Hawaiian Dance Research Articles

Cost Effectiveness of a Cultural Physical Activity Intervention to Reduce Blood Pressure Among Native Hawaiians with Hypertension.

ObjectiveThe aim of this study was to calculate the costs and assess whether a culturally grounded physical activity intervention offered through community-based organizations is cost effective in reducing blood pressure among Native Hawaiian adults with hypertension.MethodsSix community-based organizations in Hawai‘i completed a randomized controlled trial between 2015 and 2019. Overall, 263 Native Hawaiian adults with uncontrolled hypertension (≥ 140 mmHg systolic, ≥ 90 mmHg diastolic) were randomized to either a 12-month intervention group of hula (traditional Hawaiian dance) lessons and self-regulation classes, or to an education-only waitlist control group. The primary outcome was change in systolic blood pressure collected at baseline and 3, 6, and 12 months for the intervention compared with the control group. Incremental cost-effectiveness ratios (ICERs) were calculated for primary and secondary outcomes. Non-parametric bootstrapping and sensitivity analyses evaluated uncertainty in parameters and outcomes.ResultsThe mean intervention cost was US$361/person, and the 6-month ICER was US$103/mmHg reduction in systolic blood pressure and US$95/mmHg in diastolic blood pressure. At 12 months, the intervention group maintained reductions in blood pressure, which exceeded reductions for usual care based on blood pressure outcomes. The change in blood pressure at 12 months resulted in ICERs of US$100/mmHg reduction in systolic blood pressure and US$93/mmHg in diastolic blood pressure. Sensitivity analyses suggested that at the estimated intervention cost, the probability that the program would lower systolic blood pressure by 5 mmHg was 67 and 2.5% at 6 and 12 months, respectively.ConclusionThe 6-month Ola Hou program may be cost effective for low-resource community-based organizations. Maintenance of blood pressure reductions at 6 and 12 months in the intervention group contributed to potential cost effectiveness. Future studies should further evaluate the cost effectiveness of indigenous physical activity programs in similar settings and by modeling lifetime costs and quality-adjusted life-years.Trial Registration NumberNCT02620709.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41669-021-00291-6.

Colonial Rupture and Native Continuity in Indigenous Cultural Representations: Through Hawaiian Ancient Dance Kahiko

AbstractThis article discusses the role of colonial oppression in creating conflicting perspectives in the reproduction of dance as Indigenous cultural heritage. The debate on kahiko, the ancient Hawaiian dance, of which practice was severely controlled and then revived through the cultural renaissance, demonstrates that the radical deprivation of the practice has created multiple understandings of the dance among different practitioners. Of primary importance in these respects is the intergenerational divide within the dance community, manifest in the critical perspective of the post-renaissance variant of kahiko, which highlights the “continuity” of the practice through the colonial rupture.

She's a Pediatric Neurologist by Day. Come the Weekend, She's Teaching Hawaiian Dance.

She's a Pediatric Neurologist by Day. Come the Weekend, She's Teaching Hawaiian Dance.

K\u0101-HOLO Project: a protocol for a randomized controlled trial of a native cultural dance program for cardiovascular disease prevention in Native Hawaiians

BackgroundAs 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.MethodsA 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.DiscussionThis 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 registrationClinicalTrials.gov: NCT02620709, registration date November 23, 2015.

Patient Perspectives on the Hula Empowering Lifestyle Adaptation Study

The Hula Empowering Lifestyle Adaption Study, funded by the National Institute on Minority Health and Health Disparities, was a 5-year research trial evaluating the impact of the traditional Native Hawaiian dance form, hula, as an exercise modality for cardiac rehabilitation, compared with usual care, on individuals recently hospitalized for a cardiac event or who had recently undergone coronary artery bypass surgery. Seeking to learn what physical, mental, spiritual, and social effects the intervention may have had for participants, we interviewed 20 of a total of 35 patients who were enrolled in the dance arm of the study. Classical thematic triangulation analysis was used. Participants recognized that hula's coordination of body, mind, and spirit as a group activity deepened their appreciation of and connections to Hawaiian culture. This was true for those who were Native Hawaiian, connecting to their own cultural heritage, as well as for non-Native Hawaiians, who found that it improved their appreciation of the surrounding cultural traditions of the host culture where they now live. Not only was hula a safe activity that improved functional capacity, participants also regarded its significant sociocultural aspects-even for participants who are not Native Hawaiian -as enhancing its value and meaningfulness. Learning the words of well-known Hawaiian songs provided additional long-term cues that encouraged "ownership" of the therapy and acted as practical reminders of the importance of exercise and lifestyle moderation while also offering new spiritual connections to the surrounding social environment.

Developing a culturally based cardiac rehabilitation program: the HELA study.

