Search Results (14)

This study examines predictors of life satisfaction in Native Hawaiian and Pacific Islander (NH/PI) college students, who form an underrepresented group in well-being research. In a sample of 128 NH/PI students from a public university in Hawaii, self-report measures of life satisfaction, affect, stress, and mood were analyzed. The results indicate that positive affect and mood are significant positive predictors for life satisfaction, while negative affect predicts lower satisfaction. By contrast with other racial/ethnic groups, perceived stress did not significantly impact life satisfaction in NH/PI students. These findings suggest that emotional well-being is a key determinant for life satisfaction in NH/PI students, and stress is not. Culturally responsive interventions that focus on positive emotions and community support can enhance well-being and academic success in this population. This study contributes to the understanding of unique cultural influences on well-being in NH/PI students and provides implications for targeted interventions. Full article

Compared to the general population of Hawai‘i, Native Hawaiians and Other Pacific Islanders (NHPI) shoulder a disproportionately high risk for obesity-related cardiometabolic disorders, such as type 2 diabetes and cardiovascular disease. The gut microbiome is an area of rapid research interest for its role in regulating adjacent metabolic pathways, offering novel opportunities to better understand the etiology of these health disparities. Obesity and the gut microbiome are influenced by regional, racial–ethnic, and community-specific factors, limiting the generalizability of current literature for understudied populations. Additionally, anthropometric and directly measured obesity indices are variably predictive of adiposity and metabolic health risk in this diverse population. Thus, further NHPI-inclusive research is required to adequately characterize community-specific factors in the context of obesity-related disease etiology. Culturally responsible research ethics and scientific communication are crucial to conducting such research, especially among indigenous and understudied populations. In this review, we explore these limitations in current literature, emphasizing the urgent need for NHPI-inclusive research to assess community-specific factors accurately. Such accuracy in Indigenous health research may ensure that findings relevant to individual or public health recommendations and/or policies are meaningful to the communities such research aims to serve. Full article

The purpose of this study is to describe the development and initial validation of a survey focused on problematic situations involving e-cigarette use by rural Native Hawaiian and Pacific Islander (NHPI) youths. A 5-phase approach to test development and validation was used. In Phase 1 (Item Generation), survey items were created from a series of focus groups with middle school youths on Hawai‘i Island (N = 69). In Phase 2 (Item Refinement and Selection), situational items were reduced to 40 e-cigarette offer situations that were selected for inclusion in the survey. In Phase 3 (Item Reduction), items were administered to 257 youths from 11 middle, intermediate, or multi-level public or public-charter schools on Hawai‘i Island. Exploratory factor analysis indicated the presence of three factors accounting for 50% of the variance: E-Cigarette Offers from Friends (24%), E-Cigarette Offers from Non-Friends (16%), and Coercive Pressure to Use E-Cigarettes (10%). Hypothesized relationships between offer situations and e-cigarette use were partially confirmed, supporting the construct validity of the survey. This survey helps to fill the scientific and practice gap in measuring ecodevelopmental risk and protection for e-cigarette use and has implications for e-cigarette use prevention with rural, NHPI, and/or Indigenous youth populations. Full article

Native Hawaiian and Pacific Islanders (NHPIs) are overrepresented in Hawai‘i’s houseless population. Indigenous populations, such as NHPIs, may encounter experiences of historical trauma that impact their well-being. This original research project examines how NHPI identity and houselessness compound to affect the perceived stress and historical trauma of transition-aged youth. Fifty-one participants aged 18 to 24 (M = 21.37, SD = 1.93) completed a survey that included the historical traumatic events scale, historical loss scale, perceived stress scale, and a demographic questionnaire. Over half (n = 26, 51.0%) of the participants identified as NHPI. A two-way ANOVA indicated a non-significant effect of NHPI identity and housing status on perceived stress. However, housed participants scored significantly higher than participants experiencing houselessness on the historical traumatic events scale (p = 0.006). Our findings elucidate the role of knowledge in the experience of historical trauma. Further results, limitations, and future directions are offered. Full article

