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Michelle Liu, MPH

Clinical Psychology PhD Student

Hoʻouna Pono: a 20-year journey of designing, implementing, and sustaining prevention for rural, Indigenous communities


Journal article


Kelsie H. Okamura, M. Cramer, Tessa Palafu, Susana Helm, Francis Dalisay, Zoe Primack, Danielle L. Carreira Ching, Savannah Goshgarian-Miller, Michelle Liu, S. K. Chin, Sarah Momilani Marshall, Paula Angela Saladino, Z. Kon, Sarah D. Song, Reilynn Yamane, Nadia Yoshizumi-Kim, Cerila C Rapadas, Scott K. Okamoto
Substance Abuse Treatment, Prevention, and Policy, 2026

Semantic Scholar DOI PubMedCentral PubMed
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APA   Click to copy
Okamura, K. H., Cramer, M., Palafu, T., Helm, S., Dalisay, F., Primack, Z., … Okamoto, S. K. (2026). Hoʻouna Pono: a 20-year journey of designing, implementing, and sustaining prevention for rural, Indigenous communities. Substance Abuse Treatment, Prevention, and Policy.


Chicago/Turabian   Click to copy
Okamura, Kelsie H., M. Cramer, Tessa Palafu, Susana Helm, Francis Dalisay, Zoe Primack, Danielle L. Carreira Ching, et al. “Hoʻouna Pono: a 20-Year Journey of Designing, Implementing, and Sustaining Prevention for Rural, Indigenous Communities.” Substance Abuse Treatment, Prevention, and Policy (2026).


MLA   Click to copy
Okamura, Kelsie H., et al. “Hoʻouna Pono: a 20-Year Journey of Designing, Implementing, and Sustaining Prevention for Rural, Indigenous Communities.” Substance Abuse Treatment, Prevention, and Policy, 2026.


BibTeX   Click to copy

@article{kelsie2026a,
  title = {Hoʻouna Pono: a 20-year journey of designing, implementing, and sustaining prevention for rural, Indigenous communities},
  year = {2026},
  journal = {Substance Abuse Treatment, Prevention, and Policy},
  author = {Okamura, Kelsie H. and Cramer, M. and Palafu, Tessa and Helm, Susana and Dalisay, Francis and Primack, Zoe and Ching, Danielle L. Carreira and Goshgarian-Miller, Savannah and Liu, Michelle and Chin, S. K. and Marshall, Sarah Momilani and Saladino, Paula Angela and Kon, Z. and Song, Sarah D. and Yamane, Reilynn and Yoshizumi-Kim, Nadia and Rapadas, Cerila C and Okamoto, Scott K.}
}

Abstract

Background Numerous research studies indicate that Native Hawaiian and Pacific Islander (NHPI) youth report disproportionately higher substance use rates than other ethnic groups, as well as higher adverse effects associated with their use. Nonetheless, there has been a historical lack of evidence-based, culturally relevant interventions designed to prevent NHPI substance use. This article describes the trajectory of school-based, culturally grounded substance use prevention research for NHPI youth funded by the National Institute on Drug Abuse over the past two decades. Methods A review and synthesis of published research documenting the development, evaluation, implementation, and adaptation of the Hoʻouna Pono (HP) program is presented. The interconnectedness of separate funded research studies is highlighted. Results The HP program was developed and evaluated through 5 interconnected studies—a pre-prevention study, a pilot study, an efficacy trial, an implementation study, and an e-cigarette adaptation study. The program was also adapted to different regions through two complementary studies—a Guam adaptation (Fuestan Manhoben) and a Windward Oʻahu hybrid implementation trial (Mohala Na Pua). Conclusions The life course of the HP program may serve as a model for the development of culturally grounded prevention for under-researched and underserved youth populations. The program is a foundation for future substance use prevention adaptations across Hawaiʻi and the Pacific. Clinical trial Not applicable.


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