Native Hawaiian communities have long-standing and serious health disparities that are among the highest in the nation. The strength of intergenerational social and behavioral components that perpetuate both healthy and unhealthy lifestyles within this community cannot be overstated. Our long-term goal is to change the trajectory of chronic illness within this community by focusing on healthy lifestyles. Health promotion and disease prevention strategies developed out of an individualistic Western approach are not relevant and have very limited, unsustained success. Native Hawaiian's are family and community focused;it is a communally, not individualistic-based culture. Built upon this understanding, an intergenerational approach combined with community-based participatory research will be used to engage 2 Native Hawaiian communities in reducing perinatal obesity. The lOM has stated that nutrition during pregnancy and breastfeeding are the first obesity preventative behaviors. The ideal time within the life cycle for families to make changes affecting a lifetime is during the perinatal period (pregnancy - 1st year of child's life).First, a community assessment using the 'SpeakOut'process, a community event focused on community engagement, will occur. From the community assessment findings, a longitudinal pilot study will be designed aimed at improving perinatal nutrition.
The research aims are: 1. Assess community understanding of (a) Healthy nutrition for expectant/new mothers and their children,(b) Family and community responsibilities toward the eating behaviors of a child, and (c) What interventions by family, community and healthcare providers could better promote healthy eating for expectant/new mothers and their children. 2. Design and conduct a pilot intervention that targets expectant/new mothers, their infants and their extended families in how and why to make healthy eating choices that can change the chronic illness trajectory of their newborn and young child. 3. Engage expectant/new mothers and their families in examining the chronic illness trajectories and dietary patterns of their families over the past 3 generations. 4. Disseminate the findings of the project to the Native Hawaiian community and to the professional community.
The health disparities within the Native Hawaiian community have been well documented for many years;yet little progress has been made in reducing these disparities. Obesity is the common link among many disparities. Our target is to reduce perinatal obesity through improving maternal nutrition and breastfeeding durations;thus, improving the health trajectory of Native Hawaiian children.