Navigating Secularism: Pacific Communities, Intersectional Identities, and the New Zealand State

A study of Brucellosis in cattle within the Pacific Island Community as a model for disease surveillance and reporting

Data from the National Cancer Database indicates prostate cancer (CPa) prevalence in the Pacific Islander (PI) community to be nearly 1.6 times higher than the national standard. Recent data suggests that prostate cancer rates seen in United States PI men are comparable to that of African American men, the community with the longstanding recognition as having the highest rates of the disease in the US. PIs are defined as those originating from or being indigenous to the islands of Polynesia, Melanesia, and Micronesia including the US governed Hawaiian islands, Guam, Northern Marianas Islands, and American Samoa. PIs make up a grossly underrepresented minority group, often being overshadowed by their mainland Asian counterparts when aggregated together as a group defined as “AANHPI” in sociological and epidemiological data sets and studies. In addition, Pacific Islanders, at least in the mainland US, are considered a “new” minority population, and with the exception of those indigenous to US territories, the vast majority of the population are post 1970 first or second generation immigrants. Research into health disparities in the PI community is thus unsurprisingly sparse, and there is great work to be done to explore these alarming trends. The purposes of this study are threefold: further explore the data pertaining to prostate cancer prevalence in the pacific islander community; disaggregate the data between ethnic lines; and provide a foundation for future research that can further elucidate the causes and outcomes of this disease in the Pacific Islander community. Data was taken from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS). The NHPI NHIS is a national survey administered by the CDC-NCHS to collect disease data including health condition and characteristics, health care access and service utilization but specific to the national NHPI population. Among 2588 participants, 4% indicated ever having been diagnosed with cancer among which prostate cancer was the second most commonly diagnosed. This study relies heavily on large-scale national questionnaires, thus future research should incorporate additional qualitative exploratory research, including targeted and ethnicity-specific canvassing and interviews in order to better understand the real life manifestations of the disease. The preliminary findings highlight an ever growing concern for the health outcomes of this community, and provide compelling evidence in support for both disaggregation of the community from Asian Americans, as well as interethnic disaggregation in data sets. A common thread of distancing between PI communities and the healthcare system was particularly evident, raising the concern that PIs are not being screened early enough and are not seeking life saving medical attention until advanced disease progression. A hopeful outcome of this study is a recognition that more outreach and community work must be done to bridge the gap between PIs and the Western healthcare system in order to mitigate the observed disparities. Citation Format: Nicholas A. Sowizral. Disparities in occurrence and outcome of male reproductive cancers in the United States Pacific Islander community [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C007.

Kava ('Awa) is a traditional water-based beverage in Pacific island communities, prepared from the ground root and stems of Piper methysticum. Kava use is associated with an ichthyotic dermatitis and delayed type hypersensitivity reactions. In the current study we collated preparative methodologies from cultural practitioners and recreational kava users in various Pacific communities. We standardized culturally informed aqueous extraction methods and prepared extracts that were subjected to basic physicochemical analysis. Mast cells exposed to these extracts displayed robust intracellular free calcium responses, and concomitant release of proinflammatory mediators. In contrast, mast cells were refractory to single or combinatorial stimulation with kavalactones, including methysticin, dihydromethysticin and kavain. Moreover, we reproduced a traditional modification of the kava preparation methodology, pre-mixing with the mucilage of Hibiscus tiliaceus, and observed its potentiating effect on the activity of aqueous extracts in mast cells. Taken together, these data indicate that water extractable active ingredients may play a role in the physiological and pathophysiological effects of kava, and suggests that mast cell activation may be a mechanistic component of kava-related skin inflammations.

Aotearoa New Zealand has one of the highest rates of family violence in the developed world. It is an intergenerational issue that cuts across socio-economic boundaries, affecting people of all genders, ethnicities, ages, and sexualities. This research investigates and responds to the issue of family violence through an architectural lens, asking, how might architecture protest, give visibility to, and offer hope and care in response to family violence in Aotearoa New Zealand? Instead of reimagining current architectures associated with family violence, the work speculatively considers alternative ways architecture can play a role in our social sustainability. Using artefact making to give visibility to the open secret and pain of family violence, the work first explores the issue of family violence through making in empathy. Moving beyond this, the work looks to counter the pain of family violence by speculatively considering shifts in community spaces that might influence the context in which violence occurs. These speculative architectures take the form of lighthouses, intended to dot our suburban streets and act as everyday, functional community spaces and beacons of care. These speculative lighthouses embody an interrogation, critique, and protest of our current social field. They are also a call to care, challenging the architectural profession to imagine new ways in which architecture can help to address difficult social issues that ultimately affect us all.

