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Caring for loved ones as community: Supporting caregivers of Native Hawaiians living with dementia
Alexandra Jackson, Adrienne Y Dillard, Bridget Puni Kekauoha, Mahealani Mahiai Austin, Poki‘i Balaz, E. Lee, Natlie Dutro, Paige Mayeda et al.. SSM - Mental Health, 2025-06-24
Topic: Risk, prevention and care in population studies
Caregiving interventions can reduce caregiver burden and promote caregiver competence, yet caregiving is rooted in culture, with differing impacts of the caregiving role. Culturally adapted interventions may better address the unique experiences of diverse family caregivers. In this exploratory study, we aimed to adapt the Savvy Caregiver Program (SCP), an evidence-based caregiving intervention, with a Native Hawaiian community in Hawaiʻi. First, a community action board (CAB) and research team tailored the curriculum to include Hawaiian values, language, proverbs and examples while maintaining the program core components. Then, Native Hawaiian adults participated in the preliminary adapted program, ʻAuamo Kuleana O Nā Maʻi Poina (ʻAuamo Kuleana). We describe the experiences of caregiving for a Native Hawaiian adult living with ADRD and how we obtained feedback to refine ‘Auamo Kuleana prior to pilot testing. Individuals who participated in the 7-week session of ʻAuamo Kuleana ( N = 6) were asked to complete a survey and a focus group or interview to share their experiences and provide feedback that informed a process evaluation of the program. The CAB and research team analyzed qualitative data using thematic analysis. Only one participant was actively providing care; the other five participants were interested in proactive training to support their community. Caring as a community was a common theme. Participants shared positive feedback about ʻAuamo Kuleana and participants appreciated the tailored content. As such, no changes were made to the program. Two suggestions were identified: include all family members in the program to be in alignment as a ʻohana (family) in providing care and add information about planning for their own care. Future Native Hawaiian-focused caregiving interventions should consider incorporating cultural practices and values, proactive training about dementia and caregiving, caring as a community, and family-centered (rather than dyadic) caregiving.
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APA 7th
Jackson, A., Dillard, A. Y., Kekauoha, B. P., Austin, M. M., Balaz, P., Lee, E., et al. (2025). Caring for loved ones as community: Supporting caregivers of Native Hawaiians living with dementia. SSM - Mental Health. https://doi.org/10.1016/j.ssmmh.2025.100483
Vancouver
Jackson A, Dillard AY, Kekauoha BP, Austin MM, Balaz P, Lee E, et al. Caring for loved ones as community: Supporting caregivers of Native Hawaiians living with dementia. SSM - Mental Health. 2025. doi:10.1016/j.ssmmh.2025.100483.
BibTeX
@article{jackson2025-2795e56b,
author = {Jackson, Alexandra and Dillard, Adrienne Y and Kekauoha, Bridget Puni and Austin, Mahealani Mahiai and Balaz, Poki‘i and Lee, E. and Dutro, Natlie and Mayeda, Paige and others},
title = {{Caring for loved ones as community: Supporting caregivers of Native Hawaiians living with dementia}},
journal = {SSM - Mental Health},
year = {2025},
doi = {10.1016/j.ssmmh.2025.100483},
url = {https://doi.org/10.1016/j.ssmmh.2025.100483}
}
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Key findings
- Caring as a community was a common theme.
- Participants shared positive feedback about ʻAuamo Kuleana and participants appreciated the tailored content.
- As such, no changes were made to the program.
- Two suggestions were identified: include all family members in the program to be in alignment as a ʻohana (family) in providing care and add information about planning for their own care.
- Future Native Hawaiian-focused caregiving interventions should consider incorporating cultural practices and values, proactive training about dementia and caregiving, caring as a community, and family-centered (rather than dyadic) caregiving.
Why it matters
This exploratory study adapted an evidence-based caregiving program with a Native Hawaiian community, incorporating Hawaiian values, language, and examples. Participants gave positive feedback and suggested including all family members and adding information about planning for their own care.
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Study details
- Evidence strengthLow
How this study scored 32/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (SSM - Mental Health) |
| Journal's citation record | 0 / 4 | SSM - Mental Health: journal h-index 34 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Raven H. Weaver: h-index 13 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Emory University: institution h-index 1,360 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 1 country |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Total | 32 / 100 | — |
What each of these 20 components measures, and what this score is not →
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