Gretchen Swanson Center for Nutrition, Omaha, Nebraska (Drs Parks and Yaroch and Ms Fricke); and Institute for Social Research (Dr Panapasa), and Department of Health Behavior & Health Education, School of Public Health (Dr Resnicow), University of Michigan, Ann Arbor, Michigan.
J Public Health Manag Pract. 2022;28(1):E185-E193. doi: 10.1097/PHH.0000000000001181.
To determine baseline characteristics of a group of Samoans/Tongans in Southern California at risk for type 2 diabetes mellitus and identify barriers, cultural factors, and readiness and capacity to implement a culturally tailored Diabetes Prevention Program (DPP) in a faith-based setting.
A mixed-methods pilot that included piloting modified DPP sessions, conducting a survey, and focus groups (N = 4).
Samoan/Tongan faith-based organizations.
Samoan/Tongan church members in Southern California who were interested in lifestyle behavior change.
Surveys assessing sociodemographic, acculturation, health status, food insecurity, and psychosocial factors. Focus groups focusing on attitudes toward the curriculum, opportunities for tailoring, and specific barriers/facilitators for healthy weight, nutrition, and physical activity.
Participants (N = 47) were on average 42 years old, female (57%), and identified as Pacific Islander (35% Samoan, 30% American Samoan, and 35% Tongan). Ninety-eight percent of respondents were overweight/obese, and 45% of households were food insecure. Less than half of respondents were born in the United States, and 28% reported "poor" or "fair" English proficiency. Those with higher body mass indexes were more likely to score lower on internal locus of control and self-efficacy for healthy eating and were motivated to lose weight to feel in control of their health. Focus group results revealed that members of the Samoan/Tongan communities are "underserved" and experience a lack of culturally relevant programs to address obesity and chronic disease. Several barriers to healthier lifestyles were identified including adaptation of traditional recipes made in the United States (ie, to be less healthy), role of stress, cultural values (eg, preference for larger body size), and lack of awareness about healthy lifestyles. The church was identified as a resource that could be leveraged further to positively impact health outcomes.
Results demonstrate possible ways to tailor the DPP for US-based Samoan/Tongan populations by harnessing cultural traditions and addressing existing barriers and psychosocial constructs.
确定加利福尼亚州南部一群有 2 型糖尿病风险的萨摩亚人/汤加人（Samoan/Tongan）的基线特征，并确定在信仰环境中实施经文化调适的糖尿病预防计划（DPP）的障碍、文化因素以及准备情况和能力。
包括试验改良 DPP 课程、进行调查和焦点小组（N=4）的混合方法试点。
萨摩亚/汤加信仰组织。
对生活方式行为改变感兴趣的加利福尼亚州南部萨摩亚/汤加教会成员。
评估社会人口统计学、文化适应、健康状况、粮食不安全和心理社会因素的调查。重点小组侧重于对课程的态度、调整机会以及健康体重、营养和身体活动的具体障碍/促进因素。
参与者（N=47）平均年龄为 42 岁，女性（57%），并自认为是太平洋岛民（35%萨摩亚人、30%美属萨摩亚人、35%汤加人）。98%的受访者超重/肥胖，45%的家庭粮食不安全。不到一半的受访者出生在美国，28%的人英语水平报告为“较差”或“一般”。身体质量指数较高的受访者更有可能在健康饮食的内部控制和自我效能感方面得分较低，并且有动力减轻体重以控制自己的健康。焦点小组的结果表明，萨摩亚/汤加社区的成员“服务不足”，缺乏针对肥胖和慢性病的文化相关计划。确定了几种更健康生活方式的障碍，包括适应在美国制作的传统食谱（即不太健康）、压力的作用、文化价值观（例如，偏爱更大的体型）以及缺乏对健康生活方式的认识。教会被确定为可以进一步利用以积极影响健康结果的资源。
结果表明，通过利用文化传统并解决现有障碍和心理社会结构，可以针对美国萨摩亚/汤加人群调整 DPP 的方法。
