Abstract
Mauli ola mālamalama: A value-based and culturally-based Native Hawaiian health workforce program
Donna-Marie Palakiko, PhD, RN, APRN1, Lisa Kaanoi, MPH1, Kai'olu DeFries2 and Kilohana Haitsuka, BA, MSW3
(1)Papa Ola Lokahi Native Hawaiian Health Scholarship Program, Honolulu, HI, (2)Honolulu, HI, (3)Papa Ola Lokahi, Honolulu, HI
APHA 2021 Annual Meeting and Expo
Established in 1991, the Native Hawaiian Health Scholarship Program sought to increase the number of Native Hawaiian (NH) healthcare providers in primary health care. In 2021, the program is set to welcome its 30
th cohort of awardees and a re-imagined program.
Mauli Ola Mālamalama (MOM), formerly the Native Hawaiian Health Scholarship Program, is a value- and culturally-based NH Health Workforce Program of Papa Ola Lōkahi. Re-imagined in 2020 with a launch in August 2021, MOM’s purpose is to support and facilitate the continued development of NH Health Professionals to increase the economic prosperity for the NH community. The kuleana (responsibility) of MOM is rooted in the sense of knowing and living the core values reflective of suitability, commitment, and leadership. These core NH values include ‘olu‘olu (pleasant), kuleana (responsibility), ho‘iho‘i (cheerful), pono (right/correct), a‘o (to learn), ha‘aha‘a (humble), hana ka lima (hard working), and ka‘i (to lead). By creating a sense of ‘ohana (family)/lāhui (people), implementing a rigorous selection process reflective of our core NH values, establishing health profession pathways, providing workforce development, and building pilina (relationships) we are able to align with our purpose. MOM fulfills the kuleana through established hanohano (elements of distinction). These elements include increasing our reach, increasing awards, implementing a short cycle workforce, and increasing the retention of recipients who remain at their worksite.
MOM’s team will discuss their lived experience with the program transition from increasing NH healthcare providers in primary care to the launch of a broader program focused on health career pathways.
Administration, management, leadership Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Other professions or practice related to public health Public health or related organizational policy, standards, or other guidelines
Abstract
A scoping review of land and nature connectedness scales from a Native Hawaiian and indigenous worldview
Mapuana Antonio, DrPH1, Samantha Keaulana, MSW1, Melissa Kahili-Heede, MLIS, MEd1 and Lorinda Riley, SJD2
(1)University of Hawai'i at Mānoa, Honolulu, HI, (2)University of Hawaiʻi Mānoa, Honolulu, HI
APHA 2021 Annual Meeting and Expo
Many Indigenous worldviews of health emphasize the importance of maintaining respectful relationships and living in balance. For instance, from a Native Hawaiian worldview, health is holistic, with a balance of physical, mental, spiritual, and emotional health, which extends to include one’s relationships with others, land, and the spiritual realm. Consequently, identifying measures that assess for land and nature connectedness is important from a Native Hawaiian and Indigenous worldview, with a deep understanding that the health of the land is a reflection of the health of people, while one’s connection to land may serve as a facilitator of wellbeing and address socio-cultural determinants of health that stem from colonization and historical trauma. The purpose of this study was to conduct a scoping review to identify land or nature connectedness scales, including Indigenous cultural connectedness scales that assessed for land connectedness, based on studies conducted throughout the US. The findings of this study were based on articles retrieved from PubMed/MEDLINE, PsycINFO, CINAHL, and Academic Search Complete. Based on 1386 articles retrieved from the initial searches, and after applying the inclusion/exclusion criteria, five scales were identified. Nature connectedness scales included: the Connectedness to Nature Scale (CNS), Inclusion of Nature in Self (INS), and Nature Related Scale (NRS). Cultural Connectedness Scales that assessed for land connectedness included the Awareness of Connectedness Scale and Hawaiian Cultural Scale. In general, increased connections to nature and land demonstrated favorable outcomes for general health and wellbeing, with implications for future education, research, and practice.
