Project Summary/Abstract
Research has indicated that Native Hawaiian youth have significantly higher rates of drug use than their
non-Hawaiian counterparts (e.g., Wong, Klingle, & Price, 2004; Mayeda, Hishinuma, Nishimura, Garcia-
Santiago, & Mark, 2006; Nishimura, Hishinuma, & Goebert, 2013), and that these differences are particularly
pronounced in rural settings (Saka, Takeuchi, Fagaragan, & Afaga, 2014). Despite these findings, there have
been very few drug prevention programs developed and evaluated specifically for these youth (Edwards,
Giroux, & Okamoto, 2010; Rehuher, Hiramatsu, & Helm, 2008). Further, efforts to address youth substance
abuse have been poorly implemented and coordinated across the State of Hawai‘i (Waitzfelder, Engel, &
Gilbert, 1998). Therefore, the purposes of this R34 proposal are to identify potential barriers or challenges to
the implementation, adoption, and sustainability (IAS) of a culturally grounded, school-based drug prevention
curriculum (Ho‘ouna Pono) across all public middle, intermediate, or multi-level schools on Hawai‘i Island,
and to create a comprehensive, community-based IAS action plan for the curriculum. This will be
accomplished through three specific aims. AIM 1 (Assessing Environmental Demands, Year 1) is to develop and
validate an implementation, adoption, and sustainability inventory related to Ho‘ouna Pono, which will be
theoretically informed by The Consolidated Framework for Implementation Research (CFIR; Damschroder &
Hagedorn, 2011; Powell, Proctor, & Glass, 2014). The inventory will consist of items describing barriers or
challenges to the successful adoption, implementation, and/or sustainability of Ho‘ouna Pono on Hawai‘i
Island. AIM 2 (Response Enumeration, Year 2) is to systematically elicit implementation strategies (or
solutions) to the most problematic and/or difficult barriers to the IAS of the curriculum in public schools on
Hawai‘i Island, and to rank-order these solutions based on their perceived ability to address or overcome each
of the barriers to IAS. AIM 3 (Action Plan, Year 3) is to create a community based and validated action plan
based on the findings from Aims 1 and 2, which will be evaluated in a future NIDA R01 grant proposal focused
on dissemination and implementation research in health.