Hawai`i Journal of Health & Social Welfare

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Contact: Callie Weymouth

ctoner@hawaii.edu

October 16, 2023

The Center for Pacific Innovations, Knowledge, and Opportunities (PIKO) research on databases and Interventions among Indigenous Populations Featured in HJH&SW Special Issue

by: Jordan Marshall

Researchers who focus on ethnic groups of Native Hawaiians, Pacific Islanders, Filipinos, and other medically underserved populations often face challenges when handling small sample sizes as well as how and when to aggregate data. The focus of the the new special issue.

is to highlight databases that can be used for secondary analysis on these ethnic groups, and to review research methodologies and interventions proven to be effective with these groups.

Dr. Kathryn Braun, one of the guest editors, states, "Some articles present data gathering methods that fit our cultures and guidance from community members on how to respectfully enter and work with communities on research projects."

Due to the influx of manuscripts that came in for this special issue, it has turned into a double issue with 18 manuscripts in total. Dr. Deborah Taira, the other guest editor, says, "There is very little information in the academic literature on methods and resources for research on health disparities affecting Native Hawaiians, Pacific Islanders, and Filipinos. We decided to produce this special double issue to showcase local researchers' knowledge, experience, and expert advice."

The double issue is split into two different themes. The first part includes articles related to indigenous research methodologies, best practices for engaging communities in research, and training programs for future Native Hawaiian, Pacific Islander, and Filipino researchers. The second part is related to data and quantitative methods, such as recommended categories for Native Hawaiian and Pacific Islander racial and ethnic data disaggregation.

Braun notes that "the PIKO supplement adds to the health disparities literature and supports PIKO's mission to improve the health of Native Hawaiians, Pacific Islanders, Filipinos and other underserved populations in Hawai`i."

PIKO is a partnership across 3 universities in Hawai`i - the University of Hawai`i, Hawai`i Pacific University, and Chaminade University of Honolulu. Articles in this special issue include contributions from all 3 schools.

Taira states, "We are pleased to add to an expanding collaboration around health disparities research in Hawai`i and to advance the science of conducting health disparities research for the nation."

The special issue is freely available on the journal's website at www.hawaiijournalhealth.org.

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The Hawai`i Journal of Health & Social Welfare is a monthly peer-reviewed journal with the aim of advancing knowledge about health and social welfare, with a focus on the diverse peoples and unique environments of Hawai`i and the Pacific region.

December 15, 2022

Improving the System of Care for Substance Use Among Health Disparity Populations

by: Jordan Marshall

Improving Hawai`i's substance use problem with special attention to populations who are disproportionately affected is the focus of a new supplement issue of the Hawai`i Journal of Health & Social Welfare.

Local experts combine the most recent literature with community input from Hawai`i stakeholders in this special issue. The articles of the supplement highlight the intersection between substance use and public sector among health disparity populations as well as initiatives to improve these public sectors within the population.

Dr. Jane Onoye, a guest editor of the supplement, expresses, "The System of Care for substance use needs to be improved through enhanced collaboration across institutions with culturally and contextually specific practices."

Some of the systems reviewed include sexual and gender minorities, people who are homeless in Hawai`i, youth in the juvenile justice system, among several others. One of the most important themes of this supplement is to spread awareness on how to improve the System of Care for substance use with cultural practices.

Publishing this supplement is one step to improve the gap in the literature on cultural healing for diverse populations. Onoye, states, "These articles reflect a paradigm shift from traditional care systems toward a system of healing and population-based management within and across public sectors for substance use in Hawai`i."

These articles raise awareness on recommendations that will improve program and practice implementation, as told from a subject matter experts' knowledge and experience.

It is hoped that the supplement will reach a broader audience than the readers of the state plan. Onoye emphasizes, "For the audience that does not work in direct care, it is hoped that there is a greater understanding about the difficulties navigating the system to receive care."

In addition to the supplement, ADAD is releasing their own state plan which will highlight many of the same topics as the supplement.

The special issue is freely available on the journal's website at www.hawaiijournalhealth.org.

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April 19, 2022

How the Hawai`i Health Care Workforce is Addressing the Physician Shortage

by: Jordan Marshall

Hawai`i's shortage of health care professionals is the focus of a new supplement issue of the Hawai`i Journal of Health & Social Welfare.

