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

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.

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.

The COVID-19 pandemic was a public health emergency that required various public health policies and programs at the state and federal level to be established to protect the health and safety of the nation. These mainstream policies and programs proved to be inadequate in addressing the specific needs of Native Hawaiian and Pacific Islander (NHPI) communities as evidenced by the high case counts and low vaccination rates in these communities. In an effort to better understand and address the high case counts and low vaccination rates, a partnership was developed between the Hawai'i State Department of Health (HDOH), medical providers, and a network of NHPI-serving organizations. After the failure of Western approaches for data gathering, leaders of the partnership used an Indigenous qualitative interview method called Talanoa situated within a cultural safety framework to learn reasons for low vaccine uptake and identify NHPI-specific solutions. Findings suggest that the use of Talanoa and its ingrained cultural safety framework allowed us to gather richer data, identified solutions grounded in community, and assisted with building sustainable trusting partnerships.

Surfing is a globally popular recreational sport with limited epidemiologic data. Currently, there is a paucity of literature regarding injury profiles and mechanisms of orthopaedic-related injuries. This study analyzed trends, etiologies, and diagnoses of upper extremity orthopaedic-related surfing injuries presenting to United States (US) emergency departments. The National Electronic Injury Surveillance System database was accessed to query upper extremity surfing-related injuries presenting to US emergency departments from January 1, 2002 to December 31, 2021. Data were analyzed for year, body part, mechanism of injury, diagnosis, and disposition. National estimates were calculated based on the assigned statistical sample weight of each hospital. A total of 33 323 surfing-related injuries were included. The most common upper extremity body parts involved 15 169 shoulders (45.5%), 4220 fingers (12.7%), and 3753 hands (11.3%). The most common identifiable mechanisms of injuries were 7474 board-to-body (22.4%), 4188 impact with sand (12.6%), and 2639 impact with water (7.9%). Overuse constituted 7.2% of overall upper extremity injuries but 40% of strains. Only 2.2% of injuries required hospital admission. Between 2002 and 2021, there was a decreasing annual trend in upper extremity surfing-related injuries (P=.01). The decreasing trend in emergency department visits may be due to urgent care utilization and training for surfers and lifeguards to manage these injuries on-site, as the majority were minor given the small proportion requiring hospital admission. Chronic stress on rotator cuff and peri-scapular musculature while paddling in the prone position likely contributed to the large proportion of overuse injury.

Gestational diabetes mellitus (GDM) is a diagnosis of glucose intolerance during pregnancy. The risk of type II diabetes mellitus (T2DM) and obesity for the child and mother increases when GDM develops. Preventing the development of GDM could help lower the prevalence of obesity and type II diabetes mellitus morbidity rates in children of affected mothers. The purpose of the study was to identify the awareness level of females ages 12 and 51 years, on the long-term risk of obesity and T2DM on their children in Australia and Samoa. This is a quantitative study involving 202 females, from across Australia and Samoa, between April 2021 and November 2021, comparing the level of knowledge between a developing and developed country. In Australia and Samoa, 15% (n=16) and 34% (n=33) of females respectively, were aware of the long-term complications of GDM on their children. These findings indicate that there is inadequate knowledge regarding the long-term consequences associated with GDM on both the risk for T2DM in women and the risk for long-term complications for their children. The greatest source of information in both countries was obtained from physicians or midwives, 52% (n=105). This supports the need for increased education on GDM, through social media, the internet, and community health professionals. By increasing awareness of GDM and implementing preventive strategies, it may be possible to reduce the prevalence of obesity and T2DM in Australia and Samoa.

Federal race and ethnicity data standards are commonly applied within the state of Hawai'i. When a multiracial category is used, Native Hawaiians are disproportionately affected since they are more likely than any other group to identify with an additional race or ethnicity group. These data conventions contribute to a phenomenon known as data genocide - the systematic erasure of Indigenous and marginalized peoples from population data. While data aggregation may be unintentional or due to real or perceived barriers, the obstacles to disaggregating data must be overcome to advance health equity. In this call for greater attention to relevant social determinants of health through disaggregation of race and ethnicity data, the history of data standards is reviewed, the implications of aggregation are discussed, and recommended disaggregation strategies are provided.