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Sheehy B, Wepa D, Collis JM. Māori experiences of physical rehabilitation in Aotearoa New Zealand: a scoping review. Disabil Rehabil 2024:1-11. [PMID: 38989895 DOI: 10.1080/09638288.2024.2374494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/24/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE The purpose of this review was to explore what is currently known about Māori experiences of physical rehabilitation services in Aotearoa New Zealand. METHODS A scoping review was undertaken following steps described by the Joanna Briggs Institute. Databases and grey literature were searched for qualitative studies that included descriptions of Māori consumer experiences in their encounters with physical rehabilitation. Data relating to study characteristics were synthesised. Qualitative data were extracted and analysed using reflexive thematic analysis. RESULTS Fourteen studies were included in this review. Four themes were generated that describe Māori experiences of rehabilitation. The first theme captures the expectations of receiving culturally unsafe care that become a reality for Māori during rehabilitation. The second theme describes whānau as crucial for navigating the culturally alien world of rehabilitation. The third theme offers solutions for the incorporation of culturally appropriate Māori practices. The final theme encompasses solutions for the provision of rehabilitation that empowers Māori. CONCLUSIONS This scoping review highlights ongoing inequities experienced by Māori when engaging with rehabilitation services. Strategies for facilitating culturally safe rehabilitation for Māori have been proposed. It is essential that rehabilitation clinicians and policymakers implement culturally safe approaches to rehabilitation with a view to eliminating inequities in care provision and outcomes for Māori.
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Affiliation(s)
- Becky Sheehy
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Dianne Wepa
- School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand
- Faculty of Health, Charles Darwin University, Casuarina, Australia
- University of Bradford, Bradford, UK
| | - Julie M Collis
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
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Hardt J, Canfell OJ, Walker JL, Webb KL, Brignano S, Kira K, Peu T, Santos D, Bernard A, Littlewood R. Healthier Together: Implementation and evaluation of a co-designed, culturally tailored childhood obesity community prevention program for Māori and Pacific Islander children and families. Health Promot J Austr 2024; 35:744-759. [PMID: 37779219 DOI: 10.1002/hpja.803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 07/05/2023] [Accepted: 08/26/2023] [Indexed: 10/03/2023] Open
Abstract
ISSUE ADDRESSED Co-designed and culturally tailored preventive initiatives delivered in childhood have high potential to close the cross-cultural gap in health outcomes of priority populations. Māori and Pacific Islander people living in Australia exhibit a higher prevalence of overweight and obesity and higher rates of multimorbidity, including heart disease, cancer and diabetes. METHODS This mixed-methods, pilot implementation and evaluation study, aimed to evaluate the implementation of a community-based, co-designed and culturally tailored childhood obesity prevention program, using quantitative (pre-post anthropometric measurement, pre-post health behaviour questionnaire) and qualitative (semi-structured interview) methods. Sessions relating to healthy eating, physical activity and positive parenting practices were delivered to families residing in Brisbane (Australia) over 8-weeks. RESULTS Data were collected from a total of 66 children (mean age 11, SD 4) and 38 parents (mean age 40, SD 8) of Māori and Pacific Islander background, from July 2018 to November 2019. Anthropometric changes included a reduction in Body Mass Index (BMI) z-score among 59% of children (median change -0.02, n = 38, p = 0.17) and BMI among 47% of adults (median change +0.06 kg/m2, n = 18, p = 0.64). Significant improvements (p < 0.05) in self-reported health behaviours from pre- to post-program included increased vegetable consumption among children, decreased discretionary food intake of children, decreased discretionary drink consumption among both children and adults, increased minutes of daily physical activity among adults and increased parental confidence in the healthy diets of their children. Qualitative data revealed participants valued the inclusion of all family members, learning of practical skills and cultural tailoring delivered by the Multicultural Health Coaches. CONCLUSIONS This study provides preliminary evidence that the Healthier Together program improved self-reported health behaviours and physical activity levels among Māori and Pacific Islander children and their families in the short-term; however, due to the small sample size, these results must be interpreted carefully. The program empowered change via cultural tailoring and accessibility; however, long-term implementation and evaluation with a larger cohort is needed to validate the observed health behaviour improvements and their sustainability. SO WHAT?: The co-design framework that informed program development and key learnings of implementation will provide guidance to health practitioners, health workers, public health professionals and policy makers to develop inclusive and pragmatic co-design solutions for priority cultural populations in Australia. Health outcomes will improve as a result, promoting health equity for future generations.
