Journal articles on the topic 'Pacific Peoples Health'
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Kapeli, Sarah Ann. "A latent profile analysis of Pacific health values." Pacific Health Dialog 21, no. 8 (December 30, 2021): 531–44. http://dx.doi.org/10.26635/phd.2021.148.
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Introduction: Pacific health models that centre Pacific values, can serve as a tool to address Pacific disparities in healthcare. In this study, we broadly draw upon the health concepts of these models to determine how Pacific values are translate across Pacific health and wellbeing. Methods: Using data from the New Zealand Attitudes and Values Study, we identified proxy indicators of common Pacific values. With these proxy indicators we developed a LP Latent Profile Analysis A to uncover subgroups of Pacific peoples based on their orientation towards each proxy indicator and their association with psychological distress. Findings: We identified four subgroups of Pacific peoples: (1) 65% of Pacific peoples identified strongly with Pacific values with low associated psychological distress (2) 18% of Pacific peoples identified moderately with Pacific values with medium associated psychological distress (3) 5% of Pacific peoples identified less with Pacific values with low associated psychological distress (4) 12% of Pacific peoples identified ambivalent with Pacific values with high associated psychological distress. Conclusions: These results suggest that Pacific values and the utility of Pacific health models are an appropriate way of framing health and wellbeing for a vast majority of our Pacific population. However, we also need to recognise the incredible diversity among our Pacific community and be understanding and accommodating of the diverse ways that Pacific peoples can express what they consider valuable.
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Symon, Vanda, Rosalina Richards, Pauline Norris, Talai Mapusua, and Leigh Hale. "The needs of Pacific families affected by age-related cognitive impairment in New Zealand: interviews with providers from health-care organisations." Journal of Primary Health Care 13, no. 4 (2021): 317. http://dx.doi.org/10.1071/hc21082.
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ABSTRACTINTRODUCTIONPacific populations in New Zealand are aging, but little is known in the health-care environment about their experiences with cognitive impairment.AIMThe aim was to explore the needs of Pacific peoples affected by age-related cognitive decline from the perspectives of health-care providers.METHODSSix health-care service providers from organisations focused on Pacific patients were interviewed to determine services available to aged Pacific peoples, access, and whether they met Pacific people’s needs.RESULTSThree areas of concern were identified by all participants: access to services; getting a diagnosis; and communication and language. Many experienced a lack of information and poor access to services. Diagnosis of cognitive impairment was frequently made difficult by inconsistent access to general practitioners in lower socio-economic areas. Communication was hindered by poor access to information in Pacific languages.DISCUSSIONCommon themes noted by all participating health-care providers indicated the needs of aged Pacific people experiencing cognitive decline were often not being met.
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Talemaitoga, Api. "Vaikoloa: Pacific peoples: our health and wellbeing." Journal of Primary Health Care 3, no. 2 (2011): 167. http://dx.doi.org/10.1071/hc11167.
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Ludeke, Melissa, Ronald Puni, Lynley Cook, Maria Pasene, Gillian Abel, and Faafetai Sopoaga. "Access to general practice for Pacific peoples: a place for cultural competency." Journal of Primary Health Care 4, no. 2 (2012): 123. http://dx.doi.org/10.1071/hc12123.
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INTRODUCTION: Access to primary health care services has been identified as a problem for Pacific peoples. Although cost is the most frequently cited barrier to Pacific service utilisation, some research has indicated that access may also be influenced by features of mainstream primary care services. This study aimed to identify features of mainstream general practice services that act as barriers to accessing these services for Pacific peoples in order to explore strategies that providers could adopt to enable their practices to be more welcoming, accessible and appropriate for Pacific peoples. METHODS: Pacific participants were recruited through Pacific networks known to Pegasus Health and via snowball sampling. In total, 20 participants participated in one of three focus groups. A semi-structured interview explored the participants views and experiences of mainstream general practice care. Thematic analysis was utilised to interpret the data. FINDINGS: The analysis revealed five themes highlighting non-financial features of mainstream general practice services that may influence the availability and acceptability of these services to Pacific peoples: language and communication; rushed consultations; appointment availability; reception; and Pacific presence. CONCLUSION: The findings indicate that all personnel within the primary care setting have the ability to directly engage in the improvement of the health status of Pacific peoples in New Zealand by developing cultural competency and incorporating flexibility and diversity into the care and service they provide. KEYWORDS: Pacific health care; access to health care; inequalities; cultural competency; New Zealand
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Dewes, Ofa. "Vaikoloa: Hearing loss among Pacific peoples." Journal of Primary Health Care 4, no. 3 (2012): 250. http://dx.doi.org/10.1071/hc12250.
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Tiatia-Seath, Jemaima, Yvonne Underhill-Sem, and Alistair Woodward. "The Nexus between Climate Change, Mental Health and Wellbeing and Pacific Peoples." Pacific Health Dialog 21, no. 2 (September 30, 2018): 47–49. http://dx.doi.org/10.26635/phd.2018.911.
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An estimated 75 million people from the Asia-Pacific region will be forced to migrate by 2050 as a result of climate change. Moreover, New Zealand and Australia will become a potential relocation destination for many Pacific peoples.This call to action is timely, as New Zealand's current government is proposing to provide climate migration visas for Pacific peoples displaced by rising sea levels. The post-migration experience of recent migrants is important in the resettlement process and the sociocultural conditions of a host country can have powerful influence on their mental health and wellbeing.
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Sika-Paotonu, Dianne, Mischa Walton, Eseta Finau, Sepola Faavae, Jessica Vaimoli, and Parry Guilford. "The clinical considerations for early cancer detection using ctDNA within the Pacific setting." Journal of Immunology 206, no. 1_Supplement (May 1, 2021): 12.08. http://dx.doi.org/10.4049/jimmunol.206.supp.12.08.
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Abstract Pacific Peoples living in Aotearoa/New Zealand and in the Pacific Region, remain disproportionately affected by some cancers. In addition to ensuring effective treatments and therapies are available and continue to improve, continued early cancer diagnostic efforts are also critical for supporting better health outcomes for Pacific Peoples within the cancer setting. A novel and promising early cancer detection method known as circulating tumour DNA (ctDNA) analyses small fragments of tumour DNA found in the blood circulation to provide information about a tumour. This approach is more commonly associated with and utilised for monitoring patients being treated for their cancers and is being adapted to support early cancer detection efforts. To support the possible acceptability of this approach for early cancer diagnosis for Pacific Peoples, it is imperative to better understand the clinical considerations relevant to the Pacific setting. To identify the clinical considerations needed for early cancer detection with ctDNA approaches within the Pacific setting for Pacific Peoples living in Aotearoa/New Zealand, researchers and Pacific Health Professionals were consulted. Relevant considerations included the immediate need to support early cancer diagnostic efforts to avoid late presentations, better understanding of the cultural context for Pacific Peoples within the healthcare setting more broadly, with strong support expressed for a simple approach for early cancer detection such as that being proposed with ctDNA technology. These findings highlight the critical need to consider the clinical context within the cancer setting for Pacific Peoples. Health Research Council of New Zealand
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Sopoaga, Faafetai, Ken Buckingham, and Charlotte Paul. "Causes of excess hospitalisations among Pacific peoples in New Zealand: implications for primary care." Journal of Primary Health Care 2, no. 2 (2010): 105. http://dx.doi.org/10.1071/hc10105.
