Online Program

Acculturation and Childhood overweight and obesity in American Samoa: Results from the Children's Healthy Living (CHL) Program

Tuesday, November 3, 2015

Aifili Tufa, MPH, Office of Public Health Studies-Epidemiology, University of Hawaii-Manoa, Honolulu, HI
Eric L. Hurwitz, DC, PhD, Department of Public Health Sciences, University of Hawaii at Manoa, Honolulu, HI
Rachel Novotny, PhD, RDN, Department of Human Nutrition, Food and Animal Sciences, University of Hawaii-Manoa, Honolulu, HI
Marie Fialkowski, PhD, MS, RD, LDN, Department of Human Nutrition, Food and Animal Sciences, University of Hawaii-Manoa, Honolulu, HI
Fenfang Li, PhD, Department of Human Nutrition, Food and Animal Sciences, University of Hawaii at Manoa, Honolulu, HI
Aufai Areta, MA, Community and Natural Resources Division, American Samoa Community College, Pago Pago, American Samoa
Background/Significance: The role of acculturation in obesity among indigenous populations has been studied. Western cultural influences have infiltrated customs and traditions of Pacific Island nations, leading to local acculturation. American Samoan children are disproportionately affected by obesity, compared to their counterparts in the US. The role of acculturation in childhood obesity in American Samoa is unstudied.

Objective/Purpose: This study examines the association between childhood overweight and obesity and caregiver acculturation in American Samoan children. We hypothesized those children with acculturated caregivers will have lower odds of being obese.

Methods: Cross-sectional data from the Children’s Healthy Living (CHL) Program were analyzed for 757 children. Data included demographic, anthropometric, and culture. Acculturation was assessed using an eight-item cultural affiliation questionnaire. Associations between caregiver acculturation (Traditional/Marginalized and Integrated/Assimilated) and child weight status (Not Overweight/Obese, Overweight, Obese) were examined. Logistic regression, comparing ‘Not Overweight’ vs ‘Overweight and ‘Not Overweight’ vs ‘Obese’, was used to calculate crude and adjusted odds ratios.

Results: In the crude model, where weight status was ‘Not Overweight’ vs ‘Overweight’, children of caregivers who were ‘Integrated/Assimilated’ had lower odds of being overweight compared to ‘Traditional/Marginalized’ (OR = 0.849, 95% CI = (0.604, 1.193). Comparing ‘Not Overweight’ to ‘Obese’, the protective effect of being ‘Integrated/Assimilated’ was strengthened (OR = 0.625, 95% CI = (0.449, 0.870). Results were attenuated when controlling for education;  however, children whose caregivers were ‘Integrated/Assimilated’ still had lower odds of ‘Overweight’(vs ‘Not Overweight/Obese’) than those who were ‘Traditional/Marginalized’(OR = 0.847, 95% CI  (0.6, 1.196)), as did those who were ‘Obese’ (vs  ‘Not Overweight/Obese’) (OR = 0.707, 95% CI = (0.503, 0.994)).

Discussion/Conclusion: Results were not consistent with other studies on acculturation and obesity. Further examination of acculturation and lifestyle practices in American Samoa will be helpful to understand this relationship.

Learning Areas:

Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Evaluate the role of acculturation in childhood overweight and obesity in American Samoa

Keyword(s): Access Immigration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My academic development and research has focused on the role of social and environmental impact on obesity and related diseases among Pacific Islanders. I am originally from American Samoa and have a firm knowledge of its culture and social situations.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Children's Healthy Living Program For Remote Underserved Minority Populations In The Pacific Region Childhood overweight and obesity Student

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.