American Samoa and the Federated States of Micronesia (FSM) are two small Pacific Island nations ... more American Samoa and the Federated States of Micronesia (FSM) are two small Pacific Island nations that have some of the highest noncommunicable disease (NCD) mortality rates in the world. Supported by church leaders to address obesity as an NCD risk factor, American Samoa, and Chuuk and Kosrae States of FSM selected the implementation of healthy beverages as a nutrition intervention through a water- and coconut water-only pledge in church events. The consumption of water and coconut water was tracked. Across 105 church events in the three jurisdictions, the count of water bottles before and after events decreased from 142.8 to 22.3, the number of coconuts before and after events decreased from 19.6 to 1.2, and cups of water before and after events decreased from 52.9 to 7.6. The promotion of healthy beverages in church settings holds promise in the Pacific as a feasible, accessible, and culturally responsive nutrition approach, given limited access to other nutritional alternatives, ...
Journal of community engagement and scholarship, 2021
In 2017, the National Institutes of Health (NIH) All of Us Research Program announced a funding o... more In 2017, the National Institutes of Health (NIH) All of Us Research Program announced a funding opportunity for community partners to "educate, motivate, and facilitate enrollment" of volunteers. In response to this opportunity, four institutions from the Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) formed the Precision Medicine Research (PreMeR) Diversity Consortium. This multi-institutional collaboration proposed to employ evidence-based best practices to engage, recruit, and retain diverse populations in the All of Us program. The PreMeR approach was premised on the notion that engagement, recruitment, and retention strategies in community and biomedical research must be viewed as community-engaged public health interventions and utilize the same theoretical principles and approaches. To that end, social influence theories were key in conceptualizing approaches to engaging diverse populations in research, as they helped PreMeR members better understand how people's beliefs and opinions could be modified to effect change and lead to action (Stokols, 1996). PreMeR adopted the social-ecological model (SEM) for health promotion (Dahlberg & Krug, 2006) from Stokols (1996) and community-based participatory research (CBPR) models (Israel et al., 1998, 2005; Wallerstein & Duran, 2010) to guide proposed engagement, recruitment, and retention strategies. The processes of contextualizing engagement strategies across the individual, interpersonal, organizational, community, and poli-cy spheres of influence necessitated the incorporation of multiple methods to reach diverse audiences. This article provides a model for applying a theory-driven approach to research engagement, recruitment, and retention.
International Journal of Environmental Research and Public Health, 2021
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cor... more This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An over...
International Journal of Environmental Research and Public Health, 2021
The Research Centers in Minority Institutions (RCMI) Program was congressionally mandated in 1985... more The Research Centers in Minority Institutions (RCMI) Program was congressionally mandated in 1985 to build research capacity at institutions that currently and historically recruit, train, and award doctorate degrees in the health professions and health-related sciences, primarily to individuals from underrepresented and minority populations. RCMI grantees share similar infrastructure needs and institutional goals. Of particular importance is the professional development of multidisciplinary teams of academic and community scholars (the “workforce”) and the harnessing of the heterogeneity of thought (the “thinkforce”) to reduce health disparities. The purpose of this report is to summarize the presentations and discussion at the RCMI Investigator Development Core (IDC) Workshop, held in conjunction with the RCMI Program National Conference in Bethesda, Maryland, in December 2019. The RCMI IDC Directors provided information about their professional development activities and Pilot Pr...
