Abstract P329: Perceptions of Neighborhood Level Stressors in Native Hawaiian Communities: A Descriptive Study

Abstract

HTN (HTN) is an important and modifiable risk factor for cardiovascular disease, the leading cause of death. Native Hawaiians, the indigenous people of Hawai‘i, experience a prevalence of HTN (i.e., systolic blood pressure (SBP) of ≥140mmHg or diastolic blood pressure of ≥90mmHg) of over 50%. Factors that contribute to HTN control are multilevel and include neighborhood or community level determinants such as walkability, availability of healthy foods, safety, and social cohesion. However, these factors and their potential relationship to HTN have yet to be examined in Native Hawaiian communities. Identifying important neighborhood factors in Native Hawaiian communities can inform HTN control interventions. The purpose of this study is to describe the perceptions of neighborhood level stressors among Native Hawaiians participating in a randomized controlled trial testing a culturally-grounded, hula-based HTN intervention. This study was comprised of a subset of participants (N=124) from an NIH-funded, randomized controlled trial testing the effectiveness of a hula-based intervention at improving SBP in Native Hawaiians with uncontrolled HTN compared to an education only group. Neighborhood Level Stressors Scale was used to assess seven neighborhood dimensions: walkability, availability of healthy foods, safety, social cohesion, aesthetic quality, violence, and activities with neighbors. Scores ranged from 1 to 5 with lower scores indicating more positive perceptions their neighborhoods (e.g., greater safety). Demographic variables included age, gender, marital status, education. Descriptive and summary statistics are presented. Two-sample t-test was done to compare neighborhood level stressor by intervention group. Mean scores for the seven dimensions were as follows: aesthetic quality 2.54 (SD=0.61) walkability 2.48 (SD=0.72), availability of healthy foods 2.59 (SD=1.10), safety 2.63 (SD=0.97), violence 3.44 (SD=0.54), social cohesion 2.17 (SD=0.76), and activities with neighbors 2.09 (SD=0.75). The hula-based intervention group had a significantly lower (i.e., better) mean neighborhood aesthetic quality score compared to the education only group (p=0.02). The intervention group also had marginally better perceived activities with neighbors (p=0.09). This study describes perceived neighborhood dimensions in a Native Hawaiian population engaged in a HTN control intervention trial. Mean scores on walkability, availability of healthy foods, safety, social cohesion, aesthetic quality, violence, and activities with neighbors were similar to those reported in larger, multiethnic cohort studies. Perceptions of greater walkability, availability of healthy foods, safety, and social cohesion have been associate with HTN in other populations. Analysis to examine the potential associations between neighborhood level stressors and SBP is planned.