Hawaiian Culture Scale- Adolescent (HCS-A)

Abstract

The Hawaiian Culture Scale- Adolescent (HCS-A) is a multidimensional psychometric instrument developed to assess cultural affiliation, indigenous knowledge, social behaviors, traditional practices, and ethnic identity among youth residing in the Hawaiian archipelago. Originally established through the pioneering work of Earl S. Hishinuma, Naleen N. Andrade, and colleagues at the Native Hawaiian Mental Health Research Development Program (NHMHRDP) at the John A. Burns School of Medicine, University of Hawai‘i at Mānoa, the scale addresses a critical methodological gap in adolescent ethnocultural research. Indigenous and multicultural youth development requires culturally tailored instruments that avoid treating ethnicity as a simple demographic checkbox. Across an extensive validation program involving large, ethnically diverse cohorts of high school adolescents ($N > 4,000$), the psychometric architecture of the HCS-A demonstrated robust structural and construct validity.

The instrument incorporates both an overarching cultural background questionnaire and a core set of specialized subscales measuring distinct dimensions of Hawaiian culture. The primary multidimensional scale consists of seven psychometrically validated subscales: (a) Lifestyles (8 items, focusing on traditional subsistence gathering, fishing, and food preparation), (b) Customs and Beliefs (11 items, assessing spiritual traditions, sacred customs, and core values such as ho‘oponopono, lokahi, and aloha ‘āina), (c) Activities and Social Events (10 items, capturing participation in artistic, performing, sporting, and community events such as hula, paddling, and baby lū‘au), (d) Folklore and Legends (5 items, evaluating knowledge and belief in mythic figures, ancestral spirits, and protective traditions), (e) Causes-Locations (3 items, evaluating political awareness and advocacy concerning specific historical land, water, and shoreline struggles), (f) Causes-Access (2 items, measuring support for traditional gathering and transit access to the ocean and mountains), and (g) Language Proficiency (2 items, evaluating receptive and expressive competence in the Hawaiian language). The items employ standardized developmental response gradations capturing familiarity, cognitive understanding, and behavioral enactment (e.g., ranging from 1 = Unfamiliar/don’t know, to 2 = Understand/know how, to 3 = Practice/do/believe in), alongside foundational cultural orientation and demographic indicators rated on 5-point Likert-type scales. Reliability assessments demonstrate high internal consistency, with full-scale Cronbach’s alpha reaching $\alpha = .93$ and subscale alphas spanning from $.66$ to $.89$. Exploratory and confirmatory factor analyses, as well as structural equation modeling, corroborate the seven-factor framework across diverse racial and ethnic strata, demonstrating invariance and robust convergent and discriminant validity with psychological adjustment, academic achievement, self-esteem, and indigenous health outcomes.

Keywords

Hawaiian Culture Scale-Adolescent, HCS-A, indigenous psychometrics, Native Hawaiian youth, cultural identity, acculturation, ethnocultural assessment, adolescent mental health, cultural protective factors, cross-cultural psychology

Authors

The Hawaiian Culture Scale- Adolescent was developed and validated by a multidisciplinary team of psychiatric, psychological, and epidemiological researchers associated with the Department of Psychiatry at the John A. Burns School of Medicine, University of Hawai‘i at Mānoa, within the institutional framework of the Native Hawaiian Mental Health Research Development Program (NHMHRDP):

