Journal articles on the topic 'Pacific Peoples public health and wellbeing'
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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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Te Karu, Leanne, Matire Harwood, Linda Bryant, Tim Kenealy, and Bruce Arroll. "Compounding inequity: a qualitative study of gout management in an urban marae clinic in Auckland." Journal of Primary Health Care 13, no. 1 (2021): 27. http://dx.doi.org/10.1071/hc20112.
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ABSTRACT INTRODUCTIONGout remains a health equity issue; Māori and Pacific peoples are disproportionately afflicted, with increased burden and loss of quality of life, yet are less likely to receive appropriate management, which mainly occurs in primary care. AIMThis study aims to understand the perspectives of the mainly Māori and Pacific clinicians and staff at an urban marae practice about barriers and challenges to delivering effective care to a Māori and Pacific community with high burden of gout. METHODSSemi-structured interviews were conducted with 10 staff members delivering health care to a mostly Indigenous community. Interviews sought to ascertain staff views of enablers and barriers to optimal gout management and analyse them thematically. RESULTSThree themes were identified: community disadvantage; demands unique to Indigenous providers; and challenges and opportunities for optimising gout management. High prevalence and heavy impact of gout on wellbeing in the community was intertwined with socioeconomic disadvantage, precariousness of employment and entrenched inaccurate (yet pliable) patient views on gout, to the detriment of focused, effective care. Structural and funding demands on providers inhibited staff focus on the clear community need. Providers saw the culturally safe and competent approach necessary for improvement as requiring community empowerment with appropriate clinical tools and adequate resourcing. DISCUSSIONDespite provider intent to deliver culturally appropriate and safe care and equitable health outcomes for patients suffering from gout, general practice initiatives without aligned resourcing or incentives are inhibited when inequity is pervasive. Simply asking Māori providers to do more for the same amount of resource may not be effective.
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Aftab, Marium, Alsaleem Mohammed Abadi, Shamsun Nahar, Razia Aftab Ahmed, Syed Esam Mahmood, Manik Madaan, and Ausaf Ahmad. "COVID-19 Pandemic Affects the Medical Students’ Learning Process and Assaults Their Psychological Wellbeing." International Journal of Environmental Research and Public Health 18, no. 11 (May 28, 2021): 5792. http://dx.doi.org/10.3390/ijerph18115792.
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Background: With the emergence of the COVID-19 pandemic, people are living within a milieu of stress, anxiety, and fear. Medical students are susceptible to these emotional injuries, but their psychological wellbeing and learning may further be assaulted by future uncertainties and altered teaching and training programs. Our objective was to find the extent of the psychological impact of the pandemic and the learning difficulties they are experiencing; Methodology: This cross-sectional study included 418 undergraduate and postgraduate medical students from all over the world. A questionnaire was uploaded in Google survey form. It included background characteristics, questions for psychiatric impact like PHQ-9, GAD-7, ZF-OCS, and questions for learning difficulties perceived in comparison to the pre-pandemic time. Results: Among participants, 34.9% of students were male and 65.1% female. Around 46.4% belonged to the WHO, Eastern Mediterranean region, 26.8% from South East Asia region, 17.5% from the region of America, 5.5% from the European region,2.2%from the Western Pacific region, and 1.7% from the African region. Symptoms due to psychiatric illness were noticed in 393 (93.1%); depression in 386 (92.3%), anxiety in 158 (37.8%), obsessive compulsion disorder in 225 (53.8%), and post-traumatic stress syndrome in 129 (39.9%). Female gender, geographical region, and history of previous psychiatric illness were significantly related to almost all the psychiatric illnesses. Regarding learning difficulty, 96% of students faced problems: trouble with memorizing in 54.0%, concentration problems in 67.0%, about 55.5% of students made more mistakes, while 44.5% noted an increase in reaction time for solving questions. In addition, 90% experienced greater difficulty in overall learning during the pandemic in comparison to the pre-pandemic time. Conclusion: Assault on psychological wellbeing, struggling to memorize, inattention and difficulty in concentration on studies, along with perceived overall trouble with learning, have emerged as collateral damage from the COVID-19 pandemic with respect to medical students.
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Brereton, Claire F., and Paul Jagals. "Applications of Systems Science to Understand and Manage Multiple Influences within Children’s Environmental Health in Least Developed Countries: A Causal Loop Diagram Approach." International Journal of Environmental Research and Public Health 18, no. 6 (March 15, 2021): 3010. http://dx.doi.org/10.3390/ijerph18063010.
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Least developed countries (LDCs) are home to over a billion people throughout Africa, Asia-Pacific, and the Caribbean. The people who live in LDCs represent just 13% of the global population but 40% of its growth rate. Characterised by low incomes and low education levels, high proportions of the population practising subsistence living, inadequate infrastructure, and lack of economic diversity and resilience, LDCs face serious health, environmental, social, and economic challenges. Many communities in LDCs have very limited access to adequate sanitation, safe water, and clean cooking fuel. LDCs are environmentally vulnerable; facing depletion of natural resources, the effects of unsustainable urbanization, and the impacts of climate change, leaving them unable to safeguard their children’s lifetime health and wellbeing. This paper reviews and describes the complexity of the causal relationships between children’s health and its environmental, social, and economic influences in LDCs using a causal loop diagram (CLD). The results identify some critical feedbacks between poverty, family size, population growth, children’s and adults’ health, inadequate water, sanitation and hygiene (WASH), air pollution, and education levels in LDCs and suggest leverage points for potential interventions. A CLD can also be a starting point for quantitative systems science approaches in the field, which can predict and compare the effects of interventions.