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Affiliation(s)
- Jessica Hardt
- Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
- Good Start Program, Child and Youth Community Health Service, Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, Australia
| | - Oliver J Canfell
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, Australia
| | - Jacqueline L Walker
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, Australia
| | - Kerri-Lyn Webb
- Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
- Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Department of Health, Queensland Government, Brisbane, Australia
| | - Sebastien Brignano
- Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
- Good Start Program, Child and Youth Community Health Service, Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
| | - Kirstine Kira
- Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
- Good Start Program, Child and Youth Community Health Service, Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
| | - Tevita Peu
- Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
- Good Start Program, Child and Youth Community Health Service, Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
| | - Daphne Santos
- Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
- Good Start Program, Child and Youth Community Health Service, Children's Health Queensland Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
| | - Anne Bernard
- QCIF Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Robyn Littlewood
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
- Health and Wellbeing Queensland, Queensland Government, Brisbane, Australia
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Barthow C, Krebs J, McKinlay E. A multiple case study of pre-diabetes care undertaken by general practice in Aotearoa/New Zealand: de-incentivised and de-prioritised work. BMC PRIMARY CARE 2023; 24:109. [PMID: 37120507 PMCID: PMC10147904 DOI: 10.1186/s12875-023-02053-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 04/02/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND In Aotearoa/New Zealand (NZ) general practices diagnose and manage pre-diabetes. This work is important as it has the potential to delay or prevent the onset of Type 2 Diabetes (T2DM), reduce NZ's health inequities, and the burden that T2DM places on health care services. However, no study has previously examined how this work routinely occurs in NZ. METHODS Two case studies of practices serving ethnically and socio-economically diverse populations, followed by cross-case analysis. RESULTS The NZ health care context including funding mechanisms, reporting targets, and the disease centred focus of care, acted together to dis-incentivise and de-prioritise pre-diabetes care in general practices. The social determinants of health differentially influenced patients' ability to engage with and respond to pre-diabetes care, significantly impacting this work. Differing perspectives about the significance of pre-diabetes and gaps in systematic screening practices were identified. Interventions used were inconsistent and lacked comprehensive ongoing support. CONCLUSIONS Complex multi-layered factors impact on pre-diabetes care, and many of the barriers cannot be addressed at the general practice level. The practice serving the most disadvantaged population who concurrently have higher rates of pre-diabetes/T2DM were more adversely affected by the barriers identified.
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Affiliation(s)
- Christine Barthow
- Department of Medicine, University of Otago, PO Box 7343, Wellington, Wellington South, 6242, New Zealand.
