ABSTRACT
BACKGROUND: Dietary acculturation is the process by which diet and dietary practises from the environment of origin are retained or changed and/or those prevalent in a new environment are adopted. Despite rapid population growth the U.S., knowledge gaps exist on characterising dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander communities (AANHPI). This study characterise dietary patterns in a sample representative of AANHPI on key demographic characteristics. METHODS: Data were from a 2013-2014 population-based case-control study in the San Francisco Bay Area, U.S. Survey items were adapted from dietary acculturation scales developed for AANHPI populations. Validated measures assessed social capital, social standing, discrimination and immigration experiences. A principal components factor analysis was conducted to characterise dietary patterns of acculturation. RESULTS: Three dietary patterns were identified: "Asian," "Western," and a distinct "Multicultural" factor. Respondents reporting a high-Asian diet tended to also report smaller social networks, higher levels of stress, and, among those born outside of the U.S., an educational standing that was better before immigration. Respondents reporting a high-Western diet tended to also report the highest level of discrimination. Those reporting a high-Multicultural diet tended to report higher neighbourhood collective efficacy. CONCLUSIONS: The finding of a distinct "Multicultural" factor beyond the typical "Asian" and "Western" factors may reflect the multidirectional relationships between culture, diet, and dietary behavior, in which origin and destination cultures interact in complex ways and where foods from multiple ethnicities intermix.
Subject(s)
Acculturation , Asian , Diet , Native Hawaiian or Other Pacific Islander , Humans , San Francisco , Female , Adult , Asian/statistics & numerical data , Asian/psychology , Middle Aged , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , Diet/ethnology , Diet/statistics & numerical data , Case-Control Studies , Cultural Diversity , Young Adult , Aged , Pacific Island PeopleABSTRACT
Little is known about the impacts of living in diaspora from the Hawaiian Islands on Native Hawaiian health. To address this, the authors conducted an exploratory analysis using cross-sectional data from the 2021 Native American COVID-19 Alliance Needs Assessment. A total of 1418 participants identified as Native Hawaiian (alone or in any combination), of which 1222 reported residency in the continental US and 196 in Hawai'i. Residency status in the continental US vs Hawai'i was evaluated as a predictor of survey outcomes using likelihood ratio tests on linear and logistic regression models for linear and binary outcomes, respectively. Results showed that NH residency in the continental US was significantly associated with increased odds of reporting fair or poor self-rated health; increased odds for screening positive for anxiety, depression, and suicidality; and increased odds of health insurance loss (P's < .05). Residency in the continent was also associated with lower odds of reporting a diagnosed chronic health condition (P < .05). Residency in the continental US had no observed effect on the odds that participants engaged cultural activities or cultural coping strategies. These results support the role of place of residency as an important Native Hawaiian health predictor during and beyond the COVID-19 pandemic.
Subject(s)
COVID-19 , Native Hawaiian or Other Pacific Islander , Humans , COVID-19/psychology , COVID-19/epidemiology , COVID-19/ethnology , Hawaii/epidemiology , Female , Male , Cross-Sectional Studies , Adult , Middle Aged , Native Hawaiian or Other Pacific Islander/psychology , Native Hawaiian or Other Pacific Islander/statistics & numerical data , SARS-CoV-2 , Aged , Pandemics , Health StatusABSTRACT
BACKGROUND: Rates of non-communicable diseases are disproportionately high among Native Hawaiian (NH) people, and the proportion of NH infants being fed human milk (HM) is the lowest among all ethnicities within the state of Hawai'i. The aim of this study was to explore biological, socio-economic, and psychosocial determinants of the initiation and duration of human milk feeding (HMF) among a study of NH mothers and infants. METHODS: A sample of 85 NH mother-infant dyads who were participating in a larger prospective study were involved in this research. Recruitment for the parent was delayed due to the COVID-19 pandemic. Recruitment started in November 2020 and continued until April 2022. Questionnaires were distributed at birth, two-months, four-months, and six-months postpartum. Questionnaires addressed topics relating to maternal and infant characteristics and infant feeding practices. Descriptive statistics, comparative analysis, and multivariate logistic regression tests were conducted. RESULTS: The majority of participating mothers were aged between 31 and 35 years, had some college education or more, were employed, and multiparous. The majority of infants were receiving HM at each timepoint (94% at birth, 78% at two-months postpartum, and 76% at four and six-months postpartum). Factors found to be significantly associated with HMF initiation and duration were prenatal intention to HMF, maternal educational attainment, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) recipiency. A prenatal intention to HMF was found to be a strong predictor of HMF at birth (aOR = 64.18, 95% CI 2.94, 1400.28) and at two-months postpartum (aOR = 231.55, 95% CI 2.18, 2418.3). Participants not involved with WIC were more likely to be HMF at four-months postpartum (aOR = 6.83, 95% CI 1.01, 46.23). CONCLUSION: This research supports existing evidence that prenatal intention to HMF and higher maternal educational attainment are positive predictors of HMF. WIC participation and being a SNAP recipient were found to be negatively associated with HMF which suggests a need for more culturally tailored support. Further research is required to reduce the gap in knowledge related to the determinants of HMF in NH.
