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Ibrao M, Burrage R, Wu YY, Masaki K, Wen A, Braun KL. Age-Friendly Health Systems and cultural relevancy: Exploring the geriatrics 4Ms model with Native Hawaiian Elders. J Am Geriatr Soc 2024. [PMID: 38472108 DOI: 10.1111/jgs.18874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/30/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Miquela Ibrao
- Pacific Islands Geriatrics Workforce Enhancement Program, Department of Geriatric Medicine, John A Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Rachel Burrage
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Yan Yan Wu
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Kamal Masaki
- Pacific Islands Geriatrics Workforce Enhancement Program, Department of Geriatric Medicine, John A Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Aida Wen
- Pacific Islands Geriatrics Workforce Enhancement Program, Department of Geriatric Medicine, John A Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Kathryn L Braun
- Pacific Islands Geriatrics Workforce Enhancement Program, Department of Geriatric Medicine, John A Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
- Thompson School of Social Work and Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
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Ibrao M, Cadirao CM, Ariyoshi D, Lopez KS, Ilagan L, Braun KL. Kūpuna "Older Adults" COVID-19 Vaccination Efforts in Hawai'i: Barriers and Successes. Hawaii J Health Soc Welf 2023; 82:266-272. [PMID: 37969238 PMCID: PMC10630539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Prior to the availability of vaccines, kūpuna (older adults) accounted for the majority of COVID-19 hospitalizations and deaths. Hawaii's phased vaccine-release plan prioritized kūpuna, but it did not include guidance or strategies for kūpuna to get to mass vaccination sites, for those residing in care and foster homes, or for the homebound. This paper presents findings from statewide efforts to facilitate a quick uptake of vaccines among kūpuna of all ability levels. Researchers interviewed 32 individuals involved in kūpuna vaccination efforts from state and county government agencies, health care organizations, and non-profit organizations. Data on the percentage of kūpuna that initiated and completed the vaccination series by age group and island were obtained from the Hawai'i State Department of Health COVID-19 Dashboard. Overall, kūpuna vaccination efforts across the state were successful. By July 30, 2021, 94% of adults age 65+ were vaccinated, although prevalence varied by county-from 88% on Maui to 98% on Kaua'i. Key barriers included cumbersome online systems for scheduling vaccination appointments, difficulties for some elders in accessing mass vaccination sites, and the need for education and consent forms in multiple languages. Successful strategies included funding coalitions for effective partnerships, establishing county- and language-specific call centers, and supporting translation/interpretation services, mobile and pop-up clinics, and mechanisms for in-home vaccinations. Hawai'i worked hard to facilitate the quick uptake of COVID-19 vaccines among older adults. Funding for coalitions that could identify gaps, coordinate expertise across public and private sectors, and advocate for elders were crucial elements of the state's success.
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Affiliation(s)
- Miquela Ibrao
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (MI, KLB)
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (MI)
| | | | - Derrick Ariyoshi
- Elderly Affairs Division of the City and County of Honolulu, Honolulu, HI (DA)
| | | | - Lindsey Ilagan
- Kūpuna Collective at the Hawai‘i Public Health Institute, Honolulu, HI (LI)
| | - Kathryn L. Braun
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (MI, KLB)
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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. Hawaii J Health Soc Welf 2023; 82:58-66. [PMID: 37901666 PMCID: PMC10612424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Lim E, Braun KL, Taira D. Resources and Methods for Examining Native Hawaiian, Pacific Islander, and Filipino Health Disparities. Hawaii J Health Soc Welf 2023; 82:3-4. [PMID: 37901665 PMCID: PMC10612415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Affiliation(s)
- Eunjung Lim
- Center for Pacific Innovations, Knowledge, and Opportunities (PIKO), Honolulu, HI
| | - Kathryn L Braun
- Center for Pacific Innovations, Knowledge, and Opportunities (PIKO), Honolulu, HI
| | - Deborah Taira
- Center for Pacific Innovations, Knowledge, and Opportunities (PIKO), Honolulu, HI
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Hedges JR, Chow DC, Fogelgren B, Braun KL, Tsark JU, Ordinado S, Berry MJ, Yanagihara R, Mokuau N. Health Disparities Investigator Development through a Team-Science Pilot Projects Program. Int J Environ Res Public Health 2023; 20:5336. [PMID: 37047951 PMCID: PMC10094603 DOI: 10.3390/ijerph20075336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/12/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
Profound health disparities are widespread among Native Hawaiians, other Pacific Islanders, and Filipinos in Hawai'i. Efforts to reduce and eliminate health disparities are limited by a shortage of investigators trained in addressing the genetic, socio economic, and environmental factors that contribute to disparities. In this conference proceedings report from the 2022 RCMI Consortium National Conference, we describe our mentoring program, with an emphasis on community-engaged research. Elements include our encouragement of a team-science, customized Pilot Projects Program (PPP), a Mentoring Bootcamp, and a mentoring support network. During 2017-2022, we received 102 PPP preproposals. Of these, 45 (48%) were invited to submit full proposals, and 22 (19%) were awarded (8 basic biomedical, 7 clinical, 7 behavioral). Eighty-three percent of awards were made to early-career faculty (31% ethnic minority, 72% women). These 22 awards generated 77 related publications; 84 new grants were submitted, of which 31 were awarded with a resultant return on investment of 5.9. From 5 to 11 investigators were supported by PPP awards each year. A robust usage of core services was observed. Our descriptive report (as part of a scientific conference session on RCMI specialized centers) focuses on a mentoring vehicle and shows how it can support early-stage investigators in pursuing careers in health disparities research.
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Affiliation(s)
- Jerris R. Hedges
- Departments of Medicine and Surgery, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Dominic C. Chow
- Department of Medicine, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Benjamin Fogelgren
- Department of Anatomy, Biochemistry and Physiology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Kathryn L. Braun
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - JoAnn U. Tsark
- Research Corporation University of Hawai‘i, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Susan Ordinado
- Pacific Biosciences Research Center, School of Ocean & Earth Science & Technology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Marla J. Berry
- Pacific Biosciences Research Center, School of Ocean & Earth Science & Technology, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
| | - Richard Yanagihara
- Departments of Pediatrics and Tropical Medicine, Medical Microbiology & Pharmacology, John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI 96813, USA
| | - Noreen Mokuau
- Department of Social Work, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI 96822, USA
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Browne CV, Muneoka S, Ka'opua LS, Wu YY, Burrage RL, Lee YJ, Mokuau NK, Braun KL. Developing a culturally responsive dementia storybook with Native Hawaiian youth. Gerontol Geriatr Educ 2022; 43:315-327. [PMID: 33888037 DOI: 10.1080/02701960.2021.1885398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Similar to the nation's majority and racial/ethnic minority populations, Native Hawaiian families provide the bulk of care to loved ones with dementia. Limited research has focused on youth caregivers, who are largely invisible to the eldercare service system. This knowledge gap is especially critical for Native Hawaiians who place a high value on eldercare, often provided in multigenerational homes. To address this gap, we describe the process by which a university-community center developed a culturally responsive storybook on dementia targeted to Native Hawaiian youth. The development process honored community-based participatory research principles grounded in the cultural values and practices of Native Hawaiians, active collaboration of an advisory council, and face-to-face engagement with Native Hawaiian youth. Future directions are shared about culture-based programming and evaluation in dementia care that may be useful in work with other racial/ethnic youth and families.
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Affiliation(s)
- Colette V Browne
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Shelley Muneoka
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Lana Sue Ka'opua
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Yan Yan Wu
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Rachel L Burrage
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Yeonjung Jane Lee
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Noreen K Mokuau
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Kathryn L Braun
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
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Kawakami KL, Muneoka S, Burrage RL, Tanoue L, Haitsuka K, Braun KL. The Lives of Native Hawaiian Elders and Their Experiences With Healthcare: A Qualitative Analysis. Front Public Health 2022; 10:787215. [PMID: 35273936 PMCID: PMC8902069 DOI: 10.3389/fpubh.2022.787215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/19/2022] [Indexed: 11/15/2022] Open
Abstract
Native Hawaiians are proud and resilient people who have endured significant impacts from colonization. Despite being in a time of vibrant cultural revitalization, Native Hawaiians have a shorter life expectancy than other racial and ethnic groups in Hawai'i. The primary aim of this paper was to share data from the first year of a 5-year study with Native Hawaiian kūpuna (elders) on their experiences with healthcare, along with barriers to accessing healthcare. Ten kūpuna living in rural areas of Hawai'i participated in three interviews each, which were held in an informal, talk-story style. The first interview focused on establishing rapport. The second interview focused on the kūpuna's strengths, resiliencies, and what they would like to pass to the next generation. The third interview focused on the elders' experiences with healthcare, which is the focus of this paper. All ten kūpuna reported growing up with limited access to Western healthcare; rather, their families successfully treated many illnesses and injuries with lā'au lapa'au (Hawaiian herbal medicine) and other traditional healing practices, as they had done for generations. As Western medicine became more prevalent and accessible, they used both, but many preferred holistic treatments such as prayer, a return to the traditional diet, and lā'au lapa'au. As a group, the kūpuna rated their health as fair to good; two had diabetes, two had cardiovascular disease, four had neuropathies, and five were cancer survivors. The kūpuna reported high turnover among providers in rural communities. Limited access to specialists often required them to travel to Honolulu for care, which was costly and especially difficult during coronavirus disease 2019 (COVID-19). Regardless of provider ethnicity, the kūpuna appreciated those who took the time to get to know them as people and respected Hawaiian cultural practices. They advised that Western providers speak honestly and directly, have compassion, and build connections to patients and their communities.