| | - Jeremy Krebs
- Department of Medicine, University of Otago, PO Box 7343, Wellington, Wellington South, 6242, New Zealand
| | - Eileen McKinlay
- Department of Primary Health Care & General Practice, University of Otago, PO Box 7343, Wellington, Wellington South, 6242, New Zealand
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Hornung RJ, Reed PW, Gunn AJ, Albert B, Hofman PL, Farrant B, Jefferies C. Transition from paediatric to adult care in young people with diabetes; A structured programme from a regional diabetes service, Auckland, New Zealand. Diabet Med 2023; 40:e15011. [PMID: 36398457 DOI: 10.1111/dme.15011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/26/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022]
Abstract
AIM To assess participation with a structured transition programme for adolescents with diabetes. METHODS Data from a regional cohort aged less than 16 years of age with type 1 (T1) and type 2 diabetes (T2D) in Auckland, New Zealand (2006-2016). Participation was defined as opting into a structured transition programme. RESULTS Five hundrend and twelve adolescents who were to be transferred to adult care (476 type 1 (T1D) and 36 type 2 (T2D)), overall participation rate of 83%, 86% (408/476) with T1D compared to 47% (17/36) with T2D. Within the cohort of T1D, participation rates for Māori and Pacific were lower (74% and 77%, respectively) than New Zealand Europeans (88%, p = 0.020 and p = 0.039, respectively). Lower socio-economic status was associated with reduced participation (77%) compared to higher socio-economic status (90%, p = 0.002). Of the 476 T1D who participated, 408 (96%) subsequently attended at least one adult service clinic ("capture"). 42% attended an adult clinic within the planned 3 months, 87% at 6 months and retention in adult clinics over 5 years of follow-up was 78%. By contrast, the 68 young people with T1D who did not participate in the structured transition had a capture rate of 78% (p < 0.001) and retention of 63% (p = 0.036). CONCLUSIONS In adolescents with diabetes, a formal transition from a paediatric service was associated with high rates of adult capture and subsequent retention in adult care over a 5-year follow-up period. Low socio-economic status, Māori or Pacific ethnicity and T2D were associated with reduced participation in the structured transition programme.
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Affiliation(s)
- Rosalie J Hornung
- Starship Children's Health, Paediatric Diabetes and Endocrinology Service, Auckland District Health Board, Auckland, New Zealand
| | - Peter W Reed
- Starship Children's Health Children's Research Centre, Auckland District Health Board, Auckland, New Zealand
| | - Alistair J Gunn
- Starship Children's Health, Paediatric Diabetes and Endocrinology Service, Auckland District Health Board, Auckland, New Zealand
- Department of Physiology, University of Auckland, Auckland, New Zealand
| | - Ben Albert
- Starship Children's Health, Paediatric Diabetes and Endocrinology Service, Auckland District Health Board, Auckland, New Zealand
| | - Paul L Hofman
- Starship Children's Health, Paediatric Diabetes and Endocrinology Service, Auckland District Health Board, Auckland, New Zealand
- The Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Bridget Farrant
- Centre for Youth Health, Counties Manukau District Health Board, Auckland, New Zealand
| | - Craig Jefferies
- Starship Children's Health, Paediatric Diabetes and Endocrinology Service, Auckland District Health Board, Auckland, New Zealand
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Inequity in access to continuous glucose monitoring and health outcomes in paediatric diabetes, a case for national continuous glucose monitoring funding: A cross-sectional population study of children with type 1 diabetes in New Zealand. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2023; 31:100644. [DOI: 10.1016/j.lanwpc.2022.100644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/17/2022] [Accepted: 10/30/2022] [Indexed: 11/18/2022]
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Barthow C, Pullon S, McKinlay E, Krebs J. It is time for a more targeted approach to prediabetes in primary care in Aotearoa New Zealand. J Prim Health Care 2022; 14:372-377. [PMID: 36592775 DOI: 10.1071/hc22089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/14/2022] [Indexed: 11/12/2022] Open
Abstract
Type 2 diabetes (T2DM), its related morbidities and entrenched diabetes-related inequities pose significant challenges for health care delivery systems in Aotearoa New Zealand (NZ). Primary care services undertake the majority of diabetes prevention work by initially detecting and managing those with prediabetes. In this viewpoint, we present available NZ data to highlight NZ trends in prediabetes and consider the current NZ clinical guidelines and the prediabetes care pathway. Multiple areas for improvement are identified to optimise diabetes prevention, potentially reduce T2DM inequities, and sustain more effective prediabetes management in primary care in NZ.
