Symposia
Culture / Ethnicity / Race
Kelsie Okamura, Ph.D. (she/her/hers)
Implementation Researcher
The Baker Center for Children and Families
Boston, Massachusetts
Tessa R. Palafu, B.A. (she/her/hers)
Implementation Research Assistant
The Baker Center for Children and Families/Harvard Medical School
Wahiawa, Hawaii
Katlyn An, B.S.
Graduate Research Assistant
University of Hawai'i Cancer Center
Honalulu, Hawaii
Scott Okamoto, PhD
Researcher/Professor
University of Hawai'i Cancer Center
Honalulu, Hawaii
Sarah Momilani Marshall, PhD
Postdoctoral Fellow
University of Hawai'i Cancer Center
Honalulu, Hawaii
Steven Keone Chin, APRN
Hawai'i Island Field Site Coordinator
University of Hawai'i Cancer Center
Honalulu, Hawaii
Byron Powell, PhD (he/him/his)
Associate Professor
Washington University in St Louis
St. Louis, Missouri
Kelly Stern, B.A.
District Education Specialist
Hawai'i State Department of Education
Kailua-Kona, Hawaii
Sara Becker, PhD (she/her/hers)
Alice Hamilton Professor of Psychiatry
Northwestern University Feinberg School Of Medicine
Chicago, Illinois
David S. Mandell, ScD (he/him/his)
Professor and Director, Penn Center for Mental Health; Vice Chair for Faculty Development, Department of Psychiatry, University of Pennsylvania School of Medicine
Penn Center for Mental Health, University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania
The Ho‘ouna Pono curriculum is a culturally grounded, teacher-implemented, modular and video-enhanced substance use prevention program that has been developed and tested on rural Hawaiʻi Island. Despite the potential to ameliorate health disparities, provide equitable healthcare, and address youth substance use, prevention programs have been poorly disseminated and implemented across Hawaiʻi, raising the question: Why are effective prevention programs not used in communities that most need them? Concept mapping is a method for developing implementation strategies that solicits opinions about barriers and clusters the opinions together meaningfully. Seven Hawaiʻi Department of Education (HIDOE) leaders identified Ho‘ouna Pono implementation barriers (e.g., “There is a lack of HIDOE funding to support prevention curricula”) and sorted, named, and rated the barriers in terms of their perceived impact and difficulty of implementation. Participants were predominantly female (62.5%) and were Native Hawaiian (16.7%), Japanese (16.7%), Korean (8.3%), Portuguese (16.7%), White (25%), and Other Pacific Islander (8.3%). One third of participants held a Masters degree or higher. Roles included an Interim Administrator of School Health Section, District Educational Specialist in School-Based Behavioral Health, Teacher, Educational Specialist for the Office of Student Support Services, and Complex Area Superintendent. Multidimensional scaling and cluster analysis indicated a five cluster solution with areas of (1) Kumu (Hawaiian word for teacher) Controlled, (2) School Level Buy-in, (3) Curriculum, (4) Student Attitudes + Mindsets (Family + Community), and (5) Policy. Participant difficulty and impact ratings varied by individual and cluster barriers. Participant discussion revealed important intersections among barriers indicating the need for coordinated and cross-level implementation strategies to support Ho‘ouna Pono sustainment. Findings will be discussed in the context of the Consolidated Framework for Implementation Research, which organizes barriers into five meaningful domains. We will also share findings from a participant discussion that revealed several interconnected considerations in implementation strategy selection and prioritization.