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INTRODUCTION: Pacific people suffer disproportionately poorer health and reduced life expectancy at birth compared to the total New Zealand population. AIM: To assess causes of excess morbidity in the Pacific population, and identify lesser known or previously unknown causes which require further investigation. METHODS: We obtained public hospital discharge data from July 2000 to December 2002. The population data were from the 2001 Census. Standardised discharge ratios were calculated to compare Pacific peoples with the total New Zealand population. RESULTS: Pacific peoples were six times more likely to have a diagnosis of cardiomyopathy and gout, and four to five times of rheumatic fever, gastric ulcer, systemic lupus erythematosus (SLE), and diabetes. Respiratory diseases, skin abscesses, heart failure, cataracts, cerebral infarction and chronic renal failure were also significant causes of excess morbidity. Unexpected causes of excess morbidity included candidiasis, excess vomiting in pregnancy (hyperemesis gravidarum) and pterygium. DISCUSSION: The magnitude of established causes of excess morbidity among Pacific peoples were similar to our findings. Other causes of excess morbidity are less widely known, or are identified here for the first time. These are systemic lupus erythematosus, hyperemesis gravidarum, cardiomyopathy, gastric ulcer, candidiasis and pterygium. The findings draw attention to specific causes of excess morbidity in Pacific communities where effective interventions are available in primary care, and where further research may identify preventive or curative interventions. KEYWORDS: Pacific peoples; primary care; hyperemesis gravidarum; morbidity; hospitalizations
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Tiatia-Seath, Jemaima. "Pacific peoples, mental health service engagement and suicide prevention in Aotearoa New Zealand." Ethnicity and Inequalities in Health and Social Care 7, no. 3 (September 9, 2014): 111–21. http://dx.doi.org/10.1108/eihsc-10-2013-0023.
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Purpose – The purpose of this paper is to discuss the engagement of Pacific peoples in mental health services in Aotearoa New Zealand and Pacific strategies for suicide prevention. Design/methodology/approach – This qualitative study involved 22 interviews with Samoans who had made a suicide attempt and/or had suicide ideation, were engaged in a mental health service. Findings – Narratives of mental health services and suicide prevention focused on issues of cultural competency, the importance of family involvement, dichotomous views of western and traditional beliefs around mental illness and the unsuccessful engagement of Pacific youth. Originality/value – This research argues that cultural considerations for Pacific communities are of paramount importance if mental health service engagement and developments towards Pacific suicide prevention strategies are to be effective.
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Sopoaga, Faafetai. "A Pacific Immersion Programme – is it useful in teaching Pacific Health to future doctors in New Zealand?" Journal of Primary Health Care 3, no. 4 (2011): 311. http://dx.doi.org/10.1071/hc11311.
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BACKGROUND AND CONTEXT: Pacific peoples make up approximately 7% of the total population in New Zealand, and are over-represented in poor health statistics. There are very few Pacific peoples in the health workforce. Most Pacific patients will be seen by a non-Pacific health professional when seeking medical care. It is important for all health education institutions, therefore, to include Pacific health as part of their curricula. ASSESSMENT OF PROBLEM: This article outlines the development and evaluation of a Pacific immersion programme to teach medical students about Pacific health. The programme was developed with the assistance of local Pacific community leaders. Learning objectives for students, protocols and processes were developed. These learning objectives and feedback from medical students, staff and host families, formed the basis for evaluating the programme. RESULTS: Students found the programme to be very useful. Host families were satisfied with the experience. Staff support ensured the programme became a required part of learning at the Dunedin School of Medicine. STRATEGIES FOR IMPROVEMENT: The pilot programme was initially offered as an optional choice for students. In the future, all students at the Dunedin School of Medicine will be expected to undertake the programme. A research project looking at changes in knowledge, skills and attitudes of students after the programme will be of value. LESSONS: The programme provided a useful way for teaching Pacific health to undergraduate medical students. Other institutions could consider this method for teaching Pacific health in their curricula. KEYWORDS: Pacific health; health education; Pacific peoples
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Ryan, Debbie. "Pacific Peoples Perspectives of Integrated Care Services." International Journal of Integrated Care 17, no. 3 (July 11, 2017): 128. http://dx.doi.org/10.5334/ijic.3240.
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Parker, Polly. "Intelligent Careers of Pacific Island Leaders." South Pacific Journal of Psychology 16 (2005): 1–17. http://dx.doi.org/10.1017/s0257543400000031.
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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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Taua'i, Eirenei, Rose Richards, and Jesse Kokaua. "Is Pacific language ability protective of prevalence of mental disorders among Pacific peoples in New Zealand?" Pacific Health Dialog 21, no. 1 (February 27, 2018): 10–16. http://dx.doi.org/10.26635/phd.2018.902.
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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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Dekker, Damaris, Jesse Kokaua, Glenda Oben, Jean Simpson, and Rose Richards. "Are there differences within pre-school aged Pacific peoples’ hospital presentations with preventable conditions?" Pacific Health Dialog 21, no. 1 (February 27, 2018): 27–36. http://dx.doi.org/10.26635/phd.2018.904.
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Aim. To describe the top five causes of preventable health conditions among Pacific children (Cook Island, Fijian, Niuean, Samoan, Tongan, Tokelauan) aged 0-4 years living in New Zealand (NZ), and to make comparisons of these rates with NZ’s population who were of neither Maori nor Pacific ethnicity (NMNP).
Method. This study is a retrospective analysis of preschool Ambulatory Sensitive Hospitalisations (ASH) by ethnicity. The data, from 2010 to 2014, was extracted from The National Minimum Dataset.
Results. The top five preventable health conditions among Pacific under 5’s were asthma and wheeze, gastroenteritis, dental, skin infections and pneumonia. Rates for all Pacific children with any of the ASH conditions were four to five times higher among Pacific, than among NMNP, from 2000 to 2014. Pacific children were also significantly more likely to present with bronchiectasis and rheumatic fever or rheumatic heart disease (RR 25.7 and 26.4 respectively).
Conclusion. Pacific children aged 0-4 years are more likely to be exposed to health conditions that are considered preventable . The most common preventable health conditions experienced by Pacific children were asthma and wheeze, gastroenteritis, dental, skin infections and pneumonia. These findings highlight the importance of investing in effective prevention strategies to further investigate and address the underlying causes of these conditions.
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Wilson, Evan, Ben Grant, Rosa Tobin-Stickings, Hanneke Lewthwaite, Gina Franklin, Sarah Oh, Simon Guan, et al. "Traditional Medicine Use in the Dunedin Pacific Community in New Zealand." Pacific Health Dialog 21, no. 1 (February 27, 2018): 17–26. http://dx.doi.org/10.26635/phd.2018.903.
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Background: Traditional medicine (TM) has been practiced in the Pacific islands over many years, and Pacific peoples continue to use TM after migrating to New Zealand (NZ). There is limited published literature on Pacific TM use in NZ. This study explores the views, use of, and access to TM of Pacific Peoples living in Dunedin, NZ. The information provides a valuable contribution in an important area where there is a paucity of information, and will also inform content development for the Pacific health curriculum for health professional courses at the University of Otago.
Methods: Cultural processes were used to inform and guide the recruitment of participants and data collection phases. Four focus groups were conducted with 15 Pacific Island community members. Interviews were recorded, transcribed and analysed using an inductive approach to identify main themes.
Results: Three main themes emerged from the data: Firstly, perspectives of TM from Pacific peoples, was varied and included the importance of spirituality, the environment and inherited knowledge. Secondly, the use of TM which incorporated plants, massage, diet, family togetherness and other forms of healing. Reasons for the use and differences in uptake between groups were also identified. The last main theme identified was barriers in accessing TM, that included the scarcity of traditional healers, resources, and cost.
Conclusion: The findings suggest Pacific peoples’ perspectives of TM encompassed a wide spectrum of views, knowledge and techniques. There were identified barriers in access and substitution where traditional ingredients were not available. Some expressed concern that TM use may decline due to loss of exposure and availability of resources. Other challenges are fewer traditional healers and relevant plants in New Zealand. Assisting Western health professionals to engender discussion and openness to TM use in Pacific Peoples is likely to support patient care.
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Manuela, Sam. "Ethnic Identity Buffers the Effect of Discrimination on Family, Life, and Health Satisfaction for Pacific Peoples in New Zealand." Pacific Health Dialog 21, no. 7 (June 22, 2021): 390–98. http://dx.doi.org/10.26635/phd.2021.113.
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Introduction: The effect of discrimination on health and wellbeing varies. Mixed findings show that greater ethnic identity can make one more susceptible to the harmful effects of discrimination, or that ethnic identity can protect one against discrimination. This study tests how ethnic identity moderates the relationship between ethnic discrimination and a range of wellbeing measures for Pacific peoples in Aotearoa New Zealand.