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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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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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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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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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Gall, Alana, Kate Anderson, Kirsten Howard, Abbey Diaz, Alexandra King, Esther Willing, Michele Connolly, Daniel Lindsay, and Gail Garvey. "Wellbeing of Indigenous Peoples in Canada, Aotearoa (New Zealand) and the United States: A Systematic Review." International Journal of Environmental Research and Public Health 18, no. 11 (May 28, 2021): 5832. http://dx.doi.org/10.3390/ijerph18115832.
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Despite the health improvements afforded to non-Indigenous peoples in Canada, Aotearoa (New Zealand) and the United States, the Indigenous peoples in these countries continue to endure disproportionately high rates of mortality and morbidity. Indigenous peoples’ concepts and understanding of health and wellbeing are holistic; however, due to their diverse social, political, cultural, environmental and economic contexts within and across countries, wellbeing is not experienced uniformly across all Indigenous populations. We aim to identify aspects of wellbeing important to the Indigenous people in Canada, Aotearoa and the United States. We searched CINAHL, Embase, PsycINFO and PubMed databases for papers that included key Indigenous and wellbeing search terms from database inception to April 2020. Papers that included a focus on Indigenous adults residing in Canada, Aotearoa and the United States, and that included empirical qualitative data that described at least one aspect of wellbeing were eligible. Data were analysed using the stages of thematic development recommended by Thomas and Harden for thematic synthesis of qualitative research. Our search resulted in 2669 papers being screened for eligibility. Following full-text screening, 100 papers were deemed eligible for inclusion (Aotearoa (New Zealand) n = 16, Canada n = 43, United States n = 41). Themes varied across countries; however, identity, connection, balance and self-determination were common aspects of wellbeing. Having this broader understanding of wellbeing across these cultures can inform decisions made about public health actions and resources.
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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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Lansbury, Nina, Andrew M. Redmond, and Francis Nona. "Community-Led Health Initiatives for Torres Straits Island Communities in a Changing Climate: Implementing Core Values for Mitigation and Adaptation." International Journal of Environmental Research and Public Health 19, no. 24 (December 9, 2022): 16574. http://dx.doi.org/10.3390/ijerph192416574.
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First Nations Peoples have a long history of living in Australia’s changing climate and a deep knowledge of their traditional estate (‘Country’). However, human-induced climate change raises unforeseen risks to the health of First Nations Peoples—especially in remotely located communities. This includes the Torres Strait Islands, where a local leader asked our Torres Strait Islander co-author, ’We know that you will return to your Country—unlike previous researchers. So how can you help with climate change?’ In response, this research describes four core values focused on supporting First Nations Peoples’ health and wellbeing: co-design, appropriate governance, support for self-determination, and respectfully incorporating Indigenous Knowledges into health-protective climate initiatives. Supporting the health and wellbeing of Torres Strait Islanders to continue living in the remote Torres Strait Islands in a changing climate can enable long-term care for Country, maintenance of culture, and a sense of identity for First Nations Peoples. Ensuring these core values are implemented can support the health of present and future generations and will likely be applicable to other First Nations communities.
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Murrup-Stewart, Cammi, Theoni Whyman, Laura Jobson, and Karen Adams. "“Connection to Culture Is Like a Massive Lifeline”: Yarning With Aboriginal Young People About Culture and Social and Emotional Wellbeing." Qualitative Health Research 31, no. 10 (May 3, 2021): 1833–46. http://dx.doi.org/10.1177/10497323211009475.
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Culture is an important social and emotional wellbeing factor for Aboriginal peoples in Australia, particularly regarding recovery from colonization. However, little is understood about how culture and wellbeing interact for young urban Aboriginal people. This study used Yarning methods to explore experiences and perceptions of culture and wellbeing for young urban Aboriginal people in Narrm, Australia. Findings indicate that culture is experienced as connection, and that perceived connection or disconnection has an essential influence on the wellbeing of young people. Through sharing young people stories, a range of factors, including colonization, relationships, cultural knowledge, community support, and agency, were identified as affecting perceptions of connectedness, and therefore on wellbeing. Youth were able to develop strategies to increase connection and provided illuminating advice and suggestions for improving connection for future generations. This study thus contributes to efforts to improved understanding of Aboriginal perspectives about social and emotional wellbeing and culture.
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Graham, Simon, Ilias Kamitsis, Michelle Kennedy, Christina Heris, Tess Bright, Shannon K. Bennetts, Kimberley A. Jones, et al. "A Culturally Responsive Trauma-Informed Public Health Emergency Framework for Aboriginal and Torres Strait Islander Communities in Australia, Developed during COVID-19." International Journal of Environmental Research and Public Health 19, no. 23 (November 24, 2022): 15626. http://dx.doi.org/10.3390/ijerph192315626.