The study used the American Time Use Survey data from 2010 to 2019 to compare the daily moderate-to-vigorous activity of Native Hawaiians and Pacific Islanders (NHPI) and seven Asian ethnic subgroups. Adults aged 24 years and older were included. The study analyzed activities from sports and recreation, household activities, and all activities carried out during the day. Outcomes were determined by the completion of 30 min or more of moderate-to-vigorous activity and the type of activity carried out in the day. Significant ethnic differences were observed for sports and recreation but not for household activities and not for all activities carried out during the day. Of the ethnic populations, NHPI were the least active, and Asian Indians and Chinese were the most active. A majority achieved 30 min or more of moderate-to-vigorous activity during the day from all their activities. Physical activity from household activities exceeded physical activity from sports and recreation. The most physically active group was adults over the age of 65 years, perhaps reflecting more time to exercise or greater concerns about their health. For sports and recreation, exercising with someone doubled the minutes of moderate-to-vigorous activity. The results emphasize the importance of activities performed around the household in addition to sports and recreation and the benefit of exercising with someone. Ethnic populations may be receptive to interventions that emphasize activities they are performing in their daily lives. Full article

Despite radiation therapy (RT) and surgery being the curative treatments, prior work demonstrated that the aggregated Asian American (AA) and Native Hawaiian and Other Pacific Islanders (NHPI) population refuse RT and surgery at a higher rates than other races. Given that AA and NHPI are distinct groups, data disaggregation is necessary to understand racial and ethnic disparities for treatment refusal. We aimed to (1) compare RT and surgery refusal rates between AA and NHPI populations, (2) assess RT and surgery refusal on overall mortality, and (3) determine predictors of refusing RT and surgery using the United States (U.S.) National Cancer Database. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) for treatment refusal were calculated using logistic regression. Adjusted hazard ratios (aHR) were calculated for overall survival using Cox proportional hazard models among propensity score-matched groups. The overall rate of RT refusal was 4.8% and surgery refusal was 0.8%. Compared to East AA patients, NHPI patients had the highest risk of both RT refusal (aOR = 1.38, 95%CI = 1.21–1.61) and surgery refusal (aOR = 1.28, 95%CI = 1.00–1.61). RT refusal significantly predicted higher mortality (aHR = 1.17, 95%CI = 1.08–1.27), whereas surgery refusal did not. Predictors of RT and surgery refusal were older patient age, high comorbidity index, and cancer diagnosis between 2011–2017. The results show heterogenous treatment refusal patterns among AA and NHPI populations, suggesting areas for targeted intervention. Full article

Brachytherapy improves clinical outcomes among women diagnosed with cervical and endometrial cancers. Recent evidence demonstrates that declining brachytherapy boosts for women with cervical cancer were associated with higher mortality. In this retrospective cohort study, women diagnosed with endometrial or cervical cancer in the United States between 2004 and 2017 were selected from the National Cancer Database for evaluation. Women ≥18 years of age were included for high intermediate risk (PORTEC-2 and GOG-99 definition) or FIGO Stage II-IVA endometrial cancers and FIGO Stage IA-IVA—non-surgically treated cervical cancers. The aims were to (1) evaluate brachytherapy treatment practice patterns for cervical and endometrial cancers in the United States; (2) calculate rates of brachytherapy treatment by race; and (3) determine factors associated with not receiving brachytherapy. Treatment practice patterns were evaluated over time and by race. Multivariable logistic regression assessed predictors of brachytherapy. The data show increasing rates of brachytherapy for endometrial cancers. Compared to non-Hispanic White women; Native Hawaiian and other Pacific Islander (NHPI) women with endometrial cancer and Black women with cervical cancer were significantly less likely to receive brachytherapy. For both NHPI and Black women, treatment at community cancer centers was associated with a decreased likelihood of brachytherapy. The data suggest racial disparities among Black women with cervical cancer and NHPI women with endometrial cancer and emphasize an unmet need for brachytherapy access within community hospitals. Full article

Background: Young adults often derive self-identity from affiliation with peer crowds, which may be defined as reputation-based peer groups centered around characterizable lifestyle norms. Little is known about peer crowds prevalent among Asian American, Native Hawaiian, and other Pacific Islander (AANHPI) populations and the peer crowds’ normative tobacco and other substance use behavior. To address this gap in knowledge, this study conducted focus groups with young adult community college students. Methods: Focus group discussions were conducted with a convenience sample of 42 young adults (Mean age = 21.5, SD = 2.7) recruited across community colleges on O‘ahu, Hawai‘i. The participants represented 60% women, 55% NHPI, and 29% Asian American. Results: Results indicated the presence of a wide range of peer crowds in the population, which may be classified into the following seven categories prevalent in the literature: Regular, Academic, Alternative, Athlete, Geek, High Risk, and Popular. Several peer crowds within the Alternative, Athlete, Geek, High Risk, and Popular categories appeared to represent subcultures relevant for NHPI young adults. High-risk peer crowds were reported to be vulnerable to different types of substance use. Tobacco product use, particularly e-cigarette use or vaping, was noted to be characteristically present among Popular crowds and certain Athlete crowds. Conclusion: Tobacco and other substance use prevention interventions, such as mass media campaigns, may benefit from targeting high-risk peer crowds, especially those relevant for NHPI young adults, who are at high risk for tobacco and other substance use. E-cigarette use prevention interventions may benefit from paying close attention to vulnerable Popular and Athlete groups. Full article

