Native Hawaiian culturally based treatment: Considerations and clarifications

Area of Science:

• Public Health
• Health Equity
• Indigenous Health

Background:

• Native Hawaiian communities have long advocated for culturally based treatment approaches.
• Substance use disorder treatment in Hawai'i must consider historical and cultural contexts.
• Cultural-political trauma significantly impacts the health and well-being of Native Hawaiians.

Purpose of the Study:

• To document early Native Hawaiian perspectives on culturally based treatment.
• To examine research, practice, and policy for advancing evidence in cultural treatment.
• To contextualize the development of culture-based addiction treatment within Hawai'i's history.

Main Methods:

• Historical analysis of documented Native Hawaiian perspectives.
• Review of research, practice, and policy considerations.
• Contextualization within Hawai'i's socio-political and historical landscape.

Main Results:

• Early Native Hawaiian appeals for culturally based treatment are identified.
• Cultural-political trauma is a critical factor in effective addiction treatment frameworks.
• Contemporary culturally based treatment models may not be optimally serving Native Hawaiians.

Conclusions:

• There is a need to evolve the evidence base for culturally based addiction treatment.
• Aligning treatment design and delivery with Native Hawaiian needs is crucial.
• Addressing cultural-political trauma is essential for improving treatment outcomes for Native Hawaiians.