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Affiliation(s)
- Keilyn Leina‘ala Kawakami
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Shelley Muneoka
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Rachel L. Burrage
- Department of Social Work and Hā Kūpuna National Resource Center for Native Hawaiian Elders, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | | | - Kilohana Haitsuka
- Hā Kūpuna National Resource Center for Native Hawaiian Elders, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
| | - Kathryn L. Braun
- Office of Public Health Studies, Principal Investigator, Hā Kūpuna National Resource Center for Native Hawaiian Elders, Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, United States
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Kai J, Chen JJ, Braun KL, Kaholokula JK, Novotny R, Boushey CJ, Fialkowski MK. Associations between Cultural Identity, Household Membership and Diet Quality among Native Hawaiian, Pacific Islander, and Filipino Infants in Hawai'i. Children (Basel) 2022; 9:48. [PMID: 35053673 PMCID: PMC8774442 DOI: 10.3390/children9010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/18/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022]
Abstract
Public health efforts to reduce diet-related health disparities experienced by indigenous peoples could be enhanced by efforts to improve complementary infant feeding practices. The latter is possible through interventions informed by cultural determinants. This cross-sectional secondary analysis explored possible determinants of the complementary feeding practices of Native Hawaiian, Pacific Islander, and/or Filipino infants (NHPIF) in Hawai'i, ages 3-12 months. The objective was to determine the association between caregiver cultural identity and infant household membership with indicators of infant diet healthfulness. The cultural identities, infant household memberships, early infant feeding practices and additional demographic information (infant age and sex, household income) were assessed via an online questionnaire. Surrogate reporting of the infants' diets over four days was evaluated using an image-based mobile food record (mFR). Data collected by the mFR were evaluated to derive the World Health Organization's minimum dietary diversity (MDD) indicator and food group consumption. Data were summarized by descriptive statistics and analyzed using multivariate linear and logistic regressions. Seventy infant participants, ages 3-12 months, and their primary caregivers completed the study. Of these, there were 56 infant participants between the age of 6-12 months. Approximately 10% of infants, ages 6-12 months, met MDD for all four days. Meeting MDD and the number of food groups consumed were significantly associated with age. Caregiver cultural identity, infant household membership and infant sex had non-significant associations with indicators of infant diet quality. Findings inform the influences shaping dietary patterns of Native Hawaiian, Pacific Islander and Filipino infants in Hawai'i.
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Affiliation(s)
- Jessie Kai
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, 1955 East West Road, AgSci 216, Honolulu, HI 96822, USA; (J.K.); (R.N.)
| | - John J. Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaiʻi at Mānoa, 651 Ilalo Street, MEB Suite 411, Honolulu, HI 96813, USA;
| | - Kathryn L. Braun
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaiʻi at Mānoa, 1960 East-West Road, Honolulu, HI 96822, USA;
| | - Joseph Keaweʻaimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaiʻi at Mānoa, 677 Ala Moana Blvd., 1016, Honolulu, HI 96813, USA;
| | - Rachel Novotny
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, 1955 East West Road, AgSci 216, Honolulu, HI 96822, USA; (J.K.); (R.N.)
| | - Carol J. Boushey
- Nutrition Support Shared Resource, University of Hawaiʻi Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA;
| | - Marie K. Fialkowski
- Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaiʻi at Mānoa, 1955 East West Road, AgSci 216, Honolulu, HI 96822, USA; (J.K.); (R.N.)
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Lee YJ, Braun KL, Wu YY, Hong S, Gonzales E, Wang Y, Hossain MD, Terada TM, Browne CV. Neighborhood Social Cohesion and the Health of Native Hawaiian and Other Pacific Islander Older Adults. J Gerontol Soc Work 2022; 65:3-23. [PMID: 33974515 DOI: 10.1080/01634372.2021.1917033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 06/12/2023]
Abstract
Native Hawaiian and other Pacific Islander (NHPI) older adults experience various social and health challenges. There is a growing literature linking neighborhood conditions with health, yet few have focused on NHPI older adults. This study examines associations between neighborhood social cohesion and health outcomes (i.e., self-rated health, psychological distress, and memory) in this population. Data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (n=1,045 with respondents aged 50+) were analyzed with logistic regression models. The level of neighborhood social cohesion was determined by responses to items on perceptions of mutual help, dependability, trust, and close relationships within the neighborhood. Higher perceived neighborhood social cohesion was associated with lower odds of having serious psychological distress or memory problems. There was no statistical association of social cohesion with self-rated health. Socially cohesive neighborhoods are important to the health of NHPI. We discuss methods to improve neighborhood social cohesion as a way to promote health equity for NHPI older adults in the United States (U.S.).
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Affiliation(s)
- Yeonjung Jane Lee
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Kathryn L Braun
- Thompson School of Social Work & Public Health, HI Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Yan Yan Wu
- Thompson School of Social Work & Public Health, HI Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Seunghye Hong
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Ernest Gonzales
- Silver School of Social Work, New York University, New York, New York, USA
| | - Yi Wang
- School of Social Work, The University of Iowa, Iowa City, Iowa, USA
| | - Mohammad Didar Hossain
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Tyran M Terada
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
| | - Colette V Browne
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, Hawaii, USA
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Butel J, Braun KL, Nigg CR, Leon Guerrero R, Fleming T, Bersamin A, Coleman P, Novotny R. Estimating intervention dose of the multilevel multisite children's healthy living program intervention. Transl Behav Med 2021; 10:989-997. [PMID: 31116404 DOI: 10.1093/tbm/ibz073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Increased community collective efficacy (CE), defined as social cohesion among neighbors and their willingness to intervene for common good, is associated with improved community health outcomes. However, processes to increase CE and estimate its dose within an intervention are not well understood. The 2 year Children's Healthy Living (CHL) intervention aimed to improve child behaviors known to affect obesity. We used data from CHL to estimate CE dose and examine its association with a successful outcome from CHL-reduction in children's recreational screen time. Monthly reports from nine intervention communities were quantified, and CE dose was calculated for each community overall, at 4 time intervals (6, 12, 18, and 24 months), and for each CE building block-social bonding, social bridging, social leveraging, empowerment, and civic engagement. CE dose at each time interval and change in screen time was correlated using Spearman's rho. Next, communities were categorized as having a high CE dose or a low CE dose, and differences between four high-dose and five low-dose communities were compared using a two-tailed t-test. The correlation between change in screen time and CE dose was significant (rs = 0.83, p = .003). Significantly more activities facilitating empowerment and civic engagement were conducted in high-dose communities, which were more likely to show improvements in screen time, than in low-dose communities. This method of estimating an intervention's CE dose and examining change over time and effect of CE and its building blocks on intervention outcomes shows promise.
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Affiliation(s)
- Jean Butel
- Colege of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Claudio R Nigg
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | | | | | | | | | - Rachel Novotny
- Colege of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu, HI, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Kreif T, Chismar W, Braun KL, DeMattos M, Sentell T, Guo J, Mokuau N. Social Work in Action: The Thompson School of Social Work & Public Health: Continuing a Strong Legacy of Research, Training, and Service Towards Social Justice and Health Equity. Hawaii J Health Soc Welf 2021; 80:199-202. [PMID: 34355197 PMCID: PMC8334074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Theresa Kreif
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| | - William Chismar
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| | - Kathryn L Braun
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| | - Michael DeMattos
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| | - Tetine Sentell
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| | - Jing Guo
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
| | - Noreen Mokuau
- Thompson School of Social Work & Public Health, University of Hawai'i at Mānoa, Honolulu, HI
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Henry Akintobi T, Sheikhattari P, Shaffer E, Evans CL, Braun KL, Sy AU, Mancera B, Campa A, Miller ST, Sarpong D, Holliday R, Jimenez-Chavez J, Khan S, Hinton C, Sellars-Bates K, Ajewole V, Teufel-Shone NI, McMullin J, Suther S, Kimbro KS, Taylor L, Velez Vega CM, Williams C, Perry G, Zuchner S, Marzan Rodriguez M, Tchounwou PB. Community Engagement Practices at Research Centers in U.S. Minority Institutions: Priority Populations and Innovative Approaches to Advancing Health Disparities Research. Int J Environ Res Public Health 2021; 18:6675. [PMID: 34205781 PMCID: PMC8296474 DOI: 10.3390/ijerph18126675] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022]
Abstract
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An overarching theme, building community together through trust and meaningful collaborations, emerged from the supporting themes and subthemes. The RCMI institutions and their CECs serve as models to circumvent the historical and current challenges to research in communities disproportionately affected by health disparities. Lessons learned from these cores may help other institutions who want to build community trust in and capacities for research that addresses community-related health concerns.
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Affiliation(s)
- Tabia Henry Akintobi
- Prevention Research Center, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA; (C.L.E.); (R.H.)
| | - Payam Sheikhattari
- Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, USA; (P.S.); (E.S.)
| | - Emma Shaffer
- Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, USA; (P.S.); (E.S.)
| | - Christina L. Evans
- Prevention Research Center, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA; (C.L.E.); (R.H.)
| | - Kathryn L. Braun
- Department of Public Health Sciences, John A. Burns School of Medicine, Ola HAWAII, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA; (K.L.B.); (A.U.S.)
| | - Angela U. Sy
- Department of Public Health Sciences, John A. Burns School of Medicine, Ola HAWAII, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA; (K.L.B.); (A.U.S.)
| | - Bibiana Mancera
- Border Biomedical Research Center, College of Health Sciences, University of Texas at El Paso, El Paso, TX 79968, USA;
| | - Adriana Campa
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA;
| | | | - Daniel Sarpong
- Department of Biostatistics, Xavier University, Cagayan de Oro 9000, Philippines;
| | - Rhonda Holliday
- Prevention Research Center, Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA; (C.L.E.); (R.H.)
| | - Julio Jimenez-Chavez
- Department of Psychiatry and Human Behavior, Ponce School of Medicine and Health Sciences, Ponce, PR 00716, USA;
| | - Shafiq Khan
- Department of Biological Sciences, Clark Atlanta University, Atlanta, GA 30314, USA; (S.K.); (C.H.); (K.S.-B.)
| | - Cimona Hinton
- Department of Biological Sciences, Clark Atlanta University, Atlanta, GA 30314, USA; (S.K.); (C.H.); (K.S.-B.)
| | - Kimberly Sellars-Bates
- Department of Biological Sciences, Clark Atlanta University, Atlanta, GA 30314, USA; (S.K.); (C.H.); (K.S.-B.)
| | - Veronica Ajewole
- College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA;
| | | | - Juliet McMullin
- Department of Anthropology, University of California, Riverside, CA 92521, USA;
| | - Sandra Suther
- College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural and Mechanical University, Tallahassee, FL 32307, USA;
| | - K. Sean Kimbro
- Biological and Biomedical Sciences, North Carolina Central University, Durham, NC 27707, USA; (K.S.K.); (L.T.)
| | - Lorraine Taylor
- Biological and Biomedical Sciences, North Carolina Central University, Durham, NC 27707, USA; (K.S.K.); (L.T.)
