Article Text

  1. P. Forward,
  2. S. Kuartei*,
  3. R. Schneeweiss,
  4. D. Schaad
  1. University of Washington School of Medicine, Seattle, WA
  2. *Tino Faatuuala Palau Ministry of Health


Background In the last 20 years cardiovascular disease and diabetes have become the major causes of mobidity and mortality in Palau, which has resulted in an increasing drain on medical resources. Cultural, genetic, and environmental factors have been shown to be contributing factors. The purpose of this study was to evaluate the 2004 Palau Ministry of Health workplace intervention to address the problem of obesity.

Methods A 6-month workplace intervention for employees of the Palau Ministry of Health (MOH) consisted of educational sessions that were provided six times during the intervention period. There was a focus on fostering autonomy over each participants exercise routine, but scheduled activities were provided throughout each week. Traditional activities such as outrigger canoeing and dancing were incorporated into the schedule. The nutrition component consisted of the South Beach Diet phase I and The Wai'anae Diet Program modified to incorporate local fish, vegetables, and traditional foods. SPSS, Epi-Info, and CSPro were used for statistical analysis. Two tailed t-tests were used for group comparisons.

Results At baseline 40% of MOH employees were obese and 30% were overweight using the Pacific Island standard. Over 70% had greater than 30% body fat. Of the 260 who initially weighed in and answered the questionnaire 174 (66%) weighed in again after 6 months. There was not a statistically significant difference in body fat %, BMI, age, and gender between those who did and did not attend the second weigh-in. Female participants demonstrated a significant reduction in body fat percent (p = .005). Males showed a significant change in attitude towards exercise from baseline to completion (p = .04). Participants who indicated at baseline that they intended to exercise in the next 30 days were statistically more likely to experience a reduction in body fat percent (p = .006).

Conclusions A workplace intervention for weight reduction in a Pacific Island setting is feasible and effective. Culturally appropriate exercise options and dietary recommendations should be emphasized. “Contemplators” are most likely to benefit from such an intervention. Both men and women demonstrated a reduction in BMI and body fat %, but only women were shown to have a statistically significant reduction. Attitudes toward exercising improved but men showed a greater degree of change.

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