Supports and Obstacles to Cancer Survival for Hawaii's Native People

Braun, Kathryn L.; Mokuau, Noreen; Hunt, Gail; Ka'ano'i, Momi E; Gotay, Carolyn

doi:10.1046/j.1523-5394.2002.104001.x

Cited by 59 publications

(80 citation statements)

References 22 publications

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“…Lack of insurance has been identified as a possible barrier to accessing Western medical care for Native Hawaiians (34). However, according to the Hawaii State Behavioral Risk Factor Surveillance System (BRFSS), 88% of Native Hawaiians reported having any kind of health care coverage, 73% had at least one person they regarded as their personal doctor, and only 9% felt that they had not received needed medical care because of cost within the past twelve months (6).…”

Section: Discussionmentioning

confidence: 99%

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Pacific Islanders’ perspectives on heart failure management

Kaholokula

Saito

Mau

et al. 2008

Patient Education and Counseling

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Objective-To identify the health beliefs, attitudes, practices and social and family relations important in heart failure treatment among Pacific Islanders.Methods-Four focus groups were convened with 36 Native Hawaiians and Samoans with heart failure and their family caregivers. Thematic data analysis was used to categorize data into four domains: health beliefs and attitudes, preferred health practices, social support systems, and barriers to heart failure care.Results-Common coping styles and emotional experiences of heart failure in this population included avoidance or denial of illness, hopelessness and despair, and reliance on spiritual/religious beliefs as a means of support. Among study participants, more Samoans preferred to be treated by physicians whereas more Native Hawaiians preferred traditional Hawaiian methods of healing. Two types of social support (informational and tangible-instrumental) were identified as important in heart failure care. Barriers to heart failure care included poor knowledge of heart failure, lack of trust in physicians' care, poor physician-patient relations, finances, dietary changes, and competing demands on time.Conclusion-The recruitment, retention, and adherence of Pacific Islanders to heart failure interventions are affected by an array of psychosocial and socio-cultural factors.Practice Implications-Interventions might be improved by offering participants accurate and detailed information about heart failure and its treatment, engaging the extended family in providing necessary supports, and providing tools to facilitate physician-patient relationships, among others, within the context of a larger socio-cultural system.

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Section: Discussionmentioning

confidence: 99%

“…The focus group methodology was employed because it is consistent with the tradition of Pacific Islanders who prefer to share their experiences orally and face-to-face (vs. surveys or telephone interviews), allowing them to judge the researcher's intent and trustworthiness as information is shared (34)(35)(36).…”

Section: Study Design and Theoretical Frameworkmentioning

confidence: 99%

Pacific Islanders’ perspectives on heart failure management

Kaholokula

Saito

Mau

et al. 2008

Patient Education and Counseling

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“…First, we verified the importance of further segmenting Native Hawaiians by gender and age in the future development and testing of brochures. With regard to gender, we had asked men and women to examine all the brochures because previous research with Native Hawaiians stressed the importance of educating the entire family about cancer screening so that members can support each other in obtaining age-and gender-appropriate screening (Braun et al, 2002). Among clients, however, some men were uncomfortable with being asked to examine the cervical cancer brochure, and some women were uncomfortable reviewing the prostate and testicular cancer brochures.…”

Section: Discussionmentioning

confidence: 99%

Using a Participatory Four-Step Protocol to Develop Culturally Targeted Cancer Education Brochures

Kulukulualani

Braun

Tsark

2008

Health Promotion Practice

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Native Hawaiians have a high cancer burden, but few culturally targeted cancer education brochures exist. The authors followed a participatory four-step protocol, involving more than 200 health providers and clients, to develop and test culturally targeted brochures on skin, oral, cervical, prostate, and testicular cancers. The final products featured Hawaiian faces, scenes, words, and activities. They proved more attractive than existing materials, in particular to younger Hawaiians, and posttests suggested good comprehension of intended messages. This protocol may have application in other communities that want to develop brochures that are attractive, acceptable, readable, and useful to minority clients and their providers.

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“…Best response was obtained through in-person contact (i.e., having members complete questionnaires at club meetings) and secondarily by telephone (although it took several calls before finding the participant at home). Given the preference of Native Hawaiians and other Pacific peoples for personal contact and oral communication [14,17], we recommend that future studies collect data through personal interviews, meetings, or telephone rather than by mail.…”

Section: Discussionmentioning

confidence: 99%

“…Many Native Hawaiians have experienced dispossession and discrimination in the state of Hawaii, resulting in a generalized distrust for Western systems of health care. Some Hawaiians, espceially those without medical insurance, are fatalistic about cancer [17]. Health education interventions that incorporate cultural values have been found to be successful in increasing screening rates among Native Hawaiians [15,18].…”

Section: Introductionmentioning

confidence: 99%