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Jones JE, Taparra K. Indigenous Representation and Belonging in Cardiology. JAMA Cardiol 2024:2820446. [PMID: 38985456 DOI: 10.1001/jamacardio.2024.1706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Affiliation(s)
| | - Kekoa Taparra
- Department of Radiation Oncology, Stanford University, Palo Alto, California
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Darvish S, Mahoney SA, Venkatasubramanian R, Rossman MJ, Clayton ZS, Murray KO. Socioeconomic status as a potential mediator of arterial aging in marginalized ethnic and racial groups: current understandings and future directions. J Appl Physiol (1985) 2024; 137:194-222. [PMID: 38813611 DOI: 10.1152/japplphysiol.00188.2024] [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: 03/13/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 05/31/2024] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death in the United States. However, disparities in CVD-related morbidity and mortality exist as marginalized racial and ethnic groups are generally at higher risk for CVDs (Black Americans, Indigenous People, South and Southeast Asians, Native Hawaiians, and Pacific Islanders) and/or development of traditional CVD risk factors (groups above plus Hispanics/Latinos) relative to non-Hispanic Whites (NHW). In this comprehensive review, we outline emerging evidence suggesting these groups experience accelerated arterial dysfunction, including vascular endothelial dysfunction and large elastic artery stiffening, a nontraditional CVD risk factor that may predict risk of CVDs in these groups with advancing age. Adverse exposures to social determinants of health (SDOH), specifically lower socioeconomic status (SES), are exacerbated in most of these groups (except South Asians-higher SES) and may be a potential mediator of accelerated arterial aging. SES negatively influences the ability of marginalized racial and ethnic groups to meet aerobic exercise guidelines, the first-line strategy to improve arterial function, due to increased barriers, such as time and financial constraints, lack of motivation, facility access, and health education, to performing conventional aerobic exercise. Thus, identifying alternative interventions to conventional aerobic exercise that 1) overcome these common barriers and 2) target the biological mechanisms of aging to improve arterial function may be an effective, alternative method to aerobic exercise to ameliorate accelerated arterial aging and reduce CVD risk. Importantly, dedicated efforts are needed to assess these strategies in randomized-controlled clinical trials in these marginalized racial and ethnic groups.
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Affiliation(s)
- Sanna Darvish
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Sophia A Mahoney
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | | | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Kevin O Murray
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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Motta-Ochoa R, Patenaude D, Barbe-Welzel MA, Incio-Serra N, Audeoud ER, Gómez-Rendón A, Flores-Aranda J. Evidence about art-based interventions for Indigenous people: a scoping review protocol. BMJ Open 2024; 14:e083448. [PMID: 38839385 PMCID: PMC11163821 DOI: 10.1136/bmjopen-2023-083448] [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: 12/19/2023] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Indigenous people experience a unique set of health inequalities and social determinants that can negatively affect their physical health, mental health and wellness. This critical state of affairs is compounded by the limited availability of culturally appropriate care services and treatments for the different groups. In response, increasing numbers of studies are turning their focus to art-based interventions and how these might benefit Indigenous lives. The proposed scoping review aims to map this growing field of research. METHODS AND ANALYSIS This scoping review is based on the Arksey and O'Malley methodological framework and the subsequent enhancements proposed by Levac et al. Academic databases and grey literature sources will be searched to identify appropriate studies for inclusion. The search strategies of all databases were tested on 25 April 2024. This will be followed by a two-step screening process to be conducted by two researchers and consisting of (1) a title and abstract review and (2) a full-text review. Data from the selected studies will be extracted, collated and charted to summarise all relevant interventions, their outcomes and key findings. An Indigenous research partner will be hired as a consultant, and the research will be further informed by other stakeholders. ETHICS AND DISSEMINATION This study is the first step in a research programme involving working with Indigenous artists to codesign a pilot art-based intervention aimed at improving mental health and wellness among Indigenous people. The scoping review will identify the specific components in documented art-based interventions that have proven beneficial to this group. Since it will draw exclusively on data from published and public sources, no ethics approval is required. The results will be disseminated through knowledge translation activities with Indigenous organisations and art therapy groups; a summary of the results will also be distributed through Indigenous networks.
