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Ayers BL, Short E, Cline C, Ammerman AS, Council SK, Kabua PM. Assessing the acceptability of a culturally adapted group-based pediatric intervention, Kokajjiriri, for Marshallese mothers and infants to improve nutrition and prevent childhood obesity. Child Care Health Dev 2024; 50:e13311. [PMID: 39056267 DOI: 10.1111/cch.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/25/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Marshallese Pacific Islanders experience higher rates of obesity than other racial and/or ethnic communities. Despite the obesity rates experienced in this community, there are currently no childhood obesity prevention interventions designed for Marshallese Pacific Islanders in the United States. The purpose of this study is to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. METHODS A multi-methods design was used to culturally adapt the Kokajjiriri intervention for Marshallese mothers in Arkansas (n = 17). In phase one, we conducted 24-h dietary recalls with 20 Marshallese mothers to inform the cultural adaptation of the group-based pediatric intervention, and then in phase two, we culturally adapted and piloted three sessions of the intervention to determine the acceptability and feasibility of the intervention. RESULTS Participants found the adapted intervention to be acceptable and feasible, found the location to be convenient and found the facilitator to be knowledgeable. Four themes emerged from the qualitative data: (1) Lactation Support; (2) Introducing Healthy Solids; (3) Rice Portion Control; and (4) Finding Resources. CONCLUSIONS This is the first study to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. The results from this culturally adapted group-based pediatric intervention, Kokajjiriri, will be used to inform future adaptations and implementation of the full intervention for Marshallese women and children.
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Affiliation(s)
- Britni L Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Eliza Short
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
| | - Chloe Cline
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah K Council
- Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Philmar Mendoza Kabua
- Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
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Saba SK, Rodriguez A, Dickerson DL, Mike L, Schweigman K, Arvizu-Sanchez V, Funmaker G, Johnson CL, Brown RA, Malika N, D'Amico EJ. Physical Pain Among Urban Native American Emerging Adults: Sociocultural Risk and Protective Factors. Psychosom Med 2024; 86:615-624. [PMID: 38787553 PMCID: PMC11371534 DOI: 10.1097/psy.0000000000001326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVE American Indian/Alaska Native (AI/AN) people have high rates of physical pain. Pain is understudied in urban-dwelling, AI/AN emerging adults, a group with unique sociocultural risk and protective factors. We explore associations between socioeconomic disadvantage, additional sociocultural factors, and pain among urban AI/AN emerging adults. METHODS AI/AN participants aged 18-25 years ( N = 417) were recruited via social media. Regression models tested associations between socioeconomic disadvantage (income and ability to afford health care) and pain as well as additional sociocultural factors (discrimination, historical loss, cultural pride and belonging, visiting tribal lands) and pain. Multigroup regression models tested whether associations between sociocultural factors and pain differed between participants who were socioeconomically disadvantaged and those who were less disadvantaged. RESULTS In the full sample, lower income ( b = 1.00-1.48, p < .05), inability to afford health care ( b = 1.00, p = .011), discrimination ( b = 0.12, p = .001), and historical loss ( b = 0.24, p = .006) were positively associated with pain, whereas visiting tribal lands was negatively associated with pain ( b = -0.86 to -0.42, p < .05). In the multigroup model, visiting tribal lands 31+ days was negatively associated with pain only among the less socioeconomically disadvantaged group ( b = -1.48, p < .001). CONCLUSIONS Socioeconomic disadvantage may, in part, drive pain disparities among AI/AN emerging adults and act as a barrier to benefitting from visiting tribal lands. Results support a biopsychosocial approach to targeting pain in this population, including addressing socioeconomic challenges and developing culturally informed, strengths-based interventions.
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Affiliation(s)
- Shaddy K Saba
- From the University of Southern California, Suzanne Dworak-Peck School of Social Work (Saba), Los Angeles, California; RAND (Rodriguez), Boston, Massachusetts; UCLA Integrated Substance Abuse Program, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine (Dickerson), Los Angeles; Santa Cruz Indian Council Board of Directors (Mike); Public Health Consultant (Schweigman), Santa Cruz; Sacred Path Indigenous Wellness Center (Arvizu-Sanchez, Johnson), Los Angeles; American Indian Counseling Center (Funmaker), Cerritos; and RAND (Brown, Malika, D'Amico), Santa Monica, California
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Pennisi F, Genovese C, Gianfredi V. Lessons from the COVID-19 Pandemic: Promoting Vaccination and Public Health Resilience, a Narrative Review. Vaccines (Basel) 2024; 12:891. [PMID: 39204017 PMCID: PMC11359644 DOI: 10.3390/vaccines12080891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/15/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024] Open
Abstract
The COVID-19 pandemic has underscored the critical importance of adaptable and resilient public health systems capable of rapid response to emerging health crises. This paper synthesizes the lessons learned from the COVID-19 vaccination campaign and explores strategies to enhance vaccine uptake in the post-pandemic era. Key challenges identified include logistical, economic, sociocultural, and policy dimensions that impact vaccination efforts, particularly in low-resource settings. The analysis highlights the need for resilient supply chains, effective communication, community engagement, and equitable access to healthcare resources. The rapid development and deployment of mRNA vaccines exemplify the potential of innovative vaccine technologies, though public trust and acceptance remain crucial. Strategies such as partnerships with local leaders, tailored messaging, and integration of digital tools are essential for combating vaccine hesitancy. By applying these insights, future vaccination campaigns can be more efficient, equitable, and resilient, ultimately improving public health outcomes globally. This paper aims to inform policy and practice, ensuring that public health strategies are evidence based and context specific, thus better preparing for future health challenges.
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Affiliation(s)
- Flavia Pennisi
- Faculty of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Cristina Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
| | - Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133 Milan, Italy
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Abu-Ras W, Aboul-Enein BH, Almoayad F, Benajiba N, Dodge E. Mosques and Public Health Promotion: A Scoping Review of Faith-Driven Health Interventions. HEALTH EDUCATION & BEHAVIOR 2024:10901981241252800. [PMID: 39099318 DOI: 10.1177/10901981241252800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
BACKGROUND Religious institutions play a crucial role in health promotion and hold significant influence in the public health field. AIM The aim of this review is to examine outcomes of health-promoting interventions involving the use of mosques as the intervention venue, its role in promoting health behavior change, and the role of theory in each intervention. METHODS A scoping review was conducted across 17 databases for relevant publications published up to and including August 2023 that involved the use of mosques as the intervention venue. Fourteen articles met inclusion criteria and were reviewed. RESULTS The studies featured a wide range of interventions. However, only eight of these studies integrated theoretical frameworks into their approaches, indicating a need for more structured guidance in this field. These theoretical frameworks included Participatory Action Research (PAR), the theory of planned behavior, behavior-change constructs, the patient-centered outcomes research (PCOR) framework, and prolonged exposure techniques within Islamic principles. The review identified three main health-focused intervention categories: mental health, prevention, and communication, each providing valuable insights into initiatives within Muslim communities. CONCLUSIONS This review underscores the significance of inclusive and culturally sensitive health interventions, emphasizing the effectiveness of faith-based approaches in improving health outcomes, promoting positive health behaviors, and addressing communication and cultural barriers. The reviews findings stress the need for further research that incorporates theoretical frameworks and tailored interventions to meet the specific cultural needs of these communities, ultimately contributing to enhanced well-being within them.
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Affiliation(s)
| | | | - Fatmah Almoayad
- Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Seto-Myers DK, Mokiao RH, Camacho SG, Huh D, Aaron SH, Halvorson MA, Walters K, Spencer M. Nā Kānaka Maoli ma nā 'Āina 'Ē: Exploring Place of Residency as a Native Hawaiian Health Predictor During the COVID-19 Pandemic. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2024; 83:208-215. [PMID: 39131829 PMCID: PMC11307322 DOI: 10.62547/olhy2267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Little is known about the impacts of living in diaspora from the Hawaiian Islands on Native Hawaiian health. To address this, the authors conducted an exploratory analysis using cross-sectional data from the 2021 Native American COVID-19 Alliance Needs Assessment. A total of 1418 participants identified as Native Hawaiian (alone or in any combination), of which 1222 reported residency in the continental US and 196 in Hawai'i. Residency status in the continental US vs Hawai'i was evaluated as a predictor of survey outcomes using likelihood ratio tests on linear and logistic regression models for linear and binary outcomes, respectively. Results showed that NH residency in the continental US was significantly associated with increased odds of reporting fair or poor self-rated health; increased odds for screening positive for anxiety, depression, and suicidality; and increased odds of health insurance loss (P's < .05). Residency in the continent was also associated with lower odds of reporting a diagnosed chronic health condition (P < .05). Residency in the continental US had no observed effect on the odds that participants engaged cultural activities or cultural coping strategies. These results support the role of place of residency as an important Native Hawaiian health predictor during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Dayton K. Seto-Myers
- University of Washington School of Social Work, Seattle, WA (DKS, SGC, DH, SHA, MAH, MS)
- Indigenous Wellness Research Institute, Seattle, WA (DKS, DH, KW, MS)
- Ola Pasifika Lab, Seattle, WA (DKS, SGC, SHA, MS)
| | - Reya H. Mokiao
- Seattle Children’s and University of Washington Medicine Pediatrics, Seattle, WA (RHM)
| | - Santino G. Camacho
- University of Washington School of Social Work, Seattle, WA (DKS, SGC, DH, SHA, MAH, MS)
- Ola Pasifika Lab, Seattle, WA (DKS, SGC, SHA, MS)
| | - David Huh
- University of Washington School of Social Work, Seattle, WA (DKS, SGC, DH, SHA, MAH, MS)
- Indigenous Wellness Research Institute, Seattle, WA (DKS, DH, KW, MS)
| | - Sofie H. Aaron
- University of Washington School of Social Work, Seattle, WA (DKS, SGC, DH, SHA, MAH, MS)
- Ola Pasifika Lab, Seattle, WA (DKS, SGC, SHA, MS)
| | - Max A. Halvorson
- University of Washington School of Social Work, Seattle, WA (DKS, SGC, DH, SHA, MAH, MS)
| | - Karina Walters
- Indigenous Wellness Research Institute, Seattle, WA (DKS, DH, KW, MS)
- NIH Tribal Health Research Office (THRO), Bethesda, MD (KW)
| | - Michael Spencer
- University of Washington School of Social Work, Seattle, WA (DKS, SGC, DH, SHA, MAH, MS)
- Indigenous Wellness Research Institute, Seattle, WA (DKS, DH, KW, MS)
- Ola Pasifika Lab, Seattle, WA (DKS, SGC, SHA, MS)
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Antonio MCK, Keaulana S, Ing CT, Williams M, Dillard A, Kekauoha BP, Kenney M, Marshall SM, Cassel K, Abrigo S, Kauhane M, Kaholokula JK. A psychometric analysis of the adapted historical loss scale and historical loss associated symptoms scale among native Hawaiian adults. Front Public Health 2024; 12:1356627. [PMID: 39071148 PMCID: PMC11272616 DOI: 10.3389/fpubh.2024.1356627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 06/14/2024] [Indexed: 07/30/2024] Open
Abstract
Objectives The Historical Loss Scale (HLS) and Historical Loss Associated Symptoms Scale (HLASS) are standardized measures that have been accepted and previously validated among North American Indigenous communities and allow researchers to measure the impact of Historical Loss. Evidence of the psychometric properties of this instrument have not been assessed for Native Hawaiians, the Indigenous peoples of Hawai'i. The purpose of this study is to investigate the psychometric properties of the adapted HLS (aHLS) and HLASS for adults from multiple Hawaiian Homestead Communities throughout Hawai'i. Methods Data are based on cross-sectional surveys administered between 2014 and 2020. The final sample included 491 Native Hawaiian adults who were predominantly female (67.3%) and between the ages of 18-90 years, who were part of the larger study entitled the Hawaiian Homestead Health Survey. Factor analyses were conducted to determine the final model structures of each scale. Reliability and correlation matrices of items are also reported. Results The final factor structure of the aHLS model suggested 3 factors: (1) General loss of culture or cultural loss, (2) Intergenerational loss, and (3) Distrust and destruction of traditional foods. The final HLASS model also suggested 3 factors: (1) Depression and Anger, (2) Shame and Anxiety, and (3) Re-experiencing, fear, and avoidance. Conclusion These findings have implications for future research, practice, and education that explores the role of Historical Loss and associated symptoms in Native Hawaiians and Indigenous communities at large. In particular, measuring historical loss and associated symptoms in Hawaiian Homestead communities paves the way for quantitative assessments of historical trauma and healing in these communities.