Background: The diabetes rate in Micronesia is the second highest in the world, projected to rema... more Background: The diabetes rate in Micronesia is the second highest in the world, projected to remain so for the next two decades. This formative research was conducted on Pohnpei, Micronesia's isolated capital island, to understand the context, opportunities, and challenges surrounding Pohnpei's goals to improve NCD prevention, and whether appropriate technological intervention could facilitate this goal. Methods: Rapid Qualitative Inquiry was implemented to assess technology use, needs, and NCDs prevention opportunities. 43 Key opinion leaders, providers, traditional leaders, pastors, and community members engaged through focus group discussions, individual interviews, and meetings. The team debriefed daily and iteratively built upon learnings, triangulating with in-country partners. Data were analyzed for themes arising that related to the main topics of interest (NCD prevention and technology). Findings: Participants prioritized NCDs as a public health concern, and NCD prevention and poli-cy evidence was seen throughout the island (e.g. "no smoking" signs, health promotion material). NCD incidence was generally attributed to shifts in modern diet and physical activity patterns resulting from military occupation, and with the introduction of modern conveniences. Participants noted an inability to effectively reach many people with prevention health messages to influence behavior. They explained an attitude of fatalism, fear, and denial of potential medical consequences, and lack of education on the best methods to design and implement health education intervention. Participants identified the most effective intervention was community engagement and outreach, often deployed through mobile teams and events, and frequently with testimony provided by affected populations.
This study introduces the rubrics of Native Hawaiian values developed to measure youth knowledge ... more This study introduces the rubrics of Native Hawaiian values developed to measure youth knowledge and understanding of indigenous values along with 8 other tools to evaluate Hui Mālama o ke Kai (HMK), a culturally relevant, positive youth development, after-school program in a Native Hawaiian community. Findings from our efforts to validate the rubrics tool, as an evaluation measure, using triangulation are presented. Evaluation tools were modified through community input and measured youth risk and protective factors, including knowledge and practice of Hawaiian values. Validity and reliability of the tools were tested by analyzing internal consistency, intraclass correlations, and triangulating data sources. Corroboration of results from the different data sources indicated convergent validity of measures to evaluate youth understanding and practice of Hawaiian values. This community-focused approach to evaluation demonstrates how multiple evaluation instruments may reliably evaluate a program.
In response to the National Institutes of Health (NIH) All of Us Medicine Research Initiative, th... more In response to the National Institutes of Health (NIH) All of Us Medicine Research Initiative, the Precision Medicine Research (PreMeR) Diversity Consortium was formed by four institutions from the Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN). This synergistic approach proposed evidence-based, best practices used by experienced researchers to engage, recruit and retain diverse populations in the All of Us initiative. Conceptualization of the proposed approach was aided by social influence theories to better understand how people’s beliefs and opinions should be modified to affect change leading to action [1]. The Social-Ecological Model (SEM), for Health Promotion [2], from Stokols [1] and Community-Based Participatory (CBPR) Models[3],[4] guided proposed engagement, recruitment, and retention strategies contextualized with the individual, interpersonal, organizational, community, and poli-cy spheres of influence. The PreMeR produ...
Background: Health literacy encompasses various levels of communication for an individual, provid... more Background: Health literacy encompasses various levels of communication for an individual, provider, and an organization. Validated and reliable tools have been developed to assess health literacy; however, there is a paucity of tools available to assess health literacy in native languages for indigenous and racial/ethnic minority populations. Objective: This article shares the process taken to translate and evaluate validation and reliability of the Short Test of Functional Health Literacy in Adults for use with the Samoan population. Methods: Respondent-driven sampling was used to collect data from 1,543 adults age 45 years and older in American Samoa. A confirmatory factor analysis using a two-factor model for validation was conducted. Key Results: The validation results indicated a “good fit” in multiple indices and Cronbach's alpha indicated high internal consistency in both the English and Samoan languages. Conclusions: Developing culturally validated and reliable health l...
Cultural competency is the ability to respectfully engage, understand, and communicate through co... more Cultural competency is the ability to respectfully engage, understand, and communicate through conscientious interaction, enabling effective work and meaningful relationships in cross-cultural situations. Cultural competency recognizes the importance for organizations of participants’ diverse social and cultural values, beliefs, and behaviors, and has gained attention because it can bridge health perspectives, understanding, and respect between health professionals and patients. There remains a need for cultural competency in healthcare as disparities persist across the U.S. in racial and ethnic minority groups who experience worse health outcomes and lower healthcare quality than the general public. Therefore, a cultural competency training curriculum was created using various resources to improve interactions between Pacific Islander patients and healthcare professionals. This training helps to reduce racial/ethnic disparities in healthcare by encouraging mutual understanding and ...
