A predictive model for identifying health trends among Māori and Pacific people - analysis from ten years of New Zealand Public Hospital discharges

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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Is Pacific language ability protective of prevalence of mental disorders among Pacific peoples in New Zealand?

Pacific Health Dialog ◽

10.26635/phd.2018.902 ◽

2018 ◽

Vol 21 (1) ◽

pp. 10-16 ◽

Cited By ~ 1

Author(s):

Eirenei Taua'i ◽

Rose Richards ◽

Jesse Kokaua

Keyword(s):

Mental Health ◽

New Zealand ◽

Mental Health Services ◽

Mental Disorders ◽

Health Services ◽

Common Mental Disorders ◽

Mental Health Disorder ◽

Positive Role ◽

Pacific People ◽

Language Promotion

Aims: To explore associations between experiences of mental illness, migration status and languages spoken among Pacific adults living in NZ. Methods: SURVEY FREQ and SURVEY LOGISTIC procedures in SAS were applied to data from Te Rau Hinengaro: The New Zealand (NZ) Mental Health Survey, a survey of 12,992 New Zealand adults aged 16 and over in 2003/2004. Pacific people were over sampled and this paper focuses on the 2374 Pacific participants but includes, for comparison, 8160 non-Maori-non-Pacific (NMNP) participants. Results: Pacific migrant respondents had the lowest prevalence of mental disorders compared to other Pacific peoples. However, Pacific immigrants were also less likely to use mental health services, suggesting an increased likelihood of experiencing barriers to available mental health care. Those who were born in NZ and who were proficient in a Pacific language had the lowest levels of common mental disorders, suggesting a protective effect for the NZ-born population. Additionally, access to mental health services was similar between NZ-born people who spoke a Pacific language and those who did not. Conclusions: We conclude that, given the association between Pacific language and reduced mental disorder, there may be a positive role for Pacific language promotion in efforts to reduce the prevalence of mental health disorder among Pacific communities in NZ.

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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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Indigenous health worker support for patients with poorly controlled type 2 diabetes: study protocol for a cluster randomised controlled trial of the Mana Tū programme

BMJ Open ◽

10.1136/bmjopen-2017-019572 ◽

2018 ◽

Vol 8 (12) ◽

pp. e019572

Author(s):

Vanessa Selak ◽

Tereki Stewart ◽

Yannan Jiang ◽

Jennifer Reid ◽

Taria Tane ◽

...

Keyword(s):

Type 2 Diabetes ◽

New Zealand ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Determinants Of Health ◽

Pacific People ◽

Cluster Randomised ◽

Randomised Controlled

IntroductionType 2 diabetes mellitus (T2DM) and its complications are more common among Māori and Pacific people compared with other ethnic groups in New Zealand. Comprehensive and sustained approaches that address social determinants of health are required to address this condition, including culturally specific interventions. Currently, New Zealand has no comprehensive T2DM management programme for Māori or Pacific people.Methods and analysisThe Mana Tū programme was developed by a Māori-led collaborative of primary healthcare workers and researchers, and codesigned with whānau (patients and their families) in order to address this gap. The programme is based in primary care and has three major components: a Network hub, Kai Manaaki (skilled case managers who work with whānau with poorly controlled diabetes) and a cross-sector network of services to whom whānau can be referred to address the wider determinants of health. The Network hub supports the delivery of the intervention through training of Kai Manaaki, referrals management, cross-sector network development and quality improvement of the programme. A two-arm cluster randomised controlled trial will be conducted to evaluate the effectiveness of the Mana Tū programme among Māori, Pacific people or those living in areas of high socioeconomic deprivation who also have poorly controlled diabetes (glycated haemoglobin, HbA1c, >65 mmol/mol (8%)), compared with being on a wait list for the programme. A total of 400 participants will be included from 10 general practices (5 practices per group, 40 participants per practice). The primary outcome is HbA1c at 12 months. Secondary outcomes include blood pressure, lipid levels, body mass index and smoking status at 12 months. This protocol outlines the proposed study design and analysis methods.Ethics and disseminationEthical approval for the trial has been obtained from the New Zealand Health and Disability Ethics Committee (17/NTB/249). Findings will be presented to practices and their patients at appropriate fora, and disseminated widely through peer-reviewed publications and conference presentations.Trial registration numberACTRN12617001276347; Pre-result.