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Affiliation(s)
| | - David Patenaude
- Arts and Humanities Library, University of Montreal, Montreal, Québec, Canada
| | | | - Natalia Incio-Serra
- Department of Integrated Studies in Education, McGill University, Montreal, Québec, Canada
| | | | | | - Jorge Flores-Aranda
- School of Social Work, University of Quebec in Montreal, Montreal, Québec, Canada
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Kulshreshtha M, Chandel S. An Indian classical dance form, Kathak in maintaining handgrip strength symmetry and reducing the risk of hypertension. Arts Health 2024:1-13. [PMID: 38755972 DOI: 10.1080/17533015.2024.2355137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND The present paper aimed to study handgrip strength (HGS) asymmetry and its association with hypertension in a sample of Kathak dancers and non-dancers of North India. METHODS Data on HGS and blood pressure were collected from 206 Kathak dancers and 235 age-matched controls, using standardized protocols. Pearson correlation coefficients assessed the association between HGS and hypertension, and binary logistic regression identified the risk of developing hypertension. RESULTS HGS asymmetry was higher among non-dancers. In Kathak dancers, systolic blood pressure (SBP) was positively correlated with HGS and negatively correlated with HGS asymmetry whereas diastolic blood pressure (DBP) was negatively correlated with both HGS and HGS asymmetry. Dancers with high HGS, have significantly reduced risk of developing hypertension. Non-dancers with HGS asymmetry were 1.8 times more likely to report hypertension, relative to dancers. CONCLUSION Kathak may be used as an alternative method for maintaining HGS symmetry and reducing the risk of developing hypertension.
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Affiliation(s)
| | - Shivani Chandel
- Department of Anthropology, University of Delhi, Delhi, India
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Jabbarzadeh Ganjeh B, Zeraattalab-Motlagh S, Jayedi A, Daneshvar M, Gohari Z, Norouziasl R, Ghaemi S, Selk-Ghaffari M, Moghadam N, Kordi R, Shab-Bidar S. Effects of aerobic exercise on blood pressure in patients with hypertension: a systematic review and dose-response meta-analysis of randomized trials. Hypertens Res 2024; 47:385-398. [PMID: 37872373 DOI: 10.1038/s41440-023-01467-9] [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] [Received: 02/05/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023]
Abstract
We aimed to evaluate the dose-dependent effects of aerobic exercise on systolic (SBP) and diastolic blood pressure (DBP) and haemodynamic factors in adults with hypertension. PubMed, Scopus, and Web of Science were searched to April 2022 for randomized trials of aerobic exercise in adults with hypertension. We conducted a random-effects meta-analysis to estimate mean differences (MDs) and 95%CIs for each 30 min/week increase in aerobic exercise. The certainty of evidence was rated using the GRADE approach. The analysis of 34 trials with 1787 participants indicated that each 30 min/week aerobic exercise reduced SBP by 1.78 mmHg (95%CI: -2.22 to -1.33; n = 34, GRADE=low), DBP by 1.23 mmHg (95%CI: -1.53 to -0.93; n = 34, GRADE=moderate), resting heart rate (MD = -1.08 bpm, 95%CI: -1.46 to -0.71; n = 23, GRADE=low), and mean arterial pressure (MD = -1.37 mmHg, 95%CI: -1.80 to -0.93; n = 9, GRADE = low). A nonlinear dose-dependent decrement was seen on SBP and DBP, with the greatest decrement at 150 min/week (MD150 min/week = -7.23 mmHg, 95%CI: -9.08 to -5.39 for SBP and -5.58 mmHg, 95%CI: -6.90 to -4.27 for DBP). Aerobic exercise can lead to a large and clinically important reduction in blood pressure in a dose-dependent manner, with the greatest reduction at 150 min/week. The dose-dependent effects of aerobic exercise on systolic and diastolic blood pressure and haemodynamic factors in adults with hypertension.
