Unified in Our Diversity to Address Health Disparities Among Asian Americans, Native Hawaiians, and Pacific Islanders

Kaholokula, Joseph Keawe‘aimoku; AuYoung, Mona; Chau, Michelle M.; Sambamoorthi, Usha; Carson, Savanna L.; Thao, Chia; Nguyen, May; Alo, Audrey Kawaiopua; Riklon, Sheldon; Lepule, Tana; Ma, Grace

doi:10.1089/heq.2022.0034

Cited by 13 publications

(5 citation statements)

References 35 publications

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“…Previous studies have found perceived financial stress to be associated with cost-related treatment nonadherence behavior trends in NHPI populations [18]. Other studies note cultural safety, an intention to learn about diverse cultures, consideration of historical contexts of different ethnic groups, and emphasizing cautious communication with NHPI patients when introducing treatment regimens [19]. Insight into direct opinions concerning treatments will further illuminate both concerns and barriers to considering aducanumab.…”

Section: Discussionmentioning

confidence: 96%

Familiarity and Perceptions of Aducanumab in Caregivers of Hawaii Alzheimer’s Disease Patients: Results of a Telephone Survey

Goo,

Morden,

Wong

et al. 2023

Cureus

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Aim: To identify current perceptions of aducanumab among patients with Alzheimer's disease (AD) and their caregivers.Methods: A total of 352 caregivers of AD patients seen at Hawaii's largest multidisciplinary neuroscience center between January 01, 2019, and June 21, 2021, were surveyed by telephone to understand patient and caregiver knowledge, familiarity, and hesitancy toward aducanumab.Results: Thirty-seven percent of caregivers were familiar with aducanumab. Caregivers who were spouses of their respective patients with AD (p=0.0023) had increased odds of familiarity. Additional predictors of aducanumab familiarity included patients with higher mini-mental state examination scores (p=0.0076) and those who received mental stimulation (p=0.007). Conversely, caregivers who identified as native Hawaiian and other Pacific Islanders (NHPI) (p=0.044) or the patient's child (p=0.010) were predictors of decreased familiarity. Only 33% of caregivers familiar with aducanumab believed it to be safe and 56% reported "side effects" as their top concern. Thirty percent of caregivers were moderately ready or very ready to use aducanumab if given the opportunity.Conclusion: Most caregivers of Hawaii AD patients were unfamiliar with aducanumab. Furthermore, those familiar were hesitant to trial the medication. Improved education and awareness of AD therapies are important, so families and caregivers of AD patients can make more informed decisions regarding AD treatment.

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Section: Discussionmentioning

confidence: 96%

Familiarity and Perceptions of Aducanumab in Caregivers of Hawaii Alzheimer’s Disease Patients: Results of a Telephone Survey

Goo,

Morden,

Wong

et al. 2023

Cureus

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“…The speculative mechanism behind this disparity may reside in the widened socioeconomic status gap between these two racial groups. NHPI individuals have long been identified as a racial group that has disproportionate adverse health outcomes and limited access to health resources in Hawaii [ 11 ]. These disparities were similarly reflected in our study.…”

Section: Discussionmentioning

confidence: 99%

“…This further illustrates the disparities between socioeconomic statuses and healthcare outcomes. Native Hawaiian and Pacific Islander (NHPI) populations are of particular interest because of their significant presence in Hawaii and the observation that they have been historically linked to disproportionate healthcare disparities [ 11 ]. Because each TBI has a unique etiology, pathophysiology, and numerous confounding variables, such as the patient’s current health, a generalized recommendation for efficacious recovery is not yet well-defined [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Exercise and Recovery Following Mild-to-Moderate Traumatic Brain Injury in the Community Setting