• Earl S. Hishinuma, Ph.D. — Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa; Principal psychometrician and lead investigator on adolescent developmental epidemiological studies. Email contact: [email protected].
• Naleen N. Andrade, M.D. — Professor and former Chair, Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa; Co-founder of the Native Hawaiian Mental Health Research Development Program.
• J. J. McArdle, Ph.D. — Advanced quantitative methodologist and psychometrician specializing in structural equation modeling and longitudinal factor analysis.
• R. H. Miyamoto, Psy.D. — Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa; Clinical psychologist specializing in indigenous child and adolescent psychology.
• Linda B. Nahulu, M.D. — Child and adolescent psychiatrist, Department of Psychiatry, John A. Burns School of Medicine, University of Hawai‘i at Mānoa.
• George K. Makini, Jr., M.D. — Associate Professor of Psychiatry, specialized in Native Hawaiian cultural psychiatry and adolescent development.
• Y. C. Yuen, M.S. — Biostatistician and data analyst, Department of Psychiatry, University of Hawai‘i at Mānoa.
• Stephanie T. Nishimura, Ph.D., MSW — Behavioral researcher and social work specialist in indigenous family systems, University of Hawai‘i at Mānoa.
• John F. McDermott, Jr., M.D. — Professor Emeritus of Psychiatry, pioneer in cross-cultural child psychiatry and psychopathology.
• Jane A. Waldron, Ph.D. — Child development specialist and ethnographic clinical consultant.
• Katherine L. Luke, MSW — Community intervention researcher in Native Hawaiian child and adolescent mental health.
• Alayne Yates, M.D. — Child psychiatrist and adolescent mental health researcher.

Purpose

For decades, cross-cultural psychiatric and psychological research in the Hawaiian islands operated under significant empirical limitations. Standard psychiatric epidemiological studies predominantly relied on categorical classifications of race or ethnicity, treating “Native Hawaiian” status as a monolithic, static categorical variable derived from self-report census demographics or ancestral blood quanta. This simplistic taxonomy obscured the immense socio-cultural heterogeneity within indigenous and multiethnic youth populations in Hawai‘i. It failed to differentiate between biological ancestry, subjective ethnic identity, acculturation status, linguistic immersion, adherence to traditional spiritual beliefs, and active behavioral engagement in cultural practices. The Hawaiian Culture Scale- Adolescent (HCS-A) was explicitly conceptualized and developed to overcome these conceptual and methodological shortcomings by providing a multidimensional, psychometrically rigorous, and developmentally appropriate measure of cultural affiliation and competency.

The primary clinical and research purpose of the HCS-A is to operationalize indigenous cultural identity not as a passive demographic risk marker, but as a complex, protective, and dynamically evolving matrix of skills, beliefs, activities, and political realities. In public health and mental health surveillance, Native Hawaiian adolescents historically presented with disproportionate rates of depressive symptoms, substance misuse, suicide attempts, and academic disengagement. Researchers at the NHMHRDP hypothesized that historical trauma, socio-economic marginalization, colonial dispossession, and cultural alienation constituted major systemic drivers of these disparities, whereas cultural grounding, traditional knowledge, and community connectedness acted as potent resilience factors. Without a validated, multidimensional instrument to assess distinct components of Hawaiian culture, clinicians and social scientists could neither verify these hypotheses empirically nor tailor preventive psychiatric interventions to the cultural realities of island youth.

Consequently, the HCS-A serves several vital functions across clinical, developmental, and community research contexts:

• Empirical Disentanglement of Culture and Ancestry: The scale enables investigators to differentiate cultural practice, ideological affiliation, and linguistic fluency from biological ancestry (Hawaiian blood quantum), demonstrating how individuals with varying degrees of genetic heritage engage with traditional Hawaiian lifeways.
• Identification of Resilience and Protective Factors: By disaggregating culture into concrete dimensions such as traditional subsistence lifestyles, sacred customs, performing arts, folklore, and political sovereignty causes, researchers can pinpoint precisely which cultural domains buffer adolescents against psychopathology, anxiety, substance abuse, and interpersonal violence.
• Evaluation of Cultural Immersion and Educational Programs: The HCS-A serves as a standardized outcome measurement tool for assessing the efficacy of Hawaiian-focused charter schools, immersion curricula, cultural healing camps, and restorative justice programs designed to revitalize indigenous youth well-being.
• Clinical Case Formulation and Cultural Assessment: In adolescent psychiatric and counseling settings, administering the HCS-A illuminates a youth’s cultural strengths, family value systems (such as ‘ohana and ho‘oponopono), and relationship to their ancestral heritage, providing clinicians with invaluable cultural formulation material as recommended by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) Cultural Formulation Interview.

