Search Results (22)

TikTok is a popular social media platform offering educational opportunities for health issues such as rheumatic fever, which primarily affects 4–19-year-olds globally. This content analysis aimed to explore the type of rheumatic fever content available and popular on TikTok and the role that rheumatic fever representation may play in shaping public understanding and attitudes. The top 100 TikTok video posts under the hashtag #rheumaticfever were examined. Descriptive statistics were used to summarize video metrics and deductive thematic analysis enabled the coding of video content. The majority of TikTok users creating rheumatic fever content were patients or family members of people suffering from rheumatic fever (42%), followed by health professionals (30%). Forty-three percent of videos had negative connotations and personal stories were the most commonly coded type of video (42%). In terms of rheumatic fever content, symptoms (n = 59), medications/treatment (n = 37) and disease pathogenesis (n = 36) were the most common themes. Misinformation was identified in 3% of videos. This study provides a unique insight into who is making rheumatic fever-related content on TikTok and the primarily negative framing of narratives people are exposed to. There are opportunities for future health promotion strategies to focus on the gaps identified in this study, including information on where to seek health services, primordial prevention and stories of recovery. Full article

The multicultural landscape of Aotearoa New Zealand presents a rich tapestry of diversity and community needs, underscoring an imperative for inclusive participatory planning processes. This paper presents findings from an investigation of the challenges and opportunities inherent in community engagement initiatives, particularly within the context of New Zealand’s major ethnic groups, including New Zealand European, Māori, Chinese, and Pasifika. Drawing from the importance of community participation in reshaping public open spaces, this research addressed the gap in understanding which participatory planning processes are most effective across diverse cultural groups. To investigate the effectiveness of various approaches to community engagement, this research involved focus groups from the Wellington suburbs of Newtown and Porirua, utilising both on-site and online meetings. The findings identify the most effective participation processes for planning public open spaces in relation to each ethnicity. Correlations between participant preferences and their unique cultural backgrounds were assessed. In addition, the least effective participation methods along with several relatively effective participation methods are discussed. By highlighting engagement methods that can foster inclusivity, equity, and a sense of community, this research advances a collective goal of building a more cohesive and effective society for all its inhabitants. Full article

(1) Background: Although culturally grounded health interventions (CGHI) have shown efficacy in improving Indigenous health, few CGHI for Queer and Transgender Pacific Islander (QTPI) communities exist to address their health promotion. This study explores QTPI experiences of health for cultural mechanisms to develop CGHI for QTPI health promotion. (2) Methods: Using Indigenist community-engaged research methodologies, we collaborated with the United Territories of Pacific Islanders Alliance of Washington and Guma’ Gela’ to conduct 11 exploratory semi-structured interviews with QTPI community members living in the Puget Sound area of Washington state. These interviews were analyzed using thematic analysis. (3) Results: QTPI well-being was greatly influenced by how settler colonialism impacted their connectedness to their families, communities, and cultures. We also found that inágofli’e’ and alofa, relational values in CHamoru and Sāmoan culture, played essential roles in facilitating QTPI health. Many participants fostered these values through chosen family, community care, and Indigenous mobilities. (4) Conclusions: Our findings indicate a need for CGHI that facilitate inágofli’e’ and alofa for QTPI to combat settler colonialism’s impacts on QTPI well-being. Finally, we present a community-centered conceptual model for culturally grounded health promotion in QTPI communities. Full article

