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Background: A cancer diagnosis affects not only the individual but the entire family. Despite the growing body of literature on family support as a resource in cancer care, there is very little research on how cancer affects families in non-Western cultures. A minority population that experiences a disproportionate burden from cancer is Native Hawaiian women.Methods: In this study, 8 Native Hawaiian women with breast cancer and 17 family members of other Native Hawaiian women with breast cancer participated in focus groups examining family support. Specifically, types of support provided by the family (eg, informational, emotional, and tangible), changing dynamics of family roles, and recommendations for health care providers, with attention paid to the influence of culture on family support, were topics that were examined.Results: Similarly to other populations, Native Hawaiians viewed the family as the most important source of emotional and tangible support for women with cancer, and identified a need for increased informational support for both patients and families in the face of cancer. However, their reference to specific cultural values and practices within the 'ohana (family) [eg, haku (family liaison) and ho'omana (spirituality)] reflects a uniqueness that has implications for clinical work with this population.Conclusions: Consideration of cultural values and practices may enhance health care services for this population. [ABSTRACT FROM AUTHOR]

Asians and Pacific Islanders together constitute the fastest-growing minority group in the United States, yet there is a lack of responsiveness by the social work profession to the needs of these populations. This article surveys the literature in four major social work journals on direct practice with Asian and Pacific Islander populations. Findings highlight gaps in six areas in the literature: (1) distinguishing between Asian Americans and Pacific Islanders, (2) separating Asian Americans into different ethnic groups, (3) distinguishing between immigrants and refugees, (4) considering lifespan developmental differences in age, (5) focusing more on gender differences in the various ethnic groups, and (6) strengthening the practice focus on communities. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This article presents an overview of child abuse among culturally diverse populations in Hawaii, substance use among culturally diverse students in Hawaii, and culturally based interventions for preventing child abuse and substance abuse in Native Hawaiian families. OBSERVATIONS: Native Hawaiians accounted for the largest number of cases of child abuse and neglect in Hawaii between 1996 and 1998. Alcohol and other drugs have increasingly been linked with child maltreatment. Native Hawaiian youths report the highest rate of substance use in Hawaii. Cultural factors such as spirituality, family, and cultural identification and pride are important in interventions with Native Hawaiians. CONCLUSION: Human services should continue to emphasize interventions that integrate 'mainstream' and cultural-specific approaches. [ABSTRACT FROM AUTHOR]

Profound health disparities are widespread among Native Hawaiians, other Pacific Islanders, and Filipinos in Hawai'i. Efforts to reduce and eliminate health disparities are limited by a shortage of investigators trained in addressing the genetic, socio economic, and environmental factors that contribute to disparities. In this conference proceedings report from the 2022 RCMI Consortium National Conference, we describe our mentoring program, with an emphasis on community-engaged research. Elements include our encouragement of a team-science, customized Pilot Projects Program (PPP), a Mentoring Bootcamp, and a mentoring support network. During 2017-2022, we received 102 PPP preproposals. Of these, 45 (48%) were invited to submit full proposals, and 22 (19%) were awarded (8 basic biomedical, 7 clinical, 7 behavioral). Eighty-three percent of awards were made to early-career faculty (31% ethnic minority, 72% women). These 22 awards generated 77 related publications; 84 new grants were submitted, of which 31 were awarded with a resultant return on investment of 5.9. From 5 to 11 investigators were supported by PPP awards each year. A robust usage of core services was observed. Our descriptive report (as part of a scientific conference session on RCMI specialized centers) focuses on a mentoring vehicle and shows how it can support early-stage investigators in pursuing careers in health disparities research.

The Pacific Islander American racial group is smaller in terms of numbers relative to other racial groups and yet one of the fastest-growing in the United States. The complexity of their lives exceeds the implications of such small numbers, yet it reflects the contribution of their transnational ties and relationships in the Pacific and increasing multiple cultural identities as Pacific Islander Americans. Although this identity provides potential opportunities, challenges and struggles in navigating dual cultures and systems is a reality. Thus, commitment to culturally relevant social work practice with transnational Pacific Islander Americans is imperative. Social work practices that acknowledge and integrate indigenous ways of knowing and doing with consideration to the duality of their transnational identities will produce better outcomes. Emphasis on Pacific Islander cultural strengths is fundamental to generating positive health and mental health outcomes as these strengths have sustained Pacific Islanders through experiences of colonization, immigration, and historical trauma. This article discusses the multiple dimensions of the transnational experiences of Pacific Islander Americans and the implications for culturally relevant social work practice, policy, and research., (© 2019 National Association of Social Workers.)

