The importance of nature and the environment in relation to human health is coalescing, as demonstrated by the increased research that attempts to measure nature connectedness and relatedness. These findings align with constructs of cultural connectedness that assess for land connectedness as part of Indigenous ways of knowing. From an Indigenous worldview, relationships with the environment are critical to wellbeing. The purpose of this comprehensive systematic scoping literature review was two-fold: (1) identify and summarize existing measures of land, nature, and/or environmental connectedness, relatedness, and attitudes and (2) evaluate the psychometric properties of these scales. In total, 1438 articles were retrieved from select databases including PubMed/MEDLINE, PsycINFO, CINAHL (EBSCO), and Academic Search Complete (EBSCO). The final searches and application of the inclusion/exclusion criteria resulted in 57 unique articles and 38 scales categorized as connectedness and relatedness scales (n = 9 scales), attitudinal and values-based scales (n = 16 scales), cultural and spiritually based scales (n = 9 scales), and paradigm-based scales (n = 4 scales) (articles could be placed in multiple categories). Psychometric properties and general outcomes associated with nature-related scales are reported, with implications for future education, research, practice, and policy.

Optimal health from a Native Hawaiian worldview is achieved by being pono (righteous) and maintaining lōkahi (balance) with all our relations, including our relationships as Kānaka (humankind) with ‘Āina (land, nature, environment, that which feeds) and Akua (spiritual realm). The purpose of this study is to explore the role of ‘Āina connectedness in Native Hawaiian health and resilience to inform the development of the ‘Āina Connectedness Scale. Qualitative methods were conducted with 40 Native Hawaiian adults throughout Hawai‘i. Three themes emerged: (1) ‘Āina is everything; (2) Connection to ‘Āina is imperative to health; and (3) Intergenerational health, healing, and resilience are reflected through intergenerational connectedness with ‘Āina. Qualitative findings, supplemented with a scoping review of land, nature, and cultural connectedness scales, led to the development of the ‘Āina Connectedness Scale, which examined the degree to which people feel connected to ‘Āina, with implications for future research. ‘Āina connectedness may address concerns related to health disparities that stem from colonization, historical trauma, and environmental changes and better our understanding of Native Hawaiian health by fostering stronger ties to land. Resilience- and ‘Āina-based approaches are critically important to health equity and interventions that aim to improve Native Hawaiian health.

Kānaka Maoli (Native Hawaiian) worldviews of health emphasize pono (righteousness) and lōkahi (balance), which extends to include relationships with other people, akua (spiritual realm), and ʻāina (land). The purpose of this qualitative study was to explore the role of ʻāina and ʻāina connection in health and resilience based on the perspectives of 12 Kānaka Maoli adults from the Waimānalo community. Three major themes were identified: ʻĀina is everything, ʻāina is health, and community healing through community-led initiatives. A better understanding of ʻāina connection is important to improve our knowledge of Hawaiian health. A connection to ʻāina may specifically address health concerns resulting from historical trauma and environmental changes.

Biomedical definitions of health have conventionally taken problem-based approaches to health, which may disregard indigenous perspectives of health that take a holistic approach and emphasize the importance of maintaining balance between physical, mental, and spiritual health and relationships maintained with others, the land, and the spiritual realm. Resilience-based approaches to health have been shown to foster strengths in indigenous communities, including the Native Hawaiian community, which leads to more positive health outcomes. The research questions of this paper asked, “how do Native Hawaiians conceptualize health and the concept of resilience specific to health?”. Qualitative methods were employed to explore the concept of resilience from the perspective of 12 Native Hawaiian adults. Community leaders and key stakeholders aided in the purposive recruitment process. The themes of this study include: (1) health maintained through balance, (2) being unhealthy vs. being ill, (3) the concept of colonialism and resulting adversities, and (4) protective and resilience factors that foster health. Cultural values and cultural practices may address concerns related to health disparities that stem from cultural and historical trauma, determinants of health, and environmental changes. Health interventions that are culturally-, family-, spiritually-, and land-based may particularly aid in responsiveness to health programs.

Native Hawaiians, or Kānaka Maoli, the first people to arrive and settle on the Hawaiian Islands, developed an ecologically sustainable food system that sustained the health of up to a million people on the islands. Colonization disrupted this system as well as the healthy lifestyle and cultural practices of the Indigenous people of the Hawaiian Kingdom. Today, Native Hawaiians face pervasive health and social inequities. To build research processes that can meaningfully and sustainably address these inequities, the Waimānalo Pono Research Hui was borne from the vision and priorities of community leaders and members of Waimānalo. Using qualitative data from the annual survey conducted with Waimānalo Pono Research Hui members, the purpose of this study is to illustrate how community engagement and community-based participatory research has been operationalized within a Native Hawaiian community to yield meaningful research. Five themes emerged from the analysis related to the ʻāina (land), pilina (relationships), consent, equitable resources, and data sovereignty. These findings demonstrate the importance of imagining, creating, and implementing research processes that are shaped by community voices.