Morgan Nani L, Lopez Nina A, Campbell Amanda T, Cazin Marguerite, Ana Lauralee U, Lai Jennifer F, Vawer May, Yess James
The Queen's Health System, Honolulu, HI 96813, USA.
Department of Medicine, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI 96822, USA.
Int J Environ Res Public Health. 2025 Jan 3;22(1):60. doi: 10.3390/ijerph22010060.
Native Hawaiians (NHs) are a historically oppressed population disproportionately burdened by diabetes and related complications. The Kilolani Project, a patient navigator-centered, chronic disease management program, targets upstream drivers of health among vulnerable NH adult patients with diabetes within an urban academic safety-net clinic. To investigate the impact of the Kilolani Project, we performed a qualitative study to examine patient perspectives. Our goal is to ensure that their values, needs, and priorities drive future navigator-based strategies and healthcare delivery. Fifteen current Kilolani Project patients participated in one of three focus group sessions. Each session followed a semi-structured format with open-ended questions regarding their experiences with the Kilolani Project, patient navigators, and healthcare in general. Iterative transcript readings and coding revealed seven core themes: (1) Humanistic approach, (2) Trusting relationships, (3) Improved access, (4) Trauma-informed care, (5) Self-efficacy, (6) Resilience, and (7) Ethnic concordance. The Kilolani Project created a safe and culturally relevant experience for NH patients. They felt seen, heard, and valued, which resulted in an improved healthcare experience, engagement, and empowerment. Importantly, trust was the cornerstone to building a provider-patient relationship. Such culturally informed approaches are necessary to close the gap in health disparities faced by our NH communities.
夏威夷原住民（NHs）是一个历史上遭受压迫的群体，糖尿病及相关并发症给他们带来了不成比例的沉重负担。基洛拉尼项目是一个以患者导航员为中心的慢性病管理项目，目标是在城市学术安全网诊所中，针对患有糖尿病的弱势NH成年患者的健康上游驱动因素。为了调查基洛拉尼项目的影响，我们进行了一项定性研究，以审视患者的观点。我们的目标是确保他们的价值观、需求和优先事项推动未来基于导航员的策略和医疗服务提供。15名基洛拉尼项目的现有患者参加了三场焦点小组会议中的一场。每场会议都采用半结构化形式，提出关于他们在基洛拉尼项目、患者导航员以及总体医疗保健方面经历的开放式问题。反复的转录阅读和编码揭示了七个核心主题：（1）人文关怀方法，（2）信任关系，（3）就医机会改善，（4）创伤知情护理，（5）自我效能感，（6）复原力，以及（7）种族和谐。基洛拉尼项目为NH患者创造了一个安全且与文化相关的体验。他们感到被关注、被倾听和被重视，这带来了更好的医疗体验、参与度和赋权感。重要的是，信任是建立医患关系的基石。这种具有文化内涵的方法对于缩小我们NH社区所面临的健康差距是必要的。
