title: Improving health outcomes in diverse populations: competency in cross-cultural research with indigenous Pacific islander populations.
abstract: OBJECTIVE
  There is a large disparity in health status between the indigenous peoples of the US Associated Pacific compared to any population in the USA. The research process that has been supported by US academic institutions and federal agencies has been limited in its ability to address the disparate health issues and may be part of the problem. We define culturally competent research and review approaches to developing competency in cross-cultural research with indigenous Pacific Islander populations.
  
  
  METHODS
  This is a descriptive review of the investigators' experience in the Hawaii MEDTEP Center experience and of the experience of others conducting research with the indigenous people of the Pacific Islands.
  
  
  RESULTS
  Culturally competent cross-cultural research with the indigenous peoples of the Pacific requires an understanding and application of indigenous peoples' paradigms of health, knowledge, science, and research. It is not sufficient to train more indigenous Pacific Islanders to do more Western-style research. Unraveling the complex health situation and determining the changes that need to be made is dependent on the dominant culture engaging the indigenous Pacific populations in a way that bridges cultural paradigms.
  
  
  CONCLUSIONS
  Positively affecting the disparity of health in the indigenous populations of the Pacific is, in part, dependent on employing an indigenous-peoples-centered model of research. The model can have application to the study of indigenous peoples in other parts of the world.
authors.affiliation: Department of Family Practice and Community Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
authors.forename: Neal A
authors.initials: NA
authors.lastname: Palafox
authors.forename: Lee
authors.initials: L
authors.lastname: Buenconsejo-Lum
authors.forename: Sheldon
authors.initials: S
authors.lastname: Riklon
authors.forename: Beth
authors.initials: B
authors.lastname: Waitzfelder
mesh_terms: D003431:Cross-Cultural Comparison; D018864:Cultural Diversity; D005006:Ethnicity; D006254:Hawaii; D006302:Health Services Research / Q000592:standards*; D006305:Health Status Indicators; D006801:Humans; D017063:Outcome Assessment, Health Care; D010139:Pacific Islands / Q000453:epidemiology; D011361:Professional Competence