Ing Claire Townsend, Park Mei Linn N, Vegas J Kahaulahilahi, Haumea Stacy, Kaholokula Joseph Keawe'aimoku
Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI, USA.
Thompson School of Social Work & Public Health, University of Hawai'i, Honolulu, HI, USA.
Heliyon. 2023 Jan 24;9(2):e13180. doi: 10.1016/j.heliyon.2023.e13180. eCollection 2023 Feb.
Native Hawaiians have a disproportionately high prevalence of hypertension, which is an important and modifiable risk factor for cardiovascular disease (CVD). To reduce CVD among Native Hawaiians, we must better understand facilitators and barriers to hypertension management (i.e., diet, physical activity, stress reduction) unique to Native Hawaiians. Despite evidence of neighborhood-level facilitators and barriers to hypertension management in other populations, there is limited research in Native Hawaiians. Participants from a randomized controlled trial ( = 40) were recruited for 5 focus groups. All participants were self-reported Native Hawaiians and had uncontrolled hypertension. Discussions elicited experiences and perceptions of neighborhood-level stressors as they relate to participants' hypertension management efforts. Audio recordings were transcribed and analyzed using ATLAS.ti for emergent themes. Five themes were identified: neighborhood description, community resources, neighborhood change, safety, and social connectedness. Novel barriers to hypertension control included loss of culture and loss of respect for elders, change in community feel, and over-development. Facilitators included social cohesion and collective power. These data provide a deeper understanding of how Native Hawaiians experience neighborhood factors and how those factors impact their efforts to improve their diets, physical activity, and stress management. The findings help to inform the development of multilevel CVD prevention programs. Further research is needed to explore the subtheme of social and emotional stress related to neighborhood change and CVD health risk due to cultural and historic trauma references.
夏威夷原住民高血压患病率极高，而高血压是心血管疾病（CVD）的一个重要且可改变的风险因素。为了降低夏威夷原住民中的心血管疾病发病率，我们必须更好地了解夏威夷原住民在高血压管理（即饮食、体育活动、减压）方面特有的促进因素和障碍。尽管有证据表明其他人群在社区层面存在高血压管理的促进因素和障碍，但针对夏威夷原住民的研究却很有限。从一项随机对照试验（n = 40）中招募参与者，组成了5个焦点小组。所有参与者均自称是夏威夷原住民，且患有未得到控制的高血压。讨论引出了与参与者高血压管理努力相关的社区层面压力源的经历和看法。对录音进行了转录，并使用ATLAS.ti分析以找出新出现的主题。确定了五个主题：社区描述、社区资源、社区变化、安全和社会联系。高血压控制的新障碍包括文化丧失、对长者尊重的丧失、社区氛围的变化以及过度开发。促进因素包括社会凝聚力和集体力量。这些数据让我们更深入地了解了夏威夷原住民如何体验社区因素，以及这些因素如何影响他们改善饮食、体育活动和压力管理的努力。这些发现有助于为多层次心血管疾病预防项目的制定提供信息。还需要进一步研究，以探讨与社区变化相关的社会和情感压力子主题，以及文化和历史创伤导致的心血管疾病健康风险。
