Hawai''i journal of health & social welfare最新文献

The University of Hawai'i at Mānoa (UHM) created a COVID-19 pandemic team to collaborate, plan, and mitigate the spread of COVID-19 across the campus. The purpose of this study was to identify asymptomatic and pre-symptomatic cases of SARS-CoV-2 among unvaccinated UHM residence hall students during 3 distinct intervals (semesters) within the COVID-19 pandemic. Supervised self-administered nasal swab testing samples were collected from unvaccinated UHM residence hall students and sent to a clinical laboratory for COVID-19 RT-PCR testing to detect SARS-CoV-2. Positive cases were contacted and placed in isolation while contact tracing was initiated. The screening program performed 2219 tests on 725 unique persons with the identification of COVID-19 infections in 38 asymptomatic unvaccinated students and an additional 10 cases through contact tracing. A positive correlation existed between the screening program case numbers and the state of Hawai'i 7-day average positive cases as demonstrated with a Pearson coefficient of 0.79 and P<.001. The COVID-19 positivity rate was greater during Spring Semester 2022 compared to both Spring Semester 2021 (P<.001) and Fall Semester 2021 (P <.001). This program served as a component ofa larger strategy to mitigate the effects of the COVID-19 pandemic on the UHM campus. Additional benefits of the program included opportunities to increase COVID-19 awareness, enact health policy measures, evolve to meet changing pandemic demands, and maintain a safe UHM campus.

Studies that examine racial disparities in health outcomes often include analyses that account or adjust for baseline differences in co-morbid conditions. Often, these conditions are defined as dichotomous (Yes/No) variables, and few analyses include clinical and/or laboratory data that could allow for more nuanced estimates of disease severity. However, disease severity - not just prevalence - can differ substantially by race and is an underappreciated mechanism for health disparities. Thus, relying on dichotomous disease indicators may not fully describe health disparities. This study explores the effect of substituting continuous clinical and/or laboratory data for dichotomous disease indicators on racial disparities, using data from the Queen's Medical Center's (QMC) cardiac surgery database (a subset of the national Society of Thoracic Surgeon's cardiothoracic surgery database) as an example case. Two logistic regression models predicting in-hospital mortality were constructed: (I) a baseline model including race and dichotomous (Yes/No) indicators of disease (diabetes, heart failure, liver disease, kidney disease), and (II) a more detailed model with continuous laboratory values in place of the dichotomous indicators (eg, including Hemoglobin A1c level rather than just diabetes yes/no). When only dichotomous disease indicators were used in the model, Native Hawaiian and other Pacific Islander (NHPI) race was significantly associated with in-hospital mortality (OR: 1.57[1.29,2.47], P=.04). Yet when the more specific laboratory values were included, NHPI race was no longer associated with in-hospital mortality (OR: 1.67[0.92,2.28], P=.28). Thus, researchers should be thoughtful in their choice of independent variables and understand the potential impact of how clinical measures are operationalized in their research.

The Hawai'i Pacific University Undergraduate Infrastructure Student Research Center (HUI SRC) is focused on increasing participation of historically underrepresented populations, such as Native Hawaiians, other Pacific Islanders (NHPI), and Filipinos, in tomorrow's biomedical and health research workforce. This is achieved by promoting engagement and competency in entrepreneurial biomedical and health research among undergraduate students. The HUI SRC was modeled after the Morgan State University ASCEND SRC funded by the National Institute of General Medical Sciences. The HUI SRC is rooted in the Hawaiian cultural values of ho'oku'i, hui pu'ana, and lokahi, referring to the physical gathering space of the Student Research Center and the joining of people together around a unifying theme, in this case the pursuit of science. It is committed to intentionally engaging Indigenous knowledge and ways of doing in decolonizing research. This article describes the project and presents evaluation findings of the first year of implementation of the HUI SRC. The center was effective in increasing undergraduate students' science identity, academic self-concept, social self-concept, social support, peer support, and self-efficacy. These HUI SRC findings highlight the potential impact of undergraduate SRCs in expanding the pipeline of biomedical and health researchers from underrepresented populations, particularly among NHPI and Filipinos.

Numerous studies have used survey instruments to measure the degree of cultural identity/identification for a racial group to examine how they identify with their heritage or cultural group. However, only a few systematic reviews have summarized the survey instruments for Native Hawaiians, Pacific Islanders, and Filipinos. This systematic review aimed to summarize reliable and validated survey instruments that assessed the cultural identity/identification of Native Hawaiians, Pacific Islanders, and Filipinos in 3 steps: (1) identifying studies that meet the inclusion and exclusion criteria; (2) evaluating the psychometric properties of the instrument with reported validity and reliability test results; and (3) summarizing the selected studies. A search was conducted in PubMed, PsycINFO, Web of Science, and Health and Psychosocial Instruments databases for published articles related to the cultural identification for the 3 racial groups. Sixteen unique articles met the inclusion/exclusion criteria: 7 for Filipinos, 3 for Native Hawaiians, 1 for Pacific Islanders, 2 for Asian Americans, and 3 for non-specific Indigenous people. Three reviewers assessed the psychometric properties of the 16 articles using the pre-determined criteria and summarized the survey instruments and study outcomes. All the selected articles discussed their survey instrument's validity. This review can serve as a resource for researchers who want to apply a culturally tailored survey instrument for Native Hawaiians, Pacific Islanders, and Filipinos in their research studies.

