Republic of the Marshall Islands Healthy Stores Project

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Project Features

Intervention developed based on substantial formative research.
Used motivational themes: how to avoid diabetes, being healthy in life, being there for your children and grandchildren.
Identified key foods for promotion.
10 week intervention period, August-October 2001.
Four phases of intervention where different foods/themes promoted.
Twelve stores (9 small and 3 large) part of intervention, 10 comparison stores.

Introduction/Overview

The Republic of the Marshall Islands has seen a dramatic increase in obesity and related chronic diseases as its population has become more dependent on imported (and mostly high-fat, high-calorie) food sources. Pacific Islanders, like minority populations in the United States (African American, Hispanic, Native American, and others) are disproportionately affected by diabetes, cardiovascular disease, hypertension, and other chronic conditions.

Republic of the Marshall Island Facts

Located 2,000 miles southwest of Hawaii
Population ~ 50,000, spread across 33 islands grouped into two parallel chains.
Sixty percent of the population lives in one of two urban centers.
There is little diversity in edible fruits and vegetables, and therefore a limited supply of local food.
Six supermarkets and wholesale stores supply over 95 percent of all imported food consumed in the country.
Approximately 80-90 percent of all food/kcals consumed in the urban areas is supplied by imported foods.
Approximately 25-50 percent of all food/kcals consumed in the outer islands is supplied by imported foods.

Project Reports

Research article – Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands
Research article – A Pilot Food Store Intervention is Associated with Improved Health Knowledge, Food Purchasing and Preparation in the Republic of the Marshall Islands (PDF File)

Project Leaders

Joel Gittelsohn, PhD
Neal Palafox, Md, MPH
Julia Alfred
Heather Haberle, MHS
Malia K. Boggs, MPH
Kevin Frick, PhD
William Dyckman, MHS

Communication Methods and Materials

In-Store:

Owners encouraged to stock healthy food
choices
Shelf labels to identify healthy foods
Cooking demonstrations and taste tests
Recipe cards and flyers
Posters

Mass Media:

Radio announcements of key events and themes
Newspaper ads
Promotional video

Publications

Cortes, L.M.*, Gittelsohn, J., Alfred J, and Palafox, N. (2001) “Formative Research to Inform Intervention Development for Diabetes Prevention in the Republic of the Marshall Islands,” Health Education and Behavior 28(6):696-715.

http://www.ncbi.nlm.nih.gov/pubmed/11720273

Gittelsohn, J., Haberle, H., Vastine, A., Dyckman, W., and Palafox, N. (2003) “Macro and Micro-level Processes Affect Food Choice and Nutritional Status in the Republic of the Marshall Islands,” Journal of Nutrition 133(1): 310S-313S.

http://www.ncbi.nlm.nih.gov/pubmed/12514316

Gittelsohn, J., Dyckman, W., Tan, M.L., Boggs, M.K., Frick, K.D., Alfred, J., Winch, P.J., Haberle, H., and Palafox, N. (2006) “Development and Implementation of a Food Store Intervention to Improve Diet in the Republic of the Marshall Islands,” Health Promotion Practice, Aug 2; [Epub ahead of print].

http://www.ncbi.nlm.nih.gov/pubmed/16885512

Gittelsohn J, Dyckman W, Alfred J, Boggs MK, Haberle H., Fricke KD, Vastine AV, and Palafox N. (2007) “A Pilot Food Store Intervention is Associated with Improved Health Knowledge, Food Purchasing and Preparation Behaviors in the Republic of the Marshall Islands,” Pacific Health Dialogue, 14(2): 43-53.

http://www.ncbi.nlm.nih.gov/pubmed/19588606

If you would like the data collection forms please email Joel Gittelsohn.

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HEALTHY FOOD SYSTEMS

The Healthy Food Systems projects aim to improve health and prevent obesity and disease in low-income communities through culturally appropriate educational, environmental and policy interventions that increase access to healthy foods and promote their purchase, preparation and consumption.
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