| | - Carmen M. Velez Vega
- Center for Collaborative Research in Health Disparities, University of Puerto Rico Medical Sciences Campus, San Juan, PR 00921, USA;
| | - Carla Williams
- College of Medicine, Howard University, Washington, DC 20059, USA;
| | - George Perry
- College of Sciences, University of Texas at San Antonio, San Antonio, TX 78249, USA;
| | - Stephan Zuchner
- John P. Hussman Institute for Human Genomics, University of Miami, Coral Gables, FL 33146, USA;
| | | | - Paul B. Tchounwou
- Department of Biology, College of Science, Engineering and Technology, Jackson State University, Jackson, MS 39217, USA;
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Aung B, Mitchell JW, Braun KL. Effectiveness of mHealth Interventions for Improving Contraceptive Use in Low- and Middle-Income Countries: A Systematic Review. Glob Health Sci Pract 2020; 8:813-826. [PMID: 33361244 PMCID: PMC7784076 DOI: 10.9745/ghsp-d-20-00069] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 09/22/2020] [Indexed: 01/08/2023]
Abstract
Do mHealth interventions help reduce unmet contraceptive needs in low- and middle-income countries by attempting to increase the uptake of modern contraceptive methods? Which mHealth features and behavior change communication components were used in these mHealth interventions? This review aimed to answer these questions and assess the impact of these interventions on contraceptive uptake outcomes. Background: mHealth interventions are being tested to improve contraceptive uptake in low- and middle-income countries (LMICs); however, the effectiveness of these interventions has not been systematically reviewed. Objectives: The primary objective of this systematic review was to assess the effectiveness of mHealth interventions to improve contraceptive uptake and adherence in LMICs. A second objective was to identify mHealth features and behavior change communication components used in these mHealth interventions. Methods: A systematic search was conducted of online databases for peer-reviewed articles that reported on intervention studies with men and women from LMICs and measured mHealth intervention impact on contraceptive uptake and/or adherence. Key search terms included “mHealth” or “mobile health,” “contraception” or “family planning,” and “low- and middle-income countries.” PRISMA guidelines were followed for reporting review methods and findings. The Cochrane risk-of-bias 2 tool for randomized trials was used to assess the risk of bias of the included studies. The GRADE approach was used to determine the quality of evidence. Results: Eight randomized controlled trial studies met the inclusion criteria. Four studies experienced implementation challenges (e.g., intervention components were not utilized fully by participants, intervention participants did not receive the full intervention content, contamination, low response rate, and/or missing data). Only 3 interventions were found to be effective, and these included a “push” approach, interactive communication, information tailored to participants, motivational messaging, and male partner involvement. Conclusion: To date, the delivery of mHealth interventions for improving family planning in LMICs has met with implementation challenges that have reduced the researcher’s ability to test intervention effectiveness. Although 3 of 8 studies found improved contraceptive use in the intervention group, the review cannot draw concrete conclusions on the overall effectiveness of mHealth interventions to increase contraceptive use in LMICs. Further research with robust program fidelity is recommended.
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Affiliation(s)
- Banyar Aung
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, USA. .,Access to Health Fund, United Nations Office for Project Services, Myanmar
| | | | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, USA
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15
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Dela Cruz MRI, Braun KL, Tsark JAU, Albright CL, Chen JJ. HPV vaccination prevalence, parental barriers and motivators to vaccinating children in Hawai'i. Ethn Health 2020; 25:982-994. [PMID: 29745749 PMCID: PMC6230317 DOI: 10.1080/13557858.2018.1473556] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Objective: To determine the prevalence and barriers to human papillomavirus (HPV) vaccine uptake among 11-18 year olds in the Hawai'i's four major ethnic groups-Native Hawaiians, Filipinos, Japanese, and Caucasians. Study design: A telephone survey assessed parents' knowledge of HPV and the HPV vaccine, status of their child's HPV vaccine uptake, variables operationalizing the Health Belief Model, and barriers and motivators to uptake. Results: Across the groups, 799 parents completed the survey. About 35% of daughters and 19% of sons had received all three shots. Although ethnic differences in vaccine uptake were seen in bivariate analysis (with significantly lower uptake in Filipino youth), in multivariable logistic regression analysis, only Caucasian parents were significantly less likely to start their sons on the HPV vaccine series compared with Japanese parents (reference group). Having heard about the vaccine, believing in its effectiveness, and older age of the child were also associated with vaccine uptake. Motivators for HPV vaccination were physician's recommendation and wanting to protect one's child. The primary barrier to uptake was lack of knowledge about the vaccine. Conclusions: Findings reinforce the fact that a physician's recommendation and receipt of information about the vaccine are strong motivators for parents to vaccinate their children, regardless of ethnicity.
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Affiliation(s)
| | - Kathryn L. Braun
- Office of Public Health Sciences, University of Hawai’i at Mānoa, Honolulu, HI, USA
| | - Jo Ann Umilani Tsark
- Office of Public Health Sciences, University of Hawai’i at Mānoa, Honolulu, HI, USA
| | - Cheryl Lynn Albright
- School of Nursing & Dental Hygiene, University of Hawai’i at Mānoa, Honolulu, HI, USA
| | - John J. Chen
- School of Medicine, University of Hawai’i at Manoa, Honolulu, HI, USA
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16
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Browne CV, Braun KL, Mokuau NK, Wu YY, Muneoka S. Examining Long-Term Service and Support Needs and Preferences of Native Hawaiian Elders: A Mixed-Method Approach. J Aging Health 2020; 32:582-590. [PMID: 30957684 PMCID: PMC6996835 DOI: 10.1177/0898264319839903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The Native Hawaiian population experiences numerous disparities in health and income. Using a mixed-method research (MMR) design, we summarize findings from three phases of an MMR approach used to uncover kūpuna (elder) long-term service and support (LTSS) needs and care preferences. Methods: Key informants in Hawaiian health were interviewed, secondary analyses of large state data sets were conducted, and kūpuna and "ohana (family) caregivers were engaged in listening sessions. Results: Quantitative data confirmed numerous health disparities experienced by older Native Hawaiians, whereas qualitative data exposed their limited knowledge of this poor health profile and revealed their historical and contemporary experiences with discrimination in education, employment, and health care. Hawaiian culture was identified as a continued source of resilience in support of elders and family caregiving regardless of geographic setting. Discussion: We suggest three practice, policy, and research directions that offer the potential to respond to and improve kūpuna health and service use.
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Affiliation(s)
| | | | | | - Yan Yan Wu
- University of Hawai‘i at Mānoa, Honolulu, USA
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Kreif TM, Braun KL, Kreif TM. Social Work in Action: Aloha E Dean Mokuau: Mai Ka Ho'oku'i A Ka Hālāwai. From Zenith to Horizon. Hawaii J Health Soc Welf 2020; 79:259-261. [PMID: 32789298 PMCID: PMC7417635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Theresa M Kreif
- Department of Social Work, Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI and Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI
| | - Kathryn L Braun
- Department of Social Work, Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI and Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI
| | - Theresa M Kreif
- Department of Social Work, Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI and Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawai'i at Mānoa, Honolulu, HI
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18
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Antonio MCK, Hishinuma ES, Ing CT, Hamagami F, Dillard A, Kekauoha BP, Solatorio C, Cassel K, Braun KL, Kaholokula JK. A Resilience Model of Adult Native Hawaiian Health Utilizing a Newly Multi-Dimensional Scale. Behav Med 2020; 46:258-277. [PMID: 32356679 PMCID: PMC8006915 DOI: 10.1080/08964289.2020.1758610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 04/07/2020] [Accepted: 04/17/2020] [Indexed: 01/07/2023]
Abstract
Resilience has conventionally focused on an individual's ability to overcome adversity. Recent research expands on this definition, making resilience a multi-dimensional construct. Native Hawaiians experience health disparities compared to the general population of Hawai'i. Despite the pressing need to address health disparities, minimal research examines resilience factors that serve as buffers for adverse experiences of Native Hawaiians. The purpose of this study was to estimate psychometric properties of scales that measured resilience-based factors through multiple levels using higher-order confirmatory factor analyses (CFA) and ascertain if this construct of resilience mediated or moderated adversity experienced by a sample of Native Hawaiians. Participants included 125 adults who participated in the Hawaiian Homestead Health Survey. Based on higher-order CFA, resilience comprised internal assets measured by hope, satisfaction with life, and environmental mastery, and external resources measured by social support and Native Hawaiian cultural identity. Results of the structural equation models were consistent with literature focusing on resiliency and health. Findings emphasized the importance of enhancing resilience by considering strengths and resources on the individual, interpersonal, and community levels. Findings also demonstrated the need to address adversity factors directly, with a specific need of addressing socio-economic status factors. According to structural equation models, resilience slightly mediated and moderated the effect of adversity related to socio-economic status. These findings have implications for future research exploring resilience as a mediator or moderator of adversity among Native Hawaiians and emphasize a multi-faceted construct of resilience to promote better health outcomes.
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Affiliation(s)
- Mapuana C. K. Antonio
- Office of Public Health Studies, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
- Department of Human Nutrition, Food, and Animal Sciences, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
| | - Earl S. Hishinuma
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
| | - Claire Townsend Ing
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
| | - Fumiaki Hamagami
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
| | | | | | | | - Kevin Cassel
- University of Hawai’i Cancer Center, Honolulu, Hawaii, USA
| | - Kathryn L. Braun
- Office of Public Health Studies, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
| | - Joseph Keawe‘aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Manoa, Honolulu, Hawaii, USA
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Sentell TL, Seto TB, Quensell ML, Malabed JM, Guo M, Vawer MD, Braun KL, Taira DA. Insights in Public Health: Outpatient Care Gaps for Patients Hospitalized with Ambulatory Care Sensitive Conditions in Hawai'i: Beyond Access and Continuity of Care. Hawaii J Health Soc Welf 2020; 79:91-97. [PMID: 32190842 PMCID: PMC7061028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Ambulatory care sensitive conditions (ACSCs) are conditions that can generally be managed in community-based healthcare settings, and, if managed well, should not require hospital admission. A 5-year, mixed methods study was recently concluded that (1) documented disparities in hospitalizations for ACSCs in Hawai'i through quantitative analysis of state-wide hospital discharge data; and (2) identified contributing factors for these hospitalizations through patient interviews. This Public Health Insights article provides deeper context for, and consideration of, a striking study finding: the differences between typical measures of access to care and the quality of patient/provider interactions as reported by study participants. The themes that emerged from the patients' stories of their own potentially preventable hospital admissions shed light on the importance of being heard, trust, communication, and health knowledge in their relationships with their providers. We conclude that improving the quality of the relationship and level of engagement between the patient and community/outpatient providers may help reduce hospitalizations for ACSCs in Hawai'i and beyond. These interpersonal-level goals should be supported by systems-level efforts to improve health care delivery and address health disparities.
