Kokua Kalihi Valley Comprehensive Family Services

Honolulu, HI, United States

Kokua Kalihi Valley Comprehensive Family Services

Honolulu, HI, United States

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Kaholokula J.K.,University of Hawaii at Manoa | Mau M.K.,University of Hawaii at Manoa | Leake A.,University of Hawaii at Manoa | West M.,University of Hawaii at Manoa | And 5 more authors.
Health Education and Behavior | Year: 2012

Preventing weight regain after the loss of excess weight is challenging for people, especially for ethnic minorities in the United States. A 6-month weight loss maintenance intervention designed for Pacific Islanders, called the PILI Lifestyle Program (PLP), was compared with a 6-month standard behavioral weight loss maintenance program (SBP) in a pilot randomized controlled trial using a community-based participatory research approach. Adult Pacific Islanders (N = 144) were randomly assigned to either PLP (n = 72) or SBP (n = 72) after completing a 3-month weight loss program. Successful weight maintenance was defined as participants' postintervention weight change remaining ≤3% of their preintervention mean weight. Both PLP and SBP participants achieved significant weight loss maintenance (p ≤ .05). Among participants who completed at least half of the prescribed sessions, PLP participants were 5.1-fold (95% confidence interval = 1.06, 24; p = .02) more likely to have maintained their initial weight loss than SBP participants. The pilot PLP shows promise as a lifestyle intervention to address the obesity disparities of Pacific Islanders and thus warrants further investigation. © 2012 Society for Public Health Education.


Fernandes R.,University of Hawaii at Manoa | Braun K.L.,University of Hawaii at Manoa | Guzman C.,Kokua Kalihi Valley Comprehensive Family Services | Somogyi-Zalud E.,University of Hawaii at Manoa
Journal of Palliative Medicine | Year: 2010

Background: Kokua Kalihi Valley is one of the first federally qualified community health centers offering home-based palliative care (HBPC). Kokua Kalihi Valley serves low-income, immigrant populations from Asia and the Pacific Islands, whose end-of-life needs are rarely addressed. Our team includes a palliative medicine physician, nurse, case manager, psychologist, interpreter, and volunteers. Objectives: The purpose of this Institutional Review Board-approved study was to measure symptom relief and quality of life, resource utilization, and satisfaction with HBPC. Methods: Over 12 months, 91 people including 46 patients with chronic advanced illnesses and 45 corresponding primary caregivers were enrolled. Data were collected prospectively, upon admission, and repeatedly thereafter, using the Missoula-Vitas Quality of Life Index, the Edmonton Symptom Assessment Scale, and the Palliative Performance Scale. Utilization of resources was tracked, including case management, hospice, emergency department, and hospital visits. Results: The median age was 71 years, and more than half had chronic neurodegenerative conditions. Most patients (98%) were minority, including Samoans, Filipinos, Japanese, Micronesians, and Hawaiians. Median stay in HBPC was 7 months, with a median of 3.5 visits. Approximately 25% of patients enrolled in hospice (median stay 67.5 days). There was a decrease in hospitalizations (p=0.002) after HBPC admission. Discussions and documentation of end-of-life wishes increased from 50% to 90% (p<0.01). Caregiver satisfaction with HBPC was high. Conclusion: Data on outcomes and quality indicators of HBPC programs are scant, especially among immigrant Asian and Pacific Islanders patients. Our experience demonstrates the effectiveness of palliative care approaches in this population. © Mary Ann Liebert, Inc.