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The Coronavirus Disease 2019 (COVID-19) pandemic impacted peoples’ livelihoods and mental wellbeing. Aboriginal and Torres Strait Islander peoples in Australia continue to experience intergenerational trauma associated with colonization and may experience trauma-related distress in response to government responses to public health emergencies. We aimed to develop a culturally responsive trauma-informed public health emergency response framework for Aboriginal and Torres Strait Islander peoples. This Aboriginal and Torres Strait Islander-led study involved: (i) a review of trauma-informed public health emergency responses to develop a draft framework (ii) interviews with 110 Aboriginal and Torres Strait Islander parents about how COVID-19 impacted their lives, and (iii) a workshop with 36 stakeholders about pandemic experiences using framework analysis to refine a culturally responsive trauma-informed framework. The framework included: an overarching philosophy (cultural humility, safety and responsiveness); key enablers (local leadership and Eldership); supporting strategies (provision of basic needs and resources, well-functioning social systems, human rights, dignity, choice, justice and ethics, mutuality and collective responsibility, and strengthening of existing systems); interdependent core concepts (safety, transparency, and empowerment, holistic support, connectedness and collaboration, and compassion, protection and caring); and central goals (a sense of security, resilience, wellbeing, self- and collective-efficacy, hope, trust, resilience, and healing from grief and loss).
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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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MacLean, Sarah, Rebecca Ritte, Alister Thorpe, Shaun Ewen, and Kerry Arabena. "Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review." Australian Journal of Primary Health 23, no. 4 (2017): 309. http://dx.doi.org/10.1071/py16061.
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Indigenous people have long maintained that strong cultural identities are critical to health and wellbeing. The purpose of this systematic review is to examine whether interventions that entail strategies to enable expression of cultural identities for Australian Indigenous peoples are associated with measurable improvements in health and wellbeing. Peer-reviewed articles that reported quantitatively expressed health and wellbeing outcomes involving Indigenous Australian participants only were included. The cultural intervention component was defined and assessed by Indigenous researchers on the team. A narrative analysis was conducted. The protocol was registered on PROSPERO (CRD42015027387). Thirteen articles describing eleven studies were identified, including one randomised control trial (RCT), one cluster RCT and two studies with non-randomised controls. Other studies reported on case series or cross-sectional studies. All except two studies described multiple intervention strategies. Eight studies showed significant improvement in at least one psychosocial, behavioural or clinical measure, with two showing a positive direction of effect and one showing no improvement. Publication bias may discourage researchers to report negative findings of these interventions. Although studies vary in quality, this review provides evidence that interventions that include opportunities for expression of cultural identities can have beneficial effects for Australian Indigenous peoples.
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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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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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Lee, Grace Yeeun, Julie Robotham, Yun Ju C. Song, Jo-An Occhipinti, Jakelin Troy, Tanja Hirvonen, Dakota Feirer, et al. "Partnering with Aboriginal and Torres Strait Islander Peoples: An Evaluation Study Protocol to Strengthen a Comprehensive Multi-Scale Evaluation Framework for Participatory Systems Modelling through Indigenous Paradigms and Methodologies." International Journal of Environmental Research and Public Health 20, no. 1 (December 21, 2022): 53. http://dx.doi.org/10.3390/ijerph20010053.
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The social and emotional wellbeing of young Aboriginal and Torres Strait Islander peoples should be supported through an Indigenous-led and community empowering approach. Applying systems thinking via participatory approaches is aligned with Aboriginal and Torres Strait Islander research paradigms and can be an effective method to deliver a decision support tool for mental health systems planning for Indigenous communities. Evaluations are necessary to understand the effectiveness and value of such methods, uncover protective and healing factors of social and emotional wellbeing, as well as to promote Aboriginal and Torres Strait Islander self-determination over allocation of funding and resources. This paper presents modifications to a published evaluation protocol for participatory systems modelling to align with critical Aboriginal and Torres Strait Islander guidelines and recommendations to support the social and emotional wellbeing of young people. This paper also presents a culturally relevant participatory systems modelling evaluation framework. Recognizing the reciprocity, strengths, and expertise Aboriginal and Torres Strait Islander methodologies can offer to broader research and evaluation practices, the amended framework presented in this paper facilitates empowering evaluation practices that should be adopted when working with Aboriginal and Torres Strait Islander peoples as well as when working with other diverse, non-Indigenous communities.
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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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Dudgeon, Pat, Kate L. Derry, Carolyn Mascall, and Angela Ryder. "Understanding Aboriginal Models of Selfhood: The National Empowerment Project’s Cultural, Social, and Emotional Wellbeing Program in Western Australia." International Journal of Environmental Research and Public Health 19, no. 7 (March 29, 2022): 4078. http://dx.doi.org/10.3390/ijerph19074078.