An increasing number of cases of parental separation involve high conflict and claims that a parent is alienating a child. This study analyzes reported family law cases involving claims of parental alienation in Quebec between 2017 and 2020 (n = 164). Bivariate analyzes were undertaken to establish correlations between family characteristics (child's age, safety issues concerning the children and parents, severity of the parental conflict, child's age, allegations of domestic violence and child abuse) and court decisions. Judges made a finding of parental alienation in a minority of cases where a claim of alienation was made, and in more than a quarter of cases did not resolve the claim. Issues of family violence were raised in about a quarter of the cases where alienation was an issue. The courts rarely dismissed a claim of violence and made a finding of alienation. The most common outcome of all cases was a continuation of the status quo, with a custody reversal in only a few cases (n = 7). Mothers were more often alleged to be engaging in alienating behaviour, but there is a lower rate of judicial substantiation of alienation against mothers, and the study did not find evidence of gender bias. Judicial findings of alienation were associated with substantiation by a child custody evaluator or the child protection service. Only a small portion of cases resulted in orders psychosocial interventions. The authors argue that courts, agencies professionals need to better address issues of parental alienation and family violence.

Pacific Islander communities in the USA experienced some of the most severe effects of the COVID-19 pandemic. This qualitative synthesis examines the literature on Pacific Islander community responses and lessons learned from COVID-19, using a systematic search that identified 28 articles with this focus. Thematic analysis was subsequently used to classify both documented efforts by Pacific Islander communities to respond to the pandemic, as well as lessons learned and best practices from research in this area. Results revealed multiple efforts to address the pandemic, including Pacific Islander grassroots approaches, government responses, inter-sector collaboration, and research. Results further emphasized the importance of culturally and linguistically responsive outreach and messaging; partnership, engagement, and capacity building; and changes in research and policy approaches to promote health equity. Future efforts to address public health crises should make the most of Pacific Islander cultural approaches to disaster response. To achieve this, government and other organizations that work with PI communities need to support the development of the PI leadership, healthcare and research workforces, and work with Pacific Islander communities to build long-term, sustainable, and trustworthy partnerships.

Northwest Arkansas, particularly Benton and Washington counties, is one of the highest COVID-19 hot spots in the United States (US), with more than half of all reported cases in this area identifying as Latinx or Pacific Islander, even though these communities account for less than 20% of the overall population. The University of Arkansas for Medical Sciences (UAMS) leveraged their existing relationship with 18 key community partners. Partners collaboratively developed a COVID-19 Response Strategy to ensure coordinated effort for Latinx and Pacific Islander communities with four interrelated strategies: health education, testing, contact tracing, and supported quarantine/case management.

Community-based participatory research (CBPR), applied authentically according to its principles, is inherently conducive to empowerment and capacity building for academic and community partners by promoting egalitarian collaborations through all stages of research. During an intensive qualitative study exploring the intersection of HIV-HPV and cancer in the Pacific Islander (PI) communities of Southern California, we strengthen effective collaborations between an academic research team and two PI community-based organizations (CBOs). Responding to an NCI call for research exploring AIDS-related cancers, our CBOs worked closely with the academic team to examine HIV-HPV factors among Chamorro and Tongan young adults. Key informant and focus groups interviews were collaboratively chosen as the grounded theory research design. Community partners lead the process in: 1) determining most locally relevant and culturally appropriate point of entry for the study investigating HIV and its potential connections to HPV; 2) establishing and convening project specific community advisory board; 3) recruiting study participants; and 4) collecting data. The academic team conducted trainings on HIV, HPV, sampling, data collection, and analysis. Partners jointly lead dissemination efforts. The decision-making process incorporated culturally appropriate meeting protocols of sharing food and experiences through “talk story.” Through our successful CBPR collaboration, we ensured a shared discourse on cancer-related and comorbid topics, and we solidified and reaffirmed our relationship for ongoing and future projects. Thus, CBPR is critical, as the need to address cancer health disparities through collaborative research continues to play a key role in shaping the racial/ethnic minority and medically underserved healthcare landscape. Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):B14.

Community-based adaptation (CBA) is becoming an increasingly popular approach to climate change adaptation in the Pacific islands region. Building adaptive capacity should be an important component of projects supporting CBA. The literature establishes that adaptive capacity is highly context and culture specific. However, to date, there has been little research into the factors and processes that enable adaptive capacity in Pacific island communities. This paper discusses the Pacific Adaptive Capacity Analysis Framework, a theoretical framework developed to guide assessment of adaptive capacity for the purposes of supporting CBA projects. The framework identifies seven broad factors and several sub-factors of Pacific-specific adaptive capacity: (1) human capital; (2) social capital; (3) belief systems, worldviews, and values; (4) resources and their distribution; (5) options for adaptation, livelihood, and food supply; (6) information and awareness; and (7) history of dealing with climate stress. The paper presents a case study of adaptive capacity from a community in the Solomon Islands and concludes that unlike many adaptive capacity determinants identified in the broader international literature, function-based (factors shaping ability to access and use resources) and cognitive (for example, values and belief systems) determinants are of particular relevance in the Pacific community social and cultural context. The key to building upon cognitive and function-based aspects of adaptive capacity is increasing the ability of people to liaise with external support organisations to plan and acquire resources for adaptation on their own terms.