Kaholokula J.K.,University of Hawaii at Manoa | Townsend C.K.M.,University of Hawaii at Manoa | Ige A.,University of Hawaii at Manoa | Sinclair K.A.,University of Hawaii at Manoa | And 6 more authors.
Obesity | Year: 2013

Objective: Native Hawaiians and other Pacific Islanders (NHs/PIs) have a high obesity prevalence compared to other ethnic groups. We examined socio-demographic, behavioral, and biological factors related to ≥3% weight loss in 100 overweight/obese NHs/PIs who completed a lifestyle intervention. Design and Methods: Data were from 56 Native Hawaiians, 22 Chuukese, and 22 Other Pacific Islanders who participated in a randomized controlled trial of the Partnership for Improving Lifestyle Intervention (PILI) 'Ohana Project. All completed a 3-month weight loss program (WLP) to initiate weight loss and were then randomized into either a 6-month family/community focused WLP called the PILI Lifestyle Program (PLP; n = 49) or a standard behavior WLP (SBP; n = 51). We collected baseline, 3- and 9-month follow-up data on socio-demographics, weight (kg), a 6-min. walk test, dietary fat, exercise frequency, and blood pressure. Results and Conclusion: Based on ANCOVA or logistic fit, ethnicity, sex, initial weight loss, fat in diet at baseline, change in systolic blood pressure, and intervention type were significantly associated (P ≤.05) with ≥3% weight loss at 9-month follow-up. A logistic regression model indicated that Chuukese (OR = 6.04; CI = 1.14-32.17) and participants who had more weight loss in the first 3-months (OR = 1.47; CI = 1.22-1.86) and who were in the PLP (OR = 4.50; CI = 1.50-15.14) were more likely to achieve ≥3% weight loss [model; χ2 (7, N = 100) = 45.50, P <.0001]. The same lifestyle intervention does not benefit all NHs/PIs equally, possibly due to differences in acculturation status and social support. The findings also point to the importance of initial weight loss to sustain motivation toward long-term weight loss maintenance. Copyright © 2012 The Obesity Society.


PubMed | University of Hawaii at Manoa, Ola Health, Kokua Kalihi Valley Comprehensive Family Services, Kula no na Poe Hawaii and Hawaii Maoli of the Association for Hawaiian Civic Clubs
Type: Journal Article | Journal: Translational behavioral medicine | Year: 2014

Native Hawaiians/Pacific Islanders experience a high prevalence of overweight/obesity. The Diabetes Prevention Program Lifestyle Intervention (DPP-LI) was translated into a 3-month community-based intervention to benefit these populations. The weight loss and other clinical and behavioral outcomes of the translated DPP-LI and the socio-demographic, behavioral, and biological factors associated with the weight loss were examined. A total of 239 Native Hawaiian/Pacific Islander adults completed the translated DPP-LI through four community-based organizations (CBOs). Changes from pre- to post-intervention assessments in weight, blood pressure, physical functioning, exercise frequency, and fat in diet were measured. Significant improvements on all variables were found, with differences observed across the four CBOs. CBOs with predominately Native Hawaiian and ethnically homogenous intervention groups had greater weight loss. General linear modeling indicated that larger baseline weight and CBO predicted weight loss. The translated DPP-LI can be effective for Native Hawaiians/Pacific Islanders, especially when socio-cultural, socio-economic, and CBO-related contextual factors are taken into account.


Townsend C.K.M.,University of Hawaii at Manoa | Dillard A.,Kula no na Poe Hawaii | Hosoda K.K.,University of Hawaii at Manoa | Maskarinec G.G.,University of Hawaii at Manoa | And 6 more authors.
International Journal of Environmental Research and Public Health | Year: 2015

Native Hawaiians bear a disproportionate burden of type-2 diabetes and related complications compared to all other groups in Hawai‘i (e.g., Whites, Japanese, Korean). Distrust in these communities is a significant barrier to participation in epigenetic research studies seeking to better understand disease processes. The purpose of this paper is to describe the community-based participatory research (CBPR) approach and research process we employed to integrate behavior and biological sciences with community health priorities. A CBPR approach was used to test a 3-month evidence-based, diabetes self-management intervention (N = 65). To investigate the molecular mechanisms linking inflammation with glucose homeostasis, a subset of participants (n = 16) provided peripheral blood mononuclear cells. Community and academic researchers collaborated on research design, assessment protocols, and participant recruitment, prioritizing participants’ convenience and education and strictly limiting the use of the data collected. Preliminary results indicate significant changes in DNA methylation at gene regions associated with inflammation and diabetes signaling pathways and significant improvements in hemoglobin A1c, self-care activities, and diabetes distress and understanding. This study integrates community, behavioral, and epigenomic expertise to better understand the outcomes of a diabetes self-management intervention. Key lessons learned suggest the studies requiring biospecimen collection in indigenous populations require community trust of the researchers, mutual benefits for the community and researchers, and for the researchers to prioritize the community’s needs. CBPR may be an important tool in providing communities the voice and protections to participate in studies requiring biospecimens. © 2015 by the authors; licensee MDPI, Basel, Switzerland.