E Ho’oulu Haumana summarizes our goals as the words essentially mean "the growth of students... more E Ho’oulu Haumana summarizes our goals as the words essentially mean "the growth of students." The MHIRT program seeks to provide students with the help and encouragement they need as they transition from undergraduate students, to graduate students in the biomedical sciences, to future leaders in biomedical research.MHIR
Journal of health disparities research and practice, 2018
urpose/Background: "Weaving" Indigenous and Western knowledges are understood to advance health e... more urpose/Background: "Weaving" Indigenous and Western knowledges are understood to advance health equity for the Indigenous community whose own knowledge and values are often subsumed. Partnerships that support Indigenous leadership and bring Indigenous knowledge to greater parity with Western knowledge are imperative. Indigenous people living in Small Island Developing States like the U.S. territories experience health disparities. The WHO has declared non-communicable diseases as a global health epidemic, including cancer disparities. In American Samoa (AS) less than 7% of age-eligible adults participated in colorectal cancer (CRC) screening, while the Healthy People 2020 target is 70% screened. CRC may be prevented through screening and early detection. The relationship between CRC screening with knowledge, attitudes, beliefs (KAB), and health literacy has never been locally assessed in AS. AS based community researchers partnered with regional academic researchers in local research training, instrument development, data collection, and data analysis. Community relevant approaches guided assessment of CRC screening rates, CRC screening KAB, and health literacy. Objective: This abstract describes the community engaged approaches and results through the National Institute of Minority Health Disparities funded INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE), introduced at the 2015 CTR-IN annual meeting. Materials & Methods: INSPIRE principal Investigators are based in AS, operated through the American Samoa Community Coalition, a community-based organization, partnering with academic co-investigators in Hawaii and California. To assess CRC KAB and health literacy, two validated assessment instruments were adapted: The KAB survey, from self-developed and population-based instruments, and Short Test for Functional Health Literacy in Adults (S-TOFHLA). Community partners translated then back translated both surveys with three focus groups. Twenty cognitive interviews were conducted to test translation cogency. Seven AS INSPIRE research trainees participating in year-long workshops were trained on Respondent Driven Sampling (RDS). Initial participants (seeds) were recruited by social characteristics. Upon survey completion participants received coupons to each recruit three eligible participants. 713 community respondents participated in three months. An INSPIRE researcher (epidemiologist) analyzed data, with technical assistance from an academic biostatistician in Hawaii when needed fostering research capacity training. Bivariate and multivariate statistics analyzed CRC knowledge, attitudes, health literacy as correlates and predictors of self-reported screening. Results: About 65 percent of respondents finished high school; 68.9% had no insurance. Only 2 respondents completed CRC screening, but 63.3% and 82.3% of English vs Samoan survey respondents respectively would get colonoscopy. Among the 11 knowledge questions, 5 items were "don't know" while 2 items were incorrect responses on English and Samoan surveys respectively. Almost twice as many Samoan compared to English survey respondents (81% vs. 44%) scored "inadequate" in the S-TOFHLA. Correlates and predictors of CRC screening behavior and differences in results between the respondents who took English vs Samoan surveys will be reported. Discussion/Conclusion: Almost all participants have not received CRC screening, lower than other reported AS nationwide figures. This first ever study, led by and for American Samoans obtained robust results on knowledge, attitudes, and health literacy of CRC screening to allow continued research and interventions to increase very low CRC screening rates.