Methods: Two independent studies, The Pacific Identity and Wellbeing Study (N = 752) and the New Zealand Attitudes and Values Study (N = 472), surveyed Pacific peoples in New Zealand across measures of ethnic identity, perceived discrimination, family satisfaction, life satisfaction, and health satisfaction.
Findings: Moderated regression analyses for both studies showed a significant identity x discrimination interaction. Across all analyses, for those with lower ethnic identity scores, there was a significant negative relationship between discrimination and the health and wellbeing measures. For those with higher ethnic identity scores, there was no significant relationship between discrimination and wellbeing measures.
Conclusions: These results suggest that higher scores of Pacific ethnic identity buffer the negative effects of discrimination on satisfaction with family, life, and health. These findings offer support for the protective properties of Pacific ethnic identities. As such, initiatives that seek to bolster Pacific ethnic identities and culture will support a multifaceted approach for enhancing Pacific health and psychological wellbeing.
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Glover, Marewa, Vili Nosa, Dudley Gentles, Donna Watson, and Janine Paynter. "Do New Zealand Māori and Pacific ‘walk the talk’ when it comes to stopping smoking? A qualitative study of motivation to quit." Journal of Smoking Cessation 9, no. 2 (August 16, 2013): 68–75. http://dx.doi.org/10.1017/jsc.2013.22.
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Introduction: In March 2011, the New Zealand government committed to the goal of reducing the prevalence of current smokers to less than 5% by 2025. Smoking prevalence is significantly higher for Māori and Pacific peoples. To ensure a proportionately larger decrease in smoking prevalence for Māori and Pacific peoples by 2025, more effective strategies for prompting cessation among these groups are needed. Aim: This study aimed to identify what motivates Māori and Pacific people to quit smoking so that communications and mass media quit campaigns can be more effective at triggering quitting among them. Method: A qualitative approach utilising focus groups (N = 168) was used to ask participants to rank reasons why people say they should quit smoking (the ‘talk’) which we compared with participants’ reasons for actually quitting (the ‘walk’). The results were plotted on a scatter graph using a method devised by the authors. Results: Health, children and pregnancy were perceived to be strong motivating reasons to quit and they were frequently cited as triggering past quit attempts. Cost was plotted high for Pacific but low for Māori especially for talk. ‘It stinks’ was cited as triggering past quit attempts, but was not perceived as a reason to quit. Conclusion: Emotionally important reasons and more immediate reasons for quitting are likely to be more effective at prompting Māori and Pacific peoples to stop smoking.
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The National Hauora Coalition, Anneka Anderson, Rachel Brown, Jadene Wheeler, and Rawiri McKree Jansen. "Pacific Fono: a community-based initiative to improve rheumatic fever service delivery for Pacific Peoples in South Auckland." Journal of Primary Health Care 12, no. 4 (2020): 384. http://dx.doi.org/10.1071/hc20022.
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ABSTRACT BACKGROUND AND CONTEXTRheumatic fever inequitably affects Māori and Pacific children in New Zealand. School-based throat swabbing services, such as the South Auckland Mana Kidz programme, are a key element of rheumatic fever prevention interventions. ASSESSMENT OF THE PROBLEMCounties Manukau has the highest national rates of rheumatic fever (4.7 per 100,000 for first recorded rates). Given these disparities, Mana Kidz undertook an exploratory, community-based initiative to improve its service delivery for Pacific Peoples. RESULTSMana Kidz held a Pacific Leaders’ Fono (meeting) to discuss initiatives to improve rheumatic fever outcomes in South Auckland focused around challenges and solutions for addressing rheumatic fever, effective engagement strategies and leadership qualities needed to drive initiatives. Oral and written responses from 66 attendees were collected and thematically analysed. Four key themes were identified around challenges and solutions for rheumatic fever: social determinants of health; cultural responsiveness; health system challenges; and education, promotion and literacy. Three effective engagement strategies were identified: by Pacific for Pacific; developing a rheumatic fever campaign; improving health services. Three key leadership attributes were identified: culturally responsive leaders; having specific expertise and skills; youth-driven leadership. STRATEGIES FOR IMPROVEMENTMana Kidz has now created Pacific leadership roles in rheumatic fever governance groups, promotes Pacific workforce development and endorses Pacific-led initiatives and partnerships. LESSONSRecognising the value of critical reflection and the importance of good governance and collaborative, right-based partnerships in health services.
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Feigin, Valery L., Harry McNaughton, and Lorna Dyall. "Burden of Stroke in Maori and Pacific Peoples of New Zealand." International Journal of Stroke 2, no. 3 (August 2007): 208–10. http://dx.doi.org/10.1111/j.1747-4949.2007.00140.x.
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Studying ethnic particularities of stroke epidemiology may not only provide a clue to the causes of the observed racial/ethnic differences in stroke mortality but is also important for appropriate, culturally specific health care planning, prevention in stroke and improved health outcomes. This overview of published population-based stroke incidence studies and other relevant research in the multi-ethnic New Zealand population demonstrates an obvious ethnic disparity in stroke in New Zealand, with the greatest and increasing burden of stroke being imposed on Maori, who are indigenous, and Pacific people, who have migrated and settled in this country. These data warrant urgent and effective measures to be undertaken by health policy makers and health care providers to reverse the unfavourable trends in stroke and improve Maori and Pacific people's health.
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Sika-Paotonu, Dianne, Toni Anitelea, Adam Faatoese, Bridie Laing, Ron Puni, Tevita Vaipuna, and Parry Guilford. "ctDNA for early cancer diagnosis in Pacific Communities." Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 86.51. http://dx.doi.org/10.4049/jimmunol.204.supp.86.51.
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Abstract Circulating tumour DNA (ctDNA) refers to small fragments of tumour DNA found in the blood circulation, recognised by the presence of mutations in cancer genes. These DNA fragments can be isolated and quantified to obtain data about the cancer’s size and progression. Since gaining access to and obtaining biopsy samples from solid cancers in people is not always possible, the possibility of utilizing a simple blood sample to allow detection and monitoring of cancer growth is highly desirable. It is anticipated this simple method of detecting and monitoring cancer will enhance the precision of cancer diagnostics and surveillance and also lead to improved cancer health outcomes for Pacific Peoples. The purpose of this work was to support engagement with Pacific communities and share, and discuss and explore current research efforts, that included the potential utilization of ctDNA to improve the diagnosis, care and health outcomes of Pacific Peoples. A Pacific Fono (gathering) was held in the Hutt Valley region to promote appropriate knowledge translation activity, engagement and meaningful dialogue between researchers and the Pacific communities regarding current research works and findings of direct relevance and significance to Pacific communities. The Pacific community response to this research outreach effort was overwhelmingly positive and encouraging. Discussions were respectful and informative with shared information being exchanged between researchers and those in attendance. Feedback included expressed support for regarding the ctDNA research and for other areas of research focus that would be of benefit to Pacific communities. Requests from Pacific community members were also made for future similar events to be held.
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Raval, Manjri, Felicity Goodyear-Smith, and Susan Wells. "The effect of ethnicity on different ways of expressing cardiovascular treatment benefits and patient decision-making." Journal of Primary Health Care 7, no. 1 (2015): 24. http://dx.doi.org/10.1071/hc15024.