Diversity and culture Environmental health sciences Public health or related research
Abstract
Meeting the needs of Native Hawaiian students in tertiary education: An evidence-based approach to developing a mentorship program
Kaiʻolu DeFries, BA1, Kilohana Haitsuka, BA, MSW2, Lisa Kaanoi, MPH3 and Donna-Marie Palakiko, PhD3
(1)Papa Ola Lōkahi, Honolulu, HI, (2)University of Washington, Seattle, WA, (3)Papa Ola Lokahi, Honolulu, HI
APHA 2021 Annual Meeting and Expo
In 2019, approximately 12.4% of the Native Hawaiian and other Pacific Islander population 25 years and older had completed their undergraduate studies in Hawaiʻi, which is significantly lower than other racial/ethnic groups (US Census, 2019). Barriers preventing the successful completion of post-secondary degrees include social and cultural differences, finances, representation, separation from land and community, and familial and cultural obligations. Without the attainment of a bachelor’s degree, Native Hawaiians are more likely to be undereducated, work low paying jobs, receive limited access to quality healthcare, and live in poorer conditions than other racial/ethnic groups (Braun et al., 2015; Kaholokula, 2019). Mentorship programs have been shown to improve Native Hawaiian students’ educational attainment by providing culturally safe, community-centered spaces congruent with Hawaiian values and practices. Through these mentoring programs students can learn collaboratively with other students who face similar hardships, and access resources necessary for their education and future careers. By addressing students’ cultural, academic, social, financial, and professional development needs, mentorship programs can help to reduce poverty and increase well-being (Wong-Wilson, 2016; OHA, 2017).
Administration, management, leadership Diversity and culture Other professions or practice related to public health Program planning Public health or related organizational policy, standards, or other guidelines
Abstract
Transforming research results into a relational and culturally consonant handout for community members: The healthy relationships are sacred project
Christiane Parrish, MS1, Alma Knows His Gun McCormick, BA2, Vanessa Simonds, ScD3, Sloane Real Bird, MS4, Sarah Allen, PhD5 and Suzanne Held, PhD3
(1)Montana State University, Billings, MT, (2)Messengers for Health, Crow Agency, MT, (3)Montana State University, Bozeman, MT, (4)One Health, Crow Agency, MT, (5)Southern Utah University, Cedar City, UT
APHA 2021 Annual Meeting and Expo
Messengers for Health (Messengers) is a unique partnership between Montana State University and the Apsáalooke (Crow) Nation that has been working for over 20 years to improve the health and wellness of the Apsáalooke people through community-based participatory research and Indigenous research methodologies. In recent years, domestic violence was brought up by the Messengers Community Advisory Board (CAB) as a significant issue in the community. Board members expressed the need for improving healthy relationships in the youth to prevent domestic violence. In response, partners utilized the Community Readiness Model (CRM) to assess the community’s overall readiness for an intervention. It is very rare for research results to be transformed into products that are relational and culturally consonant for lay community members. This is a vital process and product for including community members in meaningful ways in health research. We will discuss steps taken to transform CRM results into a culturally consonant information handout for the Apsáalooke community. This was an Apsáalooke graduate student-led process in which partners worked collaboratively to design a handout that included Apsáalooke traditional designs, colors and pictures. Our CAB reviewed the handout and made further suggestions. The goal of the handout was to create a visually appealing representation of the research that the Apsáalooke people can relate to on a deeper level rather than reading numerical values and research terms. This process helped partners to expand on their presentation and design capabilities and to provide more culturally relevant materials for future work in the community.
Assessment of individual and community needs for health education Diversity and culture Planning of health education strategies, interventions, and programs Public health or related research Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Addressing oral health disparities in the AI/an community with traditional medicine wheels
Karina Quiroz, CHES, Amanda Rodriguez and Rita Ledesma, Ph.D, LCSW
California State University, Los Angeles, Los Angeles, CA
APHA 2021 Annual Meeting and Expo
Los Angeles County, originally Tongva/Kizh land, is home to the largest urban American Indian / Alaskan Native (AI/AN) community, representing over 125 tribes. As a consequence of the post-colonial experience and the historical failures of the federal government in serving AI/AN tribal communities, AI/AN experience stark social and health disparities, including a high prevalence of chronic diseases. Chronic disease is strongly linked to oral health and the AI/AN population presents with significant oral health disparities. These disparities include early childhood caries (ECC), periodontal disease, oral cancers, missing teeth, and lack of dental care. In 2010, a study found that AI/AN children have more decay than other US minority populations. A breakdown by age shows that one out of every six 1-year-old AI/AN child has ECC. The Educational Community Health Outreach (ECHO) program addressed oral health disparities in LA County, especially amongst AI/AN youth. After literature review, evaluation of existing programming and consultation with selected AI/AN leaders, it was found that strengths-based and culturally tailored oral health education materials were sparse. This led to the development of two preliminary medicine wheels that explain and promote oral health at a community and multidisciplinary provider level. Medicine wheels have been used in AIAN communities to promote holistic wellbeing and utilizing this perspective would celebrate the rich cultural history to promote oral health.