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Affiliation(s)
| | | | - Ahmad Jayedi
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mojtaba Daneshvar
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Gohari
- Department of Sports Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhane Norouziasl
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Ghaemi
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Selk-Ghaffari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Navid Moghadam
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran.
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Davis J, Taira DA, Lim E, Chen J. Daily Moderate-to-Vigorous Activity of Native Hawaiians and Pacific Islanders and Seven Asian Subgroups by Types of Activities, American Time Use Survey, 2010-2019. Healthcare (Basel) 2024; 12:205. [PMID: 38255093 PMCID: PMC10815051 DOI: 10.3390/healthcare12020205] [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: 10/19/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
The study used the American Time Use Survey data from 2010 to 2019 to compare the daily moderate-to-vigorous activity of Native Hawaiians and Pacific Islanders (NHPI) and seven Asian ethnic subgroups. Adults aged 24 years and older were included. The study analyzed activities from sports and recreation, household activities, and all activities carried out during the day. Outcomes were determined by the completion of 30 min or more of moderate-to-vigorous activity and the type of activity carried out in the day. Significant ethnic differences were observed for sports and recreation but not for household activities and not for all activities carried out during the day. Of the ethnic populations, NHPI were the least active, and Asian Indians and Chinese were the most active. A majority achieved 30 min or more of moderate-to-vigorous activity during the day from all their activities. Physical activity from household activities exceeded physical activity from sports and recreation. The most physically active group was adults over the age of 65 years, perhaps reflecting more time to exercise or greater concerns about their health. For sports and recreation, exercising with someone doubled the minutes of moderate-to-vigorous activity. The results emphasize the importance of activities performed around the household in addition to sports and recreation and the benefit of exercising with someone. Ethnic populations may be receptive to interventions that emphasize activities they are performing in their daily lives.
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Affiliation(s)
- James Davis
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, 651 Ilalo Street Honolulu, Honolulu, HI 96813, USA; (E.L.); (J.C.)
| | - Deborah A. Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai‘i at Hilo, 722 South Aohoku Place, Hilo, HI 96720, USA;
| | - Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, 651 Ilalo Street Honolulu, Honolulu, HI 96813, USA; (E.L.); (J.C.)
| | - John Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, 651 Ilalo Street Honolulu, Honolulu, HI 96813, USA; (E.L.); (J.C.)
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Occa A, Francis DB, Grumbein A, Stahl HM. Improving African Americans' Intentions to Enroll in a Health Registry: Message Development and Evaluation. HEALTH COMMUNICATION 2023; 38:2884-2893. [PMID: 36097854 DOI: 10.1080/10410236.2022.2124061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
African Americans' enrollment in health registries is low, negatively affecting their representation in clinical research. Young African Americans are particularly underrepresented. Because medical discoveries are typically based on findings from research that lacks minority representation, new treatments may not be equally effective with members of the African American community. This may further exacerbate health disparities. In this two-phase study, we first collected data from five focus groups to (a) investigate young African Americans' knowledge about and attitudes toward health registries and (b) explore their perceptions about current messages used to recruit participants into health registries. The findings from the first phase of our research showed that participants had limited awareness and understanding of health registries' functions and held negative attitudes toward research participation. In Phase 2, we conducted an experiment to compare the effects of a current message, a new message designed based on the findings from our Phase 1 study, and a control. Results showed mixed findings on the impact of the new targeted message. Based on the findings from both phases of this study, we present and discuss future strategies.
