Public Health Resonance Project

Tag: United States

  • Hula as a physical activity and social support intervention for sustained activity in female breast and gynecologic cancer survivors

    Erin O. Bantum, Paulette M. Yamada, TeMoana Makolo, Herbert Yu, Ian Pagano, Natalie Subia, Catherine Walsh and Lenora W. M. Loo

    Background: Physical activity improves health and psychosocial functioning for people who have been diagnosed with cancer. Native Hawaiians face disparities for some cancers, including breast cancer. Delivering culturally grounded interventions has the potential to improve enjoyment and adherence to the intervention. We sought to test the adherence and impact of a 6 month randomized wait-list controlled trial of hula.

    Methods: In this randomized wait-list controlled design people who had been diagnosed with breast or gynecologic cancers were invited to participate with other cancer survivors in a group based setting. Participants were randomized to begin hula immediately or after six months. Attendance was collected and heart-rate measured three times per session. In addition, demographic data, self-report psychosocial data, and biological data (findings will be reported elsewhere) were collected at three time points: baseline, 6 months, and 12 months. The study included six months of hula, twice per week, 60 min each session. In addition, participants committed to practice 60 min per week at home.

    Results: Participants in the study (n = 42) attended, on average, 72% of the sessions. Significant increase in moderate physical activity (d = 0.50, p = 0.03) was observed in the intervention versus control group. For the measures of intra-individual changes pre-and post-intervention, an increase in total physical activity were seen in the intervention group (d = 0.69, p = 0.003), daily caloric intake decreased (d = −0.62, p = 0.007), and a reduction in waist circumference (d = −0.89, p = 0.0002) that was sustained six months after completion of the intervention. Psychosocially, cognitive functioning significantly declined from baseline to 12 months (d = −0.50, p = 0.03), with role functioning improving (d = 0.55, p = 0.02), social constraints increasing (d = 0.49, p = 0.03), and financial difficulties improving (d = −0.55, p = 0.02).

    Conclusion: Sustainable physical activity is crucial to improve both the survival and quality of life of cancer survivors. Culturally grounded interventions, such as hula have the potential to increase the maintenance of physical activity. In addition, they create a support group where the benefits of people who have all experienced cancer can gather and garner those benefits of social support, too. This study was registered as a clinical trial through the National Cancer Institute (NCT02351479).

    Frontiers in Psychology, 14

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  • “Wherever I Go, I Have It Inside of Me,” Indigenous Cultural Dance Narratives As Substance Abuse and HIV Prevention in Urban Danza Mexica Community

    Angela R. Fernandez and Ramona E. Beltrán

    Introduction: “Mexican American Indian” (MAI) is a large and diverse population for which little empirical research on alcohol and other drug (AOD) use and HIV is available, yet for which there is a disproportionate risk. Indigenous health narratives and participation in place- and settings-based cultural practices can be protective in chronic and co-occurring disease prevention and health promotion for Indigenous people. This study explores the role of participation in cultural dance in generating narratives of prevention and health promotion among a sample of MAIs from an Urban Danza Mexica Community (UDMC), framed within a decolonizing narratives of health (DNOH) model.

    Methods: This secondary data analysis (n = 9) is drawn from a qualitative AOD and HIV health needs assessment of UDMC living in the Pacific Northwest and the Rocky Mountain West (n = 21). This study uses a community-based participatory research approach and employs narrative, Indigenized methods to analyze in-depth interviews from adult cisgender females (n = 5) and males (n = 4). The DNOH model is developed as a relational, analytic framework that contextualizes Indigenous stories in relationship to three distinct yet interconnected levels—the personal, the communal, and Indigeneity in the larger world. These levels of narrative analysis function as culturally grounded, relational pathways through which to articulate health education and promotion approaches.

    Results: Narratives delve into the complex and nuanced relationships within participants’ internal worlds (personal), between themselves and their Danza community (communal), and between themselves and their complex, intersectional Indigenous identities within society (Indigeneity). Stories of ancestral teachings about health and prevention shared within the Danza circle create spaces wherein participants navigate complex conversations that resist oppressive colonial narratives, reconnect with and strengthen their Indigenous identities, and strive toward ancestral visions of health and well-being.

    Discussion: This study contributes to Indigenized theoretical and methodological expansion and the development of place/settings-based, narrative, cultural health interventions aimed at preventing chronic and co-occurring disease and promoting wellness among populations similar to the UDMC. Identifying cultural practices as Native Hubs (relational, socially constructed places) that foster decolonizing narratives helps increase understanding of their role in public health education and promotion through recognition of Indigenous knowledge systems and frameworks.

    Frontiers in Public Health, 9

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  • Qualitative study on voyaging and health

    Perspectives and insights from the medical officers during the Worldwide Voyage

    Marjorie K Leimomi Mala Mau , Christina Mie Minami, Sarah A Stotz, Cheryl L Albright, Shawn Malia Kana’iaupuni, Heidi Kai Guth

    Objective: To examine the potential association of ocean voyaging with human health and well-being from the perspectives and experiences of the medical officers (MOs) who served during the Worldwide Voyage (WWV).

