Triumphant tides: The rise of Pacific midwifery research in Aotearoa New Zealand

Cardiovascular disease (CVD) inequities in Aotearoa New Zealand disproportionately affect Māori and Pacific peoples, who experience higher risk factors, hospitalisations and mortality than NZ Europeans. These disparities stem from the historical and contemporary effects of colonisation, including institutional racism, impacting access to healthcare and socio-economic resources. Despite guidelines for earlier CVD risk assessments (CVDRA), gaps in identification and management persist. The Manawataki Fatu Fatu (MFF) for Māori and Pacific Hearts in Unison for Achieving Cardiovascular Care in Equity Studies (ACCESS) is a Māori and Pacific-led research programme examining CVD inequities in Aotearoa New Zealand. This study presents phase three, focussing on qualitative co-design hui (meetings) across Aotearoa New Zealand to gather insights from Māori and Pacific patients, whānau (family/supports) and kaimahi (healthcare workers) engaged with CVD services spanning primary to secondary care. A total of 105 participants attended four regional hui focussed on the heart healthcare experiences of Māori and Pacific peoples in Aotearoa New Zealand. Template analysis revealed four key themes for achieving equitable healthcare: the importance of the whānau/community, the need for providers to engage with patients at their level, the persistent barriers faced and a strong commitment to protecting Māori and Pacific communities and kaimahi. This study is a comprehensive qualitative investigation into heart healthcare for Māori and Pacific peoples in Aotearoa New Zealand. The findings reiterate that care must align with the realities of Māori and Pacific peoples and that interventions must address long-standing systemic barriers to care.

The aim of the present study is to provide a snapshot of how depression is understood and addressed by Pacific peoples in Aotearoa New Zealand. Participants were 548 Pacific peoples (age range 16–83 years) residing in Aotearoa New Zealand, who completed the Pasifika Mental Health in Aotearoa (PMHA) survey containing questions regarding depression. Content Analysis was used to categorise open-ended responses, and descriptive statistics were used to analyse participant response frequencies. Participant conceptualisations of depression demonstrated a strong understanding of depression, with most identifying multiple symptoms and many describing symptoms aligned with DSM-5-TR criteria. When asked about addressing depression, participants overwhelmingly endorsed seeking informal support, followed by formal support. Consistent with these preferences, participants rated talking to friends and counsellors as most helpful, while substance use, including alcohol and drugs, was strongly identified as harmful. This study reveals that Pacific peoples in Aotearoa New Zealand understand depression with strong preferences for both informal and formal support. These findings challenge assumptions about the low level of mental health literacy in Pacific communities and highlight the importance of culturally responsive approaches.

ObjectiveMitochondria have an important role in the induction of the NLRP3 inflammasome response central in gout. The objective was to test whether mitochondrial genetic variation and copy number in New...

The Pacific population in Aotearoa New Zealand is youthful, with the majority (55%) being under the age of 25 (Statistics New Zealand, 2014). It is vital that youth mental health for Pacific is understood in relation to their overall wellbeing (Paterson et al., 2018). In parallel to this, the World Health Organization (2022) accentuates the need to protect and promote mental wellbeing for young people globally. Specifically, Pacific youth were far more likely than Aotearoa New Zealand European counterparts to have poorer mental health and higher numbers of suicidality and self-harming behaviours (Ataera-Minster & Trowland, 2018; Fa'alili-Fidow et al., 2016). Moreover, research confirms that Pacific people aged 15–24 years have higher levels of psychological distress of 38% compared to 35% of Pacific adults aged 45–64 years (Ataera-Minster & Trowland, 2018). There is a lack of evidence-based psychological approaches that are culturally appropriate and applicable for Pacific people in Aotearoa New Zealand. Considerably, substantial evidence supports the need to provide more accessible resources and interventions that are flexible, culturally adaptable and cost-effective for Pacific youth. This review aims to (1) provide an insight into Pacific people in Aotearoa New Zealand, (2) have an understanding of Pacific worldview & wellbeing, (3) highlight mental health for Aotearoa New Zealand youth & globally (4) identify therapeutic approaches, including digital mental health globally and in Aotearoa New Zealand.Understanding the perspectives of Pacific youth is a significant first step. Therefore, this article will examine the therapeutic approaches, specifically in the digital space, that are proven effective when promoting wellness for Pacific youth.

Assessing the gaps in cardiovascular disease risk assessment and management in primary care for Māori and Pacific peoples in Aotearoa New Zealand- a systematic review.

