Purpose. To explore young, multi-ethnic adolescents' attitudes and influences related to cigarette smoking for the purpose of developing and producing a youth-led, tobacco-prevention drama. Design. Focus groups and demographic surveys. Setting. Island of Oahu, Hawaii. Participants. Fifty-four multi-ethnic youth, ranging in age from 10 to 14 years, participated. The study was promoted in schools with a large representation of Hawaiian, Filipino, and Pacific Islander students. Methods. Each of five focus groups was audio-recorded, and an observer recorded extensive notes throughout the sessions. Content analysis consisted of coding focus group notes for recurrent themes and using the audio recording as confirmation. Results. Just more than one quarter (n = 15) of the youth had tried smoking, and two-thirds (n = 35) currently lived with someone who smoked. Participants expressed the feeling of being surrounded by smoking influences at home, in their communities, and at school. Youth were negatively affected by family members' tobacco use, and they desired skills that could enable them to help family members stop using tobacco. Conclusion. Family influences may play an important role in youth attitudes toward tobacco use, especially given the cultural significance of extended family and of filial piety that are reflected in many traditional, Asian and Pacific Islander families. Interventions targeting youth in Asian and Pacific Islander communities should incorporate key cultural references to the extended family and to a respect for elders to establish relevance in the life experiences of young people in these population groups.
Interviews with twelve Hawaiians, eleven of them kupuna (elders)who were raised on Hawaii, Maui, Molokai, and Oahu around the turn of the century, indicate the following attitudes and beliefs about the land. Above all the land was regarded as the provider of everything: "food, shelter over your head, and a place to plant your feet and stand firm." Land also meant work--hard work, because if you "turn your hands down to work you live; turn them up and you get nothing." For some land symbolized life, and in pre-Christian tradition mana (power). Since the 'ohana (relatives and friends) lived on the land, and their spirits returned there generation after generation, the land was also closely tied in thought with the chain of being: it was like a piko (umbilical cord). Just as one felt aloha for the 'ohana, so one felt toward the land on which the 'ohana worked, lived, and stayed in eternity. Aloha for the 'aina was expressed by attitudes of respect, returning gifts to the land, beautifying it, and using it properly (not greedily). More than anything else land, and all that was associated with it, gave a sense of identity to Hawaiians. Thus, for example, aloha 'aina meant love of country during the years when Hawaii's government was being overthrown. Thus it is understandable that those concerned with their Hawaiian heritage today, regardless of their religious or political beliefs, look first to the land which in former times was theirs.
Climate change, known as the shift in a region's average weather conditions over a long period has created an impact on human lives that extends well beyond rising temperatures. While the Earth's climate has naturally fluctuated throughout its existence, modern climate change is unprecedented, with the Earth's average temperature in 2020 being the hottest year on record. To understand the depth and complexity of this issue, our team created the following map to draw out the causes and implications of climate change on the island of Oahu, Hawaii. In the current Anthropocene, the collective release of greenhouse gases results from the overconsumption of natural resources driven by industrialization. Being economically dependent on the travel business but also geographically sensitive to rising sea levels. Hawaii's climate is trapped in a vicious cycle that desires interventions with higher leverage points, such as changes to the island's infrastructure and fundamental shifts in core values. Even though most environmental campaigns have a call to action aimed towards individual habits and consumer choices, our research concludes that the main responsibility lies in the hands of major corporations and federal level governments. Reading the climate change on O'ahu HI systems map The five-petal flower motif represents the delicate climate situation O'ahu's flora and fauna faces, and divides the map into five large categories, each containing the causes and effects across social, environmental, economic, infrastructure, and transportation aspects. The connections between elements overall indicate a mitigating or worsening effect on GHG emissions, while the gradient shows the local-to-global scope surrounding the issue. With the political bubble being the highest stakeholder, this map demonstrates how the ecology of interventions relies on government power and action.
