The Adoption of Cancer Screening and Prevention in Hawaiian Homestead Communities

Dillard, Adrienne; Marshall, Sarah Momilani; Teneza, Jane Nicole; Kekauoha, Bridget Puni; Townsend Ing, Claire; Antonio, Mapuana C.K.; Kenney, Meghan; Okamoto, Scott K.; Kauhane, Michelle; Abrigo, Scott; Kaholokula, Joseph Keawe‘aimoku; Cassel, Kevin

doi:10.31557/APJCP.2025.26.10.3691

The Adoption of Cancer Screening and Prevention in Hawaiian Homestead Communities

Document Type : Research Articles

Authors

¹ Kula no na Po‘e Hawai‘i, 2150 Tantalus Drive, Honolulu, HI 96813, USA.

² Thompson School of Social Work and Public Health, University of Hawaiʻi at Mānoa, Gartley Hall, 2430 Campus Rd, Honolulu, HI 96822, USA.

³ University of Hawai‘i Cancer Center, University of Hawai‘i, 701 Ilalo Street, Honolulu, HI 96813, USA.

⁴ Department of Native Hawaiian Health, University of Hawai‘i, 677 Ala Moana Boulevard, Honolulu, HI 96813, USA.

⁵ Hawaiian and Indigenous Health Program, Department of Public Health Sciences, University of Hawaiʻi at Mānoa, 1960 East-West Rd, Honolulu, HI 96822, USA.

⁶ Kapolei Community Development Corporation, 91-1270 Kinoiki Street, Bldg #2, Kapolei, HI 96707, USA.

10.31557/APJCP.2025.26.10.3691

Abstract

Background: This study examined screening behaviors for breast, prostate, and cervical cancers among residents on several Native Hawaiian Homesteads. Methods: From 2016 to 2020, a cross-sectional survey was administered to identify the most relevant and modifiable factors associated with participants’ health behaviors. The participating Homestead communities are located on the Islands of Oʻokinaahu and Hawai‘i. A mailed invitation letter was sent to 1,582 lessees and/or the listed resident in each Homestead community. Respondents were identified as the Homestead lessee, lessees’ successor, and/or designee who were over age 18. Sociodemographic and economic variables, as well as cancer-related and cancer screening behaviors, were assessed using items derived from the Behavioral Risk Factor Surveillance Survey (BRFSS). Four items assessing the ability to perform daily activities were also included. Descriptive statistics were calculated, followed by frequencies and percentages for categorical variables, and means and standard deviations for continuous variables. A p-value of < .05 (two-tailed) was used to determine statistical significance. Results: Out of 1,582 surveys sent, a total of 459 surveys (29%) were collected. Screening rates for several cancer sites (colon 72%, cervical 97%, breast 99%) were well-above average for Hawai‘i and the U.S. Conclusion: These results may be a direct reflection of the strong engagement efforts cultivated by community-based researchers and their longstanding university-community partnership that utilizes community-based participatory research approaches for health promotion.

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