PubMed | University of Hawaii at Manoa, Kokua Kalihi Valley Comprehensive Family Services, Washington State University, Kula no na Poe Hawaii and Hawaii Maoli
Type: | Journal: Journal of diabetes research | Year: 2016

Native Hawaiians and other Pacific Islanders (NH/PI; e.g., Samoan and Chuukese) have higher type 2 diabetes prevalence compared to other groups in Hawaii. Partners in Care (PIC), a culturally tailored, community-based, diabetes self-management education intervention (DSME), is effective at improving participants glycemic control and self-care behaviors. Maintenance of improvements is challenging. Diabetes-related social support groups (SSG) are a promising maintenance component for DSME. This study examined the effects of a diabetes-specific SSG component relative to a control group, after the receipt of the 3-month PIC intervention, which was delivered to 47 adult NH/PI with type 2 diabetes. Participants were then randomized to either a 3-month, 6-session SSG or a control group. Hemoglobin A1c (HbA1c), blood pressure, triglycerides, cholesterol, and diabetes self-management knowledge and behaviors were assessed at baseline, 3 months, and 6 months. Results indicated significant improvements in HbA1c, diabetes-related self-management knowledge, and behaviors from baseline to 3-month assessment. However, no differences between the SSG and control group from 3-month to 6-month assessment suggest that all participants were able to maintain initial improvements. The SSG group had a significant decrease in systolic blood pressure from 3-month to 6-month assessment while the control group did not. Study limitations and future directions are discussed.


PubMed | University of Hawaii at Manoa, Ke Ola Mamo, Kokua Kalihi Valley Comprehensive Family Services, Kula no na Poe Hawaii and Hawaii Maoli
Type: Comparative Study | Journal: International journal of environmental research and public health | Year: 2015

Native Hawaiians bear a disproportionate burden of type-2 diabetes and related complications compared to all other groups in Hawaii (e.g., Whites, Japanese, Korean). Distrust in these communities is a significant barrier to participation in epigenetic research studies seeking to better understand disease processes. The purpose of this paper is to describe the community-based participatory research (CBPR) approach and research process we employed to integrate behavior and biological sciences with community health priorities. A CBPR approach was used to test a 3-month evidence-based, diabetes self-management intervention (N = 65). To investigate the molecular mechanisms linking inflammation with glucose homeostasis, a subset of participants (n = 16) provided peripheral blood mononuclear cells. Community and academic researchers collaborated on research design, assessment protocols, and participant recruitment, prioritizing participants convenience and education and strictly limiting the use of the data collected. Preliminary results indicate significant changes in DNA methylation at gene regions associated with inflammation and diabetes signaling pathways and significant improvements in hemoglobin A1c, self-care activities, and diabetes distress and understanding. This study integrates community, behavioral, and epigenomic expertise to better understand the outcomes of a diabetes self-management intervention. Key lessons learned suggest the studies requiring biospecimen collection in indigenous populations require community trust of the researchers, mutual benefits for the community and researchers, and for the researchers to prioritize the communitys needs. CBPR may be an important tool in providing communities the voice and protections to participate in studies requiring biospecimens.


