May 1, 2018

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

Joseph Keawe‘aimoku Kaholokula, Claire Townsend Ing, Mele A. Look, Rebecca Delafield, and Ka‘imi Sinclair

Annals of Human Biology

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.

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