Waianae

Researchers are evaluating if a community referral program can improve services for youth with mental health and chronic health conditions in a mostly Native Hawaiian and Pacific Islander community. The study aims to find the best way for a community health center to connect youth with programs based on cultural practices and traditions and to understand if participation in these programs supports youth engagement and improves mental and physical health outcomes. This pilot clinical trial uses a stepped wedge cluster randomized design to assess the effectiveness and implementation of the Kaiona Programs offered by community organizations. Youth participants will join Kaiona Programs delivered by one of five community organizations. These programs focus on cultural activities tied to the natural environment ('āina) and local traditions. The programs are offered either as a summer intensive lasting four weeks with sessions four days per week for five hours daily, or during the school year for 16 weeks with sessions two days per week for 2.5 hours each. The programs provide about 80 hours of cultural engagement, balancing meaningful participation with family and school obligations. Participants will complete surveys about their demographics, well-being, mental health, and chronic health conditions at four time points: before starting the program, immediately after finishing, 3-4 months later, and then 6-8 months after completion. An adult family member will also provide information on the youth's demographics and well-being at these same times. The study measures changes in health and well-being using several surveys, including the Kaiona Survey, Harvard Adolescent Flourishing Measure, PHQ-9 Modified for Adolescents, Pediatric Symptom Checklist, and Positive Childhood Experiences Score. Researchers will monitor program fidelity, dosage, reach, and barriers to implementation to inform future scaling of the program.