Preliminary Hawai'i Public Health Workforce Supply and Demand Assessment.

Ensuring the adequacy of the public health workforce requires an understanding of its size and composition, as well as the population's demand for services. The current article describes research undertaken as a first step toward developing an estimate of the supply of and demand for Hawai'i's public health workforce. Using an organizational-level survey, data was obtained from a subset of 34 organizations considered to be major providers of population-based public health services in Hawai'i. The results indicate that estimates of the existing public health workforce range from 3,429 to 3,846 workers. Calculations of functional demand reveal that an additional 317 to 502 employees will be required to compensate for vacancies and projected retirements over the next five years; though, the discussion points to the fact that this number may be closer to 1,005 to 1,664. While, an additional 594 to 848 employees would be needed to meet the current missions of organizations in this sample and to best meet community need. While these findings are neither exhaustive nor definitive, they raise issues concerning the state's supply of public health workers in terms of their ability to adequately meet demand for services. More research is needed to confirm these findings and track Hawai'i's public health workforce to assure a strong local public health system.

Modifiable Determinants of Obesity in Native Hawaiian and Pacific Islander Youth.

In the United States, obesity continues to be a major public health concern. Obesity disproportionately affects Native Hawaiian and Other Pacific Islanders (NHOPI) who demonstrate alarming rates of obesity and its related chronic conditions. However, little is known about the causes of obesity for this group. Given the modest effects of individual-level obesity treatments, identifying the most impactful determinants that can be modified to prevent or reduce obesity in NHOPI youth is critical to the development of interventions that best meet the needs of this population. A systematic review was conducted in PubMed, with additional expert-recommended articles identified through the Hawai'i Initiative for Childhood Obesity Research and Education (HICORE) research database, to evaluate the current body of research on modifiable determinants or correlates of obesity in NHOPI youth. Of an initial pool of 471 articles, 60 articles were read in full and 14 articles were selected for inclusion in the qualitative synthesis. Utilizing an ecological framework to identify gaps in the literature and suggest areas for future research, findings from this review indicate that early life and contextual factors-namely, infant-feeding mode, geographic location, and education-appear to play an important role in obesity in NHOPI youth. However, more research is needed, particularly pre-birth cohort studies evaluating the effects of prenatal and early life risk factors, studies on the sociocultural influences on obesity-related psychosocial factors and health behaviors, as well as the influence of environmental and policy-level variables.

A Review of Promising Multicomponent Environmental Child Obesity Prevention Intervention Strategies by the Children's Healthy Living Program.

Childhood obesity has increased rapidly over the last three decades in the U.S. Individual-level interventions targeting healthy eating and physical activity have not significantly impacted clinical measures of obesity in children. Focusing "upstream" on physical, social, cultural, political, and economic environments may be more effective. The purpose of this qualitative review is to analyze published environmental interventions that effectively prevented or reduced obesity in children ages 2­10 years by working within their family, school, and/or community environment to increase physical activity, reduce sedentary behaviors, or improve healthy diet. Through an electronic database search, 590 original articles were identified and 33 were read in full. Using Brennan and co-authors' (2011) rating system, 18 were rated as effective intervention studies. This analysis showed that interventions targeting multiple environments (e.g., family, school, and community) show promise in reducing childhood obesity. Further research is needed to test interventions targeting multiple environments in different communities and populations.