1
|
Tan L, Ganapathy SS, Lim KK, Ahmad NA. Development and Utility of an Interactive Online Dashboard for Monitoring Data Collection and Data Processing During a School-Based Health Survey. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:605-609. [PMID: 38870377 DOI: 10.1097/phh.0000000000001906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
We built an interactive online dashboard using Google Looker Studio to monitor data collection and data processing activities during the Adolescent Health Survey (AHS) 2022, a large-scale nationwide survey conducted among school-going adolescents in Malaysia. Through user testing and training, refinements were made to the initial dashboard, resulting in a more streamlined and concise dashboard design. The dashboard comprised 2 pages that provided key metrics on the progress of data collection and data processing, respectively. The introduction of the dashboard enhanced the quality and ease of weekly progress reporting during meetings of the survey's central coordinating team, while its drill-down and filtering functionalities helped us detect arising issues early and supported collaborative problem-solving. Research teams coordinating comparable school-based health surveys are invited to duplicate the dashboard using Looker Studio's built-in "Make a copy" function and customize it further based on their country- or survey-specific requirements.
Collapse
Affiliation(s)
- LeeAnn Tan
- Author Affiliations: Institute for Public Health, National Institutes of Health, and Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | | | | | | |
Collapse
|
2
|
Guell C, Saint Ville A, Anderson SG, Murphy MM, Iese V, Kiran S, Hickey GM, Unwin N. Small Island Developing States: addressing the intersecting challenges of non-communicable diseases, food insecurity, and climate change. Lancet Diabetes Endocrinol 2024; 12:422-432. [PMID: 38782517 DOI: 10.1016/s2213-8587(24)00100-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 05/25/2024]
Abstract
Small Island Developing States (SIDS) include 37 UN member countries sharing economic, environmental, and social vulnerabilities and intractable health challenges. In over 80% of SIDS, more than one in six adults die prematurely from a non-communicable disease (NCD), with poor diet being a major factor. Complex upstream food system determinants include marginalised local food production and reliance on low nutritional quality food imports. These drivers need to be seen against colonial and post-colonial political-economic legacies as well as the environmental and climate crises that challenge local production systems. A range of policy commitments (eg, the 2023 Bridgetown Declaration on NCDs and Mental Health) highlight these complex interdependencies and call for cross-sectoral food system policies to improve food security, food sovereignty, and nutrition, including integrating measures for climate change adaptation and mitigation. Although addressing these intersecting challenges will also depend on global efforts, the unique approach of SIDS can inform other settings.
Collapse
Affiliation(s)
- Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter Medical School, Penryn Campus, Penryn, UK
| | - Arlette Saint Ville
- Faculty of Food and Agriculture, University of the West Indies, St Augustine Campus, Trinidad and Tobago
| | - Simon G Anderson
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Bridgetown, Barbados
| | - Madhuvanti M Murphy
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Bridgetown, Barbados
| | - Viliamu Iese
- Pacific Centre for Environment and Sustainable Development, The University of the South Pacific, Suva, Fiji; School of Agriculture, Food and Ecosystem Sciences, The University of Melbourne, Dookie, VIC, Australia
| | - Sashi Kiran
- Foundation for Rural Integrated Enterprises and Development, Tuvu, Lautoka, Fiji; Ministry of Women, Children and Poverty Alleviation, Suva, Fiji
| | - Gordon M Hickey
- Department of Natural Resource Sciences, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Nigel Unwin
- European Centre for Environment and Human Health, University of Exeter Medical School, Penryn Campus, Penryn, UK; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
| |
Collapse
|
3
|
Palu A, Santos JA, Silatolu AM, Deo A, Bell C, Waqa G, Webster J, McKenzie BL. Energy, nutrient and overall healthiness of processed packaged foods in Fiji, a comparison between 2018 and 2020. BMC Public Health 2024; 24:1383. [PMID: 38783234 PMCID: PMC11112809 DOI: 10.1186/s12889-024-18787-1] [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: 01/08/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
In Fiji, packaged foods are becoming increasingly available. However, it is unknown if nutrition composition of these foods has changed. This study aims to assess changes in energy, nutrient content and healthiness of packaged foods by comparing data from five major supermarkets in Fiji in 2018 and 2020. Foods were categorised into 14 groups; nutrient composition information was extracted and healthiness assessed using Health Star Rating (HSR). Descriptive statistics and a separate matched products analysis was conducted summarising differences in nutrient content and HSR. There was limited evidence of change in the nutrient content of included products however, there was a small reduction in mean saturated fat in the snack food category (-1.0 g/100 g, 95% CI -1.6 to -0.4 g/100 g). The proportion of products considered healthy based on HSR, increased in the convenience foods category (28.4%, 95% CI 8.3 to 48.5) and decreased in non-alcoholic beverages (-35.2%, 95% CI -43.6 to -26.9). The mean HSR score increased in the fruit and vegetables category (0.1 (95% CI 0.1, 0.2)) and decreased for non-alcoholic beverages (-1.1 (-1.3, -0.9)) and the sauces, dressings, spreads, and dips category (-0.3 (-0.3, -0.2)). Strengthened monitoring of the food supply is needed to improve the healthiness of foods available.