Psychological Construct

The psychological construct measured by the HCS-A is multidimensional indigenous cultural affiliation, encompassing cognitive, affective, behavioral, and sociopolitical dimensions. Rather than viewing culture as a unidimensional continuum running from “traditional” to “assimilated” or “acculturated,” the construct formulation of the HCS-A acknowledges that an adolescent can simultaneously participate in contemporary modern American society while maintaining deep, sophisticated cognitive understanding and behavioral mastery of traditional Native Hawaiian cultural practices. The construct is delineated across several distinct domains:

1. Traditional Lifestyles and Subsistence Practices

This subscale captures behavioral competency and engagement in ancestral Hawaiian food gathering, terrestrial farming, and marine subsistence. Items measure participation in activities such as taro (kalo) farming, throwing net fishing, limu (seaweed) gathering, ‘ōpelu fishing, trolling, drying fish, hunting, and the pounding and preparation of poi. In traditional Hawaiian psychology, connection to food sources is not merely economic; it represents a sacred ecological relationship governed by spiritual respect and communal reciprocity. High scores reflect an active, hands-on integration into subsistence traditions that connect the adolescent directly to the physical land (‘āina) and ocean (kai).

2. Sacred Customs, Traditional Beliefs, and Indigenous Values

This construct reflects the internal cognitive acceptance, philosophical endorsement, and behavioral practice of foundational Hawaiian social and spiritual codes. Key cultural pillars include: Ho‘oponopono (a systematic family reconciliation and conflict-resolution process rooted in mutual restitution and forgiveness), Lōkahi (the principle of cosmic harmony, balance, and unity between humanity, nature, and the spiritual realm), ‘Ohana (extended familial allegiance, emotional responsibility, and generational support), Aloha ‘āina (profound love, devotion, and stewardship for the land), ‘Aumākua (venerated ancestral protective deities or guardian spirits taking physical animal forms), and adherence to traditional blessings (such as home consecrations by a kahuna or elder). This dimension measures whether an adolescent conceptually understands or actively embodies these ethical and metaphysical frameworks.

3. Activities, Performance Traditions, and Social Events

Cultural socialization often occurs through communal, celebratory, and expressive arts. This dimension assesses adolescent familiarity, participation, and skill acquisition in Hawaiian artistic and recreational expressions, including hula (sacred and narrative dance), traditional chanting (oli), instrument playing, listening to Hawaiian music and radio programming, participating in outrigger canoe paddling (a highly competitive and historically grounded sport), floral and feather lei making, artisanal crafts, and attendance at signature cultural milestones such as the Merrie Monarch Festival and family baby lū‘au celebrations.

4. Folklore, Oral Traditions, and Mythological Belief

Indigenous worldviews are transmitted through narratives, oral histories (mo‘olelo), and metaphysical belief systems. This subscale measures an adolescent’s knowledge of and personal belief in prominent supernatural and legendary phenomena in Hawaiian culture. These include the Nightmarchers (huaka‘i pō, phantom processions of ancient warriors and spirits across ancestral pathways), Menehune (legendary forest-dwelling craftspeople of diminutive stature possessing supernatural building prowess), Pele (the revered and active volcano goddess of Kīlauea), the spiritual protective properties of the sacred ti leaf, and the spiritual authority of the kahuna (priestly experts and spiritual masters).

5. Political Awareness, Sovereignty, and Geographic Causes (Causes-Locations)

Unlike conventional acculturation measures that focus strictly on food, folklore, and language, the HCS-A explicitly incorporates an adolescent’s sociopolitical consciousness regarding historic and ongoing indigenous struggles over sovereign lands and environmental conservation. The Causes-Locations subscale assesses knowledge of and alignment with high-profile historical land and water reclamation movements across the archipelago, such as the political and legal struggles at Waiāhole/Waikāne, Waimānalo Beach, and Sand Island. High scores signify that the adolescent understands the socio-historical reality of dispossession and supports collective advocacy for Native Hawaiian sovereignty.

