The Guam Sustansia Project: Ending Childhood Obesity in Culturally Diverse, Low-Income Communities

Background: Guamanians love fiestas which are the feasts of the village patron saints. Pork and chicken barbecue, red rice, and red meat, caseloads of soda and other sweetened drinks, are normally served. Not to miss during any occasion, including fiestas, is Guam's “staple” food Spam® served as "kelaguen" (diced Spam® spiced up with lemon, salt, green onions and “boonie” pepper). It is during fiestas that over-eating is indulged, learned, and acquired as a habit, because the food is free and the fun is for everyone. When the Guam Public School System conducted a preliminary Body Mass survey a couple of school years ago, approximately 65% of the students in three elementary schools initially surveyed were found to be obese or overweight. The survey is not yet complete, but the pattern is quite evident. Childhood obesity is an epidemic in Guam.

Program background: The Sustansia Project is a social marketing and branding strategy aimed at reversing the childhood obesity epidemic in Guam. "Sustansia", the local word for "nutritious", aims at helping low-income parents and their children access nutritious and affordable food through a logo-identifier system. Grocery food items that are affordable, are low in fats and calories, and are nutrient-dense are marked with a Sustansia logo, making it easier for parents and their children to identify these food items. The logo is a face of a smiling, tongue-licking' child which conveys the idea that nutritious food items are also “yummylicious”.

Evaluation Methods and Results: The project was implemented by local grocery stores that agreed to sign a Memorandum of Agreement with the Sustansia Coalition. The agreement allowed coalition members to (a) evaluate food items that cost $3 or less and meet the nutrition criteria established by the coalition's certified nutritionist. (b) mark these items with a Sustansia logo, (c) conduct promotional activities at the store, and (d) track the sales of these items at point of sale. An ‘S' mark shows on a buyer's receipt, and a summary monthly sales report enabled the analysis of Sustansia sales. 

Conclusions: Launched last July 2009, the Sustansia project is becoming a buzzword in Guam. By introducing a Sustansia jingle that is characteristically Asian/Pacific islander, the jingle's message to “eat fruits and vegetables, drink a lot of water, put the soda away, get a good night's rest, and get up and play” is effectively becoming embedded in the minds of Guam children.  The sales tracking also showed increase in the sale of Sustansia items.

Implications for research and/or practice: Through this project, we learned that a research-based branding strategy utilizing low- to no-cost primetime TV and radio exposure, local newspaper coverage, and an effective partnership with village mayors and private businesses, all woven in a comprehensive media plan can result in an effective health promotion and communications project targeting children from culturally diverse, rural, low-income families.