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Affiliation(s)
- Aurora Occa
- Department of Communication, University of Kentucky
| | | | - Adriane Grumbein
- Department of Integrated Strategic Communication, University of Kentucky
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Keene S, Allen S, McCormick AKHG, Trottier C, Bull Shows B, Hallett J, Deernose R, Held S. Developing and Implementing a Culturally Consonant Treatment Fidelity Support Plan with the Apsáalooke Nation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6989. [PMID: 37947547 PMCID: PMC10647712 DOI: 10.3390/ijerph20216989] [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: 09/01/2023] [Revised: 10/12/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023]
Abstract
Treatment fidelity remains underreported in health intervention research, particularly among Indigenous communities. One explanation for this gap is the lack of culturally consonant strategies listed in the National Institutes of Health (NIH) Behavior Change Consortium (BCC) treatment fidelity framework, the gold standard for understanding and measuring fidelity. This paper focuses on the development and implementation of a culturally consonant treatment fidelity support plan across two of the five BCC fidelity areas, provider training and treatment delivery, within a chronic illness self-management program for the Apsáalooke (Crow) Nation. Our team selected and adapted strategies from, and added strategies to, the BCC framework, that centered on relational accountability and the Apsáalooke culture. To be culturally consonant, we approached treatment fidelity as supporting Aakbaabaaniilea (Apsáalooke program facilitators) rather than monitoring them. This resulted in the development of a fifth treatment fidelity area: building and fostering relationships. We propose that fidelity to relational accountability is the foundation of successful programs in Indigenous communities. This suggests an important shift from tracking what was conducted in an intervention to prioritizing how things were conducted. We encourage others to view the BCC framework as a starting point in developing fidelity strategies that are consonant with local cultures.
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Affiliation(s)
- Shannen Keene
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (C.T.); (B.B.S.); (S.H.)
| | - Sarah Allen
- Department of Family Life & Human Development, Southern Utah University, Cedar City, UT 84720, USA;
| | | | - Coleen Trottier
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (C.T.); (B.B.S.); (S.H.)
| | - Brianna Bull Shows
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (C.T.); (B.B.S.); (S.H.)
| | - John Hallett
- Petaluma Health Center, Petaluma, CA 94954, USA;
| | - Rae Deernose
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (C.T.); (B.B.S.); (S.H.)
| | - Suzanne Held
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (C.T.); (B.B.S.); (S.H.)
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Bantum EO, Yamada PM, Makolo T, Yu H, Pagano I, Subia N, Walsh C, Loo LWM. Hula as a physical activity and social support intervention for sustained activity in female breast and gynecologic cancer survivors. Front Psychol 2023; 14:1190532. [PMID: 37941759 PMCID: PMC10629222 DOI: 10.3389/fpsyg.2023.1190532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/07/2023] [Indexed: 11/10/2023] Open
Abstract
Background Physical activity improves health and psychosocial functioning for people who have been diagnosed with cancer. Native Hawaiians face disparities for some cancers, including breast cancer. Delivering culturally grounded interventions has the potential to improve enjoyment and adherence to the intervention. We sought to test the adherence and impact of a 6 month randomized wait-list controlled trial of hula. Methods In this randomized wait-list controlled design people who had been diagnosed with breast or gynecologic cancers were invited to participate with other cancer survivors in a group based setting. Participants were randomized to begin hula immediately or after six months. Attendance was collected and heart-rate measured three times per session. In addition, demographic data, self-report psychosocial data, and biological data (findings will be reported elsewhere) were collected at three time points: baseline, 6 months, and 12 months. The study included six months of hula, twice per week, 60 min each session. In addition, participants committed to practice 60 min per week at home. Results Participants in the study (n = 42) attended, on average, 72% of the sessions. Significant increase in moderate physical activity (d = 0.50, p = 0.03) was observed in the intervention versus control group. For the measures of intra-individual changes pre-and post-intervention, an increase in total physical activity were seen in the intervention group (d = 0.69, p = 0.003), daily caloric intake decreased (d = -0.62, p = 0.007), and a reduction in waist circumference (d = -0.89, p = 0.0002) that was sustained six months after completion of the intervention. Psychosocially, cognitive functioning significantly declined from baseline to 12 months (d = -0.50, p = 0.03), with role functioning improving (d = 0.55, p = 0.02), social constraints increasing (d = 0.49, p = 0.03), and financial difficulties improving (d = -0.55, p = 0.02). Conclusion Sustainable physical activity is crucial to improve both the survival and quality of life of cancer survivors. Culturally grounded interventions, such as hula have the potential to increase the maintenance of physical activity. In addition, they create a support group where the benefits of people who have all experienced cancer can gather and garner those benefits of social support, too. This study was registered as a clinical trial through the National Cancer Institute (NCT02351479). Clinical trial registration Clinicaltrails.gov, NCT02351479.
