Multilevel factors influencing child overweight and obesity in the Pacific Islands.

UNLABELLED: This systematic review summarizes multilevel factors influencing overweight and obesity among children in the Pacific Islands from inception to April 2024. Factors assessed in studies were grouped by types of influence and levels of the social ecological model (SEM). 38 studies met inclusion criteria. Multilevel factors influencing overweight and obesity were caregiver factors (n = 22), geography (n = 20), sociocultural factors (n = 18), child diet (n = 10), child physical activity (n = 8), race and ethnicity (n = 8), infant factors (n = 7), other child health factors (n = 5), and environmental factors (n = 2). Majority of studies focused on factors at the individual level of the SEM (n = 33), followed by the interpersonal level (n = 21), and the community level (n = 20). No studies were found that address factors at the policy level of the SEM. There were some consistent findings for modern diet, screen time, maternal BMI, and type of school the child attended (public vs. private) being positively associated with child overweight and obesity. FUNDING: USDA 2021-68012-35899, NIH 1P20GM139753-01A1, NIH T32DK137523, NIH K99HL166781.