Examining Native Hawaiian and Pacific Islander youth attitudes towards physical activity

Abstract

Background: Native Hawaiian and Pacific Islander (NHPI) populations face disproportionately low levels of physical activity (PA) and higher rates of preventable chronic disease. While existing literature largely centers on White youth, this three study dissertation identifies correlates of PA behavior for NHPI adults, children, and youth, and explores NHPI students’ attitudes toward PA and physical education (PE), along with their PA intentions and behaviors, with study 2 and 3 being guided by the Theory of Planned Behavior (TPB). Method: Study one (Chapter 2) is a scoping review that seeks to identify and better understand the correlates of PA behavior among NHPI youth and adults. Study two (Chapter 3) analyzes data from 1,163 NHPI students in grades 4–12, 41% of whom identified as female, to assess PA and PE attitudes, PA intentions and behavior, and differences by gender, grade, and race/ethnicity, as well as associations between attitudes and PA behavior. Study 3 (Chapter 4) further examines PA and PE attitudes among NHPI youth, focusing on gender and school-level differences, PA engagement, and factors shaping positive and negative attitudes. Results: Study one identified individual, environmental, social, and cultural determinants of NHPI health, revealing the lasting effects of colonization and key positive and negative correlates of PA as principal findings. Study two findings showed significant gender and school-level differences in PA attitudes and behavior, with males and secondary students reporting higher PA engagement, while females and secondary students reported more negative PA attitudes. Among NHPI youth, positive PA attitudes significantly predicted both PA intentions and behavior, with no significant differences by ethnicity. Study three quantitative findings revealed that while ethnicity and school level did not predict differences in youth attitudes toward PA, gender did have a significant impact on both general positive attitudes toward PA and specific attitudes toward PE classes, with females consistently holding slightly more positive attitudes than males. Study three qualitative results revealed that organized sports, traditional dance, and ocean-based activities strongly motivate PA among NHPI youth. Key influences included self-confidence, social support from ‘ohana and friends, and sports culture in Hawai‘i, while cultural, social, and environmental factors also shaped barriers to PA. Conclusion(s): Study one revealed more negative than positive correlates of PA among NHPI populations, highlighting the need for further investigation to better understand the factors influencing PA within this group. Study two findings reveal that NHPI youth do not inherently possess negative attitudes toward PA. Instead, they exhibit strong, positive dispositions, independent of their PE experience. These results highlight the need to explore cultural, structural, and behavioral factors that may contribute to the PA decline and obesity disparities seen in NHPI youth and adults. Study three confirms the findings in study two and offers additional insights into factors that influence PA participation among NHPI youth, due to its mixed quantitative and qualitative methods design, with confidence, social support, and traditional forms of PA emerging as major themes. The results indicate that both positive and negative experiences in PE shape their attitudes toward PA, and that social support from family and friends, along with engagement in culturally rooted physical activities, is important for youth engagement in PA. Collectively, these findings underscore the importance of considering both the social and cultural contexts in which PA occurs, as they can either enhance or hinder motivation, participation, and positive attitudes toward PA.Keywords: Native Hawaiian, Pacific Islander, physical activity (PA), correlates of PA, determinants of PA, elementary students, secondary students, Theory of Planned Behavior, intention, behavior, culture