Trial Testing in American Samoa of a Localized Durable Double Sided Healthy Behavior Placemat

Background: With an adult combined overweight and obesity prevalence of 93.5% (WHO 2007) and astronomically growing rates of childhood obesity prevalence (Vargo 2013), American Samoa has one of the worse obesity and NCD rates in the world. American Samoan programs and agencies are aware of and have developed preventative programs to address this problem. In 2013, The American Samoa Community College (ASCC) hired a health communications researcher charged with establishing a Health Communications Research and Media (HCRM) program. This presentation describes one of the first HCRM projects developed in partnership with the CHL (Children’s Health Living Program) in the first year of the program. CHL is a five-year NIFA funded project that aims to build social/cultural, physical/built, and political/economic environments that will promote active play and intake of healthy food to prevent young child obesity in the Pacific Region.

Program background: The idea for the placemat emerged from a community role focus group session focused on “Samoanizing” a template for social marketing the 6 healthy target behaviors that focus on a) physical activity; b) drinking water; c) eating fruits and vegetables; d) sleep, e) limiting SSBs, and f) limiting screen time. A placemat as opposed to a poster was chosen as a potentially more effective reminder and teaching tool for the six target behaviors to be placed in the homes where many of the behaviors take place, and where social marketing media are often missed. Putting the messages and images into a placemat would theoretically increase chances of the messages being repeatedly viewed at close range and at a point of decision for food and drink consumption. The idea was to get the child caregivers on board to use the placemat as a teaching tool and reminder to children as well as other caregivers of the daily targets. Through partnership with American Samoa ECE (Early Childhood Education) a program of getting the placemats distributed into homes with small children and encouraging caregivers to make effective use of the placemats was developed. A short documentary style film was also produced showing an American Samoan family trying to follow the targets with the help of the placemat, which was shown at workshops for caregivers where they would also receive sets of placemats.

Evaluation Methods and Results: Pre-assessment surveys were implemented to determine the knowledge and practice of the targets in households prior to receiving the placemats, followed by post assessment evaluation a month after receiving the placemats. Initial assessments revealed that it took time for some people to become habituated to using the placemat as such, but with more encouragement caregivers realized its benefits. The results showed that young children engaged in the placemat and enjoyed learning and practicing the messages, especially with the encouragement of their caregivers.

Conclusions: The placemat as an intervention tool is a success to be improved upon with continued community engagement and research.

Implications for research and/or practice: Given the results, this project warrants a larger scale adaptation, incorporating lessons learned, accompanied by the necessary evaluative research.