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INTRODUCTION: The way information is presented to communicate risk and treatment benefit affects patients' understanding and perception of their risk and can influence their decisions. AIM: To assess the effect of ethnicity on patient preferences for different ways of expressing risk and treatment benefits. METHODS: Using tailored questionnaires, we surveyed Maori, Pacific and Indian peoples of known CVD risk to assess format preferences encouraging them to take medication or assist their understanding of possible treatment benefits. Statistical analysis determined any association of ethnicity with patient preferences. RESULTS: Of the 376 participants, 50% identified as New Zealand (NZ) European; 15% Maori; 25% Pacific and 10% Indian ethnicity. Patients preferred positive framing of risk (66%). Relative risk was the format reported as most encouraging to take medication and to understand risk, with natural frequencies least preferable, although Pacific people significantly preferred natural frequencies (p<0.0001) compared with other ethnic groups. The majority (55%) preferred pictures to numbers for explaining risk. Maori, Pacific and Indian participants significantly preferred 100-people chart formats over bar graphs compared with NZ Europeans/Others (p=0.002). Most (68%) preferred doctors to give their opinion on taking medication instead of explaining risks using numbers and/or pictures. Pacific and Indian peoples significantly preferred doctors to make decisions on treatment compared to NZ European/Other and Maori participants (p<0.0001). DISCUSSION: Ethnic differences in patient preferences for communication formats and decision-making should be considered when tailoring effective communication in primary care. However, individual preferences cannot be presumed and a combination of methods should routinely be used. KEYWORDS: Decision making; ethnicity; health communication; patient preference; primary health care; risk assessment
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Sika-Paotonu, Dianne, and Parry Guilford. "Exploring the applicability of ctDNA technology as a diagnostic tool for improved Cancer care and management within the Pacific." Journal of Immunology 200, no. 1_Supplement (May 1, 2018): 120.20. http://dx.doi.org/10.4049/jimmunol.200.supp.120.20.
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Abstract For Pacific peoples living in New Zealand and in the Pacific region, the burden of cancer remains a public health concern of significance. The medical situation for cancer patients in New Zealand and also in the Pacific is of relevance given the health inequalities that exist for Pacific peoples and the global burden of cancer. This work sought to obtain clarity around the cancer diagnostic, management practices and treatments that exist for cancer patients in the Cook Islands. Circulating tumour DNA (ctDNA) is a novel cancer detection method and refers to small fragments of tumour DNA found in the blood circulation. These DNA fragments can be isolated and quantified to obtain data about the cancer’s size and progression. The possibility of utilizing a simple blood sample to allow detection and monitoring of cancer growth is highly desirable. It is anticipated this simple method of detecting and monitoring cancer will enhance the precision of cancer diagnostics and surveillance and also lead to improved cancer health outcomes for Pacific peoples in the Cook Islands. This work sought to investigate the potential utilization of ctDNA to support and improve the diagnosis, care and health outcomes of Pacific cancer patients in the Cook Islands. A high degree of interest was expressed by the medical, nursing, health and community research staff and lay persons in the development of ctDNA as a potential diagnostic tool within the Cook Islands. Of particular interest was the potential to monitor patients remotely using the technology rather than be inconvenienced by travelling far distances with their families to the Main Hospital. ctDNA remains a feasible tool with potential to support cancer patients in the Cook Islands.
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Sika-Paotonu, Dianne, Mischa Walton, Sepola Faavae, Selafi Tagi, and Parry Guilford. "Diagnostic approaches for early cancer detection in Pacific Youth using ctDNA technology." Journal of Immunology 206, no. 1_Supplement (May 1, 2021): 26.21. http://dx.doi.org/10.4049/jimmunol.206.supp.26.21.
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Abstract Circulating tumour DNA (ctDNA) refers to small fragments of tumour-derived DNA that escape into the bloodstream. Analysis of these ctDNA fragments can be utilized to monitor responses to treatment by providing information relating to tumour size and progression and can support clinical decision making. A potential adaptation of the ctDNA monitoring technology is proposed to support utility of ctDNA for early cancer diagnostic efforts. This would comprise a simple method for early cancer detection that would be helpful across multiple settings, including that for Pacific Peoples. Pacific Peoples living in Aotearoa/New Zealand and in the Pacific Region are disproportionately affected by specific cancer types. The potential utility of ctDNA for early cancer detection is an approach that could help reduce adverse health outcomes if successful particularly for Pacific communities. To understand more about the diagnostic approaches applicable for early cancer diagnostics for Pacific young people in living in Aotearoa/New Zealand, feedback was sought on the aspects requiring attention in the Youth setting and also in relation to the possible utility of ctDNA technology as an example. Preliminary aspects of the cancer setting identified as important for early cancer diagnosis for Pacific young people, included the need for improved accessibility, the importance of cultural context and awareness, and the need for simplicity with any technological approach used for early cancer diagnosis, such as that being proposed using ctDNA.
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Wright, Sarah, and Andrew Hornblow. "Emerging needs, evolving services: The health of Pacific peoples in New Zealand." Kotuitui: New Zealand Journal of Social Sciences Online 3, no. 1 (January 2008): 21–33. http://dx.doi.org/10.1080/1177083x.2008.9522430.
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Signal, Louise, Tolotea Lanumata, Jo-Ani Robinson, Aliitasi Tavila, Jenny Wilton, and Cliona Ni Mhurchu. "Perceptions of New Zealand nutrition labels by Māori, Pacific and low-income shoppers." Public Health Nutrition 11, no. 7 (July 2008): 706–13. http://dx.doi.org/10.1017/s1368980007001395.
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AbstractBackgroundIn New Zealand the burden of nutrition-related disease is greatest among Māori, Pacific and low-income peoples. Nutrition labels have the potential to promote healthy food choices and eating behaviours. To date, there has been a noticeable lack of research among indigenous peoples, ethnic minorities and low-income populations regarding their perceptions, use and understanding of nutrition labels. Our aim was to evaluate perceptions of New Zealand nutrition labels by Māori, Pacific and low-income peoples and to explore improvements or alternatives to current labelling systems.MethodsMāori, Samoan and Tongan researchers recruited participants who were regular food shoppers. Six focus groups were conducted which involved 158 people in total: one Māori group, one Samoan, one Tongan, and three low-income groups.ResultsMāori, Pacific and low-income New Zealanders rarely use nutrition labels to assist them with their food purchases for a number of reasons, including lack of time to read labels, lack of understanding, shopping habits and relative absence of simple nutrition labels on the low-cost foods they purchase.ConclusionsCurrent New Zealand nutrition labels are not meeting the needs of those who need them most. Possible improvements include targeted social marketing and education campaigns, increasing the number of low-cost foods with voluntary nutrition labels, a reduction in the price of ‘healthy’ food, and consideration of an alternative mandatory nutrition labelling system that uses simple imagery like traffic lights.
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Mauiliu, Melbourne, Sarah Derrett, Ari Samaranayaka, Faafetai Sopoaga, Jesse Kokaua, and Gabrielle Davie. "Pacific peoples three months after injury: a comparison of outcomes between Pacific and non-Pacific participants in a NZ cohort study." Australian and New Zealand Journal of Public Health 37, no. 5 (October 2013): 463–69. http://dx.doi.org/10.1111/1753-6405.12124.
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Henderson, Saras, and Elizabeth Kendall. "Culturally and linguistically diverse peoples' knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service delivery." Australian Journal of Primary Health 17, no. 2 (2011): 195. http://dx.doi.org/10.1071/py10065.
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With 28% of Australia’s population having a culturally and linguistically diverse (CALD) background, the health system faces an increasing challenge to provide accessible and culturally competent health care. The view that all CALD communities are homogenous and solutions can be developed for the entire nation is detrimental. Despite available health services, CALD communities are reluctant to use them due to cultural differences, perceived racism and misunderstandings leading to the existing health disparities. Therefore, gathering data from four prominent CALD communities, such as the Sudanese, Afghani, Pacific Islander and Burmese communities in Logan, Queensland, about how they perceive and use health services can provide insightful information towards development of a service model that will better suit these CALD communities. The objective of the study was to examine the extent to which four prominent CALD communities (Sudanese, Afghani, Pacific Islander and Burmese) access and use health services in Logan, Queensland. Six focus group interviews using interpreters were conducted in English with Sudanese, Afghani, Pacific Islander and Burmese people. The results indicated that even long-standing CALD communities, such as the Pacific Islander people, were unfamiliar with health services and experienced difficulties accessing appropriate health care. Most wanted doctors to use traditional healing methods alongside orthodox medicine, but did not feel respected for their beliefs. Language difficulties impeded communication with health professionals who were hindered by ineffective use of interpreters. In conclusion, a clear role for bilingual community-based navigators was identified by CALD participants to address concerns about the health system, and to improve accessibility and health service usage.