The articles in this special issue highlight the work the authors are doing to improve Hawai`i's health care workforce, including training future pharmacists to optimize the health care workforce, building a culturally-aware Native Hawaiian health professions workforce, and increasing care for older adults through the Geriatric Workforce Enhancement Program.

"This special edition of the HJH&SW focuses on the shortage of health care professionals across the state of Hawai`i and follows previous workforce supplements published in 2017 and 2012," said Teresa Schiff-Elfalan MD and Vanessa S. Wong MD, MS in the guest editor letter, both faculty members and graduates of JABSOM and the guest editors of the special issue.

The supplement begins with an article that gives an overview of the recent physician shortage trend by discussing the Hawai`i Physician Workforce project which was launched in 2010. "Over the past decade, workforce demands have continued to climb as the state struggles to maintain the physician supply," Kelley Withy MD, PhD said. "This article describes the current state of the physician workforce, the physician age landscape, past trends, as well as initial changes to the physician supply with the COVID-19 pandemic."

"Communities with limited numbers of physicians suffer diminished access to care and people in those communities often suffer later diagnosis and worse health outcomes," said Withy.

The journal supplement further focuses on the current efforts to address Hawai`i's physician shortage. The `Imi Ho`ōla Post-Baccalaureate Program, which aims to increase the number of underrepresented and disadvantaged students who complete medical school in Hawai`i, is an incredible example of a program that has successfully contributed to the diversity and overall numbers of physicians in Hawai`i and the Pacific.

"This edition shares the critical work being done by the authors to expand and strengthen our health care workforce, with special attention to rural health, culturally aware practices, and interprofessional teamwork," Schiff-Elfalan MD and Wong MD, MS express in the guest editor letter. "These manuscripts call us to collaborate across disciplines, practice settings, and geographic locations, in order to do the important work needed to address our health care workforce shortage and the patient care needs of our state."

The special issue is freely available on the journal's website at www.hawaiijournalhealth.org.

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September 2, 2020

Hawai`i Researchers Propose New Gesture to Encourage Face Mask Use

by: Karen Rowan

If you see someone wearing a face mask incorrectly in public, there is a new gesture invented by medical researchers in Hawai`i that you can use to give them a hint to wear their mask correctly.

Point your index finger towards your own mask, and then move your index finger up and down, without touching your mask, according to the researchers who published their work in the latest issue of the Hawai`i Journal of Health & Social Welfare.

Then, give them a shaka.

"Always follow this by giving them a shaka right away," says Kasey Tamamoto, the lead author of the new study and a medical student at the John A. Burns School of Medicine (JABSOM). The follow-up shaka is important because Tamamoto and her colleauges intend the gesture to be friendly and non-confrontational.

The idea for the gesture came about after the researchers conducted a study of the mask-wearing public on O`ahu. They collected data in downtown Honolulu and Waikiki on a recent day. Results showed 88% of people observed downtown were wearing face masks correctly, compared with just 66% of people in Waikiki.

To wear a face mask correctly, it is important for the mask to cover both the nose and the mouth, the researchers said.

"Our results suggest there are opportunities to improve rates of public face mask use on O`ahu, which could decrease the spread of COVID-19 on the island," Tamamoto said. In total, 23% of people observed in the study either wore a mask incorrectly, or did not wear one at all.

The researchers also said their results show that public health education efforts should be increased. More information should be delivered through social media platforms, perhaps featuring local athletes and social media influencers, they suggested in their study. Education could also be delivered during airplane flights to Hawai`i, the researchers said. In public places, people should be encouraged to wear masks even while exercising.

In addition, more research is needed to measure mask use in Hawai`i, the researchers wrote.

"A change in our mental model of face mask use may be one of our most effective tools in combating the recent dramatic increase in SARS-CoV-2 infections," Tamamoto said.

Tamamoto's co-authors on the study include fellow medical student Nikki Rousslang; Hyeong Jun Ahn, PhD, a professor of quantitative health science at JABSOM; retired pharmacist Heidi Better, PharmD; and Robert Hong, MD, a professor of medicine at JABSOM.

