Effectiveness of a Pilot Community Physical Activity and Nutrition Intervention in American Samoa

Abstract

Background: The addition of Western foods to the Samoan diet has greatly affected the health of the American Samoan people. The purpose of this study was to test the effectiveness of culturally tailored exercise and nutrition interventions for adults living in Tutuila, American Samoa. Method: Villages in the eastern, central, and western parts of the island of Tutuila were recruited to participate in this study. Villages were randomly assigned to one of three culturally tailored interventions: 46 individuals in one village participated in an exercise intervention, 27 individuals in another village participated in a nutrition-education intervention, and 22 individuals in a third village participated in a combined exercise and nutrition-education intervention. Participants’ nutrition knowledge was measured at pre- and post-intervention stages through a questionnaire. Body Mass Index (BMI), height, and weight were assessed at baseline and again at weeks 4, 8, and 12. Differences in mean BMI over time by group, were assessed using repeated measures ANOVA with baseline BMI as a covariate. To test for differences in nutrition knowledge over time by group, pair-wise comparisons were used for the percent of correct answers at baseline and at week 12. Results: All three groups realized a significant decrease in BMI, from 1.35 in the nutrition only group to 2.27 in the exercise and nutrition group. The exercise and nutrition group also showed significant gains in ability to identify foods high in fiber and fat. Implications: This study demonstrates that decreases in BMI and increases in nutritional knowledge can be obtained through a culturally-tailored intervention, especially one that combines nutrition education and exercise.