The Research Centers in Minority Institutions (RCMI) program was established by the US Congress to support the development of biomedical research infrastructure at minority-serving institutions granting doctoral degrees in the health professions or in a health-related science. RCMI institutions also conduct research on diseases that disproportionately affect racial and ethnic minorities (ie, African Americans/Blacks, American Indians and Alaska Natives, Hispanics, Native Hawaiians and Other Pacific Islanders), those of low socioeconomic status, and rural persons. Quantitative metrics, including the numbers of doctoral science degrees granted to underrepresented students, NIH peer-reviewed research funding, peer-reviewed publications, and numbers of racial and ethnic minorities participating in sponsored research, demonstrate that RCMI grantee institutions have made substantial progress toward the intent of the Congressional legislation, as well as the NIH/NIMHD-linked goals of addressing workforce diversity and health disparities. Despite this progress, nationally, many challenges remain, including persistent disparities in research and career development awards to minority investigators. The continuing underrepresentation of minority investigators in NIH-sponsored research across multiple disease areas is of concern, in the face of unrelenting national health inequities. With the collaborative network support by the RCMI Translational Research Network (RTRN), the RCMI community is uniquely positioned to address these challenges through its community engagement and strategic partnerships with non-RCMI institutions. Funding agencies can play an important role by incentivizing such collaborations, and incorporating metrics for research funding that address underrepresented populations, workforce diversity and health equity., Competing Interests: Competing Interests: None declared.

In order to successfully address social determinants of health and to achieve social justice for kanaka and all the people of Hawai'i, we must broaden our understanding of and approach to healing/health through interdisciplinary, culturally-informed education. Strengthening cultural competence within an Interprofessional Education framework, has potential in meeting important challenges in patient and population health, including meeting the increased demand for culturally trained professionals, increasing access to providers, and reducing health inequities in kanaka (Native Hawaiians). We present a model of course design and delivery, Ke A'o Mau (Learning Preserved), intended to provide haumana (students) with a unique body of culturally-anchored and community-based knowledge, skills and values that facilitate work with kanaka. Ke A'o Mau was implemented in the 2017-2018 academic year at University of Hawai'i (UH) at Manoa and optimized the authenticity of cultural learning through the engagement of kumu loea (expert teachers) to instruct in their area of expertise. Design and delivery of the course began with the understanding and honoring of kanaka worldviews, knowledge, and practices. Appraisal of haumana learning showed strong evaluative scores, of knowledge development, skills training, and instructional materials. This course not only seeks to resolve critical challenges in patient and population health but also provides a model to support the UH Manoa strategic priority of "striving to be a foremost indigenous-serving institution."

Building research infrastructure capacity to address clinical and translational gaps has been a focus of funding agencies and foundations. Clinical and Translational Sciences Awards, Research Centers in Minority Institutions Infrastructure for Clinical and Translational Research (RCTR), and the Institutional Development Award Infrastructure for Clinical and Translational Research funded by the US government to fund clinical translational research programs have existed for over a decade to address racial and ethnic health disparities across the USA. While the impact on the nation's health cannot be made in a short period, assessment of a program's impact could be a litmus test to gauge its effectiveness at the institution and communities. We report the success of a Pilot Project Program in the University of Hawaii RCTR Award in advancing careers of emerging investigators and community collaborators. Our findings demonstrated that the investment has a far-reaching impact on engagement with community-based research collaborators, career advancement of health disparity investigators, and favorable impacts on health policy.

Native Hawaiian and other Pacific Islanders (NHOPI) experience significant health disparities compared with other racial groups in the United States. Lower life expectancy has resulted in small proportions of elders in the population distribution of NHOPI, yet the number of NHOPI elders is growing. This article presents data on NHOPI elders and discusses possible reasons for continuing health disparities, including historical trauma, discrimination, changing lifestyle, and cultural values. We outline promising interventions with NHOPI and make suggestions for future research., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Native Hawaiians, the indigenous people of Hawai’i, are affected by varying social and health disparities that result in high prevalence of chronic disease, early onset of disability, and shorter life expectancy compared to other ethnic groups in Hawai’i. Six listening meetings were conducted, involving 41 community-dwelling kūpuna (Native Hawaiian elders) and ‘ohana (family) caregivers to investigate health and care preferences that offer the potential for improving well-being in later life for Native Hawaiian elders. As background, we provide three explanatory perspectives and theories—life course perspective, minority stress theory, and historical trauma—that guided the design of this study and provided the study’s context. A number of overarching themes and subthemes were identified, some of which point to universal concerns with age and caregiving (such as challenges and costs associated with growing old and caregiving) and others that are culturally specific (such as influence of culture and social stressors, including discrimination, on health needs and care preferences). Results give further support to the urgency of affordable, accessible, and acceptable programs and policies that can respond to the growing health and care needs of native elders and family caregivers.