Collapse
Affiliation(s)
- Aliyah Palu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Ana Moala Silatolu
- Pacific Research Centre for the Prevention of Obesity and Non-communicable Diseases, Fiji National University, Tamavua Campus, Suva, Fiji
| | | | - Colin Bell
- Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gade Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-communicable Diseases, Fiji National University, Tamavua Campus, Suva, Fiji
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| | - Briar L McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, 2042, Australia
| |
Collapse
|
4
|
Baffsky R, Koshiba C, Muna EL, Maua RF, Ivers R, Peden AE. Assessing violence and injury prevention plans, strategies and indicators in eighteen Pacific Islands countries: an environmental scan. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 44:100985. [PMID: 38226330 PMCID: PMC10788529 DOI: 10.1016/j.lanwpc.2023.100985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 01/17/2024]
Abstract
Background Similar to many other resource poor settings, due to competing priorities, injury is often neglected in the Pacific Islands despite being a prevalent cause of death and disability. This study identifies, and synthesises existing plans and strategies, and assesses progress against indicators for the prevention of violence and injury in 18 Pacific Islands nations to identify gaps and highlight opportunities. Methods An environmental scan of known government repositories and Google Advanced was conducted to identify publicly available documents describing/evaluating national-level injury prevention strategies and plans in the Pacific Islands. Data were extracted on the strategy/plan, country, government department responsible, indicators and related progress. Findings We identified 44 relevant documents. Most were published in more resourced countries (e.g., Fiji, Cook Islands) and described strategies/plans relating to traffic injury, injury from natural disaster and/or intimate partner violence. No strategies/plans to prevent injury mechanisms of drowning, falls, suffocation, burns, or electrocution were identified. Progress against only one indicator was reported for road traffic injury in the Commonwealth of the Northern Mariana Islands. Interpretation This study suggests that there would be benefit in Pacific Islands nations to develop more robust data systems to assess progress against indicators of existing strategies and plans for traffic-injury, natural disaster and intimate partner violence. Development of strategies and implementation plans to address neglected injury areas such as drowning and falls which account for a significant burden of injury in the Pacific Islands is also recommended. Funding This work was funded by the World Health Organization Regional Office for the Western Pacific (RG 221962).
Collapse
Affiliation(s)
- Rachel Baffsky
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Candace Koshiba
- Prevention Unit, Division of Behavioural Health, Ministry of Health and Health Services, Palau
| | - Esther L. Muna
- Commonwealth Healthcare Corporation, Saipan, MP, Northern Mariana Islands
| | | | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Amy E. Peden
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| |
Collapse
|
5
|
Tin STW, Na'ati E, Kubuabola I, Bertrand S, Soakai S, Vivili P, Kafoa B, Nasiga S, Ravuvu A. A Framework that Strengthens Legislative Measures to Halt and Reverse the Pacific Non-Communicable Diseases Crisis. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:219-221. [PMID: 37694218 PMCID: PMC10485767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
- Si Thu Win Tin
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Elisiva Na'ati
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Ilisapeci Kubuabola
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Solene Bertrand
- Public Health Division, Pacific Community (SPC), Noumea, New Caledonia (SB, BK)
| | - Sunia Soakai
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Paula Vivili
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Berlin Kafoa
- Public Health Division, Pacific Community (SPC), Noumea, New Caledonia (SB, BK)
| | - Selai Nasiga
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| | - Amerita Ravuvu
- Public Health Division, Pacific Community (SPC), Suva, Fiji (STWT, EN, IK, SS, PV, SN, AR)
| |
Collapse
|
6
|
Patay D, Schram A, Friel S. The challenges in protecting public health interests in multisectoral governance in the context of small island developing states: the case of tobacco control in Fiji and Vanuatu. Global Health 2023; 19:31. [PMID: 37118741 PMCID: PMC10142426 DOI: 10.1186/s12992-023-00931-y] [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: 10/13/2022] [Accepted: 04/19/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The commercial determinants of health (CDoH) drive the rise of NCDs globally, and their regulation requires multisectoral governance. Despite existing recommendations to strengthen institutional structures, protecting public health interests can be challenging amidst industry interference and conflicting policy priorities, particularly in low and middle-income countries (LMICs) where the need for rapid economic development is pronounced. Small island developing states (SIDS) face even more challenges in regulating CDoH because their unique socioeconomic, political, and geographic vulnerabilities may weaken institutional conditions that could aid health sector actors in protecting health interests. This study aims to explore the institutional conditions that shape health sector actors' capability to protect public health interests in tobacco governance in Fiji and Vanuatu. METHODS We employed a qualitative, exploratory case study design. We applied the administrative process theory to inform data collection and analysis. Seventy interviews were completed in Fiji and Vanuatu from 2018 to 2019. RESULTS The findings show that the protection of health interests in tobacco governance were not supported by the institutional conditions in Fiji and Vanuatu. While the policy processes formally ensured a level playing field between actors, policies were often developed through informal mechanisms, and the safeguards to protect public interests from vested private interests were not implemented adequately. SIDS vulnerabilities and weak regulation of political parties contributed to the politicisation of government in both states, resulting in high-level government officials' questionable commitment to protect public health interests. The system of checks and balances usually embedded into democratic governments appeared to be muted, and policymakers had limited bureaucratic autonomy to elevate health interests in multisectoral policymaking amidst high-level government officials' frequent rotation. Finally, capacity constraints aggravated by SIDS vulnerabilities negatively impacted health sector actors' capability to analyse policy alternatives. CONCLUSIONS Health sector actors in Fiji and Vanuatu were not supported by institutional conditions that could help them protect public health interests in multisectoral governance to regulate CDoH originating from the tobacco industry. Institutional conditions in these states were shaped by SIDS vulnerabilities but could be improved by targeted capacity building, governance and political system strengthening.
