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Published online January 17, 2008
Diabetes Care 31:698-700, 2008
DOI: 10.2337/dc07-1560
© 2008 by the American Diabetes Association
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Clinical Care/Education/Nutrition/Psychosocial Research
Original Research

Association Between Acculturation Modes and Type 2 Diabetes Among Native Hawaiians

Joseph Keawe‘aimoku Kaholokula, PHD1,2, Andrea H. Nacapoy3, Andrew Grandinetti, PHD2,4 and Healani K. Chang, DPH2,5,6

1 Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, Hawaii
2 Native Hawaiian Health Research Project, University of Hawai‘i at Manoa, Honolulu, Hawaii
3 Department of Psychology, University of Hawai‘i at Manoa, Honolulu, Hawaii
4 Department of Public Health Sciences and Epidemiology, University of Hawai‘i at Manoa, Honolulu, Hawaii
5 Pacific Biosciences Research Center, University of Hawai‘i at Manoa, Honolulu, Hawaii
6 Division of Ecology and Health, John A. Burns School of Medicine, University of Hawai‘i at Manoa, Honolulu, Hawaii

Address correspondence and reprint requests to Joseph Keawe‘aimoku Kaholokula, PhD, Department of Native Hawaiian Health, 651 Ilalo St., MEB 307-H, Honolulu, Hawaii 96813. E-mail: kaholoku{at}hawaii.edu

OBJECTIVE—To examine the association between acculturation modes (integrated, assimilated, traditional, and marginalized) and type 2 diabetes prevalence in Native Hawaiians.

RESEARCH DESIGN AND METHODS—Cross-sectional data were analyzed from 495 Native Hawaiians, including acculturation modes, diabetes status, triglycerides, fasting insulin, BMI, age, and education level. Acculturation modes were assessed using an eight-item cultural affiliation questionnaire.

RESULTS—Native Hawaiians in a traditional mode of acculturation were more likely to have type 2 diabetes (27.9%) than those in integrated (15.4%), assimilated (12.5%), or marginalized (10.5%) modes.

CONCLUSIONS—The higher prevalence of type 2 diabetes among Native Hawaiians in a traditional mode of acculturation could not be attributed to any of the sociodemographic or biological factors included in this study. We discuss the role of psychosocial factors as possible mediators in the relationship between acculturation modes and type 2 diabetes.

Abbreviations: KHRP, Kohala Health Research Project


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