No Ke Ola Pono o Na Kane: A Culturally Grounded Approach to Promote Health Improvement in Native Hawaiian Men.

In Hawai'i, Native Hawaiian men (kane) have the highest death rate from colon cancer among all ethnic groups. While screening can prevent 90% of these cancers, data show that >58% of kane over age 50 have never been screened. Prior research has demonstrated that community-based social networks may help kane adopt healthy behaviors such as cancer screening, however, few studies have activated such an approach. A cross-sectional study entitled No Ke Ola Pono o Na Kane (for the good health of men) was conducted statewide in Hawai'i from 2014 to 2018. The study strived to perpetuate the Native Hawaiian traditional practice of "hale mua" (men's house) to promote healthy behaviors among kane including the adoption of colon cancer prevention strategies such as fecal immunochemical testing (FIT). The study applied a peer-led intervention model using kane volunteers to deliver the program's educational components, including standardized materials to help the volunteers confidently conduct the sessions. Of the 378 kane who were recruited into the study, 232 participated in the colorectal session of which 64% (n = 149) were over age 50. Survey data from the 149 kane indicated that 31% had not discussed colon health or screening with their doctors but 92% had improved their knowledge about colon health from the session. In addition, 76% (n = 113) agreed to complete a FIT. Session evaluations indicated that >91% of kane liked the hale mua approach and benefited from talking with other kane about their health.

Increasing participation in cancer research: insights from Native Hawaiian women in medically underserved communities.

The cancer burden falls heavily on Native Hawaiian women, and of particular concern are those living in medically underserved communities where participation in potentially helpful clinical studies may be limited. Difficulty in accrual of Native Hawaiian women to a culturally-grounded intervention led researchers to conduct focus groups aimed at exploring attitudes towards research, use of a traditional Hawaiian practice for family discussion, and study promotion. Social marketing theory guided the development of discussion questions and a survey. Through purposive sampling, 30 women from medically underserved communities were recruited. Content analysis was used to identify major discussion themes. Findings indicate that lack of informational access may be a major barrier to participation. Study information disseminated through community channels with targeted outreach to social and religious organizations, promotion through face-to-face contact with researchers, and culturally tailored messages directed to families were preferred. Community oriented strategies based on linkages with organizational networks may increase participation.