Weldon,

Nakamura,

Van

et al. 2024

Cureus

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Introduction The recommendations on return to exercise post-traumatic brain injury (TBI) remain debatable. As recent as 10 years ago, the conventional recovery modality for a mild TBI was to reduce neurostimulating activity and encourage rest until the symptoms subsided. However, emerging literature has challenged this notion, stating that returning to exercise early in the course of mild TBI recovery may be beneficial to the recovery timeline. This study surveys Hawaii’s diverse population to identify trends in exercise and recovery for TBI patients to shape recommendations on return to exercise. Methods A single-center retrospective chart review of the patients with mild-to-moderate TBI was selected from a patient database at an outpatient neurology clinic between January 2020 and January 2022. The variables collected include demographics, the etiology of injury, and symptoms at diagnosis. Self-generated phone surveys were completed to evaluate exercise patterns post-TBI. Results The patients who recovered within two years displayed similar exercise patterns to the patients who took more than two years to recover. Exercise frequency, intensity, and duration did not differ significantly (p=0.75, p=0.51, and p=0.80, respectively; n=100). Hiking and walking were more common in the long recovery (LR) group (p=0.02), likely reflecting advanced age compared to the short recovery (SR) group (50 versus 39 years, p<0.01). Additionally, no correlation exists between exercise intensity and worsening symptoms (p=0.920), suggesting that the patients exhibit exercise patterns suitable for sub-symptomatic recovery. Conclusion Return to exercise does not appear to be a predictor for mild-to-moderate TBI recovery. The patients appear to self-regulate an exercise regimen that will not exacerbate their symptoms or recovery time; thus, it may be suitable to recommend return to exercise as tolerated. These, and other findings in the literature, suggest that patients should be encouraged to return to exercise shortly after a mild TBI so long as the exercise does not exacerbate their symptoms.

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“…Native Hawaiians and Pacific Islanders (NHPI) and Asians are understudied minorities [1][2][3]. NHPI suffer heightened risks of hypertension, diabetes, and stroke (and experience strokes at younger ages), have shorter average lifespans, and live in poorer socioeconomic conditions [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Daily Moderate-to-Vigorous Activity of Native Hawaiians and Pacific Islanders and Seven Asian Subgroups by Types of Activities, American Time Use Survey, 2010–2019

Davis,

Taira,

Lim

et al. 2024

Healthcare

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The study used the American Time Use Survey data from 2010 to 2019 to compare the daily moderate-to-vigorous activity of Native Hawaiians and Pacific Islanders (NHPI) and seven Asian ethnic subgroups. Adults aged 24 years and older were included. The study analyzed activities from sports and recreation, household activities, and all activities carried out during the day. Outcomes were determined by the completion of 30 min or more of moderate-to-vigorous activity and the type of activity carried out in the day. Significant ethnic differences were observed for sports and recreation but not for household activities and not for all activities carried out during the day. Of the ethnic populations, NHPI were the least active, and Asian Indians and Chinese were the most active. A majority achieved 30 min or more of moderate-to-vigorous activity during the day from all their activities. Physical activity from household activities exceeded physical activity from sports and recreation. The most physically active group was adults over the age of 65 years, perhaps reflecting more time to exercise or greater concerns about their health. For sports and recreation, exercising with someone doubled the minutes of moderate-to-vigorous activity. The results emphasize the importance of activities performed around the household in addition to sports and recreation and the benefit of exercising with someone. Ethnic populations may be receptive to interventions that emphasize activities they are performing in their daily lives.

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Unified in Our Diversity to Address Health Disparities Among Asian Americans, Native Hawaiians, and Pacific Islanders

Cited by 13 publications

References 35 publications

Familiarity and Perceptions of Aducanumab in Caregivers of Hawaii Alzheimer’s Disease Patients: Results of a Telephone Survey

Familiarity and Perceptions of Aducanumab in Caregivers of Hawaii Alzheimer’s Disease Patients: Results of a Telephone Survey

Exercise and Recovery Following Mild-to-Moderate Traumatic Brain Injury in the Community Setting

Daily Moderate-to-Vigorous Activity of Native Hawaiians and Pacific Islanders and Seven Asian Subgroups by Types of Activities, American Time Use Survey, 2010–2019

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