peter Doherty Institute for Infection and Immunity University of Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Gurruwiwi","sequence":"additional","affiliation":[{"name":"Peter Doherty Institute for Infection and Immunity University of Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Dhurrkay","sequence":"additional","affiliation":[{"name":"Peter Doherty Institute for Infection and Immunity University of Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh C","family":"Tynan","sequence":"additional","affiliation":[{"name":"Peter Doherty Institute for Infection and Immunity University of Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1997-3999","authenticated-orcid":false,"given":"Sabine","family":"Braat","sequence":"additional","affiliation":[{"name":"Peter Doherty Institute for Infection and Immunity University of Melbourne  Melbourne VIC"},{"name":"Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health University of Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Harrap","sequence":"additional","affiliation":[{"name":"Yardhura Walani Australian National University  Canberra ACT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Trudgen","sequence":"additional","affiliation":[{"name":"Hope for Health (Why Warriors Pty Ltd)  Nhulunbuy NT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hanieh","sequence":"additional","affiliation":[{"name":"Peter Doherty Institute for Infection and Immunity University of Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwyn","family":"Clark","sequence":"additional","affiliation":[{"name":"The University of Queensland  Brisbane QLD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Spencer","sequence":"additional","affiliation":[{"name":"Northern Institute Charles Darwin University  Darwin 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Hall Institute of Medical Research  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie K","family":"Brimblecombe","sequence":"additional","affiliation":[{"name":"Menzies School of Health Research  Darwin NT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverley\u2010Ann","family":"Biggs","sequence":"additional","affiliation":[{"name":"Peter Doherty Institute for Infection and Immunity University of Melbourne  Melbourne VIC"},{"name":"Victorian Infectious Diseases Service  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"e_1_2_10_1_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1999.tb127821.x"},{"key":"e_1_2_10_2_1","unstructured":"Australian Institute of Health and Welfare.Aboriginal and Torres Strait Islander health performance framework: summary report(here: sections 1.05 1.09). 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