Subject(s)
Breast Feeding , Milk, Human , Humans , Female , Hawaii , Adult , Pregnancy , Prospective Studies , Infant, Newborn , Infant , Breast Feeding/psychology , Breast Feeding/statistics & numerical data , Intention , Surveys and Questionnaires , Postpartum Period/psychology , Native Hawaiian or Other Pacific Islander/psychology , Young Adult , Mothers/psychology , COVID-19/prevention & control , COVID-19/epidemiology , MaleABSTRACT
BACKGROUND: Marshallese Pacific Islanders experience higher rates of obesity than other racial and/or ethnic communities. Despite the obesity rates experienced in this community, there are currently no childhood obesity prevention interventions designed for Marshallese Pacific Islanders in the United States. The purpose of this study is to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. METHODS: A multi-methods design was used to culturally adapt the Kokajjiriri intervention for Marshallese mothers in Arkansas (n = 17). In phase one, we conducted 24-h dietary recalls with 20 Marshallese mothers to inform the cultural adaptation of the group-based pediatric intervention, and then in phase two, we culturally adapted and piloted three sessions of the intervention to determine the acceptability and feasibility of the intervention. RESULTS: Participants found the adapted intervention to be acceptable and feasible, found the location to be convenient and found the facilitator to be knowledgeable. Four themes emerged from the qualitative data: (1) Lactation Support; (2) Introducing Healthy Solids; (3) Rice Portion Control; and (4) Finding Resources. CONCLUSIONS: This is the first study to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. The results from this culturally adapted group-based pediatric intervention, Kokajjiriri, will be used to inform future adaptations and implementation of the full intervention for Marshallese women and children.
Subject(s)
Mothers , Pediatric Obesity , Humans , Pediatric Obesity/prevention & control , Pediatric Obesity/ethnology , Female , Mothers/psychology , Mothers/education , Infant , Arkansas , Adult , Culturally Competent Care , Male , Micronesia/ethnology , Feasibility Studies , Native Hawaiian or Other Pacific Islander/psychology , Patient Acceptance of Health Care/ethnology , Patient Acceptance of Health Care/psychology , Nutritional StatusABSTRACT
This cross-sectional study examines trends in suicide rates among Asian American or Pacific Islander youth by sex from 1999 to 2021.
Subject(s)
Asian , Native Hawaiian or Other Pacific Islander , Suicide , Humans , Asian/statistics & numerical data , Asian/psychology , Adolescent , Suicide/statistics & numerical data , Suicide/ethnology , Suicide/trends , United States/epidemiology , Female , Male , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , Young Adult , Child , Pacific Island PeopleABSTRACT
Objectives: The Historical Loss Scale (HLS) and Historical Loss Associated Symptoms Scale (HLASS) are standardized measures that have been accepted and previously validated among North American Indigenous communities and allow researchers to measure the impact of Historical Loss. Evidence of the psychometric properties of this instrument have not been assessed for Native Hawaiians, the Indigenous peoples of Hawai'i. The purpose of this study is to investigate the psychometric properties of the adapted HLS (aHLS) and HLASS for adults from multiple Hawaiian Homestead Communities throughout Hawai'i. Methods: Data are based on cross-sectional surveys administered between 2014 and 2020. The final sample included 491 Native Hawaiian adults who were predominantly female (67.3%) and between the ages of 18-90 years, who were part of the larger study entitled the Hawaiian Homestead Health Survey. Factor analyses were conducted to determine the final model structures of each scale. Reliability and correlation matrices of items are also reported. Results: The final factor structure of the aHLS model suggested 3 factors: (1) General loss of culture or cultural loss, (2) Intergenerational loss, and (3) Distrust and destruction of traditional foods. The final HLASS model also suggested 3 factors: (1) Depression and Anger, (2) Shame and Anxiety, and (3) Re-experiencing, fear, and avoidance. Conclusion: These findings have implications for future research, practice, and education that explores the role of Historical Loss and associated symptoms in Native Hawaiians and Indigenous communities at large. In particular, measuring historical loss and associated symptoms in Hawaiian Homestead communities paves the way for quantitative assessments of historical trauma and healing in these communities.