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Culturally safe and responsive interventions that acknowledge Aboriginal models of selfhood are needed. Such interventions empower Aboriginal peoples and communities by increasing self-determination over individual and community social and emotional wellbeing (SEWB). In response to this need, the National Empowerment Project developed the Cultural, Social, and Emotional Wellbeing Program (CSEWB). The CSEWB aims to strengthen SEWB and cultural identity and subsequently reduce psychological distress in Aboriginal peoples. An Aboriginal Participatory Action Research approach ensured community ownership and engagement. Seven research questions and a culturally modified adaption of the Most Significant Change technique informed a thematic analysis of the evaluation content. Aboriginal adults (n = 49; 53% ≥50 years, 66% female, 34% male) from three Western Australian urban communities participated in the program evaluation workshops. Participants reported the benefits of enhanced SEWB and reduced psychological distress. This research reaffirms the need for culturally safe programs that acknowledge social determinants of health and are guided by the SEWB framework. Long-term commitment from the government is needed to support such programs.
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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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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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Griffiths, Kalinda, Abbey Diaz, Lisa J. Whop, and Joan Cunningham. "The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe: Ensuring and Promoting Best Practice in Research." International Journal of Environmental Research and Public Health 19, no. 1 (December 27, 2021): 261. http://dx.doi.org/10.3390/ijerph19010261.
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Thurber, Katherine, Emily Colonna, Roxanne Jones, Gilbert Gee, Naomi Priest, Rubijayne Cohen, David Williams, Joanne Thandrayen, Tom Calma, and Raymond Lovett. "Prevalence of Everyday Discrimination and Relation with Wellbeing among Aboriginal and Torres Strait Islander Adults in Australia." International Journal of Environmental Research and Public Health 18, no. 12 (June 18, 2021): 6577. http://dx.doi.org/10.3390/ijerph18126577.
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Discrimination is a fundamental determinant of health and health inequities. However, despite the high prevalence of discrimination exposure, there is limited evidence specific to Indigenous populations on the link between discrimination and health. This study employs a validated measure to quantify experiences of everyday discrimination in a national sample of Aboriginal and Torres Strait Islander (Australia’s Indigenous peoples) adults surveyed from 2018 to 2020 (≥16 years, n = 8108). It quantifies Prevalence Ratios (PRs) and 95% Confidence Intervals (CIs) for wellbeing outcomes by level of discrimination exposure, and tests if associations vary by attribution of discrimination to Indigeneity. Of the participants, 41.5% reported no discrimination, 47.5% low, and 11.0% moderate-high. Discrimination was more commonly reported by younger versus older participants, females versus males, and those living in remote versus urban or regional areas. Discrimination was significantly associated in a dose-response manner, with measures of social and emotional wellbeing, culture and identity, health behaviour, and health outcomes. The strength of the association varied across outcomes, from a 10–20% increased prevalence for some outcomes (e.g., disconnection from culture (PR = 1.08; 95% CI: 1.03, 1.14), and high blood pressure (1.20; 1.09, 1.32)), to a five-fold prevalence of alcohol dependence (4.96; 3.64, 6.76), for those with moderate-high versus no discrimination exposure. The association was of consistent strength and direction whether attributed to Indigeneity or not—with three exceptions. Discrimination is associated with a broad range of poor wellbeing outcomes in this large-scale, national, diverse cohort of Aboriginal and Torres Strait Islander adults. These findings support the vast potential to improve Aboriginal and Torres Strait Islander peoples’ wellbeing, and to reduce Indigenous-non-Indigenous inequities, by reducing exposure to discrimination.
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Raerino, Kimiora, Alex Macmillan, Adrian Field, and Rau Hoskins. "Local-Indigenous Autonomy and Community Streetscape Enhancement: Learnings from Māori and Te Ara Mua—Future Streets Project." International Journal of Environmental Research and Public Health 18, no. 3 (January 20, 2021): 865. http://dx.doi.org/10.3390/ijerph18030865.
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In settler countries, attention is now extending to the wellbeing benefits of recognising and promoting the Indigenous cultural identity of neighbourhoods as a contributing factor to more equitable and healthier communities. Re-indigenisation efforts to (re)implement cultural factors into urban design can be challenging and ineffective without the leadership and collaboration of local-Indigenous peoples. Undertaken in Aotearoa New Zealand, Te Ara Mua — Future Street project, demonstrated that co-design has critical potential in the reclamation of Indigenous autonomy, increased local-Indigenous presence and revitalisation of cultural identity. Employing a Kaupapa Māori (Māori-centred) research approach, we focused on the workings and perspectives of mana whenua (local-Indigenous peoples) and community stakeholder engagement in Te Ara Mua. An Indigenous theoretical framework, Te Pae Mahutonga, was utilised in the data analysis to explore perspectives of Indigenous collective agency, empowerment, and wellbeing. Our research demonstrates that developing capacity amongst Indigenous communities is integral for effective engagement and that the realisation of autonomy in urban design projects has broader implications for Indigenous sovereignty, spatial justice and health equity. Significantly, we argue that future community enhancement strategies must include not only re-designing and re-imagining initiatives, but also re-indigenising.