BACKGROUND: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is the leading infectious cause of death worldwide and the state of Hawaii (HI) has the second highest case rate of TB in the United States. The prevalence of TB among military health system (MHS) beneficiaries (active duty service members, retirees, dependents, civilians and eligible Pacific Island civilians) in HI has not been previously reported. Our analysis evaluates the prevalence of MTB among acid fast cultures (AFCs) tested at Tripler Army Medical Center (TAMC) on Oahu, HI and describes demographic factors associated with positive samples. METHODS: We analyzed AFC results from TAMC clinical diagnostic microbiology laboratory from January 2002 to November 2019. Demographic data were recorded for each individual with an AFC sample during the study period. Prevalence was calculated based on the number of MTB-positive AFCs per all AFCs over the study period. Multivariable logistic regression was used to evaluate associations between demographic factors and MTB-positive AFC results. RESULTS: From January 2002 to November 2019 there were 4768 AFCs resulted at TAMC with 49 MTB-positive AFC, leading to a cumulative prevalence of 1.03 percent (Figure 1). After controlling for other factors, Asian-Pacific Islanders had nearly 15 times higher odds of having a positive AFC than whites (OR=14.96, 95% CI 5.03, 44.55, p=< 0.001) and active duty personnel had 2.6 times the odds of having a positive AFC than dependents, civilians and retirees (OR=2.6, 95% CI 0.94, 7.22, p=0.067). Figure 1. The Prevalence of M. tuberculosis (MTB) among Acid Fast Cultures (AFC) from Military Health System Beneficiaries from Hawaii and Pacific Islands from January 2002 to November 2019. [Image: see text] CONCLUSION: The low prevalence of MTB among AFCs performed at our institution over nearly 16 years suggests that living in the state of HI does not appear to confer high rates of TB to MHS beneficiaries. Persons with Asian-Pacific Islander ethnicity have higher ...
Background The practice of viewing animals in captivity is losing popularity among tourists, who would rather observe wildlife in their natural environments. A laudable sustainability goal is to provide enjoyable viewing possibilities while also protecting wildlife. Focus of the Article This study tested a social marketing campaign that promoted replacement behaviors against standard regulatory signage in persuading individuals to follow the viewing distance guideline for Hawaiian green sea turtles. The characteristics of one of the study sites also offered the opportunity to study the impacts of symbolic barriers (e.g., rock walls, orange safety cones) and enforcement from authority-like figures on people's compliance. Research Questions The study addresses three research questions: (1) Can a social marketing-based approach encourage respectful wildlife viewing? (2) How does the approach compare to one providing simplistic information about the behavior and associated laws? (3) How do symbolic barriers and enforcement by authority-like figures add impact to influencing respectful wildlife viewing? Program Design/Approach The "Amazing from Afar" campaign was designed with insights from federal wildlife managers, existing literature on tourists' psychology and goals, and key informant interviews with local residents. The campaign promoted replacement behaviors of taking forced perspective photos of sea turtles and was evaluated alongside other techniques to encourage respectful viewing. Importance to the Social Marketing Field This article demonstrates the effectiveness of social marketing for nature-based recreation, an under-served area where interest in approaches focused on behavior change is emerging. The study documents improved compliance with wildlife viewing distances using a social marketing approach compared to the more standard approach of stating rules/laws and putting up symbolic barriers. Plus, it illustrates how symbolic barriers and enforcement can enhance impact. Methods Research took place over two studies, one on Oahu ( n = 1,437) and one on the Island of Hawai'i ( n = 10,217) using a quasi-experimental design where the control conditions reflected existing efforts at the site. Using naturalistic observation, we categorized and counted people at various distances from basking sea turtles before and during the social marketing campaign. Results Findings showed regulatory information signs located near the sea turtles positively impacted people's compliance with the viewing distance guideline, and the social marketing campaign improved compliance even further. The symbolic barrier could help or hurt compliance depending on how close sea turtles got to its edges, but compliance was over 90% with the social marketing campaign in place. Recommendations Natural resource managers and conservationists should carefully consider how regulations/enforcement, environmental design, and marketing can work together to achieve wildlife protection while preserving fulfilling viewing opportunities. Limitations The field research relying on observations of people's behavior did not allow for assurances of exposure to signage, and in some cases, the symbolic barriers could have been overlooked as well. Instead, there could have been descriptive norm cues from others since it was common for multiple parties to be viewing at once.