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Sika-Paotonu, Dianne. "Designing vaccines to combat cancer – an Indigenous approach." Journal of Immunology 206, no. 1_Supplement (May 1, 2021): 58.12. http://dx.doi.org/10.4049/jimmunol.206.supp.58.12.
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Abstract Pacific Peoples living in Aotearoa/New Zealand and the Pacific Region remain disproportionately affected by some cancers, with the growing burden of cancer globally remaining a significant health concern. Immunotherapy based therapeutic approaches hold some potential towards addressing inequitable cancer outcomes, treatment and management efforts for vulnerable communities, but requires appropriate inclusion and engagement with Pacific communities as part of the research process, consultation and understanding of the cultural context and clinical setting for vulnerable communities. This work sought to apply the use of an Indigenous Pacific framework to promote and support the potential applicability of immunotherapy based cancer research work within vulnerable communities adversely impacted by inequitable cancer outcomes. The Indigenous Pacific Kakala research framework was applied within this setting and supported engagement and research translation efforts and dissemination for researchers and Pacific communities in Aotearoa/New Zealand that was applicable, respectful, meaningful and appropriate to the cultural context for Pacific Peoples. This work highlights the importance of incorporating Indigenous frameworks to support Immunology based research work that is relevant, applicable and also appropriate within cultural settings.
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Hezel, Francis X. "Penina Uliuli: Contemporary Challenges in Mental Health for Pacific Peoples (review)." Contemporary Pacific 21, no. 2 (2009): 406–9. http://dx.doi.org/10.1353/cp.0.0075.
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Tiatia-Seath, Jemaima, Trish Tupou, and Ian Fookes. "Climate Change, Mental Health, and Well-Being for Pacific Peoples: A Literature Review." Contemporary Pacific 32, no. 2 (2020): 399–430. http://dx.doi.org/10.1353/cp.2020.0035.
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Leon Guerrero, Rachael T., Neal A. Palafox, Margaret P. Hattori-Uchima, Hali R. Robinett, and Carl-Wilhelm Vogel. "Addressing Cancer Health Disparities in the Pacific Peoples of Hawai‘i, Guam, and the US Associated Pacific Islands Through Pacific-Focused Research Capacity Building." JCO Global Oncology, no. 6 (September 2020): 155–60. http://dx.doi.org/10.1200/go.19.00213.
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Sociocultural, geographic, and biologic factors contribute to cancer health disparities (CHDs) in Indigenous Pacific peoples (IPPs) in Guam, Hawai‘i, and the US Associated Pacific Islands (USAPI). IPPs experience a greater burden of CHDs that are associated with late-stage diagnosis and poor survival outcomes compared with majority populations in the United States. A 16-year partnership between the University of Guam (UOG) and University of Hawai‘i Cancer Center (UHCC) aims to advance health equity in Guam, Hawai‘i, and the USAPI through cancer research, training, and outreach. Investigators at collaborating institutions study issues of regional and cultural relevance in IPPs, including breast, cervical, liver, and oral cancers and use of tobacco and betel nuts (Areca nuts). Junior faculty with IPP ancestry or those who are focused on CHDs in IPPs receive mentorship and career development opportunities, academic fellowships are provided for graduate students, and Pacific Island communities are engaged through a participatory development process. The partnership has generated more than 90 peer-reviewed publications, more than 100 abstracts, and 11 grant awards. Thirty graduate scholars from under-represented minorities have been trained, including two who are now UOG faculty and are conducting independent research, contributing to the partnership, and mentoring scientists of tomorrow. Participatory community engagement has contributed to the passage of significant cancer prevention and control legislation in Hawai‘i, Guam, and Saipan. Research capacity at UOG has increased significantly, and research at UHCC has expanded to address issues unique to IPPs. Graduate students from under-represented minorities are pursuing careers in cancer research. A regional research infrastructure has been established to support team science, and research findings are informing public health policy and planning.
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Sika-Paotonu, Dianne, Mischa Walton, Sepola Faavae, and Parry Guilford. "ctDNA technology for early cancer detection in the Pacific setting – the importance of Talanoa." Journal of Immunology 206, no. 1_Supplement (May 1, 2021): 26.20. http://dx.doi.org/10.4049/jimmunol.206.supp.26.20.
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Abstract For Pacific Peoples living in Aotearoa/New Zealand, the burden of cancer remains a serious health concern. A promising early cancer detection approach involves the use of circulating tumour DNA (ctDNA) found in the blood circulation. Current ctDNA approaches focus on the analysis of ctDNA derived from established tumours in patients, to help provide information relating to the cancer’s size and progression using specific laboratory isolation and quantification techniques. Adaptation of these current ctDNA technologies used in the cancer monitoring setting, for early diagnosis, would generate a cancer detection approach easily initiated by obtaining ctDNA from DNA fragments found within a blood sample. To understand the potential utility of ctDNA technology for early cancer detection within the Pacific setting in Aotearoa/New Zealand, engagement was sought with Pacific leaders using Talanoa, focused on cancer and early cancer detection. Interim analyses highlighted factors considered directly relevant to Pacific Communities and the cancer setting including the need for health technologies and systems that align with cultural contexts for Pacific Peoples and their families. Support was also expressed for the development of an early cancer detection tool utilising ctDNA as a simple methodological approach, with acknowledgement of the potential for this method to address current barriers to cancer care and services. This work highlights the importance of ensuring cultural context is understood and respected when engaging with Pacific Communities, and also within the cancer and health care setting.
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Sika-Paotonu, Dianne, and Luamanuvao Winnie Laban. "Knowledge translation for Cancer Immunotherapy and Immunology that is culturally appropriate and relevant within a Pacific context." Journal of Immunology 200, no. 1_Supplement (May 1, 2018): 113.9. http://dx.doi.org/10.4049/jimmunol.200.supp.113.9.
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Abstract Pacific peoples living in New Zealand and in the Pacific region remain disproportionately affected by some cancers and have less favourable outcomes when compared with non-Pacific populations. Researchers stand to benefit from research efforts that work collectively and in partnership with Pacific communities. Biomedical research efforts to engage and dialogue with Pacific communities in New Zealand have been limited. The purpose of this work was to support the appropriate delivery and knowledge translation of Cancer Immunotherapy and associated Immunological concepts of direct relevance and importance to Pacific communities. A Pacific Fono (gathering) event was held through the local university that invited current and previous postgraduate Clinical Health Science students who were of Pacific heritage. A portion of this event was presented by a female Pacific Biomedical scientist and dedicated to supporting increased knowledge and awareness of emergent cancer immunotherapeutic based strategies for treating cancer. This event was well attended by current and previous Pacific postgraduate Clinical Health Science students of Pacific heritage many of whom are now employed as health professionals and included current and former health leaders, family members, health researchers, community representatives. Positive verbal and written feedback was received from those in attendance with a request for more regular events be held. The Pacific Fono event was the appropriate means to support knowledge translation of Immunotherapeutic strategies for treating cancer by engaging and communicating with Pacific community members in a culturally appropriate, clear and meaningful way.
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Sika-Paotonu, Dianne, and Alana Cockburn. "The importance of cultural context in supporting STEM related Immunology content for High School students." Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 222.30. http://dx.doi.org/10.4049/jimmunol.204.supp.222.30.
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Abstract Students and young people of Indigenous Māori and Pacific Peoples heritage living in NZ, remain underrepresented for STEM and health related courses. Health and STEM focused careers require participation in science and health related subject matter throughout high school and at higher education learning levels. This work sought to support, promote and encourage positive learning experiences for STEM related teaching content that was Immunologically based for a group of high school female students from underrepresented population groups that included Māori and Pacific students. Rheumatic Fever related Penicillin research work was presented to an all-girls high school class, comprised of students who were of predominantly Māori and Pacific heritage to support appropriate knowledge translation of STEM related Immunology based work that was also relevant to Māori and Pacific communities. This was carried out by a female Pacific Biomedical Scientist. Student feedback highlighted the session was very well-received and enjoyed by those in attendance. Strong interest was also expressed by the students who participated in the Rheumatic Fever related Penicillin based focus to the in-class interactions. A key element for undertaking this work was the inclusion of a female Pacific Biomedical Scientist in the teaching, aligning with the role modelling concept important for the Pacific students in particular who were involved with this STEM related outreach effort. These findings highlight the importance and relevance of cultural context in fostering positive learning and teaching interactions in the classroom for female high school students when engaging with Immunologically based STEM related content.
