Modifiable Determinants of Obesity in Native Hawaiian and Pacific Islander Youth

In the United States, obesity continues to be a major public health concern. Obesity disproportionately affects Native Hawaiian and Other Pacific Islanders (NHOPI) who demonstrate alarming rates of obesity and its related chronic conditions. However, little is known about the causes of obesity for this group. Given the modest effects of individual-level obesity treatments, identifying the most impactful determinants that can be modified to prevent or reduce obesity in NHOPI youth is critical to the development of interventions that best meet the needs of this population. A systematic review was conducted in PubMed, with additional expert-recommended articles identified through the Hawai'i Initiative for Childhood Obesity Research and Education (HICORE) research database, to evaluate the current body of research on modifiable determinants or correlates of obesity in NHOPI youth. Of an initial pool of 471 articles, 60 articles were read in full and 14 articles were selected for inclusion in the qualitative synthesis. Utilizing an ecological framework to identify gaps in the literature and suggest areas for future research, findings from this review indicate that early life and contextual factors-namely, infant-feeding mode, geographic location, and education-appear to play an important role in obesity in NHOPI youth. However, more research is needed, particularly pre-birth cohort studies evaluating the effects of prenatal and early life risk factors, studies on the sociocultural influences on obesity-related psychosocial factors and health behaviors, as well as the influence of environmental and policy-level variables.