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Affiliation(s)
- Tetine L Sentell
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (TLS,KLB)
| | - Todd B Seto
- The Queen's Medical Center, Honolulu, HI (TBS, MDV)
| | - Michelle L Quensell
- School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI (MLQ, MG)
| | - Jhon Michael Malabed
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI (JMM)
| | - Mary Guo
- School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI (MLQ, MG)
| | - May D Vawer
- The Queen's Medical Center, Honolulu, HI (TBS, MDV)
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (TLS,KLB)
| | - Deborah A Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, Hilo, HI (DAT)
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Taualii M, Davis EL, Braun KL, Tsark JU, Brown N, Hudson M, Burke W. Correction to: Native Hawaiian Views on Biobanking. J Cancer Educ 2020; 35:210. [PMID: 31728919 PMCID: PMC7012420 DOI: 10.1007/s13187-019-01633-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The original version of this article unfortunately contained a mistake. The name of "Maile Taualii" is now corrected in the author group of this article.
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Affiliation(s)
- Maile Taualii
- University of Hawai`i, 1960 East-west Road, Honolulu, HI, 96822, USA.
| | | | - Kathryn L Braun
- University of Hawai`i, 1960 East-west Road, Honolulu, HI, 96822, USA.
- `Imi Hale, Papa Ola Lokahi, Honolulu, USA.
| | | | - Ngiare Brown
- National Aboriginal Community Controlled Health Organization, Canberra, ACT, 2601, Australia
| | - Maui Hudson
- Te Kotahi Research Institute, University of Waikato, Hamilton, New Zealand
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Anderson B, Boland MG, Braun KL, Bruno M, Hedges JR, Holcombe R, Ma C, Mokuau N. A Letter from the Executive Leadership Committee. Hawaii J Health Soc Welf 2019; 78:215. [PMID: 31475248 PMCID: PMC6697653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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22
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Felder TM, Braun KL, Wigfall L, Sevoyan M, Vyas S, Khan S, Brandt HM, Rogers C, Tanjasiri S, Armstead CA, Hébert JR. Mentoring, Training, and Scholarly Productivity Experiences of Cancer-Related Health Disparities Research Trainees: Do Outcomes Differ for Underrepresented Scientists? J Cancer Educ 2019; 34:446-454. [PMID: 29430610 PMCID: PMC6087686 DOI: 10.1007/s13187-018-1322-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The study aims to explore variation in scholarly productivity outcomes by underrepresented status among a diverse sample of researchers in a community-engaged training program. We identified 141 trainees from a web-based survey of researchers in the National Cancer Institute-funded, Community Networks Program Centers (CNPCs) (2011-2016). We conducted a series of multiple logistic regression models to estimate the effect of National Institutes of Health (NIH)-defined underrepresented status on four, self-reported, scholarly productivity outcomes in the previous 5 years: number of publications (first-authored and total) and funded grants (NIH and any agency). Sixty-five percent (n = 92) indicated NIH underrepresented status. In final adjusted models, non-NIH underrepresented (vs. underrepresented) trainees reported an increased odds of having more than the median number of total publications (> 9) (OR = 3.14, 95% CI 1.21-8.65) and any grant funding (OR = 5.10, 95% CI 1.77-14.65). Reporting ≥ 1 mentors (vs. none) was also positively associated (p < 0.05) with these outcomes. The CNPC underrepresented trainees had similar success in first-authored publications and NIH funding as non-underrepresented trainees, but not total publications and grants. Examining trainees' mentoring experiences over time in relation to scholarly productivity outcomes is needed.
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Affiliation(s)
- Tisha M Felder
- South Carolina Cancer Disparities Community Network, University of South Carolina, Columbia, SC, USA.
- College of Nursing, University of South Carolina, Columbia, SC, USA.
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Kathryn L Braun
- 'Imi Hale-Native Hawaiian Cancer Network, Papa Ola Lokahi, Honolulu, HI, USA
- Office of Public Health Studies, University of Hawaii, Honolulu, HI, USA
| | - Lisa Wigfall
- College of Education and Human Development, Department of Health and Kinesiology, Division of Health Education, Texas A&M University, College Station, TX, USA
| | - Maria Sevoyan
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shraddha Vyas
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Samira Khan
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Heather M Brandt
- South Carolina Cancer Disparities Community Network, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Charles Rogers
- Minnesota Community Networks Center for Eliminating Cancer Disparities, Minneapolis, MN, USA
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Sora Tanjasiri
- WINCART: Weaving an Islander Network for Cancer Awareness, Research and Training, Columbia, SC, USA
- Department of Health Science, California State University-Fullerton, Fullerton, CA, USA
| | - Cheryl A Armstead
- South Carolina Cancer Disparities Community Network, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - James R Hébert
- South Carolina Cancer Disparities Community Network, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Magnussen L, Shoultz J, Iannce-Spencer C, Braun KL. Testing a Talkstory Intervention to create Supportive and Safe Violence-Free Communities for Women. Hawaii J Med Public Health 2019; 78:169-174. [PMID: 31049266 PMCID: PMC6495030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The purpose of this paper is to report on a community-designed and led talkstory intervention to increase awareness of intimate partner violence (IPV), decrease acceptability of IPV, and increase community leadership to address IPV. In collaboration with women engaged in prior IPV outreach and education in Hawai'i, a talkstory intervention for IPV was developed, and a single-group, pre-post-test design was used to test it. The intervention included five talkstory sessions over seven months with community groups interested in violence prevention. Pre- and post-testing were conducted to determine changes in group means on three measures. Ninety-two individuals participated in the intervention, 77 (84%) of these completed the 1-month follow-up measure, and 59 (64%) of these also completed the 6-month follow-up measure. The findings included: (1) participants in the talkstory intervention groups decreased their acceptability of violence and increased their awareness, knowledge, and confidence to address IPV; (2) the community leaders in the intervention groups gained skills in facilitation; and (3) intervention groups continued to sponsor other IPV awareness-raising activities in their communities following completion of the study. Working with community leaders to design and facilitate the intervention not only provided IPV education within the context of the community, but also led to sustainable efforts to enhance the safety and wellbeing of women experiencing violence.
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Affiliation(s)
- Lois Magnussen
- School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI (LM, JS, Professors Emeriti)
- Domestic Violence Action Center, Honolulu, HI (CIS, retired)
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB)
| | - Jan Shoultz
- School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI (LM, JS, Professors Emeriti)
- Domestic Violence Action Center, Honolulu, HI (CIS, retired)
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB)
| | - Cindy Iannce-Spencer
- School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI (LM, JS, Professors Emeriti)
- Domestic Violence Action Center, Honolulu, HI (CIS, retired)
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB)
| | - Kathryn L Braun
- School of Nursing and Dental Hygiene, University of Hawai'i at Manoa, Honolulu, HI (LM, JS, Professors Emeriti)
- Domestic Violence Action Center, Honolulu, HI (CIS, retired)
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB)
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Abstract
Colorectal cancer (CRC) screening prevalence remains low among Asians and Pacific Islanders. This study examined disparities and predictors of CRC screening compliance in adults age 50-75 years in Asians and Pacific Islanders in Hawai'i. Hawai'i Behavioral Risk Factor Surveillance System (BRFSS) data for 2011-2014 were analyzed. CRC screening status was dichotomized. Logistic regression was used to examine ethnic differences in and predictors of CRC screening status. Filipinos (OR 0.56), Chinese (OR 0.70), and Hawaiians (OR 0.75) were significantly less likely than whites to be CRC compliant. Higher education and income, employment, regular health provider, and routine checkups were important predictors of CRC compliance. Findings confirm lower CRC screening compliance in three of the four largest Asian and Pacific Islander groups in Hawai'i and that CRC screening compliance is influenced by several factors. Culturally tailored education and navigation services may be effective in reducing these disparities.
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Affiliation(s)
- Jermy-Leigh B Domingo
- University of Hawai'i at Mānoa, Office of Public Health Studies, 1960 East-West Road, Biomed, D-204, 96822, Honolulu, Hawai'i, USA.
| | - John J Chen
- University of Hawai'i John A. Burns School of Medicine, Office of Biostatistics & Quantitative Health Sciences, Honolulu, Hawai'i, USA
| | - Kathryn L Braun
- University of Hawai'i at Mānoa, Office of Public Health Studies, 1960 East-West Road, Biomed, D-204, 96822, Honolulu, Hawai'i, USA
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25
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Yang KI, Chung-Do JJ, Fujitani L, Foster A, Mark S, Okada Y, Saad-Jube Z, Youkhana F, Braun KL, Cassel K, Helm S, Ka'opua LS, Mataira PJ, Nishita C, Okamoto SK, Ing CT, Qureshi K, Umemoto K. Advancing Community-Based Participatory Research to Address Health Disparities in Hawai'i: Perspectives from Academic Researchers. Hawaii J Med Public Health 2019; 78:83-88. [PMID: 30854253 PMCID: PMC6401203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Community-based participatory research (CBPR) continues to be recognized as an effective research approach in which academic researchers work in partnership with communities to address health disparities. Although the literature suggests benefits associated with CBPR, more needs to be done to advance CBPR to ultimately reduce health disparities. Hawai'i presents a research-rich opportunity for CBPR because of its ethnic diversity and geographic location, resulting in close-knit communities with unique experiences and concerns. This study aims to better understand the experiences of academic researchers who are conducting CBPR in Hawai'i and their perceptions of its benefits and challenges as well as recommendations to advance the field. Twelve academic researchers with Hawai'i-based CBPR experience were interviewed. Four major themes emerged from their responses: the importance of prioritizing relationship-building; reciprocal learning and other benefits of CBPR; navigating the tensions between CBPR and funding priorities; and building an academic setting that supports CBPR. Increasing awareness of CBPR and its benefits, as well as transforming the culture in all spaces where CBPR occurs may maximize its potential to ultimately promote health equity.
