In Â鶹´«Ã½, Native Hawaiian men (k¨¡ne) have the highest death rate from colon cancer among all ethnic groups. While screening can prevent 90 percent of these cancers, data shows that nearly 60 percent of k¨¡ne over age 50 have never been screened. Prior research has demonstrated that community-based social networks may help k¨¡ne adopt healthy behaviors such as cancer screening, but, few studies have activated an approach using Native Hawaiian traditional practices, such as one conducted by the .
The study results of No Ke Ola Pono o N¨¡ K¨¡ne (for the good health of men) project, conducted statewide in Â鶹´«Ã½ to promote health improvement in Native Hawaiian k¨¡ne through culturally grounded approaches, was published in the American Journal of Men¡¯s Health.
Hale mua and hui k¨±k¨¡k¨±k¨¡
The study perpetuated Native Hawaiian traditional practices of hale mua (men¡¯s house) and community hui k¨±k¨¡k¨±k¨¡ (discussion groups) to promote healthy behaviors among k¨¡ne. The study also emphasized colon cancer prevention strategies such as using the fecal immunochemical test (FIT). Native Hawaiian k¨¡ne volunteers conducted peer-led interventions using the program¡¯s educational components of standardized materials and four modules to guide the sessions. The module’s topics covered lung, colorectal and oronasopharyngeal cancers.
In partnership with Ke Ola Mamo, Oʻahu¡¯s Native Hawaiian Health Care System, 378 k¨¡ne were recruited into the study from 2014 to 2018, and 232 participated in the colorectal discussion groups, of which 64 percent (149) were over age 50. Of the 149 colorectal discussion group participants, 31 percent had not discussed colon health or screening with their physicians, but 92 percent improved their knowledge about colon health from the sessions. In addition, 76 percent agreed to complete a FIT. Session evaluations also indicated that more than 91 percent of k¨¡ne liked the hale mua approach and benefited from talking with other k¨¡ne about their health.
“Early and regular screening for precancerous colon lesions can prevent nearly 90 percent of colon cancers,” said Kevin Cassel, UH Cancer Center assistant researcher and principal investigator. “Our study results show that introducing FIT to k¨¡ne through community hui k¨±k¨¡k¨±k¨¡ may help fight the disease among k¨¡ne.”
The major discussion themes at the peer-led interventions included healthy traditional Hawaiian lifestyle and the role of k¨¡ne in the Hawaiian family. In addition, discussions focused on knowledge, attitudes and behaviors surrounding each session¡¯s health promotion topics. Participants also noted appreciation for having a Native Hawaiian kauka (physician) present at every session.
The study highlights that in Â鶹´«Ã½, Native Hawaiians bear disproportionately higher rates of chronic illnesses including diabetes, cardiovascular diseases, obesity and cancer compared to the overall state population. In addition, many Native Hawaiians live in rural communities where health care and recreation services are meager, distant or non-existent.
“The culturally-based traditions of the hale mua and community hui k¨±k¨¡k¨±k¨¡ can be the foundation to address health disparities among k¨¡ne. It is important to continue future studies to explore these culturally-based approaches, and extend group discussion topics addressing health issues relevant to Native Hawaiian men,” said Nathan Wong, study kauka and .
—By Nana Ohkawa
