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Similar to the nation's majority and racial/ethnic minority populations, Native Hawaiian families provide the bulk of care to loved ones with dementia. Limited research has focused on youth caregivers, who are largely invisible to the eldercare service system. This knowledge gap is especially critical for Native Hawaiians who place a high value on eldercare, often provided in multigenerational homes. To address this gap, we describe the process by which a university-community center developed a culturally responsive storybook on dementia targeted to Native Hawaiian youth. The development process honored community-based participatory research principles grounded in the cultural values and practices of Native Hawaiians, active collaboration of an advisory council, and face-to-face engagement with Native Hawaiian youth. Future directions are shared about culture-based programming and evaluation in dementia care that may be useful in work with other racial/ethnic youth and families.

Objectives: Native Hawaiian and other Pacific Islander (NHPI) older adults often experience social disadvantages and poor health outcomes. Physical activity has been associated with better health in other racial groups, but limited studies have examined these associations in NHPI older adults. Methods: Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey ( n = 1,045), logistic regression models examined associations between physical activity and memory/psychological distress/self-rated health. Results: Sufficient levels of physical activity were associated with lower odds of memory problems, serious psychological distress, and poor/fair self-rated health. Unfortunately, only half of the sample reported sufficient physical activity and approximately 30% reported none. Also, 78% of the sample was estimated to be overweight/obese, and 29% had diabetes. Discussion: Culturally-appropriate interventions are recommended to increase physical activity in this population, which could also help reduce high rates of overweight/obesity and diabetes.

Objective: The Native Hawaiian population experiences numerous disparities in health and income. Using a mixed-method research (MMR) design, we summarize findings from three phases of an MMR approach used to uncover kūpuna (elder) long-term service and support (LTSS) needs and care preferences. Methods: Key informants in Hawaiian health were interviewed, secondary analyses of large state data sets were conducted, and kūpuna and "ohana (family) caregivers were engaged in listening sessions. Results: Quantitative data confirmed numerous health disparities experienced by older Native Hawaiians, whereas qualitative data exposed their limited knowledge of this poor health profile and revealed their historical and contemporary experiences with discrimination in education, employment, and health care. Hawaiian culture was identified as a continued source of resilience in support of elders and family caregiving regardless of geographic setting. Discussion: We suggest three practice, policy, and research directions that offer the potential to respond to and improve kūpuna health and service use.

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.