Subject(s)
Native Hawaiian or Other Pacific Islander , Psychometrics , Humans , Female , Adult , Hawaii/epidemiology , Male , Middle Aged , Aged , Adolescent , Cross-Sectional Studies , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , Reproducibility of Results , Aged, 80 and over , Young Adult , Surveys and Questionnaires , Factor Analysis, StatisticalABSTRACT
Ka Malu a Wa'ahila, an Indigenous-centered and student-informed program, was established in 2022 to meet the growing behavioral health needs of Native Hawaiian college students at the University of Hawai'i at Manoa. Utilizing a cultural safety foundation and relying on the wisdom of community voices articulated by the Pilinaha framework, clinicians provide prevention, direct intervention, and outreach services. As the program continues to evolve, future plans include expanding to other Pacific Islanders and developing an additional layer of systemic change through building an Indigenous behavioral health training pathway and training curriculum for clinicians serving Native Hawaiian and Pacific Islander (NHPI) communities.
Subject(s)
Cultural Competency , Native Hawaiian or Other Pacific Islander , Students , Humans , Hawaii , Native Hawaiian or Other Pacific Islander/psychology , Universities , Students/psychology , Cultural Competency/education , Curriculum , Female , MaleABSTRACT
BACKGROUND: Reports of escalated discrimination experiences among Asian American and Native Hawaiian Pacific Islanders (AANHPI) continue. METHODS: Using the original and follow-up surveys of the COVID-19 Effects on the Mental and Physical Health of AAPI (Asian American and Pacific Islanders) Survey Study (COMPASS I and COMPASS II) (n = 3177), we examined changes over approximately a 1-year period in discrimination experiences attributable to being AAPI and factors associated with worse mental health outcomes. RESULTS: Experiences of discrimination remained high in COMPASS II with 60.6% (of participants (compared to 60.2% among the same people in COMPASS I) reporting one or more discrimination experiences, and 28.6% reporting worse mental health outcomes. Experiences of discrimination were associated with modest but significant increase in the odds of worse mental health: adjusted OR 1.02 (95% CI 1.01-1.04). Being younger, being of Native Hawaiian/Pacific Islander or Hmong descent (relative to Asian Indian), and having spent 50% or less of their lifetime in the US (vs. US born), were significantly associated with worse mental health. CONCLUSIONS: The fall-out from the pandemic continues to adversely impact AANHPI communities. These findings may help influence policy initiatives to mitigate its effects and support interventions designed to improve mental health outcomes.
Subject(s)
Asian , COVID-19 , Mental Health , Native Hawaiian or Other Pacific Islander , Humans , COVID-19/psychology , COVID-19/ethnology , Asian/psychology , Asian/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Female , Male , Adult , Middle Aged , Young Adult , Aged , United States/epidemiology , Racism/psychology , SARS-CoV-2 , Surveys and Questionnaires , Pandemics , Adolescent , Pacific Island PeopleABSTRACT
This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai'i. Focus groups (N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multilevel schools in low-income communities on Hawai'i Island. Sixty-nine youths (67% NHPI, Mage = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were "refuse" (saying no), "explain" (providing reasons for vaping refusal), "avoid" (avoiding people or places where e-cigarettes were used), and "leave" (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths' resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities.