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Aron, Yudit, Kim Rounsefell, Jennifer Browne, Ruth Walker, Catherine Helson, Petah Atkinson, Catherine MacDonald, and Claire Palermo. "Victorian local government priority for Aboriginal health and wellbeing: a mixed-methods study." Australian Journal of Primary Health 25, no. 5 (2019): 457. http://dx.doi.org/10.1071/py18149.
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The aim of this study is to identify if Victorian local governments prioritise Aboriginal health and wellbeing issues through policy and explore the key factors influencing policy and program development and implementation. A sequential explanatory mixed-methods study design utilised a survey to quantify commitment to Aboriginal health policy followed by in-depth interviews that explored how and why policy or programs were in place. Data were analysed separately and then interpreted together. Representatives from 39 of Victoria’s 79 local governments (49%) responded to the survey and 14 were interviewed. Seventy-four per cent had policy and programs addressing Aboriginal health and wellbeing. The key factors influencing policy and program development were: (i) the process of policy and program development and implementation and the role of other policies; (ii) the influence of Aboriginal community characteristics; and (iii) advocacy for Aboriginal health and wellbeing. Underpinning these factors was that local government is ‘working together (in partnership and through collaboration) towards reconciliation’. Victorian local governments that participated in this study appear to prioritise Aboriginal health and wellbeing, especially where collaboration with the Aboriginal community is strong. The effect of policies and their subsequent programs on the health of Aboriginal peoples warrants further exploration.
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Wright, Alyson, Mandy Yap, Roxanne Jones, Alice Richardson, Vanessa Davis, and Raymond Lovett. "Examining the Associations between Indigenous Rangers, Culture and Wellbeing in Australia, 2018–2020." International Journal of Environmental Research and Public Health 18, no. 6 (March 16, 2021): 3053. http://dx.doi.org/10.3390/ijerph18063053.
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The centrality of culture to Indigenous peoples’ health and wellbeing is becoming increasingly acknowledged in government policy. In Australia, the Indigenous Ranger program is a leading example of employment that supports increased cultural participation. In 2017, we demonstrated higher life satisfaction and family wellbeing among Indigenous Rangers compared to non-Rangers in Central Australia. Using an expanded national dataset, this present study aimed to: examine if associations between Ranger status and wellbeing continued to be observed in Central Australia; assess if these associations were observed among non-Central Australian Rangers; and, quantify the effect of mediating variables (Rangers status, cultural factors) on wellbeing outcomes. We analyzed Mayi Kuwayu baseline data (n = 9691 Aboriginal and Torres Strait Islander people) and compared participants who identified as past or currently employed Rangers compared to non-Rangers across two geographic locations (Central Australia, non-Central Australia). Ranger participation was significantly associated with very high life satisfaction and family wellbeing in Central Australia (high life satisfaction PR 1.31, 95% CI 1.09–1.57, and family wellbeing (PR 1.17, 95% CI 1.01–1.36) and non-Central Australia (high life satisfaction PR 1.29, 95% CI 1.06–1.57), family wellbeing (PR 1.37, 95% CI 1.14–1.65). These findings concord with those observed in the 2017 proof-of-concept study. Additionally, we found that Ranger status partially mediated the relationships between existing cultural practices (first language as your Indigenous language and living on your country) and the two wellbeing outcomes. Current cultural practices, spending time on country and speaking your Aboriginal language, also partially mediated the associations between Ranger status and high life satisfaction, and between Ranger status and high family wellbeing. This analysis supports evidence that both Ranger employment and cultural participation are contributors to wellbeing. Ranger work is not only good for land, but it is good for people. As such, determining policies that mutually acknowledge and enhance culture, health and wellbeing will likely have additional benefits for the broader Aboriginal and Torres Strait Islander population.
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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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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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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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Wang, Chao, Jing Ning, and Xiaohan Zhang. "International Investment and Indigenous Peoples’ Environment: A Survey of ISDS Cases from 2000 to 2020." International Journal of Environmental Research and Public Health 18, no. 15 (July 22, 2021): 7798. http://dx.doi.org/10.3390/ijerph18157798.
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Indigenous peoples’ environments can be easily disrupted by foreign investments, and disputes have occasionally occurred over the past few years. The objective of this research article is to examine if current international investment law, especially its investor-state dispute settlement (ISDS) mechanism, could provide necessary protection to Indigenous rights. We searched all publicly available ISDS cases from 2000 to 2020, and selected 10 typical ones for comprehensive case study by using various research methods such as doctrinal legal research and comparative analysis. Our research revealed that Indigenous peoples’ participation in the ISDS proceedings is legally restrained, time-consuming, and rarely favorably decided by the arbitral tribunals. Responsibility for such undesirable outcomes rests with all stakeholders involved in the process, while the consequences of post-arbitration tend to be “triple losing”. These findings highlight the quest for a more sustainable international investment regime that promotes Indigenous peoples’ wellbeing and environment protection. We argue that future reform could be promoted not only over ISDS procedural matters, but also by upgrading substantive rules in international investment agreements (IIAs), emphasizing free, prior, and informed consent (FPIC), and strengthening foreign investors’ corporate social responsibilities (CSR).
