Dr. Jane Lassetter, College of Nursing
Evaluation of how well the academic objectives of the proposal were met
Originally, I planned to collect the data in Tonga and Utah. The Tongan Ministry of Health never replied to the proposal I submitted for their review. Therefore, spring and summer 2011, I modified the study, and students and I collected data from 364 Native Hawaiian and Pacific Islander (NHPI) participants in two islands of Hawaii at a preschool and grocery stores and in Utah at NHPI events. Our research questions were the following:
- What are the levels of health literacy among NHPI caregivers according to their scores with Pfizer’s Newest Vital Sign (NVS), a tool based on a nutrition fact label?
- According to their NVS scores, 165 participants (45.3%) had a possibility or high likelihood of limited health literacy.
- What is the relationship of caregiver characteristics (age, gender, educational attainment, previous nutrition education, regional location, weight, and BMI), and their food label literacy?
- NVS scores decreased as age increased (p<0.001, r=-0.26) and as BMI increased (p=0.027, r=-0.116). NVS scored improved as income increased (p=0.001, r=0.213) and with higher education levels (p<0.001, r=0.27). Women scored significantly better than men (p=0.046). There was no significant difference in health literacy between participants in Hawaii and those residing in Utah (p=0.795).
- What is the relationship between level of food label literacy and health promotion behaviors: dietary food preparation choices and exercise promotion behaviors in children?
- The third question is currently being analyzed with few significant relationships discovered so far.
Evaluation of the mentoring environment
It was an amazing experience mentoring the students in this research. We collected data together over a three-month period, including one month in Hawaii when we were together almost continually. Involving the two students from BYU-Hawaii had an exponential impact on the experience. The BYU-H students faced a steep curve learning about nursing and research, and they really rose to the occasion. For the BYU College of Nursing students and me, involving the BYU-H students taught us a great deal about NHPI culture and cultural sensitivity. Everyone involved benefitted from the experience. Anecdotally, one of the BYU College of Nursing undergraduate students told me it was the best learning experience she had experienced and was amazed because it occurred outside her course work.
Every learning objective established for this MEG was met. Those objectives were:
- Identify and adhere to principles of protection of research subjects in survey research
- Conduct survey research interviews with NHPI caregiver populations
- Assist in entering research data in SPSS data entry program
- Clean and check data entry
- Understand results of statistical analyses
- Interpret statistical analyses to real-life meaning
- Disseminate findings through podium presentations and manuscript submission
Students who participated and academic deliverables produced or anticipated to produce
With this MEG, I mentored two graduate and four undergraduate students from BYU College of Nursing and two undergraduates from BYU-Hawaii. The graduate students were Sharla Morgan and Katrina Duncan, and the four undergraduate nursing students were Samantha Curtis, Brooke Alleger, Arielle Muffler, and Jaclyn Coleman. BYU-Hawaii students were Jonathan Cummings and Barbara Hanohano. In addition, two BYU College of Nursing alumni helped with the study: Shemnon Miyamoto and Va Mounga. Faculty from other disciplines and schools were also involved: Lora Beth Brown EdD, RD from BYU’s Department of Nutrition, Dietetics, and Food Science; Lauren Clark, Professor at the University of Utah College of Nursing; and Roger Goodwill, Associate Professor of Biology at BYU-Hawaii. Gwen Van Servellen, Visiting Professor from BYU College of Nursing was also involved.
To date, this 2010 MEG has helped generate four presentations at state professional nursing conferences, three presentations at regional professional nursing conferences, and two presentations at an international conference. All presentations have been well received as determined by audience questions and follow-up from attendees after the conferences. Two of the regional presentations have published abstracts. In addition, two manuscripts are currently under review. Those involved are included in the author lists of the manuscripts and presentations. References for these presentations and manuscripts in review as of Sept 26, 2012 include:
- Duncan, K. L., Lassetter, J. H., VanServellen, G., Brown, L. B., Curtis, S., Alleger, B., Coleman, J., Muffler, A., Miyamoto, S. Z., Mounga, V., Clark, L., Goodwill, R., Cummings, J., & Hanohano, B. (submitted July 16, 2012). The relationship between select demographic characteristics and body mass index among Native Hawaiian and other Pacific Islander caregiving adults. Journal of Transcultural Nursing
- Morgan, S., Lassetter, J. H., Brown, L. B., VanServellen, G., Clark, L., Alleger, B., Curtis, S., Muffler, A., Coleman, J., Miyamoto, S. Z., Mounga, V., Goodwill, R., Cummings, J., & Hanohano, B. (submitted August, 2012). Relationship between demographic characteristics and health literacy in Pacific Islanders. Journal of Nursing Scholarship.
- Lassetter, J. H., Morgan, S., Van Servellen, G., Brown, L. B., Clark, L., Curtis, S., Alleger, B., Cummings, J., Hanohano, B., & Goodwill, R. (2012, September 24). Health literacy and demographic variables in Pacific Islander adults, a poster presentation at Native Hawaiian and Pacific Islander Health Disparity and Health Equity Conference, Los Angeles, CA.
- Lassetter, J. H., Duncan, K., Brown, L. B., Van Servellen, G., Clark, L., Curtis, S., Alleger, B., Cummings, J., Hanohano, B., & Goodwill, R. (2012, September 24). The relationship of body mass index and demographic variables in Native Hawaiian and Pacific Islander care-giving adults, a poster presentation at Native Hawaiian and Pacific Islander Health Disparity and Health Equity Conference, Los Angeles, CA.