Subject(s)
Focus Groups , Native Hawaiian or Other Pacific Islander , Vaping , Humans , Adolescent , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , Vaping/ethnology , Hawaii , Male , Female , Child , Electronic Nicotine Delivery Systems/statistics & numerical data , Rural Population/statistics & numerical data , Pacific Island PeopleABSTRACT
Background Few studies have examined patient experiences of the Patient Centred Medical Home (PCMH). This qualitative study explores the experiences of patients of an urban Aboriginal Community Controlled Health Service during its transition to a model of a PCMH. Methods Twenty-eight community members who were registered as patients of an urban Aboriginal Community Controlled Health Service were purposively recruited to participate in yarning interviews. Yarns were conducted using a guide containing open-ended questions in the same domains as those used in patient satisfaction surveys at the participating clinic. Data from yarns were analysed by Aboriginal and non-Indigenous researchers using thematic analysis. The interpretations of Aboriginal and Torres Strait Islander researchers were privileged in the analysis. Results Key themes highlighted the importance of relationships, connectedness, and personal growth and empowerment to community members' health and wellbeing, which they described as a journey of healing and recovery. Delays in implementing a process to empanel patients in a care team meant that most community members were unaware a PCMH had been implemented. However, community members commonly reported a more welcoming environment, more contact with the same doctor and more involvement of Aboriginal Health Workers in their care. Conclusions Aboriginal and Torres Strait Islander community members' narratives of their experiences bear evidence of the acceptability of a PCMH model for delivery in Aboriginal Community Controlled Health Services to improve relational care between patients and health staff. A patient-directed empanelment process has been implemented to better connect patients to their care team in the clinic, and the role of the Aboriginal Health Worker reshaped to strengthen connections between patients and their care team in and outside the clinic.
Subject(s)
Health Services, Indigenous , Native Hawaiian or Other Pacific Islander , Patient-Centered Care , Qualitative Research , Humans , Native Hawaiian or Other Pacific Islander/psychology , Patient-Centered Care/methods , Female , Male , Health Services, Indigenous/organization & administration , Adult , Middle Aged , Patient Satisfaction , Interviews as Topic , Urban Health Services , Australian Aboriginal and Torres Strait Islander PeoplesABSTRACT
The mental health crisis among Native Hawaiian young adults is exacerbated by colonization-related risk factors, yet cultural identity stands as a key protective element. This study explored the link between cultural identity and stress, employing cultural reclamation theory, and surveyed 37 Native Hawaiians aged 18-24 through the Native Hawaiian Young Adult Well-being Survey. Engagement with culture, the significance of Hawaiian identity, and stress were assessed, revealing significant correlations between cultural and demographic factors and stress levels. Participants displayed high cultural engagement and valued their Hawaiian identity, with gender and education levels playing a notable role in stress. These findings highlight the importance of including Native Hawaiian perspectives in mental health research and may guide the development of targeted interventions.
Subject(s)
Native Hawaiian or Other Pacific Islander , Humans , Male , Female , Hawaii , Young Adult , Adolescent , Surveys and Questionnaires , Native Hawaiian or Other Pacific Islander/psychology , Native Hawaiian or Other Pacific Islander/ethnology , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Mental Health/statistics & numerical data , Stress, Psychological/psychology , Stress, Psychological/ethnology , Social IdentificationABSTRACT
Objective Along with other Australian health professionals, occupational therapy students need to understand Aboriginal and Torres Strait Islander culture and health issues to develop their capacity to work effectively with this community and meet accreditation standards. The study aimed to explore the learning experiences of occupational therapy students during a module focused on Aboriginal and Torres Strait Islander peoples' health issues and approaches. Methods A qualitative descriptive method was used. Individual interviews were audiotaped, transcribed and analysed thematically following the module. Participants were asked about their prior experience with Aboriginal and Torres Strait Islander peoples, feelings about undertaking the module, difficulties and highlights of the module, and how the module contributed to their learning. Results In all, 18 students participated in interviews. Interview themes were (1) student context of learning about Aboriginal and Torres Strait Islander peoples' heath and culture, (2) experiencing the module with others and (3) student learning gains following the module. Conclusion Students developed in their self-awareness and understanding of Aboriginal and Torres Strait Islander peoples' issues of relevance to occupational therapy. Further research is needed to evaluate educational activities with occupational therapy and other health professional students across Australia, and ongoing culturally responsiveness training for health professionals (post-registration).