This article describes recommendations for standardized race data collection developed by the Hawai'i Native Hawaiian and Pacific Islander COVID-19 Response, Recovery, and Resilience Team (NHPI 3R Team). These recommendations attempt to address the expressed desires of Native Hawaiians and the diverse Pacific Islander communities in Hawai'i who seek greater visibility in data and research. The Native Hawaiian and Pacific Islander (NHPI) racial category is 1 of the 5 racial categories listed in the 1997 Statistical Policy Directive #15 issued by the Office of Management and Budget (OMB). The OMB directive sets the minimum standard for collection of race data in federal surveys, administrative forms, records, and other data collection. The NHPI 3R Team's recommendation provides a standard for detailed data collection that could improve smaller communities' ability to identify, advocate for, and address their own needs. The article also describes lessons learned through the collaborative and iterative process that was led by members and leaders of NHPI communities impacted by data driven decisions and policies. The NHPI 3R Team focused on expanding and standardizing race data collection as part of their COVID-19 response efforts, but implementation of the recommendations could produce benefits well beyond the pandemic.

For the past 2 decades, investigations into implicit racial bias have increased, building evidence on the impact of bias on health and health care for many minority communities in the US. However, few studies examine the presence and impacts of implicit bias in Hawai'i, a context distinct in its history, racial/ethnic diversity, and contemporary inequities. The absence of measures for major racialized groups, such as Native Hawaiians, Pacific Islanders, and Filipinos, impedes researchers' ability to understand the contribution of implicit bias to the health and social disparities observed in Hawai'i. The purpose of this study was to measure bias toward these underrepresented groups to gain a preliminary understanding of the implicit racial bias within the distinctive context of this minority-majority state. This study measured implicit racial bias among college students in Hawai'i using 3 implicit association tests (IATs): (1) Native Hawaiian compared to White (N = 258), (2) Micronesian comparedto White (N =257), and (3) Filipino compared to Japanese (N = 236). Themean IAT D scores showed implicit biases that favored Native Hawaiiansover Whites, Whites over Micronesians, and Japanese over Filipinos. Multipleregression was conducted for each test with the mean IAT D score as theoutcome variable. The analysis revealed that race was a predictor in the vastmajority of tests. In-group preferences were also observed. This investigationadvances the understanding of racial/ethnic implicit biases in the uniquelydiverse state of Hawai'i and suggests that established social heirarchies mayinfluence implicit racial bias.

Kānaka 'Ōiwi (Native Hawaiians), the Indigenous Peoples of Hawai'i, have worldviews of health that emphasize the importance of being pono (ie, right and just) and maintaining balance with all our relations. Yet, the literature of health for Native Hawaiians often focuses on the disproportionate health disparities that affect the Native Hawaiian community. The purpose of this paper is to present 2 case studies that integrate Indigenous research methodologies with, for, and by Kānaka 'Ōiwi, moving beyond Community-Based Participatory Research (CBPR) approaches to respond to the health needs identified with, for, and by Native Hawaiian communities. The first case study, Mini Ahupua'a for Lifestyle and Mea'ai through Aquaponics (MALAMA), reports on the processes and outcomes for backyard aquaponics, which started with, for, and by the Waimānalo community and extended to include other Native Hawaiian communities. The second case study, Ke Ola O Ka 'Āina, reports on the development and pilot findings of the 'Āina Connectedness Scale, developed with, for, and by Native Hawaiian communities. Common themes resulting from the processes of these case examples include the importance of establishing relationships, protocols, and procedures for pono research, identifying community-based health priorities and solutions to address health disparities, and "walking in multiple worlds" to address the priorities of multiple stakeholders. Public health recommendations and implications, including lessons learned and academic policies that may counter Indigenous research methodologies, are further described.

Hawai'i is the most ethnically diverse state with the highest proportion of multiracial individuals in the United States. The Stepwise Proportional Weighting Algorithm (SPWA) was developed to bridge the categorization of multiracial Census data into single-race population estimates for common races in Hawai'i. However, these estimates have not been publicly available. A Shiny web application, the Hawai'i Single-Race Categorization Tool, was developed as a user friendly research tool to obtain the age and sex distributions of single-race estimates for common racial groups in Hawai'i. The Categorization Tool implements the SPWA and presents the results in tabular and graphic formats, stratified by sex and age. It also allows the categorization of partial Native Hawaiians as Native Hawaiians in the population estimation. Using this tool, the current paper reports population estimates and distributions for 31 common racial groups using Hawai'i Census 2010 data. Among the major Census races, Asian had the largest population (631 881; 46.5%) in Hawai'i, followed by White (431 635; 31.7%) and Native Hawaiian and Other Pacific Islander (227 588; 16.7%). Among Census detailed races within Asian, Filipino had the largest population estimate (244 730; 18.0%), followed by Japanese (227 165; 16.7%) and Chinese (103 600; 7.6%). Native Hawaiian accounted for 12.3% of the Hawai'i population (166 944). After recategorizing part-Native Hawaiians as Native Hawaiians, Native Hawaiian increased by 150.0%, with the greatest increase among the young. This publicly available tool would be valuable for race-related resource allocation, policy development, and health disparities research in Hawai'i.