Collapse
Affiliation(s)
- Dori Patay
- School of Regulation and Global Governance, College of Asia and the Pacific, The Australian National University, Canberra, Australia.
- The George Institute for Global Health, Sydney, Australia.
- Menzies Centre for Health Policy and Economy, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Ashley Schram
- School of Regulation and Global Governance, College of Asia and the Pacific, The Australian National University, Canberra, Australia
| | - Sharon Friel
- School of Regulation and Global Governance, College of Asia and the Pacific, The Australian National University, Canberra, Australia
| |
Collapse
|
7
|
The role of trade in pacific food security and nutrition. GLOBAL FOOD SECURITY 2023. [DOI: 10.1016/j.gfs.2022.100670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
8
|
Mounsey S, Waqa G, McKenzie B, Reeve E, Webster J, Bell C, Thow AM. Strengthening implementation of diet-related non-communicable disease prevention strategies in Fiji: a qualitative policy landscape analysis. Global Health 2022; 18:79. [PMID: 36050736 PMCID: PMC9434519 DOI: 10.1186/s12992-022-00859-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Noncommunicable diseases (NCDs) are the leading cause of death globally, and the World Health Organization (WHO) has recommended a comprehensive policy package for their prevention and control. However, implementing robust, best-practice policies remains a global challenge. In Fiji, despite political commitment to reducing the health and economic costs of NCDs, prevalence of diabetes and cardiovascular disease remain the highest in the region. The objective of this study was to describe the political and policy context for preventing diet-related NCDs in Fiji and policy alignment with WHO recommendations and global targets. We used a case study methodology and conducted (1) semi-structured key informant interviews with stakeholders relevant to diet-related NCD policy in Fiji (n = 18), (2) documentary policy analysis using policy theoretical frameworks (n = 11), (3) documentary stakeholder analysis (n = 7), and (4) corporate political activity analysis of Fiji’s food and beverage industry (n = 12). Data were sourced through publicly available documents on government websites, internet searches and via in-country colleagues and analysed thematically. Results Opportunities to strengthen and scale-up NCD policies in Fiji in line with WHO recommendations included (1) strengthening multisectoral policy engagement, (2) ensuring a nutrition- and health-in-all policy approach, (3) using a whole-of-society approach to tighten political action across sectors, and (4) identifying and countering food industry influence. Conclusion Diet-related NCD policy in Fiji will be strengthened with clearly defined partner roles, responsibilities and accountability mechanisms, clear budget allocation and strong institutional governance structures that can support and counter industry influence. Such initiatives will be needed to reduce the NCD burden in Fiji. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00859-9.
Collapse
Affiliation(s)
- Sarah Mounsey
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, City Road, Sydney, NSW, 2006, Australia.
| | - Gade Waqa
- Fiji National University, Suva, Fiji
| | - Briar McKenzie
- The George Institute, City Road, Newtown, NSW, Australia
| | | | - Jacqui Webster
- The George Institute, City Road, Newtown, NSW, Australia
| | - Colin Bell
- School of Medicine and Global Obesity Centre, Geelong Waurn Ponds Campus, Deakin University, Melbourne, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, City Road, Sydney, NSW, 2006, Australia
| |
Collapse
|
9
|
Win Tin ST, Kubuabola I, Snowdon W, Cash HL, Na’ati E, Waqa GD, Moadsiri A, Bertrand S, Ravuvu A. Assessing the progress on the implementation of policy and legislation actions to address the Non-Communicable Diseases crisis in the Pacific. PLoS One 2022; 17:e0272424. [PMID: 35951506 PMCID: PMC9371336 DOI: 10.1371/journal.pone.0272424] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 07/19/2022] [Indexed: 11/19/2022] Open
Abstract
Aim
To assess the progress on the implementation of Non-Communicable Diseases (NCD) related policies and legislations in the Pacific Island Countries and Territories (PICTs).
Materials and methods
The Pacific Monitoring Alliance for NCD Action (MANA) Dashboard was used to assess the progress on the implementation. The MANA Dashboard includes 31 indicators across four different domains such as leadership and governance; preventative policies and legislations; health system response programs; and monitoring This progress assessment was conducted between 2019 and 2020 for all 21 PICTs. The data were analyzed and compared with the baseline status (2018) report and presented across four different domains of the MANA dashboard.
Results
This progress assessment found that PICTs overall have made advancements in a number of areas, particularly the establishment of a national multi-sectoral NCD taskforce; implementation of referenced approaches to restrict trans-fat in the food supply in national documents; and fiscal measures to affect access and availability to less healthy foods and drinks. However, the strengths of actions varied across PICTs, and most are categorised as low strengths. Measures which had the most limited progress in implementation include policy and legislation that restrict alcohol advertising; tobacco industry interference; marketing of foods and non-alcoholic beverages to children; and marketing for breast milk substitutes.