Photo: JABSOM Professor of Medicine Dr. Rob Hong demonstrates the new gesture. Photo courtesy of Dr. Rob Hong.

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June 15, 2020

Research from Indigenous People Across the US-Affiliated Pacific Islands Highlighted in Special Issue of the HJH&W

by: Karen Rowan

New research on health disparities across the US-affiliated Pacific & as told by the Pacific Islanders who live there and conducted the research & is the focus of a new supplement issue of the Hawai`i Journal of Health & Social Welfare.

The articles in the special issue cover a wide range of research areas, including collaborations with traditional leaders and chiefs in Yap and Pohnpei to implement health interventions, the use of community-based cultural frameworks to support palliative care in the Marshall Islands, partnering with traditional chiefs in Yap and Pohnpei to prevent non-communicable disease, cervical cancer screening on Guam, and other topics.

"This issue is a landmark because of who wrote it," said Neal Palafox, MD, MPH, a professor of family medicine and community health at the University of Hawai`i John A. Burns School of Medicine and one of the editors of the special issue. "In these articles, the Indigenous people of the Pacific use their voices to tell the story of their own health interventions and research."

Some of the articles detail the efforts of Pacific Islanders to implement changes in their communities to reduce the risk of noncommunicable diseases, such as obesity and high blood pressure. "Interventions that may work on the US Continent or Hawai`i may not work on these islands," Palafox said. For example, in the continental US, smoking rates may be reduced by including warning labels on cigarette boxes or increasing visible signage in places where tobacco is sold. But in the Pacific, effective interventions can be developed by working with authorities such as traditional chiefs or with church leaders.

"If a chief announces that smoking is no longer allowed in a village, or if a church decides to allow people to drink only water, and not soda or juice, on its grounds, those interventions improve the health of the population," Palafox said.

His role as editor was to encourage and assist the community researchers tell their stories. Many of the community based writers were not academics, nor was their usual role to publish their works. "Community based Pacific Islanders are oral historians by nature, and we wanted to help them learn to articulate their narrative in writing, in a way that could be published in a traditional Western, scientific journal."

The partner organizations, including UH and the Centers for Disease Control and Prevention, wanted to support the efforts of Pacific Islanders to reduce the health disparities they face.

"This issue is the result of Indigenous people looking at their environment and their own health systems and deciding to make changes," Palafox said. "The articles show that the folks living in the island communities understand their communities best. They can conduct health interventions, measure the impacts, and share their knowledge with others & this is agency and empowerment at its best."

The special issue, Health Disparities in US-Affiliated Pacific Islanders: The Voyage Forward, is freely available on the journal's website at www.hawaiijournalhealth.org.

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May 15, 2020

Latest Research on Keiki Health Featured in HJH&SW Supplement Issue

by: Karen Rowan

Research on children's health and nutrition & including difficult topics such as rising obesity rates and drug use in pregnant women & are the focus of a new supplement issue of the Hawai`i Journal of Health & Social Welfare.

The publication compiles the work of pediatricians and children's health researchers across the state of Hawai`i.

"There is strong interest from the health research community in Hawai`i to identify ways to improve the health and well-being of keiki in our state," said Bruce Shiramizu, MD, a professor of Pediatrics at the University of Hawai`i John A. Burns School of Medicine (UH JABSOM) and a co-editor, along with Dr. David Easa of the supplemental issue. Dr. Easa is Professor Emeritus in the Department of Pediatrics at UH JABSOM.

The articles published in the special issue represent many disciplines, including medicine, nursing and social work. "The research involves hospitals, community health centers, and military health facilities," Shiramizu said. The articles cover topics that affect infants, preschoolers, grade-school age kids, and adolescents.

"Numerous individuals contributed to, and collaborated on this issue," he said. "This supplement truly represents the breadth of children's health research in Hawai`i."

The journal supplement also focused on increasing opportunities for early-career stage researchers to advance their academic careers by engaging in the process of manuscript development.

"It's crucial that our younger researchers learn how to publish their work, so they can advance the scientific community's knowledge on these issues that are so important in our state," Shiramizu said. The supplement gave early-career researchers a chance to write their research articles under the guidance of experienced faculty members.