Although indigenous peoples have lower life expectancies than the social majority populations in their countries, increasing numbers of indigenous people are living into old age. Research on indigenous elders is informed by a number of research traditions. Researchers have mined existing data sets to compare characteristics of indigenous populations with non-indigenous groups, and these findings have revealed significant disparities experienced by indigenous elders. Some investigators have attempted to validate standardized research tools for use in indigenous populations. Findings from these studies have furthered our knowledge about indigenous elders and have highlighted the ways in which tools may need to be adapted to better fit indigenous views of the constructs being measured. Qualitative approaches are popular, as they allow indigenous elders to tell their stories and challenge non-indigenous investigators to acknowledge values and worldviews different from their own. Recently, efforts have extended to participatory and decolonizing research methods, which aim to empower indigenous elders as researchers. Research approaches are discussed in light of the negative experiences many indigenous peoples have had with Eurocentric research. Acknowledgment of historical trauma, life-course perspectives, phenomenology, and critical gerontology should frame future research with, rather than on, indigenous elders.

Worksite health promotion programs can reduce prevalence of chronic disease among employees, but little research has been done to discern whether they meet the needs and incorporate the preferences of workers of different occupational types. The objective of this study is to examine differences in influences to healthy eating and physical activity and preferences for programs among multiethnic blue- and white-collar workers in Hawai'i. A total of 57 employees from a major health care corporation in Hawai'i participated. A mixed-methods approach was employed, in which findings from focus groups with white-collar workers (WCW) (n=18) were used to inform development of a questionnaire with closed and open-ended items for use with blue-collar workers (BCW) (n=39), whose jobs did not provide adequate time to participate in focus groups. Focus groups with WCW revealed that onsite availability of healthy food and fitness opportunities provided the most support for healthy eating and physical activity at work; work demands, easy access to unhealthy foods, and lack of onsite fitness opportunities were barriers; and lifestyle management was a topic of substantial interest. BCW cited the ability to bring home lunch and their (physically active) jobs as being supportive of healthy behaviors; not having enough time to eat and personal illness/injury were barriers; and chronic disease topics were of greatest interest. Knowing differences in influences to healthy eating and physical activity, as well as preferences for worksite wellness programming, among BCW and WCW, is important when planning and implementing worksite health promotion programs.

Native Hawaiians comprise 24.3% of Hawai'i's population, but only 12.6% of the state's older adults. Few published studies have compared health indicators across ethnicities for the state's older adult population or focused on disparities of Native Hawaiian elders. The current study examines data from two state surveillance programs, with attention to cause of death and social-behavioral factors relevant to elders. Findings reveal that Native Hawaiians have the largest years of productive life lost and the lowest life expectancy, when compared to the state's other major ethnic groups. Heart disease and cancer are leading causes of premature mortality. Native Hawaiian elders are more likely to report behavioral health risks such as smoking and obesity, live within/below 100-199% of the poverty level, and find cost a barrier to seeking care. Indicated is the need for affordable care across the lifespan and health services continuum. Future research might explain behavioral factors as influenced by social determinants, including historical trauma on Native Hawaiian longevity.

The United States is on the threshold of a substantial growth of older adults that increasingly reflects the cultural diversity inherent in this nation. Culture shapes the experience of aging and caregiving, and thus becomes an important factor when considering social services for older adults. One culturally distinct minority group--Japanese--is reputed to have one of the longest life expectancies in the US population, and, thus, information about their experiences may expand knowledge on aging and culture. A periodical literature review of older Japanese adults was undertaken to assess lessons learned about the association of aging and culture. Two important lessons that emerged emphasized the influence of cultural values on family caregiving, and women as caregivers. Implications for practice with this population are drawn and broad directions for the profession of social work are provided.

Purpose: This 2-year, multisite, curriculum-development project aimed to increase the pool of professionals trained in geriatric and/or gerontological social work., Design and Methods: Our methods included (a) providing advanced training in aging, cultural competence, and interdisciplinary practice to social work professionals and masters degree students, (b) developing, implementing, and testing an innovative student curriculum based on standardized learning competencies identified by project participants, (c) revising the university curriculum to support such competencies, and (d) producing a practicum handbook., Results: The project achieved its out-comes., Implications: Project conceptualization, implementation, and evaluation are discussed together with approaches for its replication.