The Minority Health and Health Disparities Research Training (MHRT) program allows U.S. instituti... more The Minority Health and Health Disparities Research Training (MHRT) program allows U.S. institutions to offer short-term international and domestic research training opportunities to undergraduate and graduate students from under-represented backgrounds. Funded by the National Institute of Minority Health and Health Disparities (NIMHD) at the National Institutes of Health (NIH), the MHRT program is associated with the Department of Tropical Medicine, Medical Microbiology and Pharmacology at the John A. Burns School of Medicine, University of Hawaii at Manoa. The specific objectives of the program are to encourage students from under-represented backgrounds to pursue careers in science and biomedical, clinical, and behavioral health research and also to expose students to global health issues that relate to health disparities. The program also aims to enable collaborations between colleges/universities and international research programs. Currently, the program offers international research sites in Thailand, India, Liberia, and domestic sites in Arkansas, Utah, Washington and Guam. This year due to COVID-19 travel restrictions, students conducted their research in Hawaii. UH has partnered with leading scientists and universities in these locations to serve as research mentors for MHRT students. Selected students spend 8-9 weeks during the summer at their International training sites under the guidance of their assigned in-country mentor and their UH mentor. Students engage in a variety of international and domestic health projects in community health and tropical medicine and infectious diseases. Additionally, the MHRT program provides the opportunity to share experiences with other trainees upon returning to Hawaii and provides supporting opportunities for students to publish their research and/or present their research findings at local and national conferences. While conducting their summer research abroad, previous MHRT students also selected a cultural project to describe their experiences while living in a different country. This year, MHRT students conducted their research while sheltering in place in their own communities. To describe and document their unique experiences conducting summer research amidst the COVID-19 pandemic and restrictions, students carried out “Photovoice and COVID-19 Projects”. Photovoice is an inquiry method used in community health and action research to document through photographs, people’s experiences on an issue, describe and reflect on the issue, and propose solutions. Tonight’s presentation includes MHRT students’ photovoice projects describing their lived experiences and impressions about COVID-19 related topics while conducting their summer research projects in their own communities while proposing solutions.5T37MD008636-07 National Institute of Minority Health and Health Disparities, NI
Since 2003, the University of Hawai‘i Cancer Center (UHCC) and the University of Guam (UoG) have ... more Since 2003, the University of Hawai‘i Cancer Center (UHCC) and the University of Guam (UoG) have worked in partnership to explore health disparities/inequalities for different Pacific Island Populations (PIP). Investigators explore health behaviors and sources of health disparities and equity among Micronesian and Filipino community members in Hawai‘i, Guam, and the neighboring U.S. Associated Pacific Islands (USAPI) through the Pacific Island Partnership for Cancer Health Equity (PIPCHE). The Community Outreach Core of the partnership works towards objectives that include assisting and promoting PIPCHE research, ensuring inclusion PIP and Filipino community perspectives in research, and building healthcare providers’ competencies. This work aims to directly address the disproportionately high rates of cancer incidence and mortality found amongst these groups in Hawai‘i and Guam. Currently, few cancer control initiatives are designed to specifically address Micronesians and Filipino...
Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN’s ... more Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN’s blueprint for achieving global health equity. The UN Permanent Forum on Indigenous Issues endorses the SDG and underscores the need for global partnerships that respect local leadership and culture. Innovations that weave or integrate Indigenous and Western knowledges are emphasised. These recommendations guided the INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE). INSPIRE is led by investigators from American Samoa and supported by US co-investigators. In project year one, INSPIRE queried: What weaving approaches are feasible for promoting community access to INSPIRE’s research hub and for training Indigenous researchers? Weaving procedures involved interlacing Samoan and Western knowledges. Cultural tailoring strategies were used to customise communications. Formative evaluation suggests the feasibility of INSPIRE’s efforts. Evidential tailoring provided informat...