E tumau le fa'avae ae fesuia'i faiga

Previous small studies in Aotearoa New Zealand have indicated a high prevalence of gout. This study sought to determine the prevalence of gout in the entire Aotearoa New Zealand population using national-level health data sets. We used hospitalization and drug dispensing claims for allopurinol and colchicine for the entire Aotearoa New Zealand population from the Aotearoa New Zealand Health Tracker (ANZHT) to estimate the prevalence of gout in 2009, stratified by age, gender, ethnicity and socio-economic status (n = 4 295 296). were compared with those obtained from an independent large primary care data set (HealthStat, n = 555 313). Results. The all-ages crude prevalence of diagnosed gout in the ANZHT population was 2.69%. A similar prevalence of 2.89% was observed in the HealthStat population standardized to the ANZHT population for age, gender, ethnicity and deprivation. Analysis of the ANZHT population showed that gout was more common in Māori and Pacific people [relative risk (RR) 3.11 and 3.59, respectively], in males (RR 3.58), in those living in the most socio-economically deprived areas (RR 1.41) and in those aged >65 years (RR >40) (P-value for all <0.0001). The prevalence of gout in elderly Māori and Pacific men was particularly high at >25%. Applying algorithms to national administrative data sets provides a readily available method for estimating the prevalence of a chronic condition such as gout, where diagnosis and drug treatment are relatively specific for this disease. We have demonstrated high gout prevalence in the entire Aotearoa New Zealand population, particularly among Māori and Pacific people.

Dysmenorrhea affects the majority of young women worldwide, but geographical and cultural differences can influence the reporting, impact and management of symptoms. Aotearoa New Zealand is a culturally diverse country, with a high proportion of Māori and Pacific peoples. The aim of this scoping review was to assess the current literature on the prevalence, impact and management strategies for dysmenorrhea in Aotearoa New Zealand. The Joanna Briggs Institute (JBI) scoping review methodology was used to systematically map the evidence of prevalence, severity and symptoms, impact and management strategies for dysmenorrhea in Aotearoa New Zealand. Eight electronic databases were searched in August 2024. Ten studies met the inclusion criteria. Our findings show that the current data for the prevalence, impact and management strategies for dysmenorrhea in Aotearoa New Zealand are both limited and outdated. The results from this scoping review highlight the need for updated data on dysmenorrhea in Aotearoa New Zealand, with particular focus on Māori and Pacific peoples, and geographical diversity.

Dysmenorrhea affects the majority of young women worldwide, but geographical and cultural differences can influence the reporting, impact and management of symptoms. Aotearoa New Zealand is a culturally diverse country, with a high proportion of Māori and Pacific peoples. The aim of this scoping review was to assess the current literature on the prevalence, impact and management strategies for dysmenorrhea in Aotearoa New Zealand. The Joanna Briggs Institute (JBI) scoping review methodology was used to systematically map the evidence of prevalence, severity and symptoms, impact and management strategies for dysmenorrhea in Aotearoa New Zealand. Eight electronic databases were searched in August 2024. Ten studies met the inclusion criteria. Our findings show that the current data for the prevalence, impact and management strategies for dysmenorrhea in Aotearoa New Zealand are both limited and outdated. The results from this scoping review highlight the need for updated data on dysmenorrhea in Aotearoa New Zealand, with particular focus on Māori and Pacific peoples, and geographical diversity.

Even though Pacific peoples in tertiary education in Aotearoa New Zealand strive to achieve milestones which bring honour and prestige to their families and communities in New Zealand and the Pacific, socio-economic factors still hinder many from achieving their set goals. This article begins by relating the author’s own narrative as a Sāmoan living in the Pacific diaspora and working in tertiary education in Auckland. It then outlines the diverse aspirations of Pacific peoples living in New Zealand, with a focus on the educational hopes of recent migrants as well as New Zealand-born members of Pacific communities. These aspirations are presented with reference to the existing literature on Pacific success within tertiary education in Aotearoa New Zealand. We discuss how education providers support Pacific students, and the ways in which institutions are working to improve Pacific educational outcomes. It is argued that even if the New Zealand Tertiary Education Strategy (TES), the Action Plan for Pacific Education 2020- 2030 (APPE), and Unitec's Pacific Success Strategy 2019- 2022 are aligned in their goals, more effort is needed to ensure that these initiatives are implemented effectively through multi-disciplinary and value-based approaches. This article adds value by providing an insider’s perspective of migration and a first-hand account of the challenges facing students in higher education in Aotearoa New Zealand. Moreover, the analysis contributes to the repertoire of academic studies and publications that help to understand and improve the Pacific experience in tertiary education in Aotearoa New Zealand.

