Kathryn L. Braun

Regular physical activity (PA) is essential for healthy aging. For older adults residing in urban areas, access to urban green space (UGS) can help increase PA levels. This systematic review examined the association between availability, accessibility, and attractiveness of the UGS on PA among older adults. PubMed, CINAHL, and Web of Science were searched for articles published 2016–2024 that used quantitative methods to explore associations between the qualities of UGS and measures of PA in this demographic. Findings from nine studies from Europe, China, Hong Kong, and Australia were synthesized by availability, accessibility, and attractiveness domains. For availability, the presence and size of UGS were positively associated with older adults’ PA in several studies, whereas UGS proximity was inconsistently associated with PA. For accessibility, infrastructure-related features such as trail length were positively associated with PA, but findings for park features and safety were mixed. Results were also inconsistent for attractiveness; some land-cover and amenity features showed positive associations, while others showed no clear relationship with PA. In addition to variability in associations, there was great heterogeneity across studies in age inclusion criteria (e.g., 45+ vs. 65+), participant inclusion criteria, setting, operationalization of UGS quality, PA measures, and study rigor, reducing the ability to draw conclusions about the association between UGS qualities and PA. Although findings can begin to inform urban planners, public health professionals, and policymakers in designing UGS to promote PA in older adults, the field would benefit from more consistent definitions and measures of UGS qualities and PA.

In Indigenous communities, the concept of healthy aging often differs from mainstream views. In Taiwan, policy is influenced by the Han (people solely of Chinese ancestry, descendants of the people of the central plains in China), who categorize Indigenous individuals as elders at age 55. This study examined the eastern Paiwan (a subgroup of Paiwan people Indigenous to Taiwan) and their perspective on healthy aging to inform eldercare services. Approved by local chiefs, a focus group with 10 elders revealed that elderhood is defined by personal achievements and contributions rather than age. Participants defined a healthy elder as one who: (1) continuously interacted with others in the community; (2) practiced and transmitted cultural traditions; (3) contributed to family and tribe; and (4) continued to learn new things. Future research should explore how these findings are received by and used to improve Han-controlled Taiwanese Government services for Paiwan elders.

The Council of Indigenous Peoples in Taiwan has established tribal-based Cultural Health Stations offering basic health services and social activities for Indigenous communities. However, little is known about the factors influencing participation. This pilot study examined the reasons for attendance among older adults from five Paiwan communities in eastern Taiwan. A structured questionnaire, informed by Andersen’s Behavioral Model of Health Services Use and shaped through community consensus, was administered to 211 elders, 77 of whom were attending Cultural Health Stations. Participants who attended were generally older, female, living alone, not engaged in paid work or farming, and reported positive perceptions of the activities. Common reasons for non-attendance included time constraints, preference for alternative social settings, and dissatisfaction with the programs. Multivariable logistic regression analysis revealed that being aged 75 years or older, living alone, and reporting a higher self-rated ability to manage health issues were positively associated with attendance. In contrast, having paid employment was negatively associated. Findings from the open-ended questions suggested attendees appreciated services and activities but requested more cultural content. Non-attendees expressed that activities should be inclusive of different age groups and ability levels, culturally connected to local communities, and mindful that many elders still need to work. These findings highlight the importance of incorporating elders’ perspectives in the planning and evaluation of community-based services and may inform policy improvements for Indigenous elder care in Taiwan. However, it is also necessary to consider the economic circumstances of elders, design culturally centered activities, and respond to their interest in courses related to cultural transmission to ensure services are both accessible and meaningful.

The COVID-19 pandemic was assoicated with a significant drop in US life expectancy, with a 2.4-year decline from 2019 to 2021. This study evaluated if changes in life expectancy in Hawaiʻi followed the national trend from 2018 to 2022. We calculated life expectancy at birth for Hawaiʻi’s overall, male, and female populations from 2018 to 2022 using Chiang’s abridged life table method, with data from the Hawaiʻi State Department of Health and population estimates from the American Community Survey and 2020 Census. Life expectancy in Hawaiʻi was stable from 2018 to 2020, then declined by 1.3 years in 2021 to 80.7, with a partial rebound to 81.2 in 2022. Males saw a drop from 79.2 years in 2018 to 77.5 in 2021, rising to 78.2 in 2022, while females declined from 85.4 years in 2018 to 84.0 in 2021, rebounding slightly to 84.4 in 2022. Hawaiʻi’s COVID-19 response shows that early interventions and high vaccine uptake reduce mortality and preserve life expectancy. Future policy should focus on rapid-response systems and maintaining high vaccination rates.

This paper introduces a 48-page guide for conducting qualitative interviews with Native Hawaiian elders. The guide was developed based on work with and for Native Hawaiian elders through a partnership between ALU LIKE, Inc., a community-based service provider, and Hā Kūpuna National Resource Center for Native Hawaiian Elders at the University of Hawai‘i at Mānoa. Components of the guide include a brief history of research harms experienced by Native Hawaiians, a summary of advancements in Hawaiian-led research, tips for researcher self-reflection as required by community-based research, and recommendations for successfully engaging community, developing research questions, gathering and analyzing data, and reporting findings in ways meaningful to community members. Although experiences of colonization and discrimination are unique to each group, this protocol has application for qualitative research with other Indigenous and minority communities.