Conclusions
This progress assessment further highlights that while PICTs continue to make progress, NCD policy and legislation gaps still exist, both in terms of weaknesses of existing measures and areas that have had little attention to-date. These require urgent actions to scale up NCD related policies and legislation at regional and national level.
Collapse
Affiliation(s)
- Si Thu Win Tin
- Public Health Division, Pacific Community (SPC), Suva, Fiji
- * E-mail: ,
| | | | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organisation (WHO), Suva, Fiji
| | - Haley L. Cash
- Pacific Islands Health Officers’ Association (PIHOA), Honolulu, Hawaii
| | - Elisiva Na’ati
- Public Health Division, Pacific Community (SPC), Suva, Fiji
| | - Gade D. Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine, Nursing & Health Sciences, Fiji National University, Suva, Fiji
| | - Ada Moadsiri
- Division of Pacific Technical Support, World Health Organisation (WHO), Suva, Fiji
| | - Solene Bertrand
- Public Health, Division, Pacific Community (SPC), Noumea, New Caledonia
| | - Amerita Ravuvu
- Public Health Division, Pacific Community (SPC), Suva, Fiji
| |
Collapse
|
10
|
Reeve E, Lamichhane P, McKenzie B, Waqa G, Webster J, Snowdon W, Bell C. The tide of dietary risks for noncommunicable diseases in Pacific Islands: an analysis of population NCD surveys. BMC Public Health 2022; 22:1521. [PMID: 35948900 PMCID: PMC9364577 DOI: 10.1186/s12889-022-13808-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To describe changes over time in dietary risk factor prevalence and non-communicable disease in Pacific Island Countries (PICTs). METHODS Secondary analysis of data from 21,433 adults aged 25-69, who participated in nationally representative World Health Organization STEPs surveys in 8 Pacific Island Countries and Territories between 2002 and 2019. Outcomes of interest were changes in consumption of fruit and vegetables, hypertension, overweight and obesity, and hypercholesterolaemia over time. Also, salt intake and sugar sweetened beverage consumption for those countries that measured these. RESULTS Over time, the proportion of adults consuming less than five serves of fruit and vegetables per day decreased in five countries, notably Tonga. From the most recent surveys, average daily intake of sugary drinks was high in Kiribati (3.7 serves), Nauru (4.1) and Tokelau (4.0) and low in the Solomon Islands (0.4). Average daily salt intake was twice that recommended by WHO in Tokelau (10.1 g) and Wallis and Futuna (10.2 g). Prevalence of overweight/obesity did not change over time in most countries but increased in Fiji and Tokelau. Hypertension prevalence increased in 6 of 8 countries. The prevalence of hypercholesterolaemia decreased in the Cook Islands and Kiribati and increased in the Solomon Islands and Tokelau. CONCLUSIONS While some Pacific countries experienced reductions in diet related NCD risk factors over time, most did not. Most Pacific adults (88%) do not consume enough fruit and vegetables, 82% live with overweight or obesity, 33% live with hypertension and 40% live with hypercholesterolaemia. Population-wide approaches to promote fruit and vegetable consumption and reduce sugar, salt and fat intake need strengthening.
Collapse
Affiliation(s)
- Erica Reeve
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Prabhat Lamichhane
- School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
| | - Briar McKenzie
- Food Policy Division, The George Institute for Global Health, UNSW, 1 King St, Newtown, Sydney, Australia
| | - Gade Waqa
- Pacific Research Centre for Prevention of Obesity and Non-Communicable Disease (C-POND), Fiji National University, Suva, Fiji
| | - Jacqui Webster
- Food Policy Division, The George Institute for Global Health, UNSW, 1 King St, Newtown, Sydney, Australia
| | - Wendy Snowdon
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Colin Bell
- School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
| |
Collapse
|
11
|
Webster J, Waqa G, Thow AM, Allender S, Lung T, Woodward M, Rogers K, Tukana I, Kama A, Wilson D, Mounsey S, Dodd R, Reeve E, McKenzie BL, Johnson C, Bell C. Scaling-up food policies in the Pacific Islands: protocol for policy engagement and mixed methods evaluation of intervention implementation. Nutr J 2022; 21:8. [PMID: 35105346 PMCID: PMC8807012 DOI: 10.1186/s12937-022-00761-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/19/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND There is a crisis of non-communicable diseases (NCDs) in the Pacific Islands, and poor diets are a major contributor. The COVID-19 pandemic and resulting economic crisis will likely further exacerbate the burden on food systems. Pacific Island leaders have adopted a range of food policies and regulations to improve diets. This includes taxes and regulations on compositional standards for salt and sugar in foods or school food policies. Despite increasing evidence for the effectiveness of such policies globally, there is a lack of local context-specific evidence about how to implement them effectively in the Pacific. METHODS Our 5-year collaborative project will test the feasibility and effectiveness of policy interventions to reduce salt and sugar consumption in Fiji and Samoa, and examine factors that support sustained implementation. We will engage government agencies and civil society in Fiji and Samoa, to support the design, implementation and monitoring of evidence-informed interventions. Specific objectives are to: (1) conduct policy landscape analysis to understand potential opportunities and challenges to strengthen policies for prevention of diet-related NCDs in Fiji and Samoa; (2) conduct repeat cross sectional surveys to measure dietary intake, food sources and diet-related biomarkers; (3) use Systems Thinking in Community Knowledge Exchange (STICKE) to strengthen implementation of policies to reduce salt and sugar consumption; (4) evaluate the impact, process and cost effectiveness of implementing these policies. Quantitative and qualitative data on outcomes and process will be analysed to assess impact and support scale-up of future interventions. DISCUSSION The project will provide new evidence to support policy making, as well as developing a low-cost, high-tech, sustainable, scalable system for monitoring food consumption, the food supply and health-related outcomes.