Introduction Participation in the health-care system is a key component of healthy ageing strategies. The number of Pacific people aged ≥65 years in Aotearoa New Zealand will increase significantly over the next decade. Addressing the considerable health inequities and unmet need for care Pacific Island people experience when compared to other ethnicities in Aotearoa New Zealand should be a priority. Aim To identify barriers to older Pacific people's participation in the health-care system in Aotearoa New Zealand. Methods A participatory action research design was utilised. In total, 104 Pacific co-researchers contributed to focus groups using Talanoa , a traditional method of conversational dialogue deeply rooted in Pacific Island culture. Data were collected in Pacific Island languages from storytelling and conversations shared within the focus groups. Data were translated into English and analysed using a collaborative approach. Results Three main themes captured older Pacific peoples' barriers to participation in the health-care system: accessing health care; relationships with health-care providers; and understanding the health-care system. Discussion Older Pacific people have the capacity to influence locally driven programmes to be more responsive to their needs and aspirations. Improving older Pacific peoples' participation in health care will require a commitment to partnership and inter-sectoral collaboration identified in recent ageing strategies. The findings will inform local communities, and policy and practice aimed at improving the health and wellbeing of Pacific peoples who are ageing in Aotearoa New Zealand.

Recent research indicates that rates of psychological distress are almost 1.5 times higher for adult Pacific peoples versus non-Pacific peoples1. Leveraging data from the New Zealand Attitudes and Values Study and utilising cross-lagged regression modelling, we examined changes in psychological distress across time for adult Pacific peoples in Aotearoa New Zealand (n = 514). Our study found that experiences of psychological distress were associated with a greater likelihood of experiencing psychological distress in the future. Additionally, experiencing higher levels of social support was associated with a lower likelihood of experiencing psychological distress in the future. Our research is vital because psychological distress is a serious mental health issue, and research that signals protective factors towards psychological distress for our Pacific peoples can help in creating better mental health outcomes for our Pacific communities. Preview on terminology: We use the term Pacific peoples, which are inclusive of a group of people in Aotearoa New Zealand that have ethnic roots from many Pacific nations. Unless a research study specifically uses the term mental illness or mental disorder, the study uses the terms mental distress and mental health issues/concerns to broadly refer to diagnosis of a mental illness or any other challenges or experiences with mental health. The choice in terminology is to shift the focus away from a deficit model of health, to those that are more consistent with Pacific views of health and wellbeing1.

PURPOSE In Aotearoa New Zealand, there are inequitable outcomes for Pacific peoples who experience higher rates of preventable cancers and poorer survival compared with other ethnicities. The aim of this study was to explore Pacific peoples lived experience of cancer and its treatment in the Auckland setting. METHODS Data were collected through semistructured interviews (talanoa) with Pacific patients under the Auckland Regional Cancer and Blood Service. A general inductive approach was used to analyze the data. Ethical approval was granted by the Auckland Health Research Ethics Committee (reference number AH24086). RESULTS Thirteen participants of Samoan and Tongan ethnicity were interviewed. Participants had a range of tumor diagnoses and were receiving curative and noncurative treatments. Five key themes were identified, giving insight into beliefs around cancer, struggles faced by patients, and potential areas of priority. These include (1) cancer means death, (2) holistic and collective approach to support, (3) communication and trust, (4) cost in accessing cancer care and treatment, and (5) Pacific representation. CONCLUSION This study sheds light on both positive and negative experiences of Pacific peoples living with cancer in Aotearoa New Zealand. It highlights gaps in the current model of oncology care for this population, which are multilevel and therefore require a multifaceted approach. It calls for priority toward reducing barriers to access of care and creating a more culturally safe pathway.

Who are Pacific peoples in terms of ethnicity and country of birth? A cross sectional study of 2,238,039 adults in Aotearoa New Zealand's Integrated Data Infrastructure

Despite the inclusion of both individual interventions and population-based measures in the Aotearoa New Zealand (Aotearoa NZ) Tobacco Control Programme, the gap between Māori, Pacific peoples and European/Asian/Other (EAO) populations in tobacco use has not decreased significantly. Tobacco control interventions that focus on individual behaviour change have produced little impact towards reducing tobacco smoking inequities for Māori and Pacific peoples in Aotearoa NZ. Using data from the New Zealand Health Survey (NZHS), this research investigates the impact of the wider determinants of health and individual-level factors on inequities in tobacco use between Māori, Pacific peoples and EAO. A conceptual framework was developed to support the theoretical positioning of this research and to inform data categorization, framing, discourse, analyses and interpretation. We conducted hierarchical regression to examine the effect of factors from each domain on ethnic inequities in tobacco use. We found that socioeconomic factors accounted for a significant amount of the disparity in adults currently smoking between Māori and Pacific peoples and EAO. Our results suggest that socioeconomic factors may be a more effective target of intervention than individual behaviours for reducing tobacco-related inequities. Addressing the broader determinants of health through comprehensive cross-agency cooperation to reduce ethnic inequities in tobacco use in Aotearoa NZ is likely to be more effective than individual behaviour change approaches.