443 - Centering curriculum in evolving paradigms of disability justice and cultural responsiveness to improve care for children and youth with disabilities in Hawai’i

Publication Number: 443.4473

Erika S.. Phelps Nishiguchi, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI, United States; Mahealani Ahia, University of Hawaii, Kaneohe, HI, United States; Jonathan R. Alexander, MCH LEND Hawaii, Honolulu, HI, United States; Mellanie L. Lee, University of Hawaii, John A. Burns School of Medicine, Kapaau, HI, United States; Roxanne M. Bristol, University of Hawaii, John A. Burns School of Medicine, Waipahu, HI, United States; Jeffrey D. Stern, Chaminade University of Honolulu, Honolulu, HI, United States; Susan B. Wood, University of Hawaii, John A. Burns School of Medicine, Honokaa, HI, United States; Kristiann Miyamoto, University of Hawaii, John A. Burns School of Medicine, Waipahu, HI, United States; May Okihiro, University of Hawaii, John A. Burns School of Medicine, Waianae, HI, United States

Background: Maternal Child Health Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs nationwide improve healthcare for Children and Youth with Autism Spectrum Disorder and other Developmental Disabilities (CYASD/DD) through interdisciplinary, culturally responsive clinical and leadership training. Our Hawaiʻi LEND Program, now in its 30th year, focuses on Native Hawaiian and other Pacific Islander (NHPI) children and their families who have endured persistent health and economic disparities, racism, and bias, which have increased since the COVID-19 pandemic. Hawaii's critical health professional shortages exacerbate these disparities for the rural and impoverished communities, especially for those with disabilities.

Objective: To strengthen and recenter the Hawaiʻi LEND curriculum on matters of equity and inter-cultural humility and responsiveness that align with current and evolving paradigms relevant to communities of Hawaiʻi.

Design/Methods: Faculty used an iterative process, informed by feedback from trainees, self-advocates, family-advocates, and others, to identify areas of need and develop curriculum components to promote trainee knowledge and skills related to the disability justice movement, Hawaii's rich NHPI cultures, historical trauma, and social-determinants of health. New faculty positions were filled to include those with lived experience and expertise in disability advocacy, indigenous studies, and health equity.

Results: Existing and expanded curricular content in disability justice and NHPI history and culture are outlined in Figure 1. Topics include models of disability, the neurodiversity paradigm, intersectionality, social determinants of health in Hawaii and the connection to colonization and migration, indigenous storytelling and connections to epistemology, narrative medicine/advocacy, and immersive community experiences. Evaluations of our LEND trainee cohort and community presentations note increased confidence in core MCH topic areas, leadership outcomes, appreciation for the cultural content, and request for much more content in these topics. In 2024, we received our largest trainee applicant pool, adding new disciplines to our trainee cohort.

Conclusion(s): The Hawaiʻi MCH LEND program is curating and disseminating local place-based and disability content with an expanding reach through current and future professionals serving our CYASD/DD. Rising interest in our program and positive evaluations indicate that our program is reaching its objective to expand expertise and leadership skills focused on cultural responsiveness and equity in these professionals.

Table 1: Description of Hawaiʻi LEND Disability Justice and NHPI curricular content.
Those marked with *represent existing content.