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Review
. 2018 May;45(3):249-263.
doi: 10.1080/03014460.2018.1465593. Epub 2018 May 29.

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

Joseph Keawe'aimoku Kaholokula  1 , Claire Townsend Ing  1 , Mele A Look  1 , Rebecca Delafield  1 , Ka'imi Sinclair  2
Affiliations
Review

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

Joseph Keawe'aimoku Kaholokula et al. Ann Hum Biol. 2018 May.

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 are a public health priority.

Objective: To describe cultural adaptation and culturally 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 was 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 behavioural outcomes of both types of interventions.

Results: Both culturally adapted and culturally 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.

Keywords: Native Hawaiians; Pacific Islanders; cardiometabolic; cardiovascular disease; diabetes; health promotion; intervention; obesity.

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Conflict of interest statement

Declaration of interest statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Figures

Figure 1
Figure 1
Socioecological model for Health Promotion in NHOPI communities modified from Kaholokula et al. 2014
See this image and copyright information in PMC

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