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Making the Transition to Insulin Therapy: The Experiences of Samoan People with Type 2 Diabetes in New Zealand

10.26686/wgtn.16985230.v1 ◽

2021 ◽

Author(s):

◽

Sera Tapu-Ta'ala

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

New Zealand ◽

Insulin Therapy ◽

Health Care Professionals ◽

Pacific People ◽

Qualitative Descriptive

<p>Background Pacific people are dying younger compared to other New Zealanders because of complications resulting from uncontrolled type 2 diabetes mellitus. Good diabetes control is achievable with early use of insulin because of its effectiveness, and proven long term benefits to quality of life. An understanding of how Samoan people with type 2 diabetes make their transition to insulin therapy will assist in understanding how insulin is perceived, which will inform health care professionals in their work with those diagnosed with diabetes. Aim of Research The aim of the research is to explore and describe how Samoan people with type 2 diabetes in New Zealand made the transition to insulin therapy for better glycaemic control. Design The Fonofale Model was used as the theoretical framework, from which to understand Samoan peoples' experiences. This research used a qualitative descriptive methodology. In-depth interviews were used to gather the stories of four Samoan participants over the age of 18 years diagnosed with type 2 diabetes. The data was analysed using thematic analysis. Findings Three major themes emerged from the analysis of the participants' stories. These were: living with diabetes, making the transition to insulin therapy and realisation. The findings led to the creation of the Ia Malu model, which describes the experiences of the participants in this study. Conclusion This study confirmed that there are immense challenges and struggles encountered by people with diabetes. Their adjustment to the illness as well as making the transition to using insulin takes time. As a result of this, it is fundamental for nurses/health care professionals to understand that this is the reality for these people, and they must therefore provide time for people to adjust.</p>

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Prevalence and Clinical Significance of Anti-DFS70 in Antinuclear Antibody (ANA)–positive Patients Undergoing Routine ANA Testing in a New Zealand Public Hospital

The Journal of Rheumatology ◽

10.3899/jrheum.170849 ◽

2018 ◽

Vol 45 (2) ◽

pp. 289-291 ◽

Cited By ~ 1

Author(s):

STACEY LUCAS ◽

WEE LEONG CHANG ◽

FABRICE MERIEN

Keyword(s):

New Zealand ◽

Clinical Significance ◽

Antinuclear Antibody ◽

Public Hospital

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Pacific models of mental health service delivery in New Zealand: Part I: What do we know about Pacific mental health in New Zealand? A narrative review

Australasian Psychiatry ◽

10.1177/1039856219859274 ◽

2019 ◽

Vol 28 (1) ◽

pp. 16-20

Author(s):

Roger Mulder ◽

Debbie Sorensen ◽

Staverton Kautoke ◽

Seini Jensen

Keyword(s):

Mental Health ◽

New Zealand ◽

Mental Disorders ◽

Psychotropic Drug ◽

Service Use ◽

Health Service Delivery ◽

Narrative Review ◽

Limited Evidence ◽

Mental Health Service Delivery ◽

Pacific People

Objective: To update measures of mental disorders and service use in Pacific people living in New Zealand. Method: A narrative review was conducted of available data on the prevalence of mental disorder, psychotropic drug prescribing and service use by Pacific people. Results: The 12-month prevalence of mental disorders in Pacific people was similar to European/Other in 2004. Currently Pacific people report high rates of psychological distress but lower levels of psychiatric disorders. Pacific adults have low rates of drinking but many who drink have a hazardous pattern. While Pacific people previously accessed services less than half the rate of European access, access rates in secondary care are now similar. Pacific people have relatively low rates of psychotropic drug use but these are increasing. Conclusion: There is limited evidence about Pacific people’s mental health in New Zealand. Patterns of psychopathology and service use may be different from other ethnic groups. Protective factors in Pacific culture should not be undermined when delivering mental health services.

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