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Affiliation(s)
- Mapuana C. K. Antonio
- Native Hawaiian and Indigenous Health, Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Samantha Keaulana
- Native Hawaiian and Indigenous Health, Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Claire Townsend Ing
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Madison Williams
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Adrienne Dillard
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
- Kula no na Po‘e Hawai‘i, Honolulu, HI, United States
| | | | - Meghan Kenney
- Kula no na Po‘e Hawai‘i, Honolulu, HI, United States
| | - Sarah Momilani Marshall
- Kula no na Po‘e Hawai‘i, Honolulu, HI, United States
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Kevin Cassel
- University of Hawai‘i Cancer Center, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Scott Abrigo
- Kapolei Community Development Corporation, Kapolei, HI, United States
| | - Michelle Kauhane
- Kapolei Community Development Corporation, Kapolei, HI, United States
| | - Joseph Keawe‘aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
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Buchanan Z, Hopkins SE, Ryman TK, Austin MA, Wiener HW, Tiwari HK, Klejka JA, Boyer BB, Fohner AE. Electronic health record reveals community-level cardiometabolic health benefits associated with 10 years of community-based participatory research. Public Health 2024; 232:38-44. [PMID: 38733959 PMCID: PMC11176004 DOI: 10.1016/j.puhe.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/18/2024] [Accepted: 04/05/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND While a major goal of community-based participatory research (CBPR) is to improve community health; it is unclear how to measure longstanding success of CBPR. OBJECTIVE We sought to determine the impact of ongoing CBPR on cardiometabolic health of participating communities, including in people not directly participating in research. METHODS We used linear mixed-effects modelling with electronic medical records from 2002 to 2012 from the Yukon-Kuskokwim Health Corporation, which provides health care to all Alaska Native people in southwestern Alaska, to compare rates of change in cardiometabolic risk factors between communities that did and did not participate in ongoing CBPR beginning in 2003. RESULTS We analysed 1,262,035 medical records from 12,402 individuals from 10 study and 38 control communities. Blood pressure declined faster in study than in control communities: systolic blood pressure (0.04 mmHg/year; 95% confidence interval [CI]: 0.01, 0.08); diastolic blood pressure (DBP) (0.07 mmHg/year; 95% CI: 0.04, 0.09). Body mass index increased 0.04 units/year faster in study communities than in control communities (95% CI: 0.03, 0.05). More study visits were associated with faster reduction of DBP and triglyceride levels in study communities. CONCLUSIONS Ongoing CBPR may improve overall cardiometabolic health in communities, perhaps by increasing engagement in health and advocacy.
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Affiliation(s)
- Z Buchanan
- University of Washington, Department of Epidemiology, Seattle, WA, USA
| | - S E Hopkins
- Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, USA; University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA
| | - T K Ryman
- University of Washington, Department of Epidemiology, Seattle, WA, USA; Bill and Melinda Gates Foundation, Seattle, WA, USA
| | - M A Austin
- University of Washington, Department of Epidemiology, Seattle, WA, USA
| | - H W Wiener
- University of Alabama at Birmingham, Department of Epidemiology, Birmingham, AL, USA
| | - H K Tiwari
- University of Alabama at Birmingham, Department of Biostatistics, Birmingham, AL, USA
| | - J A Klejka
- Yukon-Kuskokwim Health Corporation, Bethel, AK, USA
| | - B B Boyer
- Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR, USA; University of Alaska Fairbanks, Center for Alaska Native Health Research, Fairbanks, AK, USA
| | - A E Fohner
- University of Washington, Department of Epidemiology, Seattle, WA, USA.
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Lee YJ. Work and self-rated memory among native Hawaiian and other Pacific Islander older adults. ETHNICITY & HEALTH 2024; 29:523-532. [PMID: 38591263 DOI: 10.1080/13557858.2024.2337620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES Engagement in work has an important association with cognitive health in later life, yet little is known about this association among Native Hawaiian and other Pacific Islander (NHPI) older adults. This study assesses the associations between various work characteristics and memory problems among this population. DESIGN Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), the research question was explored among those who were aged 50+. RESULTS Engagement in work, certain occupation types (e.g., clerical or professional occupations compared to blue-collar jobs), and the current/most recent job that is also the longest job held were associated with lower odds of having memory problems. CONCLUSION The study's results suggest that work characteristics and opportunities to engage in work are important considerations in preventing memory problems in later life. As the NHPI population experiences cognitive health disparities earlier than other groups, timely interventions that focus on work engagement and a culturally relevant environment require further investigation.
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Affiliation(s)
- Yeonjung Jane Lee
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI, USA
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Sereika SM, Moore KR, Stotz S, Chalmers LJ, Garrow H, Gonzales K, O'Banion N, Powell J, Knoki-Wilson U, Charron-Prochownik D. The Associations Between Health-Related Knowledge and Health Beliefs Regarding Risk for Gestational Diabetes in American Indian and Alaska Native Female Adolescents and Young Adults at Risk for Gestational Diabetes and Their Female Caregivers: A Cross-Sectional Dyadic Analysis. J Midwifery Womens Health 2024; 69:383-393. [PMID: 38831486 DOI: 10.1111/jmwh.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/13/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Research on associations between knowledge and health beliefs for women at risk for gestational diabetes mellitus (GDM) has focused on adults at risk for or having GDM. Gaps also exist in examining interpersonal associations with family members or peers. We examined dyadic associations between knowledge and health beliefs about the risk for GDM between and within American Indian and Alaska Native (AIAN) female adolescents and young adults (FAYAs) at risk for GDM and their mothers or adult female caregivers (FCs). METHODS Grounded in the Expanded Health Belief Model, we employed a cross-sectional design using baseline data from 147 dyads of AIAN FAYAs at risk for GDM and their FCs who participated in the Stopping GDM in Daughters and Mothers trial. FAYAs were 12.0 to 24.5 years of age, and 89.1% were students. FCs had a mean (SD) age of 44.0 (9.3) years, 87.0% were AIAN, 44.9% were college educated, 19.7% had ever had GDM, and 81.0% were the FAYA's mother. FAYAs and FCs completed surveys about knowledge and health beliefs (benefits, barriers, severity, susceptibility) regarding GDM risk and prevention. Bivariate correlational analyses were performed to examine associations between and within dyad members. Dyadic associations were investigated using actor-partner interdependence modeling (APIM) assuming distinguishable dyad members. RESULTS Compared with their FCs, FAYAs had lower health-related knowledge and perceived benefits of GDM prevention and susceptibility regarding GDM risk. APIM revealed actor and partner effects of health-related knowledge on health beliefs for dyads. In particular, positive actor effects were found for FAYAs and FCs for GDM-related knowledge with perceived benefits (P < .001), and positive partner effects of GDM-related knowledge for FCs were related to perceived susceptibility and severity for FAYAs (P < .05). DISCUSSION As shown in these AIAN dyads, FAYAs and their FCs, as members of one another's social network, may influence each other's health beliefs regarding GDM risk and prevention.
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Affiliation(s)
- Susan M Sereika
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kelly R Moore
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Stotz
- Department of Food Science and Human Nutrition, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado
| | - Laura J Chalmers
- Department of Pediatrics, School of Medicine, University of Oklahoma, Tulsa, Oklahoma
| | | | - Kelly Gonzales
- School of Public Health, Oregon Health Science University-Portland State University, Portland, Oregon
| | - Nancy O'Banion
- Indian Health Care Resource Center of Tulsa, Tulsa, Oklahoma
| | - Jeffrey Powell
- Northern Navajo Medical Center, Navajo Area Indian Health Service, Shiprock, New Mexico
| | | | - Denise Charron-Prochownik
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
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Mew EJ, Hunt L, Toelupe RL, Blas V, Winschel J, Naseri J, Soliai-Lemusu S, Tofaeono JF, Seui MA, Ledoux-Sunia T, Sunia F, Reid A, Helsham D, Lowe SR, Poulin R, Hawley NL, McCutchan-Tofaeono J. O le tagata ma lona aiga, o le tagata ma lona fa'asinomaga (Every person belongs to a family and every family belongs to a person): Development of a parenting framework for adolescent mental wellbeing in American Samoa. CHILDREN AND YOUTH SERVICES REVIEW 2024; 160:107502. [PMID: 38946713 PMCID: PMC11209950 DOI: 10.1016/j.childyouth.2024.107502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
American Samoan adolescents experience a high prevalence of mental health problems, including depression, anxiety, substance use, and suicidal thoughts and behaviors. To complement existing health system efforts, family-based interventions may be a feasible, cost-effective, and relevant opportunity to promote mental health. This community-partnered, qualitative study aimed to: (1) identify potential family-related psychosocial protective factors for adolescent mental health and (2) develop a framework for a parenting program to promote adolescent mental health in American Samoa. Applying the fa'afaletui framework developed for research in Samoan communities, which emphasizes the importance of weaving a range of community member perspectives to reach consensus, semi-structured in-depth interviews with adult key informants (n=28) were conducted between October 2020 and February 2021. Results were validated through five focus groups with Samoan adolescents (n=35) between May and June 2022. Adult participants were sampled for diversity in profession, age, gender, education, and region of residence; adolescent participants were sampled for diversity in gender. Participants were recruited using personal networks and snowball sampling; adolescent participants also responded to Facebook advertising. The semi-structured interviews focused on broad topics including common mental health problems, contributors to mental illness, and potential interventions, among others. Transcripts were coded in duplicate and analyzed using deductive thematic analysis. Themes were collaboratively mapped onto an adapted fonofale model, an existing framework for Pacific Island health research. Six themes described key practices: (1) provide emotional safety and security; (2) provide physical safety and security; (3) encourage sense of self; (4) strengthen intergenerational communication skills; (5) prioritize quality time; and (6) cultivate healthy coping strategies. Participants also expressed the importance of a supportive environment grounded in culture, family and community, and caregiver mental health. These results provide an initial step to identify family-focused factors that promote adolescent mental health in American Samoa and categorize them into a framework to inform intervention development. Drawing on a collaborative and community-partnered process, these findings provide the first evidence-based framework to develop a parenting program to promote adolescent mental wellbeing and resilience in Samoan communities.
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Affiliation(s)
- Emma J. Mew
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Leiema Hunt
- Department of Health, American Samoa Government, Pago Pago, American Samoa, USA
| | | | - Vanessa Blas
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Julia Winschel
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Joshua Naseri
- Obesity, Lifestyle, And Genetic Adaptations (OLAGA) Study Group, Pago Pago, American Samoa, USA
| | | | | | | | - Trude Ledoux-Sunia
- Christopher James Foeoletini Ledoux Foundation, Pago Pago, American Samoa, USA
| | - Fiafia Sunia
- Christopher James Foeoletini Ledoux Foundation, Pago Pago, American Samoa, USA
| | - Adney Reid
- The Church of Jesus Christ of Latter-day Saints, Pago Pago, American Samoa, USA
| | - Derek Helsham
- American Samoa Community College, Pago Pago, American Samoa, USA
| | - Sarah R. Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Rhayna Poulin
- Yale College, Yale University, New Haven, Connecticut, USA
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut, USA
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Masuda A, Nakamura L, Preston-Pita H, Hermosura S, Morgan L, Stueber K, Spencer SD, Qinaʻau J, Austin-Seabury AA. Native Hawaiians' Views on Depression and Preferred Behavioral Health Treatments: a Preliminary Qualitative Investigation. J Behav Health Serv Res 2024; 51:203-218. [PMID: 38191769 DOI: 10.1007/s11414-023-09874-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/10/2024]
Abstract
Behavioral health issues, especially depression, are a major health disparity concern for Native Hawaiians in Hawai'i. Following the cultural safety framework and contextual behavioral science approach to intervention development, the present preliminary qualitative investigation aimed to gather better insight into Native Hawaiians' views of depression and its causes as well as their preferred forms of behavioral health services. Data were initially collected from a 2-hour virtual focus group with three behavioral health service providers working with Native Hawaiians, followed by a total of 38 online one-on-one in-depth interviews with Native Hawaiian clients with depression (n = 19), behavioral health service providers working with Native Hawaiian adults (n = 9), and Native Hawaiian cultural leaders (n = 10). Our qualitative data suggested that Native Hawaiians tend to view depression contextually and socioculturally as the manifestation of one's vital connection to the 'āina (land), 'ohana (family; continuity from ancestry and future generations), community, culture/spirituality, and one's authentic self being disrupted. Our findings also suggested that Native Hawaiians often attribute these disruptions to disparities due to the ongoing impact of colonization, historical trauma, and cultural loss. As a preferred form of treatment for depression, participants recommended various Hawaiian cultural practices to be integrated into existing behavioral health services to nurture the above-mentioned vital connection.
