UH Cancer Center’s Native Hawaiian men’s health study highlights importance of culturally grounded prevention efforts

February 24, 2020

No Ke Ola Pono o Nā Kāne discussion group facilitators

The study results of the University of Hawaiʻi Cancer Center, No Ke Ola Pono o Nā Kāne (for the good health of men) project, conducted statewide in Hawaiʻi to promote health improvement in Native Hawaiian kāne (men) through culturally grounded approaches was published in the American Journal of Men’s Health .

The study perpetuated Native Hawaiian traditional practices of hale mua (men’s house) and community hui kūkākūkā (discussion groups) to promote healthy behaviors among Native Hawaiian kāne. The study also emphasized colon cancer prevention strategies such as using the fecal immunochemical test (FIT). Native Hawaiian kāne volunteers conducted peer-led interventions using the program’s educational components of standardized materials and four modules to guide the sessions. The module's topics covered lung, coloretal, and oronasopharyngeal cancers.

In partnership with Ke Ola Mamo, Oʻahu’s Native Hawaiian Health Care System, 378 kāne were recruited into the study from 2014 to 2018, and 232 participated in the colorectal discussion groups, of which 64% (149) were over age 50. Of the 149 colorectal discussion group participants, 31% had not discussed colon health or screening with their physicians, but 92% improved their knowledge about colon health from the sessions. In addition, 76% agreed to complete a FIT. Session evaluations also indicated that more than 91% of kāne liked the hale mua approach and benefited from talking with other kāne about their health.

“Early and regular screening for precancerous colon lesions can prevent nearly 90% of colon cancers. Our study results show that introducing FIT to kāne through community hui kūkākūkā may help fight the disease among kāne,” said Kevin Cassel, DrPH, study principal investigator and UH Cancer Center assistant researcher.

The major discussion themes at the peer-led interventions included healthy traditional Hawaiian lifestyle and the role of kāne in the Hawaiian family. In addition, discussions focused on knowledge, attitudes, and behaviors surrounding each session’s health promotion topics. Participants also noted appreciation for having a Native Hawaiian kauka (physician) present at every session.

The study highlights that in Hawaiʻi Native Hawaiians bear disproportionately higher rates of chronic illnesses including diabetes, cardiovascular diseases, obesity, and cancer compared to the overall state population. In addition, many Native Hawaiians live in rural communities where health care and recreation services are meager, distant, or non-existent.

“The culturally-based traditions of the hale mua and community hui kūkākūkā can be the foundation to address health disparities among kāne. It is important to continue future studies to explore these culturally-based approaches, and extend group discussion topics addressing health issues relevant to Native Hawaiian men,” said Nathan Wong, MD, study kauka and UH Cancer Center Native Hawaiian Community Advisory Board member.

“We plan to conduct additional studies to explore continued use of the hale mua approach to extend group discussion topics to address other health issues relevant to Native Hawaiian men,” stated Kevin Cassel, DrPH.