Understanding Native Hawaiian Caregivers' Beliefs About Pediatric Asthma Management

Native Hawaiian health beliefs and cultural practices may influence how Native Hawaiian caregivers manage their children's asthma. Understanding the use of cultural practices as an asthma management strategy among Native Hawaiian caregivers who have a child with mild persistent, moderate persistent, or severe persistent asthma may inform the development of effective culturally-based asthma management interventions. A qualitative descriptive methodology with medical anthropology framework was used to describe pediatric asthma management strategies, define cultural asthma management practices, and identify cultural practices caregivers were aware of but did not use. Eighteen face-to-face interviews with self-identified Native Hawaiian caregivers of school-aged children between 5 and 12 years with asthma were interviewed. The study found that Native Hawaiian caregivers across all asthma severity types believed that the perceived cause of asthma was hereditary and environmental exposure. Also, standard asthma management strategies were used by caregivers with an emphasis on preventing exposure to known asthma triggers. If asthma symptoms presented themselves, Native Hawaiian caregivers often managed them with alternative practices before using the prescribed medication. Alternative practices included the use of massage and exposure to salt air. Native Hawaiian caregivers readily discussed awareness of cultural practices. However, cultural practices such as lā'au lapa'au (herbal medicine) and lomilomi (massage) were seldom, if ever, used. The study provides healthcare providers with knowledge regarding Native Hawaiian caregivers and their beliefs about the perceived cause of asthma and strategies for managing asthma, including use and awareness of cultural practices.