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Affiliation(s)
- Akihiko Masuda
- Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA.
| | - Lisa Nakamura
- Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA
| | | | | | | | | | - Samuel D Spencer
- Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA
| | - Joanne Qinaʻau
- Department of Psychology, University of Hawai'i at Mānoa, 2530 Dole Street, Sakamaki C400, Honolulu, HI, 96822, USA
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Holman-Allgood I, Cline C, Durand C, Purvis RS, Mendoza Kabua P, Ayers BL. Providers' Perspectives of a Culturally Adapted CenteringPregnancy Intervention for Marshallese Women in Arkansas. Nurs Womens Health 2024; 28:117-127. [PMID: 38460942 PMCID: PMC10999336 DOI: 10.1016/j.nwh.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 03/11/2024]
Abstract
OBJECTIVE To explore health care providers' perspectives on the successes, challenges, and suggestions for future directions regarding the implementation of CenteringPregnancy for Marshallese women in Arkansas. DESIGN A descriptive qualitative design was used as an exploratory method. SETTING/LOCAL PROBLEM This study took place in northwest Arkansas. Arkansas is home to the largest Marshallese Pacific Islander population in the United States. Marshallese Pacific Islanders residing in the United States have disproportionally high rates of poor maternal and infant health outcomes, even compared to other Pacific Islanders. PARTICIPANTS Seven CenteringPregnancy providers from the University of Arkansas for Medical Sciences Northwest. INTERVENTION/MEASUREMENTS Individual interviews were conducted from February to March of 2023. Data were managed using MAXQDA12 software. Content analysis was used to analyze the data. Initial coding was completed to identify each data segment with short summations of emergent themes. The focused thematic codes that emerged were used to identify and develop the most salient thematic categories of the data, which became the thematic codes. RESULTS Three overarching themes emerged: Implementation Successes, Challenges to Implementation, and Future Suggestions to Improve Implementation and Sustainability. Each theme had representative subthemes. CONCLUSION Findings provide insight for future implementation of CenteringPregnancy for Marshallese and other Pacific Islander individuals.
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Mousavi Z, Troxel WM, Dickerson DL, Dong L, Brown RA, Palimaru AI, Klein DJ, Johnson CL, D’Amico EJ. Neighborhood determinants of sleep and the moderating role of cultural factors among native adolescents. Health Psychol 2024; 43:101-113. [PMID: 38127509 PMCID: PMC10842707 DOI: 10.1037/hea0001342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study examined the association between neighborhood social environment and sleep among urban American Indian and Alaska Native (AI/AN) adolescents as well as the moderating role of cultural factors in this association. METHOD The analytic sample included 133 urban AI/AN adolescents (age 12-16, 57.1% female, Mage = 14.03, SDage = 1.35). Perceived neighborhood social environment included safety and cohesion. Cultural factors included AI/AN cultural identification and historical loss. Sleep duration, efficiency, and wake after sleep onset (WASO) were measured via actigraphy. Sleep disturbance was measured via a questionnaire. RESULTS Greater neighborhood safety was significantly associated with lower sleep disturbance (b = -2.17, SE = 0.8, p = .008), higher sleep efficiency (b = 1.75, SE = 0.64, p = .006), and lower WASO (b = -8.60, SE = 3.34, p = .01). Neighborhood cohesion was not associated with any sleep outcomes. Cultural factors moderated the association between neighborhood social environment and sleep outcomes (p < .05). Specifically, both neighborhood safety and cohesion were associated with lower sleep disturbance, only among individuals reporting higher levels of AI/AN cultural identification. Further, neighborhood safety was associated with greater sleep efficiency and lower WASO (i.e., better sleep) only among adolescents with higher contemplation of historical loss. CONCLUSIONS Findings highlight the importance of considering cultural factors in addressing sleep and health disparities. AI/AN cultural identification and a sense of historical loss may be important targets for identifying adolescents who might benefit the most from policies and interventions focused on improving the social environment in order to improve sleep and other health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Zahra Mousavi
- Department of Psychological Science, University of California, Irvine, California, USA
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Wendy M. Troxel
- Division of Behavior and Policy Sciences, RAND Corporation, Pittsburgh, Pennsylvania, USA
| | - Daniel L. Dickerson
- UCLA Integrated Substance Abuse Program, Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | - Lu Dong
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Ryan A. Brown
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Alina I. Palimaru
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - David J. Klein
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
| | - Carrie L. Johnson
- Sacred Path Indigenous Wellness Center, Los Angeles, California, USA
| | - Elizabeth J. D’Amico
- Division of Behavior and Policy Sciences, RAND Corporation, Santa Monica, California, USA
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14
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Short E, Council SK, Bennett Milburn A, Ammerman A, Callaghan-Koru J, Mendoza Kabua P, Ayers BL. Assessing the acceptability and implementation feasibility of a culturally adapted parenting intervention for Marshallese mothers: A study protocol. Contemp Clin Trials Commun 2024; 37:101240. [PMID: 38261960 PMCID: PMC10796808 DOI: 10.1016/j.conctc.2023.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 01/25/2024] Open
Abstract
Background Pacific Islanders, including the Marshallese, face higher rates of obesity and obesity-related chronic conditions. Early-life interventions targeting eating patterns during the first 1000 days of life are essential to promote proper nutrition and growth. Marshallese mothers and caregivers are important decision-makers for feeding practices that could affect childhood obesity rates in Marshallese children. However, little is known about dietary patterns and practices of Marshallese families from birth to 12 months. Culturally-adapted approaches using community-based assets and Pacific Islander cultural values/practices have demonstrated effectiveness in reducing obesity but have not been developed for children. Methods This article describes the protocol for a study to culturally adapt the Centering Parenting intervention for Marshallese mothers in Arkansas. Conclusion This will be the first study to culturally adapt and implement Centering Parenting with Marshallese women in the United States. This study will be an important first step to assess the feasibility and acceptability of an abbreviated parenting intervention to reduce childhood obesity in Marshallese communities.
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Affiliation(s)
- Eliza Short
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Sarah K. Council
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | | | - Alice Ammerman
- University of North Carolina at Chapel Hill, 1700 MLK, Chapel Hill, NC, 27599, USA
| | - Jennifer Callaghan-Koru
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Philmar Mendoza Kabua
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Britni L. Ayers
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
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Chung-Do JJ, Scott SK, Jones BR, Look MA, Taira DA, Palafox NA, Farrar K, Mau MKLM. "Community 101 for researchers": an online training program to build capacity for ethical community-engaged research with Native Hawaiians and Pacific Islanders. Front Public Health 2024; 11:1121748. [PMID: 38249373 PMCID: PMC10796991 DOI: 10.3389/fpubh.2023.1121748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
To address the history of unethical research and community distrust in research among Native Hawaiian and Pacific Islander communities, we developed the "Community 101 for Researchers" training program, which was launched in 2014 to enhance the capacity of researchers to engage in ethical community-engaged research. The purpose of this paper is to describe the development of this training program as well as its reach and feedback from participants. The Community 101 training program is a self-paced, 2-h online training program featuring community-engaged researchers from the University of Hawai'i and their longstanding community partners. Throughout the five modules, we highlight the historical context of Native Hawaiians and Pacific Islander populations in Hawai'i related to research ethics and use examples from the community as well as our own research projects that integrate community ethics, relevance, benefits, and input. To determine reach and gather participant feedback on the training, we extracted data from the user accounts. The training has been completed by 697 users to-date since its launch. Despite very little advertisement, an average of nearly 70 users have completed the Community 101 Program each year. The majority of the participants were located in Hawai'i though participants were also from other states and territories in the US, and international locations. The majority of participants were from universities in Hawai'i in 51 different departments demonstrating multidisciplinary relevance of the program's training. The general feedback from the 96 participants who completed an optional anonymous evaluation survey given at the end of the training was positive. The "Community 101 for Researchers" Training program is an accessible and relevant tool that can be used to advance ethical community engaged research, specifically with Native Hawaiian and Pacific Islander communities.
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Affiliation(s)
- Jane J. Chung-Do
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Samantha Keaulana Scott
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Bradley R. Jones
- Pacific Biosciences Research Center, School of Ocean and Earth Science and Technology, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Mele A. Look
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Deborah A. Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, Hilo, HI, United States
| | - Neal A. Palafox
- Department of Family Medicine and Community Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, United States
| | - Kamahanahokulani Farrar
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
- Papa Ola Lōkahi, Honolulu, HI, United States
| | - Marjorie K. Leimomi M. Mau
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI, United States
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Nair M, Moore K, Sanford SJ, McNair A, Matheson A, Wong E. Impacts of COVID-19 on Young Children and Families: A Qualitative Study Using Best Starts for Kids Health Survey Data in King County, WA. Matern Child Health J 2024; 28:116-124. [PMID: 37922058 PMCID: PMC10876728 DOI: 10.1007/s10995-023-03810-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVES To evaluate the impacts of the COVID-19 pandemic on parents and caregivers with young children in King County, Washington using data from a local population-based survey, the Best Starts for Kids Health Survey (BSKHS). METHODS 7033 parents and caregivers in King County, Washington with children 5th grade and younger participated in the BSKHS in 2021. Three evaluators adopted a framework method approach to thematic analysis for open-ended survey responses regarding the impacts of COVID-19 on families. RESULTS Children aged 0-5 years missed important social development opportunities, while elementary-school children missed social interactions and felt isolated during remote schooling. Parents were exhausted by the competing demands of work and schooling/childcare, with mothers bearing the brunt of additional responsibilities. Many families faced financial uncertainty and were unable to meet basic needs. Yet, families were grateful for more quality time with family members. CONCLUSIONS FOR PRACTICE Parents expressed that children aged 0-5 years missed out on social development opportunities with both adults and children their own age and elementary-school children and felt isolated while schools were closed to in-person schooling.
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Affiliation(s)
- Mohit Nair
- Assessment, Policy Development, and Evaluation Unit, Public Health-Seattle & King County, Seattle, USA
| | - Kristin Moore
- Assessment, Policy Development, and Evaluation Unit, Public Health-Seattle & King County, Seattle, USA
| | - Sara Jaye Sanford
- Assessment, Policy Development, and Evaluation Unit, Public Health-Seattle & King County, Seattle, USA.
| | - Anne McNair
- Assessment, Policy Development, and Evaluation Unit, Public Health-Seattle & King County, Seattle, USA
| | - Alastair Matheson
- Assessment, Policy Development, and Evaluation Unit, Public Health-Seattle & King County, Seattle, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Eva Wong
- Assessment, Policy Development, and Evaluation Unit, Public Health-Seattle & King County, Seattle, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
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Haakenstad MK, Butcher MB, Noonan CJ, Fyfe-Johnson AL. Outdoor Time in Childhood: A Mixed Methods Approach to Identify Barriers and Opportunities for Intervention in a Racially and Ethnically Mixed Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7149. [PMID: 38131701 PMCID: PMC10743276 DOI: 10.3390/ijerph20247149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/25/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
A growing body of literature suggests that outdoor time is beneficial for physical and mental health in childhood. Profound disparities exist in access to outdoor spaces (and the health benefits thereof) for children in communities of color. The objectives of this research were to: (1) identify challenges and solutions to outdoor time for children; (2) assess the importance of outdoor time for children; and (3) evaluate results stratified by race/ethnicity. Using a convergent mixed methods approach, we conducted a thematic analysis from 14 focus groups (n = 50) with outdoor educators, parents with children attending outdoor preschools, and community members with children. In addition, 49 participants completed a survey to identify challenges and solutions, perceived importance, and culturally relevant perspectives of outdoor time. The main challenges identified for outdoor time were safety concerns, inclement weather, lack of access to outdoor spaces, and parent work schedules. The primary proposed solution was integrating outdoor time into the school day. Nearly all participants, independent of racial identity, reported that outdoor time improved physical and mental health. Overall outdoor time was lower in participants from communities of color (~8 h/week) compared to their White counterparts (~10 h/week). While 50% of people of color (POC) reported that outdoor time was an important cultural value, only 18% reported that people in their respective culture spent time outside. This work contributes to accumulating knowledge that unique barriers to outdoor time exist for communities of color, and the children that live, learn, and play in these communities. Increasing outdoor time in school settings offers a potential solution to reduce identified barriers and to promote health equity in childhood.
