Ke 'Ano Ola is the newest healthy lifestyle program on Molokai and Lanai. It focuses on reducing the risk of the common illnesses affecting the Hawaiian community.
Requests for a weight-management program for Molokai's small, rural and predominantly Native Hawaiian communi-
ty came to Na Pu'uwai, the Native Hawaiian Health Care System that serves both Molokai and Lanai. Community members wanted a program that was tailored for them.
The goal of the Ke 'Ano Ola program is to lower risk factors for chronic disease such as diabetes and cardiovascular disease through healthy nutrition, physical activity and specific chronic disease prevention education in a support group setting.
Ke 'Ano Ola was tested and evaluated by Na Pu'uwai staff members. Based on this evaluation, improvements were made, and the first Ke 'Ano Ola group started in January 2008. Since this first group, we have completed four groups on Molokai and one on Lanai. Community members on Lanai requested that Ke 'Ano Ola be brought to them after hearing of the success on Molokai.
Once enrolled in Ke 'Ano Ola, participants complete an initial health assessment of body weight, body fat, cholesterol and blood sugar. This measurement is done again at the end of the 12-week program and again one year after starting the program to help evaluate progress.
Ke 'Ano Ola has two phases. The first 12-week phase includes weekly group sessions that start with interactive education and conclude with goal setting and a communal meal. At each class, participants meet with a program nurse or community health worker to do a weight and blood pressure assessment.
During the program, participants are enrolled at their community's fitness center where they establish fitness goals with, and are subsequently supported by, the gym staff. A group meal is prepared by two or three of the participants, who learn ways to modify local meals to make them "healthier." We do this by promoting recommended portions of lean protein, vegetables, fat and whole grains. For example, we are cooking chicken adobo wilted salad with brown rice this week on Molokai, using a recipe from the "A Dash of Aloha" cookbook.
Weekly education sessions taught by various specialists within the community aim to promote disease prevention. We have a class taught by a dietitian to explain how eating healthier not only achieves weight loss but can also prevent high cholesterol levels and high blood pressure.
Other classes focus on the emotional aspect of eating, cancer-fighting foods, cardiovascular disease prevention, chronic kidney disease prevention, understanding the nutrition fact labels on foods, incorporating more physical activity and health promotion through la'au lapa'au, or Hawaiian medicine. On-island psychologists and master-level social work students assist each week with setting goals that are specific, measurable, achievable, realistic and timely.
Maintaining gains is the second phase of the program and includes monthly support group meetings, which include an educational session, goal setting, evaluation and a potluck meal. Participants bring a "healthier" option for the potluck based on what they learned during the first-phase cooking experience.
We are in our sixth and seventh Ke 'Ano Ola groups, one on Molokai and the other on Lanai. Results from the initial 12-week phase have shown an average of 3.5 percent loss in total body weight, or 7.5 pounds. The average decrease in blood glucose among those with diabetes was 8.7 mg/dL. Among those who had high cholesterol, the average decrease was 26.83 mg/dL.
Participant evaluations have shown that the inclusion of group support, relevant disease prevention education and goal setting help Ke 'Ano Ola participants to achieve a healthy lifestyle.
Kapuaola Gellert is the epidemiologist/wellness program director at Na Pu'uwai, the Native Hawaiian Health Care System on Molokai. She serves on the board of directors of the Maui County Nutrition & Physical Activity Coalition.
