This study aimed to describe health indicators and behaviors of Native Hawaiian and Pacific Islander (NHPI) adults and to compare findings to previous reports on US NHPI and the US population. A sample of N = 100 (56 M, 44 F) NHPI adults aged 40–59 years completed an anonymous questionnaire addressing education and household income, tobacco use, physical activity, fruit and vegetable (F&V) consumption, cancer screening and health status. Objective measures of height and weight were taken to calculate body mass index (BMI). The study sample consisted of 49% current smokers and the majority was not meeting guidelines for physical activity (80%) or F&V consumption (99%). Cancer screening rates ranged from 0 to 57% and were higher among females. Mean BMI was 33.9 ± 7.5 kg/m2 and 95% were overweight or obese. While 36.7% were hypertensive, only 11.1% were taking prescribed medication. Compared to both the general US population and available data for US NHPI, study participants reported higher prevalence of obesity and chronic conditions (hypertension, high cholesterol, diabetes, and angina/CHD) and lower levels of physical activity, F&V consumption and cancer screening rates. Study findings contribute to the limited knowledge regarding health behaviors of US NHPI. Comparisons to US data increase evidence of NHPI health disparities, while comparisons to previous NHPI studies emphasize the magnitude of unhealthy lifestyle behaviors and subsequent adverse health conditions for this particular sample. Further improvements to community outreach and recruitment strategies could successfully encourage high-risk individuals to participate in health promotion and behavior intervention studies to improve NHPI health behaviors.

Introduction

Physical activity is an important contributor to the health disparities experienced by Native Hawaiian and Pacific Islander (NHPI) populations. A culturally-specific measurement instrument that minimizes interpretation bias is necessary to obtain accurate assessments of this lifestyle behavior. The purpose of this study was to 1) create two versions of the Pacific Islander Physical Activity Questionnaire (PIPAQ-short and PIPAQ-long) for United States NHPI, and 2) pilot test the PIPAQ instruments and two objective physical activity monitors to evaluate cultural-appropriateness and acceptability.

Methods

Forty NHPI adults (20M, 20F) aged 21-65 years attended focus group discussions addressing cultural perspectives related to physical activity. Feedback from participants, community leaders and physical activity experts guided cultural modifications to existing questionnaires to create PIPAQ-short and PIPAQ-long with accompanying showcards. Pilot testing of both PIPAQs and two objective physical activity monitors, the Actiheart and ActiTrainer, was carried out in another sample of 32 NHPI adults (17M, 15F) aged 18-63 years. Participants were instructed to wear one monitor for ≥10 hours/day for 7 consecutive days. At the follow-up visit, participants completed PIPAQ-short and PIPAQ-long, and a written and verbal exit interview to provide feedback on both subjective and objective instruments.

Results

The majority of participants felt PIPAQ-long provided a more accurate reflection of activity levels, compared to PIPAQ-short. The Actiheart was the preferred monitor due to higher comfort and lower participant burden. Self-reported duration of physical activities was most difficult to recall, compared to activity type, frequency and intensity.

Conclusion

Both PIPAQ instruments and the Actiheart monitor have demonstrated cultural acceptability and appropriateness for NHPI adults. Future studies will investigate the validity and reliability of both PIPAQ instruments in larger samples of NHPI adults.

This exploratory study aimed to assess obesity, physical activity, and nutrition among Pacific Islander youth and young adults in Southern California. A total of 129 Tongan, Samoan, and Marshallese participated in the study, including relatively similar proportions of males and females and age groups. We calculated Body Mass Index (BMI), dietary intake by a food frequency questionnaire (FFQ), and 7-day physical activity levels with accelerometers. Overall, 84% of Tongan, 76% of Samoan, and 24% of Marshallese participants were overweight or obese, with mean BMI of 31.2 and 34.3 kg/m² (for Tongan males and females), 32.3 and 33.4 kg/m² (Samoan males and females), and 25.3 and 22.1 kg/m² (Marshallese males and females). We found moderate- and vigorous-intensity physical activity (MVPA) fell below current guidelines at 38 min/day, with over 87% engaging in light-intensity PA and large sedentary times. Daily percent of energy from saturated fat, fiber/1,000 kcal and dairy intake were higher in Tongans compared to Samoans and Marshallese. Despite promising outcomes from this study, high prevalence of overweight, low physical activity levels, and high caloric intake put Pacific Islander youth and young adults at risk for a variety of health concerns and future efforts should focus on further research as well as community-wide prevention and amelioration efforts.