The editors were thrilled to see so many fantastic researchers write articles for the supplement. "We were really excited with the unexpected response we received from the research community; there were many researchers who submitted articles to make this issue a success," Shiramizu said.

The issue was sponsored by a grant from the Hawai`i IDeA Center for Pediatric and Adolescent Clinical Trials (HIPACT) funded by the National Institutes of Health's Environmental influences on Child Health Outcomes (ECHO) Program (UG1OD024948). ECHO is a nationwide research program designed to understand the effects of a broad range of early environmental influences on child health and development. To address disparities in pediatric research, ECHO established the IDeA States Pediatric Clinical Trials Network, which helps ensure that children in states with historically low NIH funding have access to clinical trials.

The grant provides opportunities for children in Hawai`i, especially those in rural or underserved areas, to participate in clinical trials, Shiramizu said. "Indeed, the researchers leading these trials as well as those conducting other pediatric studies in Hawai`i are dedicated to reversing the health inequities of vulnerable populations of children residing in Hawai`i including Native Hawaiian and Other Pacific Islanders."

The special issue is freely available on the journal's website at www.hawaiijournalhealth.org.

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December 18, 2019

Pacific Region Indigenous Doctors Congress Highlighted in Special Issue of the HJH&SW

by: Karen Rowan

Educators and researchers are working worldwide to improve Indigenous health outcomes, and this work is highlighted in a new supplement issue of the Hawai`i Journal of Health & Social Welfare.

The publication focuses on efforts to provide cultural training in health care and medical education, and to increase the number of Indigenous physicians and academic faculty in medicine.

The issue grew out of a biannual conference called the Pacific Region Indigenous Doctors Congress (PRIDoC), which brings Indigenous physicians and medical students together from around the Pacific and North America. The Association of Native Hawaiian Physicians, `Ahahui o nā Kauka, spearheaded the the 2018 conference, and physican organizations from Aotearoa (New Zealand), Australia, Canada, Taiwan, and the continental United States attended the week-long event.

"Educators, students, and health care workers who presented at PRIDoC 2018 were invited to submit abstracts on topics that align with the mission of the Native Hawaiian Center of Excellence (NHCOE) including physician workforce development, student and faculty development, and cultural training in medical education," said Malia Lee, MD, the guest editor of the issue and the director of the NHCOE at the John A. Burns School of Medicine.

"We wanted to showcase the efforts being made to increase Indigenous representation in medicine and to build cultural understanding in healthcare," Lee said. Along with PRIDoC program overview and the student curriculum, the issue also includes articles on Indigenous faculty development, pathway programs for underrepresented and Indigenous students, Native Hawaiian community school-based programs, cultural training for surgical residents, and student research on end-of-life care from the Native Hawaiian perspective.

"Finding solutions to the health disparities faced by Indigenous people around the world is a monumental task," Lee said. With many factors impacting the health of Indigenous people, she keeps in mind the Hawaiian proverb, `a `ohe hana nui ke alu `ia (no task is too big when done together by all).

"Despite some of the works spanning decades, sometimes it seems as if we are at the beginning of a very long journey," Lee said. "This journal offers a snapshot of the multifaceted steps that are being taken around the Pacific that will help Indigenous people to regain the health and stature they once held."

The special issue, Conference Report: The Pacific Region Indigenous Doctors Congress (PRIDoC) 2018, is available by open access on the journal's website, www.hawaiijournalhealth.org.

Photo: JABSOM medical students and `Aha Hui o nā Kauka physicians at the PRIDoC opening Awa Ceremony. Photo courtesy of Dr. Malia Lee.

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July 12, 2019

Special Issue Highlights Innovative Efforts in Hawai`i to Link Clinical Medicine with Community Needs

by: Karen Rowan

A community member participates in a health promotion program

The Hawai`i Journal of Health & Social Welfare is pleased to announce the publication of a supplement issue on the topic of community-clinical linkages in health care in Hawai`i. The issue includes 20 distinct articles and editorials highlighting many innovative efforts across the state, ranging from bicycle programs and Native Hawai`ian patient navigators to health data applications and health policy issues.

