Connecting culturally and spiritually to healthy eating: A community assessment with Native Hawaiians

Abstract

Many of the chronic illnesses disproportionately experienced by Native Hawaiians are directly related to poor diets and long-standing obesity beginning in childhood. We report on the findings of in-depth key informant interviews (N=14) that took place in two Native Hawaiian communities as part of a larger, community-based participatory research study that included a community assessment through individual interviews and focused group discussions, and a pilot intervention targeting pregnant women, their infants, and families. Four categories emerged from the qualitative analysis of interview transcripts that described an understanding of “healthy eating”: family roles and responsibilities, aspects of community and physical environment, deeper spiritual meaning of food, and ways of operationalizing personal eating choices. The findings revealed previously undocumented intergenerational influences on healthy eating patterns and informed the design of the next study phases and are of significance in targeting nutritional interventions for Native Hawaiians.

Best Practices for Community-Engaged Research with Pacific Islander Communities in the US and USAPI: A Scoping Review

“…Engagement of a community advisory board was cited as a way to ensure the needs and desires of the wider community were included in the research. 72,109 Faith-based leaders and community elders.-The engagement of faith-based leaders and community elders as a best practice was identified in 22% of the articles, [62][63][64]77,84,85,93,95,97,101,102,108,110,118,119,126,128,133,135,[137][138] which is consistent with CBPR best practices already identified concerning some populations (e.g., rural African Americans). 139,140 When discussing the involvement of faith-based leaders, articles cited the role of faith-based leaders as extending beyond religious beliefs and discussed the role of faith-based organizations and faith-based leaders as representing the clan structures, and faith-based leaders as having a role almost similar to that of a governmental leader within the community.…”

“…99 Sharing a meal.-Another cultural practice described in 17% of the articles was the sharing of a meal. 64,67,70,73,75,77,80,85,97,104,112,118,131,135,138 For many Pacific Islander communities, food is the center of social interaction and is described as a vital part of gatherings. Communal meals facilitated the opportunity for researchers and participants to engage with one another as equals and potentially as extensions of family and community.…”

“…Group engagement.-Over half (55%) of the articles discussed the importance of implementing research in group settings citing using focus group discussions and collecting data via surveys in groups as examples. [62][63][64]66,67,[70][71][72]74,[76][77][78][79][80][81][85][86][87][88]90,92,93,[95][96][97]99,100,102,104,106,108,109,112,113,116,119,121,124,125,127,134,144,145 Group engagement in study activities supported increased community and participant comfort with research activities and was described as reflective of Pacific Islander cultural values, yielding enhanced involvement from Pacific Islander participants. For example, Kagawa-Singer et al documented that Pacific Islander participants may be more comfortable providing information if friends from their community were allowed to participate as well.…”

“…78 Family engagement.-More than a third (39%) of the articles reviewed discussed the importance of focusing on the family unit when conducting research and/or incorporating family into the intervention design. 62,63,66,68,[70][71][72][75][76][77][78][79]88,90,[96][97][98][99][100][101]104,109,110,112,113,118,119,121,125,127,134,145 The definition of family cited in some articles went beyond parents, children, and siblings to include extended family members such as aunts, uncles, and cousins. The definitions of family also extended beyond biology and included close friends or people from the same clan or island.…”

“…62,68,75,76,78,84,86,87,90,92,93,95,97,[99][100][101][102]105,[107][108][109]112,113,118,119,120,124,125,128,[141][142] …”