- Morgan, S., Lassetter, J. H., Brown, L. B. Van Servellen, G., Curtis, S., Alleger, B., Muffler, A., Coleman, J., Miyamoto, S., Mounga, V., Clark, L., Goodwill, R., Cummings, J., & Hanohano, B. (2012). Food label literacy and demographic variables in Pacific Islander adults. Communicating Nursing Research Conference Proceedings, 45, Portland, OR: Western Institute of Nursing, p. 272.
- Duncan, K., Lassetter, J. H., Brown, L. B. Van Servellen, G., Curtis, S., Alleger, B., Muffler, A., Coleman, J., Miyamoto, S., Mounga, V., Clark, L., Goodwill, R., Cummings, J., & Hanohano, B. (2012). BMI and demographic variables in Pacific Islander adults. Communicating Nursing Research Conference Proceedings, 45, Portland, OR: Western Institute of Nursing, p. 271.
- Lassetter, J. H., Duncan, K., Morgan, S., Van Servellen, G., Brown, L. B., Clark, L., Curtis, S., Alleger, B., Coleman, J. T., Muffler, A., Mounga, V., Goodwill, R., Cummings, J., Hanohano, B., Miyamoto, S., & Cahoon, S. (2012, March 28). Food label literacy, BMI, and demographic variables in Pacific Islander adults, a podium presentation at the Pacific Institute of Nursing Conference, Honolulu, HI.
- Morgan, S., Lassetter, J. H., Van Servellen, G., Brown, L. B., Clark, L., Curtis, S., Alleger, B., Cummings, J., Hanohano, B., & Goodwill, R. (2012, March 2). Food label literacy and demographic variables in Pacific Islander adults, a poster presentation at Global Family Health Conference, Brigham Young University, Provo, UT.
- Duncan, K., Lassetter, J. H., Brown, L. B., Van Servellen, G., Clark, L., Curtis, S., Alleger, B., Cummings, J., Hanohano, B., & Goodwill, R. (2012, March 2). The relationship of body mass index and population characteristics in Native Hawaiian and Pacific Islander care-giving adults, a poster presentation at Global Family Health Conference, Brigham Young University, Provo, UT.
- Morgan, S., Lassetter, J. H., Van Servellen, G., Brown, L. B., Clark, L., Curtis, S., Alleger, B., Cummings, J., Hanohano, B., & Goodwill, R. (2011, October 28). Food label literacy and demographic variables in Pacific Islander adults, a poster presentation at Intermountain Healthcare’s Evidence-Based Nursing Research Conference, Salt Lake City, UT.
- Duncan, K., Lassetter, J. H., Brown, L. B., Van Servellen, G., Clark, L., Curtis, S., Alleger, B., Cummings, J., Hanohano, B., & Goodwill, R. (2011, October 28). The relationship of body mass index and population characteristics in Native Hawaiian and Pacific Islander care-giving adults, a poster presentation at Intermountain Healthcare’s Evidence-Based Nursing Research Conference, Salt Lake City, UT.
Description of the results/findings of the project
As a summary of our research, I am including the abstracts submitted with manuscripts this summer.
Abstract #1
Purpose: Native Hawaiian and other Pacific Islanders (NHOPIs) have the highest prevalence of overweight and obesity in the world. We identified the proportion of our NHOPI sample in each body mass index (BMI) category and explored relationships between BMI and demographic characteristics.
Design/Method: Our descriptive correlational study included 364 NHOPI caregiver adults in Utah (n=155) and Hawaii (n=209). We gathered demographic information with a questionnaire. Height and weight were measured for BMI calculations. Results: According to the CDC’s BMI categories, 84.3% of our sample was overweight or obese. Participants in Utah had significantly higher BMIs than participants in Hawaii. Educational attainment was inversely related with BMI; however, age, gender, and income were not significantly related with BMI.
Discussion: NHOPIs on the U.S. mainland may be at greater risk for obesity than those in Hawaii; food price differences between locations may help explain this. NHOPIs in early adulthood had high BMIs; overtime this situation could worsen without intervention. Implications for practice: NHOPIs with low education levels or in areas of low food prices are at increased risk for obesity. Future research should focus on culturally sensitive interventions to reduce NHOPI obesity and associated risks.
Abstract #2
Purpose: Our study described the relationships and differences between health literacy and demographic characteristics and BMI among Native Hawaiian and other Pacific Islander (NHOPI) adults.
Design: We used a descriptive, correlational design and convenience, purposeful sampling. From May to July 2011, data were collected from 364 NHOPI participants in two islands of Hawaii at a preschool and grocery stores and in Utah at NHOPI events.
Methods: We used the Newest Vital Sign (NVS), a six-item health literacy tool based on a nutrition fact label, and a demographic questionnaire and measured participants’ height and weight. T-tests and ANOVA were used to identify health literacy differences between groups (e.g. gender, regional location, and ethnic subgroups), and correlations were used to determine associations between health literacy and age, education, income, and BMI.
Results: According to their NVS scores, 165 participants (45.3%) had a possibility or high likelihood of limited health literacy. NVS scores decreased as age increased (p Conclusions: Health literacy is complex; however, age, income, education, and BMI explained a combined 13% of the variance in NVS scores.
Clinical Relevance: Community-based interventions to help families use nutrition fact labels may improve health literacy and help prevent cross-generational transmission of obesity.
Description of how the budget was spent
Airfare to and from and around for Hawaii data collection= $4,422.33
4 weeks food, lodging, and car rental for Hawaii data collection = $12,988.47 Undergraduate research assistants wages = $5,214.38
Participant compensation (364 @ $10/person) = $3,640
Research supplies = $579.84
BYU Van Rental for Utah data collection = $186.48
Booth rental at Samoan Flag Day in Taylorsville, Utah = 100
TOTAL = $27,131.5