Hā Kūpuna National Resource Center for Native Hawaiian Elders: Decolonizing Research through Qualitative Methods and Community Partnership

Housed under the Thompson School of Social Work & Public Health at the University of Hawai‘i at Mānoa, Hā Kūpuna National Resource Center for Native Hawaiian Elders, strives to decolonize Western research as we increase opportunities of Native Hawaiian elders to pass their knowledge and stories to younger generations. One of Hā Kūpuna’s current projects is a five-year qualitative study examining healthcare experiences among Native Hawaiian elders in rural communities to gain advice for medical and social service providers to improve Native Hawaiian health. The project was co-designed by ALU LIKE, Inc.’s Kumu Kahi program (Elderly Services Department), which advised us to conduct a series of three interviews with each elder to build rapport before jumping into questions about healthcare. The first interview focuses on establishing rapport and learning about the kupuna’s family and everyday life. The second interview asks about values they learned from their own kupuna, what they want to pass to their mo`opuna, and other strengths and resiliencies. The third interview hones in on healthcare experiences they had over their lifetime and what advice they would like to share with providers. Results from the first 26 kūpuna have revealed that many kūpuna grew up with limited access to allopathic healthcare (healthcare providers treating diseases and symptoms with drugs and surgery) and that families treated many illnesses and injuries with traditional Hawaiian cultural healing practices, including lāʻau lapaʻau (plant-based medicine), lomilomi (massage), and ho`oponopono (conflict resolution). Even with the increased access and utilization of allopathic medicine, many kūpuna preferred cultural practices or a combination of both. Kūpuna advised that allopathic healthcare providers should take the time to gain knowledge of Native Hawaiian history and culture, allow for use of both Hawaiian and allopathic modes of healing, and interact with patients on both a personal as well as a professional level. They also noted that increasing access to specialty care on Neighbor Islands could improve Native Hawaiian health and life expectancy. Results and experiences from the ALU LIKE interview project helped to inform the creation of a 48-page qualitative interviewing protocol aimed to help researchers avoid extractive practices by increasing their knowledge of Hawaiian history, engaging communities in research, and creating safe and trusting research environments. Although experiences of colonization and discrimination are unique to each Indigenous and minority group, this protocol can apply to other populations as they are at a similar risk for extractive research experiences as well. As elements of the protocols were developed, they were discussed in-depth with researchers, non-profit stakeholders, community-based organization leaders (including ALU LIKE, Inc.), and past research participants. The qualitative protocol includes sections summarizing the history of colonization and instances of poorly-executed research in Hawaiʻi that caused harm. Also included are examples of Native Hawaiian researchers who are changing the face of research, a guide for researcher self-reflection and cultural humility, roles for community members in research, data ownership and management, the need to give more than take from participants, and a step-by-step guide on how to successfully join with community partners to conduct one-on-one interviews. Included are tips on developing research questions, and gathering and reporting data in ways accessible to the community. This qualitative protocol can be used as a guide to decolonizing research. Hā Kūpuna is supported by the US Administration on Community Living (#90OIRC0001) and the Barbara Cox Anthony Endowment

Effects of MIld cold shock (25°C) followed by warming up a 37°C on the cellular stress response.

Temperature variations in cells, tissues and organs may occur in a number of circumstances. We report here that reducing temperature of cells in culture to 25°C for 5 days followed by a rewarming to 37°C affects cell biology and induces a cellular stress response. Cell proliferation was almost arrested during mild hypothermia and not restored upon returning to 37°C. The expression of cold shock genes, CIRBP and RBM3, was increased at 25°C and returned to basal level upon rewarming while that of heat shock protein HSP70 was inversely regulated. An activation of pro-apoptotic pathways was evidenced by FACS analysis and increased Bax/Bcl2 and BclXS/L ratios. Concomitant increased expression of the autophagosome-associated protein LC3II and AKT phosphorylation suggested a simultaneous activation of autophagy and pro-survival pathways. However, a large proportion of cells were dying 24 hours after rewarming. The occurrence of DNA damage was evidenced by the increased phosphorylation of p53 and H2AX, a hallmark of DNA breaks. The latter process, as well as apoptosis, was strongly reduced by the radical oxygen species (ROS) scavenger, N-acetylcysteine, indicating a causal relationship between ROS, DNA damage and cell death during mild cold shock and rewarming. These data bring new insights into the potential deleterious effects of mild hypothermia and rewarming used in various research and therapeutical fields