An Investigation of Hula as a Culturally Appropriate Physical Activity for Health Promotion

Abstract

Physical activity (PA) both prevents and treats many established cardiovascular disease (CVD) risk factors, including hypertension and obesity. CVD continues to be the leading cause of death in the United States (US), making it a major public health concern. Native Hawaiians and Pacific Islanders (NHPI) share an unequal burden of CVD compared to the general population. According to the Office of Minority Health, NHPI in Hawai‘i are 3 times more likely to have CVD and are 1.7 times more likely to die of heart disease than their White counterparts. This dissertation explored hula, the indigenous dance of Native Hawaiians, as a physical activity (PA) in health interventions. This three-part dissertation aimed to: 1) evaluate physiological variables of hula to establish the dance as a moderate and/or vigorous physical activity, 2) ask NHPI that participated in a hula-based intervention for hypertension about their thoughts about the use of hula, and 3) determine if changes in blood pressure could predict changes in health-related quality of life after participation in a hula-based intervention for hypertension. The study in Chapter two demonstrated that physiological variables of low and high intensity hula were able to reach moderate and vigorous intensity PA, respectively. The qualitative study in Chapter three asked participants of a hula-based, hypertension management intervention about their thoughts on the use of hula for a health intervention. Participants all agreed that hula appeared to be a suitable alternative PA for a health intervention. The study in Chapter four conducted a multiple regression to determine if change in systolic and diastolic blood pressure could predict changes in health-related quality of life (HRQOL). Only one subscale from the SF-12, Social Functioning, was shown to be significant. This study showed that improvement in hypertension does not appear to have an impact on HRQOL for NHPI that participated in a hula-based study. Overall, this dissertation demonstrated that hula can be implemented as a valid alternative to traditional PA for health interventions as shown both quantitatively from several indicators and qualitatively from program participants.