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Sika-Paotonu, Dianne, Kolinisiupeli Vaea, Lisiate Kilipeni ‘Ulufonua, Siale ‘Akau’ola, George Aho, Amelia Afuha’amango Tuipulotu, Seventeen Toumoua, Filimone Lilo, Latu Fotu, and Parry Guilford. "The utilization of ctDNA technology as an early diagnostic tool for Cancer detection in Tonga." Journal of Immunology 200, no. 1_Supplement (May 1, 2018): 120.38. http://dx.doi.org/10.4049/jimmunol.200.supp.120.38.
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Abstract Circulating tumour DNA (ctDNA) refers to small fragments of tumour DNA found in the blood circulation. These DNA fragments can be isolated and quantified to obtain data about a cancer’s size and progression. The possibility of utilizing a simple blood sample to allow early detection and monitoring of cancer growth is a highly desirable application for this ground breaking technology. Significant health inequalities exist for Pacific peoples with cancer living in New Zealand and in the Pacific region, where the burden of cancer remains a public health concern. The application of this simple ctDNA method of detecting and monitoring cancer to enhance the precision of early cancer diagnostics and surveillance to improve cancer health outcomes for Pacific peoples in Tonga was investigated. Consultation was sought with senior Government officials, Medical, Nursing, Health and Community research staff concerning the development and implementation of ctDNA as a diagnostic tool within the health care setting throughout Tonga. Preliminary assessment of the on-the-ground laboratory requirements needed for the implementation of the ctDNA technology was also undertaken. Strong support for the development of ctDNA as an early diagnostic tool within the clinical setting was expressed. A key feature of the ctDNA technology within this resource constrained environment was the anticipated detection of cancers at an earlier stage with a greater chance of being treatable given that most cancer presentations in Tonga are late. This work sought to explore and progress the implementation of ctDNA as an early cancer diagnostic tool within the Pacific setting, and remains a highly feasible early cancer detection tool within Tonga.
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Sika-Paotonu, Dianne, Toni Anitelea, Alana Cockburn, and Parry Guilford. "Early cancer detection using ctDNA technology – what is the relevance for Pacific Communities?" Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 159.54. http://dx.doi.org/10.4049/jimmunol.204.supp.159.54.
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Abstract A novel cancer detection method known as circulating tumour DNA (ctDNA) analyses the small fragments of tumour DNA found in the blood circulation. Information relating to a cancer’s size and progression can be easily obtained from the DNA fragments found in a blood sample using specific isolation and quantification techniques. This is a relatively simple method for monitoring cancer and is being adapted to support early cancer detection efforts. Pacific Peoples living in New Zealand (NZ) and in the Pacific Region, remain disproportionately affected by some cancers. Given the increasing cancer rates worldwide and the medical situation for cancer patients in NZ and in the Pacific, the burden of cancer remains concerning as significant health inequalities exist for Pacific Peoples in particular. To support meaningful and respectful scientific knowledge translation activity with appropriate engagement promoting dialogue between researchers and Pacific communities, a Pacific Fono (gathering) event was held in the Wellington Region that included discussion of the ctDNA early cancer detection technology. Feedback from members of the various Pacific communities who attended indicated that researchers had engaged respectfully and facilitated discussion appropriately that was helpful, and also supported understanding of the ctDNA research work. Strong support was also expressed for the development of an early detection tool that involved a simple blood test methodology. The importance of taking into account the cultural context, combined with the appropriate scientific communication was shown to build meaningful connections and support respectful dialogue with Pacific communities.
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Gurney, Jason, James Stanley, and Diana Sarfati. "The inequity of morbidity: Disparities in the prevalence of morbidity between ethnic groups in New Zealand." Journal of Comorbidity 10 (January 1, 2020): 2235042X2097116. http://dx.doi.org/10.1177/2235042x20971168.
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Objective: The burden of chronic disease is not evenly shared within our society. In this manuscript, we use comprehensive national-level data to compare morbidity burden between ethnic groups in New Zealand. Methods: We investigated the prevalence of morbidity among all New Zealanders aged 18+ (n = 3,296,837), stratified by ethnic group (Māori, Pacific, Asian, Middle Eastern/Latin American/African, European/Other), using national-level hospitalisation and pharmaceutical data and two measures of morbidity (the M3 and P3 indices). Results and Conclusions: We observed substantial disparities for Māori and Pacific peoples compared to other ethnic groups for the vast majority of commonly-diagnosed morbidities. These disparities appeared strongest for the most-common conditions – meaning that Māori and Pacific peoples disproportionately shoulder an increased burden of these key conditions. We also observed that prevalence of these conditions emerged at earlier ages, meaning that Māori and Pacific peoples also experience a disproportionate impact of individual conditions on the quality and quantity of life. Finally, we observed strong disparities in the prevalence of conditions that may exacerbate the impact of COVID-19, such as chronic pulmonary, liver or renal disease. The substantial inequities we have presented here have been created and perpetuated by the social determinants of health, including institutionalised racism: thus solutions will require addressing these systemic issues as well as addressing inequities in individual-level care.
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Oliver, Jane, Julie Bennett, Sally Thomas, Jane Zhang, Nevil Pierse, Nicole J. Moreland, Deborah A. Williamson, Susan Jack, and Michael Baker. "Preceding group A streptococcus skin and throat infections are individually associated with acute rheumatic fever: evidence from New Zealand." BMJ Global Health 6, no. 12 (December 2021): e007038. http://dx.doi.org/10.1136/bmjgh-2021-007038.
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IntroductionAcute rheumatic fever (ARF) is usually considered a consequence of group A streptococcus (GAS) pharyngitis, with GAS skin infections not considered a major trigger. The aim was to quantify the risk of ARF following a GAS-positive skin or throat swab.MethodsThis retrospective analysis used pre-existing administrative data. Throat and skin swab data (1 866 981 swabs) from the Auckland region, New Zealand and antibiotic dispensing data were used (2010–2017). Incident ARF cases were identified using hospitalisation data (2010–2018). The risk ratio (RR) of ARF following swab collection was estimated across selected features and timeframes. Antibiotic dispensing data were linked to investigate whether this altered ARF risk following GAS detection.ResultsARF risk increased following GAS detection in a throat or skin swab. Māori and Pacific Peoples had the highest ARF risk 8–90 days following a GAS-positive throat or skin swab, compared with a GAS-negative swab. During this period, the RR for Māori and Pacific Peoples following a GAS-positive throat swab was 4.8 (95% CI 3.6 to 6.4) and following a GAS-positive skin swab, the RR was 5.1 (95% CI 1.8 to 15.0). Antibiotic dispensing was not associated with a reduction in ARF risk following GAS detection in a throat swab (antibiotics not dispensed (RR: 4.1, 95% CI 2.7 to 6.2), antibiotics dispensed (RR: 4.3, 95% CI 2.5 to 7.4) or in a skin swab (antibiotics not dispensed (RR: 3.5, 95% CI 0.9 to 13.9), antibiotics dispensed (RR: 2.0, 95% CI 0.3 to 12.1).ConclusionsA GAS-positive throat or skin swab is strongly associated with subsequent ARF, particularly for Māori and Pacific Peoples. This study provides the first population-level evidence that GAS skin infection can trigger ARF.
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Cheer, Tarin, Robin Kearns, and Laurence Murphy. "Housing Policy, Poverty, and Culture: ‘Discounting’ Decisions among Pacific Peoples in Auckland, New Zealand." Environment and Planning C: Government and Policy 20, no. 4 (August 2002): 497–516. http://dx.doi.org/10.1068/c04r.