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Affiliation(s)
- Magdalena K. Haakenstad
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Maria B. Butcher
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202, USA;
| | - Carolyn J. Noonan
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Amber L. Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
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18
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Lin JC, Scott IU, Greenberg PB. Prevalence and Risk Factors of Self-reported Vision Impairment among Native Hawaiians and Pacific Islanders in the United States. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:296-301. [PMID: 38093762 PMCID: PMC10713738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Racial disparities in vision impairment have been reported among Black, Hispanic, and White Americans. However, there is a paucity of research on vision impairment among Native Hawaiians and Pacific Islanders (NHPIs). The objective of this study was to determine the prevalence of, and risk factors for, self-reported visual impairment in NHPI adults in the United States (US). Data from the NHPI and 2014 National Health Interview Surveys were analyzed using sample weights and variance estimates. Prevalence was calculated for vision impairment and blindness for the NHPI and overall US populations. Sociodemographic and clinical risk factors of vision impairment were explored using descriptive statistics, χ2 tests, and simple and multiple logistic regression. In total, 2 586 NHPIs and 36 673 individuals in the US were included. The prevalence of vision impairment was 8.8% among NHPIs and 9.1% for the overall US population, and the prevalence of blindness was 0.72% for NHPIs and 0.35% for the overall population. Independent risk factors associated with vision impairment were having a Charlson Comorbidity Index over 1 [OR: 2.89, 95% CI: (1.42-5.88)] and having a family income below $35 000 [OR: 2.03, 95% CI: (1.06-3.89)]. In summary, the rate of blindness is higher among NHPIs than the overall US population, especially for older and unemployed individuals with more comorbidities. Higher comorbidity burden, lower family income, and recent eye care were risk factors for vision impairment. More research is necessary to develop targeted and culturally sensitive interventions to promote NHPI eye health.
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Affiliation(s)
- John C Lin
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (JCL)
- Division of Ophthalmology, Alpert Medical School, Brown University, Providence, RI (JCL, PBG)
| | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA (IUS)
| | - Paul B Greenberg
- Division of Ophthalmology, Alpert Medical School, Brown University, Providence, RI (JCL, PBG)
- Section of Ophthalmology, VA Providence Healthcare System, Providence, RI (PBG)
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Antonio MC, Keaulana S, Keli’iholokai L, Ho-Lastimosa HI, Chung-Do JJ. Indigenous Research Methodologies with Kānaka 'Ōiwi to Address Health Inequities: Two Case Studies. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:5-9. [PMID: 37901659 PMCID: PMC10612425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Kānaka 'Ōiwi (Native Hawaiians), the Indigenous Peoples of Hawai'i, have worldviews of health that emphasize the importance of being pono (ie, right and just) and maintaining balance with all our relations. Yet, the literature of health for Native Hawaiians often focuses on the disproportionate health disparities that affect the Native Hawaiian community. The purpose of this paper is to present 2 case studies that integrate Indigenous research methodologies with, for, and by Kānaka 'Ōiwi, moving beyond Community-Based Participatory Research (CBPR) approaches to respond to the health needs identified with, for, and by Native Hawaiian communities. The first case study, Mini Ahupua'a for Lifestyle and Mea'ai through Aquaponics (MALAMA), reports on the processes and outcomes for backyard aquaponics, which started with, for, and by the Waimānalo community and extended to include other Native Hawaiian communities. The second case study, Ke Ola O Ka 'Āina, reports on the development and pilot findings of the 'Āina Connectedness Scale, developed with, for, and by Native Hawaiian communities. Common themes resulting from the processes of these case examples include the importance of establishing relationships, protocols, and procedures for pono research, identifying community-based health priorities and solutions to address health disparities, and "walking in multiple worlds" to address the priorities of multiple stakeholders. Public health recommendations and implications, including lessons learned and academic policies that may counter Indigenous research methodologies, are further described.
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Affiliation(s)
- Mapuana C.K. Antonio
- Native Hawaiian and Indigenous Health, Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI (MCKA, SK)
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (MCKA, JJC, SK)
| | - Samantha Keaulana
- Native Hawaiian and Indigenous Health, Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI (MCKA, SK)
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (MCKA, JJC, SK)
| | | | - H. Ilima Ho-Lastimosa
- Ke Kula Nui O Waimānalo, Waimānalo, HI (LK, HIH, JJC)
- College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, Honolulu, HI (HIH)
| | - Jane J. Chung-Do
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (MCKA, JJC, SK)
- Ke Kula Nui O Waimānalo, Waimānalo, HI (LK, HIH, JJC)
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Taafaki MR, Taira D, Braun KL. Scoping Review of Interventional Studies in Chronic Disease for Native Hawaiian, Pacific Islander, and Filipino Populations in the United States. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:58-66. [PMID: 37901666 PMCID: PMC10612424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Native Hawaiians (NHs), Pacific Islanders (PIs), and Filipinos experience health disparities in the United States (US) and need interventions that work for them. The purpose of this paper is to present a review of interventions designed to address chronic disease in Native Hawaiian, Pacific Islander, and Filipino populations in the US that were tested for clinical impact through a randomized controlled trial (RCT). Articles were identified through a search of 4 databases, citation chasing, and colleagues. The 23 included articles reported on 21 interventions addressing 4 chronic conditions-cancer, obesity, cardiovascular disease, and diabetes. All projects were guided by advisory groups, and all interventions were theory-based and tailored to the population, with culturally- and language-appropriate educational materials delivered by same-race individuals in familiar church, club, or home settings. About half were tested through cluster RCT. The majority of the interventions were successful, confirming the value of developing and delivering interventions in partnership with community. Given the growing numbers of NHs, PIs, and Filipinos in the US, more investigational studies are needed to develop and test culturally tailored and grounded interventions that meet the health needs of these populations.
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Affiliation(s)
- Munirih R. Taafaki
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (MRT)
| | - Deborah Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai’i at Hilo, Hilo, HI (DT)
| | - Kathryn L. Braun
- Thompson School of Social Work & Public Health, University of Hawai’i at Mānoa, Honolulu, HI (KLB)
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Akaka G, Daniels S, Davis K, Dillard A, Farrar K, Goebert D, Howard J, Kaio C, Makahi E, Inada M, Oneha M, Purdy M. Prioritizing Connection and Centering on Community: Take Your Shoes Off and Don't Put Your Feet on the Furniture. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:10-13. [PMID: 37901672 PMCID: PMC10612427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
This column describes what it means to be "in" a community and how to create a leading role for community partners in shaping research. It highlights essential components for conducting clinical and translational research in the community, including: (1) invitation to share history and purpose; (2) community-initiated collaboration and engagement; (3) focus on social and cultural determinants of health; (4) community-driven measures and frameworks; (5) application of Indigenous methods and approaches; and (6) implementation of Indigenous and adaptable interventions. Partnering with a community entails building relationships and positioning research around community interests, using methodologies and interventions right for the community.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Emily Makahi
- Wai‘anae Coast Comprehensive Health Center, Wai‘anae, HI (EM)
| | - Megan Inada
- Kōkua Kalihi Valley Comprehensive Family Services, Honolulu, HI (MI)
| | - Mary Oneha
- Waimānalo Health Center, Waimānalo, HI (MO)
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Fok CL, Fifita M, Tanjasiri SP. Decision-Making Regarding Elective Child and Adolescent Vaccinations Among Native Hawaiian and Pacific Islander Parents in Orange County. Health Promot Pract 2023:15248399231193707. [PMID: 37772336 DOI: 10.1177/15248399231193707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
Native Hawaiians and Pacific Islanders (NHPIs) in aggregate experience greater health burdens than non-Hispanic Whites, such as a higher incidence of cervical cancer and COVID-19. Given the importance of vaccinations in preventing and reducing the severity of diseases, such as the flu, cervical cancer, and COVID-19, the receipt of vaccines during childhood and adolescence is crucial. Therefore, this qualitative study aimed to explore the factors associated with NHPI parents' decisions regarding vaccinating their children with these elective vaccinations-that is, vaccinations not required for child care, preschool, or K-12 admissions in California but highly recommended. A total of 15 NHPI parents were recruited through a community-based organization. Semi-structured interviews explored parents' reasons for accepting or denying each vaccine for their child(ren). Results demonstrated variable acceptance of each vaccine, though consistent themes included protection and concerns over side effects. This study also found two general types of parents-those who treat vaccines the same and those with varying opinions about each vaccine. Results from this study demonstrate the family- and community-oriented nature of NHPI communities, suggesting that future interventions target not only parents but also their families and communities to cultivate vaccine acceptance through social networks. Furthermore, addressing all three vaccines during well-child visits may benefit parents who view each vaccine as separate entities with individual pros and cons. Such interventions could contribute toward reducing the burdens of particularly chronic health disparities.
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Affiliation(s)
| | - Melenaite Fifita
- University of California, Irvine, CA, USA
- Pacific Islander Health Partnership, Santa Ana, CA, USA
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Ching JN, Agard JK, Antonio MC. Systematic Review of Culturally-Based Breast Cancer Health Studies in Hawai'i. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:158-168. [PMID: 37465470 PMCID: PMC10351241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Breast cancer disproportionately impacts Native Hawaiian and Pacific Islander communities in Hawai'i, as exemplified by high breast cancer prevalence and mortality rates. Breast cancer disparities are linked to socio-cultural determinants of health, signifying the importance of culturally-based interventions. This paper systematically reviewed breast cancer studies conducted in Hawai'i. The literature search yielded 813 published studies, with a final total of 13 peer-reviewed studies that met this paper's inclusion criteria. All but 1 study incorporated cultural components. By evaluating key intervention components and assessing the quality of each study, the research team aimed to analyze the importance of cultural values in health interventions. Family and spirituality in coping with a cancer diagnosis were key themes in patients' lived experiences. Other culturally-based components in these studies included community-engaged research and cultural training for health professionals. The collective findings suggest that breast cancer health interventions that incorporate cultural strengths, values, and worldviews may play a central role in reducing the overall breast cancer burden among these communities. The present review advocates for future research to take a more culturally-based strategy in addressing breast cancer health disparities among Native Hawaiian and Pacific Islanders in Hawai'i.
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Affiliation(s)
- Jade N. Ching
- Office of Public Health Studies, University of Hawai‘i at Mānoa, Honolulu, HI (JNC)
| | - Joie K. Agard
- College of Natural and Health Sciences, University of Hawai‘i at Hilo, Hilo, HI (JKA)
| | - Mapuana C.K. Antonio
- Native Hawaiian and Indigenous Health Specialization Head, University of Hawai‘i at Mānoa, Honolulu, HI (MCKA)
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Look MA, Maskarinec GG, de Silva M, Werner K, Mabellos T, Palakiko DM, Haumea SL, Gonsalves J, Seabury AA, Vegas JK, Solatorio C, Kaholokula JK. Developing culturally-responsive health promotion: insights from cultural experts. Health Promot Int 2023; 38:daad022. [PMID: 37067166 PMCID: PMC10108309 DOI: 10.1093/heapro/daad022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
Culturally-responsive health promotion initiatives are important to the creation of health equity for Indigenous and minority populations and these initiatives are complex and time-intensive to establish. The knowledge and resources of cultural experts are often pivotal in programs, yet there is minimal research on effective collaborations. The KāHOLO Project demonstrated strong success in the management of uncontrolled hypertension in the high-risk Indigenous population through a 6-month program based on the Hawaiian cultural dance of hula. This program was developed utilizing a community-based participatory research approach and implemented by cultural experts. To better understand the effectiveness of the research endeavor and program, six experienced hula experts and educators who delivered the community-based program were interviewed. As skilled and trusted cultural experts they set a safe supportive learning environment that promoted health and cultural goals. They articulated it was important that the program maintained cultural priorities and integrity. Through the methodical establishment of mutual respect, cooperation on research protocols and requirements was achieved. The development of cultural experts as health allies offers important inroads to the inclusion of minority and Indigenous cultures in health programming.