Experiences with endometriosis have been understudied in indigenous and people of colour populations. This study aimed to investigate the experiences of Māori and Pasifika endometriosis patients in Aotearoa New Zealand. Twenty-seven Māori endometriosis participants from 21 iwi (tribes), and 10 Pasifika participants from 8 different island nations participated in online, asynchronous, anonymous text-based discussions about their endometriosis journeys. Their explanations were analysed qualitatively with an inductive thematic approach. The average delay from symptom onset to a confirmed or suspected endometriosis diagnosis was 11.6 ± 7.8 years in the Māori cohort and 12.4 ± 6.2 years in the Pasifika cohort. There were high levels of dissatisfaction with the availability of treatment, with 66.7% of Māori participants and 60.0% of Pasifika participants feeling that endometriosis treatment was not readily available to them. Poor experiences with the medical profession might dissuade Māori and Pasifika patients from seeking care, exacerbating a culture of distrust and perpetuating healthcare inequities. This could potentially be improved by increasing the capacity to take time for relationship building within general practice or through the incorporation of cultural advisors to support relationship establishment that emphasises holistic consideration of patient well-being and culturally safe care. Full article

Kiribati is a Pacific Island nation with a widely dispersed population and one of the highest rates of leprosy worldwide. Single-dose rifampicin post-exposure prophylaxis (SDR-PEP) of leprosy contacts has reduced new case detection rates in controlled trials. In 2018, an SDR-PEP programme was introduced in Kiribati that included screening and chemoprophylaxis of household contacts of leprosy cases retrospectively (2010–2017) and prospectively (2018–2022). We conducted a retrospective audit to determine the comprehensiveness, timeliness and feasibility of the SDR-PEP programme. Overall, 13,641 household contacts were identified (9791 in the retrospective and 3850 in the prospective cohort). In the retrospective cohort, 1044 (11%) contacts were absent, 403 (4%) were ineligible for SDR, and 42 new cases were detected (0.4%) Overall, SDR coverage was 84.7%. In the prospective cohort, 164 (4%) contacts were absent, 251 (7%) were ineligible for SDR, and 23 new cases were diagnosed (0.6%). Overall, SDR coverage was 88.1%. Across both cohorts, there were 23 SDR refusals. The median time to SDR administration was 220 days (IQR 162–468) and 120 days (IQR 36–283) for the retrospective and prospective cohorts, respectively. SDR was readily accepted in both cohorts. The new case detection rate (0.5%) is consistent with that in other studies. Overall SDR coverage in both the retrospective and prospective phases met programmatic expectations. Full article

Despite well-established Pasifika communities in Australia, there has been no examination of the English spoken by members of these communities in the sociolinguistic literature. Yet, research shows that Pasifika English may exhibit key differences from local ‘mainstream’ varieties. In this paper, we present a case study of members of a drill rap group with Pasifika heritage to examine whether Pasifika English features are evident in their speech. We first analyze their monophthong productions and compare these to those of mainstream Australian English speakers. We also analyze their dental fricative realizations to examine whether there is evidence of th-stopping and dh-stopping, commonly described as markers of Pasifika English. Finally, we investigate whether their speech is more syllable-timed than mainstream Australian English. The results show that these speakers produce monophthongs generally consistent with mainstream Australian English vowels, despite some small differences. We also show consistent th-fronting and dh-stopping in their speech, which serves as a marker of their Pasifika heritage. We find a tendency towards more syllable-timed speech; however, this occurs to a lesser extent than has been reported for other Pasifika varieties of English. The results suggest that these speakers index their Pasifika identities by employing indicators/markers of Pasifika English that diverge from mainstream Australian English. Full article

Background: New Zealand was one of the first countries to adopt an elimination strategy based on a four-tier Alert Level system that included strict lockdowns at levels three and four. The lockdowns meant shutting out external social networks and being confining to individual household ‘bubbles’ only. This presented challenges for minority Pasifika communities in New Zealand as their cultural values are based on social bonding, interconnectedness, community engagement and caring for each other. The aim of this research was to conduct a small-scale pilot study to test and refine the study design and identify the major challenges faced by Pasifika communities in relation to accessing health, social and mental services while in lockdown. Methods: This exploratory study was designed using an online anonymous questionnaire survey targeting people who identified as Pasifika. A total of eighty-seven respondents were included in our analyses following the questionnaire survey. Results: Five main barriers to accessing health, social and mental health services during lockdowns were identified; (1) unavailability of or limited services; (2) fear of contracting the virus; (3) perception of high costs associated with seeking medical assistance; (4) transportation difficulties; and (5) lack of time. Almost a quarter of the respondents reported losing their jobs, 80% indicated a decline in their household income and more than half experienced some form of psychosocial distress while in lockdown. Conclusions: The findings of this research highlight existing challenges faced by Pasifika communities in adequately accessing essential services. Future research can focus on the key barriers to access identified in this research to gain a deeper understanding of services and its interaction with Pasifika communities during lockdowns. Full article