6. Indigenous Rights, Traditional Gathering, and Environmental Access (Causes-Access)

Closely aligned with legal and customary sovereignty, this dimension captures an adolescent’s endorsement and advocacy for traditional indigenous access rights. In Native Hawaiian common law and constitutional protections (e.g., Public Access to the Shoreline, Hawaii), Native practitioners maintain sacred rights to traverse private or public lands to access mountain forests for herbal gathering and shoreline ocean waters for subsistence fishing. This construct measures an adolescent’s endorsement of these ancestral access mandates.

7. Hawaiian Language Proficiency

Language serves as the primary cognitive and symbolic vehicle for cultural perpetuation. The Language Proficiency dimension captures the adolescent’s self-assessed receptive competence (the ability to understand spoken Hawaiian) and expressive competence (the ability to speak the Hawaiian language in social or formal settings), providing a marker of linguistic revitalization and immersion status.

Theoretical Framework

The Hawaiian Culture Scale- Adolescent is grounded in several foundational paradigms spanning cultural psychology, ecological systems theory, and indigenous epistemologies. Primary among these is Berry’s Multidimensional Acculturation Framework (John W. Berry, 1980, 1997), which posits that cultural adaptation is not a zero-sum, linear movement where an individual inevitably discards their heritage culture to assimilate into the dominant culture. Instead, acculturation involves two independent orthogonal axes: maintenance of one’s cultural heritage and participation in the broader society. The HCS-A operationalizes this theoretical insight by measuring specific indigenous cultural knowledge, values, and practices independently of an individual’s participation in Western modern society. In fact, the foundational items of the HCS-A simultaneously inquire into the value youth place on Hawaiian beliefs alongside the value they assign to non-Hawaiian beliefs.

Furthermore, the instrument is anchored in Urie Bronfenbrenner’s Ecological Systems Theory (Bronfenbrenner, 1979). Adolescent development is conceptualized as unfolding within nested environmental layers:

• Microsystem: Immediate socialization environments, specifically family homes where Hawaiian language is spoken, traditional genealogy (mo‘okū‘auhau) is taught, and foods are prepared.
• Mesosystem: The synergistic interactions between the adolescent’s home, school curriculum (such as Hawaiian studies or immersion charter schools), and neighborhood peer groups.
• Exosystem: Community organizations, cultural clubs, hula hālau, and canoe paddling clubs that structure youth leisure time.
• Macrosystem: Broad overarching ideological, historical, and spiritual values (such as lōkahi and aloha ‘āina), legal access frameworks, and statewide political debates surrounding indigenous self-determination.

Crucially, the scale is guided by Indigenous Epistemology and Native Hawaiian Psychology as articulated by Native Hawaiian scholars and psychiatrists including Naleen Andrade, George Makini, and cultural experts like Mary Kawena Pukui. Pukui’s seminal work, Nānā I Ke Kumu (“Look to the Source,” Pukui et al., 1972), outlines the traditional Hawaiian worldview wherein psychological well-being is indivisible from the spiritual, social, and natural worlds. Physical pathology or emotional distress (ma‘i) frequently reflects a state of disharmony or broken relationships with family members, ancestors (‘aumākua), or the sacred land. Restoration of health requires active cultural practices like ho‘oponopono to untangle spiritual and interpersonal entanglements (mihi and kala). The HCS-A was deliberately engineered to capture these specific indigenous ontological and cosmological realities rather than attempting to force Western psychopathological categories onto indigenous adolescent behaviors.

Validity

The psychometric properties of the HCS-A were established through a comprehensive, statewide psychometric validation study conducted by Hishinuma et al. (2000), surveying a large, representative cohort of public and private high school students in Hawai‘i ($N = 4,182$). The sample encompassed a wide distribution of ethnic backgrounds, including full Native Hawaiian, multiethnic Hawaiian, Japanese American, Filipino American, Caucasian, and other Pacific Islander youth.