Heart disease disproportionately affects Native Hawaiians and other Pacific people. In response, researchers proposed and communities endorsed, developing a cardiac rehabilitation (CR) program based on the hula, a Native Hawaiian dance form. The utilization of cultural practices in health interventions can improve outcomes and increase enrollment and retention, but requires sensitivity and understanding. This paper provides the conceptual framework and methods used for integration of multiple communities' perspectives to inform the design of a hula-based CR intervention. Specific strategies and processes were established to ensure the equity of scientific-clinical and patient- cultural knowledge and perspectives. Multiple methods were used and a flow diagram defined steps for the intervention development. Patient and cultural consultations provided information about the multidimensional benefits of hula and its use in a CR intervention. Clinical and scientific consultations provided specific guidelines for exercise prescription and patient monitoring. Integrating findings from all consultations identified important direction and requirements. Community-based participatory research (CBPR) principles guided a complex collaboration of multiple communities; although time consuming, inclusive consultations provided valuable information and relationships.

Hā: Breath of Life (review)

Reviewed by: Hā: Breath of Life Chai Blair-Stahn Hā: Breath of Life. Performance nightly except Sunday, 90 minutes, Polynesian Cultural Center, Lā‘ie, Hawai‘i. Director: David Warner; Producer: Delsa Moe. Premiered 14 August 2009; ongoing. Coming from the US continent, I have encountered firsthand many inaccurate conceptions about Polynesia. I remember numerous individuals who confused hula with Tahitian dancing or thought that Māori poi was a Hawaiian dance form. I found that few people were aware of the existence of hula kahiko or realized that hula can have sacred and esoteric dimensions. And male dancers? Forget it. A friend’s sister, when she heard I was a student of hula, asked me a bit hesitantly, “But do the guys really dance? I thought they just stand in the back and spin that fire knife . . .” What surprised me more than these ill-informed comments and inaccurate perceptions was that they frequently came from people who had visited and vacationed in Hawai‘i! They were basing their (mis)information on direct, personal experiences—the kind of experiences most tourists to Hawai‘i will have. So when I saw Hā: Breath of Life, the latest nighttime production at the Polynesian Cultural Center (pcc), I could not help but be critical. As I glanced around the stadium during the performance, I could only envision the majority of the audience returning to their homes filled with the same kinds of misconceptions that I knew all too well. Although located on the opposite side of O‘ahu from Waikīkī, the pcc in Lā‘ie remains one of the most visited tourist destinations in Hawai‘i, offering a mix of entertainment and cultural education. Students from around the Pacific who attend Brigham Young University–Hawai‘i can earn scholarships by working, for instance, in the pcc “villages” of Hawai‘i, Tahiti, Sāmoa, Fiji, Tonga, and Aotearoa. To conclude a day spent strolling over shallow waterways from village to village—symbolically traversing Polynesia—tourists are encouraged to attend the “night show,” a large-scale production of song and dance that brings the six cultures together in a grand finale. Hā: Breath of Life is the first of the pcc’s many night shows to interweave all of the cultures into a single narrative, and made its debut on 14 August 2009, after $3 million and three years of production time (Mormon Times, 18 Nov 2009). Hā depicts the life story of Mana, a muscular and youthful Polynesian, tracing his own birth, his marriage to the beautiful Lani, the death of his father, and finally, the birth of his son. Each significant life event takes place in one of the six Island groups represented at the pcc. Hā: Breath of Life certainly has its strengths. Like previous night shows, it successfully engages the audience with surround-sound and compelling visuals including waterworks with colorful lights and lots of fire. A new special effect, both impressive and innovative, is the narrated petroglyph animation projected onto large fabric sheets (vaguely reminiscent of tapa) used to facilitate transitions from one culture to the next. But, without a doubt, the dance sequences are the highlight of the show. One can see, [End Page 492] even feel, the joy expressed by the performers as they sing and dance the stories of the different Islands. The trouble with Hā, I found, is unfortunately the aspect that is also most celebrated and marketed: the plot. The use of a rudimentary plotline designed to have universal appeal by telling “every man’s story” (http://www.habreathoflife.com/media-room/press-kit.html) leaves no room for cultural complexity. Whether intentional or not, embedded in the series of events that dramatize Mana’s life are stereotypes that reify representations of Polynesia, and, in turn, of the Pacific as a whole. This begins in Tonga, where Mana is born. His shipwrecked, non-Tongan parents are immediately assisted by Tongans in the delivery of Mana, followed by song and dance to celebrate his birth. Such a hospitable reception is a fitting introduction to invite the audience—also strangers to another land—along on this journey through Polynesia. Furthermore, locating the warm reception in Tonga reinforces...

Acculturation in Hawaiian Dance

Dance in Hawaii, before the coming of the Europeans, was an extension of poetry that honored the gods and chiefs, in the form of stylized visual accompaniment. Trained under the religious restrictions imposed by Laka, patron goddess of the hula, dancers were often part of the retinue of chiefly households. Hula schools (halau hula) were under the tutelage of a kumu hula (hula teacher) who was a kahuna (priest). Schools and hula troupes were subsidized by chiefs who maintained them for their own entertainment and the enhancement of their prestige. The main function of the hula was to honor the gods and to praise the chiefs and their ancestors in this highly stratified society.