title: Promoting Optimal Native Outcomes (PONO) by Understanding Women's Stress Experiences.
abstract: A growing body of evidence links stress with mental illness and chronic disease. Existing scales of women's stress fail to capture the daily stressors of low-income, rural women. We explored the psychosocial stressors of local women residing in a rural Hawaii community with a large Native Hawaiian and Other Pacific Islander population. We recruited women, aged 18-35 years, at a community health center. We convened four focus groups to elicit information about women's stress. We identified key themes from the focus group data to generate questions that target concerns raised by participants. These were corroborated by additional focus groups. Thirty-six women participated in the study. Seven stressor themes emerged: intimate relationships-limited partner assistance, gender stereotype; family and home life-feeling like an outsider, lack of respect; childrearing-quality and affordable childcare, conflicting discipline styles; time for self-never-ending duties, being too tired to relax; neighborhood environment-safety concerns, not feeling part of the community; workplace-workload and transportation obstacles; and finances-making ends meet and arguments about money. Women in this study articulated a broad range of daily stressors. Sociocultural factors leading to feeling like an outsider within their own family, intercultural marriage conflicts, and perceptions of community discrimination are not included in other published scales. Our focus group investigations thus provided critical knowledge for developing a community-relevant scale. This is a prerequisite for developing and testing innovative intervention strategies designed to reduce stress in this population. We believe that reducing stress is necessary to mitigate the negative effects of stressors on physical and mental health among women in this rural community.
authors.affiliation: University of Hawaii John A. Burns School of Medicine, 1319 Punahou St., Suite 720, Honolulu, HI, 96826, USA. okihirom@hawaii.edu.|Waianae Coast Comprehensive Health Center, Waianae, HI, USA. okihirom@hawaii.edu.
authors.forename: May
authors.identifier: 0000-0002-7787-3905
authors.initials: M
authors.lastname: Okihiro
authors.affiliation: Waianae Coast Comprehensive Health Center, Waianae, HI, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Duke
authors.affiliation: University of Hawaii John A. Burns School of Medicine, 1319 Punahou St., Suite 720, Honolulu, HI, 96826, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Goebert
authors.affiliation: Waianae Coast Comprehensive Health Center, Waianae, HI, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Ampolos
authors.affiliation: Waianae Coast Comprehensive Health Center, Waianae, HI, USA.
authors.forename: Casandra
authors.initials: C
authors.lastname: Camacho
authors.affiliation: Waianae Coast Comprehensive Health Center, Waianae, HI, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Shanahan
authors.affiliation: University of Hawaii John A. Burns School of Medicine, 1319 Punahou St., Suite 720, Honolulu, HI, 96826, USA.
authors.forename: Earl
authors.initials: E
authors.lastname: Hishinuma
authors.affiliation: University of Hawaii John A. Burns School of Medicine, 1319 Punahou St., Suite 720, Honolulu, HI, 96826, USA.
authors.forename: J Keawe
authors.initials: JK
authors.lastname: Kaholokula
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000208:ethnology* / Q000523:psychology; D003466:Cultural Characteristics; D005195:Family Relations / Q000208:ethnology; D005260:Female; D017144:Focus Groups; D006254:Hawaii / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D001523:Mental Disorders / Q000208:ethnology* / Q000209:etiology / Q000523:psychology; D044468:Native Hawaiian or Pacific Islander / Q000523:psychology*; D036301:Qualitative Research; D012111:Residence Characteristics; D012423:Rural Health / Q000208:ethnology; D012449:Safety; D063508:Social Discrimination / Q000208:ethnology / Q000523:psychology; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications / Q000208:ethnology* / Q000209:etiology / Q000523:psychology; D016387:Women's Health / Q000208:ethnology*; D016526:Workload / Q000523:psychology; D055815:Young Adult
keywords: Health disparities; Native Hawaiian; Pacific Islanders; Rural health; Stress; Women