College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA.
Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA.
Curr Diab Rep. 2019 Mar 18;19(5):19. doi: 10.1007/s11892-019-1138-1.
The Native Hawaiian and Pacific Islander (NHPI) population is rapidly growing in the USA. NHPIs face significant health disparities and have a high prevalence of diabetes compared to the general US population.
Recent culturally-adapted diabetes interventions have shown promise in addressing these disparities among NHPI communities. The interventions showed success by utilizing a community-based approach that honored NHPIs' collectivist culture, addressed social determinants of health that influence disease control and prevention, and utilized NHPI community health workers (CHWs) and peer educators for key roles in implementation of the intervention. To address health disparities in the NHPI community, much can be learned from existing, successful interventions. Promising interventions share several attributes. The interventions were: culturally adapted using a community-based participatory research approach; addressed specific social determinants of health (i.e., cost of healthy food, transportation, access to health care) that influence disease control and prevention; honored the collectivist culture of NHPI communities by integrating social networks and extended family members; and utilized NHPI community members, including peer educators and CHWs, for intervention implementation. Further investment to scale these interventions for regional and national implementation is needed to address the significant diabetes disparities that NHPIs face.
综述目的：美国的夏威夷原住民和太平洋岛民（NHPI）人口正在迅速增长。与美国一般人群相比，NHPI 面临着严重的健康差距，糖尿病患病率较高。
最新发现：最近针对糖尿病的文化适应性干预措施在解决 NHPI 社区的这些差异方面显示出了前景。这些干预措施通过利用尊重 NHPIs 集体主义文化的基于社区的方法取得了成功，解决了影响疾病控制和预防的健康决定因素，并利用 NHPI 社区卫生工作者（CHW）和同伴教育者在干预措施的实施中发挥关键作用。为了解决 NHPI 社区的健康差距，可以从现有的成功干预措施中学到很多东西。有希望的干预措施有几个共同特点。这些干预措施是：使用基于社区的参与式研究方法进行文化适应性调整；解决影响疾病控制和预防的特定健康决定因素（即健康食品的成本、交通、获得医疗保健的机会）；通过整合社交网络和大家庭成员来尊重 NHPI 社区的集体主义文化；并利用 NHPI 社区成员，包括同伴教育者和 CHW，来实施干预措施。需要进一步投资来扩大这些干预措施在区域和全国范围内的实施，以解决 NHPI 面临的重大糖尿病差距问题。