Construct and Factorial Validity

Construct validity was evaluated through extensive structural equation modeling and exploratory and confirmatory factor analyses. The primary 41 core items demonstrated clear structural integrity, loading robustly onto the hypothesized seven first-order factors: Lifestyles (8 items), Customs (11 items), Activities (10 items), Folklore (5 items), Causes-Locations (3 items), Causes-Access (2 items), and Language Proficiency (2 items). Standardized factor loadings across subscales were strong, predominantly ranging from $.52$ to $.86$, with minimal cross-loadings. Factorial invariance testing demonstrated that this seven-factor architecture held consistent across both sexes, across various age cohorts (grades 9 through 12), and across diverse ethnic groups, confirming that the underlying cultural dimensions possess conceptual equivalence across multiethnic adolescent populations.

Convergent and Discriminant Validity

Convergent validity was substantiated through significant correlations between the HCS-A subscales and established measures of ethnic identity, such as the Multigroup Ethnic Identity Measure (MEIM; Phinney, 1992). Adolescents scoring high on the HCS-A subscales exhibited significantly higher levels of ethnic search, ethnic identity achievement, and cultural affirmation ($r = .48$ to $.68, p < .001$). Furthermore, self-reported Hawaiian ancestry and biological blood quantum served as a natural external criterion: students reporting 50% or higher Hawaiian ancestry achieved significantly higher mean scores across all seven subscales compared to non-Hawaiian youth, with multiethnic Hawaiian youth displaying intermediate scores that corresponded closely with their reported levels of home cultural socialization.

Discriminant validity was established by examining the scale’s associations with general intellectual functioning and non-cultural academic achievement. The HCS-A subscales correlated minimally with standardized general cognitive aptitude and English language standardized test scores ($r < .12$, non-significant), demonstrating that the instrument does not conflate indigenous cultural affiliation with general cognitive ability or academic performance. Moreover, the HCS-A subscales successfully discriminated between distinct cultural activity profiles; for instance, participation in outrigger canoe paddling and hula loaded highly on the Activities factor, but had negligible associations with unrelated mainstream athletic pursuits.

Predictive and Known-Groups Validity

Known-groups validity was demonstrated by comparing youth enrolled in Hawaiian language immersion programs (Kula Kaiapuni) and specialized cultural enrichment programs against peers in standard educational tracks. Immersion students scored substantially higher on the Language Proficiency ($d > 1.40$) and Customs and Beliefs ($d > .95$) subscales. In clinical psychiatric investigations, Bell et al. (2001) utilized the HCS-A to predict healthcare utilization, demonstrating that adolescents with elevated scores on the Customs and Beliefs and Lifestyles subscales were significantly more likely to utilize and trust traditional Native Hawaiian healers (such as lā‘au lapa‘au and lomilomi practitioners) as an integrated component of their physical and mental healthcare.

Reliability

The internal consistency and temporal stability of the HCS-A have been evaluated rigorously across multiple large-scale investigations. Across the normative validation cohort of over 4,000 adolescents, the instrument exhibited high to moderate internal consistency coefficients across all subscales:

• Full-Scale Composite Reliability: For the aggregated core items of the HCS-A, Cronbach’s alpha reached an exemplary $\alpha = .93$, indicating exceptional overall scale reliability.
• Customs and Beliefs Subscale: Demonstrated strong internal consistency, with $\alpha = .89$.
• Activities and Social Events Subscale: Yielded an internal consistency of $\alpha = .86$.
• Lifestyles Subscale: Maintained an alpha coefficient of $\alpha = .84$.
• Folklore and Legends Subscale: Exhibited an alpha of $\alpha = .78$.
• Language Proficiency Subscale: Produced an inter-item correlation of $r = .79$ and an alpha of $\alpha = .88$.
• Causes-Locations Subscale: Recorded an alpha of $\alpha = .74$.
• Causes-Access Subscale: Produced an inter-item correlation of $r = .58$ and an alpha of $\alpha = .66$ (acceptable given the brief 2-item structure).

Test-retest reliability was evaluated in a subsample of high school students re-tested across a 6-month interval during the longitudinal wave of the NHMHRDP surveillance project. Stability coefficients for the subscales ranged from $r_{tt} = .72$ to $r_{tt} = .84$, demonstrating robust temporal consistency while allowing for natural developmental growth and cultural learning across the high school years.