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After numerous delays and extensive cost overruns, Honolulu's Skyline passenger rail system launched on June 30. Skyline is the first U.S. system to use automated trains, hopefully serving as an example to the nation's other urban transit operators. Driverless train technology is common in Canada, Asia, France and at U.S. airports. They offer lower costs and the potential for more frequent service. Skyline opened with five days of free service through July 4, when daily ridership peaked at 18,108. The elevated train system with its unique views proved to be something of a tourist attraction during the holiday weekend. But when Skyline began to collect fares on Wednesday, July 5 ridership plummeted to only 1,245. (It subsequently revised the total to 3,276 stating that the original figure did not include passengers transferring from buses). The city expects that after a year, daily ridership will stabilize in the range of 8,000 to 10,000. All of this is a far cry from original projections. The project's 2010 Environmental Impact Statement projected that ridership would reach 116,300 in 2030. As late as 2018, Honolulu officials were offering aggressive ridership projections of up to 121,600 per day in 2030. One reason that today's ridership is so far below the old forecasts is that only a portion of the system is now in service. The 2030 ridership projections applied to the full 20‐mile, 21‐station system originally planned. The phase that just opened encompasses the easternmost 11 miles and nine stations. The two westernmost stations have been dropped from the project to contain cost overruns. But much of the gap between real and forecast ridership levels is attributable to excessively optimistic modeling assumptions. As recently as 2020, the city thought daily ridership on the initial nine‐station segment would by over 19,000 or double the city's latest prediction. A longtime critic of Honolulu's transit plans, University of Hawaii Civil Engineering Professor Panos Prevedouros, previously offered a projection for the full system that was also about half of official forecasts. He came to this conclusion after seeing a decline in Honolulu bus ridership as well as very low ridership on Tren Urbano, a similar rail system in Puerto Rico. Dr. Prevedouros offered the following reaction to the first day ridership figures: While the recent numbers are truly abysmal, it'll take till about November of this year for ridership to settle down to a representative number of rail and bus ridership on Oahu, from which one can make a reasonable estimate about the ridership of the full line. If I were placing a bet, I'd be betting on more abysmal levels of ridership, much worse than those I estimated in the 2010s, which were about half of what HART (the Honolulu Authority for Rapid Transit) was projecting.
Aggressive ridership forecasts are not unique to Honolulu. Earlier in 2023, San Francisco's $2 billion, 1.6‑mile Central Subway began revenue service with a far lower number of passenger boardings than originally anticipated. Had ridership projections been more realistic, perhaps Honolulu would have opted to serve the route with Bus Rapid Transit (BRT) instead of rail. Individual BRT vehicles can accommodate up to 300 passengers and BRT lines in several international cities handle a peak load of over 10,000 passengers per hour. In the US, the Los Angeles Metro G Line served about 30,000 passengers daily at its peak before the pandemic. If the LA line was grade separated and not impacted by traffic signals, its capacity could be far higher. Not only does BRT have adequate capacity for the Honolulu Skyline, its use would not have had a major impact on travel times. While trains have much higher maximum speeds than buses, this difference is only material when stations are far apart. On the Skyline, stations are no more than a couple of miles apart and trains will achieve a maximum speed of only 55 mph. Had Honolulu opted to run large buses rather than trains along the elevated Skyline, it could have started service far sooner and at much lower cost than with a rail‐based solution. And a less aggressive, more realistic ridership forecast may have led to the conclusion that Skyline was best served by BRT. For other local governments considering new transit services, Honolulu's lessons are worth considering.