Until recently, the practice of medicine in hospitals and clinics was largely separated from public health and social service efforts to meet the needs of people in the communities where they live. Given a growing understanding of the importance of social needs, like housing, to overall health, after innovative thinking and hard work, many partners have forged valuable community-clinical linkages across Hawai`i.

"Patients' social and behavioral needs contribute to their overall health," said Tetine L. Sentell, PhD, a associate professor with the University of Hawai`i at M?noa Office of Public Health Studies and one of the editors of the special issue. "The articles in this issue tell the stories of the programs in Hawai`i that are working to meet these needs to prevent illness and improve the management of common conditions for communities across the state."

Chronic health problems are prevalent in Hawai`i. Nearly 10% of Hawai`i residents have diabetes, 24% have obesity, and 29% have hypertension.

"One aim of the issue was to show how community-clincal linkages can fight health disparties," Sentell said. Related to this, several articles in the new issue highlight the efforts of community health workers, the critcal frontline workers who advocate for patients and work to guide them through the complex web of health care providers, community programs, and social agencies that affect their health.

"What emerges from the data that are presented in this special issue is a clear picture of the real health outcomes that have been improved in Hawai`i by the deep collaboration between community and clinical partners," said Lance K. Ching, PhD, MPH, an epidemiologist with the Hawai`i State Department of Health and also a co-editor of the special issue.

"This is a critical time in health care, and in this special issue of the journal, we're showcasing the enormous efforts that have taken place in recent years to change the face of health care in Hawai`i and marry clinical care with community efforts," said S. Kalani Brady, MD, MPH, co-editor of the Hawai`i Journal of Health & Social Welfare.

The special issue, Community-Clinical Linkages Within Health Care in Hawai`;i, is available by open access on the journal's website, www.hawaiijournalhealth.org.

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The Hawai`;i Journal of Health & Social Welfare is a monthly peer-reviewed journal with the aim of advancing knowledge about health and social welfare, with a focus on the diverse peoples and unique environments of Hawai`i and the Pacific region.

July 10, 2019

Hawai`i's Top Health Journal Is Renamed the Hawai`i Journal of Health & Social Welfare

by: Karen Rowan

The Hawai`i Journal of Medicine & Public Health is changing its name to the Hawai`i Journal of Health & Social Welfare with the publication of the July 2019 issue.

The name change reflects the recently broadened scope of the journal. Instead of focusing primarily on medical and public health research, the journal will also now publish research and case reports from other health fields including social work, nursing, and pharmacology.

"Publishing important research on the health of the diverse peoples of Hawai`i and the Pacific region remains our priority," said S. Kalani Brady, MD, MPH, a co-editor of the journal. "Now, we will include more fields of health research."

This peer-reviewed, PubMed-indexed, journal continues to be published monthly both in print and online. Articles are freely available online at http://hawaiijournalhealth.org/ and through the National Library of Medicine's PubMed Central.

"Our goal is to ensure that the journal is a must-read publication for the health researchers and health practitioners in Hawai`i and the Pacific from all fields of health," said Tonya Lowery St. John, PhD, MPH also a co-editor of the journal.

Regular features of the journal include peer-reviewed research articles, columns, and the Hawai`i Journal Watch, which highlights articles from Hawai`i-based researchers published in other journals.

The volunteer staff of associate editors, assistant editors, and contributing editors are health researchers and professionals primarly based at the Hawai`i State Department of Health and the University of Hawai`i (UH).

The journal reaches about 7,000 readers monthly. Individuals may receive the journal through print subscriptions, online access, or partner organizations. The journal is funded by the Hawai`i State Department of Health, the John A. Burns School of Medicine, the UH Cancer Center, the UH Daniel K. Inouye College of Pharmacy, the UH Office of Public Health Studies, the Myron B. Thompson School of Social Work, and the UH School of Nursing and Dental Hygiene.

"We look forward to continuing to serve our readership by offering compelling articles that give unique insights into the health and welfare of the people of Hawai`i and the Pacific," Lowery St. John said.

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The Hawai`i Journal of Health & Social Welfare is a monthly peer-reviewed journal with the aim of advancing knowledge about health and social welfare, with a focus on the diverse peoples and unique environments of Hawai`i and the Pacific region.