Purpose: Investigators have suggested that high cancer mortality rates among Native Hawaiians are due to fatalistic attitudes toward the disease, poor access to care, and lack of consideration of Native Hawaiian cultural values in Western approaches to healthcare. This study used qualitative methods to examine these factors in Native Hawaiian cancer survivors., Methods: Eight focus groups were held on five islands, attracting 45 Native Hawaiian cancer survivors from both rural and urban locales. The focus groups explored survivors' experiences with cancer diagnosis, treatment, and recovery. Participatory research methods were used, with researchers gaining community input on study design, incorporating appropriate Native Hawaiian cultural protocols into the focus groups, and engaging participants in the interpretation of the data., Results: Similar to cancer survivors of other ethnicities, these individuals demonstrated the following: success in accessing healthcare information, professionals, facilities, and insurance; the ability to overcome the barriers confronted; and proactive health behaviors regarding screening, diagnosis, and treatment. They also demonstrated ways in which they were sustained through the cancer experience by Native Hawaiian traditions, such as helping others, gaining strength from Hawaiian spiritual beliefs, and relying on family for personal support. Participants did not respond passively to their cancer diagnoses, and they expressed few fatalistic attitudes. Participants did give numerous examples of other Native Hawaiians who did not seek screening or treatment for cancer because they lacked insurance, had poor access to care, or felt alienated by Western healthcare., Clinical Implications: The findings suggest that improving access to care and incorporating cultural values in health education and services can enhance survivorship and quality of life for Native Hawaiians with cancer. These themes may have applications for other minority groups.

Native Hawaiians experience disproportionate rates of cancer incidence and mortality both nationally and in their homeland, Hawai'i. 'Imi Hale--the Native Hawaiian Cancer Awareness, Research, and Training Project, a five-year project funded by the National Cancer Institute, is aimed at reducing the burden of cancer among Native Hawaiians. The project's overall goal is to reduce cancer incidence and mortality among Native Hawaiians through the establishment of a sustainable infrastructure to 1) promote cancer awareness within Native Hawaiian communities, and 2) initiate cancer research, training, and control activities. A community-based project, 'Imi Hale emphasizes community participation, respect for cultural values, and the sharing of information, as we believe that a commitment to involve Native Hawaiians in all activities of the project will help assure that the community's awareness, training, and research priorities are addressed. In the first year of operation, cancer awareness activities included the development of culturally sensitive booklets on breast cancer and the provision of cancer education and screening for members of the Association of the Hawaiian Civic Clubs. Research and training activities included focus groups to explore the perceptions and experiences of cancer survivors, surveys to assess research priorities, the identification of Native Hawaiian researchers and the development of pilot research projects. The work of 'Imi Hale is guided by the hope that Native Hawaiians can reverse the negative effects of cancer and leave a powerful legacy and inheritance for future generations based on good health and well-being. 'Imi Hale means "to establish, as a dynasty; to acquire authority, power; to seek and establish an inheritance for one's children; and to form a friendship so close that one feels welcome in the house of the other." "By using our language for a name, we are invoking and honoring our ancestors, our culture, language and restoration as a nation."

Religiousness and spirituality are integral to the human experience. There is emerging literature that shows that religiousness and spirituality are associated with various mental and physical health outcomes. Yet, the development of measures to accurately assess these phenomena in health settings is still in its early stages. The difficulties in developing standardized definitions and measures relate to varying interpretations of religiousness and spirituality, a reluctance to utilize a scientific approach to understand an existential and personal experience, and multicultural distinctions. The potential for designing health interventions in which religiousness and spirituality are integrated rests upon the development of measures that are psychometrically sound. This paper reports on preliminary research that empirically assesses one measure of religiousness and spirituality for Native Hawaiians--a group besieged with an array of health problems. The measure is the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) developed by the National Institute on Aging and the Fetzer Institute. This instrument has shown to have appropriate reliability and validity scores. A modified BMMRS was administered to 15 Native Hawaiians who underwent a cultural intervention of exercise, diet, and education in a program called Uli'eo Koa (warrior fitness). The BMMRS was slightly modified based on the literature and earlier research to be more specific to Native Hawaiians. Overall, measures of internal consistency supported the reliability of the BMMRS. The strongest subscales included the domains of "daily spiritual experiences," "religious and spiritual coping," and "religious support." Low internal consistency estimates for the items, "watches/listens to religious programs," "family makes demands," and "significant loss in faith," suggest that these items do not measure the same concept for participants. Although the intercorrelations among the subscales were generally low and with wide variability, 10 of the 17 subscales/single items were moderately to highly correlated with one another, indicating concurrent validity. These subscales, some of which assessed, "daily spiritual experiences," "religious and spiritual coping," and "organizational religiousness," suggest that core ideas on spirituality and religiousness for these participants, broadly reflect both "personal" and "organizational" viewpoints. Caution should be used in interpreting the results of the study because of limitations in the study's design. However, despite these limitations in design, this study provides empirical support for future research on religiousness and spirituality for Native Hawaiians.

