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Empowering Native Hawaiians with Tobacco Resources

The Coalition for Tobacco-Free Hawaiʻi Island had the pleasure of working alongside Jill Tamashiro from the Department of Health and Ikaika Regidor from Papa Ola Lōkahi to evaluate our readiness to provide tobacco resources tailored to Native Hawaiians on Hawaiʻi Island. We used the APPEAL Community Readiness Model and the Stages of Change to evaluate our tobacco-related support for Native Hawaiians. By applying these stages to our Native Hawaiian community, we were able to identify what different individuals, organizations, or community groups are providing tobacco-related services.


Stage 1: Precontemplation – Not thinking seriously about change.

Stage 2: Contemplation – Acknowledging there is a problem but not yet ready to make a change.

Stage 3: Preparation or “Determination” – Ready to make the change.

Stage 4: Action – Actively taking steps to make the change.

Stage 5: Maintenance – Successfully overcoming barriers to maintain the new status quo.

The APPEAL Community Readiness Model provides a continuum on which a community can move from a pre-contemplation stage to a maintenance stage in relation to addressing tobacco control issues. This model assesses a community’s readiness to address a specific topic, such as tobacco prevention and control among Native Hawaiians. The model allows us to gauge where our community resources stand in their readiness and capacity to make changes related to tobacco use. This assessment has helped us understand our efforts’ specific strengths and weaknesses.

The purpose of the APPEAL Model is to provide a framework for which communities can assess their readiness to engage in different aspects of tobacco control or other health equity issues. Adapted from the Transtheoretical Model of assessing individual behavioral change, this model helps to identify stage-appropriate technical assistance and training (TAT) needed to support the movement of a community along the continuum of change. This model is intended to be fluid, dynamic, and adaptable for assessment purposes, with great benefit, particularly in capacity building and infrastructural development.

“A’ohe hana ke alu ‘ia”- No task is too big when done together by all.

Overall, through this process, we gained a better understanding of where we stand as a coalition in addressing tobacco use for Native Hawaiians. Using this model allowed us to create a baseline and roadmap for progress as we work towards our goal of improving tobacco-related support and resources in our community. We can now progress from here by enhancing and ensuring that resources are available to Native Hawaiians in our community.

If this interests you, consider joining our efforts to provide resources for Native Hawaiians by joining our Coalition for Tobacco-Free Hawaiʻi Island. To learn more about this project or to get involved, please email West Hawai‘i Tobacco and HEAL Coalition Coordinator Kealoha Madriaga at

Kealoha Madriaga

Kealoha Madriaga

West Hawai‘i Tobacco and HEAL Coalition Coordinator
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