ABSTRACT OF THE DISSERTATIONHow do Native Hawaiian Concepts of Well-being Inform the Meaning And Social Function of Food?ByDarrah Leigh Goo KurataniDoctor of Philosophy in Public HealthUniversity of California, Los Angeles, 2015Professor Marjorie Kagawa Singer, ChairIt is well known that indigenous communities are vulnerable to the plight of the social gradient of health and are overly burdened by chronic diseases. One common risk factor for the major chronic illnesses among indigenous communities, such as heart disease, metabolic syndrome, diabetes, and cancer is obesity. The indigenous people of Ka Pae Aina (the Hawaiian Islands), the Kanaka Maoli (Native Hawaiians), reside as minorities in their native land, and have the poorest health outcomes. They also have one of the highest rates of obesity in the world. Even though obesity rates have risen for all groups nationally, Native Hawaiians are almost twice as likely to be obese. In Hawaii, Native Hawaiians have the highest obesity rate (47%) when compared to other ethnic and racial groups, including Non-Hispanic Whites (NHW) (21%), Japanese (16%), and Filipinos (21%) (HHDW, 2013). The epidemiology clearly shows that the problem exists, but current research does not explain why the obesity rate for Native Hawaiians is so incredibly high. Such reasons remain poorly explored, and this lack of knowledge undermines efforts to effectively reduce the rates of obesity. The U.S. colonized native Hawaiians in 1898, and colonial culture and laws have worked to marginalize, stigmatize and alienate Native Hawaiian people from the larger society. The overarching impact of imposed and embedded colonial denigration of the Native Hawaiian people has been reported to be the perpetuation of negative self-image and their social position has been restricted to the bottom of the political hierarchy. The consequences of both these forces generally has been to limit their lifestyle choices and options about their own health and well-being. Yet these factors are rarely included as active factors in the theoretical frameworks used to address the health status of this population. Rather, studies that address Native Hawaiians and other indigenous peoples, often intimate that their culture is a large part of the problem. However, interventions designed to improve the negative health status of native peoples and Native Hawaiians, in particular, do not seem to identify what it is about culture, and in particular, whose culture, may actually be influencing the behaviors that lead to overweight and obesity. Previous interventions that have integrated cultural values and practices in weight loss programs with Native Hawaiians have shown initial benefit, but were unable to sustain long term results. This is likely because the focus was on individual level beliefs and practices. The larger social and political forces that address daily realities of work and low incomes, and institutionalized discrimination towards Native Hawaiians were not addressed. Individual level strategies are necessary, but not sufficient to sustain healthier choices if these contextual forces are not addressed. In the 1970s, the Hawaiian Renaissance was founded and became an emotional and political turning point for Native Hawaiians. Its goal was to reinvigorate cultural pride and interest in the values and wisdom of Native Hawaiian culture in contrast to the 120 years of explicit denigration of Native Hawaiian culture, and explicit pressure to assimilate into white European Christian culture. The spirit of the Hawaiian renaissance has given rise to a counter consciousness and spurred an ongoing struggle to recognize and reconcile the two competing sets of cultural messages for the native peoples and, primarily, the political power and social structure of Hawaiian society today. This study applied a socio-ecologic conceptual cultural lens to understand the concepts of well-being among Native Hawaiians to investigate if and how social, political, and historical contextual forces may still affect Native Hawaiians' sense of self, and if and how these forces may impact their conceptualizations of and decisions regarding health. The intent was to investigate how a multi-level, multidimensional concept of culture might better elucidate how we understand the relationships of these contextual forces on the meaning of well-being and food, the use of food in social relationships, and, ultimately, its potential relationship to rates of obesity. This ethnographic study was conducted on the island of Oahu with participant, observational, archival investigations and one-on-one inductive qualitative, interviews with twenty-nine Native Hawaiian participants. Interviews were audio-recorded, transcribed, and analyzed. The conceptual frameworks that guided this study included, the Cultural Framework for Health (CFH), and the philosophical and theoretical concept of empathy. The CFH recognizes and incorporates an explicit definition of culture as a scientifically grounded, multidimensional, and multi-level construct, inclusive of biopsychosocial and ecological frameworks and recognizes and incorporates geographical, historical, social and political realities of diverse communities. The findings show that Native Hawaiians' conceptualizations of well-being are based on five core Native Hawaiian cultural values: 1) ohana (family), 2) aloha (love, care, and compassion), 3) kokua (to help without being asked), 4) lokahi (harmony), and 5) mana (life force, energy, power). One of the key ways these values are expressed and manifested interpersonally is symbolically through the meaning and use of food. Food was found to be a key component in how Native Hawaiian identity is conceptualized and as a way to express and access love, compassion, and comfort. Notably, the findings showed that the conceptualizations of well-being extend beyond the individual and include family, community, social, political and historical issues and structures that have the potential to provide a sense of worth and empowerment. This study suggests that the use of food may also be a coping mechanism for Native Hawaiians to seek comfort from the feelings of powerlessness and denigration by the overarching social structure that has relegated them to being "the forgotten people." Health interventions would likely be more effective and long lasting if this more comprehensive and scientifically grounded cultural analysis informed the design and implementation of such efforts.
