We used a convergent parallel design to explore Native Hawaiian and Pacific Islander (NHPI) men’s multilevel perspectives of the factors that influence healthy eating, physical activity, and weight, to elicit recommendations for lifestyle interventions and to understand the intersection of masculinity and health from a social constructionist perspective. From June to December 2017, NHPI men 18 years and older were recruited to participate in a survey and in focus groups. The survey included demographic questions and questions about the physical and cultural activities men engage in, perceived social support for lifestyle behaviors, dietary behaviors, masculine characteristics, and values important to NHPI men. The Kessler Psychological Distress Scale was used to assess psychological distress. Focus groups were audio-recorded and transcribed for a thematic analysis. Descriptive statistics were computed for survey data. We conducted 8 focus groups with 89 NHPI men (50% Samoan, 20% Native Hawaiian, and 30% Marshallese). The average age of the participants was 39 years, 43% reported some college or college graduate, 64% were currently married, and 63% were working full time. In all, 90% of men scored 20 or higher on the Kessler 10-item screening scale, indicating mild-to-severe psychological distress. Men described food as a major part of their culture and their identity. Men defined their roles as a provider and protector, with little attention being paid to their own health. Our study found that hegemonic or traditional masculinity and social norms may encourage some men to put their health at risk but may also be used to motivate healthy behaviors.
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