Collapse
Affiliation(s)
- Jacqui Webster
- George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, Sydney, New South Wales, 2046, Australia.
| | - Gade Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases, Fiji National University, Suva, Fiji
| | - Anne-Marie Thow
- Menzies Centre for Health Policy, The University of Sydney, Sydney, Australia
| | - Steven Allender
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbourne, Australia
| | - Thomas Lung
- George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, Sydney, New South Wales, 2046, Australia
| | - Mark Woodward
- George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, Sydney, New South Wales, 2046, Australia.,George Institute for Global Health, Oxford University, Oxford, UK.,Johns Hopkins University, Baltimore, USA
| | - Kris Rogers
- George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, Sydney, New South Wales, 2046, Australia
| | | | - Ateca Kama
- Ministry of Health and Medical Services, Suva, Fiji
| | - Donald Wilson
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases, Fiji National University, Suva, Fiji
| | - Sarah Mounsey
- Menzies Centre for Health Policy, The University of Sydney, Sydney, Australia
| | - Rebecca Dodd
- George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, Sydney, New South Wales, 2046, Australia
| | - Erica Reeve
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbourne, Australia
| | - Briar Louise McKenzie
- George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, Sydney, New South Wales, 2046, Australia
| | - Claire Johnson
- George Institute for Global Health, University of New South Wales, 1 King Street, Newtown, Sydney, New South Wales, 2046, Australia
| | - Colin Bell
- Global Obesity Centre, School of Health and Social Development, Institute for Health Transformation, Deakin University, Melbourne, Australia
| |
Collapse
|
12
|
Progress and strength of response against noncommunicable diseases in the US-affiliated Pacific Island jurisdictions, 2010-2021. Western Pac Surveill Response J 2022; 13:1-10. [PMID: 35355902 PMCID: PMC8935315 DOI: 10.5365/wpsar.2022.13.1.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective To determine the effectiveness of the response to the 2010 declared regional noncommunicable diseases (NCDs) emergency in nine US-affiliated Pacific Island jurisdictions. Methods Vital statistics and risk prevalence surveys were retrospectively reviewed using 14 standardized NCD risk, prevalence and death rate indicators to measure changes in health status over time. NCD risk and prevalence change scores were derived from subsets of these indicators, and NCD composite death rates were examined. An NCD strength-of-intervention score derived from a standardized regional monitoring tool provided measures for assessing responses aimed at curbing risk factors, prevalence and death rates. Associations between the strength-of-intervention score and changes in health status were examined. Results Pairs of values were available for 97 of 126 individual comparisons for 14 core indicators in nine jurisdictions. The composite mean prevalence of all risk factors across the jurisdictions between baseline and follow-up (26.7% versus 24.3%, P = 0.34) and the composite mean diabetes and hypertension prevalence (28.3% versus 28.2%, P = 0.98) were unchanged, while NCD death rates increased (483.0 versus 521.9 per 100 000 per year, P < 0.01). The composite strength-of-intervention score for the region was 37.2%. Higher strength-of-intervention scores were associated with improvements in health indicators. Discussion Despite some improvements in selected NCD indicators at the jurisdiction level, there was no significant overall change in the prevalence of risk factors, diabetes and hypertension, and death rates have continued to increase since the NCD emergency declaration. However, the adoption of public sector NCD interventions was associated with improvements in health indicators.
Collapse
|
13
|
Sacks G, Kwon J, Vandevijvere S, Swinburn B. Benchmarking as a Public Health Strategy for Creating Healthy Food Environments: An Evaluation of the INFORMAS Initiative (2012-2020). Annu Rev Public Health 2021; 42:345-362. [PMID: 33351647 DOI: 10.1146/annurev-publhealth-100919-114442] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Diet-related noncommunicable diseases (NCDs) and obesity are the leading contributors to poor health worldwide. Efforts to improve population diets need to focus on creating healthy food environments. INFORMAS, established in 2012, is an international network that monitors and benchmarks food environments and related policies. By 2020, INFORMAS was active in 58 countries; national government policies were the most frequent aspect benchmarked. INFORMAS has resulted in the development and widespread application of standardized methods for assessing the characteristics of food environments. The activities of INFORMAS have contributed substantially to capacity building, advocacy, stakeholder engagement, and policy evaluation in relation to creating healthy food environments. Future efforts to benchmark food environments need to incorporate measurements related to environmental sustainability. For sustained impact, INFORMAS activities will need to be embedded within other existing monitoring initiatives. The most value will come from repeated assessments that help drive increased accountability for improving food environments.
