{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T06:34:25Z","timestamp":1792996465979,"version":"4.5.0"},"reference-count":58,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100006374","name":"David O. McKay School of Education, Brigham Young University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Qual Health Res"],"abstract":"<jats:p>\n                    Mothers raising children with developmental disabilities in American Samoa navigate caregiving within fa\u2019a Samoa (\n                    <jats:italic toggle=\"yes\">the Samoan way of life<\/jats:italic>\n                    ), where family, culture, and spirituality are deeply intertwined. Yet, the lived experiences of these mothers remain largely undocumented. This study explored how mothers make meaning of caregiving and its implications for holistic well-being within this unique cultural and geographic context. Using interpretative phenomenological analysis with culturally congruent focus group methods, 15 mothers participated across three focus groups. Data were interpreted through the Fonofale model, a Pacific framework conceptualizing well-being through interconnected cultural, spiritual, physical, mental, and familial dimensions. Two superordinate themes emerged: (a) impossible choices between inadequate on-island services and family-fragmenting off-island care and (b) painful tensions between cultural expectations of obedience and children\u2019s disability-related behaviors, often leading to stigma and isolation. Across both themes, mothers described strain across every dimension of the Fonofale, revealing caregiving as a totalizing experience affecting cultural belonging, family integrity, spiritual life, and emotional well-being. Findings highlight the need for culturally embedded developmental disability supports that strengthen rather than fracture Pacific family and community systems.\n                  <\/jats:p>","DOI":"10.1177\/10497323261479883","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:50:13Z","timestamp":1792021813000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cWe\u2019re Trapped\u201d: Maternal Well-Being and Caregiving for Children With Developmental Disabilities in American Samoa"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8038-1752","authenticated-orcid":false,"given":"Elizabeth A.","family":"Cutrer-P\u00e1rraga","sequence":"first","affiliation":[{"name":"Brigham Young University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ditto","sequence":"additional","affiliation":[{"name":"Brigham Young University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Seu","sequence":"additional","affiliation":[{"name":"Connections-The Learning Resource"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel Medina","family":"Hull","sequence":"additional","affiliation":[{"name":"Alpine School District"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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Kawika","family":"Allen","sequence":"additional","affiliation":[{"name":"Brigham Young University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca R.","family":"Winters","sequence":"additional","affiliation":[{"name":"Brigham Young University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ofa Hafoka","family":"Kanuch","sequence":"additional","affiliation":[{"name":"Brigham Young University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Hee","sequence":"additional","affiliation":[{"name":"Brigham Young University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melia Fonoimoana","family":"Garrett","sequence":"additional","affiliation":[{"name":"Nebo School District"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristofer J.","family":"Urbina","sequence":"additional","affiliation":[{"name":"Brigham Young University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"e_1_3_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/10497323251384538"},{"key":"e_1_3_7_3_1","article-title":"Pacific Islander contrapuntal tensions about mental health help seeking: An interpretative phenomenological focus group (IPA-FG) analysis","author":"Allen G. 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