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Affiliation(s)
- Katherine I Yang
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Jane J Chung-Do
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Loren Fujitani
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Alyssa Foster
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Shannon Mark
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Yuito Okada
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Zeyana Saad-Jube
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Fadi Youkhana
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Kevin Cassel
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Susana Helm
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Lana Sue Ka'opua
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Peter J Mataira
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Christy Nishita
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Scott K Okamoto
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Claire Townsend Ing
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Kristine Qureshi
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
| | - Karen Umemoto
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI (KIY, JJC-D, LF, AF, SM, YO, FY)
- University of Hawai'i Cancer Center, Honolulu, HI (KC, SKO)
- Department of Psychiatry, University of Hawai'i, Honolulu, HI (SH, SKO)
- Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, HI (LSK)
- School of Social Work, Hawai'i Pacific University, Honolulu, HI (PJM, SKO)
- Center on Aging and Center on Disability Studies, University of Hawai'i, Honolulu, HI (CN)
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI (CTI)
- School of Nursing and Dental Hygiene, University of Hawai'i, Honolulu, HI (KQ)
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA (KU)
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Hwang PW, Gomes CDS, Auais M, Braun KL, Guralnik JM, Pirkle CM. Economic Adversity Transitions From Childhood to Older Adulthood Are Differentially Associated With Later-Life Physical Performance Measures in Men and Women in Middle and High-Income Sites. J Aging Health 2019; 31:509-527. [PMID: 29254426 PMCID: PMC6087498 DOI: 10.1177/0898264317736846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: This study examines the relationship between economic adversity transitions from childhood to older adulthood and older adulthood physical performance among 1,998 community-dwelling older adults from five demographically diverse sites from middle and high-income countries. Method: The principal exposure variable was economic adversity transition. No adversity encompassed not experiencing poverty in both childhood and older adulthood, improved described having only experienced poverty in childhood, worsened captured having experienced poverty in older adulthood, and severe is having experienced poverty in both childhood and older adulthood. The short physical performance battery (SPPB) was used for outcome measures. Analyses of the continuous SPPB score used linear regression, while analysis of a binary outcome (SPPB < 8 vs. ≥8) used Poisson regression models with robust error variance, both adjusting for sex, education, and site location. Result: In sex-stratified models, the SPPB < 8 prevalence rate ratio (PRR) was higher for the severe (PRR: 2.80, 95% confidence interval [CI] = [1.70, 4.61]), worsened (PRR: 2.40, 95% CI = [1.41, 4.09]), and improved (PRR: 1.82, 95% CI = [1.11, 3.01]) groups, compared with those with no adversity in childhood or as adults, but only for females. Discussion: Findings from this study indicate that persistent economic adversity has a negative effect on older adult physical performance, especially among women.
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Abstract
Introduction The prevalence of diabetes varies widely among racial/ethnic groups in Hawai‘i. How prevalence varies by age for Asian subgroups and Native Hawaiian/Other Pacific Islanders (NHOPIs) is understudied. We examined diabetes prevalence by age and race/ethnicity and assessed how socioeconomic status and lifestyle behaviors affected prevalence among Japanese, Filipino, Chinese, NHOPI, and white populations in Hawai‘i. Methods We studied 18,200 subjects aged 18 or older from the Hawai‘i Behavioral Risk Factor Surveillance System. We performed Poisson regression analyses to examine the prevalence of diabetes by race/ethnicity, age, sex, marital status, education, income, health care coverage, obesity, smoking and drinking status, physical activity, and fruit and vegetable consumption and examined the interactions of these factors with age and race/ethnicity. Results We found disparities in diabetes prevalence among respondents aged 35 to 44 and among Asians and NHOPIs, and disparities increased with age. NHOPIs and Filipinos had the highest prevalence of diabetes after controlling for other demographic factors and lifestyle variables. Japanese adults were less likely than NHOPIs and Filipinos to have diabetes; however, whites had the lowest prevalence. Income, physical activity, and obesity were the strongest predictors of diabetes. Conclusion NHOPIs and Filipinos have higher rates of diabetes compared with other races/ethnicities in Hawai‘i. More research is needed to reduce diabetes disparities among NHOPI and Filipino populations in Hawai‘i. This study also shows the importance of conducting age-specific analyses of racial/ethnic-subgroups for health disparities.
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Affiliation(s)
- Olivia Uchima
- Office of Public Health Studies, University of Hawai'i, Honolulu, Hawai'i.,Ha Kūpuna National Resource Center for Native Hawaiian Elders, Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, Hawai'i.,Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Rd, Biomed 104W, Honolulu, HI 96822. E-mail:
| | - Yan Yan Wu
- Office of Public Health Studies, University of Hawai'i, Honolulu, Hawai'i.,Ha Kūpuna National Resource Center for Native Hawaiian Elders, Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, Hawai'i
| | - Colette Browne
- Ha Kūpuna National Resource Center for Native Hawaiian Elders, Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, Hawai'i
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i, Honolulu, Hawai'i.,Ha Kūpuna National Resource Center for Native Hawaiian Elders, Myron B. Thompson School of Social Work, University of Hawai'i, Honolulu, Hawai'i
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Nelson-Hurwitz DC, Kehl L, Braun KL. Aloha Undergraduates: Development and Application of Local & Indigenous Topics into an Undergraduate Public Health Curriculum. Front Public Health 2019; 7:16. [PMID: 30809518 PMCID: PMC6379341 DOI: 10.3389/fpubh.2019.00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/21/2019] [Indexed: 12/05/2022] Open
Abstract
As public health education expands to include undergraduate students, it is important to include discussion of local public health topics and issues to provide a sense of place to the educational experience. Inclusion of Native Hawaiian and indigenous issues and perspectives is also an established priority of the University of Hawai‘i system. To address both needs, a required course was created during development of a new Bachelor of Arts (BA) public health program at the University of Hawai‘i at Mānoa to specifically focus on discussion of local and indigenous public health topics of interest. Public Health Issues in Hawai‘i is an introductory course included early in the recommended undergraduate curriculum and emphasizes the application of public health skills and principles to local issues (e.g., state-level legislative awareness and local sustainability topics). The Public Health Issues in Hawai‘i course further challenges students to recognize public health practice in their daily activities, and encourages them to become actively engaged in local community issues early in their public health educational careers. Among multiple advantages, improved awareness of local health challenges and early connections to community members and organizations have been instrumental in actively engaging local students in their education, and has also proved beneficial for students participating in required undergraduate applied learning capstone experiences and entry-level public health careers following graduation. Here we present insights into course development, articulation with broader program curricula, and successes and challenges in the past 4 years of implementation and instruction.
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Inada MK, Braun KL, Mwarike P, Cassel K, Compton R, Yamada S, Sentell T. Chuukese community experiences of racial discrimination and other barriers to healthcare: Perspectives from community members and providers. Soc Med (Soc Med Publ Group) 2019; 12:3-13. [PMID: 31723340 PMCID: PMC6853624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Megan Kiyomi Inada
- Kokua Kalihi Valley Comprehensive Family Services 2239 North School Street, University of Hawai'i Manoa, Office of Public Health Studies, 1960 East-West Road Honolulu, HI 96822
| | - Kathryn L Braun
- University of Hawai'i Manoa, Office of Public Health Studies, 1960 East-West Road Honolulu, HI 96822
| | - Parkey Mwarike
- College of Micronesia -FSM P.O. Box 879, Chuuk, FM 96942
| | - Kevin Cassel
- University of Hawai'i Cancer Center, 701 Ilalo Street Honolulu, HI 96822
| | - Randy Compton
- Medical-Legal Partnership for Children in Hawai'i, University of Hawai'i, William S. Richardson School of Law, 2515 Dole Street, Honolulu, HI 96822
| | - Seiji Yamada
- John A. Burns School of Medicine, Department of Family Medicine and Community Health, 651 Ilalo St, Honolulu, HI 96813
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Abstract
Many improvements in health equity are spearheaded by community collaborations working to change policy and social norms. But how can collective efficacy (CE), defined as the willingness and ability of a group to work toward a common good, be increased? Eight articles reporting on interventions aiming to reduce health disparities by improving CE were found for this systematic literature review. All studies showed improvements in CE and most found reduction in disparities, but operationalization of CE varied. Findings support a model of how CE can address health disparities, which can guide standardization of CE interventions and measures.
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Affiliation(s)
- Jean Butel
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu
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Agner J, Braun KL. Patient empowerment: A critique of individualism and systematic review of patient perspectives. Patient Educ Couns 2018; 101:2054-2064. [PMID: 30143254 DOI: 10.1016/j.pec.2018.07.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/26/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The purpose of this review is two-fold: 1) to broaden conceptualization of patient empowerment by synthesizing qualitative research on patient perspectives, and 2) to examine how researcher's method and background may have affected their framing of patient empowerment, thereby shaping the results. METHODS A systematic search for qualitative research on patient definitions of power, powerlessness, and empowerment was completed. Articles were analyzed at three levels (theory, method, and data) as suggested by the meta-study method for qualitative synthesis. RESULTS The search yielded 13 articles from 11 investigator teams across 9 countries (the United Kingdom, Norway, Australia, Taiwan, New Zealand, China, Iran, Belgium and Italy). Emergent themes from patient perspectives included control, psychological coping, legitimacy, support, knowledge, and participation. CONCLUSIONS Despite variation in diagnosis, age, ethnicity, income and country of origin, patients share many perspectives on empowerment. Furthermore, there are indications that interview questions may have influenced findings such that structural barriers to empowerment were not deeply explored. PRACTICE IMPLICATIONS This review provides knowledge that can be of direct use to medical professionals who aim to increase patient empowerment (via findings on patient perspectives) and to researchers who can use the critical appraisal of past work to improve future research on this topic.
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Affiliation(s)
- Joy Agner
- Department of Cultural and Community Psychology at the University of Hawai'i at Mānoa, 2530 Dole Street, Honolulu, HI 96822, USA.
| | - Kathryn L Braun
- Office of Public Health Studies at the University of Hawai'i at Mānoa, 1960 East-West Road, Honolulu, HI 96822, USA.
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Abstract
Quantitative studies of yoga have reported reduced posttraumatic stress disorder (PTSD) symptoms in veterans, but little is known about how and why veterans are attracted to and stick with a yoga practice. Guided by the Health Belief Model, this study examined veterans' perceptions of the benefits, barriers, and motivations to continue practicing trauma-sensitive yoga. Interviews were conducted with nine individuals, five of whom completed a 6-week trauma-sensitive yoga intervention designed for veterans and four who did not complete the intervention. Transcripts were analyzed for themes. The benefits identified by veterans were finding mental stillness, body awareness, and social connection. The barriers were perceptions that yoga is socially unacceptable, especially for men, and physically unchallenging. Understanding these benefits and barriers can help to make yoga more attractive to service members and veterans. For example, medical personnel can refer service members and veterans to yoga not only for PTSD symptoms, but also to address back pain and to reduce isolation. Access to male yoga instructors, especially those who are themselves service members or veterans, could be expanded, and classes could be integrated into physical activity routines required of active-duty personnel. Promotional materials can feature male service members and veterans with captions related to yoga as a way to increase resiliency, self-sufficiency, and physical and mental mission readiness. Findings from this study can help the Department of Defense and the Veterans Health Administration implement yoga as an adjunct or alternative treatment for veterans with PTSD symptoms.