The aim of this study was to investigate caregivers’ experiences of complementary feeding (CF) among the Native Hawaiian and Other Pacific Islander (NHPI), and Filipino populations. Research focused on the timing of CF commencement, and the influence of transgenerational experience on feeding practices. The experiences and practices of those who fed human milk exclusively (HME), were compared to those who included infant formula (F&HM). Caregivers of a subset of 32 infants who were participating in a larger longitudinal study relating to CF and diet diversity, took part in voluntary in-depth interviews relating to CF practices. Interviews were recorded and transcribed. Two researchers analyzed interview transcripts. Interrater reliability and saturation were established. Institutional Review Board exemption was confirmed prior to study commencement. Interviews with 29 caregivers of infants were included in this study. Only infants of the F&HM group had an early introduction to complementary foods (<4 months of age). Caregivers reported receiving conflicting advice from healthcare professionals (HCPs) in relation to timing of the introduction of complementary foods. Nonetheless, the majority of caregivers reported following the advice of HCPs. Extended family (including grandparents) played less of a role in infant feeding, compared to previous generations. While transgenerational practices were valued and included, ultimately, the perceived health and safety of the practice for infants influenced decisions. Full article

Native Hawaiians and other Pacific Islanders (NHPIs) were disproportionately impacted by COVID-19 and remain significantly under-vaccinated against SARS-CoV-2. To understand vaccine hesitancy, we surveyed 1124 adults residing in a region with one of the lowest vaccination rates in Hawaii during our COVID-19 testing program. Probit regression analysis revealed that race/ethnicity was not directly associated with the probability of vaccine uptake. Instead, a higher degree of trust in official sources of COVID-19 information increased the probability of vaccination by 20.68%, whereas a higher trust in unofficial sources decreased the probability of vaccination by 12.49% per unit of trust. These results revealed a dual and opposing role of trust on vaccine uptake. Interestingly, NHPIs were the only racial/ethnic group to exhibit a significant positive association between trust in and consumption of unofficial sources of COVID-19 information, which explained the vaccine hesitancy observed in this indigenous population. These results offer novel insight relevant to COVID-19 mitigation efforts in minority populations. Full article

Background: We examined e-cigarette use as a prospective predictor of alcohol and marijuana abuse symptoms in a sample consisting of Native Hawaiian and Other Pacific Islander (NHPI), Filipino, Asian (i.e., Japanese, Chinese, Korean), and White young adults. NHPI represent a highly vulnerable group with regard to substance use and are severely understudied. Methods: Data were collected from 1463 young adults (M age = 22.2, SD = 3.2; 59.5% women) enrolled across community colleges in Hawai‘i at two time-points six months apart. Results: Higher frequency of e-cigarette use at baseline was predictive of higher alcohol (B = 0.06, SE = 0.02, p < 0.01) and marijuana (B = 0.06, SE = 0.02, p < 0.01) use problems at six-month follow up, adjusting for baseline cigarette smoking, problem alcohol/marijuana use, sensation seeking, and demographic variables. Ethnicity was found to significantly moderate the relationship between baseline e-cigarette use and problem marijuana use later, such that White and NHPI ethnicities were particularly vulnerable to the effects of e-cigarette use on problem marijuana use. Conclusion: NHPI are often combined with Asians in national surveys, which obfuscates the higher risks faced by NHPI compared with groups that are routinely classified as Asians (e.g., Chinese, Japanese, Filipinos). The current research highlights the NHPI’s vulnerability in terms of the effects of e-cigarette use on marijuana and alcohol abuse symptoms. Full article