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This paper explores the links between housing and other welfare policies, low income, and culture among Pacific peoples within Auckland, New Zealand. These migrant peoples occupy an ambiguous social space within Auckland: they represent the visible face of the world's largest Polynesian city, yet are occupants of some of the city's poorest and least health-promoting housing. Through considering the balance between choice and constraint, we examine how housing costs, poverty, and cultural practices converge to influence household expenditure decisions. Specifically, we are interested in the ways health-promoting behaviours (for example, obtaining fresh food) and utilising health care services are ‘discounted’ (that is, postponed or substituted with cheaper alternatives) because of costs associated with structural changes in housing and the broader policy context. We draw on narratives gathered from in-depth interviews conducted with seventeen Samoan and Cook Island families undertaken in the South Auckland suburb of Otara in mid-2000. Our findings illustrate a lack of ‘fit’ between state housing stock and its occupants. We conclude that, although a recent return to a policy of income-related rents may alleviate these conditions, further longitudinal and community-supported research is required to monitor whether health inequalities are in fact lessened through income-related interventions alone.
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Sika-Paotonu, Dianne, Jane Anderson, Phillipa Cashin, and Alana Cockburn. "Immunology that supports STEM participation for High School students." Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 222.28. http://dx.doi.org/10.4049/jimmunol.204.supp.222.28.
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Abstract The global burden of cancer is growing. The impact on Pacific communities living in New Zealand (NZ) and in the Pacific Region is significant and remains of concern. Pacific Peoples in NZ and in the Region remain overrepresented in adverse health statistics and outcomes. To improve health outcomes for Pacific communities, various strategies that include increasing the Pacific Health workforce have been proposed. These career pathways require participation in STEM and health related courses at high school and higher education learning levels. Pacific students remain underrepresented amongst these groups. This work sought to use Immunology based examples for improving the interest, engagement and participation of underrepresented student groups in High School the science laboratory. A teaching session was organized to include cancer related Immunology teaching content that was associated with subsequent laboratory workshop activities and was presented by a Pacific Biomedical Scientist. A question and answer was also set-up for the students to support their STEM learning in this context. Feedback indicated students who attended the teaching session found the Immunology related content helpful for their understanding of the overall STEM related laboratory and workshop content. Enthusiastic in-class interactions and engagement was observed. This work demonstrated the value of designing an in-class/laboratory environment that supports positive interactions and participation by students, by incorporating Immunology within the laboratory focus that is appropriately delivered and contextualized.
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Sika-Paotonu, Dianne, and Parry Guilford. "The potential application of ctDNA for improved cancer management, treatment and diagnosis within the Pacific." Journal of Immunology 198, no. 1_Supplement (May 1, 2017): 157.4. http://dx.doi.org/10.4049/jimmunol.198.supp.157.4.
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Abstract The burden of cancer among Pacific peoples living in New Zealand and in the Pacific remains a significant health concern. Given the health inequalities that exist for Pacific peoples and the global burden of cancer, it remains a priority to consider the medical situation for cancer patients in the Pacific. It is acknowledged that within resource constrained environments, the diagnosis, treatment and management of cancer patients is fraught with unique challenges and difficulties. A novel cancer detection method known as circulating tumour DNA (ctDNA) monitors small fragments of tumour DNA found in the blood circulation. These fragments can be isolated and quantified to obtain information providing data concerning cancer progression and treatment response. It is anticipated this simple method of detecting and monitoring cancer will enhance the precision of cancer care for patients, and will eventuate into a particularly useful tool within resource constrained environments such as the Pacific. The purpose of this work was to identify the diagnostic, treatment and pharmacologic options currently available for cancer patient within the main and rural Hospitals in Tonga and to explore the potential utility of ctDNA to support the management, treatment and diagnosis of cancer patients. Cancer diagnosis, treatment and management pathways were available in Tonga but options were limited. The potential diagnostic utility of the ctDNA technology was an element of intense interest as cancer presentation is typically late with medical, nursing and support staff operating within resource constrained environments. The potential application of ctDNA for improved support of cancer patients in Tonga remains a highly appealing possibility.
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Sika-Paotonu, Dianne. "Connecting with STEM and Immunology in the Classroom – the importance of Role Modelling." Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 222.34. http://dx.doi.org/10.4049/jimmunol.204.supp.222.34.
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Abstract Connecting young people with STEM and Immunology within the classroom setting can be a challenge. Outreach education and knowledge translation efforts can be supported by appropriate Role Modelling and Contextualisation for students and young people. The purpose of this work was to support improved interest and engagement by young Pacific students within a STEM related context, within the classroom setting using an Immunology based in-class teaching focus. Pacific students remain underrepresented in STEM and health related subjects and courses. An outreach education STEM based knowledge translational programme was specifically designed for Pacific students aged 10–12 years (Year 7 & 8) by an external organisation, and included an outreach activity contribution by a female Pacific Biomedical Scientist. Context specific STEM related Immunology content was shared with the Pacific students in the form of cancer related research work and was targeted to the 10–12 year age group. The growing burden of cancer remains a significant concern for Pacific Peoples living in New Zealand and the Pacific Region. Student feedback in verbal and written form indicated this in-class session was very well received. Students engaged well with the in-class question and answer session involving the Pacific Biomedical Scientist and expressed interest in considering STEM as possible subject options. The importance of appropriate Role Modelling and Contextualization of STEM associated Immunology based teaching in the Classroom in supporting positive and constructive classroom experiences for students, was reinforced by the feedback and interactions outlined in this work.
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Sika-Paotonu, Dianne, and Alana Cockburn. "Immunology as a basis for STEM related teaching that is culturally appropriate and engages underrepresented High School students." Journal of Immunology 202, no. 1_Supplement (May 1, 2019): 61.15. http://dx.doi.org/10.4049/jimmunol.202.supp.61.15.
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Abstract Indigenous Māori and Pacific Peoples in New Zealand (NZ) remain overrepresented both in adverse health statistics and education outcomes. To improve education and health outcomes for Māori and Pacific communities, various strategies and interventions have been proposed. This includes efforts to increase the Māori and Pacific health workforce populations figures more reflective of the make-up of the NZ population. These health careers require participation in science and health related subject matter throughout high school and at higher education learning levels. Māori and Pacific students remain underrepresented amongst these groups. The purpose of this work was to support improved interest and participation in science related learning that was Immunologically focused, amongst high school students from underrepresented groups that included Māori and Pacific students. A visit was carried out by a Biomedical Scientist to an all-girls high school class comprised of students who were of predominantly Māori and Pacific heritage to teach and share about Immunology research work that was Cancer based. The female Biomedical Scientist was of Pacific heritage and was an important consideration in the application of the role modelling concept for the Pacific students within this interaction. Verbal and written feedback highlighted the session was well-received and enjoyed by those in attendance. An important observation was the positive impact and enthusiasm of the students in response to the emphasis on the Immunologically focused Cancer based examples. This work demonstrated the importance of cultural considerations blended with scientific knowledge communication and interactions in the classroom.
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Sika-Paotonu, Dianne. "Cancer Vaccines in the Pacific Region." Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 169.34. http://dx.doi.org/10.4049/jimmunol.204.supp.169.34.
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Abstract Pacific communities remain disproportionately affected by some cancers and stand to benefit from research that will contribute to improvements in health outcomes. Significant health inequalities already exist for Pacific Peoples with cancer, where the burden of cancer remains a growing public health concern. Emerging immunotherapeutic based strategies such as therapeutic cancer vaccines being developed to treat cancer, offer potential as one day becoming a frontline treatment for cancer. The purpose of this work was to facilitate appropriate engagement and discussion to explore the potential applicability of therapeutic cancer vaccines within the Pacific setting. As part of wider cancer related discussions and consultation activities, preliminary engagement efforts were made to understand the potential utility of therapeutic cancer vaccines for treating cancer in the Pacific context in Tonga. The need for developing stronger cancer immunotherapies was acknowledged. Within the Pacific setting, therapeutic cancer vaccines would need to be affordable with the appropriate infrastructure required to support their utility in place. Strong support was also expressed for developing technologies to support early cancer detection given the constrained resources in the Pacific Region setting and as cancer presentation in Tonga is usually late and with poor prognostic outcomes. Overall, therapeutic cancer vaccines remain a promising treatment option, however their future applicability within the resource constrained setting, would require further research development and the provision to ensure appropriate resourcing and infrastructure in place for support.
