Cultural Dance Program Improves Hypertension Management for Native Hawaiians and Pacific Islanders: a Pilot Randomized Trial

ObjectiveNative Hawaiians and Pacific Islanders (NHPI) bear an unequal burden of hypertension and cardiovascular disease. Hula, the traditional dance of Hawaii, has shown to be a culturally meaningful form of moderate-vigorous physical activity for NHPI. A pilot study was done in Honolulu, Hawaii, to test a 12-week hula-based intervention, coupled with self-care education, on blood pressure management in NHPI with hypertension in 2013.MethodNHPI with a systolic blood pressure (SBP) ≥140 mmHg were randomized to the intervention (n = 27) or a wait-list control (n = 28). Blood pressure, physical functioning, and eight aspects of health-related quality of life (HRQL) were assessed.ResultsThe intervention resulted in a reduction in SBP compared to control (−18.3 vs. −7.6 mmHg, respectively, p ≤ 0.05) from baseline to 3-month post-intervention. Improvements in HRQL measures of bodily pain and social functioning were significantly associated with SBP improvements in both groups.ConclusionUsing hula as the physical activity component of a hypertension intervention can serve as a culturally congruent strategy to blood pressure management in NHPI with hypertension.Trial registrationclinicaltrials.gov Identifier: NCT01995812

[1]  A. Bauman,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.

[2]  T. Laveist,et al.  Race/Ethnicity and hypertension: the role of social support. , 2010, American journal of hypertension.

[3]  J S Lai,et al.  The effect of Tai Chi on cardiorespiratory function in patients with coronary artery bypass surgery. , 1999, Medicine and science in sports and exercise.

[4]  Roger B. Davis,et al.  Effects of tai chi mind-body movement therapy on functional status and exercise capacity in patients with chronic heart failure: a randomized controlled trial. , 2004, The American journal of medicine.

[5]  K. Braun,et al.  Testing the feasibility of a culturally tailored breast cancer screening intervention with Native Hawaiian women in rural churches. , 2011, Health & social work.

[6]  Jeannine S. Schiller,et al.  Summary health statistics for U.S. adults: National Health Interview Survey, 2001. , 2004, Vital and health statistics. Series 10, Data from the National Health Survey.

[7]  Daniel W. Jones,et al.  Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. , 2003, Hypertension.

[8]  W. Liu,et al.  Tai Chi for Essential Hypertension , 2013, Evidence-based complementary and alternative medicine : eCAM.

[9]  Bert N. Uchino,et al.  The relationship between social support and physiological processes: a review with emphasis on underlying mechanisms and implications for health. , 1996, Psychological bulletin.

[10]  U. Siering,et al.  Long-term Effects of Weight-Reducing Interventions in Hypertensive Patients: Systematic Review and Meta-analysis , 2009 .

[11]  J. Kaholokula,et al.  Sociodemographic, behavioral, and biological variables related to weight loss in native hawaiians and other pacific islanders , 2013, Obesity.

[12]  D. Sutoo,et al.  Music improves dopaminergic neurotransmission: demonstration based on the effect of music on blood pressure regulation , 2004, Brain Research.

[13]  ATS statement: guidelines for the six-minute walk test. , 2002, American journal of respiratory and critical care medicine.

[14]  Jeannine S. Schiller,et al.  Summary health statistics for U.S. adults: National Health Interview Survey, 2010. , 2012, Vital and health statistics. Series 10, Data from the National Health Survey.

[15]  L. Green,et al.  Evaluation of Family Health Education to Build Social Support for Long-Term Control of High Blood Pressure , 1985, Health education quarterly.

[16]  Jiang He,et al.  Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. , 2002, JAMA.

[17]  W L Haskell,et al.  Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. , 1998, The New England journal of medicine.

[18]  Gregory G. Maskarinec,et al.  Patient Perspectives on the Hula Empowering Lifestyle Adaptation Study , 2015, Health promotion practice.

