No Ke Ola Pono o Nā Kāne: A Culturally Grounded Approach to Promote Health Improvement in Native Hawaiian Men

Abstract

In Hawai’i, Native Hawaiian men (kāne) have the highest death rate from colon cancer among all ethnic groups. While screening can prevent 90% of these cancers, data show that >58% of kāne over age 50 have never been screened. Prior research has demonstrated that community-based social networks may help kāne adopt healthy behaviors such as cancer screening, however, few studies have activated such an approach. A cross-sectional study entitled No Ke Ola Pono o Nā Kāne (for the good health of men) was conducted statewide in Hawai’i from 2014 to 2018. The study strived to perpetuate the Native Hawaiian traditional practice of “hale mua” (men’s house) to promote healthy behaviors among kāne including the adoption of colon cancer prevention strategies such as fecal immunochemical testing (FIT). The study applied a peer-led intervention model using kāne volunteers to deliver the program’s educational components, including standardized materials to help the volunteers confidently conduct the sessions. Of the 378 kāne who were recruited into the study, 232 participated in the colorectal session of which 64% ( n = 149) were over age 50. Survey data from the 149 kāne indicated that 31% had not discussed colon health or screening with their doctors but 92% had improved their knowledge about colon health from the session. In addition, 76% ( n = 113) agreed to complete a FIT. Session evaluations indicated that >91% of kāne liked the hale mua approach and benefited from talking with other kāne about their health.