Community-Based Participatory Research Integrates Behavioral and Biological Research to Achieve Health Equity for Native Hawaiians

Claire K. M. Townsend, Adrienne Dillard, Kelsea K. Hosoda, Gregory G. Maskarinec, Alika K. Maunakea, Sheryl R. Yoshimura, Claire Hughes, Donna-Marie Palakiko, Bridget Puni Kehauoha and Joseph Keawe‘aimoku Kaholokula
Additional contact information
Claire K. M. Townsend: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Mānoa, 651 Ilalo Street, MEB 307L, Honolulu, HI 96813, USA
Adrienne Dillard: Kula no na Po‘e Hawai‘i, P.O. Box 2368, Honolulu, HI 96823, USA
Kelsea K. Hosoda: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Mānoa, 651 Ilalo Street, MEB 307L, Honolulu, HI 96813, USA
Gregory G. Maskarinec: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Mānoa, 651 Ilalo Street, MEB 307L, Honolulu, HI 96813, USA
Alika K. Maunakea: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Mānoa, 651 Ilalo Street, MEB 307L, Honolulu, HI 96813, USA
Sheryl R. Yoshimura: Kōkua Kalihi Valley Comprehensive Family Services, 2239 N. School Street, Honolulu, HI 96819, USA
Claire Hughes: Hawai‘i Maoli, Association of Hawaiian Civic Clubs, P.O. Box 3866 Honolulu, HI 96812, USA
Donna-Marie Palakiko: Ke Ola Mamo, Dillingham Plaza, 1505 Dillingham Blvd #205, Honolulu, HI 96817, USA
Bridget Puni Kehauoha: Kula no na Po‘e Hawai‘i, P.O. Box 2368, Honolulu, HI 96823, USA
Joseph Keawe‘aimoku Kaholokula: Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai’i at Mānoa, 651 Ilalo Street, MEB 307L, Honolulu, HI 96813, USA

IJERPH, 2015, vol. 13, issue 1, 1-10

Abstract: 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.

Keywords: community-based participatory research; epigenomics; diabetes self-management; Native Hawaiians (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2015
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