[19]  B. Howard,et al.  All-cause and CVD mortality in Native Hawaiians. , 2010, Diabetes research and clinical practice.

[20]  J. Kaholokula,et al.  Developing a Culturally Based Cardiac Rehabilitation Program: The HELA Study , 2012, Progress in community health partnerships : research, education, and action.

[21]  Chenchen Wang,et al.  The effect of tai chi exercise on blood pressure: a systematic review. , 2008, Preventive cardiology.

[22]  G. Bray,et al.  A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. , 1997, The New England journal of medicine.

[23]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[24]  D. Mozaffarian,et al.  Executive summary: heart disease and stroke statistics--2012 update: a report from the American Heart Association. , 2012, Circulation.

[25]  T. Seto,et al.  Pacific Islanders' perspectives on heart failure management. , 2008, Patient education and counseling.

[26]  P. Wolf,et al.  The lifetime risk of stroke: estimates from the Framingham Study. , 2006, Stroke.

[27]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[28]  William Londeree Kumu hula perspectives on health. , 2014 .

[29]  Fernando Costa,et al.  Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Ph , 2003, Circulation.

[30]  P. Harris,et al.  Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support , 2009, J. Biomed. Informatics.

[31]  P. Jardim,et al.  Music therapy effects on the quality of life and the blood pressure of hypertensive patients. , 2009, Arquivos brasileiros de cardiologia.

[32]  Gregory G. Maskarinec,et al.  Kumu hula perspectives on health. , 2014, Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health.

[33]  T. Seto,et al.  Metabolic Equivalent Determination in the Cultural Dance of Hula , 2013, International Journal of Sports Medicine.

[34]  L. Hemkens,et al.  Benefit assessment of salt reduction in patients with hypertension: systematic overview , 2011, Journal of hypertension.

[35]  D. Palakiko,et al.  Translating Diabetes Prevention Into Native Hawaiian and Pacific Islander Communities: The PILI 'Ohana Pilot Project , 2010, Progress in community health partnerships : research, education, and action.

[36]  M. Law,et al.  Lowering blood pressure to prevent myocardial infarction and stroke: a new preventive strategy. , 2003, Health technology assessment.

[37]  Tom Fahey,et al.  Interventions used to improve control of blood pressure in patients with hypertension. , 2010, The Cochrane database of systematic reviews.

[38]  Ross Arena,et al.  ACSM's new preparticipation health screening recommendations from ACSM's guidelines for exercise testing and prescription, ninth edition. , 2013, Current sports medicine reports.

[39]  J. Ware,et al.  A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. , 1996, Medical care.

[40]  R Callister,et al.  Social cognitive theory and physical activity: a systematic review and meta‐analysis , 2014, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[41]  Benjamin J. Epstein,et al.  Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure , 2007 .

[42]  J. Kaholokula,et al.  Cardiometabolic health disparities in native Hawaiians and other Pacific Islanders. , 2009, Epidemiologic reviews.

[43]  Daniel W. Jones,et al.  Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. , 2005, Hypertension.

[44]  Thomas Semlitsch,et al.  Increasing Physical Activity for the Treatment of Hypertension: A Systematic Review and Meta-Analysis , 2013, Sports Medicine.

[45]  B Neal,et al.  Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials , 2000, The Lancet.

[46]  T. Seto,et al.  Racial disparities among Native Hawaiians and Pacific Islanders with intracerebral hemorrhage , 2012, Neurology.

[47]  J. Kaholokula,et al.  Social Justice as a Public Health Imperative for Kānaka Maoli , 2009 .

[48]  F. Pashkow,et al.  Clinical Cardiac Rehabilitation: A Cardiologist's Guide , 1992 .

[49]  J. Kaholokula,et al.  Assessment and Priorities for Health & Well-Being in Native Hawaiians & other Pacific Peoples. , 2013 .