Design and implementation of a Pacific intervention to increase uptake of urate-lowering therapy for gout: a study protocol

Abstract Background Gout is a painful chronic disease which disrupts work and family life and can lead to chronic joint damage. Pacific people in Aotearoa/New Zealand experience significant inequities, with over three times the gout prevalence of the non-Pacific non-Māori populations. Pacific people receive less regular urate-lowering drugs to prevent gout flare-ups, and have nine times the hospitalisation from gout compared with non-Pacific non-Māori people. Rates for Indigenous Māori lie between Pacific and non-Pacific non-Māori. A long-established Collective comprising community members from the Pacific People’s Health Advisory Group, clinical staff from the Pacific Practice-Based Research Network, and University of Auckland researchers have identified that improving Pacific urate-lowering therapy use as the research question of prime importance for improved health outcomes of Pacific people in South Auckland. Building on the existing knowledge, this study aims to develop, implement and evaluate a novel innovative intervention to improve the uptake of urate-lowering therapy by Pacific patients with gout. Methods Three-phase mixed methods co-design study using the Fa’afaletui research framework following the STROBE statement. Phase1 is observational times series of prevalence of patients with gout, proportion with urate blood-level monitoring and use of urate-lowering medication over past 5 years. In Phase 2 the Collective will workshop new interventions to address previous uptake barriers, using culturally-appropriate Talanga communications with results synthesised in line with Kakala principles. The designed intervention will be implemented and process and outcome evaluations conducted. Finally, an implementation framework will be produced to facilitate further roll-out. Discussion The study aims to enhance health and reduce inequities for Pacific people, contribute to creation of Pacific health knowledge and translation of research findings into Pacific health gains. Potential longer-term impact is a gout-management pathway for use throughout Aotearoa/New Zealand. Māori have similar issues with high gout prevalence and low urate-lowering therapy use hence the intervention is likely to translate to Māori healthcare. The project will contribute to Pacific research capacity and capability-building as well as general upskilling of community and practice members involved in the co-design processes. Trial registration The Australian New Zealand Clinical Trial Registry is in process, request number 38206, 1-09-2021.

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What are young Pacific peoples understandings of leadership in Aotearoa New Zealand?

10.26686/wgtn.17068043 ◽

2021 ◽

Author(s):

◽

Grace Faletutulu

Keyword(s):

New Zealand ◽

Leadership Development ◽

Future Research ◽

Development Programs ◽

Leadership Development Programs ◽

Pacific People ◽

Education Outcomes ◽

Aotearoa New Zealand ◽

The Pacific ◽

Leadership Beliefs

<p>This thesis is an exploration of the way leadership is understood by young Pacific peoples. It looks at the possible relationship between leadership and education outcomes for young Pacific peoples. It is located in an interpretative paradigm, and uses qualitative methods and seeks phenomenological date. This is because individuals interpret experiences differently, therefore understanding how these young Pacific people interpret ideas can help answer the thesis question. As Pacific research it foregrounds Pacific concepts such as vā and Pacific methods such as talanoa. These features seek to alignment with the community participating in the study. The findings suggest that young Pacific peoples understand leadership as a negotiation between Pacific and Western ideas. This negotiation is performed contextually. However, young Pacific peoples are also redefining leadership for themselves and a way they are doing this is by combining their Pacific and Western understandings of leadership. From the research there were three implications found for young Pacific peoples. Firstly, too much focus on culture can become a problem. Secondly, the different contexts that young Pacific peoples are being raised in influences their leadership beliefs, especially compared to the older generation. Lastly, young Pacific peoples need to receive recognition for their ability to negotiate ideas between the Pacific and Western worlds. Therefore, recommendations for future research come under two main categories environment. This is focused on rethinking leadership, firstly for young Pacific peoples in New Zealand-Pacific context, then rethinking for young Pacific peoples in a Western context. The second recommendation discusses ways to improve leadership development programs for young Pacific peoples in New Zealand.</p>

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Covid-19 outbreak reflects inequities in health and socioeconomic disadvantage in Aotearoa/New Zealand and the Pacific Islands

Pacific Health Dialog ◽

10.26635/phd.2021.124 ◽

2021 ◽

Vol 21 (8) ◽

pp. 475-476

Author(s):

Colin Tukuitonga ◽

Alec Ekeroma

Keyword(s):

New Zealand ◽

Socioeconomic Factors ◽

Pacific Islands ◽

Hospital Admissions ◽

Socioeconomic Disadvantage ◽

Pacific People ◽

Aotearoa New Zealand ◽

The Pacific ◽

Timely Reminder

The Covid-19 outbreak in Aotearoa/New Zealand is a timely reminder of the chronic inequities in health and the importance of socioeconomic factors in the origins of the disease. The pandemic has affected mainly indigenous Maori and Pacific people. There were 5,371 confirmed and probable cases of Covid-19 as at 13 November 2021, of which 2,104 (39%) were in Maori and 1,646 (31%) were in Pacific people. Furthermore, 228 (70%) of all hospital admissions were Maori and Pacific people

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What are young Pacific peoples understandings of leadership in Aotearoa New Zealand?