Diversity and culture Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related education Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Caring message text intervention for American Indian and Alaska Native college students
Colbie Caughlan
Vancouver, WA
APHA 2021 Annual Meeting and Expo
Native American college students face unique challenges, from feeling isolated on campus to being disconnected from culture. The Caring Message Text Intervention is culturally-tailored for Native college students and provides expressions of care and interest in order to increase protective factors such as self-esteem, cultural connectedness, and resiliency. Previous studies have defined caring contacts as
brief, periodic messages that express unconditional care, ask nothing in return, and provide mental health resources. They have been shown to prevent suicide deaths, attempts, and ideation, and are relatively simple to implement and low cost.
The Northwest Portland Area Indian Health Board’s suicide prevention project recruited 11 Native college students from schools across the country to write caring messages. The messages students wrote touched on the resilience of Native young people, acknowledged the stressors of college, and offered encouragement. Involving young people with lived experience is critical to designing an intervention that is effective for that group.
The intervention will be launched in Spring 2021 and will consist of 30 messages delivered over 15 weeks, during which subscribers will receive two text messages per week. A survey at the end of the intervention will allow users to provide feedback and rate the effectiveness and impact of the text messages. This presentation will explain the process of creating the text intervention, strategies used to create culturally tailored messages through community recruitment, and evaluation outcomes received in Summer 2021. This project and presentation is led by a recent Native college graduate with lived experience.
Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs
Abstract
Development of a food pharmacy in a rural Native American reservation
Lisa Huang, PharmD, MPH and Disney Rachel-Philip, PharmD, BCPS
Quentin N. Burdick Memorial Healthcare Facility, Belcourt, ND
APHA 2021 Annual Meeting and Expo
The Native American population has long endured food insecurity that perpetuates obesity and many chronic health conditions, including high blood pressure and cardiovascular disease. Research has demonstrated that removing barriers and increasing access to fresh fruits and vegetables may improve dietary habits and reduce these chronic health conditions. In 2017, over 48 percent of Native American adults struggled with obesity, compared to 30 percent of Non-Hispanic Whites. In Native American children, 22 percent of high school students were reported to be overweight or obese. The concept of a food pharmacy to prevent and mitigate chronic conditions is an emerging area of research. This study is a community-based pilot program to develop a food pharmacy model in rural North Dakota for Native American children. Eligible children meeting specific criteria (<17 years old, pediatric BMI Z-score of ≥85th percentile, no reported allergies to fresh fruits and vegetables) will be recruited to participate in the 6-month pilot. Baseline BMI Z-score, BMI percentile, waist circumference, weight, height and blood pressure will be assessed. These measurements will be measured at 3-months and at the 6-month conclusion of program. A pre- and post-survey on knowledge, skills and abilities (KSA) of nutrition and healthy eating habits will also be assessed. The primary outcomes are reductions in BMI percentile, waist circumference and blood pressure, if appropriate. The goal of the program is to encourage healthy eating habits, food positivity and provide food security that may lead to healthier generational changes.
Chronic disease management and prevention Implementation of health education strategies, interventions and programs Other professions or practice related to public health Planning of health education strategies, interventions, and programs Public health or related research Social and behavioral sciences
Abstract
Strengthening tribal organization’s social connectedness in Alaska during COVID-19
Carrie Rowland, Ingrid Stevens, MPH and Michael Doyle
Alaska Native Tribal Health Consortium, Anchorage, AK
APHA 2021 Annual Meeting and Expo
The Alaska Native Tribal Health Consortium (ANTHC) Injury Prevention team developed social marketing awareness campaigns in 2020 and 2021 to promote social connectedness during the COVID-19 pandemic. The safety measures, such as social distancing, limited in-person activities and prompted ANTHC to identify innovative ways to provide education, awareness, and outreach to Alaskans. The ANTHC Injury Prevention and Marketing teams created three photo contests, one mental health and one suicide prevention awareness social media campaign. The overall aims of the photo contests encouraged Alaskans to share how they celebrated physical and mental well-being, show the individual and community strengths to increase resilience; and share what provided them with connectedness, spirit and joy in their part of Alaska.
