Scott K. Okamoto’s research while affiliated with Honolulu University and other places

Background To promote caregiver health and reduce burden, the Savvy Caregiver Program (SCP), an evidence‐based caregiving intervention, was adapted with a Native Hawaiian (NH) community in Hawaiʻi. The adaptation process occurred prior to pilot testing in two phases: 1) the preliminary adaptation by a community action board (CAB) and mentorship team and 2) pre‐pilot testing and expert validation with NH adults. The preliminary adaptation, titled ʻAuamo Kuleana O Nā Maʻi Poina (ʻAuamo Kuleana), aimed to include Hawaiian values, language, proverbs, and culturally relevant examples while maintaining the core components of the program. The CAB also created new videos with cultural foods, mirroring the existing training videos. To continue refining the adapted program prior to pilot testing, we pre‐piloted the curriculum and invited participants to describe their experiences and provide feedback. Method Individuals who participated in the 7‐week pre‐pilot of ʻAuamo Kuleana (n = 6) were asked to complete a focus group or interview to share their experiences and provide feedback. The CAB was invited to analyze the qualitative data using thematic analysis. Result Five pre‐pilot participants attended a focus group or interview. Only one participant was actively providing care, the other participants were interested in proactive training to support their community. This was a common theme: caring as a community. Participants shared positive feedback about the program; most participants attended all sessions and read the caregiver manual. All participants preferred to meet in‐person and appreciated the revised curriculum. Two suggestions emerged: include all family members in the program to be in alignment as a ʻohana (family) in providing care; and add information about planning for their own care. Conclusion There were high rates of satisfaction and engagement and the pilot test of ʻAuamo Kuleana proceeded without additional changes. The suggested changes from the pre‐pilot required modifications to program core components and were not incorporated at this stage. However, it may be important to consider how to incorporate cultural aspects of caring, like participants' interest in proactively learning about dementia and caregiving, caring as a community, and family‐centered caregiving (rather than dyadic caregiving), in future caregiving interventions co‐created with the NH community.

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.

Introduction: We aimed to describe the health and well-being of family caregivers of Native Hawaiian and Pacific Islander (NHPI) adults living with Alzheimer's disease and related dementias (ADRD), explore cultural values related to caregiving, and characterize barriers and facilitators to their health and well-being. Methodology: Caregivers of NHPIs living with ADRD were recruited from across the United States to complete a multimethod study including a survey followed by an interview about their health and well-being. Results: Eleven participants completed surveys, six of whom completed an interview. Themes included caring as a community, lōkahi (balance), and the importance of sleep, food, and physical activity. Cultural values included connection to cultural practices, kūpuna (elders) as cultural knowledge holders, and the kuleana (responsibility) of caregiving. Discussion: Caregiving for an NHPI adult living with ADRD occurs beyond the dyad, and is a matter of family and community. Culturally-based interventions offered through community and healthcare organizations may be critical to promoting caregiver health.

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.

Background: Over the past decade, youth e-cigarette use has grown into a national epidemic, with Native Hawaiian and Pacific Islander (NHPI) youths' rates among some of the highest in the nation. Family factors significantly contribute to NHPI youths' decisions to engage in or resist substance use, yet few studies have specifically examined familial influences on NHPI youths' substance use decision-making and behaviors. Objective: The objective of this study is to examine adult familial influences on rural NHPI youths' decisions to engage in e-cigarette use. Method: Seventeen gender-specific focus groups with NHPI youths (N = 69) from eight public schools on Hawai'i Island were conducted. Results: Two family-related themes emerged from the data: 1) parental substance use permissiveness, and 2) family normalization of e-cigarette use. Conclusions: Examining adult familial contributors to NHPI youths' e-cigarette use needs to be part of a comprehensive effort to address NHPI health and substance use disparities. Prevention interventions should be explicit in addressing the family and relational context of NHPI youths' substance use.

The HUI Scholars Program at Hawai‘i Pacific University was established to address challenges in conducting research at teaching-intensive colleges. The HUI Scholars Program complemented the Hawai‘i Pacific University’s Undergraduate Infrastructure Student Research Center (HUI SRC) by encouraging faculty to engage in mentorship training. The program focuses on scientific writing, grantsmanship, and career progression, benefiting faculty and students. Faculty surveys were conducted at three-time points to evaluate one aspect of the program (writing retreats). Evaluation findings showed increased confidence in research skills, improved publication and grant-writing abilities, and reduced writing anxiety among 15 faculty participants. This article underscores the importance of mentorship training that is aligned with faculty research.

Background This study examined the implementation determinants of a culturally grounded, school-based drug prevention curriculum in rural Hawai‘i. Test development and validation procedures were used to examine the impact of implementation barriers and facilitators of the curriculum in public or charter middle/intermediate schools on Hawai‘i Island. Method A five-phase, mixed-methods approach toward test development and validation was used. These phases included item generation (Phase 1), item refinement and selection (Phase 2), item reduction (Phase 3), reliability testing (Phase 4), and validity testing (Phase 5). Educational administrators, teachers, and staff employed by the Hawai‘i State Department of Education (HIDOE) participated in the study. Results Phases 1 and 2 yielded 50 implementation barriers and 27 implementation facilitators that were evaluated by 204 HIDOE administrators, teachers, and staff. Factor analysis of the barrier items indicated a four-factor solution: (1) Innovation Barriers, (2) HIDOE State-Level Barriers, (3) Teacher-Level Barriers, and (4) Administrator-Level Barriers. Mean comparisons indicated that several barrier and facilitator items differentiated teachers from administrators in the sample. Conclusions This study contributes to the implementation measurement literature, specifically in the areas of mental health and substance use. It also highlights the importance of addressing multiple contextual levels in the implementation of culturally focused prevention interventions. Plain Language Summary Title Examining Implementation Barriers and Facilitators for School-Based Prevention in Hawai‘i. Plain Language Summary Compared with other major ethnic groups, Native Hawaiian and Pacific Islander (NHPI) youth have substantially higher rates of substance use and higher adverse mental and physical health effects related to their use. Despite these disparities, educational and community-based practitioners have long struggled with implementing and sustaining promising substance use interventions for NHPI youth. This study contributes to our understanding of measuring implementation barriers and facilitators for substance use prevention for NHPI youth in rural school settings. It contributes to the field of health disparities and health equity promotion, by addressing calls for research to understand factors affecting successful implementation of prevention programs. This is critical toward achieving health equity for underrepresented and vulnerable populations, such as NHPI and rural youth.

This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai‘i. Focus groups (N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multi-level schools in low-income communities on Hawai‘i Island. Sixty-nine youths (67% NHPI, M age = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were “refuse” (saying no), “explain” (providing reasons for vaping refusal), “avoid” (avoiding people or places where e-cigarettes were used), and “leave” (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths’ resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities.