Moving with the times: evolution of Buttabean Motivation – a community-based, Pacific-centred approach to health

Buttabean Motivation (BBM) is a grassroot initiative aiming to improve Pasifika and M?ori health through free community bootcamps offering exercise, motivation and nutritional advices, and with online programmes of workouts and meal plans. It is a dynamic organisation, responding to community needs,  providing practical solutions to issues such as food insecurity and influenza vaccination while maintaining its core focus of reducing obesity among Pasifika and M?ori through nutrition and physical activity.. BBM forms active and changing relationships with numerous organisations that offer support. They would like to work with the government and the district health boards, but the structure and changing nature of their organisation does not fit traditional funding models. To show that BBM is effective for Pacific people beyond anecdotal evidence, BBM has partnered with University of Auckland researchers. The research team are using a kaupapa M?ori and co-design approach to explore how BBM might benefit the community and reduce health inequities, especially whether BBM’s model of social collectivism enables sustainable weight loss for Pasifika and M?ori in the current obesogenic environment. Weight reduction programmes typically find that after initial success, participants have reverted to pre-programme weight by five years. BBM’s “whole of life change” approach may lead to sustained weight loss not demonstrated by other programmes. Using co-design, a BBM/University of Auckland partnership is evaluating the effectiveness of the BBM programme for sustained health and wellbeing. BBM is grounded in the Pacific/indigenous health frameworks fonofale, te whare tapa wh? and fa’afaletui addressing physical, mental, spiritual, family and social health in the context of people’s lives. The research will use a longitudinal cohort approach study design, using metrics and outcomes of relevance to its participants and the programme. A systems analysis will facilitate understanding of the strengths and challenges to delivering a holistic and sustained service for the community. BBM provides much promise in reducing health inequities for Pasifika and M?ori, however the model creates challenges for ongoing funding, business structure and evaluation. The goal is to find ways that both the programme and social institutions, including funders and evaluators, can adapt to meet these real-world challenges.