Native Hawaiian adolescents' weight status, physical activity and dietary behaviors

Abstract

Increased prevalence of childhood obesity is a public health problem. From 1976 to 2010, the national prevalence has increased from 5% to approximately 17%, and Native Hawaiians youth are more likely to be obese than White and Asian youth. Obese children and adolescents are more likely than healthy-weight youth to maintain excess weight into adulthood and experience earlier onset of chronic disease. Based on the socio-ecological model, this dissertation examined three questions. The first question was: "Is there an association between weight status (healthy, overweight or obese) and dietary behaviors, physical activity, sedentary behaviors, smoking, and bullying victimization among Hawaiʻi 's public school adolescents, and are there differences in association by ethnic-sex groups?" A secondary data analysis of the 2011 HYRBS was conducted. The second question was: "Is there a difference in engagement of healthy behaviors and weight status for 9th grade Native Hawaiian students by school type (public vs. private)?" Data were collected from Native Hawaiian 9th graders in private school (N=252) and compared to HYRBS data for Native Hawaiian 9th graders in public school (N=335). Multinomial logistic regression was used to determine if school type was a significant predictor of weight status. The third question was: "How do obese Native Hawaiian adolescents perceive supports and challenges to healthy eating and physical activity in their school and neighborhood environments?" Photovoice was used, through which students took photographs and wrote captions to illustrate their perceptions. Five key findings emerged. First, Native Hawaiian adolescents have a higher prevalence of obesity than White, Japanese, and Filipino adolescents, but a lower prevalence than Other Pacific Islanders. Second, females were less likely than males to have an obese weight status regardless of school type. Third, Native Hawaiian 9th graders in private school had a lower prevalence of obesity than Native Hawaiian 9th graders in public school. Fourth, students who engaged in physical activity at least 5 days a week had a greater healthy weight-to-obese ratio. Fifth, limitations in resources (financial, community, or school) contribute to increased weight status. These findings can help inform the tailoring of interventions to prevent and reduce obesity among Native Hawaiians adolescents.