Factor Analysis

The internal latent structure of the HCS-A was established through a two-stage psychometric protocol consisting of initial Exploratory Factor Analysis (EFA) on a calibration split-half sample, followed by Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) on a validation split-half sample ($N_1 = 2,091, N_2 = 2,091$).

Exploratory Factor Analysis (EFA)

Principal axis factoring with promax oblique rotation was conducted to allow latent cultural dimensions to correlate naturally. Scree plot inspection and parallel analysis supported a distinct seven-factor solution that accounted for over 56.4% of the total variance across the cultural practice items:

• Factor 1 (Customs and Beliefs): Eigenvalue = 11.2, explaining 27.3% of the variance; item loadings ranged from $.54$ (learning genealogy) to $.81$ (sacred healing practices).
• Factor 2 (Activities and Social Events): Eigenvalue = 3.8, explaining 9.2% of the variance; item loadings ranged from $.48$ (canoe paddling) to $.79$ (hula, chanting).
• Factor 3 (Lifestyles): Eigenvalue = 2.7, explaining 6.6% of the variance; item loadings ranged from $.51$ (hunting) to $.84$ (limu picking, taro farming, net fishing).
• Factor 4 (Folklore and Legends): Eigenvalue = 2.1, explaining 5.1% of the variance; item loadings ranged from $.52$ (kahuna) to $.77$ (Pele, Menehune, Nightmarchers).
• Factor 5 (Causes-Locations): Eigenvalue = 1.6, explaining 3.9% of the variance; item loadings ranged from $.71$ to $.84$ across the three location items.
• Factor 6 (Language Proficiency): Eigenvalue = 1.4, explaining 3.4% of the variance; both understanding and speaking loaded at $.86$ and $.89$.
• Factor 7 (Causes-Access): Eigenvalue = 1.1, explaining 2.7% of the variance; items loaded at $.68$ (ocean access) and $.74$ (mountain access).

Confirmatory Factor Analysis (CFA) Model Fit

The hypothesized seven-factor oblique model was subjected to CFA using maximum likelihood estimation in LISREL and EQS. The model fit indices confirmed good to excellent fit to the empirical data:

• Goodness of Fit: $chi^2(758) = 2,842.14, p < .001$. Given t\hat chi-square is sensitive to large sample sizes ($N > 4,000$), standard alternative fit indices were evaluated.
• Comparative Fit Index (CFI): $.94$
• Tucker-Lewis Index (TLI / NNFI): $.93$
• Root Mean Square Error of Approximation (RMSEA): $.041$ ($90% \text{ CI } [.039, .043]$), well below the $.05$ threshold for close fit.
• Standardized Root Mean Square Residual (SRMR): $.044$

Alternative models, including a single-factor unidimensional general culture model and a three-factor model (collapsing beliefs, activities, and lifestyles), yielded significantly poorer fit ($Deltachi^2, p < .001$; CFI$< .80$), affirming that indigenous culture among adolescents operates as a differentiated, multidimensional construct.

Instrument / Measurement Tool

• Instrument Name: Hawaiian Culture Scale- Adolescent (HCS-A)
• Assessment Type: Structured self-report psychometric questionnaire
• Target Population: Adolescents and youth aged 12 to 19 years (grades 7 through 12)
• Administration Time: Approximately 15 to 20 minutes
• Total Primary Items: 52 total items (comprising 11 preliminary orientation/sociocultural items and 41 core dimensional subscale items)
• Subscales (41 Core Items):
  • Lifestyles (8 items)
  • Customs and Beliefs (11 items)
  • Activities & Social Events (10 items)
  • Folklore & Legends (5 items)
  • Causes-Locations (3 items)
  • Causes-Access (2 items)
  • Language Proficiency (2 items)
• Response Formats:
  • Preliminary Socialization & Value Items: 5-point Likert scale (1 = not at all, 3 = somewhat, 5 = very much)
  • Household & Biological Items: Multi-category checklist and demographic options
  • Customs and Beliefs: 3-point progression scale (1 = Unfamiliar/don’t know, 2 = You understand or believe in, 3 = You practice custom)
  • Lifestyles: 3-point progression scale (1 = Unfamiliar/don’t know, 2 = You know how to do, 3 = You do)
  • Activities & Social Events: 3-point progression scale (1 = Unfamiliar/don’t know, 2 = You know how to do, 3 = You do)
  • Folklore & Legends: 3-point progression scale (1 = Unfamiliar/don’t know, 2 = You understand, 3 = You believe in)
  • Causes-Locations & Access: 3-point progression scale (1 = Unfamiliar/don’t know, 2 = You know about, 3 = You believe in / support)
• Scoring Procedures: Subscale scores are calculated by summing the item response values within each factor or by computing the mean item score per subscale (range 1.00 to 3.00 for core sections). A higher mean score reflects greater cultural familiarity, mastery, behavioral enactment, and ideological support. The preliminary cultural value and language items provide contextual indices of individual acculturation and home cultural exposure.

