{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:23:02Z","timestamp":1781655782686,"version":"3.54.5"},"reference-count":75,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":56,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Hawai"},{"name":"i Department of Health, Chronic Disease Prevention and Health Promotion Division"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Outrigger canoe paddling (\u201cpaddling\u201d) is a culturally and regionally relevant physical activity (PA) in Hawai\u2018i and the Pacific with potential for public health promotion and disease prevention, yet paddling remains understudied from a public health perspective. This study explored the meaning of paddling across levels of the social\u2013ecological model (SEM) using qualitative methods. The study goal was to develop a research base and inform scholarship about participation in paddling for public health. A total of 1066 Hawai\u2018i residents (18 + years) completed an online or phone survey about culturally relevant PA. Among them, 362 self-identified as current or former paddlers and responded to the open-ended question: \u2018What does outrigger canoe paddling mean to you?\u2019. Qualitative analysis was conducted using a deductive\u2013inductive approach. Findings revealed themes spanning an adapted SEM: (i) intrapersonal\u2014fun, relaxation, PA; (ii) proximal connections\u2014relationships with people past and present; (iii) distal connections\u2014teams, canoe(s), and the ocean \u201chumanized\u201d as part of the community; (iv) environmental\u2014immersion in the natural world; (v) macrosocial\u2014culture, traditions, ancestral knowledge; and (vi) spiritual\u2014life symbolism and spirituality. Many respondents reported multiple levels of the SEM in their responses, which can be seen in this illustrative quote, sharing that padding meant: \u2018\u2026physical health, emotional balance, spiritual connection with ocean and self, building trust and communication with a team.\u2019 Paddling fosters health, well-being, and community across SEM levels, making it a strong candidate for PA interventions aligned with best-practice public health guidelines.<\/jats:p>","DOI":"10.1093\/heapro\/daaf130","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T04:13:57Z","timestamp":1756181637000},"source":"Crossref","is-referenced-by-count":1,"title":["Culturally relevant physical activity in Hawai\u2018i: outrigger canoeing across an adapted social\u2013ecological model"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3982-2507","authenticated-orcid":false,"given":"Simone M","family":"Schmid","sequence":"first","affiliation":[{"name":"Department of Public Health Science (DPHS), University of Hawai\u02bbi at M\u0101noa , 1960 East-West Road, Biomed D-104 W, Honolulu, HI 96822, USA"},{"name":"Hawai\u02bbi State Department of Health, Chronic Disease Prevention and Health Promotion Division , 1250 Punchbowl Street, Honolulu, HI 96813, USA"},{"name":"AccesSurf Hawai\u02bbi, Grants and Evaluations , P.O. Box 15152, Honolulu, HI 96830, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Soo Hoo","sequence":"additional","affiliation":[{"name":"Department of Public Health Science (DPHS), University of Hawai\u02bbi at M\u0101noa , 1960 East-West Road, Biomed D-104 W, Honolulu, HI 96822, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1528-5438","authenticated-orcid":false,"given":"Catherine M","family":"Pirkle","sequence":"additional","affiliation":[{"name":"Department of Public Health Science (DPHS), University of Hawai\u02bbi at M\u0101noa , 1960 East-West Road, Biomed D-104 W, Honolulu, HI 96822, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Public Health Science (DPHS), University of Hawai\u02bbi at M\u0101noa , 1960 East-West Road, Biomed D-104 W, Honolulu, HI 96822, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6594-3814","authenticated-orcid":false,"given":"Mika","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Public Health Science (DPHS), University of Hawai\u02bbi at M\u0101noa , 1960 East-West Road, Biomed D-104 W, Honolulu, HI 96822, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Yoshida","sequence":"additional","affiliation":[{"name":"AccesSurf Hawai\u02bbi, Grants and Evaluations , P.O. 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