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Affiliation(s)
- Mele A Look
- Department of Native Hawaiian Health in Honolulu, University of Hawaiʻi, John A. Burns School of Medicine, Honolulu, HI, USA
- Hālau Mōhala ʻIlima, Kāohao, HI, USA
| | | | | | - Kamuela Werner
- Department of Native Hawaiian Health, University of Hawaiʻi, John A. Burns School of Medicine, Honolulu, HI, USA
| | - Tricia Mabellos
- Department of Native Hawaiian Health, University of Hawaiʻi, John A. Burns School of Medicine, Honolulu, HI, USA
| | - Donna-Marie Palakiko
- University of Hawaiʻi, School of Nursing, Ke Ola Mamo, Native Hawaiian Health Care System, Honolulu, HI, USA
| | | | - Joseph Gonsalves
- Hui No ke Ola Pono, Native Hawaiian Health Care System, Waikuku, HI, USA
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25
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Oneha MF, Spencer M, Bright L, Elkin L, Wong D, Sakurai M. Ho'oilina Pono A'e: Integrating Native Hawaiian Healing to Create a Just Legacy for the Next Generation. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:72-77. [PMID: 36908646 PMCID: PMC9995151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Native healing practitioners have been incorporated into health centers serving large populations of Kānaka 'Ōiwi (Native Hawaiians). However, no studies have examined their impact. A community based participatory research study at Waimanalo Health Center from 2017 to 2019 examined the added value of integrating native healing practices into primary care, including whether there is acceptability of the integration, cultural connectedness due to integration, and empowerment for patients, providers, and staff. Semi-structured interviews were conducted by the research team with 24 patients, providers and staff, and community residents. Through content analysis, 5 themes emerged. The integration of native healing practices provides an alternative to western medicine, recalls ancestral knowledge, focuses on the whole person, generates increased disclosure leading to behavior change, and is central to a decolonizing process. The findings support the integration of native healing practices providing added value in primary care.
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Affiliation(s)
| | - Michael Spencer
- University of Washington School of Social Work and Indigenous Wellness Research Institute, Seattle, WA (MS)
| | | | | | - Daisy Wong
- University of Washington, Seattle, WA (DW)
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26
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Ayers BL, Purvis RS, Callaghan-Koru J, Reece S, CarlLee S, Manning N, Langston K, Riklon S, McElfish PA. Marshallese Mothers' and Marshallese Maternal Healthcare Providers' Perspectives on Contraceptive Use and Reproductive Life Planning Practices and Influences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3949. [PMID: 36900960 PMCID: PMC10001766 DOI: 10.3390/ijerph20053949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Pacific Islander communities experience significant maternal and infant health disparities including high maternal and infant mortality. Contraception and reproductive life planning prevent approximately one-third of pregnancy-related deaths and neonatal deaths. We report the results of formative research devoted to understanding Marshallese mothers' as well as their maternal healthcare providers' practices and influences related to contraceptive use and reproductive life planning. This study used an exploratory, descriptive qualitative design to explore Marshallese mothers' and maternal healthcare providers' practices and influences of contraception use and reproductive life planning. Twenty participants were enrolled in the study, 15 Marshallese mothers and five Marshallese maternal healthcare providers. For the Marshallese mothers, two themes emerged: (1) Reproductive Life Planning Practices and Information; and (2) Reproductive Life Planning Influences. For the Marshallese maternal healthcare providers, two themes emerged: (1) Reproductive Life Planning Practices; and (2) Reproductive Life Planning Influences. This is the first study to document Marshallese mothers' and maternal healthcare providers' practices and influences with contraceptive use and reproductive life planning. Study results will inform the development of a culturally-adapted contraception and reproductive life planning tool with an educational program for Marshallese family units and maternal healthcare providers serving Marshallese women.
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Affiliation(s)
- Britni L. Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Rachel S. Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Jennifer Callaghan-Koru
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Sharon Reece
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72701, USA
| | - Sheena CarlLee
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR 72701, USA
| | - Nirvana Manning
- College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR 72205, USA
| | - Krista Langston
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St, Springdale, AR 72762, USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR 72762, USA
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AlAzzeh O, M Roman Y. The frequency of rs2231142 in ABCG2 among Native Hawaiian and Pacific Islander subgroups: implications for personalized rosuvastatin dosing. Pharmacogenomics 2023; 24:173-182. [PMID: 36661065 PMCID: PMC10072122 DOI: 10.2217/pgs-2022-0160] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/12/2022] [Indexed: 01/21/2023] Open
Abstract
Statins are among the most commonly prescribed medications worldwide. Rosuvastatin is a moderate- to high-intensity statin depending on the prescribed dose. Statin-associated muscle symptoms are the main side effects, contributing to low adherence to statins. The missense variant rs2231142 in ABCG2 affects the functionality of the ABCG2 transporter, altering the pharmacokinetics and pharmacodynamics of rosuvastatin. This special report aims to accentuate the importance of considering the ABCG2 genotype upon prescribing rosuvastatin in high cardiovascular disease risk subgroups, specifically Native Hawaiian and Pacific Islander populations. Based on the reported frequencies of rs2231142 in ABCG2, it may be justifiable to initiate low-dose rosuvastatin in Samoans relative to Marshallese or Native Hawaiians. Interpopulation differences in pharmacogenetic allele frequencies underscore the need to disaggregate broad population categories to achieve health equity in treatment outcomes.
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Affiliation(s)
- Ola AlAzzeh
- Department of Pharmacotherapy & Outcome Science, Virginia Commonwealth University School of Pharmacy, 410 N 12th Street, Richmond, VA 23298, USA
| | - Youssef M Roman
- Department of Pharmacotherapy & Outcome Science, Virginia Commonwealth University School of Pharmacy, 410 N 12th Street, Richmond, VA 23298, USA
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Ing CT, Park MLN, Vegas JK, Haumea S, Kaholokula JK. Neighborhood level facilitators and barriers to hypertension management: A Native Hawaiian perspective. Heliyon 2023; 9:e13180. [PMID: 36798760 PMCID: PMC9925873 DOI: 10.1016/j.heliyon.2023.e13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023] Open
Abstract
Native Hawaiians have a disproportionately high prevalence of hypertension, which is an important and modifiable risk factor for cardiovascular disease (CVD). To reduce CVD among Native Hawaiians, we must better understand facilitators and barriers to hypertension management (i.e., diet, physical activity, stress reduction) unique to Native Hawaiians. Despite evidence of neighborhood-level facilitators and barriers to hypertension management in other populations, there is limited research in Native Hawaiians. Participants from a randomized controlled trial (n = 40) were recruited for 5 focus groups. All participants were self-reported Native Hawaiians and had uncontrolled hypertension. Discussions elicited experiences and perceptions of neighborhood-level stressors as they relate to participants' hypertension management efforts. Audio recordings were transcribed and analyzed using ATLAS.ti for emergent themes. Five themes were identified: neighborhood description, community resources, neighborhood change, safety, and social connectedness. Novel barriers to hypertension control included loss of culture and loss of respect for elders, change in community feel, and over-development. Facilitators included social cohesion and collective power. These data provide a deeper understanding of how Native Hawaiians experience neighborhood factors and how those factors impact their efforts to improve their diets, physical activity, and stress management. The findings help to inform the development of multilevel CVD prevention programs. Further research is needed to explore the subtheme of social and emotional stress related to neighborhood change and CVD health risk due to cultural and historic trauma references.
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Affiliation(s)
- Claire Townsend Ing
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
- Corresponding author. Department of Native Hawaiian Health University of Hawai‘i 677 Ala Moana Blvd, Suite 1016B Honolulu, HI 96813, USA.
| | - Mei Linn N. Park
- Thompson School of Social Work & Public Health, University of Hawai‘i, Honolulu, HI, USA
| | - J. Kahaulahilahi Vegas
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i, Honolulu, HI, USA
- Thompson School of Social Work & Public Health, University of Hawai‘i, Honolulu, HI, USA
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29
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Choy CC, Nyhan K, Savusa K, Soti-Ulberg C, Rosen RK, Naseri T, Hawley NL, Sharifi M. Scoping review protocol of multicomponent interventions to address cardiometabolic disease risk among Pacific Islander children. PLoS One 2023; 18:e0280888. [PMID: 36689458 PMCID: PMC9870166 DOI: 10.1371/journal.pone.0280888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Multicomponent interventions can reduce cardiometabolic disease (CMD) risk factors in childhood; however, little synthesis of the literature has taken place in the Pacific region. Pacific Islanders experience a disproportionately high prevalence of CMD risk factors, yet interventions have been slow to reach many communities. We present this protocol for a scoping review to identify and summarize existing multicomponent interventions to address CMD risk in Pacific Islander children. MATERIALS AND METHODS Eligible interventions will (1) address CMD risk factors (including but not limited to obesity, hyperglycemia, dyslipidemia, elevated blood pressure, and/or health behaviors) in 2-to-12-year-old Pacific Islander children, and (2) be multi-component (including at least two lifestyle/behavior change strategies to address CMD risk factors). To investigate existing interventions for adaptation and potential use in Pacific Islander communities, we will search Scopus, MEDLINE ALL (Ovid), EMBASE (Ovid), Yale-licensed Web of Science Core Collection, Cochrane Library, CINAHL (EBSCOhost), ProQuest Dissertations & Theses Global, Global Health (EBSCO), non-indexed Pacific journals, grey literature, government reports, and clinical trial registrations. The Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Scoping Reviews will guide data extraction, evidence mapping, synthesis, and reporting of information including study population, intervention components, behavioral changes, health and implementation outcomes, theoretical frameworks, and evaluation measures. ETHICS AND DISSEMINATION Formal ethical approval is not required. The dissemination strategy will include peer-reviewed journal publications and presentations. Synthesis of existing multicomponent interventions for Pacific Islander children will help to identify best practices that could be replicated, adapted, or combined.
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Affiliation(s)
- Courtney C. Choy
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, United States of America
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut, United States of America
| | - Kima Savusa
- Samoan Obesity, Lifestyle, and Genetic Adaptations Study (OLaGA) Group, Yale School of Public Health, New Haven, Connecticut, United States of America
| | | | - Rochelle K. Rosen
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, United States of America
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island, United States of America
| | - Take Naseri
- Ministry of Health, Apia, Samoa
- Department of Epidemiology, International Health Institute, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, United States of America
- Department of Epidemiology, International Health Institute, Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Mona Sharifi
- Department of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut, United States of America
- Department of Biostatistics (Health Informatics), Yale School of Public Health, New Haven, Connecticut, United States of America
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30
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Playdon M, Rogers TN, Brooks E, Petersen EM, Tavake-Pasi F, Lopez JA, Quintana X, Aitaoto N, Rogers CR. Sociocultural influences on dietary behavior and meal timing among Native Hawaiian and Pacific Islander women at risk of endometrial cancer: a qualitative investigation. Cancer Causes Control 2023; 34:23-37. [PMID: 36208351 PMCID: PMC9547093 DOI: 10.1007/s10552-022-01628-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 09/06/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Determine sociocultural influences on dietary behavior, body image, weight loss, and perceptions of the cultural appropriateness of a meal-timing intervention design and menu among Native Hawaiian and Pacific Islander (NHPI) women at risk of endometrial cancer. METHODS Six 90-min videoconference focus groups among NHPI women (n = 35) recruited by a community champion in Utah. Eligible women were aged ≥ 18 years at risk of endometrial cancer (i.e., BMI ≥ 25 kg/m2, history of non-insulin-dependent diabetes or complex atypical endometrial hyperplasia) had a working cell phone capable of downloading a phone app, could use their cell phone during the day, and were not night-shift workers. Twelve semi-structured questions were posed during the focus groups. Using inductive qualitative methods based on Hatch's 9-step approach, de-identified transcript data were analyzed. RESULTS Overarching themes included economic factors, cultural influences, meal choice and timing, and perceptions of health. Subthemes included affordability, waste avoidance, inundated schedules, and cultural influences. Perceptions of body size and weight loss were influenced by family, community, and social media, whose messages could be conflicting. Important intervention components included satisfying, convenient pre-made meals, while barriers included the need to cook for family members. CONCLUSIONS Dietary interventions targeting metabolic health among NHPI women should consider the multitude of sociocultural and economic factors that influence food choices and meal timing in this population, including affordability, hectic schedules, and immigrant adjustment. Promoting the link between physical and mental well-being as opposed to weight loss is a key approach to reaching this population.
