Mavis Nitta1, Dioreme Navasca2, Aileen Tareg3, Neal A Palafox4. 1. Department of Family Medicine and Community Health, JABSOM - University of Hawaii at Manoa, 677 Ala Moana Blvd, Suite 815, Honolulu, HI 96813, United States. Electronic address: nittam@hawaii.edu. 2. Department of Family Medicine and Community Health, JABSOM - University of Hawaii at Manoa, 677 Ala Moana Blvd, Suite 815, Honolulu, HI 96813, United States. Electronic address: dioreme@hawaii.edu. 3. Yap State Department of Health Services, P.O. Box 1010, Colonia, Yap 96943, Federated States of Micronesia. Electronic address: atareg@fsmhealth.fm. 4. Department of Family Medicine and Community Health, JABSOM - University of Hawaii at Manoa, 677 Ala Moana Blvd, Suite 815, Honolulu, HI 96813, United States. Electronic address: npalafox@hawaii.edu.
Abstract
BACKGROUND: The Health Directors of the US Affiliated Pacific Islands (USAPI) declared a State of Emergency due to epidemic proportions of lifestyle diseases: cancer, obesity and other non-communicable diseases (NCDs) in 2010. This paper describes the development, implementation, and evaluation of a USAPI policy, system and environment (PSE) approach to address lifestyle behaviors associated with cancer and other NCDs. METHODS: Each of USAPI jurisdictions applied the PSE approach to tobacco and nutrition interventions in a local institution, faith based, or community setting. A participatory community engagement process was utilized to: identify relevant deleterious health behaviors in the population, develop PSE interventions to modify the context in which the behavior occurs in a particular setting, implement the PSE intervention through five specified activities, and evaluate the activities and behavior change associated with the intervention. RESULTS: PSE interventions have been implemented in all USAPI jurisdictions. Current human and financial resources have been adequate to support the interventions. Process and behavior change evaluations have not been completed and is ongoing. Personnel turnover and maintaining the intervention strategy in response due to shifting community demands has been the biggest challenge in one site. CONCLUSION: From 2014 through 2016 the PSE approach has been used to implement PSE interventions in all USAPI jurisdictions. The intervention evaluations have not been completed. The PSE intervention is novel and has the potential to be a scalable methodology to prevent cancer and modify NCD risk in the USAPI and small states. Published by Elsevier Ltd.
BACKGROUND: The Health Directors of the US Affiliated Pacific Islands (USAPI) declared a State of Emergency due to epidemic proportions of lifestyle diseases: cancer, obesity and other non-communicable diseases (NCDs) in 2010. This paper describes the development, implementation, and evaluation of a USAPI policy, system and environment (PSE) approach to address lifestyle behaviors associated with cancer and other NCDs. METHODS: Each of USAPI jurisdictions applied the PSE approach to tobacco and nutrition interventions in a local institution, faith based, or community setting. A participatory community engagement process was utilized to: identify relevant deleterious health behaviors in the population, develop PSE interventions to modify the context in which the behavior occurs in a particular setting, implement the PSE intervention through five specified activities, and evaluate the activities and behavior change associated with the intervention. RESULTS: PSE interventions have been implemented in all USAPI jurisdictions. Current human and financial resources have been adequate to support the interventions. Process and behavior change evaluations have not been completed and is ongoing. Personnel turnover and maintaining the intervention strategy in response due to shifting community demands has been the biggest challenge in one site. CONCLUSION: From 2014 through 2016 the PSE approach has been used to implement PSE interventions in all USAPI jurisdictions. The intervention evaluations have not been completed. The PSE intervention is novel and has the potential to be a scalable methodology to prevent cancer and modify NCD risk in the USAPI and small states. Published by Elsevier Ltd.
Entities:
Keywords:
Cancer prevention; Disparity; Nutrition; Pacific; Policy, system and environment change; Tobacco
Authors: Rebecca Bunnell; Dara O'Neil; Robin Soler; Rebecca Payne; Wayne H Giles; Janet Collins; Ursula Bauer Journal: J Community Health Date: 2012-10
Authors: Neal A Palafox; Leslie Given; Karin Hohman; John Ray Taitano; Johnny Hedson; Lee E Buenconsejo-Lum; Kamal Gunawardane; Janos Baksa; Martina Reichhardt Journal: Cancer Causes Control Date: 2018-12-10 Impact factor: 2.506