The objective of this study was to explore the potential enhancement of response within GP medical centres in New Zealand when facing heightened healthcare demand during a pandemic. This investigation sheds light on effective crisis management and leadership. By elucidating the contributions of this research, we gain a deeper appreciation of its importance in advancing our understanding of pandemic management. This study has yielded fresh insights and knowledge, beneficial to both academic and real-world applications, particularly concerning the adoption and effects of leadership and management within the healthcare domain amidst crisis situations. Using a multiple case study design, we conducted 86 in-depth interviews with staff from 16 General Practice centres in New Zealand. The critical activities delivered during the first six months of the COVID pandemic to keep New Zealand communities safe during the initial COVID-19 outbreak were (a) leadership in health service planning, including workforce planning, new operational processes, and expansion in the use of Information Communication Technology systems by the GP medical centres; (b) environment disinfection using national guidelines, education and establishment of respiratory clinics and expanding testing sites in GP medical centres; and (c) education and outreach to the patients including the protection of Māori, Pasifika, and remote communities. The decision to adopt a localised response to the pandemic, centralise testing, and better understand local-level needs prompted GP medical centres to communicate and engage early and effectively with patients. This enabled centres to lead and manage the COVID-19 pandemic with greater efficiency in the first six months of the outbreak. The New Zealand government’s “team of 5 million” COVID-compliance campaign program provided clear and persistent communication by the Ministry of Health. This campaign assisted in a better national understanding and compliance with the regulation of the COVID-19 pandemic. The dedication of medical centre managers to forward planning using contingency and accrued funding and setting up Community-Based Assessment Centres and respiratory clinics, including walk-in and outreach services, proved to be highly effective. GP centres led the way in COVID-19 pandemic planning, response, and management. Full article

Media representations and dominant social constructions of the ‘ideal’ physique for young women are often framed through a Westernised lens that focuses on heteronormative, White able-bodied aesthetics of beauty and femininity. Until very recently, the imagery available for young women to connect with and aspire to has been highly limited, failing to represent the embodied cultural beliefs that Indigenous and culturally-minoritised young women may have towards the gendered body. In this paper, we draw upon focus groups (wānanga) and digital diaries with young, physically active Māori and Pasifika wāhine (women) in Aotearoa New Zealand, to reveal how they are making meaning out of dominant framings of beauty, and drawing upon cultural knowledge to refuse such portrayals, instead reclaiming power in their own bodies. Working at the intersection of Mana Wahine and Masi methodologies, this article amplifies the voices of young Māori and Pasifika wāhine who actively participate in sport and/or physical activity, embrace and appreciate their strong brown bodies, and are critically reading and rejecting dominant Western framings of beauty and femininity. In so doing, this paper contributes to a growing international dialogue about the need for new culturally-informed understandings of body image by young women from Indigenous and culturally marginalised communities. Full article