    Design: Using a phenomenology framework, focus group and individual interviews were conducted and analysed by three diverse core researchers and then reviewed by three external researchers to enhance triangulation. Analysis used the Framework Method and Atlas-ti software (V.8.4.4) to facilitate coding, identify categories and develop an analytical matrix. The matrix was applied to all data using the constant comparative method to construct major themes and subthemes. Synthesised member checking was performed.

    Setting: In 2014–2017, the WWV began in Hawai’i on a traditional voyaging canoe, known as Hōkūle’a, using a non-instrument navigational method, ‘wayfinding’, powered only by natural forces and guided by traditional ecological knowledge. Each segment of the voyage included ~12 individuals, including an MO physician. The entire WWV included 172 ports-of-call, 36 legs and 250+ crew members.

    Participants: We purposively sampled all MO physicians who participated in the WWV and enrolled 87% of eligible MOs (n=20 of 23). We conducted two focus groups (n=17=11+6, 85%) and three individual informant interviews (n=3, 15%).

    Results: The four major themes: (1) Relationships; (2) Preventive Care to Enhance Health; (3) Holistic Health and Wellbeing beyond Voyaging and (4) Spiritual Transformative Experience, strongly suggest that ocean voyaging aboard a traditional voyaging canoe enhanced human health and well-being. The overall impact to perceived health and well-being extended beyond any increase in physical exercise. Essentially, traditional Polynesian ocean voyaging provided a cultural-based context for holistic health and well-being that influenced multiple levels and multiple dimensions.

    Conclusion: Polynesian ocean voyaging was perceived as positively associated with holistic health and overall well-being and it may offer a new approach to confront complex health disparities.

    BMJ Open, 11:e048767

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  • Effects of an African Circle Dance Programme on Internally Displaced Persons with Depressive Symptoms

    A Quasi-Experimental Study

    Dauda Salihu, Eliza M. L. Wong, and Rick Y. C. Kwan

    Background: Internally Displaced Persons (IDPs) are people who have been forced to flee their homes due to disasters. Depressive symptoms, at over 31–67%, are prevalent in IDPs in Africa. Despite the evidence for the benefits of the promotion of dance interventions on psychological health, supporting information is needed to outline the benefits of an African Circle Dance (ACD) intervention for IDPs in Africa.

    Methods: A quasi-experimental design (pre-/post-test) was employed. Two IDP camps were randomized into the intervention group (psychoeducation and ACD intervention) and the control group (psychoeducation). Adults aged ≥18 years, living in an IDP camp, able to perform brisk walking, and who scored ≥10 on a depressive symptoms subscale were recruited. The intervention group received an 8-week ACD dance intervention and two 1-h psychoeducation sessions on stress management; the controls only received the psychoeducation sessions. Outcomes were depressive symptoms, stress, and anxiety. Data were collected at baseline (T0), immediately after the intervention at week 8 (T1), and at week 12 (T2) at the post-intervention and follow-up session. A generalized estimating equation was used to test the effects of the ACD intervention, with a 0.05 significance level.

    Results: 198 IDPs completed the study (ncontrol = 98; nintervention = 100). The intervention group reported significantly greater improvements in depressive symptoms (v = 0.33, p < 0.001) and stress (v = 0.15, 0.008) than did the control group.

    Conclusions: ACD could be a valuable complementary intervention in health promotion but more research is needed.

    International Journal of Environmental Research and Public Health, 18(2), 843

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  • Engaging South Asian women with type 2 diabetes in a culturally relevant exercise intervention

    A randomized controlled trial

    Alamelu Natesan, Vani C Nimbal, Susan L Ivey, Elsie J Wang, Kristine A Madsen, and Latha P Palaniappan

    Background: We examined the efficacy of a culturally relevant exercise program in improving glycated hemoglobin (HbA1c) among South Asian women with type 2 diabetes, compared with usual care.

    Methods: This was a randomized controlled 8-week pilot study of Bollywood dance among South Asian women with type 2 diabetes. The intervention consisted of 1 h Bollywood dance classes offered twice per week. The primary outcome was change in HbA1c. The effect of attendance on this outcome was also examined.

    Results: The intervention group demonstrated a decrease in HbA1c from baseline (−0.18% (0.2%); p=0.018) compared with a non-significant increase in the usual care group (+0.03% (0.2%)); p value for difference between groups was 0.032. Participants attending at least 10 of 16 sessions had a statistically significant reduction in weight (−0.69 kg (0.76 kg)) compared with those attending fewer sessions (+0.86 kg (0.71 kg)).

    Conclusions: These results support culturally relevant dance as a successful exercise intervention to promote HbA1c control, compared with usual care.

    BMJ Open Diabetes Research and Care, 3:e000126

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