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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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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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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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Griffiths, Kalinda E., Jessica Blain, Claire M. Vajdic, and Louisa Jorm. "Indigenous and Tribal Peoples Data Governance in Health Research: A Systematic Review." International Journal of Environmental Research and Public Health 18, no. 19 (September 30, 2021): 10318. http://dx.doi.org/10.3390/ijerph181910318.
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There is increasing potential to improve the research and reporting on the health and wellbeing of Indigenous and Tribal peoples through the collection and (re)use of population-level data. As the data economy grows and the value of data increases, the optimization of data pertaining to Indigenous peoples requires governance that defines who makes decisions on behalf of whom and how these data can and should be used. An international a priori PROSPERO (#CRD42020170033) systematic review was undertaken to examine the health research literature to (1) identify, describe, and synthesize definitions and principles; (2) identify and describe data governance frameworks; and (3) identify, describe, and synthesize processes, policies and practices used in Indigenous Data Governance (ID-GOV). Sixty-eight articles were included in the review that found five components that require consideration in the governance of health research data pertaining to Indigenous people. This included (1) Indigenous governance; (2) institutional ethics; (3) socio-political dynamics; (4) data management and data stewardship; and (5) overarching influences. This review provides the first systematic international review of ID-GOV that could potentially be used in a range of governance strategies moving forward in health research.
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McCullough, Kylie, Lisa Whitehead, Sara Bayes, and Rebecca Schultz. "Remote area nursing: best practice or paternalism in action? The importance of consumer perspectives on primary health care nursing practice in remote communities." Australian Journal of Primary Health 27, no. 1 (2021): 62. http://dx.doi.org/10.1071/py20089.
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This paper reports on a study that aimed to understand how remote area nurses implemented primary health care principles in the Australian remote health care setting. Twenty-four Registered Nurses and Nurse Practitioners who worked in remote health services without inpatient facilities were interviewed using constructivist grounded theory methods. Findings revealed that nurses in this study aimed to practice in a way that was guided by Indigenous empowerment and social justice. However, some nurses questioned elements of their practice such as ‘chasing’ people for appointments or routine screening required by clinical guidelines that may not reflect the values of Indigenous peoples. Nurses expressed concern that they may be reinforcing past colonising practices and their actions may be considered paternalistic rather than empowering. Nurses in this study wanted to develop partnerships and provide nursing care that aligned with the health and wellbeing expectations of communities. However, ways of communicating the needs of communities and the development of partnerships between health providers and communities need to be developed. The present study calls for further research from the perspective of remote community members in order to develop ways of sharing knowledge about health and wellbeing between remote area nurses and communities.
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Schmidt‐Busby, Jacqueline, Janine Wiles, Daniel Exeter, and Timothy Kenealy. "Understandings of disease among Pacific peoples with diabetes and end‐stage renal disease in New Zealand." Health Expectations 22, no. 5 (August 2019): 1122–31. http://dx.doi.org/10.1111/hex.12946.
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Espinoza-Kulick, Mario Alberto Viveros. "Movement Pandemic Adaptability: Health Inequity and Advocacy among Latinx Immigrant and Indigenous Peoples." International Journal of Environmental Research and Public Health 19, no. 15 (July 23, 2022): 8981. http://dx.doi.org/10.3390/ijerph19158981.
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The COVID-19 pandemic exacerbated longstanding inequities in resources and healthcare, stacked on top of historical systems that exploit immigrants and communities of color. The range of relief, mutual aid, and advocacy responses to the pandemic highlights the role of social movement organizations in addressing the ways that immigration status creates systemic barriers to adequate health and wellbeing. This paper conceptualizes what I call, “movement pandemic adaptability,” drawing from a decolonial-inspired study including participant-observation (September 2018–September 2020), interviews (n = 31), and focus groups (n = 12) with community members and health advocates. Data collection began before the COVID-19 pandemic (September 2018–February 2019) and continued during its emergence and the initial shelter-in-place orders (March 2019–September 2020). Movement pandemic adaptability emerged as a strategy of drawing from pre-existing networks and solidarities to provide culturally relevant resources for resilience that addressed vulnerabilities created by restrictions against undocumented people and language barriers for communities that speak Spanish and a range of Indigenous languages. This paper presents how the relationship between immigration status and health is influenced by the local context, as well as the decisions of advocates, policymakers, and community members.
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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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Reine, Ieva, Edward Palmer, and Karin Sonnander. "Are there gender differences in wellbeing related to work status among persons with severe impairments?" Scandinavian Journal of Public Health 44, no. 8 (September 27, 2016): 772–83. http://dx.doi.org/10.1177/1403494816669638.
