Comorbid Conditions Are Associated With Cognitive Impairment in Native Hawaiians and Pacific Islanders.

We examined the association between comorbid conditions and mild cognitive impairment (MCI) in Native Hawaiians and Pacific Islanders (NHPI) (n = 54). Cross-sectional, self-reported questionnaires were utilized to collect demographic, comorbid conditions, and MCI (via the AD8 index) data. Separate logistic regression models were conducted to investigate the relationship between comorbid conditions and MCI, adjusting for other covariates. We found significantly increased odds of MCI in those reporting high blood pressure (OR = 5.27; 95% CI: [1.36, 20.46]; p = 0.016), high cholesterol (OR = 7.30; 95% CI: [1.90, 28.14], p = 0.004), and prediabetes or borderline diabetes (OR = 4.53; 95% CI: [1.27, 16.16], p = 0.02) compared with those not reporting these respective conditions. These data show that hypertension, hypercholesterolemia, and prediabetes are associated with MCI in the NHPI community, suggesting that preventive strategies to reduce chronic conditions may also potentially slow cognitive decline in underrepresented/understudied NHPI.

Reservations to Participate in Biospecimen Research among Pacific Islanders.

BACKGROUND AND SIGNIFICANCE: Despite high rates of chronic diseases like cancer, diabetes and cardiovascular disease, Pacific Islanders (PIs) are underrepresented in clinical and genetic studies designed to identify the physiological causes of poor health outcomes. There are limited genetic data and biospecimen samples from PIs under study. This paper described why PIs have reservations about donating their biospecimen samples for research. METHODS: Data were drawn from a pilot study designed to assess the knowledge, attitudes and beliefs surrounding biospecimen research among PIs in southern California. Utilizing a community-based participatory research approach, community and academic partners collected quantitative and qualitative data from a total of 60 PI adults with a mean age of 61 years (SD 13 years). RESULTS: "Fear", "God or Spirituality" and "Lack of Information or Knowledge" were the most cited reasons for not participating in biospecimen research. Respondents younger than age 65 years expressed more concerns about donating their biospecimen samples than those older than age 65 years (p<0.012). No significant gender differences were found (p=0.84). CONCLUSION: Our results emphasize the need to conduct relevant and appropriate biospecimen education among minority communities in order to address misconceptions and build support to increase PI and other minority participation in biospecimen-related studies.

Dietary intakes, obesity and health behaviors in Native Hawaiians residing in Southern California.

OBJECTIVES: Accessing dietary intakes, body mass index (BMI) and health behaviors in Native Hawaiians residing in Southern California. DESIGN: Cross-sectional, community based participatory research. PARTICIPANTS: Native Hawaiian (N = 55); Mean age 59 (± 15). MAIN OUTCOME MEASURES: Diet, body mass index (BMI), and diet/exercise health behaviors. Collected diet via 24-hr dietary recalls, health behaviors through questionnaires and BMI via measurement/self-report. ANALYSIS: Frequencies/means and multiple linear regression were used to assess diet, BMI, and health behaviors. RESULTS: Nearly 90% of the participants were either overweight or obese. Less than 20% met the vegetable, fruit, fiber, and whole grain recommendations. Most were a little or somewhat sure (relative to almost always sure) about their ability "to stick with an exercise program when attending a cultural gathering", and "when visiting Hawai'i". CONCLUSIONS AND IMPLICATIONS: These results suggest that developing a culturally-based education program to reduce obesity and improve diet is critical for Native Hawaiians residing in Southern California.

Diet, psychosocial factors related to diet and exercise, and cardiometabolic conditions in Southern Californian Native Hawaiians.

OBJECTIVE: Native Hawaiians are at higher risk for cardiometabolic disease, including diabetes and cardiovascular disease compared with other ethnic groups. Diet, body mass index (BMI) and psychosocial, as well as cultural issues may influence risk for cardiometabolic disease. Our team conducted a community-based participatory research study and examined diet, height/weight, psychosocial factors, and community health concerns in Native Hawaiians living in Southern California. DESIGN AND METHODS: Cross-section of 55 participants, <18-years-old. Dietary data were collected via three 24-hr dietary recalls, anthropometrics were measured, and psychosocial factors and cardiometabolic conditions were self-reported. Talk story related to diet and health was completed in a sub-sample. Means and frequencies were calculated on dietary intakes, cardiometabolic disease and BMI. Independent t-test and chi square analyses, as appropriate, were performed to assess differences in dietary intakes, obesity and psychosocial factors between those with and without a pre-existing cardiometabolic condition. RESULTS: Of those with pre-existing health conditions (n=28), 72% reported being diagnosed with a cardiometabolic condition. For those with pre-existing cardiometabolic conditions, the daily vegetable consumption was 2.57 servings (+/-1.66) and the mean fruit consumption was 1.43 servings (+/-0.1.99). The mean fiber intake was 16.24 grams (+/-6.92), the mean percentage energy from fat was 34.82% (+/-6.40) and the mean % energy from carbohydrate was 47.15 (+/-6.77). The psychosocial data showed significantly (p<0.05) lower social support, social interaction, self-monitoring and cognitive-behavioral strategies related to exercise for those with cardiometabolic disease compared with those without disease. All the talk story discussion groups expressed concern over diabetes and weight management, both as an individual and community issue. CONCLUSIONS: The dietary data indicate that Native Hawaiians residing in Southern California should aim to increase their vegetable, fiber, and reduce % energy from fat and saturated fat. Additionally, the psychosocial data suggests that implementing physical activity programs based on socio-cultural values such as ohana, community gatherings, as well as individual self-monitoring and cognitive-behavioral strategies may improve cardiometabolic outcomes. In efforts to reduce cardiometabolic disease disparity, these data suggest that Native Hawaiians in Southern California are aware and concerned about cardiometabolic disease in the community, and that implementation of an effective energetic (diet plus physical activity) intervention that is socially, and culturally specific for Native Hawaiians in Southern California is critical.