Subject(s)
Cultural Competency , Curriculum , Native Hawaiian or Other Pacific Islander , Occupational Therapy , Qualitative Research , Humans , Native Hawaiian or Other Pacific Islander/psychology , Occupational Therapy/education , Cultural Competency/education , Australia , Female , Male , Interviews as Topic , Health Services, Indigenous , Students, Health Occupations/psychology , Adult , Australian Aboriginal and Torres Strait Islander PeoplesABSTRACT
OBJECTIVE: The purpose of this article is to evaluate the COVID-19 Care in the Home (CCITH) program during the first COVID-19 omicron wave across Torres Strait and Cape York region of Far North Queensland in 2022. METHODS: A mixed-method study: An online survey and semi-structured interviews of CCITH internal and external stakeholders and participants was utilised to develop a greater understanding of perspectives of the program. RESULTS: Survey participants n=140. Most survey respondents did not attend hospital, emergency, or primary healthcare centre during isolation for medical assistance (82%, 115/140) and most strongly agreed/agreed (87%, 122/140) that the CCITH program cared for their health needs. Interview participants n=14. Thematic analysis of interviews verified survey responses and identified successes of this program including improved community relationships and primary healthcare centres and community members felt supported. Limitations included rapid changes to policies and roles and limited food availability during isolation. CONCLUSIONS: The CCITH program highlights the resilience and self-determination of First Nations communities and primary health staff across the Torres Strait and Cape York throughout the first COVID-19 outbreak in the region. IMPLICATIONS FOR PUBLIC HEALTH: This virtual model of care could be employed in similar settings to improve service provision in both primary and public health to increase community safety and achieve good health outcomes.
Subject(s)
COVID-19 , SARS-CoV-2 , Humans , COVID-19/epidemiology , Queensland/epidemiology , Male , Female , Adult , Public Health , Surveys and Questionnaires , Middle Aged , Home Care Services , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , PandemicsABSTRACT
OBJECTIVES: Engagement in work has an important association with cognitive health in later life, yet little is known about this association among Native Hawaiian and other Pacific Islander (NHPI) older adults. This study assesses the associations between various work characteristics and memory problems among this population. DESIGN: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), the research question was explored among those who were aged 50+. RESULTS: Engagement in work, certain occupation types (e.g., clerical or professional occupations compared to blue-collar jobs), and the current/most recent job that is also the longest job held were associated with lower odds of having memory problems. CONCLUSION: The study's results suggest that work characteristics and opportunities to engage in work are important considerations in preventing memory problems in later life. As the NHPI population experiences cognitive health disparities earlier than other groups, timely interventions that focus on work engagement and a culturally relevant environment require further investigation.
Subject(s)
Native Hawaiian or Other Pacific Islander , Humans , Native Hawaiian or Other Pacific Islander/psychology , Female , Male , Middle Aged , Aged , Hawaii , Health Surveys , Memory Disorders/ethnology , Memory Disorders/psychology , Employment/psychology , Self Report , Aged, 80 and over , Occupations , Memory , Pacific Island PeopleABSTRACT
BACKGROUND: Limited studies have focused on recent trends in Asian American and Pacific Islander (AAPI) youth suicide. This study aimed to evaluate epidemiological trends in AAPI youth suicide and reports of depressive symptoms among Asian and Pacific Islander youth in the USA. METHODS: This cross-sectional study analyzed mortality data from the Centers for Disease Control Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) and reports of depressive symptoms from the Youth Risk Behaviour Surveillance System (YRBSS). Data from 1999 to 2021 were analyzed for suicide rates and methods used among AAPI youth aged 5-24 years. YRBSS data from 1991 to 2021 were analyzed for depressive symptoms reported by Asian American (AA) 9th-12th graders. RESULTS: From 1999 to 2021, 4747 AAPI youth died by suicide in the USA. Rates of suicide doubled from 3.6 to 7.1 per 100,000 during 1999-2021, with an increasing trend observed from 2014 onwards. The most common methods of suicide deaths in this population were suffocation, firearms and poisoning. Rates of suicide were higher among AA males than females, although more AA females reported depressive symptoms, including suicidal planning and attempts. CONCLUSION: This study shows a concerning increase in suicide rates among AAPI youth over 1999-2021. Suffocation, firearms and poisoning were the most common methods used. While more AAPI males died by suicide, AA females reported higher rates of depressive symptoms. These findings highlight the urgent need for targeted prevention strategies and clinical interventions for this vulnerable population. The study also emphasizes the importance of addressing mental health stigma to improve reporting and support for Asian American, Native Hawaiian and Pacific Islander (AANHPI) youth.
