Strengthening Sugar-Sweetened Beverage Taxation for Non-Communicable Disease Prevention: A Comparative Political Economy Analysis Case Study of Fiji and Tonga.

Diet-related fiscal policy is an effective NCD prevention strategy. However, current sugar-sweetened beverage (SSB) taxes in Fiji and Tonga have not had the desired effect; SSB consumption in Fiji, for example, contributes to mortality more than double the global rates and is highest in the WHO Western Pacific Region. We therefore aimed to better understand the perceived underlying political economy drivers that have and continue to affect change in each country. Our study design utilised a comparative case study that triangulated documentary policy and stakeholder analysis with semi-structured stakeholder interviews in both countries and an in-depth corporate political activity analysis in Fiji. We drew on theoretical frameworks relevant to political economy to collect and analyse policy and stakeholder data, and utilised established corporate political activity frameworks to analyse industry activity. Common findings to both Fiji and Tonga suggested that the SSB tax impact could be increased through multisectoral engagement, embracing a whole-of-society approach, strengthened institutional structures and leveraging off competing priorities across sectors towards more common goals. These findings provide opportunities and lessons for Fiji and Tonga as well as other similar settings seeking to strengthen or upscale the impact of diet-related fiscal policy.

The role of cultural values and religion on views of body size and eating practices among adolescents from Fiji, Tonga, and Australia.

OBJECTIVES: This study investigated cultural values related to body image and eating practices in Western and non-Western societies. DESIGN AND METHODS: In total, 628 Fijian, 463 Indo-Fijian, 598 Tongan, and 534 Australian adolescents completed measures of cultural values and religious influences in relation to the ideal body and eating practices. RESULTS: Fijian and Tongan adolescents were more likely to value a large body. Religious influences were most strongly associated with eating practices for Fijians, Indo-Fijians, and Tongans. CONCLUSIONS: The findings support the role of religion in transmitting cultural values regarding eating practices in Pacific Island communities. STATEMENT OF CONTRIBUTION: What is already known on this subject? Previous research has demonstrated that sociocultural factors shape body image and eating behaviours. Most of this research has been conducted in Western countries. What does this study add? The current study identifies the role of cultural values and religious influences on body image and eating behaviours in a number of different cultural groups. This is the first study to use the same methodology to explore these relationships across Western and Pacific Island communities.

The Pacific OPIC Project (Obesity Prevention in Communities): action plans and interventions.

BACKGROUND: The Pacific OPIC Project (Obesity Prevention In Communities) includes whole-of-community intervention programs in four countries (Fiji, Tonga, New Zealand, Australia) aimed at reducing the prevalence of overweight and obesity in youth. DEVELOPMENT OF ACTION PLANS: At each intervention site, preliminary interviews were conducted with youth to identify the potential socio-cultural barriers and facilitators to healthy eating and regular physical activity in order to attain and sustain a healthy body size. This and other information was presented at a 2-day workshop with community stakeholders, including youth. The participants then prioritised the components for a draft action plan which was later consolidated through further community consultation. ACTION PLAN OBJECTIVES: Each action plan had two overall aims: to build community capacity and to promote healthy weight. The first three objectives in each action plan were on capacity building, social marketing messages, and evaluation. Next were a set of four to five behavioural objectives with associated strategies involving programs, events, social marketing and environmental change. Lastly, each site had one or two innovative or developmental objectives. PROGRESS: Interventions began in all sites from 2005, with the action plans guiding implementation priorities. The initial behavioural objective for targeting in Fiji was eating regular breakfast and meals throughout the day, for Tonga it was physical activity, and for Australia and New Zealand it was increasing water consumption and decreasing consumption of sweet drinks. CONCLUSIONS: The action plans have provided the basis for community engagement in the project, the guide to the implementation of activities and the template for the evaluation plan.