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Affiliation(s)
- M. Playdon
- grid.223827.e0000 0001 2193 0096Department of Nutrition and Integrative Physiology, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA ,grid.223827.e0000 0001 2193 0096Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, RN4511, Salt Lake City, UT 84112 USA
| | - T. N. Rogers
- grid.223827.e0000 0001 2193 0096University of Utah David Eccles School of Business, Sorenson Impact Center, 85 Fort Douglas Blvd, Building #602, Salt Lake City, UT 84113 USA
| | - E. Brooks
- grid.223827.e0000 0001 2193 0096Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108 USA
| | - E. M. Petersen
- grid.223827.e0000 0001 2193 0096Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108 USA
| | - F. Tavake-Pasi
- National Tongan American Society, 5296 S Commerce Dr., Suite 204, Murray, UT 84117 USA
| | - J. A. Lopez
- grid.223827.e0000 0001 2193 0096Department of Family & Preventive Medicine, University of Utah School of Medicine, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108 USA
| | - X. Quintana
- grid.223827.e0000 0001 2193 0096Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, RN4511, Salt Lake City, UT 84112 USA
| | - N. Aitaoto
- grid.223827.e0000 0001 2193 0096Department of Nutrition and Integrative Physiology, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT 84112 USA
| | - C. R. Rogers
- grid.30760.320000 0001 2111 8460Medical College of Wisconsin, Institute for Health & Equity, 8701 W Watertown Plank Rd., Milwaukee, WI 53226 USA
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Hawley NL, Rivara AC, Naseri J, Faumuina K, Potoa’e-Solaita N, Iopu F, Faiai M, Naveno E, Tasele S, Lefale T, Lantini R, Carlson JC, Rabin TL, Semaia P, Mugadza P, Rosen RK. Protocol: Implementation and evaluation of an adolescent-mediated intervention to improve glycemic control and diabetes self-management among Samoan adults. PLoS One 2023; 18:e0279084. [PMID: 36795707 PMCID: PMC9934313 DOI: 10.1371/journal.pone.0279084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/25/2022] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Diagnoses of Type 2 Diabetes in the United States have more than doubled in the last two decades. One minority group at disproportionate risk are Pacific Islanders who face numerous barriers to prevention and self-care. To address the need for prevention and treatment in this group, and building on the family-centered culture, we will pilot test an adolescent-mediated intervention designed to improve the glycemic control and self-care practices of a paired adult family member with diagnosed diabetes. METHODS We will conduct a randomized controlled trial in American Samoa among n = 160 dyads (adolescent without diabetes, adult with diabetes). Adolescents will receive either a six-month diabetes intervention or a leadership and life skills-focused control curriculum. Aside from research assessments we will have no contact with the adults in the dyad who will proceed with their usual care. To test our hypothesis that adolescents will be effective conduits of diabetes knowledge and will support their paired adult in the adoption of self-care strategies, our primary efficacy outcomes will be adult glycemic control and cardiovascular risk factors (BMI, blood pressure, waist circumference). Secondarily, since we believe exposure to the intervention may encourage positive behavior change in the adolescent themselves, we will measure the same outcomes in adolescents. Outcomes will be measured at baseline, after active intervention (six months post-randomization) and at 12-months post-randomization to examine maintenance effects. To determine potential for sustainability and scale up, we will examine intervention acceptability, feasibility, fidelity, reach, and cost. DISCUSSION This study will explore Samoan adolescents' ability to act as agents of familial health behavior change. Intervention success would produce a scalable program with potential for replication in other family-centered ethnic minority groups across the US who are the ideal beneficiaries of innovations to reduce chronic disease risk and eliminate health disparities.
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Affiliation(s)
- Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
- * E-mail:
| | - Anna C. Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | - Joshua Naseri
- Obesity, Lifestyle and Genetic Adaptations Study Group, Pago Pago, American Samoa
| | - Kitiona Faumuina
- Obesity, Lifestyle and Genetic Adaptations Study Group, Pago Pago, American Samoa
| | | | - Francine Iopu
- Department of Public Health, Portland State University, Portland, OR, United States of America
| | - Mata’uitafa Faiai
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | | | - Susie Tasele
- Obesity, Lifestyle and Genetic Adaptations Study Group, Pago Pago, American Samoa
| | - Temukisa Lefale
- Obesity, Lifestyle and Genetic Adaptations Study Group, Pago Pago, American Samoa
| | - Ryan Lantini
- Center for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, RI, United States of America
| | - Jenna C. Carlson
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Tracy L. Rabin
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - Penny Semaia
- Athletic Department, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Phyllis Mugadza
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | - Rochelle K. Rosen
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
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Erland LAE, Needham AMLW, Kehinde AZ, Adebowale AP, Lincoln NK, Ragone D, Murch SJ. Impact of microclimate on Artocarpus altilis (Parkinson) Fosberg var Ma’afala fruit and nutritional quality. J Food Compost Anal 2023. [DOI: 10.1016/j.jfca.2022.104983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Prussing E. Ethnography and quantification: Insights from epidemiology for Indigenous health equity. AMERICAN ANTHROPOLOGIST 2022. [DOI: 10.1111/aman.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Erica Prussing
- Department of Anthropology and Department of Community & Behavioral Health University of Iowa
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Louis JM, Parchem J, Vaught A, Tesfalul M, Kendle A, Tsigas E. Preeclampsia: a report and recommendations of the workshop of the Society for Maternal-Fetal Medicine and the Preeclampsia Foundation. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2022.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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35
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Native Hawaiian wellbeing and transdiagnostic trauma symptoms: The protective role of physical activity in dissociation. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Nguyen CJ, Pham C, Jackson AM, Ellison NLK, Sinclair KI. Online Food Security Discussion Before and During the COVID-19 Pandemic in Native Hawaiian and Pacific Islander Community Groups and Organizations: Content Analysis of Facebook Posts. Asian Pac Isl Nurs J 2022; 6:e40436. [PMID: 36212246 PMCID: PMC9528231 DOI: 10.2196/40436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
Background The Native Hawaiian and Pacific Islander (NHPI) population experiences disproportionately higher rates of food insecurity, which is a risk factor for cardiometabolic diseases such as cardiovascular disease, type 2 diabetes, obesity, and hypertension, when compared to white individuals. Novel and effective approaches that address food insecurity are needed for the NHPI population, particularly in areas of the continental United States, which is a popular migration area for many NHPI families. Social media may serve as an opportune setting to reduce food insecurity and thus the risk factors for cardiometabolic diseases among NHPI people; however, it is unclear if and how food insecurity is discussed in online communities targeting NHPI individuals. Objective The objective of this study was to characterize the quantity, nature, and audience engagement of messages related to food insecurity posted online in community groups and organizations that target NHPI audiences. Methods Publicly accessible Facebook pages and groups focused on serving NHPI community members living in the states of Washington or Oregon served as the data source. Facebook posts between March and June 2019 (before the COVID-19 pandemic) and from March to June 2020 (during the COVID-19 pandemic) that were related to food security were identified using a set of 36 related keywords. Data on the post and any user engagement (ie, comments, shares, or digital reactions) were extracted for all relevant posts. A content analytical approach was used to identify and quantify the nature of the identified posts and any related comments. The codes resulting from the content analysis were described and compared by year, page type, and engagement. Results Of the 1314 nonduplicated posts in the 7 relevant Facebook groups and pages, 88 were related to food security (8 in 2019 and 80 in 2020). The nature of posts was broadly classified into literature-based codes, food assistance (the most common), perspectives of food insecurity, community gratitude and support, and macrolevel contexts. Among the 88 posts, 74% (n=65) had some form of engagement, and posts reflecting community gratitude and support or culture had more engagement than others (mean 19.9, 95% CI 11.2-28.5 vs mean 6.1, 95% CI 1.7-10.4; and mean 26.8, 95% CI 12.7-40.9 vs mean 5.3, 95% CI 3.0-7.7, respectively). Conclusions Food security–related posts in publicly accessible Facebook groups targeting NHPI individuals living in Washington and Oregon largely focused on food assistance, although cultural values of gratitude, maintaining NHPI culture, and supporting children were also reflected. Future work should capitalize on social media as a potential avenue to reach a unique cultural group in the United States experiencing inequitably high rates of food insecurity and risk of cardiometabolic diseases.
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Affiliation(s)
- Cassandra Jean Nguyen
- Institute for Research and Education to Advance Community Health Washington State University Seattle, WA United States
| | - Christian Pham
- Elson S Floyd College of Medicine Washington State University Spokane, WA United States
| | - Alexandra M Jackson
- Institute for Research and Education to Advance Community Health Washington State University Seattle, WA United States
| | | | - Ka Imi Sinclair
- Institute for Research and Education to Advance Community Health Washington State University Seattle, WA United States
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Gonzalez MB, Sittner KJ, Walls ML. Cultural efficacy as a novel component of understanding linkages between culture and mental health in Indigenous communities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:191-201. [PMID: 35285956 PMCID: PMC9452443 DOI: 10.1002/ajcp.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 05/22/2023]
Abstract
We used a novel measure of cultural efficacy to examine empirical pathways between enculturation, efficacy, and two wellbeing outcomes. Cultural factors are not consistently linked to better wellbeing in the academic literature despite widespread understanding of these processes in Indigenous communities. Healing pathways is a community-based participatory study with eight reservations/reserves in the upper Midwest and Canada. This study uses data collected in 2017-2018 (n = 453, 58.1% women, mean age = 26.3 years) and structural equation modeling to test the relationships between enculturation, cultural efficacy, and mental health. The direct effect of enculturation on anxiety was positive. The indirect effect of enculturation via cultural efficacy was negatively associated with anxiety and positively associated with positive mental health. Cultural efficacy is an important linking variable through which the protective effects of culture manifest. The complex nature of culture must be met with innovative measures and deep understanding of Indigenous peoples to fully capture the protective role of culture.
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Affiliation(s)
- Miigis B. Gonzalez
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
| | - Kelley J. Sittner
- Department of SociologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Melissa L. Walls
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
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Sentell TL, Agner JL, Davis J, Mannem S, Seto TB, Valente TW, Vawer M, Taira DA. Social networks in patients hospitalized with preventable conditions for heart disease and diabetes in Hawai'i by health literacy. Chronic Illn 2022; 18:517-531. [PMID: 33497289 DOI: 10.1177/1742395320987892] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Reducing potentially preventable hospitalizations (PPH) for chronic disease is a research and practice priority. Native Hawaiians and other Pacific Islanders (NHOPI) have disparities in PPH, and are understudied in both health literacy and social network research. Greater inclusion of social and familial networks can help address health disparities among people with chronic illness and enhance culturally relevant healthcare. METHODS Adults hospitalized with a heart disease or diabetes-related PHH in Hawai'i (N = 22) were assessed for health literacy and social network membership ("alters"). RESULTS Sixty-nine percent of respondents were NHOPI. Three respondents (14%) had no alters ("isolates"). Among non-isolates, 79% desired the participation of at least one alter in chronic disease management-related interventions. Fifty-nine percent of respondents had low health literacy. While the mean number of alters did not vary significantly by health literacy, those with lower health literacy had a trend (p = .055) towards less interest in social network engagement. DISCUSSION In a sample primarily comprised of NHOPI with chronic disease, many patients wished to include social network members in interventions. Engagement varied by health literacy with implications for health disparities. Not all patients were interested in social network engagement, which must be considered in intervention planning.