Background: Since contact with Westerners in 1778, the native people of the Hawaiian Islands have experienced multiple health and social problems. Among these are the debilitating effects of high rates of cancer incidence and mortality., Methods: The method used in this article was a review and integration of the literature on cancer among Native Hawaiians. The empiric and conceptual literature related to cancer among Native Hawaiians has emerged primarily in the past two decades; therefore, it is limited and sometimes not fully complete. Despite the restricted nature of the literature, there is sufficient evidence to indicate the disproportionate rates of cancer among this native population., Results: An important result of this review is the prescription regarding the incorporation of cultural practices and beliefs into health care services. In particular, incorporating the traditional Hawaiian diet into nutrition programs aimed at health education and promotion may have long-term consequences for cancer prevention. Preliminary data on dietary intervention for Native Hawaiians reveal success on several health indices., Conclusions: Intervention programs that use elements of a culture, such as the traditional Hawaiian diet, reflect the inherent strengths of that culture. A resolution to improve health status of Native Hawaiians in the 21st century will, in part, require a respect and systematic inclusion of such traditional elements into health care services.

The incidence of heart disease is disproportionately large among the Hawaiian population. This article discusses the prevalence of heart disease and associated risk factors among Hawaiians and identifies barriers to health care, including accessibility and the acceptability of services to this population. Case examples are provided. Culturally responsive strategies to address these problems are described, and implications for social work are discussed.

According to the 1990 census, the highly diverse Asian and Pacific Islander (API) American population has doubled in size from 1980 to 1990, and is now the nation's fastest growing minority group. Several studies have documented this population's comparative underuse of mental health services. A review of recent studies on the mental health of Asian and Pacific Island elders identifies a number of risk factors and protectors. Elder APIs appear to have poorer mental health compared to white counterparts, but not the poorest mental health within their own ethnic group. Within-group differences emerge, with recent immigrant groups and colonized populations appearing as most at-risk for mental health problems. A critical variable on this population's mental health status appears to be socioeconomic status,and yet an analysis of other demographic variables, notably nativity and gender, remain contradictory. A research agenda is proposed and implications for mental health administrators are suggested.

Ethnic minorities of color are disadvantaged on most indicators of health and wellness, yet, health services have not been adequately responsive to this group's needs. This paper explores the improvement of health services for this population by discussing common criteria for the assessment of responsiveness: availability, accessibility, and acceptability. Illustrative examples drawn from different ethnic minority groups will be utilized in the discussion of assessment criteria and ideas for cultural responsiveness highlighted.

Women of color represent a growing segment of the rapidly increasing aging population in the United States, and yet descriptive and epidemiological data on this population remain sparse. This article examines the life experiences of aging native Hawaiian women. Oral history methodology is used to collect information on the life experiences of six female elders (kupuna) to identify life themes and cultural values and, more important, to contribute to cultural preservation. Implications for social work policy and research are identified.

Inquiries over the past three decades have shown that ethnic minorities drop out of treatment early and tend to have poorer outcomes in psychotherapy. Despite the widespread acceptance that culturally responsive therapy and programs will produce better treatment outcomes for ethnic minorities, few studies have empirically tested this proposition. This paper reviews two types of interventions, ethnic match and parallel programs, to make the mental health system more responsive to the needs of Asian Americans and Pacific Islanders.

Native Hawaiians, the people indigenous to the Hawaiian Islands, are impoverished in quality of life. Only recently has the myth that native Hawaiians are a carefree people living in a tropical paradise been dispelled. The number of health and mental health problems confronting native Hawaiians is alarming; their general health status is far below that of other U.S. population groups. It is urgent that social workers begin to examine the unique circumstances of native Hawaiians and encourage professional support for the planning of culturally appropriate services for this population.