The Kaiona Framework: Centering Hawaiian and Pasifika Community in Defining, Measuring, and Promoting Health and Well-Being

Abstract

The place and people of Wai'anae, Hawai'i, are rich in connection with 'āina (natural environment) and culture. Counter to this strengths-based approach, metrics and narratives imposed by outside systems assess many communities like ours as "sick", "poor", or "unwell". This paper details our community's approach to defining "well-being" around the values specific to our place, overseen by a council of community leaders with decades of experience supporting youth. The development was a mixed methods process including formal focus groups, informal community conversations, review of existing models, and collaboration with a professional artist. Centering community was the priority through each phase, engaging youth, parents, cultural practitioners, healthcare providers, and educators. Our community built the Kaiona Framework around the mo'olelo (traditional story) of Kaiona who helps the lost find home through empathy and compassion. Well-being is grounded in connection to, in relationship with, and in service to 'āina. The child is at the center of our work, but inseparable from the family, community, and wider nation of people. Wellness comprises four values vital to our community: mauli ola, a balanced state of physical, mental, emotional, spiritual, and environmental health; waiwai, abundance and prosperity; pilina, mutually sustaining relationships; and ea, self-determination and agency.

Keywords: community empowerment; community-based participatory research; community-informed intervention; cultural relevance; health equity; indigenous health; youth mental health.

Figure 1

Collective governance. In this partnership between the community health center and 5 community-based organizations, we prioritize governance, ensuring that multigenerational voices of our community are directing the work. ʻAha Kū Kamaehu (community council); Kīkaha Nā Kamaliʻi (youth council); Moʻolelo (storytelling); Hoʻoulu Lāʻau (enhancing existing work).

Figure 2

Evolution of the Kaiona Framework. (a) Draft 1 based on ʻAha Kū community council conversations, pulling from existing frameworks across Hawaiʻi while incorporating imagery and elements specific to the Waiʻanae community. (b) Draft 2, based on community leader feedback, reorients the central ʻiwa figure to direct to the northwest (see Section 4) and to honor the four cardinal directions, while adding definitions for the four key cultural values. (c) Draft 3, based on community feedback, redefines the layers of community, ʻohana (family) to ʻohana nui (extended family) emphasizing the importance of extended family beyond blood relations, and hui (club, organization) to lāhui (nation, people) to be more inclusive. (d) Draft 4, based on ongoing community conversations and ʻAha Kū reflections, substitutes the domain mauli ola for ʻāina momona as a better conceptualization of holistic health. The layers of community are further refined to have kaiāulu (community) and lāhui (nation, people) as the outer bands. Feedback on imagery specifically requested that the elemental symbols for water and wind align better with Polynesian traditions.

Figure 3

The framework imagery in its entirety is a representation of navigation through both space and time. The 8-pointed star surrounding the central point represents the 8 cardinal directions. To the left in the western region is the waiwai symbol, representing the ancestral abundance of our past. To the right in the eastern region is the ea symbol, representing the winds of emerging times that breathe life into our daily activities and endeavors. The lōkahi triangle representing mauli ola in the northern region repeats 3 times to denote harmony within the past, present, and future. The lau hala triangle representing pilina in the southern region repeats 3 times to denote relationship and support in the past, present, and future. The piko symbol in the west triangle represents the kūpuna that have come before us and the piko symbol in the east represents the keiki (children) who have yet to emerge. The large piko that contains the entirety of the framework represents us, as lāhui, in the present and for all time, for all time is now. Finally, the ʻiwa is a direct nod to the star navigational compass of Oceania, facing northwest toward our origin of our journey as a people, as well as toward Kaʻala for us on Oʻahu.