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Affiliation(s)
- Erin O. Bantum
- Cancer Prevention in the Pacific, Population Sciences in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Paulette M. Yamada
- Kinesiology and Rehabilitation Science, College of Education, University of Hawaii at Manoa, Honolulu, HI, United States
| | - TeMoana Makolo
- Cancer Prevention in the Pacific, Population Sciences in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Herbert Yu
- Cancer Epidemiology, Population Sciences in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Ian Pagano
- Cancer Prevention in the Pacific, Population Sciences in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Natalie Subia
- Cancer Epidemiology, Population Sciences in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Catherine Walsh
- Cancer Epidemiology, Population Sciences in the Pacific, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Lenora W. M. Loo
- Cancer Biology Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI, United States
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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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Komro KA, D'Amico EJ, Dickerson DL, Skinner JR, Johnson CL, Kominsky TK, Etz K. Culturally Responsive Opioid and Other Drug Prevention for American Indian/Alaska Native People: a Comparison of Reservation- and Urban-Based Approaches. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:88-98. [PMID: 35750937 PMCID: PMC9244356 DOI: 10.1007/s11121-022-01396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
Abstract
There are few substance use treatment and prevention programs for AI/AN people that integrate culturally based practices with evidence-based treatment and prevention. The National Institutes of Health's (NIH's) Helping to End Addiction Long-term (HEAL) Prevention Cooperative supports two projects focused on AI/AN populations. One focuses on youth ages 15 to 20 years living within the Cherokee Nation reservation, a multicultural rural area in northeastern Oklahoma, and the second focuses on emerging adults ages 18 to 25 years living in diverse urban areas. We provide a brief overview of the two prevention trials and a case comparison across approaches using the framework of promising practices for intervention science with Indigenous communities (Whitesell et al., 2020) related to (1) integration of Indigenous and academic perspectives to respond to community needs, (2) community partnership and engagement, (3) alignment with Indigenous cultural values and practices, (4) capacity building and empowerment, (5) implementation within complex cultural contexts, and (6) tribal oversight. Overall, these two projects highlight the importance of long-standing relationships with community partners, engaging the community at all levels to ensure that programming is culturally and developmentally appropriate, and having tribal and elder oversight. These practices are key to establishing trust and building confidence in research in these communities and ensuring that research can benefit AI/AN people. These studies showcase how strong partnerships can advance health and support the conduct of rigorous science to help pinpoint optimal health solutions by identifying efficacious, culturally grounded intervention strategies. Although the sovereign status of tribes demands this type of partnership, this research serves as a model for all community research that has a goal of improving health.
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Affiliation(s)
- Kelli A Komro
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | | | - Daniel L Dickerson
- Integrated Substance Abuse Programs (ISAP), University of California Los Angeles, Los Angeles, CA, USA
| | | | | | | | - Kathy Etz
- Epidemiology Research Branch, National Institute On Drug Abuse, North Bethesda, USA
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Sentell T, Wu YY, Look M, Gellert K, Lowery St John T, Ching L, Lee R, Pirkle C. Culturally Relevant Physical Activity in the Behavioral Risk Factor Surveillance System in Hawai'i. Prev Chronic Dis 2023; 20:E43. [PMID: 37229648 DOI: 10.5888/pcd20.220412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Culturally relevant physical activity is a promising field for chronic disease prevention and management. Native Hawaiians and Other Pacific Islanders have higher rates of physical inactivity than other racial or ethnic groups and increased risk of chronic disease. The study objective was to provide population-level data from Hawai'i on lifetime experiences in the Native Hawaiian Indigenous practices of hula and outrigger canoe paddling across demographic and health factors to identify opportunities for public health intervention, engagement, and surveillance. METHODS Questions about hula and paddling were added to the Hawai'i 2018 and 2019 Behavioral Risk Factor Surveillance System (N = 13,548). We considered level of engagement by demographic categories and health status indicators, accounting for the complex survey design. RESULTS Overall, 24.5% of adults engaged in hula and 19.8% in paddling in their lifetime. Prevalence of engagement was higher among Native Hawaiians (48.8% hula, 41.5% paddling) and Other Pacific Islanders (35.3% hula, 31.1% paddling) than among other racial and ethnic groups. In adjusted rate ratios, experience in these activities was strong across age groups, education, sex, and income levels, particularly among Native Hawaiians and Other Pacific Islanders. CONCLUSION Throughout Hawai'i, hula and outrigger canoe paddling are important and popular cultural practices with high physical activity demands. Participation was notably high for Native Hawaiians and Other Pacific Islanders. Surveillance information around culturally relevant physical activities can benefit public health programming and research from a strength-based community perspective.