The Mental Health Awareness Month campaign encouraged Alaskans to participate in four weekly mindfulness activities to promote mental health and wellness. The Suicide Prevention awareness campaign also provided four skills based exercises to promote effective communication about mental health.
This project serves as a pilot for Tribal Injury Prevention programs interested in developing a social media marketing campaign to promote the use of mental health resources. Tribally sponsored social marketing campaigns are culturally tailored and help increase knowledge of decreased mental health, potential signs of suicide, crisis intervention, and prevention resources.
Public health or related education
Abstract
Examining Native Hawaiian health professional retention at Native Hawaiian serving organizations: A gap analysis
Donna-Marie Palakiko, PhD, RN, APRN1 and Lei Palakiko, MBA, EdDc2
(1)Papa Ola Lokahi Native Hawaiian Health Scholarship Program, Honolulu, HI, (2)Honolulu, HI
APHA 2021 Annual Meeting and Expo
Employee retention leads to an increase employer return on investment and positive outcomes for the communities they serve. Little is known on the impact employee retention has among Native Hawaiian Health Professionals who work for Native Hawaiian serving organizations. Specifically, the retention of Native Hawaiian Health Scholarship Program recipients who remain at their Native Hawaiian serving organization after their service plan is fulfilled. The purpose of my doctoral research is to conduct a gap analysis to examine the knowledge, motivation, and organizational elements that relate to 100% of Native Hawaiian health professionals remaining at their organization an additional two years after completion of their service plan. The study seeks to understand the knowledge and motivation related to remaining at service site, alignment between organizational culture and context of knowledge and motivation, and recommendations related to organizational solutions. A mixed methods approach including interviews, surveys, and document analysis was conducted to examine Native Hawaiian health professional retention at Native Hawaiian serving organizations. Interview and survey participants included Native Hawaiian Health Scholarship Program recipients who completed their service plan. Documents from the Native Hawaiian Health Scholarship program were examined to identify and support findings from the interview and survey data. A thematic analysis was completed on interview data and descriptive analysis on survey data. The document analysis was used to triangulate findings from the interviews and surveys. Findings from my doctoral research on Native Hawaiian health professional retention at Native Hawaiian serving organizations will be presented.
Administration, management, leadership Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Other professions or practice related to public health Public health or related organizational policy, standards, or other guidelines
Abstract
Using social media as a public health tool for social connection and trust with American Indian and Alaska Native youth
Nicole Reed, MPH, CHES, Sarah Boland, MPH, Savannah Smith, MPH, Umit Shrestha, PhD, Nicole Tuitt, DrPH, Sheana Bull, PhD, Michelle Sarche, PhD and Carol Kaufman, PhD
University of Colorado, Aurora, CO
APHA 2021 Annual Meeting and Expo
Fetal Alcohol Spectrum Disorders (FASD) are the leading cause of preventable birth defects in the U.S and result in neurodevelopmental deficits and lifelong disability. American Indian and Alaska Native (AIAN) young women are especially vulnerable to alcohol-exposed pregnancy (AEP), with high levels of alcohol consumption and sexual risk-taking compared to other races. Native WYSE (Women, Young, Strong, Empowered) CHOICES is an AIAN centered alcohol-exposed pregnancy prevention project that has created, and will evaluate, a culturally adapted evidence-based intervention phone app for urban AIAN young women.
Past and present research exploitation of AIAN populations has resulted in widespread mistrust among AIAN communities. To rebuild relationships, Native WYSE CHOICES is using social media (SM) to connect with urban AIAN young women, recruit potential participants for the app, and bring research into practice. We integrated insights from urban AIAN young women and other AIAN-serving organization partners to develop a trusted, culturally grounded, and growing social media presence.
Qualitative research methods, including in-depth interviews, were used to identify important topics to urban AIAN young women in the mobile app and SM content. The presentation will explore the evolution of Native WYSE CHOICES SM content, the importance of partnering with other AIAN-serving organizations, and how to communicate with AIAN communities and build social connection. Additionally, this presentation will share lessons learned on communicating with and for multiple tribal communities. Tribal and Native-serving health professionals, organizations, and researchers can use similar SM methods as a tool to connect with AIAN youth and restore trust in research.
Communication and informatics Diversity and culture Public health or related research Social and behavioral sciences