Subject(s)
Asian , Mental Health , Suicide , Adolescent , Female , Humans , Male , Asian/psychology , Asphyxia , Cross-Sectional Studies , Native Hawaiian or Other Pacific Islander/psychology , Child, Preschool , Child , Young AdultABSTRACT
BACKGROUND: Little is known about trauma and its mental health impact on Native Hawaiians/Pacific Islanders (NH/PI), an understudied Indigenous-colonized population that endures severe mental health disparities. AIMS: This novel investigation assessed trauma prevalence and its mental health and substance use correlates in NH/PIs in the U.S. METHOD: Using community-based participatory research methods, survey data on NH/PI trauma, depression, anxiety, substance use, and treatment need were collected from 306 NH/PI adults using online, telephone, and in-person methods. Descriptive statistics and adjusted regression models were employed. RESULTS: Sixty-nine percent of participants experienced lifetime trauma, reporting mean exposure to 2.5 different trauma types. Childhood physical and sexual abuse, and lifetime forced sexual assault rates were 34%, 25%, and 27%, respectively, exceeding general population rates. Women and men reported equivalent total mean exposure to different trauma types, as well as equal prevalence for every trauma type examined (e.g. sexual abuse/assault). Confirming hypotheses, after controlling for key demographic and mental health risk factors, increased exposure to multiple trauma types uniquely associated with greater depression, anxiety, alcohol symptomology, and greater likelihood for needing treatment and using illicit substances. CONCLUSIONS: Trauma is prevalent in NH/PI populations and significantly impacts NH/PI mental health; serving as an important but overlooked contributor to NH/PI mental health disparities. Current findings fill critical gaps in our knowledge of NH/PI trauma and mental health while revealing the importance of screening and treating NH/PIs for trauma exposure to alleviate existing mental health disparities.
Subject(s)
Mental Health , Native Hawaiian or Other Pacific Islander , Substance-Related Disorders , Humans , Female , Male , Native Hawaiian or Other Pacific Islander/psychology , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Adult , Middle Aged , Substance-Related Disorders/epidemiology , Young Adult , Prevalence , Community-Based Participatory Research , Adolescent , Depression/epidemiology , Anxiety/epidemiology , Hawaii/epidemiology , Risk Factors , Surveys and Questionnaires , Aged , Pacific Island PeopleABSTRACT
PURPOSE: This study sought an improved understanding of household emergency preparedness (EP) among Native Hawaiian, Pacific Islander, and Filipino (Indigenous Pacific People [IPP]) parents in Hawaii. DESIGN: We conducted an exploratory qualitative descriptive study with 60-minute interviews occurring from October 2022 through March 2023. A semi-structured interview guide exploring participant household EP was employed. METHODS: Prospective participants were females who identified as IPP, caregivers of a 0-12-year-old child, spoke English, and received health services at a federally qualified health center clinic. Two researchers conducted qualitative content analysis on interview transcripts. Initial coding of transcripts identified broad categories or themes. The process was reviewed continuously to verify data and coding procedures. Three investigators independently verified final themes and subthemes. FINDINGS: Participants (N=25) were female, between 30-49 years of age (68%), had received some college education (60%), and were fully employed (68%). Major themes included: 1) Perceptions of family EP and current behaviors, 2) Barriers and challenges to family EP, and 3) Perspectives on strategies to improve family EP. Subthemes included risk perception for emergencies; family EP practices; health protection and pandemic preparedness; lack of knowledge and experience; social, cultural and economic barriers; and clinic-based, technology-driven, and community-based interventions. CONCLUSION: Factors impeding access to healthcare services also impede family EP among IPP groups and their ability to mitigate the impact of future public health emergencies. CLINICAL EVIDENCE: Targeted, innovative interventions, including ones led by health clinics and those that utilize technology, are needed to overcome common barriers faced and to facilitate the uptake of household EP behaviors among IPP families.