10.26686/wgtn.17068043.v1 ◽

2021 ◽

Author(s):

◽

Grace Faletutulu

Keyword(s):

New Zealand ◽

Leadership Development ◽

Future Research ◽

Development Programs ◽

Leadership Development Programs ◽

Pacific People ◽

Education Outcomes ◽

Aotearoa New Zealand ◽

The Pacific ◽

Leadership Beliefs

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Cytisine as an alternative smoking cessation product for Pacific smokers in New Zealand

Pacific Health Dialog ◽

10.26635/phd.2018.919 ◽

2018 ◽

Vol 21 (2) ◽

pp. 89-95

Author(s):

Vili Nosa ◽

Kotalo Leau ◽

Natalie Walker

Keyword(s):

Smoking Cessation ◽

New Zealand ◽

Nicotinic Acetylcholine Receptors ◽

Cultural Practices ◽

Partial Agonist ◽

Snowball Sampling ◽

Structured Interviews ◽

Liquid Form ◽

Pacific People ◽

The Pacific

ABSTRACT Introduction: Pacific people in New Zealand have one of the highest rates of smoking. Cytisine is a plant-based alkaloid that has proven efficacy, effectiveness and safety compared to a placebo and nicotine replacement therapy (NRT) for smoking cessation. Cytisine, like varenicline, is a partial agonist of nicotinic acetylcholine receptors, and blocks the rewarding effects of nicotine. Cytisine is naturally found in some plants in the Pacific region, and so may appeal to Pacific smokers wanting to quit. This paper investigates the acceptability of cytisine as a smoking cessation product for Pacific smokers in New Zealand, using a qualitative study design. Methods: In December 2015, advertisements and snowball sampling was used to recruit four Pacific smokers and three Pacific smoking cessation specialists in Auckland, New Zealand. Semi-structured interviews where undertaken, whereby participants were asked about motivations to quit and their views on smoking cessation products, including cytisine (which is currently unavailable in New Zealand). Interviews were recorded and transcribed verbatim, with thematic analysis conducted manually. Findings: Pacific smokers reported wanting to quit for loved ones and family, but did not find currently available smoking cessation products effective. Almost all participants had not previously heard of cytisine, but many of the Pacific smokers were keen to try it. Participants identified with cytisine on a cultural basis (given its natural status), but noted that their use would be determined by the efficacy of the medicine, its cost, side-effects, and accessibility. They were particularly interested in cytisine being made available in liquid form, which could be added to a “smoothie” or drunk as a “traditional tea”. Participants thought cytisine should be promoted in a culturally-appropriate way, with packaging and advertising designed to appeal to Pacific smokers. Conclusions: Cytisine is more acceptable to Pacific smokers than other smoking cessation products, because of their cultural practices of traditional medicine and the natural product status of cytisine.

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The characteristics of behaviour change interventions used among Pacific people: a systematic search and narrative synthesis

BMC Public Health ◽

10.1186/s12889-021-10420-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Amio Matenga-Ikihele ◽

Judith McCool ◽

Rosie Dobson ◽

Fuafiva Fa’alau ◽

Robyn Whittaker

Keyword(s):

United States ◽

Social Support ◽

New Zealand ◽

Behaviour Change ◽

Health Behaviour ◽

Narrative Synthesis ◽

Pacific Region ◽

Behaviour Change Interventions ◽

Pacific People ◽

The Pacific

Abstract Background Pacific people living in New Zealand, Australia, United States, and the Pacific region continue to experience a disproportionately high burden of long-term conditions, making culturally contextualised behaviour change interventions a priority. The primary aim of this study was to describe the characteristics of behaviour change interventions designed to improve health and effect health behaviour change among Pacific people. Methods Electronic searches were carried out on OVID Medline, PsycINFO, PubMed, Embase and SCOPUS databases (initial search January 2019 and updated in January 2020) for studies describing an intervention designed to change health behaviour(s) among Pacific people. Titles and abstracts of 5699 papers were screened; 201 papers were then independently assessed. A review of full text was carried out by three of the authors resulting in 208 being included in the final review. Twenty-seven studies were included, published in six countries between 1996 and 2020. Results Important characteristics in the interventions included meaningful partnerships with Pacific communities using community-based participatory research and ensuring interventions were culturally anchored and centred on collectivism using family or social support. Most interventions used social cognitive theory, followed by popular behaviour change techniques instruction on how to perform a behaviour and social support (unspecified). Negotiating the spaces between Eurocentric behaviour change constructs and Pacific worldviews was simplified using Pacific facilitators and talanoa. This relational approach provided an essential link between academia and Pacific communities. Conclusions This systematic search and narrative synthesis provides new and important insights into potential elements and components when designing behaviour change interventions for Pacific people. The paucity of literature available outside of the United States highlights further research is required to reflect Pacific communities living in New Zealand, Australia, and the Pacific region. Future research needs to invest in building research capacity within Pacific communities, centering self-determining research agendas and findings to be led and owned by Pacific communities.

