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Kā-HOLO Project: a protocol for a randomized controlled trial of a native cultural dance program for cardiovascular
Joseph Keawe'aimoku Kaholokula1, Mele A Look2,3, Thomas A Wills4
1Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, USA. kaholoku@hawaii.edu.
Insights
This study tested hula dancing as a culturally relevant intervention to manage hypertension and reduce cardiovascular disease (CVD) risk in Native Hawaiians. Results will inform culturally-based health programs for indigenous populations globally.
Area of Science:
- Public Health
- Cardiovascular Disease Research
- Indigenous Health Interventions
Background:
- Hypertension affects 33% of U.S. adults and is a major risk factor for cardiovascular and cerebrovascular disease (CVD).
- Native Hawaiians exhibit a disproportionately high prevalence of hypertension and CVD compared to other U.S. racial/ethnic groups.
- Culturally tailored interventions are crucial for addressing CVD risk in this population.
Purpose of the Study:
- To evaluate the efficacy of a hula dance-based intervention for managing hypertension and reducing CVD risk in adult Native Hawaiians.
- To assess the impact of the intervention on systolic blood pressure and Framingham Risk Score.
- To identify psychosocial and sociocultural mediators of the intervention's effects.
Main Methods:
- A 2-arm randomized controlled trial with a wait-list control group.
- 250 adult Native Hawaiians diagnosed with hypertension were randomized to a 6-month hula intervention or a wait-list control.
- Primary outcomes (systolic blood pressure, Framingham Risk Score) and secondary measures were assessed at baseline, 3, and 6 months, with a 12-month follow-up for the intervention group.
Main Results:
- Data collection and analysis are ongoing; specific results are pending.
- The study design allows for robust evaluation of hula's impact on hypertension and CVD risk factors.
Conclusions:
- This trial will determine the effectiveness of a novel, culturally-based hypertension management program utilizing hula.
- Findings are expected to have significant implications for CVD risk reduction in indigenous populations worldwide.
- The study aims to offer a sustainable and culturally relevant approach to addressing health disparities.
Background:
As a major risk factor for cardiovascular and cerebrovascular disease (CVD), hypertension affects 33% of U.S. adults. Relative to other US races and ethnicities, Native Hawaiians have a high prevalence of hypertension and are 3 to 4 times more likely to have CVD. Effective, culturally-relevant interventions are needed to address CVD risk in this population. Investigators of the Kā-HOLO Project developed a study design to test the efficacy of an intervention that uses hula, a traditional Hawaiian dance, to increase physical activity and reduce CVD risk.
Methods:
A 2-arm randomized controlled trial with a wait-list control design will be implemented to test a 6-month intervention based on hula to manage blood pressure and reduce CVD risk in 250 adult Native Hawaiians with diagnosed hypertension. Half of the sample will be randomized to each arm, stratified across multiple study sites. Primary outcomes are reduction in systolic blood pressure and improvement in CVD risk as measured by the Framingham Risk Score. Other psychosocial and sociocultural measures will be included to determine mediators of intervention effects on primary outcomes. Assessments will be conducted at baseline, 3 months, and 6 months for all participants, and at 12 months for intervention participants only.
Discussion:
This trial will elucidate the efficacy of a novel hypertension management program designed to reduce CVD risk in an indigenous population by using a cultural dance form as its physical activity component. The results of this culturally-based intervention will have implications for other indigenous populations globally and will offer a sustainable, culturally-relevant means of addressing CVD disparities.
Trial Registration:
ClinicalTrials.gov: NCT02620709 , registration date November 23, 2015.