Subject(s)
Native Hawaiian or Other Pacific Islander , Qualitative Research , Adult , Female , Humans , Middle Aged , Asian , Hawaii , Interviews as Topic , Native Hawaiian or Other Pacific Islander/psychology , Prospective StudiesABSTRACT
BACKGROUND: Eating disorders are as common in Maori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Maori; however, research has focused on the experiences of non-Maori. This paper will describe explanatory factors, treatment experiences and what helps with recovery for Maori. METHODS: Kaupapa Maori research methodology informed the methods and analysis. Fifteen semi-structured interviews comprised thirteen Maori participants with eating disorders (anorexia nervosa, bulimia nervosa and binge eating disorder) and two whanau (support network) members. A thematic analysis was undertaken by a first cycle of coding that used deductive structural coding to identify data describing participants' perceived causes of eating disorders, their experience of treatment and recovery. A second cycle of coding used inductive analysis with descriptive and pattern coding. RESULTS: Three overarching themes were antecedents (cumulative exposure), treatment (a system of complexities) and recovery (resource empowerment). Antecedents comprised cumulative exposure to body and sporting ideals and adversity as causal factors of eating disorders. In the treatment theme, a system of complexities critiqued rural settings for generalised mental health services, allocation of Maori cultural support, the economic burden of treatment, culturally incongruent treatment (methods, values) and a weight-focused discharge criterion. Recovery (resource empowerment) found appropriate health information, self-determination and connection to Maori culture and whanau aspirations helped with recovery. CONCLUSION: The diversity of birdcalls reminds us of the individuality of eating disorders. Health practitioners are reminded that just as the Tui, Kaka and Kereru possess their own unique birdcalls, so do Maori with eating disorders and their whanau have their own experiences, needs and required treatment responses.
Subject(s)
Feeding and Eating Disorders , Mental Health Services , Humans , Maori People , Native Hawaiian or Other Pacific Islander/psychology , Qualitative Research , New ZealandABSTRACT
The suicide rate among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Veterans increased from 2001 to 2020. Identifying regions where suicide rates are elevated and increasing among AANHPI Veterans would inform targeted prevention efforts for members of this cohort. We conducted a population-based retrospective cohort study of 377,833 AANHPI Veterans to examine suicide rates and methods (2005-2019) by United States (US) region and over time (2005-2009, 2010-2014, 2015-2019), using US Veteran Eligibility Trends and Statistics and Joint DoD/VA Mortality Data Repository data. AANHPI Veterans across most regions experienced increases in suicide rates from the earliest to latest period; however, patterns differed by region. Age-adjusted suicide rates increased across all three periods among those in the Northeast and West, but increased, then declined in the Midwest and South. In 2015-2019, the age-adjusted suicide rate among AANHPI Veterans was highest in the Northeast (42.0 per 100,000) and lowest in the West (27.5). However, the highest percentages of AANHPI Veteran suicide deaths in 2005-2019 occurred in the West (39.5%) and South (34.7%), with lower percentages in the Midwest (15.0%) and Northeast (10.8%). Across regions, those ages 18-34 had the highest suicide rates. Firearms were the most frequently used suicide method across regions (44.4%-60.2%), except the Northeast (35.2%), where suffocation was more common (38.3%). Results suggest particular needs for suicide prevention efforts among AANHPI Veterans in the Northeast and to ensure that lethal means safety initiatives for AANHPI Veterans encompass both firearms and suffocation, with some variations in emphasis across regions.
Subject(s)
Asian , Native Hawaiian or Other Pacific Islander , Pacific Island People , Suicide , Veterans , Humans , Asphyxia/epidemiology , Pacific Island People/psychology , Pacific Island People/statistics & numerical data , Retrospective Studies , Suicide/ethnology , Suicide/statistics & numerical data , United States/epidemiology , Veterans/psychology , Veterans/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Asian/psychology , Asian/statistics & numerical dataABSTRACT
As an increasing number of Native Hawaiian and Pacific Islander adults move to the continental United States, the development and implementation of resources that promote access to cultural foods and support food sovereignty on the continent is crucial to perpetuate cultural practice and connection to the 'aina (land that feeds). Kalo (taro) is an important cultural food central to Native Hawaiian identity. Native Hawaiians connect their genealogy as far back to the cultivation of kalo and the creation of kalo itself. In this practice note, we describe the creation of a mala kalo (cultivated field for taro) in Oregon by the Ka'aha Lahui O 'Olekona Hawaiian Civic Club. An ongoing project over the past 3 years, the creation of a mala kalo exceeded expectations. Not only did the mala allow the cultivation of kalo outside of Hawaii, the mala became a place for the community to unite toward common goals of connecting with the land, promoting mental health, and creating a sense of place in their diaspora. This project indicates that not only is the creation of mala kalo in Oregon feasible, it may also be an important opportunity for the growing number of Native Hawaiians and Pacific Islanders adults living on the continent to improve health outcomes through connections with cultural foods and practices.