Ocular antibiotics are integral to the prevention and treatment of bacterial ocular infections. This study aimed to describe their utilisation across New Zealand according to patient and healthcare factors. Every subsidy-eligible community dispensing of ocular chloramphenicol, fusidic acid and ciprofloxacin in New Zealand, between 2010 and 2019, was included in this analysis. Number of dispensings/1000 population/year was quantified, stratified by patient age and urban/non-urban health districts. Dispensing rates by ethnicity were determined and were age adjusted. The proportion of dispensings by socioeconomic deprivation quintile was also determined. Chloramphenicol was the most commonly dispensed antibiotic; however, its utilisation decreased over time. Ciprofloxacin use was higher in children, while chloramphenicol use was higher in older patients. Ciprofloxacin usage was higher among Māori and Pasifika ethnicities, while fusidic acid use was lower. Chloramphenicol usage was higher among Pasifika. Antibiotic utilisation was higher in urban health districts, and in the most deprived quintile; both were most marked with ciprofloxacin. The utilisation of publicly funded ocular antibiotics across New Zealand varied between patient subgroups. These findings will help improve the prevention, management and outcomes of bacterial ocular infections, and support wider initiatives in antibiotic stewardship and medicine access equity. Full article

Household food insecurity, defined in New Zealand (NZ) as a ‘limited or uncertain availability of nutritionally adequate and safe foods or limited ability to acquire acceptable foods in a socially acceptable way’, is a serious public health concern associated with poorer diet quality and nutritional deficiencies. Preventing food insecurity in infancy is crucial because adequate nutrition is essential for normal infant growth and development. Household food insecurity was investigated in the First Foods NZ study, a cross-sectional study of families with infants aged 6.9–10.1 months in Auckland and Dunedin. A NZ-specific questionnaire consisting of eight validated food security indicator statements relating to household financial constraint over the previous 12 months was administered. The participants’ responses were scored using a total scoring protocol developed in the study. Cut-offs were applied to the total scores to create categories of food insecurity (secure, moderately insecure, severely insecure), and each household (n = 604) was classified into a category. In total, 17.4% (n = 105) of the households were moderately food insecure and 7.6% (n = 46) were severely food insecure. Of the food security indicators, the participants most frequently reported that the variety of foods the household was able to eat was limited by a lack of money (18.5% sometimes; 3.3% often), feeling stressed because of not having enough money for food (16.6% sometimes; 3.2% often), or feeling stressed because they could not provide the food they wanted for social occasions (13.9% sometimes; 3.0% often). Severe food insecurity was most prevalent in participants of Māori or Pasifika ethnicity, <25 years of age, not in work or on leave from work, or for whom school was their highest level of education. One quarter (25%) of the families experienced a degree of food insecurity, highlighting the need for dignified solutions that support all NZ families to acquire foods that are nutritious, affordable, and culturally acceptable to them. Full article

Transitioning from milk to complementary food (CF) is a critical time for infants, with the non-timely introduction associated with poorer health outcomes. We aimed to describe the timing of the introduction of CF and its sociodemographic associations in an ethnically diverse cohort of urban-dwelling infants. The timing of CF introduction and sociodemographic characteristics (ethnicity, maternal education, parity, deprivation index, infant sex) were collected by questionnaire when infants were 7.0–10.0 months. Early CF introduction was defined as ≤4 months and late as ≥7 months of age. Of 625 infants, 131 (20.1%) were identified as Māori, 82 (13.2%) as Pasifika, and 450 (72.1%) as other. The mean (SD) age of CF introduction was 4.9 (1.1) months for both Māori and Pasifika infants and 5.3 (0.8) months for other. 6.9% of Māori infants were introduced to CF before 4 months, 33.6% at 4 months, and 3.1% at 7 months. For Pasifika, the percentages were 9.8%, 24.4%, and 3.7%, respectively. For others, percentages were lower at <1%, 16.7%, and 1.8%, respectively. Using logistic regression analysis, Māori and Pasifika had higher odds of early CF introduction for infants with mothers whose highest education was secondary school (Māori: 3.8 ([95% CI] 1.5, 9.8); Pasifika: 3.3 (1.1, 10.3)). The odds of early CF introduction for other infants were higher for those with mothers whose highest education was secondary school (2.1 (1.2, 3.5)), who lived in areas of high deprivation (1.8 (1.0, 3.2)), and whose infant sex was male (1.7 (1.1, 2.9)). Parity was not associated with early CF introduction for any group. Most infants in all groups were introduced to CF between 4 and 6 months of age and over half at around 6 months of age. A small proportion of infants were introduced before 4 months. This research identifies groups that would benefit from more targeted infant feeding support. Full article

