Need: A way to improve health of women in Chuuk, one of 4 states that make up the Federated States of Micronesia.
Intervention: The Chuuk Women's Council offers a program that educates and trains women to prevent and manage diabetes, and adopt healthy lifestyles.
Results: The program's goal of gaining 30 participants in its second year has been exceeded. Participants have lost weight, been referred to needed medical services, and are training others in diabetes education.
The Federated States of Micronesia (FSM) is a group of
islands located in the western Pacific Ocean. The latest
report from the World Health Organization indicates that
prevalence of diabetes has risen the past few
decades. A total of 18% of the population has been
diagnosed with the non-communicable disease. Type 2
diabetes has become the second
leading cause of death in Chuuk, one of the 4 FSM
The Chuuk Women's
Council (CWC) was founded in 1984 by a committee of
women. It now serves as an umbrella organization,
streaming communication and resources for 64
organizations throughout the state. The Council promotes
women's leadership to its 1,000 members through
programming in health, education, environmental
conservation, and the preservation of Chuukese tradition.
CWC has become a host site for the
Pacific Islander Diabetes Prevention Program, a
national initiative that helps Pacific Islanders adopt
healthy lifestyles to prevent type 2 diabetes by applying
programs recognized by the Center for Disease Control
CWC operates the program under the name Coaching Healthy
Islander Program (CHIP) and partners with the Association of Asian Pacific
Community Health Organization (AAPCHO) to promote it
throughout FSM. The Coaching Healthy Islander Program
received a 2017-2021 CDC grant that support its
CWC offers a wide range
of health services, all of them related to CWC's
diabetes initiatives in some way. Below are services
specific to diabetes prevention and management:
Train the Trainer: Diabetes education
teaches women how to conduct prevention and educational
classes in their own villages and schools. Topics
covered include diabetes and non-communicable disease
prevention, the importance of regular doctor visits,
and the risks of tobacco use. Trainers also arrange
activities for attendees to promote healthy lifestyles
in their communities.
Classes: CWC hosts classes for CHIP
participants with 22 modules on healthy lifestyle
adoption and diabetes prevention and management.
Coaches: Lifestyle Coaches work with
program participants to help them set and meet their
weight and health goals.
Customizable Tools: CWC customizes
educational tools through the CHIP program.
Events: CWC coordinates events on
World Diabetes Day (Nov. 14th). In 2017, CWC hosted a
one stop Healthy Islander Fair in collaboration with
Chuuk Health Services. Over 200 people participated in
demonstrations, screenings, and education sessions. In
2019, CWC put on a similar event at their headquarters.
Thirty-nine out of the 50 attendees were found to be
overweight or obese, and 20 tested positive for risk of
At the start of its second year, the program's goal was
to enroll 30 participants who are at high risk of
developing prediabetes and help participants complete
their training and meet their fitness and nutritional
goals. Results so far include:
CWC initially recruited 36 participants. After some
dropped out, a total of 31 remain, meeting the program's
goal for the second year.
11 participants were referred to a clinic for HbA1c
testing. Referrals are continually being made by
Lifestyle Coaches to specialty treatment services.
5 participants met their weight loss goal during the
first 6 months of the program's second year.
CWC trained 44 school principals
and teachers who are continuing diabetes education in
The following are some programming and member challenges:
Funding: Securing funding for
utilities (power) and communications (internet and
phone) and staff has been difficult. Until 2016, those
working for CWC were volunteers. 2016 marked the first
year CWC was able to pay full-time accounting and
Grant Operations: In the Federal State
of Micronesia, there are no private insurance companies
to supplement funding for project participants.
Attempting to fit a CDC model has been difficult and
has required a more flexible grant payment structure.
Drop Outs and Schedule Conflicts:
Personal and health conflicts prevented some members
from fulfilling their courses and attending program
activities. Some had to drop out of the diabetes
courses because of lack of attendance. Others were not
able to get their referral forms from the clinic
completed on time.
Geographical location: CWC and program
participants live on 41 municipalities that make up
Chuuk State, FSM. Traveling to meetings and programs
can be difficult to coordinate, and CWC staff are
limited in their transportation means to meet outer
Cost of Healthy Food: Because of high
import costs, healthy food for Chuukese residents is
expensive. This makes it difficult for some to
regularly incorporate fruits and vegetables into their
Leadership: Having dedicated,
respected women serving as president of the
organization has been a key factor in CWC's successful
programs. Appointing a leader with great vision, the
ability to connect with other people and organizations,
and recruitment skills are essential.
Collaborative Work: This project has
been the most successful through the work of
partnerships among CWC staff, volunteers, government
agencies, and community members.
Work Commitment: Commitment was the
key to program building and participant involvement.
Lifestyle Coaches have an influential hand in motivated
participants to stay in the programs. Incentives help
participants maintain the energy and motivation among
Coaching Strategies: Applying more
than 1 coaching approach helped both the coaches and
the participants finish each class. More training on
report writing is highly recommended for lifestyle
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.