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Mauli ola, optimal health and wellbeing from a Hawaiian perspective, is achieved by being pono, or morally just and upright, and maintaining an intricate balance physically, mentally, spiritually, and emotionally through one's relations. Cultural practices, including practices that foster a connection to the water, land, ocean, and natural environment, may serve as protective and resilience factors, thereby promoting health and wellbeing. This paper starts by sharing the genealogical foundations of cultural practices in Hawai'i as the foundations of Native Hawaiian lifestyles and ways of knowing. The paper proceeds with data analyses that aim to better understand the role of cultural practices in relation to connectedness to 'Āina (the land, nature, and the environment, which nourish our bodies) and Native Hawaiian health based on cross-sectional correlations and qualitative data. The findings demonstrate the importance of cultural practices, specifically 'Āina practices, and identify 'Āina protection, restoration, and conservation as major health priorities. The correlations demonstrate statistically significant relationships between cultural practices; a physical, mental, spiritual, and emotional connection to 'Āina; and health outcomes. These findings continue to support literature and other declarations that support healthcare and medicine that are culturally grounded in Indigenous values and traditional systems of medicine. [ABSTRACT FROM AUTHOR]

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 Waim ānalo 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. [ABSTRACT FROM AUTHOR]

Living in one of the most remote island chains in the world, Native Hawaiians developed sophisticated food cultivation systems that sustained a thriving and robust population for centuries. These systems were disrupted by colonization, which has contributed to the health disparities that Native Hawaiians face today. MALAMA, a culturally grounded backyard aquaponics program, was developed to promote food sovereignty among Native Hawaiians. This study utilized participant interview and focus group data to identify how participating in the MALAMA program impacts the wellbeing. The findings demonstrate that MALAMA enhanced the participants' pilina (relationship, connection) to traditional foods, land, cultural identity, family, and community, which contributed to the quick adoption of the program into Native Hawaiian communities. To address food insecurity, it is imperative to seek Indigenous-developed, community-based, and culturally grounded programs and solutions like the MALAMA program. [ABSTRACT FROM AUTHOR]

Schools are an ideal setting for asthma education programs as they can reach many children. However, it is unknown if school-based asthma education programs in the United States (US) reduce acute care services. This scoping review sought to identify whether school-based asthma education programs lead to improved acute care services. Overall, the evidence provides provisional support that school-based asthma education programs can reduce acute care utilization and may be a potential treatment intervention. Future research is needed to determine more definitive conclusions about the effectiveness of school-based asthma education programs and which components yield significant changes. [ABSTRACT FROM AUTHOR]

Prior to western arrival in 1778, Native Hawaiians possessed a sophisticated culture and resource management system conducive to an island ecosystem. However, disenfranchisement from ancestral lands and traditional food sources as a result of colonization led to Native Hawaiians being forced to abandon many of their traditional practices. Today, many Native Hawaiians experience food insecurity, placing them at further risk for obesity and other nutrition-related chronic diseases. Consequently, there is a growing need for place-based and culturally relevant strategies rooted in Hawaiian epistemology to address these issues. This paper describes the history and development of one such intervention - the MALAMA study - in the community of Waimānalo that innovatively merges the modern technology of aquaponics with traditional Native Hawaiian practices and values. [ABSTRACT FROM AUTHOR]

The Brief COPE (Coping Orientation to Problems Experienced) Inventory is a standardized and widely used scale that enables researchers to measure coping responses of persons in relation to stressors. The psychometric properties of this scale, however, have not been assessed for communities in Hawai'i. This study investigated the psychometric properties of the Brief COPE for diverse women from a rural community on the island of O'ahu in Hawai'i. This study was conducted in a federally qualified health center (FQHC) with 161 women who were of a childbearing age between the ages of 18 to 38 years. Contrary to previous research, the factor structure of the final model suggested six factors: Behavioral Disengagement, Denial, Venting, and Self-Blame; Action Coping, Positive Reframing, Acceptance, and Planning; Humor; Substance Use; Social Support; and Religion. The final model demonstrated good model fit with an RMSEA of .07 and CFI of .95. The reduced factor structure may be a more robust measure of coping strategies, which may allow for better resources and interventions that adequately address the way women of childbearing ages from rural communities respond to stressful situations. Exploring coping mechanisms of diverse women will better our understanding of the way people respond to stress and develop strengths and mechanisms that mediate stressors including those that are linked to social and cultural determinants of health. Findings from this study may also inform future research and policy that aim to foster coping, and thus, resiliency of diverse women, particularly in rural settings.

Kānaka Maoli (Native Hawaiian) worldviews of health emphasize pono (righteousness) and lōkahi (balance), which extends to include relationships with other people, akua (spiritual realm), and 'āina (land). The purpose of this qualitative study was to explore the role of 'āina and 'āina connection in health and resilience based on the perspectives of 12 Kānaka Maoli adults from the Waimānalo community. Three major themes were identified: 'Āina is everything, 'āina is health, and community healing through community-led initiatives. A better understanding of 'āina connection is important to improve our knowledge of Hawaiian health. A connection to 'āina may specifically address health concerns resulting from historical trauma and environmental changes.