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Affiliation(s)
- Tetine L Sentell
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Joy L Agner
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - James Davis
- John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | | | - Todd B Seto
- The Queens Medical Center, Honolulu, HI, USA
| | - Thomas W Valente
- Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
| | - May Vawer
- The Queens Medical Center, Honolulu, HI, USA
| | - Deborah A Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Honolulu, HI, USA
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Maskarinec G, Raquinio P, Kristal BS, Franke AA, Buchthal SD, Ernst TM, Monroe KR, Shepherd JA, Shvetsov YB, Le Marchand L, Lim U. Body Fat Distribution, Glucose Metabolism, and Diabetes Status Among Older Adults: The Multiethnic Cohort Adiposity Phenotype Study. J Epidemiol 2022; 32:314-322. [PMID: 33642515 PMCID: PMC9189316 DOI: 10.2188/jea.je20200538] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND As the proportion of visceral (VAT) to subcutaneous adipose tissue (SAT) may contribute to type 2 diabetes (T2D) development, we examined this relation in a cross-sectional design within the Multiethnic Cohort that includes Japanese Americans known to have high VAT. The aim was to understand how ectopic fat accumulation differs by glycemic status across ethnic groups with disparate rates of obesity, T2D, and propensity to accumulate VAT. METHODS In 2013-2016, 1,746 participants aged 69.2 (standard deviation, 2.7) years from five ethnic groups completed questionnaires, blood collections, and whole-body dual X-ray absorptiometry and abdominal magnetic resonance imaging scans. Participants with self-reported T2D and/or medication were classified as T2D, those with fasting glucose >125 and 100-125 mg/dL as undiagnosed cases (UT2D) and prediabetes (PT2D), respectively. Using linear regression, we estimated adjusted means of adiposity measures by T2D status. RESULTS Overall, 315 (18%) participants were classified as T2D, 158 (9%) as UT2D, 518 (30%) as PT2D, and 755 (43%) as normoglycemic (NG), with significant ethnic differences (P < 0.0001). In fully adjusted models, VAT, VAT/SAT, and percent liver fat increased significantly from NG, PT2D, UT2D, to T2D (P < 0.001). Across ethnic groups, the VAT/SAT ratio was lowest for NG participants and highest for T2D cases. Positive trends were observed in all groups except African Americans, with highest VAT/SAT in Japanese Americans. CONCLUSION These findings indicate that VAT plays an important role in T2D etiology, in particular among Japanese Americans with high levels of ectopic adipose tissue, which drives the development of T2D to a greater degree than in other ethnic groups.
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Affiliation(s)
| | | | - Bruce S. Kristal
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | | | | - Unhee Lim
- University of Hawaii Cancer Center, Honolulu, HI, USA
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Moon PK, Ma Y, Megwalu UC. Head and Neck Cancer Stage at Presentation and Survival Outcomes Among Native Hawaiian and Other Pacific Islander Patients Compared With Asian and White Patients. JAMA Otolaryngol Head Neck Surg 2022; 148:636-645. [PMID: 35616952 PMCID: PMC9136676 DOI: 10.1001/jamaoto.2022.1086] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Research studies often group Native Hawaiian and Other Pacific Islander individuals together with Asian individuals despite being consistently identified as having worse health outcomes and higher rates of comorbidities and mortality. Native Hawaiian and Other Pacific Islander individuals also have high incidence rates of oral cavity and pharyngeal cancer compared with the general population; however, disparities in clinical presentation and survival outcomes of head and neck cancer squamous cell carcinoma (HNSCC) among this population have not been investigated nor compared with those of other races. Objective To determine the association of race with cancer stage at diagnosis and survival outcomes among Native Hawaiian and Other Pacific Islander patients with HNSCC compared with Asian and non-Hispanic White patients. Design, Setting, and Participants This was a retrospective population-based cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) 18 database. Asian, Native Hawaiian or Other Pacific Islander, and non-Hispanic White adult patients diagnosed in 1988 through 2015 with HNSCC of the oral cavity, oropharynx, nasopharynx, larynx, and hypopharynx were included; any patient whose record was missing data on disease or demographic information was excluded. Main Outcomes and Measures Cancer stage at presentation was compared among Asian, Native Hawaiian and Other Pacific Islander, and non-Hispanic White patients using a multivariable logistic regression model. Survival outcomes were compared among these racial groups using Cox regression models. Data analyses were performed from July 1, 2021, to March 20, 2022. Results The total study population comprised 76 473 patients: 4894 Asian (mean [SD] age at presentation, 60.7 [14.6] years), 469 Native Hawaiian and Other Pacific Islander (57.8 [12.3] years), and 71 110 non-Hispanic White (62.2 [12.1] years) individuals. Native Hawaiian and Other Pacific Islander patients were more likely to present with advanced-stage HNSCC (odds ratio [OR], 1.38; 95% CI, 1.12 -1.72) compared with non-Hispanic White patients. Asian patients presented with similar stage disease (OR, 1.04; 95% CI, 0.97-1.11) compared with non-Hispanic White patients. Native Hawaiian and Other Pacific Islander patients had worse disease-specific survival (HR, 1.18; 95% CI, 1.02-1.36) compared with non-Hispanic White patients after adjusting for clinical and demographic factors. In contrast, Asian patients had improved disease-specific survival (HR, 0.93; 95% CI, 0.88-0.98) compared with non-Hispanic White patients. Conclusions and Relevance This retrospective population-based cohort study suggests that Native Hawaiian and Other Pacific Islander race was associated with more advanced HNSCC, and worse disease-specific survival compared with non-Hispanic White race, while Asian race was associated with improved survival. This study highlights the importance of disaggregating Asian from Pacific Islander data when assessing health disparities, and the need for culturally sensitive interventions to promote earlier detection of head and neck cancer and improved survival among the Native Hawaiian and Other Pacific Islander population.
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Affiliation(s)
- Peter Kim Moon
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Yifei Ma
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
| | - Uchechukwu C. Megwalu
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Stanford, California
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Sasa SM, Yellow Horse AJ. Just data representation for Native Hawaiians and Pacific Islanders: A critical review of systemic Indigenous erasure in census and recommendations for psychologists. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:343-354. [PMID: 34878178 DOI: 10.1002/ajcp.12569] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 09/27/2021] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Abstract
The decennial Census survey marks the emergence of federal classifications of race and ethnicity by which the U.S. government has historically conflated Native Hawaiians and Pacific Islanders (NHPI, hereafter) as "Asian or Pacific Islander." This conflation amplifies health injustices and inequities of NHPIs through multiple mechanisms because it masks the complex and heterogeneous experiences of NHPIs, whose positions and relations with the settler state are qualitatively and substantially distinct from Asian Americans. This critical review examines federal documents and research to examine how the panethnic categorizations are often sustained through scientific inquiry and methodologies. We found that self-determination and self-identification for NHPIs are impeded by settler-colonial relations between U.S. colonization of parts of Oceania (e.g., Hawai'i, Sāmoa, Fiji, and Guam) and the forcefully imposed categorization that continues to be in use to legitimize the domination of Indigenous Peoples through race misclassification. Specifically, Census data collection fails to capture accurate and reliable data due to serious methodological limitations. These implications for psychological research compel us to make several recommendations for psychologists: (1) engage with NHPI community partners in all research processes; (2) critically examine Census research design and consider oversampling NHPI households to ensure just data representation; (3) meaningfully engage when, whether and how to aggregate Asian Americans with NHPIs; and (4) use Indigeneity as a critical framework.
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Affiliation(s)
- Steven M Sasa
- Department of Counseling and Counseling Psychology, Arizona State University, Tempe, Arizona, USA
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Yamane CYEW, Helm S. Indigenous Culture-as-Health: A Systematized Literature Review. JOURNAL OF PREVENTION (2022) 2022; 43:167-190. [PMID: 35286545 DOI: 10.1007/s10935-022-00666-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
This paper has two goals regarding cultural rigor, defined as privileging cultural ways of knowing and being as a means to achieving health and well-being for future generations. First, we move the continuum of health practices beyond cultural grounding to include Indigenous Culture-as-Health. Second, this project expands the concept of Indigenous Culture-as-Health in addiction and recovery to include a broader range of health, inclusive of prevention, to further understand this emerging model. Our review of the literature yielded an expanded cultural continuum that includes Indigenous Culture-as-Health, which appears to rely on four modalities: 1) Indigenous ways of knowing, 2) Indigenous cultural practices, 3) place-based/sacred sites, and 4) Indigenous spirituality. For Indigenous health, standards are defined by centuries of ancestral consciousness among Indigenous people across generations, in spite of settler-colonial systems that do not serve them. In other words, Indigenous Culture-as-Health practices contribute to self-determination, sovereignty, and liberation. Incorporating these strategies also will ameliorate other problems related to White supremacy and health, such as epistemic exploitation. Additional implications for prevention practice and policy are described.
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Affiliation(s)
- Cherry Y E W Yamane
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai`i at Mānoa, Honolulu, HI, USA.
| | - Susana Helm
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai`i at Mānoa, Honolulu, HI, USA
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McElfish PA, Rowland B, Scott AJ, Boyers J, Long CR, Felix HC, Kaholokula JK, Sinclair K, Bursac Z, Riklon S. Examining the Relationship Between Physical Activity and Self-Efficacy for Exercise Among Overweight and Obese Marshallese Adults. J Immigr Minor Health 2022; 24:461-468. [PMID: 33837895 PMCID: PMC9540904 DOI: 10.1007/s10903-021-01194-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 01/26/2023]
Abstract
This study examined associations between physical activity frequency and self-efficacy for exercise (SEE) among Marshallese adults in the United States. Data were collected from overweight and obese Marshallese participants (N = 378) enrolled in a Diabetes Prevention Program trial. Logistic and ordinal logistic regressions were employed to examine associations between physical activity and SEE, adjusting for covariates. SEE was significantly associated with engaging in sufficient total physical activity [odds ratio (OR) = 1.70], moderate physical activity (OR = 2.23), and vigorous physical activity (OR = 2.13). Unemployment was associated with less frequent moderate physical activity (OR = 0.59). Younger age (OR = 0.98), being male (OR = 2.67), and reporting excellent health (OR = 3.14) or good health (OR = 2.06) were associated with more frequent vigorous physical activity. Physical activity is a modifiable lifestyle behavior associated with many chronic disease disparities faced by the Marshallese community, and the study results will be useful for practitioners and researchers working to address these disparities.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA.
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA
| | - Janine Boyers
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii At Manoa, Honolulu, HI, 96813, USA
| | - Ka'imi Sinclair
- Institute for Research and Education To Advance Community Health, College of Nursing, Washington State University, Seattle, WA, 98101, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, 33199, USA
| | - Sheldon Riklon
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, 72703, USA
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Lin JC, Ghauri SY, Scott IU, Greenberg PB. Eye Health Care Utilization among Native Hawaiian and Pacific Islander Adults in the United States. Ophthalmic Epidemiol 2022; 30:1-5. [PMID: 35109764 DOI: 10.1080/09286586.2022.2036765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/20/2021] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
Affiliation(s)
- John C Lin
- Program in Liberal Medical Education, Brown University, Providence, Rhode Island, USA
- Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA
| | - Sophia Y Ghauri
- Program in Liberal Medical Education, Brown University, Providence, Rhode Island, USA
- Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA
| | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Paul B Greenberg
- Division of Ophthalmology, Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Section of Ophthalmology, Providence VA Medical Center, Providence, Rhode Island, USA
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Fernandez AR, Beltrán RE. “Wherever I Go, I Have It Inside of Me”: Indigenous Cultural Dance Narratives as Substance Abuse and HIV Prevention in an Urban Danza Mexica Community. Front Public Health 2022; 9:789865. [PMID: 35127622 PMCID: PMC8814356 DOI: 10.3389/fpubh.2021.789865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/28/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction “Mexican American Indian” (MAI) is a large and diverse population for which little empirical research on alcohol and other drug (AOD) use and HIV is available, yet for which there is a disproportionate risk. Indigenous health narratives and participation in place- and settings-based cultural practices can be protective in chronic and co-occurring disease prevention and health promotion for Indigenous people. This study explores the role of participation in cultural dance in generating narratives of prevention and health promotion among a sample of MAIs from an Urban Danza Mexica Community (UDMC), framed within a decolonizing narratives of health (DNOH) model. Methods This secondary data analysis (n = 9) is drawn from a qualitative AOD and HIV health needs assessment of UDMC living in the Pacific Northwest and the Rocky Mountain West (n = 21). This study uses a community-based participatory research approach and employs narrative, Indigenized methods to analyze in-depth interviews from adult cisgender females (n = 5) and males (n = 4). The DNOH model is developed as a relational, analytic framework that contextualizes Indigenous stories in relationship to three distinct yet interconnected levels—the personal, the communal, and Indigeneity in the larger world. These levels of narrative analysis function as culturally grounded, relational pathways through which to articulate health education and promotion approaches. Results Narratives delve into the complex and nuanced relationships within participants' internal worlds (personal), between themselves and their Danza community (communal), and between themselves and their complex, intersectional Indigenous identities within society (Indigeneity). Stories of ancestral teachings about health and prevention shared within the Danza circle create spaces wherein participants navigate complex conversations that resist oppressive colonial narratives, reconnect with and strengthen their Indigenous identities, and strive toward ancestral visions of health and well-being. Discussion This study contributes to Indigenized theoretical and methodological expansion and the development of place/settings-based, narrative, cultural health interventions aimed at preventing chronic and co-occurring disease and promoting wellness among populations similar to the UDMC. Identifying cultural practices as Native Hubs (relational, socially constructed places) that foster decolonizing narratives helps increase understanding of their role in public health education and promotion through recognition of Indigenous knowledge systems and frameworks.
