# Systems Science Informed Multilevel Theoretical Model of Cardiovascular Health in Native Hawaiians

> **NIH NIH K01** · UNIVERSITY OF HAWAII AT MANOA · 2021 · $54,000

## Abstract

The purpose of this supplement application is to support the research and career development of Dr. Claire
Townsend Ing in establishing herself as an independent investigator engaging community and using system
science theory and methods to examine and address multilevel determinants of cardiovascular disease. Native
Hawaiians bear a disproportionate burden of hypertension and cardiovascular disease. Multilevel interventions
are relevant for hypertension prevention as blood pressure is influenced by risk and protective factors at
individual, family, community, societal, and environmental levels. However, research examining these factors’
complex interactions and processes is lacking in Native Hawaiians. Such information is critical to developing a
multilevel theoretical model of Native Hawaiian cardiovascular health to guide the design of culturally relevant,
multi-level interventions for this understudied group. Dr. Ing will build on her experience in community-based
participatory and translational research to achieve four short-term career objectives; to 1) examine multilevel
determinants of cardiovascular health, 2) use systems science theory and methods to include group-based
model building and community-based system dynamics, 3) improve knowledge and skill in hypertension and
CVD prevention, and 4) engage Native Hawaiian community members and leaders. The proposed research
will build on a partnership with a USDA-funded study (Children’s Healthy Living Center of Excellence) that
includes 6 Native Hawaiian communities. Its 2019 reassessment included sociodemographic, psychosocial,
behavioral, household, and community factors. Through leveraging this partnership, Dr. Ing will recruit 240
adults for additional data collection on blood pressure, height, weight, and behavioral and psychosocial factors
(e.g., diet, physical activity, discrimination). Using these data, she will examine the relationships between
individual, household, and community factors and blood pressure. Additionally, she will engage community
leaders in 6 focus group workshops (n=48) to create causal structures of perceived links between multilevel
factors and HTN. She will then synthesize the qualitative data and causal structures to create a causal loop
diagram. This causal loop diagram will serve as a novel theoretical model of cardiovascular health in Native
Hawaiians. The specific aims are to: 1) estimate the associations between behavioral (physical activity, diet,
alcohol consumption, tobacco use), biological (BMI), psychosocial (acculturation, discrimination), household
(size, composition, food scarcity, use of food assistance), and community (walkability, food environment)
factors and blood pressure in 240 adult Native Hawaiians, and 2) engage community leaders via focus group
workshops to create a causal loop diagram depicting multilevel determinants of cardiovascular health in Native
Hawaiian communities. The proposed research continuity supplement will ensure that t...

## Key facts

- **NIH application ID:** 10411862
- **Project number:** 3K01HL146930-03S1
- **Recipient organization:** UNIVERSITY OF HAWAII AT MANOA
- **Principal Investigator:** Claire Townsend Ing
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $54,000
- **Award type:** 3
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10411862

## Citation

> US National Institutes of Health, RePORTER application 10411862, Systems Science Informed Multilevel Theoretical Model of Cardiovascular Health in Native Hawaiians (3K01HL146930-03S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10411862. Licensed CC0.

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