Increased rates of childhood obesity combined with more accessible information about the relationship between diet, physical activity and inactivity, and chronic diseases suggest the need for analyzing the complex process of receiving and transmitting messages related to child feeding practices. This study examined the perceptions of childhood obesity within 1 multiethnic community, the Commonwealth of the Northern Mariana Islands. In particular, through the use of focus groups, individuals indicated that sociocultural, familial, and official nutritional messages were most influential to their health care behaviors. The coordinated management of meaning (CMM) theory was used to gain insight into how individuals negotiate competing messages occurring at different levels of meaning. Given its focus on cultural influences (parallel to the concepts of archetypes), CMM proved especially relevant for understanding child feeding beliefs, values, attitudes, and practices in diverse ethnic populations. Implications for future health communication research that might draw from a CMM approach were identified, as well as pragmatic endeavors that focus on the development, implementation, and evaluation of culturally appropriate interventions in the prevention of childhood obesity.

Community-based participatory research (CBPR) was used to design and evaluate the effectiveness of a culturally relevant, science-based intervention for the prevention of childhood obesity in the Commonwealth of the Northern Mariana Islands (CNMI), a US Commonwealth in the western Pacific. This cognitive behavioral lifestyle intervention, Project Familia Giya Marianas (PFGM), was offered during the 2005-2007 school years in all CNMI public elementary schools over eight sessions to primary caregivers of 3rd grade children (N = 407). A crossover design was utilized with half of the schools offering the intervention in the Fall term, while the other half delivered the sessions in the Spring term. The primary outcome measure was change in BMI z-score. There was an intervention-dependent effect on BMI z-score, with program impact being a function of baseline BMI and the number of lessons attended. This effect was most apparent in students whose baseline BMI z-score was in healthy range (>/=5 to <85 percentile). In both Asian and Pacific Island groups, children whose caregivers completed 5-8 lessons experienced a significant change in BMI z-score as compared to those with 0 lessons (P < 0.05). Research that integrates multidisciplinary and multimethod approaches is effective in identifying and/or devising solutions to address a complex condition such as childhood obesity. PFGM demonstrated that community participation can be successfully utilized in the development and implementation of childhood obesity prevention programs.

This paper presents a community-school-higher education partnership approach to the prevention of childhood obesity. Public elementary school personnel, primarily teachers, participated in the design and delivery of a curriculum targeting primary caregivers of 8-9-year-old children. Theoretical framework and methodological approaches guided the development of a cognitive behavioral lifestyle intervention targeting childhood obesity prevention in the Commonwealth of the Northern Mariana Islands (CNMI), a U.S. commonwealth. This project demonstrated that in populations with health disparities, teachers can be a valuable and accessible resource for identifying key health issues of concern to communities and a vital partner in the development of parent and child interventions. Teachers also benefited by gaining knowledge and skills to facilitate student and parent learning as well as impact on personal and familial health. Successful community-school-higher education partnerships require consideration of local culture and community needs and resources. Moreover, within any community-school-higher education partnership it is essential that a time-sensitive and culturally appropriate feedback loop be designed to ensure that programs are responsive to the needs and resources of all stakeholders, and that leaders and policymakers are highly engaged so they can make informed policy decisions.

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Obesity is a growing global concern. Examining dietary habits of individuals can facilitate the development of important prevention approaches, which are needed to decrease the incidence of obesity and other related diseases and improve quality of life indices. Because food preferences and dietary habits vary across cultures, it is essential that prevention programs are based on specific populations. Using both ethnographic and quantitative methods, food-consumption patterns were investigated among 1,125 children in the Commonwealth of the Northern Mariana Islands. Differences were observed related to food frequency, age of children, and grade level. Exploratory factor analyses suggested that the individual foods were best organized into food-consumption groups that reflected cultural characteristics rather than more commonly referenced food organizational systems. In addition to developmental differences in food consumption patterns, results suggest that the ethnicity of parents may play a role in the diet of children.