Abstract
Native Hawaiians, representing 25% of Hawai'i's population, suffer socioeconomic and health strains as evidenced by overrepresentation in low-wage jobs without health insurance and a higher prevalence of chronic disease compared with Hawai'i's other ethnic groups. Native Hawaiians are more likely to attend community colleges than 4-year colleges and have high dropout rates. To describe a culturally relevant, community-based action research approach to build a program to keep Hawaiians in college to advance career options and improve long-term health and socioeconomic outcomes. Culturally relevant approaches that depended on participation from a variety of community partners were used to evaluate needs and design interventions. The Pathway Out of Poverty Program uses Hawaiian values and traditions of healthy living to lead students through a nursing pathway from nurse aide (NA) to licensed practical nurse (LPN) to registered nurse (RN), with inherent increases in wage-earning potential. In the first 3.5 years, 150 students enrolled in NA training, and 135 students (90%) graduated and were certified. Of the 135, 77 (57%) transitioned to higher education and 79% transitioned to jobs that offered health insurance (20% were in both groups). Of the 77 entering higher education, 33 (43%) aimed for a degree in nursing. Students expressed growing interest in health promotion for themselves, family members, and others. Community partners were key to developing a successful community college-based Pathway Program to help marginalized and other underrepresented students move from low-wage to living-wage jobs and improve their long-term health outcomes.
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