Culturally Responsive Health Education in the Pacific: Lessons Learned in American Samoa

Abstract

American Samoa is a unique Pacific region with alarmingly high obesity and Type 2 diabetes mellitus percentages. American Samoa is also an unorganized and unincorporated United States Territory with a comprehensive ecological system that is complicated by over 100 years of affiliation with the United States. The history of US colonial influence on education in American Samoa is described to establish the unique and important consideration of context and place when designing health interventions. Given the negative effects that colonization and modernization have had on Pacific Islander health, decolonization health education is a logical ecological approach to combating escalating obesity and diabetes rates. Innovative health interventions need to continue to be explored to impact the escalating negative health trends in American Samoa. This exploratory qualitative study contributes to the literature on cultural translation and implementation science health intervention by providing an additional autoethnographic vantage point of place-based and culturally responsive pedagogy in American Samoa from the discipline of health education. The selfstudy by university health educators produced five potential place-based and culturally responsive health interventions perceived to be effective within the cultural context of American Samoa. Participants perceived to value health interventions a) aimed at the community rather than the individual; b) experienced as cooperative and reciprocal; c) designed as holistic; d) rooted in Samoan cultural values; and e) distinguished as placed-based.