https://cris.nifa.usda.gov/cgi-bin/starfinder/3547/crisassist.

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ACCESSION NO: 0199107 SUBFILE: HNRIMS; CRIS

PROJ NO: HAW00212-G AGENCY: NIFA HAW
PROJ TYPE: NRI COMPETITIVE GRANT PROJ STATUS: TERMINATED
CONTRACT/GRANT/AGREEMENT NO: 2004-35215-14252 PROPOSAL
NO: 2003-05281
START: 01 MAR 2004 TERM: 28 FEB 2009 FY: 2009
GRANT AMT: $1,000,000 GRANT YR: 2004
INITIAL AWARD YEAR: 2004

INVESTIGATOR: Novotny, R.; Murphy, S.; Gittelsohn, J.; Cheung, L.

PERFORMING INSTITUTION:
UNIV OF HAWAII
3190 MAILE WAY
HONOLULU, HAWAII 96822

HEALTHY LIVING IN THE PACIFIC ISLANDS (HLPI) HEALTHY PACIFIC

CHILD PROGRAM (HPCP)

NARRATIVE: The Pacific Islands are in nutrition transition, and are

experiencing some of the highest rates of obesity in the world. The project will
identify physical activity, dietary, educational, economic and food assistance
and agricultural elements influencing body weight in the Pacific region. These
will be used to develop nutritional intervention programs with Land Grant
colleges, health departments, food stores, schools and community-based food
and nutrition education programs throughout the Pacific region.

OBJECTIVES: The goal of the Healthy Living in the Pacific Islands Healthy

Pacific Child Program (HLPI-HPCP) is to improve the nutritional status of
children and to prevent overweight among children in the US-affiliated Pacific
Islands. Specific objectives are to: 1) Design and test dietary assessment
instruments to be used to target, develop and evaluate nutrition related
intervention programs for children. 2) Develop and test a Healthy Foods
intervention program centered on food stores and local food systems to
improve production, preparation, sales and consumption of healthy foods by
Pacific Islander children and their families.

APPROACH: A dietary assessment instrument will be developed and tested

for validity (Pacific Interactive Healthy Eating Index - PIHEI). Dietary data will
be collected in Pacific Island populations: results from one day of dietary data
using a validated traditional method, the 24-hour recall, will be compared to
dietary data collected using the Pacific IHEI for the same day. The dietary
data collection module of the existing IHEI website program and databases
will be adapted for use by Native Hawaiians in Hawaii and Marshallese in
Marshall Islands. Focus groups will be conducted prior to the main data
collection phase of the study, with approximately 10 to 12 elementary age
children attending a meeting for the purpose of trying the IHEI. Their feedback
will be used to further refine the screens and menus. The validity of the Pacific
IHEI for collection of dietary data will then be evaluated. Data collected
through the Pacific IHEI will be compared with data collected by a validated
method (24-hour recalls). Participants will be elementary age children in
Hawaii (200 students) and a field test in Marshall Islands will evaluate use of
the tool in island populations (through the EFNEP program and hospital).
Access to the Pacific IHEI will be provided to organizations in the Pacific
Islands. The Healthy Foods intervention will develop, implement and evaluate
a community-based intervention strategy to improve diet in Pacific Islander
children. The Healthy Foods program will work with local food retailers and will
be linked to local production systems as a means of enhancing the economic
viability and sustainability. Formative research will be conducted through: in-
depth interviews, participant observation, and a food source survey to assess
location and availability of food in selected areas. A pilot instrument will be
developed to assess family food purchasing, preparation and consumption of
healthy foods and related psychosocial factors. Intervention approaches and
instruments developed from this study will be used in future intervention trials
in small and large food stores and community-based family education
programs in Hawaii. After development in Hawaii the program will be pilot
tested in other Pacific island sites.

