Part 1: A Systematic Review to Describe Existing Cultural Adaptations in Lifestyle, Nutrition, and Physical Activity Programs for Native Hawaiian, CHamoru, and Filipino Populations

Monica K. Esquivel (), Kristi Hammond, Bernice C. Delos Reyes, Dareon C. Rios, Niza Mian, Elaine C. de Leon, Samantha M. Torres and Tanisha Franquez Aflague
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Monica K. Esquivel: Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resilience, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA
Kristi Hammond: Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resilience, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA
Bernice C. Delos Reyes: Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resilience, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA
Dareon C. Rios: Cooperative Extension & Outreach, College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96913, USA
Niza Mian: Cooperative Extension & Outreach, College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96913, USA
Elaine C. de Leon: Cooperative Extension & Outreach, College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96913, USA
Samantha M. Torres: Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resilience, University of Hawaiʻi at Mānoa, Honolulu, HI 96822, USA
Tanisha Franquez Aflague: Cooperative Extension & Outreach, College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96913, USA

IJERPH, 2025, vol. 22, issue 11, 1-23

Abstract: This research aims to describe existing evidence on the availability of culturally adapted lifestyle, nutrition, and physical activity programs among Native Hawaiian, CHamoru, and Filipino populations who are affected by obesity at rates higher than the general US population, contributing to poorer health outcomes. Addressing this disparity requires programs that are culturally adapted and grounded for these specific populations. A comprehensive description of the availability of lifestyle interventions for Native Hawaiians, Pacific Islanders, and Filipinos is missing in the literature. A systematic literature review was performed in July 2025 to gather articles that included lifestyle (nutrition and/or physical activity) interventions addressing obesity and/or related chronic diseases and that utilized one or more cultural adaptations for Native Hawaiian, CHamoru, and/or Filipino populations. Data were extracted, and methodological quality, social ecological model (SEM) level, and risk for bias was assessed. Twenty-nine articles met inclusion criteria. Interventions addressed pre-diabetes ( n = 7), hypertension ( n = 7), and/or obesity ( n = 5) and included combined nutrition and physical activity ( n = 16). Sixteen articles included interventions culturally adapted for Filipino populations only, 7 for Native Hawaiians only, 6 for both Native Hawaiians and Filipinos, and 2 included CHamorus. The most common combination of approaches were interventions that incorporated individual, interpersonal, and community SEM levels ( n = 17). Intervention components were reflective of culturally relevant physical activities ( n = 16) and nutrition ( n = 11). Based on this research, there is a need for additional research to include CHamoru communities and interventions to be tested in geographic locations where these populations have migrated.

Keywords: lifestyle interventions; culturally adapted; Native Hawaiian; Filipino; CHamoru; Pacific Islander (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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