Introduction: Given that the success of vaccines against coronavirus disease 2019 (COVID-19) relies on herd immunity, identifying patients at risk for vaccine hesitancy is imperative—particularly for those at high risk for severe COVID-19 (i.e., minorities and patients with neurological disorders). Methods: Among patients from a large neuroscience institute in Hawaii, vaccine hesitancy was investigated in relation to over 30 sociodemographic variables and medical comorbidities, via a telephone quality improvement survey conducted between 23 January 2021 and 13 February 2021. Results: Vaccine willingness (n = 363) was 81.3%. Univariate analysis identified that the odds of vaccine acceptance reduced for patients who do not regard COVID-19 as a severe illness, are of younger age, have a lower Charlson Comorbidity Index, use illicit drugs, or carry Medicaid insurance. Multivariable logistic regression identified the best predictors of vaccine hesitancy to be: social media use to obtain COVID-19 information, concerns regarding vaccine safety, self-perception of a preexisting medical condition contraindicated with vaccination, not having received the annual influenza vaccine, having some high school education only, being a current smoker, and not having a prior cerebrovascular accident. Unique amongst males, a conservative political view strongly predicted vaccine hesitancy. Specifically for Asians, a higher body mass index, while for Native Hawaiians and other Pacific Islanders (NHPI), a positive depression screen, both reduced the odds of vaccine acceptance. Conclusion: Upon identifying the variables associated with vaccine hesitancy amongst patients with neurological disorders, our clinic is now able to efficiently provide ancillary COVID-19 education to sub-populations at risk for vaccine hesitancy. While our results may be limited to the sub-population of patients with neurological disorders, the findings nonetheless provide valuable insight to understanding vaccine hesitancy. Full article

Background: Recent studies have shown that parental educational attainment is associated with a larger superior temporal cortical surface area associated with higher reading ability in children. Simultaneously, the marginalization-related diminished returns (MDRs) framework suggests that, due to structural racism and social stratification, returns of parental education are smaller for black and other racial/ethnic minority children compared to their white counterparts. Purpose: This study used a large national sample of 9–10-year-old American children to investigate associations between parental educational attainment, the right and left superior temporal cortical surface area, and reading ability across diverse racial/ethnic groups. Methods: This was a cross-sectional analysis that included 10,817 9–10-year-old children from the Adolescent Brain Cognitive Development (ABCD) study. Parental educational attainment was treated as a five-level categorical variable. Children’s right and left superior temporal cortical surface area and reading ability were continuous variables. Race/ethnicity was the moderator. To adjust for the nested nature of the ABCD data, mixed-effects regression models were used to test the associations between parental education, superior temporal cortical surface area, and reading ability overall and by race/ethnicity. Results: Overall, high parental educational attainment was associated with greater superior temporal cortical surface area and reading ability in children. In the pooled sample, we found statistically significant interactions between race/ethnicity and parental educational attainment on children’s right and left superior temporal cortical surface area, suggesting that high parental educational attainment has a smaller boosting effect on children’s superior temporal cortical surface area for black than white children. We also found a significant interaction between race and the left superior temporal surface area on reading ability, indicating weaker associations for Alaskan Natives, Native Hawaiians, and Pacific Islanders (AIAN/NHPI) than white children. We also found interactions between race and parental educational attainment on reading ability, indicating more potent effects for black children than white children. Conclusion: While parental educational attainment may improve children’s superior temporal cortical surface area, promoting reading ability, this effect may be unequal across racial/ethnic groups. To minimize the racial/ethnic gap in children’s brain development and school achievement, we need to address societal barriers that diminish parental educational attainment’s marginal returns for middle-class minority families. Social and public policies need to go beyond equal access and address structural and societal barriers that hinder middle-class families of color and their children. Future research should test how racism, social stratification, segregation, and discrimination, which shape the daily lives of non-white individuals, take a toll on children’s brains and academic development. Full article

(1) Background: The purpose of this exploratory study was to describe variation in age of onset of functional limitations of Native Hawaiian and Pacific Islanders (NHPI) compared to other racial and ethnic groups. (2) Methods: Adults age 45 years and older who responded to the Functioning and Disability module within the 2014 National Health Interview Survey (NHIS) were included (n = 628 NHPI; 7122 non-Hispanic Whites; 1418 Blacks; 470 Asians; and 1216 Hispanic adults). The NHIS Functioning and Disability module included 13 items, which we organized into three domains of functional limitations using factor analysis: Mobility, Gross Motor Skills, and Fine Motor Skills. Responses were summed within each domain. (3) Results: After adjusting for age and sex, we found that racial/ethnic minority groups, with the exception of Asians, experience more functional limitations than Whites. Results further indicate that NHPI adults experienced an earlier surge in all three domains of functional limitations compared to other racial/ethnic groups. (4) Conclusions: These findings are novel and provide additional evidence to the existence of disparities in functional health outcomes across racial/ethnic groups. Future studies are needed to develop targeted and culturally tailored interventions for those most in need. Full article