Research has indicated that Native Hawaiian youth have significantly higher rates of drug use than their non-Hawaiian counterparts (e.g., Wong, Klingle, & Price, 2004; Mayeda, Hishinuma, Nishimura, Garcia- Santiago, & Mark, 2006; Nishimura, Hishinuma, & Goebert, 2013), and that these differences are particularly pronounced in rural settings (Saka, Takeuchi, Fagaragan, & Afaga, 2014). Despite these findings, there have been very few drug prevention programs developed and evaluated specifically for these youth (Edwards, Giroux, & Okamoto, 2010; Rehuher, Hiramatsu, & Helm, 2008). Further, efforts to address youth substance abuse have been poorly implemented and coordinated across the State of Hawai?i (Waitzfelder, Engel, & Gilbert, 1998). Therefore, the purposes of this R34 proposal are to identify potential barriers or challenges to the implementation, adoption, and sustainability (IAS) of a culturally grounded, school-based drug prevention curriculum (Ho?ouna Pono) across all public middle, intermediate, or multi-level schools on Hawai?i Island, and to create a comprehensive, community-based IAS action plan for the curriculum. This will be accomplished through three specific aims.
AIM 1 (Assessing Environmental Demands, Year 1) is to develop and validate an implementation, adoption, and sustainability inventory related to Ho?ouna Pono, which will be theoretically informed by The Consolidated Framework for Implementation Research (CFIR; Damschroder & Hagedorn, 2011; Powell, Proctor, & Glass, 2014). The inventory will consist of items describing barriers or challenges to the successful adoption, implementation, and/or sustainability of Ho?ouna Pono on Hawai?i Island.
AIM 2 (Response Enumeration, Year 2) is to systematically elicit implementation strategies (or solutions) to the most problematic and/or difficult barriers to the IAS of the curriculum in public schools on Hawai?i Island, and to rank-order these solutions based on their perceived ability to address or overcome each of the barriers to IAS.
AIM 3 (Action Plan, Year 3) is to create a community based and validated action plan based on the findings from Aims 1 and 2, which will be evaluated in a future NIDA R01 grant proposal focused on dissemination and implementation research in health.
Because Hawaiians or part-Hawaiians represent the largest Pacific Islander population in the U.S. (Harris & Jones, 2005) and have been shown to have significantly higher rates of drug use compared with other ethnic groups (Wu et al., 2013), research focused on drug prevention of these individuals is important to improve public health both in Hawai?i and on the Mainland U.S. This study actively engages rural public schools and communities in assessing the implementation, adoption, and sustainability of the Ho?ouna Pono drug prevention curriculum. The findings from this study will point to barriers and challenges to the successful implementation of evidence-based prevention curricula for rural, Pacific Islander, and indigenous communities, as well as to culturally grounded implementation strategies to promote the sustained public health impact of the curriculum.