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Ho’ouna Pono
A culturally grounded, video-enhanced substance use prevention program for rural Hawai’ian students in 6th through 8th grades.
The Ho’ouna Pono drug prevention intervention is a culturally grounded training program for drug resistance skills that includes local Hawai’i Island cultural values and beliefs. The 10-week program consists of nine classroom-based sessions (each 45 to 60 minutes in length) incorporating videos demonstrating drug-related problem situations and resistance strategies. The intervention was tested using a randomized, wait-listed control group design, with school cohorts receiving the intervention earlier than those who got it later.
Outcomes
No prevention of alcohol use, but some effect on cigarette use.
Alcohol use, frequency, and amount were not reduced nor was the trajectory slowed with the intervention, but there were small beneficial effects on use of cigarettes and hard drugs.
Costs
High start-up costs followed by lower ongoing costs.
Developing a culturally grounded curriculum—including videos, website technical assistance, and teacher training—specific to cultural groups differing from the original Hawai’ian rural communities would be time-consuming and expensive. If using the original curriculum among the communities for which it was developed, thus avoiding development costs, the remaining start-up costs would be in the mid-range. Once the curriculum was established, ongoing costs, including teacher and staff training to ensure appropriate delivery of the intervention, would be low.
Cultural Engagment
Intervention incorporates local cultural concepts.
This culturally grounded program involved community input on research design and focus. Each of the nine sessions included a "culture wall activity," in which local cultural concepts were discussed and applied to substance use prevention.
Participants
Child, Adolescent; Native, Non-Native; Female, Male
Setting
Rural, School
Delivery
Medium Group, Face-to-Face
Native and non-Native Hawai’ian youth in rural Hawai’ian middle schools
A total of 486 youth ages 10–13+ years) in grades 6 through 8 (52% female, 54% Native Hawai’ian) in 13 rural public schools in Hawai’i received the intervention as part of regular classes. One of four cohorts was dropped, leaving a total of 374 youth in the final analysis.
Staffing Needs
Certified Professional, Educator
Trained regular teachers delivered the intervention.
Teachers received an 8-hour, in-person training on how to administer the intervention and had access to an implementation website for technical assistance.
Research Design
Randomized controlled experimental design
Developmental stage of research
Strong basic research design hampered by implementation shortcomings.
Despite the strong research design, several problems may have prevented a clear answer regarding beneficial effects on alcohol use. These include differences between the cohorts at the start and the situations they are exposed to, low substance use in general, and that the last cohort was dropped.
Potential
Promising cultural program with need for more research.
Although reductions in alcohol were not observed, Ho’ouna Pono appears to be transportable and feasible to implement in schools with similar cultural backgrounds.
References
Okamoto SK, Kulis SS, Helm S, et al. An efficacy trial of the Ho'ouna Pono Drug Prevention Curriculum: An evaluation of a culturally grounded substance abuse prevention program in rural Hawai'i. Asian Am J Psychol. 2019;10(3):239-248. https://pubmed.ncbi.nlm.nih.gov/32395199. https://doi.org/10.1037/aap0000164.
Okamoto SK, Helm S, Chin SK, Hata J, Hata E, Okamura KH. The implementation of a culturally grounded, school-based, drug prevention curriculum in rural Hawai'i. J Community Psychol. 2020;48(4):1085-1099. https://pubmed.ncbi.nlm.nih.gov/31332808. https://doi.org/10.1002/jcop.22222.
Okamoto SK, Kulis S, Helm S, Lauricella M, Valdez JK. An evaluation of the Ho’ouna Pono curriculum: A pilot study of culturally grounded substance abuse prevention for rural Hawaiian youth. J Health Care Poor Underserved. 2016;27(2):815-833. https://pubmed.ncbi.nlm.nih.gov/27180710. https://doi.org/10.1353/hpu.2016.0061.
Okamoto SK, Helm S, Ostrowski LK, Flood L. The validation of a school-based, culturally grounded drug prevention curriculum for rural Hawaiian youth. Health Promot Pract. 2018;19(3):369-376. https://pubmed.ncbi.nlm.nih.gov/28443350. https://doi.org/10.1177/1524839917704210.
Helm S, Okamoto SK. Developing the Ho'ouna Pono substance use prevention curriculum: Collaborating with Hawaiian youth and communities. Hawaii J Med Public Health. 2013;72(2):66-69. https://pubmed.ncbi.nlm.nih.gov/23463854.
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