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Aim: The aim of this study was to analyse gender differences in wellbeing, as related to work status, among working-age people with severe impairments. Methods: This study is based on register and survey data for a sample of 7298 persons, drawn from the entire Swedish population of 15,515 working-age people 16–64 years old who, at the end of 2010, received Sweden’s unique personal assistance allowance, an allowance paid from the Swedish Social Insurance Agency (SSIA) to persons with severe impairments, enabling them to pay for assistants to support them in the functions of daily life. Logistic regression models were used to estimate the strength of relations between six measures of wellbeing, work status (not working, irregular work and regular work) and gender, together with key confounders. Results: Of the persons surveyed, 21% responded that they had regular work. Gender differences were found for all confounders, except for age. They were mostly in favour of men, which could reflect the general pattern in the labour market at large. Our results indicated there are substantial differences between non-working, irregularly working and working persons for several wellbeing aspects. Conclusions: This study analyses the contributions to wellbeing of work participation among working-age people with severe impairments, with a focus on gender differences. The analysis shows that work is an important determinant of the six measures of wellbeing examined, where the relationship between work participation and wellbeing is especially strong for peoples’ perceived standard of living. This major finding holds for both genders; however, the data show gender imbalance, in that compared with women, there was a larger percentage of men with severe impairments who have regular work. Future research should focus on finer distinctions between the types of work and the value added of personal assistants in the work context. Measures of general health not available for this study are needed to filter out a clearer picture of the interaction of work and well-being. Despite drawbacks, this study is nevertheless path-breaking in its focus on the value of work participation for the well-being of persons with severe impairments. For this reason, it provides a valuable extension of our knowledge and a clear point of departure for future studies.
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Neuendorf, Nalisa, Karen Cheer, Rachael Tommbe, Clare Kokinai, Lalen Simeon, Kelwyn Browne, David MacLaren, and Michelle Redman-MacLaren. "Sexual health and wellbeing training with women in Pacific Island Countries and Territories: a scoping review." Global Health Action 14, no. 1 (January 1, 2021): 1948673. http://dx.doi.org/10.1080/16549716.2021.1948673.
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Doery, Elizabeth, Lata Satyen, Yin Paradies, Bosco Rowland, Jennifer A. Bailey, Jessica A. Heerde, Heidi Renner, Rachel Smith, and John W. Toumbourou. "Young Adult Development Indicators for Indigenous and Non-Indigenous People: A Cross-National Longitudinal Study." International Journal of Environmental Research and Public Health 19, no. 24 (December 19, 2022): 17084. http://dx.doi.org/10.3390/ijerph192417084.
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Worldwide, Indigenous youth face ongoing challenges and inequalities. Increasing our understanding of life course patterns in Indigenous youth will assist the design of strategies and interventions that encourage positive development. This study aimed to increase understanding of resilience and positive development in Indigenous and non-Indigenous youth across Australia and the United States of America. The Australian sample comprised 9680 non-Indigenous and 176 Pacific Islander and Aboriginal and Torres Strait Islander peoples. The USA sample comprised 2258 non-Indigenous and 220 Pacific Islander, Native Hawaiian and Native American/American Indian peoples. Data were used to examine how Indigenous background, volunteering, and community involvement at average age 15 years (Grade 9) predicted five young adult positive development indicators: Year 12 (Grade 12) school completion, tertiary education participation, independent income, paid employment, and intimate relationship formation from age 18 to 28 years. Multilevel regression analyses revealed that while Indigenous youth showed slower increases in positive young adult development over time, when adjusting for socioeconomic disadvantage, there was a reduction in this difference. Moreover, we found that Grade 9 community involvement and volunteering were positively associated with young adult development for Indigenous and non-Indigenous youth. Findings indicate the importance of addressing structural inequalities and increasing adolescent opportunities as feasible strategies to improve positive outcomes for young Indigenous adults.
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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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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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Bell, Lorraine, Kate Anderson, Afaf Girgis, Samar Aoun, Joan Cunningham, Claire E. Wakefield, Shaouli Shahid, et al. "“We Have to Be Strong Ourselves”: Exploring the Support Needs of Informal Carers of Aboriginal and Torres Strait Islander People with Cancer." International Journal of Environmental Research and Public Health 18, no. 14 (July 7, 2021): 7281. http://dx.doi.org/10.3390/ijerph18147281.
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Informal carers provide an important role in supporting people with cancer. Aboriginal and Torres Strait Islander peoples experience higher cancer mortality than other Australians. To date, very little is known about the support needs of carers of Aboriginal and Torres Strait Islander adults with cancer. This article explored these needs through a qualitative study. Twenty-two semi-structured qualitative interviews and one focus group were conducted with carers of Aboriginal and Torres Strait Islander adults with cancer (n = 12) and Aboriginal and Torres Strait Islander cancer survivors (n = 15) from Queensland, Australia. Half of the carers interviewed were Aboriginal or Torres Strait Islander Australians. Interviews were transcribed, coded and thematically analysed following an interpretive phenomenological approach. Thematic analysis of carer and survivor interviews revealed four key themes relating to carers’ needs: managing multiple responsibilities; maintaining the carer’s own health and wellbeing; accessing practical support and information; and engaging with the health system. Within these overarching themes, multiple needs were identified including specific needs relevant for carers of Aboriginal and Torres Strait Islander peoples, such as advocating for the patient; accessing Indigenous support services and health workers; and ensuring that the cultural needs of the person are recognised and respected. Identifying the needs of informal carers of Aboriginal and Torres Strait Islander cancer patients will enable greater understanding of the support that carers require and inform the development of strategies to meet these areas of need.