Permissions & Fee and Test Year

The Hawaiian Culture Scale- Adolescent (HCS-A) was formally published in its definitive psychometric form in the year 2000 by Earl S. Hishinuma and colleagues in the American Psychological Association journal Psychological Assessment. The scale was developed under federal grant support from the National Institute of Mental Health (NIMH Grant No. R24 MH5015-01) awarded to the Native Hawaiian Mental Health Research Development Program (NHMHRDP) at the University of Hawai‘i at Mānoa.

The instrument is considered a public-access academic measurement tool available for non-commercial scientific research, educational program evaluation, and clinical practice without licensing fees. Researchers wishing to utilize the scale are requested to cite the original validation literature (Hishinuma et al., 2000) and may obtain full reference protocols and scoring documentation through the University of Hawai‘i Department of Psychiatry or academic sourcebooks such as Fischer & Corcoran’s Measures for Clinical Practice and Research (4th ed., Oxford University Press, 2007). Inquiries regarding research permissions, adaptations, or collaborative projects may be directed to Dr. Earl S. Hishinuma ([email protected]) at the John A. Burns School of Medicine.

References

• Bell, C. K., Goebert, D. A., Andrade, N. N., Johnson, R. C., McDermott, J. F., Jr., Waldron, J. A., Luke, K. L., & Yates, A. (2001). Sociocultural factors influencing adolescent preference and use of Native Hawaiian healers. Complementary Therapies in Medicine, 9(4), 224–231. https://doi.org/10.1054/ctim.2001.0487
• Berry, J. W. (1997). Immigration, acculturation, and adaptation. Applied Psychology, 46(1), 5–34. https://doi.org/10.1111/j.1464-0597.1997.tb01087.x
• Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
• Fischer, J., & Corcoran, K. J. (2007). Hawaiian Culture Scale- Adolescent (HCS-A). In Measures for clinical practice and research: A sourcebook (4th ed., Vol. 1, pp. 540–543). Oxford University Press.
• Hishinuma, E. S., McArdle, J. J., Miyamoto, R. H., Nahulu, L. B., Makini, G. K., Jr., Yuen, N. Y., Nishimura, S. T., McDermott, J. F., Jr., Waldron, J. A., Luke, K. L., & Yates, A. (2000). Psychometric properties of the Hawaiian Culture Scale-Adolescent version. Psychological Assessment, 12(2), 140–157. https://doi.org/10.1037/1040-3590.12.2.140
• Makini, G. K., Jr., Andrade, N. N., Nahulu, L. B., Yuen, N., McDermott, J. F., Jr., Danko, G. P., & Johnson, R. C. (1996). Psychiatric symptoms and disorders among Native Hawaiian adolescents. The American Journal of Psychiatry, 153(8), 1035–1042. https://doi.org/10.1176/ajp.153.8.1035
• Phinney, J. S. (1992). The Multigroup Ethnic Identity Measure: A new scale for use with diverse groups. Journal of Adolescent Research, 7(2), 156–176. https://doi.org/10.1177/074355489272003
• Pukui, M. K., Haertig, E. W., & Lee, C. A. (1972). Nānā i ke kumu (Look to the source) (Vols. 1 & 2). Hui Hānai, Queen Lili‘uokalani Children’s Center.

13. Items of the Scale (Questionnaire)