PROGRESS: 2004/03 TO 2009/02
OUTPUTS: Full descriptive reports (wire bound booklets) of key food and
nutrition practices in the study communities were provided to partners and
participating communities. In the Northern Marianas Islands newspaper
articles and public presentations were also provided. The project developed a
dietary assessment tool, Pacific Tracker (PacTRAC) from the USDA
Interactive Health Eating Platform, which contains Pacific foods and dishes
that were obtained from Healthy Living in the Pacific Island (HLPI) partners in
American Samoa, Guam, the Commonwealth of the Northern Marianas,
Palau, Marshall Islands and the Federated States of Micronesia; and by
participants in the research program. PacTRAC is publically available at
www.crch.hawaii.edu/pactrac and at www.hawaiifoods.hawaii.edu. This tool
provides a means for both professionals and the public to evaluate foods and
dietary intake of the Pacific region. Testing and adapting of the PacTRAC tool
and other intervention materials developed for this project has occurred
through HLPI in those island jurisdictions. PARTICIPANTS: Carrie Martin,
received MS degree at the University of Hawaii. Nutritional Sciences. In
addition to the investigators, we collaborated closely with faculty in the
colleges in American Samoa, Guam, the Commonwealth of the Northern
Marianas, Palau, Marshall Islands, and Federated States of Micronesia-
through the Healthy Living in the Pacific Islands Initiative. We also worked
closely with the Department of Health in the Commonwealth of the Northern
Marianas Islands, the Waianae Comprehensive Health Center on Oahu and
Set It Up non-profit on the Big Island of Hawaii. TARGET AUDIENCES: The
target audience was children, families and communities of the US affiliated
Pacific. Primary participants were from the communities of Waianae and
Waimanalo, Oahu and North Kohala and Kau, Big Island of Hawaii; and the
Commonwealth of the Northern Marianas. Other Healthy Living in the Pacific
Islands partners in American Samoa, Federated States of Micronesia, Palau,
Guam and the Marshall Islands contributed and are using the tools and
information generated. PROJECT MODIFICATIONS: Nothing significant to
report during this reporting period.

IMPACT: 2004/03 TO 2009/02
Key findings were provided to the legislature and to the key stakeholders in
the Commonwealth of the Northern Marianas Islands. Findings have
contributed to program and policy planning for the Commonwealth. In other
Pacific jurisdictions, similar intervention efforts were conducted at the initiative
of faculty at colleges and extension offices in the HLPI jurisdictions of Guam,
American Samoa, the Commonwealth of the Northern Marianas, the
Federated States of Micronesia, Palua, and the Marshall Islands. In Hawaii,
intervention results informed a subsequent intervention study (Pacific Kids
DASH for Health, PacDASH) that is currently being conducted in a health
system, to target messages to child's self efficacy and readiness to change, in
partnership with parents and physicians at well child visits in order to reinforce
messages.

PUBLICATIONS (not previously reported): 2004/03 TO 2009/02

1. Gittelsohn J, Vijayadeva V, Davison N, Ramirez V, Cheung LWK, Murphy
S, Novotny R. A food store intervention trial improves caregiver psychosocial
factors and children's dietary intake in Hawaii. Obesity, 2010, in press.
2. Murphy SP, Martin CL, Davison N, Cheung L W-K, Au DL, Novotny R. A
Comparison of Two Systems for Entering and Assessing Dietary Data for a
Research Study. Journal of the American Dietetic Association. 2009;109:905-
908.
3. Martin CL, Murphy SP, Novotny R. The contribution of dietary supplements
to nutrient adequacy among children in Hawaii. Journal of the American
Dietetic Association 2008. Nov;108(11):1874-80.
4. Paulino YC, Coleman P, Davison NH, Lee SK, Camacho TB, Tenorio LF,
Murphy SP, Novotny R. Nutritional characteristics and body mass index of
children in the Commonwealth of the Northern Mariana Islands. Journal of the
American Dietetic Association. 2008 Dec;108(12):2100-4
5. Martin CL, Murphy SP, Leon Guerrero RT, Davison N, Jung YO, Novotny
R. The Pacific Tracker (PacTrac): Development of a Dietary Assessment
Instrument for the Pacific. Journal of Food Composition and Analysis.
2008;21:S103-S108.
6. Novotny R, Coleman P, Tenorio L, Davison N, Camacho T, Ramirez V,
Untalan P, Vijayadeva V. Breastfeeding is associated with lower risk of
overweight among children of the Commonwealth of the Northern Marianas
Islands. Journal of the American Dietetic Association 2007; 107(10):1743-6.
7. Novotny R, Coleman P, Tenorio L, Davison N, Camacho T, Ramirez V.
Acanthosis nigricans among Pacific Islander children in the Commonwealth of
the Northern Marianas. Experimental Biology Annual Meeting, Washington
DC, April 2007.
8. Blitz CL, Murphy SP, Novotny R, Jung YO, Au DM, Davison N. The Pacific
Tracker (PACTRAC): Development of a dietary assessment instrument for the
Pacific. National Nutrient Databank Conference, Honolulu, HI, September
2006.
9. Novotny R, Coleman P, Tenorio L, Davison N, Camacho T, Ramirez V,
Danigellis E, Vijayadeva V, Untalan P, Tudela M. Breastfeeding is associated
with lower risk of overweight among children of the Commonwealth of the
Northern Marianas Islands. Experimental Biology 06, San Francisco, CA, April
2006.
10. Carrie Martin, MS, Nutritional Sciences, University of Hawaii at Manoa.
MS Thesis: Dietary supplement use among children in Hawaii 2007.