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Intelligent Careers of Pacific Island Leaders

South Pacific Journal of Psychology ◽

10.1017/s0257543400000031 ◽

2005 ◽

Vol 16 ◽

pp. 1-17 ◽

Cited By ~ 3

Author(s):

Polly Parker

Keyword(s):

New Zealand ◽

Leadership Development ◽

Minority Population ◽

Pacific Island ◽

Cultural Issues ◽

Dominant Culture ◽

The Public ◽

Aotearoa New Zealand ◽

The Pacific ◽

Leadership Behaviour

AbstractPacific peoples hold a unique place as an ethnic community within Aotearoa-New Zealand. The largest immigrant minority population in New Zealand brings a different culture to that of the dominant Pakeha (European). One implication is the need for acculturation into New Zealand society. Leadership, when characterised here as a process through which Pacific elders model the “Pacific way” to guide their youth, is critical to manage the tension between maintaining traditional ways and integrating into a dominant culture different from the people's own. This paper reports an empirical study conducted with Pacific professionals working in the public sector of New Zealand. Recognised for their potential to influence Pacific peoples, the participants were sponsored by the ministries of Health and Pacific Island Affairs to attend a three-day leadership development course that included a careers component. The scarcely researched links among leadership, careers and social cultural issues are explored. Intelligent career theory is introduced and the processes associated with eliciting subjective and inter-subjective career data are explained The results reflect the interdependence of motivation, skills and knowledge, and relationships, which together strongly influence the career and leadership behaviour of Pacific peoples to enhance the outcomes for Pacific peoples in New Zealand. Theoretical and practical implications are discussed.

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Pacific Women's Stories of Becoming a Nurse in New Zealand: a Radical Hermeneutic Reconstruction of Marginality

10.26686/wgtn.16920883 ◽

2021 ◽

Author(s):

◽

Margaret R Southwick

Keyword(s):

New Zealand ◽

Cultural Heritage ◽

Nurse Educator ◽

Normative Values ◽

First Year ◽

Dominant Culture ◽

Pacific People ◽

Aotearoa New Zealand ◽

Multiple Worlds ◽

Philosophical Underpinning

<p>This thesis examines Pacific women’s experiences of becoming a nurse and their first year of practice post Registration, within the New Zealand context. The participant’s stories of being students and beginning practitioners are inter-woven with my own reflections as a nurse and nurse educator who also claims a Pacific cultural heritage. To create the space in which our stories can be laid down, the thesis includes a description of the migration and settlement of Pacific peoples in Aotearoa/New Zealand. This description shows how Pacific people have been systematically stigmatised and locked into marginalised positions by mainstream dominant culture. The thesis deconstructs taken-for-granted and self perpetuating conceptualisations of marginality that currently underpins most theoretical explanations and proposes a reconstructed map of marginality. This deconstructed/reconstructed map of marginality is used as a template through which the experiences of the participants are filtered and interpreted. Radical Hermeneutics provides a philosophical underpinning for this project that has as one of its objectives the desire to resist reducing complexity to simplistic explanation and superficial solutions. The thesis challenges Nursing to examine its role in reproducing the hegemonic power of dominant culture by applying unexamined cultural normative values that create binary boundaries between ‘them’ and ‘us’. At the same time the thesis challenges Pacific people to move past hegemonically induced states of alienation and learn how to walk in multiple worlds with confidence and power.</p>

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Practices of cultural collectivity: Style activism, Miromoda and Māori fashion in Aotearoa New Zealand

Critical Studies in Fashion and Beauty ◽

10.1386/csfb_00024_1 ◽

2021 ◽

Vol 12 (1) ◽

pp. 131-149 ◽

Cited By ~ 1

Author(s):

Harriette Richards

Keyword(s):

New Zealand ◽

World View ◽

Fashion Industry ◽

Fashion History ◽

Aotearoa New Zealand ◽

The Pacific ◽

The Status ◽

History Of ◽

Fashion Apparel ◽

Fashion Designers

Familiar narratives of fashion history in Aotearoa New Zealand recount the successes of Pākehā (New Zealand European) designers who have forged a distinctive fashion industry at the edge of the world. This narrative overlooks the history of Māori fashion cultures, including the role of ‘style activism’ enacted by political figures such as Whetu Tirikatene-Sullivan and collectives such as the Pacific Sisters who advanced the status of Māori and Pasifika design in the twentieth century. It also ignores the changing nature of the New Zealand fashion industry today. One of the most significant recent initiatives to alter perceptions of fashion in Aotearoa New Zealand has been Miromoda, the Indigenous Māori Fashion Apparel Board (IMFAB), established in 2008. By championing the work of Māori fashion designers and prioritizing the values of te ao Māori (the Māori world-view), Miromoda is successfully contributing to the ‘decolonization’ of the New Zealand fashion industry. This article foregrounds practices of cultural collectivity, including that of style activists such as Tirikatene-Sullivan and the Pacific Sisters, and Māori fashion designers such as Kiri Nathan, Tessa Lont (Lontessa) and Bobby Campbell Luke (Campbell Luke), to explore the expansion of a more affirmative fashion future in Aotearoa New Zealand.

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