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Sika-Paotonu, Dianne, Jennika Patel, Katie Reed, Arthur McTavish, Felix Humphries, and Lakin Motu. "Immunology education within an undergraduate program for Health Sciences education." Journal of Immunology 206, no. 1_Supplement (May 1, 2021): 54.23. http://dx.doi.org/10.4049/jimmunol.206.supp.54.23.
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Abstract Immunology education remains an essential component for undergraduate Health Sciences education across the health professions. The clinical relevance of Immunology teaching can be emphasised by utilisation and appropriate reference to pertinent health conditions affecting populations locally and across the global setting. Health issues of significance to Māori and Pacific populations groups in Aotearoa/New Zealand and in the Pacific Region include Cancer and Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD). ARF is the body’s autoimmune response to untreated Group A Streptococcal (GAS) infection of the throat or skin. If left untreated, repeated or severe ARF episodes can lead to permanent cardiac damage known as RHD. RHD is a significant cause of morbidity and mortality worldwide. The growing global burden of cancer remains of concern, while Pacific Peoples and Māori are disproportionately affected by specific cancers. The utilisation of two areas with strong Immunological relevance for teaching examples in undergraduate Health Sciences education were shown to support improved understanding, class participation, topical interest, and research focus for Medical students engaged within Health Sciences education platforms in Aotearoa/New Zealand. This highlights the value of supporting Immunology education efforts by incorporating appropriate reference to pertinent health conditions relevant to populations groups locally and across the global setting.
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Murray, Catriona, and Christine Roke. "Who can afford a Mirena® for contraception?" Journal of Primary Health Care 10, no. 3 (2018): 201. http://dx.doi.org/10.1071/hc18024.
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ABSTRACT INTRODUCTION The Mirena®, a levonorgestrel-releasing intrauterine system (LNG-IUS), is an effective form of contraception that lasts for 5 years. In New Zealand, it is not subsidised for contraception and the device costs NZ$340 at Family Planning clinics. AIM To determine if there is a difference in the socioeconomic status and ethnicity of women who chose an LNG-IUS for contraception compared with women opting for a subsidised long-acting contraceptive (copper intrauterine device (IUD) or Jadelle® implant) or who qualified for a Special Authority Mirena® (funded by Pharmac, as treatment for heavy menstrual bleeding). METHODS All the Mirena®, Jaydess®, IUD and Jadelle® insertions that occurred at Family Planning clinics in 2015 in the Wellington region were identified. The deprivation quintile of current address and ethnicity were determined. RESULTS In the study period, 1410 devices were inserted. Of the self-funded LNG-IUSs inserted, 5% were for women with quintile 5 addresses (areas with the most deprived New Zealand Deprivation (NZDep) scores) and 28% for quintile 1 areas (least deprived NZDep scores). Of the Special Authority Mirenas® inserted, 24% were for women residing in quintile 5 areas and 19%, quintile 1 areas. Self-funded LNG-IUS were chosen by 2.5% of Māori women choosing contraception at study Family Planning clinics and no Pacific Peoples, whereas 21% of New Zealand European women chose LNG-IUS. Special Authority Mirenas® were chosen by 9.5% Māori and 9.6% Pacific Peoples compared to 4% New Zealand Europeans. DISCUSSION Māori, Pacific Peoples and women residing in quintile 5 areas chose self-funded LNG-IUSs less often than Special Authority Mirenas®. This was not the case for the other groups, who showed higher use of self-funded LNG-IUSs than Special Authority Mirenas®.
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Ofanoa, Malakai, Samuela Ofanoa, and Stephen Buetow. "Alea Ke Pau or Negotiated Evaluation: A Vital Concept in Pacific Health Promotion." Advances in Social Sciences Research Journal 8, no. 9 (September 25, 2021): 200–206. http://dx.doi.org/10.14738/assrj.89.10815.
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For Pacific peoples, health promotion, community nursing and community development initiative over many years, has often been conducted within a framework of one-sided decision-making. There is always an imbalance between the power relationships of the community being studied and those of the researchers or health practitioners. As a result, there is lack of understanding on the part of the researchers and the health funding agencies of the need to negotiate processes with members of the community being studied or engaging with. All of this are within an overarching lack of understanding of, and respect for, Pacific cultural values, frameworks and Pacific ways of doing things. This paper seeks to explore an alternative concept whereby these values are acknowledged. This concept is metaphorically called “alea ke pau” (or, negotiated evaluation). This approach is forward-looking and one that respects a ‘bottom-up’ view rather than the traditional ‘top-down’ view of health work and funding agencies.
However, using two Pacific research methodologies called Talanga and Kakala, to explore the concept of alea ke pau were held with five men’s focus groups operating within Kava Clubs in Auckland, New Zealand, and five focus groups in Tonga. The results from these discussions are presented demonstrating the development and application of the “alea ke pau” or “negotiated evaluation” approach.
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Sika-Paotonu, Dianne. "Role modelling Immunology to support STEM education outreach efforts for Pacific College students." Journal of Immunology 202, no. 1_Supplement (May 1, 2019): 61.17. http://dx.doi.org/10.4049/jimmunol.202.supp.61.17.
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Abstract Educators are important role models for their students. Specialists and professionals working within STEM related areas can support outreach related education activities as role models for children and young people. To support improved education and health outcomes for Māori and Pacific young people in New Zealand (NZ), various strategies and interventions have been proposed. The importance of role modelling in this context is recognised. The purpose of this work was to support a STEM-related outreach education event organised by an external organisation, with a teaching contribution delivered by a Pacific Biomedical Scientist that was Immunologically based. The female Pacific Biomedical Scientist was invited to contribute to this work as a role model specifically to support improved interest and participation with STEM related learning in a workshop classroom environment. Given that context relevant science related learning was a primary focus, clinical research work was presented to the Pacific College students aged 14–16 years. The research work in part related to the autoimmune condition known as Acute Rheumatic Fever (ARF) that can trigger permanent heart damage known as Rheumatic Heart Disease (RHD) if left untreated. It is recognised that Māori and Pacific Peoples in NZ and in the Pacific Region are affected disproportionately by ARF and RHD. Verbal and written feedback from the College students highlighted the Immunology teaching session was well-received and enjoyed by the students. This work also demonstrated the importance of role modelling in the classroom blended with scientific knowledge communication in supporting positive interactions in the classroom for Pacific College students.
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Fan, Chien-Te, Tzu-Hsun Hung, and Chan-Kun Yeh. "Taiwan Regulation of Biobanks." Journal of Law, Medicine & Ethics 43, no. 4 (2015): 816–26. http://dx.doi.org/10.1111/jlme.12322.
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Taiwan is an island country situated in the northwest Pacific, close to the southeast of China. The land area is about 36,000 square kilometers. The population of Taiwan is about 23 million, and it consists of the majority Han ethnic groups (it can be further divided into Ho-ló, Hakka, and Mainlander) and dozens of minority groups who are collectively called “Formosan,” an appellation for indigenous peoples in Taiwan. Formosans can be divided into Pingpu (plain-land indigenous peoples) and Gaoshan (mountain indigenous peoples) by their living area. In recent years, marriages between Taiwanese, Mainland Chinese, and Southeast Asians have increased significantly. Because of the genetic background of the Taiwanese people, it was thought to be highly beneficial for Taiwan to establish a biobank specifically designed for the Taiwanese population, as it would enable large-scale cohort studies to be carried out for common diseases occurring in Taiwan.
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Harrop, S., and H. Aonga. "EFFECTIVE PRACTICE: AN IMMEDIATE COLLABORATIVE RESPONSE TO PREVENT FURTHER NET FISHING DROWNING AMONG PACIFIC PEOPLES." Injury Prevention 18, Suppl 1 (October 2012): A70.1—A70. http://dx.doi.org/10.1136/injuryprev-2012-040580f.28.
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