Collapse
Affiliation(s)
- Gary Sacks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria 3125, Australia; ,
| | - Janelle Kwon
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Burwood, Victoria 3125, Australia; ,
| | | | - Boyd Swinburn
- School of Population Health, The University of Auckland, St. Johns, Auckland 1072, New Zealand;
| |
Collapse
|
14
|
Odrovakavula L, Mohammadnezhad M. "Everything else is going to be ok if your spiritual wellness is well". A qualitative exploration of wellness amongst secondary school students in Fiji. Int J Qual Stud Health Well-being 2021; 16:2001895. [PMID: 34806562 PMCID: PMC8843379 DOI: 10.1080/17482631.2021.2001895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Purpose Adolescent wellness over the years has been a major public health concern. The adolescent period is stated to be a critical phase as developments occur in all areas of the individual. This study aims to explore secondary school students’ perceptions on knowledge of wellness, influences of wellness, prioritization of wellness dimensions and ideal adolescent wellness programmes in Fiji. Method This study qualitatively investigates adolescents in four purposively selected schools in Suva, Fiji. 31 students who enrolled into years 11 to 13 in the selected schools were interviewed in-depthly using a semi-structured, open-ended questionnaire. Data was transcribed and classified into categories, sub-themes and major themes. Results Participants’ responses indicated wellness perceived as multidimensional with no regard to dimensional balance. Family, peers and school support, social media, nutrition and physical activities are factors perceived to influence wellness. The availability of school counsellors, facilitation of effective school health programmes, and incorporation of wellness into the school curriculum were perceived as ideal ways to increase adolescent wellness. Conclusions This study provides important research findings of adolescent wellness for Fiji’s health sector, its policymakers and programme developers. Further studies are needed to understand the broad concept of wellness and its several dimensions.
Collapse
Affiliation(s)
- Latileta Odrovakavula
- Public Health, School of Public Health and Primary Care, Fiji National University, Suva Fiji Islands
| | - Masoud Mohammadnezhad
- Public Health (Health Promotion), School of Public Health and Primary Care, Fiji National University, Suva Fiji Islands
| |
Collapse
|
15
|
Paulino YC, Ada A, Dizon J, Benavente ERJ, Campbell KMDL, Cristobal B, Daughtry A, Estabillo LMO, Flisco VDC, Badowski G, Hattori-Uchima M. Development and evaluation of an undergraduate curriculum on non-communicable disease research in Guam: The Pacific Islands Cohort of College Students (PICCS). BMC Public Health 2021; 21:1994. [PMID: 34732169 PMCID: PMC8567551 DOI: 10.1186/s12889-021-12078-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The non-communicable disease (NCD) epidemic among Pacific Islanders prompted the declaration of a regional state of NCD emergency throughout the United States-Affiliated Pacific Islands (USAPIs) in 2010. Subsequently, the University of Guam Health Science Program launched a pilot study on NCD research in its undergraduate curriculum modeled after the Pacific Data for Decision Making (DDM) framework - a field epidemiology training program employed in the USAPIs. The primary objective of the research is to conduct annual assessments of student health indicators with plans for longitudinal follow-up. Here, development and evaluation of the undergraduate research curriculum are described. METHODS The Pacific DDM framework covering knowledge and skills in resourcing, types of data and indicators, data sources, data management, information products, and data dissemination and use were incorporated in undergraduate core courses of the Health Science Program. During the data collection pilot years, 2013 and 2014, a survey containing questions predominantly on NCD risk factors was launched at the university. The survey was administered by upperclassmen in the Health Science Program and evolved into the Pacific Islands Cohort of College Students (PICCS) research study. The initial years were spent developing the infrastructure. Program outputs were tracked annually to measure program success. RESULTS Students in the Health Science Program obtained research knowledge and skills through various courses while enrolled in the program. The PICCS data collection continued annually as a cross-sectional survey from 2015 to current. Numerous successes have resulted including student abstracts and publications, acceptances to summer programs and fellowships, a sustained annual health fair for college students, a grant award, and other program-related impacts. CONCLUSION The PICCS framework provided the organizational structure and documented tools, protocols, roles, and responsibilities to enhance consistency and reproducibility. Undergraduate students applied their knowledge and skills to an ongoing study focused on NCD risk factor surveillance of college students. Additionally, multiple research successes have been achieved through the PICCS curriculum. Plans are underway to begin the longitudinal design of the PICCS research study and sustain it through the curriculum, with room for adaptation as courses are updated over time.
Collapse
Affiliation(s)
- Yvette C Paulino
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA.
