Grass roots and taro roots: Community interventions for health promotion among Utah Pacific Islanders

The disproportionate prevalence of diabetes and its risk factors among Pacific Islanders is well known. This population has increased dramatically in the U.S., and especially in Utah. Over one in 10 (10.5%) Pacific Islander adults in Utah has diabetes, a rate nearly twice that for the state (5.3%). Three-fourths (74.8%) are overweight or obese. The high prevalence of diabetes and overweight/obesity in the Pacific Islander population, coupled with its rapid growth, can be expected to substantially impact delivery of diabetes care and prevention. Yet, too little is known about the specific issues related to health care in this minority population. Public health efforts, particularly those through the National Diabetes Education Program (NDEP), have been well received among Pacific Islanders. However, some interventions may be even more effective if they are developed within the community itself and designed to address its particular challenges. The National Tongan American Society, based in Salt Lake City, Utah, implemented a grassroots community-based program to assist Pacific Islanders in managing diabetes among those diagnosed and in preventing it among those at risk. Culturally specific health education classes have been held since 2004 with materials in Tongan and Samoan. The curriculum, which complements NDEP materials, is taught in native languages at local churches and social centers. A qualitative analysis, based on input from class participants, was used to identify barriers (e.g., family, cultural, health care access) that initially challenged positive lifestyle modifications. Solutions for overcoming barriers, as suggested by participants, are being used to refine the interventions.