Presentation description

Background: Pacific Islander communities face some of the highest rates of obesity and type 2 diabetes. While many health programs for Pacific Islander populations include cultural elements, few studies have examined how the depth and breadth of cultural tailoring may relate to outcomes like weight loss.

Methods: We reviewed 22 lifestyle interventions identified in a recent systematic review of obesity-focused programs for Pacific Islander communities. Each program was assessed using the Hewitt-Ott Scale for Cultural Adaptation, which includes 16 indicators across five domains: (1) Family and Community Values (FCV), (2) Faith-Based Integration (FBI), (3) Cultural Activities and Practices (CAP), (4) Traditional Foods and Nutrition (TFN), and (5) Visual and Language Representation (VLR). Indicators were rated on a 0 (not addressed) to 2 (thoroughly addressed) scale. Averages across domain-specific items and a total score were calculated for each article. The interventions took place across Samoa, Tonga, Fiji, Hawaii, New Zealand, the United States, Ebeye (Marshall Islands), and Vanuatu.

Results: Across interventions the cultural tailoring scores based on what was reported in the articles ranged from 1.17 to 4.42 with an average of 2.57(SD=0.95). When considering specific domains, interventions were most to least likely to focus on FCV, VLR, TFN, FBI, and CAP. The average weight loss was 2.94 kilograms (SD=2.41 kgs) and there was a trend towards interventions with a higher reporting of cultural domains achieving a higher weight loss (r=0.22, p=0.32).

Conclusion: Although not statistically significant, the results suggest cultural tailoring may contribute to program effectiveness. Other unreported or underreported factors may also influence outcomes. Importantly, this study offers a consistent method for assessing cultural elements in Pacific Islander health programs. It supports the continued importance of culturally meaningful design and highlights the need for more consistent reporting and tool development in future research.