Katie Azama, PhD, APRN, FNP-C, APHN
The Queen’s Medical Center
Native Hawaiian and Filipino Physician and Nurse Practitioner Burnout
Native Hawaiian (NH) and Filipino physicians and nurse practitioners (NPs) are at compounded risk for poor health outcomes, including cardiometabolic and mental illnesses. National organizations emphasize the importance of a multicultural healthcare workforce to address health disparities. Studies show that patient satisfaction is higher with ethnically concordant healthcare providers, and minority physicians are more likely to work in underserved communities. Despite their critical role in providing culturally appropriate care, NH and Filipino providers face high levels of burnout, exacerbated by the COVID-19 pandemic. This study will conduct a mixed-methods analysis on burnout among NH, Filipino, and White physicians and NPs at The Queen’s Medical Center, with the aim of developing strategies to mitigate burnout and improve workplace conditions.
Michiko Bruno, MD, Clinical Professor
The Queen’s Medical Center
Parkinson’s Improvement Activated by Hula Understanding (PAHU)
Parkinson’s Disease (PD) is a chronic progressive neurodegenerative disease that is the fastest-growing neurological disorder in the world and has no cure. As PD progresses, patients’ worsening motor function and physical disability are matched by worsening non-motor symptoms, such as cognitive decline, sleep disorders, constipation, orthostatic hypotension, and depression. Therapies to treat PD mainly ameliorate motor symptoms, with non-motor symptoms more refractory to medical treatment even as they have a greater impact on PD patients health-related quality of life (HRQOL). Numerous studies document the benefit of various exercise and dance programs to help the motor symptoms of PD. These programs – based on tango, waltz, foxtrot, and other forms of dance – have most commonly demonstrated improvements in motor functioning, including balance, walking speed and mobility, and may also have positive effects on HRQOL. However, adoption and maintenance of these programs remain a challenge, especially for minority populations and populations with limited access to health care. Hula, the traditional cultural dance of Hawaiʻi, connects Native Hawaiians to their language, history, and natural environment. The Native Hawaiian Health Affairs Program at The Queen’s Medical Center (QMC)/University of Hawaii John A Burns School of Medicine (JABSOM) has shown that hula is a culturally relevant, safe, and effective intervention to reduce cardiovascular risk. Hula holds promise as an intervention to improve motor and non-motor outcomes for patients with PD, including gait, balance, voice volume, cognitive function and psychological well-being.
The Parkinson’s and Movement Disorder Center and the Native Hawaiian Health Affairs Program at QMC will collaborate for this project to develop a Parkinson’s disease specific hula program though stakeholder interviews and collaboration with the “Dance for PD” program in New York. We will then conduct a pilot study to evaluate the feasibility of this novel intervention, a 3-month hula program Parkinson’s Disease (PD). Assessments will include patient retention, safety, resource needs, and staff workflow in anticipation of submitting a larger definitive NIH application.
Lori Daniels, PhD, Professor
Social Work – College of Liberal Arts, Hawaii Pacific University
Mo‘olelo: Life Review for Native Hawaiian Kūpuna
Native Hawaiian (NH) kūpuna provide knowledge of their people while maintaining family structures, community well-being, and the cultural fabric. Kūpuna also face mental health challenges, including severe depression and high life-time trauma exposure which may impede successful aging due to low self-regard, social isolation, anxiety, and grief. Yet, there are no existing traumatic stress interventions that address needs of NH kūpuna. Trauma experts have advocated for a full life span approach that encourages sharing stories, and gerontology experts have used facilitated life-review (LR) – an evidenced intervention that encourages personal reminiscing, overall self-reflection, and contributes to “successful aging” (i.e., positive self-concept, maintenance of social supports). Acknowledging the tradition of oral transmission by Hawaiian elders and in collaboration with kūpuna-centric programs on Oahu, our study will learn from NH kūpuna what values, beliefs, and practices can be applied towards developing a facilitated NH version of LR. We will use in-depth interviews and focus groups with NH kūpuna community members to explore the feasibility and acceptability of LR within the NH paradigm and determine whether an adaptation of an existing life review intervention is warranted. Our long-term goal is to develop an intervention that can be implemented as an age-appropriate and culturally relevant modality for older adult NH trauma survivors.
Kyoung Eun Lee, PhD, Associate Professor
Nancy Atmospera-Walch School of Nursing, University of Hawaii at Manoa
Culturally-tailored Community-based Prenatal Education for Filipino Immigrants
A significant portion of pregnant Filipino Immigrant Women (FIW) receive late or no prenatal care in Hawai’i, which can increase risks for perinatal health disparity. An increasing body of literature documents the effectiveness of Culturally-tailored Community-based Prenatal Education Programs (CCPEPs) in promoting perinatal health among underserved populations, especially immigrant women with language barriers, but those programs have never been pilot-tested among pregnant FIWs in Hawai’i. Therefore, this pilot study will fill the gap by examining the acceptability and feasibility of a CCPEP, specifically designed and developed for the FIW population in Hawai’i, as an effective intervention to improve perinatal care disparities among them.
Kelle Murphy, PhD, Associate Specialist
University of Hawaii at Manoa College of Education & Center on Disability Studies
Jeffrey Stern, PhD
Chaminade University of Honolulu and JABSOM Department of Pediatrics
Barriers to Behavioral Healthcare for ASD
BBHA is a set of questionnaires designed to examine barriers that families of children with ASD may experience when trying to access behavioral healthcare, such as diagnostic and treatment services. The project involves validating these questionnaires and identifying the needs of caregivers as they proceed from initial concern to seeking diagnosis, to seeking treatment services for their child. Results are expected to inform applications for additional funding to address identified barriers, such as language, transportation, and systemic marginalization.
Nicholas Schumann, PsyD, Assistant Professor
The Queen’s Medical Center, Trauma Department
Implementing a Contingency Management Program Addressing Methamphetamine Use For and With the People of Hawaii
In the State of Hawai‘i, up to 17,000 people or over 1% of the population use methamphetamine regularly, at more than double the national prevalence. This project aims to recruit traumatically injured participants from The Queen’s Medical Center, the sole Level I trauma center in the Pacific Basin who had positive urine drug screens for methamphetamine at the time of admission. Participants will be enrolled in a 12–week pilot behavioral treatment called Contingency Management, which offers rewards with real-world value in exchange for drug-negative urine specimens at discharge. Addressing the implementation gap and disseminating lessons learned from this pilot may change the way both academic and community centers in Hawaii treat patients struggling with methamphetamine use.