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Affiliation(s)
- Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, 2430 Campus Rd, Honolulu, HI 96822
| | - Yan Yan Wu
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu
| | - Mele Look
- John A. Burns School of Medicine, Department of Native Hawaiian Health, University of Hawai'i, Honolulu
| | - Kapuaola Gellert
- John A. Burns School of Medicine, Department of Native Hawaiian Health, University of Hawai'i, Honolulu
| | - Tonya Lowery St John
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu
| | - Lance Ching
- Surveillance, Evaluation and Epidemiology Office, Chronic Disease Prevention and Health Promotion Division, Hawai'i State Department of Health, Honolulu
| | - Riko Lee
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu
| | - Catherine Pirkle
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu
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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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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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15
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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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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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Chirinos DA, Vargas E, Kamsickas L, Carnethon M. The role of behavioral science in addressing cardiovascular health disparities: A narrative review of efforts, challenges, and future directions. Health Psychol 2022; 41:740-754. [PMID: 35849358 PMCID: PMC9886136 DOI: 10.1037/hea0001191] [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] [Indexed: 02/02/2023]
Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States. Despite improvements in the prevention and treatment of CVD over the past 20 years, racial/ethnic minority groups including non-Hispanic Blacks, Hispanic/Latinos, and some Asian subgroups (e.g., Asian Indians, Filipinos) experience higher rates of CVD risk factors and morbidity and mortality from CVD than non-Hispanic Whites. Therefore, addressing cardiovascular health disparities is an immediate priority. Behavioral science can play an important role in reducing disparities by capitalizing on expertise in human behavior change, social determinants of health, and implementation science. In this narrative review, we describe the efforts made within behavioral science to address CVD health disparities. We review current interventions to reduce CVD health disparities and provide practical recommendations that can be used as the field moves forward. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Diana A. Chirinos
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Emily Vargas
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Lisa Kamsickas
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Mercedes Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Lewis ME, Smith J, Wildcat S, Anderson A, Walls ML. The Health Effects of a Cherokee Grounded Culture and Leadership Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138018. [PMID: 35805678 PMCID: PMC9266134 DOI: 10.3390/ijerph19138018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/16/2022]
Abstract
Introduction: Indigenous youth and young adults endure some of the highest rates of physical and mental health problems in the United States compared to their non-Indigenous counterparts. Colonization, oppression, and discrimination play a substantial role in these inequitable disease rates. However, culture (e.g., identity, participation, and connection) relates to the prevention of and recovery from illness in Indigenous populations. The Remember the Removal program aims to teach Indigenous youth and young adults tribally specific culture, history, and language to put them on a trajectory to become informed and culturally connected community leaders. We examined the program’s effects on health. Method: Thirty Remember the Removal program participants, mainly young adults, completed surveys four times: before the program’s start, at the end of the training period, at the program’s end, and at a six-month follow-up. Various indicators of physical, mental, spiritual, and cultural health and well-being were measured at each time period. Paired t-tests were completed to compare baseline scores to each subsequent time interval. Results: At program completion, and as indicated with an asterisk at the six month follow-up, participants had statistically significantly improved diet and exercise measures (e.g., reduced sugary, salty, and fatty foods, reduced soda consumption, increased fruit consumption, and improved self-efficacy for exercise), improved mental health indicators (e.g., reduced stress, anxiety, depression*, anger*, post-traumatic stress disorder, and microaggressions*, and improved positive mental health) and improved social and cultural connection (e.g., social support, Cherokee identity*, Cherokee values). Discussion: This is one of the first quantitative studies to demonstrate the profound effects that cultural learning and connection have on the health and well-being of Indigenous people and practices. It also demonstrates the specificity and effectiveness of a program created by and for tribal citizens. Future programs with Indigenous populations should work to center cultural connection and ensure that programs are created and directed by tribal community members.
