ABSTRACT
Similar to other indigenous people, Native Hawaiian (NH) view health and well-being holistically.
These concepts are centered on lōkahi (balance) among relationships with family and
community, akua (spiritual), and ʻāina (land, sea). NH communities were once thriving,
sustainable ecosystems. However, westernization of local economies, displacement of people
from their ʻāina, and the illegal overthrow of the Hawaiian monarchy brought about rapid
changes. Today, historical trauma persists as intergenerational cycles of disparities. The health
of NH youth has worsened. Eurocentric approaches to address health disparities have done
little to interrupt these cycles, especially in under-resourced communities.
The project will address historical trauma and barriers to effective care by moving beyond clinic
walls to create a system of support that embraces NH cultural values and practices, empowers
youth, and promotes lōkahi, resilience, health, and a stronger community. Two well-established
NH-serving federally-qualified community health centers will partner with schools and place-
based community organizations. Together they will increase access to care by identifying and
cross-referring challenged youth for wellness promotion and targeted care/management across
organizations, especially for mental health concerns. Partners will apply NH values, promote
traditional NH concepts in the context of modern methods, and use trauma-informed
approaches. Partners will also collaborate around community-identified outcomes of value
through data sharing and dissemination of results to community members, funders, and
policymakers. This important project will expand knowledge about strategies needed to
implement and sustain a NH youth-centered system of care and the value of such a system to
support youth through young adulthood.