Background: Samoans experience among the worst five-year breast cancer survival rates in the U.S., largely due to late stage diagnosis. There is great potential for screening interventions to reduce cancer mortality among Samoans. This paper examines the effectiveness of a culturally and linguistically tailored breast cancer education workshop for Samoan and other Pacific Islander women in Southern California. Methods: Educational workshops were conducted in churches, homes, and the Samoan National Nurses Association office to Pacific Islander women. Effectiveness was assessed using pre- and post-tests. Selfadministered questionnaires queried participants about demographics, access, personal or family breast cancer history, screening knowledge and behaviors, and plans to obtain screening (n=495). Results: Participants were predominantly Samoan, with 57% reporting they were ≥40 years of age. At pre-test, half of the participants did not know how to perform Breast Self Examination (BSE), 40% never had a Clinical Breast Examination (CBE), and 30% never had a mammogram. Less than 40% reported having a mammogram in the past two years. At post-test, 98% reported increased knowledge. Older women were more likely to report plans for screening at post-test. Conclusions: Health educators in Samoan and other Pacific Islander communities must recognize and appropriately address screening barriers such as cultural beliefs and lack of knowledge, and should consider working with important institutions such as the church.

To address the history of unethical research and community distrust in research among Native Hawaiian and Pacific Islander communities, we developed the "Community 101 for Researchers" training program, which was launched in 2014 to enhance the capacity of researchers to engage in ethical community-engaged research. The purpose of this paper is to describe the development of this training program as well as its reach and feedback from participants. The Community 101 training program is a self-paced, 2-h online training program featuring community-engaged researchers from the University of Hawai'i and their longstanding community partners. Throughout the five modules, we highlight the historical context of Native Hawaiians and Pacific Islander populations in Hawai'i related to research ethics and use examples from the community as well as our own research projects that integrate community ethics, relevance, benefits, and input. To determine reach and gather participant feedback on the training, we extracted data from the user accounts. The training has been completed by 697 users to-date since its launch. Despite very little advertisement, an average of nearly 70 users have completed the Community 101 Program each year. The majority of the participants were located in Hawai'i though participants were also from other states and territories in the US, and international locations. The majority of participants were from universities in Hawai'i in 51 different departments demonstrating multidisciplinary relevance of the program's training. The general feedback from the 96 participants who completed an optional anonymous evaluation survey given at the end of the training was positive. The "Community 101 for Researchers" Training program is an accessible and relevant tool that can be used to advance ethical community engaged research, specifically with Native Hawaiian and Pacific Islander communities.

Research on park use among Asians and Pacific Islanders is limited. This study examined use and conditions of 6 urban parks, varying in size, location, and neighborhood income level, in predominantly Asian and Pacific Islander communities in Honolulu, Hawaii. Sociodemographic predictors of park use were also identified. Observations were conducted from June through October 2009. Raters used the System for Observing Play and Recreation in Communities to count the number of people in predesignated zones and to code their physical activity level as sedentary, moderate, or vigorous. Raters coded park conditions on the basis of accessibility and usability, whether equipment and supervision were provided, and whether organized activities were occurring. Differences associated with sex and age of park users and income level of the neighborhood were examined by using χ² and logistic regression. Raters observed 6,477 park users, most of whom were men. Approximately 60% of users were sedentary, 26% were engaged in moderate activities, and 14% performed vigorous activities. Women and girls were less active than men and boys. More users were present in the evenings, but morning users were more active. Although park users in low-income neighborhoods were more active than users in high-income neighborhoods, fewer people used the low-income parks. Most parks were accessible and usable but few provided equipment and supervision. Organized activities were rarely observed. More efforts should be made to promote parks as a physical activity resource in Asian and Pacific Islander communities, particularly for women, girls, and low-income residents. More research should be conducted to identify barriers and facilitators to park use, especially among underrepresented populations.