| | - Anthony Ada
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | - John Dizon
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | | | | | - Breinard Cristobal
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | - Alexandria Daughtry
- University of Guam, School of Health, University Drive, Mangilao, GU, 96923, USA
| | | | - Victoria Diana Cruz Flisco
- University of Guam, College of Natural & Applied Sciences, Biology Program, University Drive, Mangilao, GU, 96923, USA
| | - Grazyna Badowski
- University of Guam, College of Natural & Applied Sciences, Mathematics Program, University Drive, Mangilao, GU, 96923, USA
| | | |
Collapse
|
16
|
Cash HL, De Jesus S, Durand AM, Tin STW, Shelton D, Robles R, Mendiola AR, Brikul S, Ipil M, Murphy M, Hunt LSS, Nielsen Lesa F, Sigrah CA, Waguk R, Abraham D, Kapiriel SF, Camacho J, Chutaro E. 'Hybrid Survey' approach to non-communicable disease surveillance in the US-Affiliated Pacific Islands. BMJ Glob Health 2021; 6:bmjgh-2021-006971. [PMID: 34706881 PMCID: PMC8552153 DOI: 10.1136/bmjgh-2021-006971] [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: 08/04/2021] [Accepted: 10/08/2021] [Indexed: 11/12/2022] Open
Abstract
In 2010 the US-Affiliated Pacific Islands (USAPI) declared a regional state of health emergency due to the epidemic of non-communicable disease (NCD) and an NCD monitoring and surveillance framework was developed that includes adult NCD risk factor and disease prevalence indicators to be collected every 5 years using a population-based survey. On evaluation of existing data from adult population-based NCD surveys, it was found that there was a lack of valid, available and consistently collected data. Therefore, a new model was developed to combine various indicators and survey tools from different partner agencies into one survey. After the report was endorsed by local health leadership, a dissemination workshop was conducted. In 2015 (baseline for Hybrid Survey implementation), three out of nine jurisdictions (33.3%) had completed a population-based survey in the past 5 years. Four (44.4%) had no adult prevalence data at all, two (22.2%) had data sets from their surveys and four (44.4%) had at least two surveys ever collected that could be used for comparison. As of 2020, all nine jurisdictions have, or are in the process of completing an adult population-based survey. Eight (88.9%) have data sets from their surveys, and five (55.6%) have at least two surveys collected that can be used for comparison. This Hybrid Survey model has helped to improve adult NCD surveillance in the USAPI by more efficiently using limited resources. This model could be considered in other small island nations, or rural areas where adult NCD surveillance is challenging.
Collapse
Affiliation(s)
- Haley L Cash
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
| | - Stacy De Jesus
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - A Mark Durand
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
| | - Si Thu Win Tin
- Public Health Division, Secretariat of the Pacific Community Suva Regional Office, Suva, Fiji
| | - Dana Shelton
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Rebecca Robles
- Division of Public Health, Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands
| | - Amber R Mendiola
- Public Health Division, Commonwealth Healthcare Corporation, Saipan, Northern Mariana Islands
| | - Suzette Brikul
- Non-Communicable Disease Unit, Republic of Palau Ministry of Health, Koror, Palau
| | - Maybelline Ipil
- Marshall Islands Epidemiology and Prevention Initiatives, Majuro, Marshall Islands
| | - Molly Murphy
- Marshall Islands Epidemiology and Prevention Initiatives, Majuro, Marshall Islands
| | - Leiema S S Hunt
- American Samoa Department of Health, Pago Pago, American Samoa
| | | | | | - Robina Waguk
- Kosrae State Department of Health, Tofol, Micronesia
| | - Delpihn Abraham
- Pohnpei State Department of Health and Social Services, Palikir, Micronesia
| | | | - Janet Camacho
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
| | - Emi Chutaro
- Pacific Island Health Officers Association, Honolulu, Hawaii, USA
| |
Collapse
|
17
|
Guell C, Brown CR, Iese V, Navunicagi O, Wairiu M, Unwin N. "We used to get food from the garden." Understanding changing practices of local food production and consumption in small island states. Soc Sci Med 2021; 284:114214. [PMID: 34274709 DOI: 10.1016/j.socscimed.2021.114214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 02/11/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
Many Small Island Developing States (SIDS) lead global rates in obesity and non-communicable chronic diseases (NCDs). Drivers for this are complex and include lack of food sovereignty, evidenced by an increasing reliance on cheap nutrient-poor food imports and a focus on export orientated cash crop production for much local agriculture. To better inform SIDS' policy goals of improving nutrition through increased local food production, we explored in two SIDS current practices of food production and consumption. Teams of researchers from the two main regional universities conducted 28 focus groups in Fiji in the Pacific and Saint Vincent and the Grenadines in the Caribbean with rural and urban communities of different socio-economic or land-owning status. In both countries home gardens were still common, valued as providing staple foods to households and contributing to health and livelihoods. Yet social changes had been experienced over the life course and across generations, such as increased purchase of foods, consumption of processed and often imported foods, and fast foods. While participants associated local foods with better nutrition and health outcomes than imported foods, some local foods were also acknowledged as unhealthy (e.g. locally produced tinned products, pesticide contaminated fresh produce). Finally, as food and related health advice moves globally, crossing national boundaries, and through formal and informal channels, local experiences can be confusing and contested. We suggest the need to understand temporal and spatial aspects of social practices, as social practices and their meaning change over time, travel globally and are experienced locally. To enhance and support re-localising food to counteract unhealthy consumption of ultra-processed, shop-bought, often imported foods, it is vital to understand these lived experiences of changes and resulting uncertainties, and to explicitly build on the longstanding positive relationships that people continue to express about home gardens and local food.
Collapse
Affiliation(s)
- Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK.
| | - Catherine R Brown
- George Alleyne Chronic Disease Research Centre, The University of the West Indies, Bridgetown, Barbados
| | - Viliamu Iese
- Pacific Centre for Environment and Sustainable Development, The University of the South Pacific, Suva, Fiji
| | - Otto Navunicagi
- Pacific Centre for Environment and Sustainable Development, The University of the South Pacific, Suva, Fiji
| | - Morgan Wairiu
- Pacific Centre for Environment and Sustainable Development, The University of the South Pacific, Suva, Fiji
| | - Nigel Unwin
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | |
Collapse
|
18
|
Malekzadeh R, Yaghoubian S, Hasanpoor E, Ghasemi M. Health system responsiveness in Iran: a cross-sectional study in hospitals of Mazandaran province. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2021. [DOI: 10.1108/ijhrh-03-2020-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Responsiveness is a reaction to the reasonable expectations of patients regarding ethical and non-clinical aspects of the health-care system. Responsiveness is a characteristic of health-care system and the observance of the patient’s rights. The purpose of this study is to compare the responsiveness of the health-care system based on the hospital ownership in Mazandaran province in Iran.
