Obesity Prevention in Pacific Adolescents: Is there a role for the church?

Abstract

The aim of this study was to contribute to the emerging interest and body of knowledge regarding obesity prevention in Pacific communities who have an affiliation with Christian religions, and provide evidence to inform public health policy and guide the development of church-based interventions. METHOD A mixed methods approach was used. Quantitative methods included analyses of data on Pacific adolescents (sub-sample n=2495) from the cross-sectional survey (total sample n=4250) in South Auckland secondary schools. Comparisons were made between Pacific church attendees (77%) and non-attendees (23%) and ethnic groups (Samoa n=1107, Cook Island Maori n=557, Tongan n=592, Other Pacific n=239). Qualitative methods included analyses of data from Pacific church leaders (n=23) using semi-structured group interviews (n=4) and 1:1 interviews (n=9). Interviews were preceded by individual meetings with church ministers (n=20) to profile their churches (n=20), and a community fono for church leaders (n=50) to develop obesity prevention strategies. RESULTS Schools: Church attendees had a higher body mass index (BMI) (mean BMI = 27.4) compared with non-attendees (mean BMI = 26.6), (p=0.01), adjusted for age, gender and Pacific ethnicity. Compared with non attendees, church attendees were more likely to consume fruit and vegetables more frequently, source breakfast and lunch from the school canteen or shop, and consume more snack foods (p=<0.05). They were also more likely to have a supportive family and community environment for healthy eating and physical activity (p=<0.05). Church attendees were more likely to be dissatisfied with their own body weight, but less likely to have a sound knowledge of the risk factors for obesity (p=<0.05). Compared with non-attendees, church attendees were less likely to walk/bike to/from school and more concerned about traffic in their neighbourhood (p=<0.05). Church attendees were more likely to participate in lunch time activities, undertake weight control and activities to gain muscle size, and spend less time on sedentary activities (p=<0.05). Protective factors outweighed the risk factors for obesity among church attendees. However, these results were not consistent with their anthropometric measures. Churches CONCLUSION : Obesity is a key health issue facing Pacific churches. Church leaders had a sound knowledge of the aetiology and consequences of obesity, and engaged in lifestyle behaviours that are protective against obesity. They were also supportive of opportunities to encourage and support healthy eating habits and physical activities at church and at home. Parents/caregivers, especially mothers/female caregivers, had the most influence over food and physical activity at church and at home. Church leaders perceived themselves as role models for healthy lifestyle standards at church, and at home, and supported church-based health promotion programmes. Pacific adolescents who attend church are more likely to be obese than non-attendees. Churches can play a central role in the delivery of obesity prevention and management strategies to influence positive health behaviours among Pacific adolescents, and the church community as a whole.