Good nutrition in early childhood is essential for optimal brain development, growth, learning to eat, and establishing healthy food preferences. Little is known about exposure to food insecurity among young children in Aotearoa New Zealand and the impact of this on child nutrition. This study sought to understand the relationship between household food grant/foodbank use when children were aged 9- and 54-months old and eight indicators of early childhood nutrition. Data were from the Growing Up in New Zealand cohort (n = 6032) born in 2009/10. Descriptive and multivariate logistic regression were used. At 9 months of age, 12% of mothers reported using food grants/foodbanks in the past 12-months, decreasing to 8.4% at 54-months. However, these were largely different families. Ethnic inequities were marked: 34.5% of tamariki Māori and 40.3% of Pasifika children experienced food grant/foodbank use at either or both time points. Children living in households accessing food grants/foodbanks were significantly more likely to have poorer nutrition across the eight indicators. After adjustment for differences in household income and size, child ethnicity, mother’s age and education, and neighbourhood deprivation, infants whose mothers had made use of special food grants/foodbanks were more likely to have tried sugary drinks (AOR:1.45, p < 0.01) and unhealthy foods (AOR:1.44, p < 0.01) compared to other infants. At 54-months of age, they were nearly twice as likely to be served a low variety of vegetables (AOR:1.91, p < 0.01) compared to other children. In the early 2010s, the use of food grants/foodbanks was common in young families, and ethnic inequities were stark and persistent. Food insecurity was associated with multiple aspects of child nutrition. Policy responses to food insecurity must be made in meaningful partnerships with Māori and Pasifika whānau and communities, and enable sufficient support for families with young children, to ensure all tamariki have the best nutritional start in life. Full article

Compliance with the Convention on the Rights of Persons with Disabilities (CRPD) requires substitute decision making being abolished and replaced with supported decision making. The current exploratory study involved a series of hui (meetings) with subject matter experts across the spectrum of the mental health care system to identify interventions facilitative of supported decision making; and the prioritisation of those in accordance with their own perspectives. A mixed-methods approach was used to categorise, describe and rank the data. Categories of intervention identified included proactive pre-event planning/post-event debriefing, enabling options and choices, information provision, facilitating conditions and support to make a decision, and education. The category of facilitating conditions and support to make a decision was prioritised by the majority of stakeholders; however, people from Māori, Pasifika, and LGBTQIA+ perspectives, who disproportionally experience inequities and discrimination, prioritised the categories of proactive post-event debriefing/pre-event planning and/or information provision. Similar attributes across categories of intervention detailed the importance of easily and variably accessible options and choices and how these could best be supported in terms of people, place, time, material resources, regular reviews and reflection. Implications of these findings, particularly in terms of the operationalisation of supported decision making in practice, are discussed. Full article

Queensland is home to the largest diaspora of Māori and Pasifika peoples in Australia. They form an understudied population concerning experiences and challenges of food insecurity. This community co-designed research aims to explore the conceptualization of household food security by Māori and Pasifika peoples living in south-east Queensland. Participatory action research and talanoa were used to collect and analyse forty interviews with leaders representing 22 Māori and Pasifika cultural identities in south-east Queensland. Eight key themes emerged that conceptualise food security as an integral part of the culture and holistic health. These themes included: spirituality, identity, hospitality and reciprocity, stigma and shame, expectations and obligations, physical and mental health and barriers and solutions. Addressing food insecurity for collectivist cultures such as Māori and Pasifika peoples requires embracing food sovereignty approaches for improved food security through the co-design of practical solutions that impact social determinants and strengthen existing networks to produce and distribute affordable and nutritious food. Full article