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Affiliation(s)
- Christine Barthow
- Department of Medicine, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Sue Pullon
- Department of Primary Health Care & General Practice, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand
| | - Eileen McKinlay
- Centre for Interprofessional Education, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Jeremy Krebs
- Department of Medicine, University of Otago, Wellington, PO Box 7343, Wellington South 6242, New Zealand
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Te’o DT, Wild CEK, Willing EJ, Wynter LE, O’Sullivan NA, Hofman PL, Maessen SE, Derraik JGB, Anderson YC. The Impact of a Family-Based Assessment and Intervention Healthy Lifestyle Programme on Health Knowledge and Beliefs of Children with Obesity and Their Families. Nutrients 2022; 14:nu14204363. [PMID: 36297048 PMCID: PMC9607640 DOI: 10.3390/nu14204363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/04/2022] [Accepted: 10/13/2022] [Indexed: 12/02/2022] Open
Abstract
Objective: To determine the impact of a family-based assessment-and-intervention healthy lifestyle programme on health knowledge and beliefs of children and families affected by obesity. Second, to compare the health knowledge of the programme cohort to those of a national cohort in Aotearoa/New Zealand (NZ). Design: This mixed-methods study collected health knowledge and health belief data in a questionnaire at baseline and 12-, 24-, and 60-month follow-up assessments. Health knowledge over time was compared with baseline knowledge and with data from a nationally representative survey. A data-driven subsumption approach was used to analyse open-text responses to health belief questions across the study period. Setting: Taranaki region, a mixed urban−rural setting in NZ. Participants: Participants (caregiver/child dyads) from the Whānau Pakari randomised trial. Results: A greater proportion of the cohort correctly categorised foods and drinks as healthy or unhealthy at 12 months compared to baseline for most questionnaire items. Retention of this health knowledge was evident at 24- and 60-month follow-ups. More than twice as many participants correctly reported physical activity recommendations at follow-up compared to baseline (p < 0.001). Health knowledge of participants was similar to the national survey cohort at baseline, but surpassed it at 12 and 24 months. Participant beliefs around healthy lifestyles related to physical functioning, mental and emotional wellbeing, and enhancement of appearance, and gained greater depth and detail over time. Conclusions: This study demonstrates the important role that community-level healthy lifestyle programmes can have in knowledge-sharing and health promotion.
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Affiliation(s)
- Dayna T. Te’o
- Department of Paediatrics, Taranaki Base Hospital, Taranaki District Health Board, David Street, New Plymouth 4310, New Zealand
| | - Cervantée E. K. Wild
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Esther J. Willing
- Kōhatu—Centre for Hauora Māori, Division of Health Sciences, University of Otago, Dunedin 9016, New Zealand
| | - Lisa E. Wynter
- Department of Paediatrics, Taranaki Base Hospital, Taranaki District Health Board, David Street, New Plymouth 4310, New Zealand
| | - Niamh A. O’Sullivan
- Department of Paediatrics, Taranaki Base Hospital, Taranaki District Health Board, David Street, New Plymouth 4310, New Zealand
| | - Paul L. Hofman
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Sarah E. Maessen
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - José G. B. Derraik
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Yvonne C. Anderson
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
- Enable Institute, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA 6102, Australia
- Telethon Kids Institute, Northern Entrance, Perth Children’s Hospital, 15 Hospital Avenue, Nedlands, WA 6009, Australia
- Community Health, Child and Adolescent Health Service, 2 Mill Street, Perth, WA 6000, Australia
- Correspondence:
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Hadley TS, Cave TL, Derraik JGB, Hofman PL, Anderson YC. Associations between changes in caregiver's and child's weight status in a community-based obesity intervention programme. Int J Obes (Lond) 2022; 46:1406-1409. [PMID: 35488029 PMCID: PMC9239902 DOI: 10.1038/s41366-022-01121-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES We examined whether caregivers of children/adolescents enroled in a randomised controlled trial (RCT) of a family-centred intervention indirectly achieved reductions in body mass index (BMI), and if these were associated with changes in their children's BMI. METHODS RCT participants were New Zealand children/adolescents aged 4.8-16.8 years with BMI ≥ 98th percentile or >91st with weight-related comorbidities. Participants and accompanying caregivers were assessed at baseline, 12, and 24 months. RESULTS Overall, caregivers' BMI was unchanged at 12 or 24 months. Among Māori participants, reductions in caregivers' BMI at 12 months were associated with reductions in their children's BMI SDS at 12 (r = 0.30; p = 0.038) and 24 months (r = 0.39; p = 0.009). Further, children identifying as Māori whose caregivers' BMI decreased at 12 months had greater BMI SDS reductions at 12 months [-0.30 (95% CI -0.49, -0.10); p = 0.004] and 24 months [-0.39 (95% CI -0.61, -0.16); p = 0.001] than children of caregivers with increased/unchanged BMI. CONCLUSIONS This intervention programme for children/adolescents with obesity did not indirectly reduce caregiver weight status. However, reductions in caregivers' BMI were key to BMI SDS reductions among Māori participants. Given the intergenerational nature of obesity, our findings highlight the importance of culturally relevant, family-focused programmes to achieve clinically meaningful improvements in weight status across the family.
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Affiliation(s)
- Thomas S Hadley
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Starship Children's Health, Auckland District Health Board, Auckland, New Zealand
| | - Yvonne C Anderson
- Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand. .,Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. .,enAble Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia. .,Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia. .,Community Health, Child and Adolescent Health Service, Perth, WA, Australia.
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Feasibility and effect of adding a concurrent parental component to a school-based wellness program using two modes of mobile-based technology - mixed methods evaluation of RCT. BMC Public Health 2022; 22:297. [PMID: 35164721 PMCID: PMC8842894 DOI: 10.1186/s12889-022-12581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study assessed the feasibility and effect of two mobile modes (WhatsApp vs. a specially designed app) in their delivery of updates and assignments to parents. METHODS Two three-armed, randomized, controlled feasibility studies were conducted. In each trial, four schools with a total of 418 students in grade 5th, mean age 10.1 years, were randomly allocated to the control arm, youth-only arm, or youth & parental component arm. Only the data of those that completed all three assessments (pre, post and 3 months post program) were analyzed: 133 in the first trial and 137 in the second. In the youth-only arm, students participated in an interactive age-tailored prevention program delivered in 10 weekly, 90-min sessions on self-care behaviors, media literacy, self-esteem, and positive body image. The control groups in both studies received three health- and nutrition-related sessions. In the parental arm, in addition to the 'Favoring-Myself-Young's ten sessions program, parents received updates and were requested to complete shared assignments with their children. In the first year, the assignments were sent via WhatsApp, and in the following year via "Favoring Myself" smartphone application. Facilitators were third year undergraduate students. They used a detailed semi-structured guide and received 4-weekly hours of didactic and group dynamic supervision. Mixed-methods assessments were performed using semi-structured interviews with ten parents and five school staff members each year, as well as a computerized self-report questionnaire. RESULTS Feasibility of parent-adolescent shared assignments in both digital modes was lower than expected. The use of WhatsApp had higher feasibility and uptake than the use of the special application. The addition of the concurrent parental component via WhatsApp was associated with superior improvement in self-esteem and identification of advertisement strategies, compared with the youth-only program. However, adolescents in the youth-only program delivered via the smartphone application demonstrated superior improvement compared to those in the youth and parental component arm. CONCLUSIONS Although the addition of the concurrent parenting component was praised by the actively participating parents, overall, under the chosen structure and population, it did not prove to add statistically significant value to the youth-only arm. TRIAL REGISTRATIONS NCT03216018 (12.7.2017) and NCT03540277 (26.4.2018).