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Affiliation(s)
- Angela R. Fernandez
- School of Nursing, University of Wisconsin-Madison, Madison, WI, United States
- *Correspondence: Angela R. Fernandez
| | - Ramona E. Beltrán
- Graduate School of Social Work, University of Denver, Denver, CO, United States
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Railey AF, Muller C, Noonan C, Schmitter-Edgecombe M, Sinclair K, Kim C, Look M, Kaholokula JK. Cost Effectiveness of a Cultural Physical Activity Intervention to Reduce Blood Pressure Among Native Hawaiians with Hypertension. PHARMACOECONOMICS - OPEN 2022; 6:85-94. [PMID: 34389923 PMCID: PMC8807791 DOI: 10.1007/s41669-021-00291-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The aim of this study was to calculate the costs and assess whether a culturally grounded physical activity intervention offered through community-based organizations is cost effective in reducing blood pressure among Native Hawaiian adults with hypertension. METHODS Six community-based organizations in Hawai'i completed a randomized controlled trial between 2015 and 2019. Overall, 263 Native Hawaiian adults with uncontrolled hypertension (≥ 140 mmHg systolic, ≥ 90 mmHg diastolic) were randomized to either a 12-month intervention group of hula (traditional Hawaiian dance) lessons and self-regulation classes, or to an education-only waitlist control group. The primary outcome was change in systolic blood pressure collected at baseline and 3, 6, and 12 months for the intervention compared with the control group. Incremental cost-effectiveness ratios (ICERs) were calculated for primary and secondary outcomes. Non-parametric bootstrapping and sensitivity analyses evaluated uncertainty in parameters and outcomes. RESULTS The mean intervention cost was US$361/person, and the 6-month ICER was US$103/mmHg reduction in systolic blood pressure and US$95/mmHg in diastolic blood pressure. At 12 months, the intervention group maintained reductions in blood pressure, which exceeded reductions for usual care based on blood pressure outcomes. The change in blood pressure at 12 months resulted in ICERs of US$100/mmHg reduction in systolic blood pressure and US$93/mmHg in diastolic blood pressure. Sensitivity analyses suggested that at the estimated intervention cost, the probability that the program would lower systolic blood pressure by 5 mmHg was 67 and 2.5% at 6 and 12 months, respectively. CONCLUSION The 6-month Ola Hou program may be cost effective for low-resource community-based organizations. Maintenance of blood pressure reductions at 6 and 12 months in the intervention group contributed to potential cost effectiveness. Future studies should further evaluate the cost effectiveness of indigenous physical activity programs in similar settings and by modeling lifetime costs and quality-adjusted life-years. TRIAL REGISTRATION NUMBER NCT02620709.
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Affiliation(s)
- Ashley F Railey
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA.
- Department of Sociology, Indiana University, 1022 E. Third St, Bloomington, IN, 47405-7103, USA.
| | - Clemma Muller
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Carolyn Noonan
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | | | - Ka'imi Sinclair
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Corin Kim
- Kilohana, University of Hawai'i at Hilo, Hilo, HI, USA
| | - Mele Look
- Department of Native Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Mānoa, HI, USA
| | - J Keawe'aimoku Kaholokula
- Department of Native Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Mānoa, HI, USA
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Long CR, Narcisse MR, Bailey MM, Rowland B, English E, McElfish PA. Food insecurity and chronic diseases among Native Hawaiians and Pacific Islanders in the US: results of a population-based survey. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022; 17:53-68. [PMID: 35432687 PMCID: PMC9012098 DOI: 10.1080/19320248.2021.1873883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Data from the 2014 Native Hawaiian and Pacific Islander (NHPI) National Health Interview Survey were used to examine associations between food security and individual chronic diseases, total number of chronic diseases, and general health status among 637 NHPI adults with income below 200 percent federal poverty level. Very low food security was associated with hypertension, diabetes, and asthma. Very low food security and marginal food security were associated with having any chronic disease and with having a higher number of chronic diseases. Risk for food insecurity increased as health status decreased. These associations had not previously been documented for NHPI.
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Affiliation(s)
- Christopher R. Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Mary M. Bailey
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Emily English
- Department of Pediatrics, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N College Avenue, Fayetteville, AR, USA
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48
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Kaholokula JK, Look M, Mabellos T, Ahn HJ, Choi SY, Sinclair KA, Wills TA, Seto TB, de Silva M. A Cultural Dance Program Improves Hypertension Control and Cardiovascular Disease Risk in Native Hawaiians: A Randomized Controlled Trial. Ann Behav Med 2021; 55:1006-1018. [PMID: 33677520 PMCID: PMC8489304 DOI: 10.1093/abm/kaaa127] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Native Hawaiians have higher hypertension (HTN) and cardiovascular disease (CVD) rates than non-Hispanic whites, calling for culturally responsive interventions to close this gap. PURPOSE We tested the effects of a 6-month behavioral intervention, a cultural dance program based on hula (the customary dance of Hawai'i), for improving blood pressure (BP) and CVD risk among Native Hawaiians with uncontrolled HTN. METHODS In a randomized controlled trial, we tested the effects of the hula-based intervention among 263 Native Hawaiians with uncontrolled HTN (systolic ≥ 140 or ≥ 130 mmHg if diabetes) and no CVD at enrollment. All participants received a brief culturally tailored heart health education before random assignment to the hula-based intervention (n = 131) or the education-only waitlist control (n = 132). Intervention received hula lessons and group-based activities for 6 months. Control received only 1-week education through 6 months. RESULTS Intervention yielded greater reductions in systolic (-15.3 mmHg) and diastolic (-6.4 mmHg) BP than control (-11.8 and -2.6 mmHg, respectively) from baseline to 6 months (p < .05). At 6 months, 43% of intervention participants compared to 21% of controls achieved a HTN stage <130/80 mmHg (p < .001). The 10-year CVD risk reduction was two times greater for the intervention group than the control group based on the Framingham Risk Score calculator. All improvements for intervention participants were maintained at 12 months. CONCLUSIONS This trial represents one of the few rigorously conducted examinations of an Indigenous practice leveraged for health promotion, with implications for other ethnic populations.
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Affiliation(s)
| | - Mele Look
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI
- Hālau Mōhala 'Ilima, Ka'ōhao, HI
| | - Tricia Mabellos
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI
| | - Hyeong Jun Ahn
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI
| | - So Yung Choi
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI
| | - Ka'imi A Sinclair
- Institute for Research and Education to Advance Community Health (IREACH), Washington State University, Seattle, WA
| | - Thomas A Wills
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI
- Cancer Prevention in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI
| | - Todd B Seto
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI
- The Queen’s Medical Center, The Queen’s Health Systems, Honolulu, HI
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49
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D'Amico EJ, Dickerson DL, Rodriguez A, Brown RA, Kennedy DP, Palimaru AI, Johnson C, Smart R, Klein DJ, Parker J, McDonald K, Woodward MJ, Gudgell N. Integrating traditional practices and social network visualization to prevent substance use: study protocol for a randomized controlled trial among urban Native American emerging adults. Addict Sci Clin Pract 2021; 16:56. [PMID: 34565444 PMCID: PMC8474938 DOI: 10.1186/s13722-021-00265-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nonmedical use of prescription opioids (defined as taking opioid medications for hedonic effects or in a manner other than prescribed) and the use of heroin have emerged in recent years as major public health concerns in the United States. Of particular concern is the prevalence of opioid use among emerging adults (ages 18-25), as this is a developmental period of heightened vulnerability and critical social, neurological, and psychological development. Data from 2015 show that American Indian/Alaska Native (AI/AN) people have the highest rates of diagnosis for opioid use disorders (OUDs). One recent study found that the overdose death rate among urban-dwelling AI/AN individuals was 1.4 times higher compared to those living in rural areas. To date, there are no evidence-based prevention programs addressing opioid use among urban AI/AN emerging adults that integrate culturally-appropriate strategies with evidence-based treatment. Traditions and Connections for Urban Native Americans (TACUNA) builds on our prior work with AI/AN communities across California to develop and evaluate culturally appropriate programming to address opioid, alcohol, and cannabis use among urban AI/AN emerging adults. METHODS/DESIGN In a randomized controlled trial, 18-25 year old urban AI/AN emerging adults will receive either TACUNA (n = 185), which comprises three virtual workshops utilizing motivational interviewing, social network visualization, and integrating traditional practices and a wellness circle, or one virtual culturally sensitive opioid education workshop (n = 185). We will evaluate intervention effects on primary outcomes of frequency of opioid, alcohol, and cannabis use, as well as secondary outcomes of social network characteristics and cultural connectedness, over a 12-month period. DISCUSSION This project has the potential to expand the range and effectiveness of opioid, alcohol, and cannabis services for urban AI/AN emerging adults by addressing the opioid epidemic and use of other substances at both the community and individual level. In addition, it provides important culturally grounded conceptual and practical information to advance the field of substance use interventions and enhance resiliency among this population. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04617938. Registered October 26, 2020 https://clinicaltrials.gov/ct2/show/record/NCT04617938 .
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Affiliation(s)
- Elizabeth J D'Amico
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA.
| | - Daniel L Dickerson
- UCLA Integrated Substance Abuse Programs (ISAP), Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, 1640 Sepulveda Blvd., Suite 200, Los Angeles, CA, 90025, USA
| | | | - Ryan A Brown
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - David P Kennedy
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - Alina I Palimaru
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - Carrie Johnson
- Sacred Path Indigenous Wellness Center, Los Angeles, CA, 90017, USA
| | - Rosanna Smart
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - David J Klein
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - Jennifer Parker
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - Keisha McDonald
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - Michael J Woodward
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
| | - Ninna Gudgell
- RAND Corporation, 1776 Main Street, PO Box 2136, Santa Monica, CA, 90407-2138, USA
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50
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Quint JJ, Van Dyke ME, Maeda H, Worthington JK, Dela Cruz MR, Kaholokula JK, Matagi CE, Pirkle CM, Roberson EK, Sentell T, Watkins-Victorino L, Andrews CA, Center KE, Calanan RM, Clarke KE, Satter DE, Penman-Aguilar A, Parker EM, Kemble S. Disaggregating Data to Measure Racial Disparities in COVID-19 Outcomes and Guide Community Response - Hawaii, March 1, 2020-February 28, 2021. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1267-1273. [PMID: 34529634 PMCID: PMC8445382 DOI: 10.15585/mmwr.mm7037a1] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Native Hawaiian and Pacific Islander populations have been disproportionately affected by COVID-19 (1-3). Native Hawaiian, Pacific Islander, and Asian populations vary in language; cultural practices; and social, economic, and environmental experiences,† which can affect health outcomes (4).§ However, data from these populations are often aggregated in analyses. Although data aggregation is often used as an approach to increase sample size and statistical power when analyzing data from smaller population groups, it can limit the understanding of disparities among diverse Native Hawaiian, Pacific Islander, and Asian subpopulations¶ (4-7). To assess disparities in COVID-19 outcomes among Native Hawaiian, Pacific Islander, and Asian populations, a disaggregated, descriptive analysis, informed by recommendations from these communities,** was performed using race data from 21,005 COVID-19 cases and 449 COVID-19-associated deaths reported to the Hawaii State Department of Health (HDOH) during March 1, 2020-February 28, 2021.†† In Hawaii, COVID-19 incidence and mortality rates per 100,000 population were 1,477 and 32, respectively during this period. In analyses with race categories that were not mutually exclusive, including persons of one race alone or in combination with one or more races, Pacific Islander persons, who account for 5% of Hawaii's population, represented 22% of COVID-19 cases and deaths (COVID-19 incidence of 7,070 and mortality rate of 150). Native Hawaiian persons experienced an incidence of 1,181 and a mortality rate of 15. Among subcategories of Asian populations, the highest incidences were experienced by Filipino persons (1,247) and Vietnamese persons (1,200). Disaggregating Native Hawaiian, Pacific Islander, and Asian race data can aid in identifying racial disparities among specific subpopulations and highlights the importance of partnering with communities to develop culturally responsive outreach teams§§ and tailored public health interventions and vaccination campaigns to more effectively address health disparities.
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