Insights in Public Health: Ask the Keiki: Perceived Factors that Affect Asthma Among Adolescents from the Wai'anae Coast Using Photovoice.

Hawai'i has among the highest childhood asthma prevalence compared to all other states in the United States. Native Hawaiian children have a higher prevalence of asthma compared other racial/ethnic groups in the state. Photovoice is a method in community-based participatory research that enables participants to use photos to express themselves and advocate on behalf of their community. In this study, students from the Wai'anae Coast used Photovoice to identify perceived factors that affect asthma management. Seven students, ages 14 and 18, with self-reported asthma met virtually, with facilitators, after school once a week for four weeks. Students identified eight factors as positively or negatively impacting the students' asthma and explained how these factors influence their health. The Photovoice results provided an in-depth understanding on the role a student's culture and environment plays in asthma management. Continued efforts to develop asthma education programs tailored to address the specific factors that youth identify as impacting their asthma may be more effective in reducing asthma disparities. Future research should expand on the key themes identified in this study and include continued advocacy efforts among students to improve asthma-related outcomes in this community.

Empowering 'Opio (Next Generation): Student Centered, Community Engaged, School Based Health Education.

Education and health are vital for children to thrive, especially for those from rural and disparate communities. For Native Hawaiians, the indigenous people of the State of Hawai'i, lokahi (balance) frames the concept of ola (health), consisting of physical, emotional, and spiritual health. The foundation of ola is embedded in the cultural values - kupuna (ancestors), 'aina (land), environment, and 'ohana (family). Unfortunately, since westernization, Native Hawaiians have significant health disparities that begin in early childhood and often continue throughout their lifetime. Native Hawaiians also have a history of educational disparities, such as lower high school an college graduation rates compared to other ethnic groups. Social and economic determinants, such as poverty, homelessness, and drug addiction, often contribute to these educational disparities. In rural O'ahu, the Waianae Coast Comprehensive Health Center recently established two school-based health centers at the community's high and intermediate schools to improve student access to comprehensive health services. Recognizing the need to improve student health literacy and address specific health issues impacting the community and students, two health educators were added to the school-based health team. This article describes: 1) the initial steps taken by the health educators to engage and empower students as a means to assess their needs, interests and facilitate student lokahi, ola, and wellness and; 2) the results of this initial needs assessment.