Abstract: The broad purpose of this translational (T3) research is to improve rural Native Hawaiian health by improving access to a community-based model of drug prevention. We have developed such an intervention, called Puni Ke Ola. Given the scale of the small grant program, we will implement a single month-long module, and our aims are to study both the process and outcomes of Puni Ke Ola as an initial step in preparing for a larger scale intervention study. Our long-term goal is to eliminate substance use/abuse and related health disparities in Hawaiian populations and communities.


Substance use and abuse represent significant and persistent health disparities among minority and indigenous populations, including Native Hawaiians. Further, substance use contributes to co-morbid health problems ranging from diabetes to cardiovascular diseases to cancer. While substance use among Hawaiian youth tends to start younger and use rates tend to be higher than among their non-Hawaiian peers in the State of Hawai`i, evidence-based drug prevention interventions have not been based on cultural and community assets grounded in Native Hawaiian values, beliefs, practices, and places. Our intervention, Puni Ke Ola, has been developed in this way, which we believe is critical for sustained effectiveness. The lack of cultural relevance in existing evidence-based community interventions targeting rural Native Hawaiian communities limits their use and effectiveness. We hypothesize that a culturally relevant intervention (intervention design and evaluation design) developed with rural Native Hawaiian communities will reduce youth substance use in such communities.

A single module of Puni Ke Ola will be implemented with a small purposive sample of youth. Each module features a specific cultural practice. Modules are implemented following the lunar cycle, which structures a series of activities for community-based experiential learning with classroom-based individual and group reflection. Youth will participate in a photovoice project through which they will document (photo) the hands-on cultural immersion learning, and reflect (voice) on its role in promoting individual & community health and preventing substance use and related youth health risks (Aim 1: document implementation). The main product of the proposed research is to develop a tool for evaluation that aligns with the implementation strategy and includes both standard and novel culturally relevant items (Aim 2: develop outcome measure). We will collaborate with the RCMI CC DCC to migrate the tool to an online web-based platform for use in future intervention studies.