title: Formative research to inform intervention development for diabetes prevention in the Republic of the Marshall Islands.
abstract: Formative research was conducted in the Republic of the Marshall Islands to help develop a diabetes prevention intervention. Methods included in-depth interviews, semistructured interviews, and direct observation of household behaviors in urban and remote settings. Foods were classified into two main conceptual spheres: foods from the islands/Marshallese foods and imported/American foods. Diabetes (nanimij in tonal) is a highly salient illness and is believed to be caused by foods high in fat and sugar, consumption of imported/American foods, family background, and the atomic bomb testing. Physical activity and eating a traditional diet were viewed as important for preventing diabetes. The traditional belief system links a large body with health, and a thin body with illness; however, perceptions are changing with increased acculturation and education about the health risks of obesity. These findings were used to develop a diabetes prevention home visit intervention currently being implemented and evaluated in Marshallese households.
authors.affiliation: Injury Research Center at the Medical College of Wisconsin, Department of Emergency Medicine, Milwaukee, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Cortes
authors.forename: J
authors.initials: J
authors.lastname: Gittelsohn
authors.forename: J
authors.initials: J
authors.lastname: Alfred
authors.forename: N A
authors.initials: NA
authors.lastname: Palafox
mesh_terms: D001824:Body Constitution; D015992:Body Mass Index; D003466:Cultural Characteristics; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D004041:Dietary Fats / Q000009:adverse effects; D005247:Feeding Behavior; D005518:Food Preferences; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008519:Medicine, Traditional; D008849:Micronesia / Q000453:epidemiology
chemical_list: D004041:Dietary Fats