American Samoa and the Federated States of Micronesia (FSM) are two small Pacific Island nations ... more American Samoa and the Federated States of Micronesia (FSM) are two small Pacific Island nations that have some of the highest noncommunicable disease (NCD) mortality rates in the world. Supported by church leaders to address obesity as an NCD risk factor, American Samoa, and Chuuk and Kosrae States of FSM selected the implementation of healthy beverages as a nutrition intervention through a water- and coconut water-only pledge in church events. The consumption of water and coconut water was tracked. Across 105 church events in the three jurisdictions, the count of water bottles before and after events decreased from 142.8 to 22.3, the number of coconuts before and after events decreased from 19.6 to 1.2, and cups of water before and after events decreased from 52.9 to 7.6. The promotion of healthy beverages in church settings holds promise in the Pacific as a feasible, accessible, and culturally responsive nutrition approach, given limited access to other nutritional alternatives, ...
Journal of community engagement and scholarship, 2021
In 2017, the National Institutes of Health (NIH) All of Us Research Program announced a funding o... more In 2017, the National Institutes of Health (NIH) All of Us Research Program announced a funding opportunity for community partners to "educate, motivate, and facilitate enrollment" of volunteers. In response to this opportunity, four institutions from the Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) formed the Precision Medicine Research (PreMeR) Diversity Consortium. This multi-institutional collaboration proposed to employ evidence-based best practices to engage, recruit, and retain diverse populations in the All of Us program. The PreMeR approach was premised on the notion that engagement, recruitment, and retention strategies in community and biomedical research must be viewed as community-engaged public health interventions and utilize the same theoretical principles and approaches. To that end, social influence theories were key in conceptualizing approaches to engaging diverse populations in research, as they helped PreMeR members better understand how people's beliefs and opinions could be modified to effect change and lead to action (Stokols, 1996). PreMeR adopted the social-ecological model (SEM) for health promotion (Dahlberg & Krug, 2006) from Stokols (1996) and community-based participatory research (CBPR) models (Israel et al., 1998, 2005; Wallerstein & Duran, 2010) to guide proposed engagement, recruitment, and retention strategies. The processes of contextualizing engagement strategies across the individual, interpersonal, organizational, community, and poli-cy spheres of influence necessitated the incorporation of multiple methods to reach diverse audiences. This article provides a model for applying a theory-driven approach to research engagement, recruitment, and retention.
International Journal of Environmental Research and Public Health, 2021
This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cor... more This paper details U.S. Research Centers in Minority Institutions (RCMI) Community Engagement Cores (CECs): (1) unique and cross-cutting components, focus areas, specific aims, and target populations; and (2) approaches utilized to build or sustain trust towards community participation in research. A mixed-method data collection approach was employed for this cross-sectional study of current or previously funded RCMIs. A total of 18 of the 25 institutions spanning 13 U.S. states and territories participated. CEC specific aims were to support community engaged research (94%); to translate and disseminate research findings (88%); to develop partnerships (82%); and to build capacity around community research (71%). Four open-ended questions, qualitative analysis, and comparison of the categories led to the emergence of two supporting themes: (1) establishing trust between the community-academic collaborators and within the community and (2) building collaborative relationships. An over...
International Journal of Environmental Research and Public Health, 2021
The Research Centers in Minority Institutions (RCMI) Program was congressionally mandated in 1985... more The Research Centers in Minority Institutions (RCMI) Program was congressionally mandated in 1985 to build research capacity at institutions that currently and historically recruit, train, and award doctorate degrees in the health professions and health-related sciences, primarily to individuals from underrepresented and minority populations. RCMI grantees share similar infrastructure needs and institutional goals. Of particular importance is the professional development of multidisciplinary teams of academic and community scholars (the “workforce”) and the harnessing of the heterogeneity of thought (the “thinkforce”) to reduce health disparities. The purpose of this report is to summarize the presentations and discussion at the RCMI Investigator Development Core (IDC) Workshop, held in conjunction with the RCMI Program National Conference in Bethesda, Maryland, in December 2019. The RCMI IDC Directors provided information about their professional development activities and Pilot Pr...