Tomioka M.,University of Hawaii at Manoa | Braun K.L.,University of Hawaii at Manoa | Compton M.,Kokua Kalihi Valley Comprehensive Family Services | Tanoue L.,ALU LIKE Inc.
Gerontologist | Year: 2012

Purpose of the study: Stanford's Chronic Disease Self-Management Program (CDSMP) has been proven to increase patients' ability to manage distress. We describe how we replicated CDSMP in Asian and Pacific Islander (API) communities. Design and Methods: We used the "track changes" tool to deconstruct CDSMP into its various components (e.g., recruitment and staffing) and the "adaptation traffic light" to identify allowable modifications to the original program. We monitored local leaders' fidelity of delivery of CDSMP and tracked participants' attendance, satisfaction, and 6-month outcomes. Results: Between July 2007 and February 2010, 584 completed a CDSMP workshop. Baseline and 6-month data were available for 422 (72%), including 53 Caucasians, 177 Asians, and 194 Pacific Islanders. All 3 groups realized significant decreases in social and role activity limitations and significant increases in communication with physicians. Asians and Pacific Islanders also realized significant increases in self-rated health and time spent engaging in stretching/strengthening exercise. Asians also reported significant reductions in health distress and self-reported physician visits and increases in time spent in aerobic exercise, ability to cope with symptoms, and self-efficacy. Implications: Our experience suggests that CDSMP can be modified for increased cultural appropriateness for API communities while maintaining the key components responsible for behavior change. © The Author 2011. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.


Chung-Do J.J.,University of Hawaii at Manoa | Look M.A.,University of Hawaii at Manoa | Mabellos T.,University of Hawaii at Manoa | Trask-Batti M.,University of Hawaii at Manoa | And 2 more authors.
Progress in Community Health Partnerships: Research, Education, and Action | Year: 2016

Background: Health disparities continue to persist among Native Hawaiian and Pacific Islander (NHPI) communities. Objectives: This study sought to understand the perspectives of community organizations in the Ulu Network on how researchers can collaborate with communities to promote community wellness. Methods: Key informant interviews and small group interviews were conducted with the leadership in the Ulu Network. Results: Five themes were identified that highlight the importance of investing time and commitment to build authentic relationships, understanding the diversity and unique differences across Pacific communities, ensuring that communities receive direct and meaningful benefits, understanding the organizational capacity, and initiating the dialog early to ensure that community perspectives are integrated in every stage of research. Conclusions: Increasing capacity of researchers, as well as community organizations, can help build toward a more equitable and meaningful partnership to enhance community wellness. © 2016 The Johns Hopkins University Press.


Fernandes R.,Kokua Kalihi Valley Comprehensive Family Services | Braun K.L.,University of Hawaii at Manoa | Spinner J.R.,U.S. National Institutes of Health | Sturdevant C.,Kokua Kalihi Valley Comprehensive Family Services | And 5 more authors.
Journal of Health Care for the Poor and Underserved | Year: 2012

Kokua Kalihi Valley, a federally qualified health center in Hawaii, collaborated with the National Heart, Lung, and Blood Institute to test the efficacy of community health workers (CHWs) to deliver the Healthy Heart, Healthy Family curriculum to low-income Filipinos with cardiovascular disease (CVD) risk factors. At 12 months, significant improvements were seen in health behaviors, knowledge, and self-efficacy in managing chronic diseases. We also observed decreases in total cholesterol from 186.25 mg/dl to 170.88 mg/dl (p5.001), low-density lipoprotein from 114.43 mg/dl to 103.04 mg/dl (p5.013), and fasting blood glucose from 117.95 mg/dl to 109.07 mg/dl (p5.034). Although these changes were statistically significant, they are small and not clinically meaningful in reducing CVD risk. The high-density lipoprotein was 3.3 mg/dl lower (worse) at 12 months (p5.003), mean values for blood pressure, BMI, and waist circumference increased. Community health workers can be trained to deliver evidence-based curricula that improve health behaviors and increase self-efficacy in managing chronic diseases. © Meharry Medical College.

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