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Affiliation(s)
- Melissa E. Lewis
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO 65212, USA;
- Correspondence:
| | - Jamie Smith
- Department of Family and Community Medicine, School of Medicine, University of Missouri, Columbia, MO 65212, USA;
| | - Sky Wildcat
- Department of Rehabilitation, Human Resources, & Communication Disorders, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Amber Anderson
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Melissa L. Walls
- Center for American Indian Health, Bloomberg School of Public Health, Johns Hopkins University, Duluth, MN 55812, USA;
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19
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Watanabe LM, Seale LA. Challenging Aspects to Precise Health Strategies in Native Hawaiian and Other Pacific Islanders Using Statins. Front Public Health 2022; 10:799731. [PMID: 35296045 PMCID: PMC8918550 DOI: 10.3389/fpubh.2022.799731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/31/2022] [Indexed: 12/03/2022] Open
Abstract
Cardiometabolic disorders (CD), including cardiovascular disease (CVD), diabetes, and obesity, are the leading cause of health concern in the United States (U.S.), disproportionately affecting indigenous populations such a Native Hawaiian and Other Pacific Islanders (NHOPI). Dyslipidemia, a prevalent risk factor for the development and progression of CVD, is more prone to occur in NHOPI than other populations in the U.S. High-intensity statin therapy to reduce low-density lipoprotein cholesterol is associated with the prevention of CVD events. However, significant side-effects, such as muscle disorders, have been associated with its use. Different ethnic groups could experience variation in the prevalence of statin side effects due to sociodemographic, behavioral, and/or biological factors. Therefore, identifying the most impactful determinants that can be modified to prevent or reduce statin side effects for individuals from high-risk ethnic minority groups, such as NHOPI, can lead to more effective strategies to reduce health disparities. Thus, our Mini-Review explores the challenging aspects of public health precise strategies in NHOPI taking statins, including a culturally informed additional therapy that could positively impact the NHOPI population.
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Affiliation(s)
- Ligia M. Watanabe
- Division of Nutrition and Metabolism, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Lucia A. Seale
- Pacific Biosciences Research Center, School of Ocean and Earth Science and Technology, University of Hawaii at Mānoa, Honolulu, HI, United States
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20
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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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21
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Lee YJ, Braun KL, Wu YY, Burrage R, Muneoka S, Browne C, Mokuau NK, Terada TM, Hossain MD. Physical Activity and Health Among Native Hawaiian and other Pacific Islander Older Adults. J Aging Health 2021; 34:120-129. [PMID: 34376094 DOI: 10.1177/08982643211032468] [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: 11/15/2022]
Abstract
Objectives: Native Hawaiian and other Pacific Islander (NHPI) older adults often experience social disadvantages and poor health outcomes. Physical activity has been associated with better health in other racial groups, but limited studies have examined these associations in NHPI older adults. Methods: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n = 1,045), logistic regression models examined associations between physical activity and memory/psychological distress/self-rated health. Results: Sufficient levels of physical activity were associated with lower odds of memory problems, serious psychological distress, and poor/fair self-rated health. Unfortunately, only half of the sample reported sufficient physical activity and approximately 30% reported none. Also, 78% of the sample was estimated to be overweight/obese, and 29% had diabetes. Discussion: Culturally-appropriate interventions are recommended to increase physical activity in this population, which could also help reduce high rates of overweight/obesity and diabetes.
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Affiliation(s)
- Yeonjung J Lee
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Kathryn L Braun
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Yan Yan Wu
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Rachel Burrage
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Shelley Muneoka
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Colette Browne
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Noreen K Mokuau
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Tyran M Terada
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Mohammad D Hossain
- Thompson School of Social Work & Public Health, 3939University of Hawai'i at Mānoa, Honolulu, HI, USA
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