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Barthow C, Pullon S, Weatherall M, Krebs J. They’re sicker than we think: an exploratory study profiling the cardio-metabolic health in a sample of adults with pre-diabetes in Aotearoa New Zealand. J Prim Health Care 2022; 14:221-228. [DOI: 10.1071/hc22068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/22/2022] [Indexed: 11/23/2022] Open
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Wild CEK, Rawiri NT, Cormack DM, Willing EJ, Hofman PL, Anderson YC. A Collaborative Indigenous-non-Indigenous Partnership Approach to Understanding Participant Experiences of a Community-Based Healthy Lifestyles Program. QUALITATIVE HEALTH RESEARCH 2021; 31:1404-1411. [PMID: 33703952 PMCID: PMC8278546 DOI: 10.1177/1049732321998640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We describe the approach of an Indigenous-non-Indigenous research partnership in the context of a qualitative study which aimed to understand barriers and facilitators to engagement in a community-based healthy lifestyles program in Aotearoa/New Zealand. Informed by Kaupapa Māori research principles and by "Community-Up" research values, this collaborative approach between the mixed Māori-non-Māori research team effectively engaged with Māori and non-Māori families for in-depth interviews on participant experience, including with non-service users. "Community-Up" research principles allowed for a respectful process which upheld the mana (status, dignity) of the interview participants and the research team. Challenges included maintaining flexibility in our conceptions of ethnicity to reflect the complexity of modern family life in Aotearoa/New Zealand. We were committed to ongoing communication, awareness, and attention to the relationships that formed the basis of our research partnership, which allowed effective navigation of challenges and was critical to the study's success.
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Affiliation(s)
- Cervantée E. K. Wild
- The University of Auckland, Auckland, New Zealand
- Tamariki Pakari Child Health and Wellbeing Trust, Taranaki, New Zealand
| | | | | | | | - Paul L. Hofman
- The University of Auckland, Auckland, New Zealand
- Auckland District Health Board, Auckland, New Zealand
| | - Yvonne C. Anderson
- The University of Auckland, Auckland, New Zealand
- Tamariki Pakari Child Health and Wellbeing Trust, Taranaki, New Zealand
- Taranaki District Health Board, New Plymouth, New Zealand
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12
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Wild CEK, Cave TL, Willing EJ, Derraik JGB, Grant CC, Hofman PL, Anderson YC. Correspondence: systematic reviews do not always capture context of real-world intervention programmes for childhood obesity (response to Littlewood, et al., 2020 in BMC Public Health). BMC Public Health 2021; 21:501. [PMID: 33715630 PMCID: PMC7958484 DOI: 10.1186/s12889-021-10486-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/23/2021] [Indexed: 11/23/2022] Open
Abstract
In a recent issue of the BMC Public Health journal, Littlewood et al. described the results of a systematic review of interventions to prevent or treat childhood obesity in Māori or Pacific Island peoples. They found that studies to date have had limited impact on improving health outcomes for Māori and Pacific Island peoples, and suggest this may be due to a lack of co-design principles in the conception of the various studies. Ensuring that interventions are appropriate for groups most affected by obesity is critical; however, some inaccuracies should be noted in the explanation of these findings. There is a risk with systematic reviews that the context of intervention trials is lost without acknowledging the associated body of literature for programmes that refer to the ongoing commitment to communities and groups most affected by obesity.
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Affiliation(s)
- Cervantée E K Wild
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. .,Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, New Zealand. .,Liggins Institute, University of Auckland, Auckland, New Zealand.
| | - Tami L Cave
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Esther J Willing
- Kōhatu - Centre for Hauora Māori, University of Otago, Dunedin, New Zealand
| | - José G B Derraik
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, New Zealand.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
| | - Yvonne C Anderson
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Tamariki Pakari Child Health and Wellbeing Trust, New Plymouth, New Zealand.,Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand
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