Fefine Tonga moe ifi tapaka: A qualitative study to explore Tongan female tobacco smoking & cessation in the Auckland region.

ABSTRACT Introduction Tongan female smokers’ smoking experiences have manifested within a realm of socioeconomic and cultural conditions in New Zealand with cessation service engagement relatively low. Due to the projected tobacco burden attributed to Pacific women, pertinent research proves vital to bettering understandings of smoking and cessation within this group. This study explored the knowledge and experiences of smoking and smoking cessation services among Tongan women aged 16 years and over, living in the Auckland region. Methods This qualitative research design utilised the Kakala model to ensure processes were culturally appropriate and meaningful. Data was collected through eight face-to-face semi-structured interviews transcribed by the researcher and employed the toli, teu and luva process from the Kakala model to form relevant themes. Findings The findings suggest smoking among Tongan females is a social vector that marks independence and maintains friendships, despite known adverse health effects and stigma. It is characterised as stress relief that has habituated into day-to-day routine for most. Their aspirations to live longer for their family is a strong motivator but quitting remains difficult and should be done autonomously by the individual. Tongan female smokers stated smoking cessation services as ineffective and need to be adapted and consulted by and within the community. Stop smoking services should encourage autonomy among Tonga women in order to improve utilisation and engagement. Service delivery for Tongan female smokers needs to be on-going and long-term support reoriented within the community for more Tongan women to become completely smokefree. Conclusions Tongan female smoking in New Zealand is comprised of experiences surrounding friendships, family and culture. This study concludes that although smoking harms are widely known, cessation service delivery can be transformed by utilizing existing Tongan cultural roles such as that of the mehikitanga (paternal aunt) to encourage non-smoking among extended female generations.

Closing the rehabilitation utilization gap of New Zealand’s (Aotearoa) Māori people: Multiple case studies

We aimed to explore personal factors in use of rehabilitation counseling and mental health services by Māori adults. Participants were three Māori adults (females = 2, residing in major urban settings, age range 45–50 years old; male = 1, residing in a rural setting, age range = 25–30 years old). Thematic analysis yielded the following findings: (a) a preference of Māori service providers who understand whānau culture, (b) an understanding of whakapapa or the family structure as an integral source of social support as counselors are planning for treatment, (c) establishing and maintaining trusting relationships within the Māori community by non-Māori counselors, (d) having financial difficulties when attempting to access rehabilitation resources, (e) limited access to health care facilities and services or lack of information about the services available, and (f) a general mistrust of government operated systems. Rehabilitation and mental health services with Māori should address personal cultural and systemic exclusion factors for better service engagement.

Community Engagement Abroad: Perspectives and Practices on Service, Engagement, and Learning Overseas

Community Engagement Abroad: Perspectives and Practices on Service, Engagement, and Learning Overseas, edited by Pat Crawford and Brett Berquist, is a valuable contribution to the literature on global community engagement and study abroad, charting one institution’s history and practice from a variety of perspectives.

Responsive Medical Providers and Recent HIV Medical Services Engagement Among Transgender Women and Cisgender Men Who Have Sex With Men in the Philippines

Transgender women and cisgender men who have sex with men (trans-WSM and cis-MSM) comprise the majority of new HIV infections in the Philippines. There is limited research in the Philippines on the relationship between having a provider responsive to the needs of these populations and recent engagement in HIV medical services such as HIV testing and treatment. We used multivariate logistic regression to examine the relationship between having a responsive medical provider and engagement in HIV medical services in the past 12 months among an online sample of 318 trans-WSM and cis-MSM in the Philippines. Participants without a responsive medical provider had lower adjusted odds of recent HIV medical service engagement than those who did (aOR = 0.32, 95% CI [0.16, 0.62], p = .00). In stratified analyses, this relationship was significant for trans-WSM but not cis-MSM. Increasing access to responsive providers in the Philippines could bolster recent engagement with HIV medical services.

Diagnosed Incidence of Non-Affective Psychotic Disorders Amongst Adolescents in British Columbia and Sociodemographic Risk Factors: A Retrospective Cohort Study

Objectives To estimate the diagnosed incidence of non-affective psychotic disorder between the ages of 13 and 19 years in South-Western British Columbia (BC) and to examine variation in risk by sex, family and neighbourhood income, family migration background, parent mental health contact and birth year. Methods Linked individual-level administrative data were used to construct a cohort of individuals born in 1990–1998 and residing in South-Western BC ( n = 193,400). Cases were identified by either one hospitalization or two outpatient physician visits within 2 years with a primary diagnosis of a non-affective psychotic disorder (ICD-10: F20–29, ICD-9: 295, 297, 298). We estimated cumulative incidence, annual cumulative incidence and incidence rate between the ages of 13 and 19 years, and conducted Cox proportional hazards regression to estimate associations between sociodemographic factors and risk over the study period. Results We found that 0.64% of females and 0.88% of males were diagnosed with a non-affective psychotic disorder between the ages of 13 and 19 years, with increasing risk observed over the age range, especially amongst males. Incidence rate over the entire study period was 106 per 100,000 person-years for females and 145 per 100,000 person-years for males. Risk of diagnosis was elevated amongst those in low-income families and neighbourhoods, those with a parent who had a health service contact for a mental disorder, and more recent birth cohorts. Risk was reduced amongst children of immigrants compared to children of non-migrants. Conclusions Findings from this study provide important information for health service planning in South-Western BC. Future work should examine whether variations in diagnosed incidence is driven by differences in health service engagement or reflect genuine differences in risk.

Facilitating treatment engagement for early psychosis through peer-delivered decision support: intervention development and protocol for pilot evaluation

Background Emerging adults with early psychosis demonstrate high rates of service disengagement from critical early intervention services. Decision support interventions and peer support have both been shown to enhance service engagement but are understudied in this population. The purposes of this article are to describe the development of a novel peer-delivered decision coaching intervention for this population and to report plans for a pilot study designed to gather preliminary data about its feasibility, acceptability, and potential impact. Methods The intervention was developed based on formative qualitative data and in collaboration with a diverse team of researchers, key stakeholders, and expert consultants. The pilot trial will utilize a single-group (N = 20), pre-post, convergent mixed-methods design to explore whether and how the intervention addresses decision-making needs (the primary intervention target). The impact of the intervention on secondary outcomes (e.g., engagement in the program) will also be assessed. Additionally, through observation and feedback from the peer decision coach and study participants, we will evaluate the feasibility of research and intervention procedures, and the acceptability of information and support from the peer decision coach. Discussion The peer-delivered decision coaching intervention holds promise for assisting young people with making informed and values-consistent decisions about their care, and potentially enhancing service engagement within this traditionally difficult-to-engage population. If the intervention demonstrates feasibility and acceptability, and pilot data show its potential for improving treatment decision-making, our work will also lay the foundation for a new evidence base regarding roles for peer specialists on early intervention teams. Trial registration This trial was registered with ClinicalTrials.gov (Identifier: NCT04532034) on 28 August 2020 as Temple University Protocol Record 261047, Facilitating Engagement in Evidence-Based Treatment for Early Psychosis.