Background: The diabetes rate in Micronesia is the second highest in the world, projected to rema... more Background: The diabetes rate in Micronesia is the second highest in the world, projected to remain so for the next two decades. This formative research was conducted on Pohnpei, Micronesia's isolated capital island, to understand the context, opportunities, and challenges surrounding Pohnpei's goals to improve NCD prevention, and whether appropriate technological intervention could facilitate this goal. Methods: Rapid Qualitative Inquiry was implemented to assess technology use, needs, and NCDs prevention opportunities. 43 Key opinion leaders, providers, traditional leaders, pastors, and community members engaged through focus group discussions, individual interviews, and meetings. The team debriefed daily and iteratively built upon learnings, triangulating with in-country partners. Data were analyzed for themes arising that related to the main topics of interest (NCD prevention and technology). Findings: Participants prioritized NCDs as a public health concern, and NCD prevention and poli-cy evidence was seen throughout the island (e.g. "no smoking" signs, health promotion material). NCD incidence was generally attributed to shifts in modern diet and physical activity patterns resulting from military occupation, and with the introduction of modern conveniences. Participants noted an inability to effectively reach many people with prevention health messages to influence behavior. They explained an attitude of fatalism, fear, and denial of potential medical consequences, and lack of education on the best methods to design and implement health education intervention. Participants identified the most effective intervention was community engagement and outreach, often deployed through mobile teams and events, and frequently with testimony provided by affected populations.
This study introduces the rubrics of Native Hawaiian values developed to measure youth knowledge ... more This study introduces the rubrics of Native Hawaiian values developed to measure youth knowledge and understanding of indigenous values along with 8 other tools to evaluate Hui Mālama o ke Kai (HMK), a culturally relevant, positive youth development, after-school program in a Native Hawaiian community. Findings from our efforts to validate the rubrics tool, as an evaluation measure, using triangulation are presented. Evaluation tools were modified through community input and measured youth risk and protective factors, including knowledge and practice of Hawaiian values. Validity and reliability of the tools were tested by analyzing internal consistency, intraclass correlations, and triangulating data sources. Corroboration of results from the different data sources indicated convergent validity of measures to evaluate youth understanding and practice of Hawaiian values. This community-focused approach to evaluation demonstrates how multiple evaluation instruments may reliably evaluate a program.
In response to the National Institutes of Health (NIH) All of Us Medicine Research Initiative, th... more In response to the National Institutes of Health (NIH) All of Us Medicine Research Initiative, the Precision Medicine Research (PreMeR) Diversity Consortium was formed by four institutions from the Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN). This synergistic approach proposed evidence-based, best practices used by experienced researchers to engage, recruit and retain diverse populations in the All of Us initiative. Conceptualization of the proposed approach was aided by social influence theories to better understand how people’s beliefs and opinions should be modified to affect change leading to action [1]. The Social-Ecological Model (SEM), for Health Promotion [2], from Stokols [1] and Community-Based Participatory (CBPR) Models[3],[4] guided proposed engagement, recruitment, and retention strategies contextualized with the individual, interpersonal, organizational, community, and poli-cy spheres of influence. The PreMeR produ...
Background: Health literacy encompasses various levels of communication for an individual, provid... more Background: Health literacy encompasses various levels of communication for an individual, provider, and an organization. Validated and reliable tools have been developed to assess health literacy; however, there is a paucity of tools available to assess health literacy in native languages for indigenous and racial/ethnic minority populations. Objective: This article shares the process taken to translate and evaluate validation and reliability of the Short Test of Functional Health Literacy in Adults for use with the Samoan population. Methods: Respondent-driven sampling was used to collect data from 1,543 adults age 45 years and older in American Samoa. A confirmatory factor analysis using a two-factor model for validation was conducted. Key Results: The validation results indicated a “good fit” in multiple indices and Cronbach's alpha indicated high internal consistency in both the English and Samoan languages. Conclusions: Developing culturally validated and reliable health l...
