Search results

In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.

A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.

Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.

To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.

This study reports on changes made within the study, plan, teach and reflect steps of lesson study with pre-service teachers who were learning to teach within a disciplinary literacy course.

Using methods associated with formative experiments and design-based research, this study gathered data over four iterations of the disciplinary literacy course. Data included the course materials, pre-service teachers’ written work, observational notes from research lessons, transcripts of post-lesson discussions and teacher-educators’ analysis sessions and pre-service teachers’ post-program interviews. Data were analyzed within and across iterations.

Initial adjustments to the lesson study process focused on the reflect step, as we learned to better scaffold pre-service teachers sharing of observational data from research lessons. Later adjustments occurred in the study and plan steps, as we refined the design of four-day lesson sequences that better supported pre-service teachers’ attention to disciplinary literacy while providing room for their instructional mentors to provide specific team-based feedback. Adjustments to the teach step included reteaching and more explicit attention to literacy objectives.

This paper contributes to the literature by explicitly applying formative experiment and design-based research methods to the implementation of lesson study with pre-service teachers. Furthermore, it contributes examples of lesson study within a disciplinary literacy context, expanding the examples of lesson study’s applicability across content areas.