An Evaluation of the Ho’ouna Pono Curriculum: A Pilot Study of Culturally Grounded Substance Abuse Prevention for Rural Hawaiian Youth
Open accessAbstract
This pilot study evaluated the Ho'ouna Pono curriculum, which is a culturally grounded, school-based, drug prevention curriculum tailored to rural Native Hawaiian youth. The curriculum focuses on culturally relevant drug resistance skills training and is aligned with the State of Hawai'i academic standards. Six Hawai'i Island public middle/intermediate schools randomly assigned to intervention or treatment-as-usual comparison conditions (N = 213) were evaluated in this study. Paired sample t-tests separating intervention and comparison groups were conducted, as well as mixed models that adjusted for random effects (nesting) at the school level. Findings suggested that the curriculum was effective in maintaining youths' use of culturally relevant drug resistance skills, as well as decreasing girls' aggressive behaviors, at six-month follow-up. Unanticipated findings also suggested areas for curricular improvement, including more emphasis on normative drug education. Implications for future research and development of the curriculum are discussed.
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Some researchers described tension between maintaining fidelity to standardized evidence-based interventions and making necessary cultural adaptations.
“Some researchers described the tension between maintaining fidelity to standardized, evidence-based interventions and making necessary cultural adaptations (Castro et al., 2010; Okamoto et al., 2016).”
From Bridging Traditions and Prevention: Insights into Implementing and Sustaining Substance Use Programs for Urban AI/AN Communities (2026) · cites this paper as Okamoto et al., 2016
The Literature review distinguishes culturally adapted programs from culturally grounded ones and suggests that prevention programs for indigenous youth may need to be grounded rather than adapted. It does not describe a tension between preserving fidelity to standardized evidence-based interventions and making cultural adaptations; the Methods section discusses implementation fidelity only for this curriculum. (LLM, conf=0.78)
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- [23]Marsiglia FF Hecht ML keepin’ it REAL: An evidence-based program Santa Cruz, CA ETR Associates 2005 PMC3043619 21359122
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Special issue introduction: Advancing Native Hawaiian and other Pacific Islander health.
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Self-citationPalimaru, A. I., Malika, N., Brown, R. A., Holmes, P., Dickerson, D. L., Johnson, C. L., Sanchez, V. A., Schweigman, K., & D’Amico, E. J. (2026) · Journal of Substance Use and Addiction Treatment · doi:10.1016/j.josat.2026.209892
- Authors
- Okamoto, S. K., Kulis, S., Helm, S., Lauricella, M., & Valdez, J. K.
- Affiliations
- Hawaii Pacific University (US)
- Arizona State University (US)
- University of Hawaiʻi at Mānoa (US)
- Columbia University (US)
- Corresponding author
- Okamoto, Scott K.
- Venue
- Journal of Health Care for the Poor and Underserved
- Publisher
- Project MUSE
- Published
- 2016
- Volume
- 27
- Issue
- 2
- Pages
- 815-833
- ISSN
- 1049-2089 (ISSN-L)
- 1548-6869
- PMC
- PMC4984839
- OpenAlex
- W2373739525
- Cited by
- 39
- References
- 59
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 8 · 2018: 2 · 2017: 3 · 2016: 2
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Health Care for the Poor and Underserved (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Project Muse (Johns Hopkins University) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Drug Abuse (R34DA031306)
- National Institute on Minority Health and Health Disparities (P20MD002316)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Social Sciences › Demography › Youth, Drugs, and Violence
- Keywords
- substance use prevention, rural youth, school-based prevention, junior high school students, aggression, girls, curriculum evaluation
- MeSH terms
- Adolescent, Curriculum, Female, Hawaii, Health Education, Humans, Pilot Projects, Substance-Related Disorders, Cultural Competency
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