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Affiliation(s)
- Robin E Cushing
- 1. Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu
| | - Kathryn L Braun
- 1. Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu
| | - Susan Alden
- 2. Executive Director, Warriors at Ease, Silver Spring, Md
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Novotny R, Davis J, Butel J, Boushey CJ, Fialkowski MK, Nigg CR, Braun KL, Leon Guerrero RT, Coleman P, Bersamin A, Areta AAR, Barber LR, Belyeu-Camacho T, Greenberg J, Fleming T, Dela Cruz-Talbert E, Yamanaka A, Wilkens LR. Effect of the Children's Healthy Living Program on Young Child Overweight, Obesity, and Acanthosis Nigricans in the US-Affiliated Pacific Region: A Randomized Clinical Trial. JAMA Netw Open 2018; 1:e183896. [PMID: 30646266 PMCID: PMC6324447 DOI: 10.1001/jamanetworkopen.2018.3896] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
IMPORTANCE Pacific Islanders have among the highest rates of obesity and type 2 diabetes in the world. Targeting children is critical for primary prevention. OBJECTIVES To prevent young child overweight and obesity and to improve health in the US-Affiliated Pacific region via the Children's Healthy Living Program. DESIGN, SETTING, AND PARTICIPANTS In this multijurisdictional, multilevel, multicomponent community randomized clinical trial, where all evaluable children were analyzed according to the random assignment of their community, hierarchical difference-in-difference models accounted for the community randomization, community clustering with jurisdictions, and these models were adjusted for the age and sex distribution of the community. The setting was 27 communities in 5 jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, and Hawaii). Participants were 4329 children (time 1) and 4042 children (time 2) aged 2 to 8 years in 27 selected communities from October 7, 2012, to October 25, 2015. Data analysis was completed in June 2018. INTERVENTIONS Nineteen activities addressed policy, environment, messaging, training, and 6 target behaviors (sleep time, screen time, physical activity, fruits and vegetables, water, and sugar-sweetened beverages). MAIN OUTCOMES AND MEASURES Primary outcomes were body size measurements. Secondary outcomes were acanthosis nigricans, sleep quality and duration, dietary intake, physical activity, and other questionnaire reponses. RESULTS The study included 27 communities and 8371 evaluable children (mean [SD] age, 5.4 [1.8] years; 50.9% male [n = 4264]). Data analysis included 952 children in the intervention group and 930 children in the control group aged 2 to 5 years at time 1; 825 children in the intervention group and 735 children in the control group aged 2 to 5 years at time 2; 565 children in the intervention group and 561 children in the control group aged 6 to 8 years at time 1; and 517 children in the intervention group and 560 children in the control group aged 6 to 8 years at time 2. The intervention communities showed significant improvement compared with control communities in overweight and obesity prevalence (effect size [d] = -3.95%; 95% CI, -7.47% to -0.43%), waist circumference (d = -0.71 cm; 95% CI, -1.37 to -0.05 cm), and acanthosis nigricans prevalence (d = -2.28%; 95% CI, -2.77% to -1.57%). Age and sex subgroup analysis revealed greater difference among the intervention communities in acanthosis nigricans prevalence in the group aged 2 to 5 years (-3.99%) vs the group aged 6 to 8 years (-3.40%), and the interaction was significant (d = 0.59%, P < .001), as well as the smaller difference in the group aged 2 to 5 years (-0.10%) vs the group aged 6 to 8 years (-1.07%) in screen time (d = -0.97 hour per day, P = .01). CONCLUSIONS AND RELEVANCE The intervention reduced the prevalence of young child overweight and obesity and acanthosis nigricans. Comprehensive, effective, and sustainable interventions are needed to improve child health in the US-Affiliated Pacific region. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01881373.
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Affiliation(s)
- Rachel Novotny
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
| | - James Davis
- Office of Biostatistics and Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Jean Butel
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
| | - Carol J. Boushey
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
- Nutrition Support Shared Resource, University of Hawaii Cancer Center, Honolulu
| | - Marie Kainoa Fialkowski
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
| | - Claudio R. Nigg
- Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu
| | - Kathryn L. Braun
- Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu
| | | | - Patricia Coleman
- Cooperative Research and Extension Education Services, Northern Marianas College, Saipan, Northern Mariana Islands
| | - Andrea Bersamin
- Department of Biology and Wildlife, University of Alaska, Fairbanks
| | - Aufai Apulu Ropeti Areta
- Agriculture, Community and Natural Resources Division, American Samoa Community College, Pago Pago
| | - Leroy R. Barber
- Division of Agriculture and Life Sciences, College of Natural and Applied Sciences, University of Guam, Mangilao
| | - Tayna Belyeu-Camacho
- Cooperative Research and Extension Education Services, Northern Marianas College, Saipan, Northern Mariana Islands
| | - Joshua Greenberg
- School of Natural Resources and Extension, University of Alaska, Fairbanks
| | - Travis Fleming
- Agriculture, Community and Natural Resources Division, American Samoa Community College, Pago Pago
| | | | - Ashley Yamanaka
- Office of Public Health Studies, Myron B. Thompson School of Social Work, University of Hawaii at Manoa, Honolulu
| | - Lynne R. Wilkens
- Department of Human Nutrition, Food and Animal Science, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, Honolulu
- Biostatistics and Informatics Shared Resource, University of Hawaii Cancer Center, Honolulu
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Uchima O, Sentell T, Dela Cruz MR, Braun KL. Community health workers in pediatric asthma education programs in the United States: A systematic literature review. Children's Health Care 2018. [DOI: 10.1080/02739615.2018.1520107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Olivia Uchima
- Office of Public Health Studies, University of Hawai‘i, Honolulu, HI
| | - Tetine Sentell
- Office of Public Health Studies, University of Hawai‘i, Honolulu, HI
| | | | - Kathryn L. Braun
- Office of Public Health Studies, University of Hawai‘i, Honolulu, HI
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Malabed JM, Taira DA, Seto TB, Braun KL, Sentell T. 2017 Writing Contest Undergraduate Winner: Pathways to Preventable Hospitalizations for Filipino Patients with Diabetes and Heart Disease in Hawai'i. Hawaii J Med Public Health 2018; 77:155-160. [PMID: 30009093 PMCID: PMC6037827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Filipinos are one of the fastest growing Asian ethnic groups in the United States, yet little is known about how to specifically address the varying health needs of the Filipino community with diabetes and heart disease. This is a problem because rates of potentially preventable hospitalizations (PPH) are high for Filipinos with these conditions. A PPH is a hospitalization that could potentially have been avoided with better access to quality primary care. Patients over 21 years of age with heart disease or diabetes and who were hospitalized at the Queen's Medical Center with a PPH were recruited to complete a face-to-face interview eliciting the patients' perspectives on key factors leading to this hospitalization (n=102). This study focused on a subset of Filipino patients (n=21). Two independent coders reviewed interviews to identify factors leading to their PPH. A majority of the Filipino respondents identified social vulnerabilities as the most common factor that led to their hospitalization, including financial challenges, limited social support, and life instability. Many respondents also noted challenges with the healthcare system as precipitating their hospitalization, including poor communication/coordination, management plan issues, and bad experience with their healthcare providers. Cultural and language barriers were also identified by Filipino patients as challenges leading to their hospitalizations. These findings emphasize the importance of considering patients' perspectives of the barriers they face inside and outside of healthcare facilities.
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Nelson-Hurwitz DC, Tagorda M, Kehl L, Buchthal OV, Braun KL. Developing an Undergraduate Public Health Introductory Core Course Series. Front Public Health 2018; 6:155. [PMID: 29892596 PMCID: PMC5985697 DOI: 10.3389/fpubh.2018.00155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/08/2018] [Indexed: 11/19/2022] Open
Abstract
The number of undergraduate public health education programs is increasing, but few publications provide examples of introductory public health courses that provide foundational knowledge and meet 2016 Council on Education in Public Health (CEPH) accreditation standards. This article presents the development and testing of a three-course, introductory series in public health at the University of Hawai‘i at Mānoa (UHM). Development was informed by best pedagogical practices in education, web review of existing programs, literature review, key informant interviews, and accreditation standards. Student mastery of required concepts, domains, and competencies is assessed through testing and class assignments. Data from course evaluations, students' exit questionnaires at graduation, and faculty feedback were used to continuously evolve and adapt the curriculum. The three-course series—including Introduction to Public Health, Public Health Issues in Hawai‘i, and Introduction to Global Health—was designed to provide incoming undergraduate public health students with a foundation in local, national, and global public health concepts and domains, while improving their skills in public health communication and information literacy. Data from class assignments, examinations, and later coursework suggest students are mastering the course materials and gaining required competencies. Data from course evaluation and exit questionnaires suggest that the students appreciate the series' approach and the challenge to apply course concepts locally and globally in subsequent courses. This foundational public health series provides a model for an introductory course series that can be implemented with existing resources by most programs, meets the new CEPH requirements, is well-received by students, and prepares students well for upper-division public health courses.
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Affiliation(s)
- Denise C Nelson-Hurwitz
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Michelle Tagorda
- Health Careers Opportunity Program, Student Equity, Excellence and Diversity, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Lisa Kehl
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Opal V Buchthal
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, United States
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, United States
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Domingo JLB, Gavero G, Braun KL. Strategies to Increase Filipino American Participation in Cardiovascular Health Promotion: A Systematic Review. Prev Chronic Dis 2018; 15:E59. [PMID: 29786501 PMCID: PMC5985898 DOI: 10.5888/pcd15.170294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction Cultural tailoring of interventions can be effective in reducing health disparities by attracting underserved populations to health promotion programs and improving their outcomes. The purpose of this systematic review was to assess what is known about increasing access to and participation in cardiovascular disease (CVD) prevention and control programs among Filipino Americans. Methods PubMed MEDLINE, CINAHL, and Sociologic Abstracts were searched for peer-reviewed studies and dissertations conducted in the United States from 2004 through 2016. Results A total of 347 articles were identified through the search, and 9 articles reporting on 7 interventions focused on CVD prevention in a Filipino American sample were included. All but one intervention used evidence-based curricula, and implementation varied across sites. All but 2 interventions used word-of-mouth advertising from friends, family, and community leaders to increase participation. The Filipino cultural values of food, social relationships, and family were prevalent aspects across interventions tailored for Filipino Americans. Aspects of spirituality and the arts were integrated into only 3 studies. Conclusion Given the burden of CVD in Filipino American populations, tailored interventions rooted in Filipino cultural values are vital to address this known health disparity.