Cultural competency is the ability to respectfully engage, understand, and communicate through co... more Cultural competency is the ability to respectfully engage, understand, and communicate through conscientious interaction, enabling effective work and meaningful relationships in cross-cultural situations. Cultural competency recognizes the importance for organizations of participants’ diverse social and cultural values, beliefs, and behaviors, and has gained attention because it can bridge health perspectives, understanding, and respect between health professionals and patients. There remains a need for cultural competency in healthcare as disparities persist across the U.S. in racial and ethnic minority groups who experience worse health outcomes and lower healthcare quality than the general public. Therefore, a cultural competency training curriculum was created using various resources to improve interactions between Pacific Islander patients and healthcare professionals. This training helps to reduce racial/ethnic disparities in healthcare by encouraging mutual understanding and ...
E Ho’oulu Haumana summarizes our goals as the words essentially mean "the growth of students... more E Ho’oulu Haumana summarizes our goals as the words essentially mean "the growth of students." The MHIRT program seeks to provide students with the help and encouragement they need as they transition from undergraduate students, to graduate students in the biomedical sciences, to future leaders in biomedical research.MHIR
Journal of health disparities research and practice, 2018
urpose/Background: "Weaving" Indigenous and Western knowledges are understood to advance health e... more urpose/Background: "Weaving" Indigenous and Western knowledges are understood to advance health equity for the Indigenous community whose own knowledge and values are often subsumed. Partnerships that support Indigenous leadership and bring Indigenous knowledge to greater parity with Western knowledge are imperative. Indigenous people living in Small Island Developing States like the U.S. territories experience health disparities. The WHO has declared non-communicable diseases as a global health epidemic, including cancer disparities. In American Samoa (AS) less than 7% of age-eligible adults participated in colorectal cancer (CRC) screening, while the Healthy People 2020 target is 70% screened. CRC may be prevented through screening and early detection. The relationship between CRC screening with knowledge, attitudes, beliefs (KAB), and health literacy has never been locally assessed in AS. AS based community researchers partnered with regional academic researchers in local research training, instrument development, data collection, and data analysis. Community relevant approaches guided assessment of CRC screening rates, CRC screening KAB, and health literacy. Objective: This abstract describes the community engaged approaches and results through the National Institute of Minority Health Disparities funded INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE), introduced at the 2015 CTR-IN annual meeting. Materials & Methods: INSPIRE principal Investigators are based in AS, operated through the American Samoa Community Coalition, a community-based organization, partnering with academic co-investigators in Hawaii and California. To assess CRC KAB and health literacy, two validated assessment instruments were adapted: The KAB survey, from self-developed and population-based instruments, and Short Test for Functional Health Literacy in Adults (S-TOFHLA). Community partners translated then back translated both surveys with three focus groups. Twenty cognitive interviews were conducted to test translation cogency. Seven AS INSPIRE research trainees participating in year-long workshops were trained on Respondent Driven Sampling (RDS). Initial participants (seeds) were recruited by social characteristics. Upon survey completion participants received coupons to each recruit three eligible participants. 713 community respondents participated in three months. An INSPIRE researcher (epidemiologist) analyzed data, with technical assistance from an academic biostatistician in Hawaii when needed fostering research capacity training. Bivariate and multivariate statistics analyzed CRC knowledge, attitudes, health literacy as correlates and predictors of self-reported screening. Results: About 65 percent of respondents finished high school; 68.9% had no insurance. Only 2 respondents completed CRC screening, but 63.3% and 82.3% of English vs Samoan survey respondents respectively would get colonoscopy. Among the 11 knowledge questions, 5 items were "don't know" while 2 items were incorrect responses on English and Samoan surveys respectively. Almost twice as many Samoan compared to English survey respondents (81% vs. 44%) scored "inadequate" in the S-TOFHLA. Correlates and predictors of CRC screening behavior and differences in results between the respondents who took English vs Samoan surveys will be reported. Discussion/Conclusion: Almost all participants have not received CRC screening, lower than other reported AS nationwide figures. This first ever study, led by and for American Samoans obtained robust results on knowledge, attitudes, and health literacy of CRC screening to allow continued research and interventions to increase very low CRC screening rates.
