Culturally responsive approaches to health promotion for Native Hawaiians and Pacific Islanders

Abstract

Context Obesity, diabetes, and cardiovascular disease (CVD) have reached epidemic proportions among Native Hawaiians/Pacific Islanders (NHPI). Culturally responsive interventions that account for their interpersonal, sociocultural, and socioeconomic realities is a public health priority. Objective To describe cultural adaptation and cultural grounded approaches to developing health interventions for NHPI and to review the culturally responsive approaches used by, and outcomes from, two long-standing community-based participatory research projects (CBPR) in Hawai‘i: PILI ‘Ohana and KāHOLO Projects. Methods A literature review of 14 studies from these two projects were done to exemplify the methods applied to culturally adapting existing evidence-based interventions and to developing novel interventions from the “ground up” to address health disparities in NHPI. Of the 14 studies reviewed, 11 were studies of the clinical and behavioral outcomes of both types of interventions. Results Both cultural adapted and cultural grounded approaches using community-based assets and NHPI cultural values/practices led to establishing sustainable and scalable interventions that significantly improved clinical measures of obesity, diabetes, and hypertension. Conclusion Several recommendations are provided based on the lessons learned from the PILI ‘Ohana and KāHOLO Projects. Multidisciplinary and transdisciplinary research using CBPR approaches are needed to elucidate how human biology is impacted by societal, environmental, and psychological factors that increase the risk for cardiometabolic diseases among NHPI to develop more effective health promotion interventions and public health policies.

(Re)constructing Conceptualizations of Health and Resilience among Native Hawaiians

“…Findings from this study support the need to develop culturally-based and culturally-grounded programs that address health. These findings align with other research that demonstrates the positive effects of culturally-based and culturally-grounded health interventions (Kaholokula et al 2018;Walters et al 2018). Although recent interventions have implemented culturally-based programs to address chronic illnesses, continued efforts are needed to address concerns related to promoting holistic health.…”

Considering Health Literacy, Health Decision Making, and Health Communication in the Social Networks of Vulnerable New Mothers in Hawai‘i: A Pilot Feasibility Study

“…We also focused on two racial/ethnic groups that have health disparities within our specific context, the state of Hawai'i. We include Native Hawaiians and Filipinos due to the cultural relevance of the collective in Pacific Islander communities [15,42,43] as well as the importance of improving health in these populations to achieve health equity. Native Hawaiians and Filipinos are also some of the fastest growing racial/ethnic population in the United States (US) and are understudied generally [44].…”

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

“…48 The meaningful inclusion of community members in the decision-making process and in the implementation of a study helps to build community capacity to engage in health promotion activities, to provide cultural relevance and context, and to increase the likelihood that the findings or products of the research will be used and sustained beyond the life of the research project. 147 Also consistent with prior CBPR literature is the best practice of removing barriers to research by using the participants' native language and cultural perspectives, holding meetings in an easily accessible location for community partners, and spending significant time in the community to build trust and to understand their concerns, values, customs, and preferred ways of addressing issues. This finding is consistent with CBPR literature that has included other Indigenous populations.…”