Hawaii and the U.S.-Affiliated Pacific Islands (USAPI) are facing a climate change crisis that threatens the health, safety, and well-being of Pacific Islander communities. This article provides an overview of the unique impacts of climate change on this often-overlooked region from an environmental public health perspective, as well as its vulnerabilities and resilience efforts. The article highlights the urgent need for action and the crucial role that environmental health professionals can play in partnering with Pacific Islander communities to build climate resilience. We conducted research and key informant interviews between September 2023 and June 2024, which provided valuable insights into the lived experiences and perspectives of local leaders, environmental health practitioners, and community members who are grappling with the effects of climate change. By bringing together scientific data, case studies, and perspectives from local leaders and storytellers, this article paints a holistic picture of the complex realities of climate change in Hawaii and the USAPI. This nuanced understanding is essential for informing effective, equitable, and culturally appropriate interventions to protect the health and well-being of Pacific Islander communities in the face of the climate crisis.

Facing food security risks: The rise and rise of the sweet potato in the Pacific Islands

The Region in Review: International Issues and Events, 2019 Nic Maclellan (bio) Melanesia in Review: Issues and Events, 2019 volker boege, rebecca bogiri, mathias chauchat, joseph daniel foukona, budi hernawan, michael leach, james stiefvater, jope tarai [End Page 523] The Region in Review: International Issues and Events, 2019 Around the Pacific, advertising agencies had a boom year in 2019 as governments rebranded their support for the Pacific Islands. Australia is “stepping up” and New Zealand “resetting” their Pacific policies. The United States launched its “Pacific pledge,” while Indonesia announced a “Pacific elevation.” China and Taiwan jousted for diplomatic support, offering “South-South” solidarity. Despite this renewed engagement, Pacific Island citizens are grappling with a challenging international context. With the slowdown of the global economy in late 2018, many Island governments geared up for tough economic times. The adverse effects of climate change and the ongoing failure of global climate negotiations generated economic as well as environmental costs. With an increasingly hostile tone, Australia and the United States ramped up efforts to blunt Chinese influence in a region now dubbed the “Indo-Pacific.” The policy of strategic denial in the Islands promoted by the anzus alliance of Australia, New Zealand, and the United States is designed to reinforce Western power in the wider Asia-Pacific region. This agenda is supported by external powers like France, India, and Japan, which all have their own regional agendas. In response, Pacific Island government and community leaders are outlining their vision of a unified, sustainable region. Recognizing that “the world wants Oceania like never before,” the Reclaiming Oceania Collective at the University of the South Pacific highlighted the resistance of Pacific communities: “Pacific islanders—stewards of the ocean for thousands of years—are organizing at unprecedented scales. New social movements aim to reassert an ‘oceanic’ identity, and are confronting forces that would usurp their sovereignty and heritage. Pacific islanders are also leveraging their ‘oceanic presence’ in processes of multi lateral oceans diplomacy” (Reclaiming Oceania Collective 2018). There is a growing body of research that seeks to redefine notions of regional security and development, which stress the importance of collective diplomacy, civil society engagement, and Indigenous perspectives (Fry and Tarte 2015; Salesa 2017; Fry 2019; Ratuva 2019; Morgan 2019). In August, the annual Pacific Islands Forum meeting in Tuvalu reaffirmed the “Blue Pacific” as its key policy framework. Dame Meg Taylor, secretary-general of the Pacific Islands Forum Secretariat, noted: “The Blue Pacific represents our recognition that as a region, we are large, connected and strategically important” (Taylor 2019b). The year was marked by significant engagement with the United Nations (UN), including an unprecedented regional visit by UN Secretary-General António Guterres in May, with stops in Fiji, New Zealand, Tuvalu, and Vanuatu. Guterres sees the UN Pacific Small Island Developing States (psids) [End Page 524] group as an ally in his global advocacy on climate change. Seeking to drive momentum toward his UN Climate Action Summit in September and global climate negotiations in November, the secretary-general said that Pacific Island leaders have a unique moral authority to speak out on the climate crisis. In May, the Forum hosted a summit with Guterres in Nadi, where he highlighted two fundamental challenges for the Pacific region: “First, the increasingly severe impacts of climate change, and second, the deepening threats to the world’s oceans and seas” (Maclellan 2019e). Following the summit, Pacific leaders issued the “Blue Pacific’s Call for Urgent Global Climate Change Action,” stressing the importance of higher ambition at the Climate Action Summit in New York (pifs 2019a). In line with the Boe Declaration issued at the 2018 Nauru Forum, Island leaders called on the UN secretary-general to appoint a Special Adviser on Climate Change and Security (pifs 2018). Despite this visit, officials from the Council of Regional Organizations of the Pacific are concerned that increased UN activity in the Pacific may draw resources away from existing regional organizations. Outgoing Director-General of the Pacific Community (spc) Dr Colin Tukuitonga noted: “We compete with UN agencies for the same pot of money and the UN has the advantage over us because of their size and global reach” (Magick 2019). After six...