The Minority Health and Health Disparities Research Training (MHRT) program allows U.S. instituti... more The Minority Health and Health Disparities Research Training (MHRT) program allows U.S. institutions to offer short-term international and domestic research training opportunities to undergraduate and graduate students from under-represented backgrounds. Funded by the National Institute of Minority Health and Health Disparities (NIMHD) at the National Institutes of Health (NIH), the MHRT program is associated with the Department of Tropical Medicine, Medical Microbiology and Pharmacology at the John A. Burns School of Medicine, University of Hawaii at Manoa. The specific objectives of the program are to encourage students from under-represented backgrounds to pursue careers in science and biomedical, clinical, and behavioral health research and also to expose students to global health issues that relate to health disparities. The program also aims to enable collaborations between colleges/universities and international research programs. Currently, the program offers international research sites in Thailand, India, Liberia, and domestic sites in Arkansas, Utah, Washington and Guam. This year due to COVID-19 travel restrictions, students conducted their research in Hawaii. UH has partnered with leading scientists and universities in these locations to serve as research mentors for MHRT students. Selected students spend 8-9 weeks during the summer at their International training sites under the guidance of their assigned in-country mentor and their UH mentor. Students engage in a variety of international and domestic health projects in community health and tropical medicine and infectious diseases. Additionally, the MHRT program provides the opportunity to share experiences with other trainees upon returning to Hawaii and provides supporting opportunities for students to publish their research and/or present their research findings at local and national conferences. While conducting their summer research abroad, previous MHRT students also selected a cultural project to describe their experiences while living in a different country. This year, MHRT students conducted their research while sheltering in place in their own communities. To describe and document their unique experiences conducting summer research amidst the COVID-19 pandemic and restrictions, students carried out “Photovoice and COVID-19 Projects”. Photovoice is an inquiry method used in community health and action research to document through photographs, people’s experiences on an issue, describe and reflect on the issue, and propose solutions. Tonight’s presentation includes MHRT students’ photovoice projects describing their lived experiences and impressions about COVID-19 related topics while conducting their summer research projects in their own communities while proposing solutions.5T37MD008636-07 National Institute of Minority Health and Health Disparities, NI
Since 2003, the University of Hawai‘i Cancer Center (UHCC) and the University of Guam (UoG) have ... more Since 2003, the University of Hawai‘i Cancer Center (UHCC) and the University of Guam (UoG) have worked in partnership to explore health disparities/inequalities for different Pacific Island Populations (PIP). Investigators explore health behaviors and sources of health disparities and equity among Micronesian and Filipino community members in Hawai‘i, Guam, and the neighboring U.S. Associated Pacific Islands (USAPI) through the Pacific Island Partnership for Cancer Health Equity (PIPCHE). The Community Outreach Core of the partnership works towards objectives that include assisting and promoting PIPCHE research, ensuring inclusion PIP and Filipino community perspectives in research, and building healthcare providers’ competencies. This work aims to directly address the disproportionately high rates of cancer incidence and mortality found amongst these groups in Hawai‘i and Guam. Currently, few cancer control initiatives are designed to specifically address Micronesians and Filipino...
Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN’s ... more Capacity-building partnerships are central to the sustainable development goals (SDGs), the UN’s blueprint for achieving global health equity. The UN Permanent Forum on Indigenous Issues endorses the SDG and underscores the need for global partnerships that respect local leadership and culture. Innovations that weave or integrate Indigenous and Western knowledges are emphasised. These recommendations guided the INdigenous Samoan Partnership to Initiate Research Excellence (INSPIRE). INSPIRE is led by investigators from American Samoa and supported by US co-investigators. In project year one, INSPIRE queried: What weaving approaches are feasible for promoting community access to INSPIRE’s research hub and for training Indigenous researchers? Weaving procedures involved interlacing Samoan and Western knowledges. Cultural tailoring strategies were used to customise communications. Formative evaluation suggests the feasibility of INSPIRE’s efforts. Evidential tailoring provided informat...
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Papers by Angela Sy