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Affiliation(s)
- Jermy-Leigh B Domingo
- Hawai'i Primary Care Association, Honolulu, Hawai'i, 1003 Bishop St, Pauahi Tower, Suite 1810, Honolulu, HI 96813.
| | - Gretchenjan Gavero
- University of Hawai'i John A. Burns School of Medicine, Department of Psychiatry, Honolulu, Hawai'i
| | - Kathryn L Braun
- University of Hawai'i at Mānoa, Office of Public Health Studies, Honolulu, Hawai'i
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Cushing RE, Braun KL, Alden C-Iayt SW, Katz AR. Military-Tailored Yoga for Veterans with Post-traumatic Stress Disorder. Mil Med 2018; 183:e223-e231. [PMID: 29415222 PMCID: PMC6086130 DOI: 10.1093/milmed/usx071] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/23/2017] [Accepted: 11/04/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Among veterans of post-9/11 conflicts, estimates of post-traumatic stress disorder (PTSD) range from 9% shortly after returning from deployment to 31% a year after deployment. Clinical and pharmaceutically based treatments are underutilized. This could be due to concerns related to lost duty days, as well as PTSD patients' fears of stigma of having a mental health condition. Yoga has been shown to reduce PTSD symptoms in the civilian population, but few studies have tested the impact of yoga on veterans of post-9/11 conflicts. The purpose of this study is to test the impact of yoga on post-9/11 veterans diagnosed with PTSD. Materials and Methods Participants were 18 yr of age or older and veterans of post-9/11 conflicts. They had subthreshold or diagnostic-level PTSD related to their combat military service, as determined by a score of 30 or higher on the PTSD Checklist-Military version (PCL-M). Veterans participated in 60-min weekly yoga sessions for 6 wk taught by a Warriors at Ease-trained yoga instructor who is a, post-9/11 veteran. The yoga sessions incorporated Vinyasa-style yoga and a trauma-sensitive, military-culture informed approach advocated by two separate organizations: Warriors at Ease and Meghan's Foundation. Data were collected at baseline and again after 7 wk. The primary outcome was PCL-M score. Participants also completed the Patient Health Questionnaire, the Beck Anxiety Inventory, the Pittsburgh Sleep Quality Index, and the Mindful Attention Awareness Scale at both time points. Results Eighteen Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans completed the pre- and post-intervention self-report questionnaires. Age ranged from 26 to 62 yr (median = 43 yr), length of service ranged from 2 to 34 yr (median = 18.8 yr), and 13 (72.2%) had completed college. Decreased PTSD symptomatology was demonstrated in the three-symptom clusters represented in the PCL-M (i.e., hyperarousal, re-experiencing, and avoidance). In addition, the total score on the PCL-M decreased significantly, by both statistical and clinical measures. The participants also demonstrated improved mindfulness scores and reported decreased insomnia, depression, and anxiety symptoms. Conclusion This study demonstrates that a trauma-sensitive yoga intervention may be effective for veterans with PTSD symptoms, whether as stand-alone or adjunctive therapy. The impressive decrease in PTSD symptomatology may be due to the tailored military-specific nature of this intervention and the fact that it was led by a veteran of post-9/11 conflicts. More research is needed with a larger sample and a more diverse veteran population.
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Affiliation(s)
- Robin E Cushing
- 1st Infantry Division, Attn. DIV SURG Office Bld. 580, 1st Division Rd., Fort Riley, KS 66442
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Manoa, 1960 East-West Road, Biomed D209, Honolulu, HI 96822
| | | | - Alan R Katz
- Office of Public Health Studies, University of Hawai'i at Manoa, 1960 East-West Road, Biomed D209, Honolulu, HI 96822
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Ing CT, Miyamoto RES, Fang R, Antonio M, Paloma D, Braun KL, Kaholokula JK. Comparing Weight Loss-Maintenance Outcomes of a Worksite-Based Lifestyle Program Delivered via DVD and Face-to-Face: A Randomized Trial. Health Educ Behav 2018; 45:569-580. [PMID: 29504468 DOI: 10.1177/1090198118757824] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Native Hawaiians and other Pacific Islanders have high rates of overweight and obesity compared with other ethnic groups in Hawai'i. Effective weight loss and weight loss-maintenance programs are needed to address obesity and obesity-related health inequities for this group. AIMS Compare the effectiveness of a 9-month, worksite-based, weight loss-maintenance intervention delivered via DVD versus face-to-face in continued weight reduction and weight loss maintenance beyond the initial weight loss phase. METHOD We tested DVD versus face-to-face delivery of the PILI@Work Program's 9-month, weight loss-maintenance phase in Native Hawaiian-serving organizations. After completing the 3-month weight loss phase, participants ( n = 217) were randomized to receive the weight loss-maintenance phase delivered via trained peer facilitators or DVDs. Participant assessments at randomization and postintervention included weight, height, blood pressure, physical functioning, exercise frequency, and fat intake. RESULTS Eighty-three face-to-face participants were retained at 12 months (74.1%) compared with 73 DVD participants (69.5%). There was no significant difference between groups in weight loss or weight loss maintenance. The number of lessons attended in Phase 1 of the intervention (β = 0.358, p = .022) and baseline systolic blood pressure (β = -0.038, p = .048) predicted percent weight loss at 12 months. DISCUSSION AND CONCLUSION Weight loss maintenance was similar across groups. This suggests that low-cost delivery methods for worksite-based interventions targeting at-risk populations can help address obesity and obesity-related disparities. Additionally, attendance during the weight loss phase and lower baseline systolic blood pressure predicted greater percent weight loss during the weight loss-maintenance phase, suggesting that early engagement and initial physical functioning improve long-term weight loss outcomes.
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Affiliation(s)
| | | | - Rui Fang
- 1 University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | | | - Diane Paloma
- 2 Queen's Health Systems, Honolulu, Hawai'i, USA
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Domingo JLB, Braun KL. Characteristics of Effective Colorectal Cancer Screening Navigation Programs in Federally Qualified Health Centers: A Systematic Review. J Health Care Poor Underserved 2018; 28:108-126. [PMID: 28238992 DOI: 10.1353/hpu.2017.0013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
In the U.S., colorectal cancer (CRC) incidence and mortality have declined due to screening and improvements in early detection; however, racial/ethnic disparities in screening and mortality persist. Patient navigation has been shown to be effective in increasing CRC screening prevalence. This systematic review answered three questions about navigation in federally qualified community health centers (FQHCs): 1) Which navigation activities increased CRC screening prevalence? 2) What were the challenges to implementing these programs in FQHCs? 3) Which clinic protocols supported screening completion? Findings suggest that navigation services must be tailored to the specific screening test provided. Federally qualified community health centers report difficulty maintaining a current electronic medical records system and sustaining funding; they should establish excellent patient tracking systems (for follow-up and annual rescreening) and establish multiple protocols to facilitate screening completion. With the movement toward patient-centered care models, patient navigation will be integral to FQHCs and their clients.
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Choy LB, Maddock JE, Brody B, Richards KL, Braun KL. Examining the role of a community coalition in facilitating policy and environmental changes to promote physical activity: the case of Get Fit Kaua'i. Transl Behav Med 2017; 6:638-647. [PMID: 27848212 DOI: 10.1007/s13142-015-0379-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Community coalitions help to generate policy and environmental changes that address community health problems. This qualitative study examined how one community coalition, Get Fit Kaua'i, catalyzed built environment (BE) policy and infrastructure changes in a rural county in Hawai'i. The purpose was to develop a theory that explained the process by which the community coalition facilitated BE changes to support physical activity. Using a grounded theory approach, semi-structured interviews were conducted with a purposeful sample of 25 stakeholders engaged in the coalition's BE activities. The model to emerge from the coalition interviews consisted of five phases: (1) coalition formation, (2) capacity building, (3) policy development, (4) policy passage, and (5) policy implementation. Community context influenced all of these phases. Although community context limits generalizability, other community coalitions pursuing BE changes can learn from the process of the coalition under study.
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Affiliation(s)
- Lehua B Choy
- Department of Public Health Sciences, University of Hawai'i at Mānoa, Honolulu, HI, 96822, USA.
| | - Jay E Maddock
- School of Public Health, Texas A & M Health Science Center, College Station, TX, USA
| | - Beverley Brody
- Department of Public Health Sciences, University of Hawai'i at Mānoa, Honolulu, HI, 96822, USA
| | - Katherine L Richards
- Healthy Hawai'i Initiative, Hawai'i State Department of Health, Honolulu, HI, USA
| | - Kathryn L Braun
- Department of Public Health Sciences, University of Hawai'i at Mānoa, Honolulu, HI, 96822, USA
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Browne CV, Braun KL. Away from the Islands: Diaspora’s Effects on Native Hawaiian Elders and Families in California. J Cross Cult Gerontol 2017; 32:395-411. [DOI: 10.1007/s10823-017-9335-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Townsend CKM, Miyamoto RES, Antonio M, Zhang G, Paloma D, Basques D, Braun KL, Kaholokula JK. The PILI@Work Program: a translation of the diabetes prevention program to Native Hawaiian-serving worksites in Hawai'i. Transl Behav Med 2017; 6:190-201. [PMID: 27356989 PMCID: PMC4927448 DOI: 10.1007/s13142-015-0383-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
A previously translated Diabetes Prevention Program Lifestyle Intervention (DPP-LI) was adapted for delivery as a worksite-based intervention, called PILI@Work, to address obesity disparities in Native Hawaiians/Pacific Islanders. This study examined the effectiveness of PILI@Work and factors associated with weight loss at post-intervention. Overweight/obese employees of 15 Native Hawaiian-serving organizations received the 3-month component of PILI@Work. Assessments included weight, systolic/diastolic blood pressure, physical activity and functioning, fat intake, locus of weight control, social support, and self-efficacy. Weight, systolic/diastolic blood pressure, physical functioning, physical activity frequency, fat intake, family support, and eating self-efficacy improved from pre- to post-intervention. Regression analysis indicated that worksite type, decreased diastolic blood pressure, increased physical activity, and more internalized locus of weight control were significantly associated with 3-month weight loss. PILI@Work initiated weight loss in Native Hawaiians/Pacific Islanders. DPP-LI translated to worksite settings and tailored for specific populations can be effective for addressing obesity.