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Kyoon Achan, Grace, Rachel Eni, Wanda Phillips-Beck, Josée G. Lavoie, Kathi Avery Kinew, and Alan Katz. "Canada First Nations Strengths in Community-Based Primary Healthcare." International Journal of Environmental Research and Public Health 19, no. 20 (October 19, 2022): 13532. http://dx.doi.org/10.3390/ijerph192013532.
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Introduction: First Nation (FN) peoples and communities in Canada are still grappling with the effects of colonization. Health and social inequities result in higher disease burden and significant disparities in healthcare access and responsiveness. For resilience, survival, and self-determination, FN are looking inwards for strengths. This paper reports on the cultural, community, and family strengths that have supported FN communities in developing community-based primary healthcare (CBPHC) strategies to support health and wellbeing. Methods: The study was a partnership between university-based researchers; The First Nations Health and Social Secretariat of Manitoba; and eight First Nation communities in Manitoba. Community-based participatory research methods were used to engage the participating communities. One hundred and eighty-three in-depth, semi-structured key informant interviews were completed between 2014 and 2016 with key members of the First Nation communities, i.e., community-based health providers and users of primary healthcare services, representing all age and genders. Data-collection and analysis were conducted following iterative grounded theory analysis. Results: Community-based healthcare models based on local strengths support easier access and shorter wait times for care and compassionate care delivery. Resources such as homecare and medical transportation are helpful. Community cooperation, youth power, responsive leadership, and economic development as well as a strong cultural and spiritual base are key strengths supporting health and social wellbeing. Conclusions: Locally led, self-determined care adds strength in FN communities, and is poised to create long-lasting primary healthcare transformation.
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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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de Lannoy, Louise, Kheana Barbeau, Nick Seguin, and Mark S. Tremblay. "Scoping review of children’s and youth’s outdoor play publications in Canada." Health Promotion and Chronic Disease Prevention in Canada 43, no. 1 (January 2023): 1–13. http://dx.doi.org/10.24095/hpcdp.43.1.01.
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Introduction Since 2015, interest in the benefits of outdoor play for physical, emotional, social and environmental health, well-being and development has been growing in Canada and elsewhere. Methods This scoping review aims to answer the question, “How, and in what context, is children’s and youth’s outdoor play being studied in Canada?” Included were studies of any type on outdoor play published after September 2015 in English or French by authors from Canadian institutions or assessing Canadian children and/or youth. Articles retrieved from MEDLINE, CINAHL and Scopus by March 2021 were organized according to eight priority areas: health, well-being and development; outdoor play environments; safety and outdoor play; cross-sectoral connections; equity, diversity and inclusion; professional development; Indigenous Peoples and land-based outdoor play; and COVID-19. Within each priority, study design and measurement method were tallied. Results Of the 275 articles included, the most common priority area was health, wellbeing and development (n = 239). The least common priority areas were COVID-19 (n = 9) and Indigenous Peoples and land-based outdoor play (n = 14). Cross-sectional studies were the most common; the least common were rapid reviews. Sample sizes varied from one parent’s reflections to 999 951 data points from health databases. More studies used subjective than objective measurement methods. Across priorities, physical health was the most examined outcome, and mental/emotional development the least. Conclusion A wealth of knowledge on outdoor play in Canada has been produced since 2015. Further research is needed on the relationship between outdoor play and mental/emotional development among children and youth.
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Newman, Janessa, Inna Rivkin, Cathy Brooks, Kathy Turco, Joseph Bifelt, Laura Ekada, and Jacques Philip. "Indigenous Knowledge: Revitalizing Everlasting Relationships between Alaska Natives and Sled Dogs to Promote Holistic Wellbeing." International Journal of Environmental Research and Public Health 20, no. 1 (December 23, 2022): 244. http://dx.doi.org/10.3390/ijerph20010244.
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Introduction: Indigenous peoples have documented their culture’s history in oral stories, revealing lessons about holistic relationships fostering perseverance. Despite vast differences in time, relationships and stories are equally important today. Athabascans retain their values, life skills, and wellness through cultural practices. Creating opportunities for youths to learn through reciprocal relationships increases wellness in Indigenous communities, highlighting the significance of community-developed programs that connect youths to their place and culture. Method: Athabascan youths in rural Alaska get hands-on experience and Elder mentorship working with sled dogs in the Frank Attla Youth and Sled Dog Care-Mushing Program (FAYSDP). Through a community-based participatory research partnership with the community of Huslia and Jimmy Huntington School, we examined how FAYSDP affects youths, and how relationships within culture and land promote wellbeing. Fifteen middle and high-school youths shared their perspectives on how FAYSDP impacts them and their community using photovoice and digital storytelling. Nineteen adults contributed their perspectives in focus groups. We used emerging themes (inductive) and Athabascan cultural values and elements of social capital (deductive approaches) to analyze the qualitative data. Results: Findings illustrate how FAYSDP promotes wellbeing by empowering youths to apply what they learn to generate their own knowledge, while centering communities around culturally significant practices such as dog mushing. It connects youths to their home and their cultural values, using dogs as the driving force to bridge generations and foster youth wellness. Discussion: We discuss implications for community-based programs that engage Elders as teachers and the land as their classroom to promote youth holistic wellness.