We describe a training series using a scaffolded approach informed by Vygotsky’s Learning Theory to advance Hawai‘i -based faculty grant-writing skills. Sponsored by the Professional Development Core of the Center for Pacific Innovations, Knowledge, and Opportunities (PIKO) at the University of Hawai‘i at Mānoa, the initiative includes a 2-week series of 1-hour introductory sessions on aspects of grant writing, a 3-session workshop to develop a specific aims page, and a 5-month training program in grant writing. Over three years, 202 Hawai‘i investigators attended at least one 1-hour introductory session, 62 completed the workshop on preparing specific aims, and 30 completed the 5-month training on grant writing. Participants rated all 3 programs as very useful. Of the 62 unique investigators who completed the Specific Aims Workshop, 21 (33%) submitted PIKO pilot grant applications, 4 (6%) submitted grants elsewhere, and 16 (30%) applied to the 5-month training on grant writing. The 30 GUMSHOE participants reported significant gains in their confidence in accomplishing 21 proposal-writing tasks and, as of May 2025, 26 (87%) submitted grants to the National Institutes of Health or another external funder. This scaffolded training approach is labor- and time-intensive for trainees and faculty mentors, but our outcomes demonstrate its success.

A principal strategic goal of the RCMI Coordinating Center (RCMI-CC) is to improve the health of minority populations and to reduce ethnic and geographic disparities in health by coordinating the development and facilitating the implementation of clinical research across the RCMI Consortium. To more effectively spur inter-institutional collaborative research, the RCMI-CC supports a Clinical Research Pilot Projects Program for hypothesis-driven clinical research projects proposed by postdoctoral fellows, early-career faculty and/or early-stage investigators from two or more RCMI U54 Centers. The purpose of this brief report is to summarize the Science Speed Dating sessions to facilitate cross-site collaboration at the RCMI Investigator Development Core (IDC) Workshop, held in conjunction with the 2024 RCMI Consortium National Conference. RCMI investigators and IDC Directors from 20 RCMI U54 Centers participated in two rounds of highly interactive small-group presentations of research ideas and resource needs in search of new collaborative and mentoring partnerships. Workshop participants expressed a high level of satisfaction with the speed-networking format and strongly agreed that the workshop was beneficial to their professional-development goals.

Background The lack of engagement and use of pre-exposure prophylaxis (PrEP) among Black women in the Southern United States is an enduring health disparity. Guided by an integrated theoretical framework and the PrEP Cascade, this qualitative inquiry aimed to explore Black women’s motivation and decision-making regarding PrEP engagement and identify strategies to enhance PrEP messaging and uptake for those with indication(s) for PrEP use. Materials and Methods Twelve semi-structured Zoom interviews were conducted between February 2020 and March 2022. Participants were sampled from a larger pool in an online survey study about factors associated with PrEP uptake among Black women. Interviews explored whether women started PrEP (or not) within 3 months after learning about PrEP in the survey and explored their reasoning. Data analysis included quantitative descriptive statistics and directed content analysis. Results None of the 12 women had started PrEP at the time of the interview. Two were in discussions with their provider about PrEP (stage 3: PrEParation), and one intended to initiate PrEP within the next 3 months (i.e., thinking about it). Two main themes emerged as their reasons for not starting PrEP: current relationship status and PrEP information (awareness, knowledge, and literacy). Participants expressed a lack of trust in PrEP due to insufficient information while anticipated challenges in obtaining PrEP included cost and the patient-provider relationship (engagement and communication). Conclusion The findings highlight missed opportunities to improve PrEP use among Black women within the PrEP contemplation phase, emphasizing the need for improved PrEP messaging and tailored PrEP programs and/or interventions for this group.

For many vulnerable older adults, food access was disrupted during the COVID-19 pandemic. In Hawai‘i, the Kūpuna (the Hawaiian word for elders) Food Security Coalition (KFSC) was formed in March 2020 to address this challenge, leveraging local and federal funding support. This case study presents information on coalition formation and success in addressing this emergency, as well as evaluation data on coalition functioning as assessed by the Collective Impact (CI) framework. Coalition functioning was assessed across the five CI conditions: common agenda, shared measurement, mutually reinforcing activities, continuous communication, and backbone support. Case study data were available from interview and learning circle transcripts, survey findings, and other program documents. Between March and December 2020, the KFSC coordinated efforts of 46 organizations to serve approximately 1.2 million meals to 8300 vulnerable seniors in Honolulu County. Within the first 9 months of existence, the coalition’s measurement system and the common agenda conditions showed advanced maturity, while the other conditions demonstrated moderate maturity levels. Despite challenging leadership transitions, the coalition was successful in helping increase food access and then pivoting in 2021 to promote kūpuna vaccinations, and the coalition continues to meet regularly to address issues of concern to vulnerable older adults. This study provides evidence-based guidance for communities seeking to establish public/non-profit partnerships for emergency food response for older adults, demonstrating how structured coalition approaches can effectively mobilize and coordinate multi-stakeholder efforts during and beyond crises.