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Affiliation(s)
- Claire K M Townsend
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA.
| | - Robin E S Miyamoto
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| | - Mapuana Antonio
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| | - Guangxing Zhang
- Office of Biostatistics & Quantitative Health Sciences John A Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Diane Paloma
- Native Hawaiian Health Program, Queen's Health Systems, Honolulu, HI, USA
| | - DeAnna Basques
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A Burns School of Medicine, University of Hawai'i at Mānoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
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Zhang W, Braun KL, Wu YY. The educational, racial and gender crossovers in life satisfaction: Findings from the longitudinal Health and Retirement Study. Arch Gerontol Geriatr 2017; 73:60-68. [PMID: 28779590 DOI: 10.1016/j.archger.2017.07.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Revised: 05/26/2017] [Accepted: 07/20/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine variations in life satisfaction by education, gender, and race/ethnicity over a period of eight years among middle-aged and older Americans. METHODS Mixed-effects models were used to analyze five waves (2006, 2008, 2010, 2012 and 2014) of longitudinal data from 16,163 participants born 1890-1953 in the U.S. Health and Retirement Study. RESULTS Life satisfaction was higher in older adults, and the Great Recession had great impact on life satisfaction. Crossover interactions were found by gender, education, and race/ethnicity. Higher education was associated with higher life satisfaction for both genders, with stronger effects for females. Hispanics had the higher level of life satisfaction than non-Hispanic Whites and African Americans. DISCUSSION Longitudinal evidence revealed disparities in life satisfaction. The racial/ethnic differences in the impact of education suggest that the economic and health returns of education vary by social group. Researchers should continue to examine reasons for these disparities.
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Affiliation(s)
- Wei Zhang
- Department of Sociology, College of Social Sciences, University of Hawai'i at Mānoa, 2424 Maile Way, Saunders Hall 239, Honolulu, HI, 96822, USA
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Biomed D-209, Honolulu, HI, 96822, USA
| | - Yan Yan Wu
- Office of Public Health Studies, University of Hawai'i at Mānoa, 1960 East-West Road, Biomed D-209, Honolulu, HI, 96822, USA.
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Power JM, Braun KL, Bersamin A. Exploring the Potential for Technology-Based Nutrition Education Among WIC Recipients in Remote Alaska Native Communities. J Nutr Educ Behav 2017; 49:S186-S191.e1. [PMID: 28689556 PMCID: PMC5505314 DOI: 10.1016/j.jneb.2016.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/12/2016] [Accepted: 11/15/2016] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Estimate media technology use in Alaska Native communities to inform the feasibility of technology-based nutrition education. METHODS A self-administered questionnaire was mailed to a random selection of about 50% of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) authorized representatives in remote Alaska Native communities (n = 975). Media technology use, interest in media technology-based nutrition education, and potential barriers were assessed. Chi-square tests were used to investigate associations among technology use, age, and education. RESULTS Technology use was common among respondents (n = 368); use was significantly more common among younger age groups and participants with a higher level of education. Smartphone (78.8%) and Facebook (95.8%) use was comparable to national averages, but having a computer at home (38.4%) was much less likely. Less than 50% of participants have Internet access at home. CONCLUSIONS AND IMPLICATIONS Findings shed light on new opportunities for WIC and other programs to deliver nutrition education to Alaska Native people in remote communities.
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Affiliation(s)
- Julianne M Power
- Center for Alaska Native Health Research and the Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i, Honolulu, Hawaii
| | - Andrea Bersamin
- Center for Alaska Native Health Research and the Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK.
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Braun KL, Nelson-Hurwitz DC, Ono M, Godinet M, Perkinson MA, Mokuau N, Hayes D. Insights in Public Health: From Hale to Kauhale: Public Health, Social Work, and Aging. Hawaii J Med Public Health 2017; 76:135-138. [PMID: 28484669 PMCID: PMC5418539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB, DN-H)
| | | | - Mari Ono
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB, DN-H)
| | - Meripa Godinet
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB, DN-H)
| | - Margaret A Perkinson
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB, DN-H)
| | - Noreen Mokuau
- Office of Public Health Studies, University of Hawai'i at Manoa, Honolulu, HI (KLB, DN-H)
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Quensell ML, Taira DA, Seto TB, Braun KL, Sentell TL. "I Need my Own Place to get Better": Patient Perspectives on the Role of Housing in Potentially Preventable Hospitalizations. J Health Care Poor Underserved 2017; 28:784-797. [PMID: 28529224 PMCID: PMC5630224 DOI: 10.1353/hpu.2017.0074] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To analyze patient perspectives on the role of housing in their potentially preventable hospitalization. METHODS Individuals admitted with cardiovascular-or diabetes-related diagnoses (n = 90) in a major medical center in Hawai'i completed an in-person interview eliciting patient perspectives on key factors leading to hospitalization. Using the framework approach, two independent coders identified themes. This study focused on housing-related findings. RESULTS Overall, 23% of participants reported housing as a precipitating factor to their hospitalization, including 12 with no regular place to stay. Four housing-related themes emerged: challenges meeting basic needs, complex chronic care management difficulties, stigma and relationship with provider, and stress and other mental health issues. DISCUSSION Almost 25% of patients identified housing as a key factor to their hospital stay. Patient-reported themes highlight specific mechanisms by which housing challenges may lead to hospitalization. Addressing housing issues could help reduce the number and associated cost burden of preventable hospitalizations.
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Abstract
The authors developed and tested 5 educational booklets to improve end-of-life knowledge, attitudes, intention, and practices in a multiethnic sample of family caregivers of well, homebound, and institutionalized elders. Of 570 participants, 424 (74%) read at least 1 booklet and completed pretests and posttests. At 3-month follow-up, small improvements were seen in completion of advance directives, and significant increases were seen in proportions of caregivers with funeral or burial plans and willingness to consider hospice. The booklets had wide appeal, but end-of-life measures varied by care-giver stage and ethnicity, suggesting that these factors need to be considered in developing education interventions for family caregivers.
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Affiliation(s)
- Kathryn L Braun
- Center on Aging, Office of Public Health Studies, University of Hawaii, Honolulu, USA.
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Sentell TL, Seto TB, Young MM, Vawer M, Quensell ML, Braun KL, Taira DA. Pathways to potentially preventable hospitalizations for diabetes and heart failure: a qualitative analysis of patient perspectives. BMC Health Serv Res 2016; 16:300. [PMID: 27456233 PMCID: PMC4960879 DOI: 10.1186/s12913-016-1511-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 07/02/2016] [Indexed: 11/10/2022] Open
Abstract
Background Potentially preventable hospitalizations (PPH) for heart failure (HF) and diabetes mellitus (DM) cost the United States over $14 billion annually. Studies about PPH typically lack patient perspectives, especially across diverse racial/ethnic groups with known PPH health disparities. Methods English-speaking individuals with a HF or DM-related PPH (n = 90) at the largest hospital in Hawai‘i completed an in-person interview, including open-ended questions on precipitating factors to their PPH. Using the framework approach, two independent coders identified patient-reported factors and pathways to their PPH. Results Seventy-two percent of respondents were under 65 years, 30 % were female, 90 % had health insurance, and 66 % had previously been hospitalized for the same problem. Patients’ stories identified immediate, precipitating, and underlying reasons for the admission. Underlying background factors were critical to understanding why patients had the acute problems necessitating their hospitalizations. Six, non-exclusive, underlying factors included: extreme social vulnerability (e.g., homeless, poverty, no social support, reported by 54 % of respondents); health system interaction issues (e.g., poor communication with providers, 44 %); limited health-related knowledge (42 %); behavioral health issues (e.g., substance abuse, mental illness, 36 %); denial of illness (27 %); and practical problems (e.g., too busy, 6 %). From these findings, we developed a model to understand an individual’s pathways to a PPH through immediate, precipitating, and underlying factors, which could help identify potential intervention foci. We demonstrate the model’s utility using five examples. Conclusions In a young, predominately insured population, factors well outside the traditional purview of the hospital, or even clinical medicine, critically influenced many PPH. Patient perspectives were vital to understanding this issue. Innovative partnerships and policies should address these issues, including linkages to social services and behavioral health. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1511-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tetine L Sentell
- Office of Public Health Studies, University of Hawai'i at Manoa, 1960 East-West Road, Biomed, Honolulu, HI, 96821, USA.
| | - Todd B Seto
- Queens Medical Center, 1301 Punchbowl Street, Honolulu, HI, 96813, USA
| | | | - May Vawer
- , 1301 Punchbowl Street, Honolulu, HI, 96813, USA
| | - Michelle L Quensell
- Office of Public Health Studies, University of Hawai'i at Manoa, 1960 East-West Road, Biomed, Honolulu, HI, 96821, USA
| | - Kathryn L Braun
- Office of Public Health Studies, University of Hawai'i at Manoa, 1960 East-West Road, Biomed, Honolulu, HI, 96821, USA
| | - Deborah A Taira
- Daniel K. Inouye College of Pharmacy, University of Hawai'i at Hilo, 677 Ala Moana Boulevard, Suite 1025, Honolulu, HI, 96813, USA
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Dela Cruz MRI, Tsark JAU, Soon R, Albright CL, Braun KL. Insights in Public Health: Community Involvement in Developing a Human Papillomavirus (HPV) Vaccine Brochure Made for Parents in Hawai'i. Hawaii J Med Public Health 2016; 75:203-207. [PMID: 27437166 PMCID: PMC4950096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- May Rose I Dela Cruz
- Papa Ola Lokahi, 'Imi Hale Native Hawaiian Cancer Network, Honolulu, HI (MRIDC, JUT, KLB)
| | - Jo Ann U Tsark
- Papa Ola Lokahi, 'Imi Hale Native Hawaiian Cancer Network, Honolulu, HI (MRIDC, JUT, KLB)
| | - Reni Soon
- Papa Ola Lokahi, 'Imi Hale Native Hawaiian Cancer Network, Honolulu, HI (MRIDC, JUT, KLB)
| | - Cheryl L Albright
- Papa Ola Lokahi, 'Imi Hale Native Hawaiian Cancer Network, Honolulu, HI (MRIDC, JUT, KLB)
| | - Kathryn L Braun
- Papa Ola Lokahi, 'Imi Hale Native Hawaiian Cancer Network, Honolulu, HI (MRIDC, JUT, KLB)
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