Design/methodology/approach
The cross-sectional study design was used on 1,083 patients referred to public and private hospitals and hospitals affiliated to social security organization in Mazandaran province in 2017. The World Health Organization’s responsibility questionnaire was used to collect data. Data were analyzed by using SPSS version 21. Descriptive statistics and one-way ANOVA results are presented is the results section.
Findings
All responsiveness dimensions were salient for respondents. The response rate in the selected hospitals was very close, which ranged from 85.7 to 90.2%, and there was no significant difference between public, private and social security hospitals (p > 0.05). The most crucial responsiveness dimension in hospitals was autonomy.
Originality/value
In the current study, the dimensions of communication and confidentiality were identified as priority dimensions based on the least score for breeding actions to improve the responsiveness of the health-care system. At the end, some useful recommendations such as re-engineering the processes, training to engage the employees with patients and encouraging them to fill the gap were suggested.
Collapse
|
19
|
Matenga-Ikihele A, McCool J, Dobson R, Fa'alau F, Whittaker R. The characteristics of behaviour change interventions used among Pacific people: a systematic search and narrative synthesis. BMC Public Health 2021; 21:435. [PMID: 33663438 PMCID: PMC7931368 DOI: 10.1186/s12889-021-10420-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/10/2021] [Indexed: 11/19/2022] Open
Abstract
Background Pacific people living in New Zealand, Australia, United States, and the Pacific region continue to experience a disproportionately high burden of long-term conditions, making culturally contextualised behaviour change interventions a priority. The primary aim of this study was to describe the characteristics of behaviour change interventions designed to improve health and effect health behaviour change among Pacific people. Methods Electronic searches were carried out on OVID Medline, PsycINFO, PubMed, Embase and SCOPUS databases (initial search January 2019 and updated in January 2020) for studies describing an intervention designed to change health behaviour(s) among Pacific people. Titles and abstracts of 5699 papers were screened; 201 papers were then independently assessed. A review of full text was carried out by three of the authors resulting in 208 being included in the final review. Twenty-seven studies were included, published in six countries between 1996 and 2020. Results Important characteristics in the interventions included meaningful partnerships with Pacific communities using community-based participatory research and ensuring interventions were culturally anchored and centred on collectivism using family or social support. Most interventions used social cognitive theory, followed by popular behaviour change techniques instruction on how to perform a behaviour and social support (unspecified). Negotiating the spaces between Eurocentric behaviour change constructs and Pacific worldviews was simplified using Pacific facilitators and talanoa. This relational approach provided an essential link between academia and Pacific communities. Conclusions This systematic search and narrative synthesis provides new and important insights into potential elements and components when designing behaviour change interventions for Pacific people. The paucity of literature available outside of the United States highlights further research is required to reflect Pacific communities living in New Zealand, Australia, and the Pacific region. Future research needs to invest in building research capacity within Pacific communities, centering self-determining research agendas and findings to be led and owned by Pacific communities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10420-9.
Collapse
Affiliation(s)
- Amio Matenga-Ikihele
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. .,Moana Research, Nga Hau Māngere Birthing Centre, 14 Waddon Place, Auckland, Māngere, New Zealand.
| | - Judith McCool
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Rosie Dobson
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Fuafiva Fa'alau
- Pacific Health Section, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| |
Collapse
|
20
|
Abstract
PURPOSE OF REVIEW Childhood obesity is increasing substantially in many Pacific island countries and poses an urgent and serious challenge. The Sustainable Development Goals set by the United Nations and the NCD Roadmap created at the request of the Pacific Finance and Economic Ministers identify prevention and control of noncommunicable diseases as core priorities. Among the various risk factors responsible for the development of noncommunicable diseases (NCDs), overweight and obesity are particularly of concern with the potential to negate many of the health benefits that have contributed to increased life expectancy. With the increase in childhood obesity across the region, it has become apparent that surveillance data remains a challenge; however, it is essential to inform the development of effective policies and strategies to tackle the challenge of childhood obesity in the Pacific region. RECENT FINDINGS The paper highlights the paucity of childhood obesity surveillance data available in the Pacific region and how the absence of a standardised tool to collect this data makes it difficult to do comparative analysis between countries. Drawing on a global protocol and identifying the gaps that currently exist in the region, the paper aims to highlight opportunities via which childhood obesity surveillance data can be improved to monitor better childhood obesity across the Pacific region.
Collapse
Affiliation(s)
- Amerita Ravuvu
- Non-Communicable Disease Policy & Planning Adviser, Public Health Division, Pacific Community (SPC), C/- Pacific Community (SPC), Private Mail Bag, Suva, Fiji.
| | - Gade Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji Institute of Pacific Health Research, College of Medicine, Nursing & Health Sciences, Fiji National University (FNU), Suva, Fiji
| |
Collapse
|
21
|
Van Dyne EA, Saraiya M, White A, Novinson D, Senkomago V, Buenconsejo-Lum L. Cancer Mortality in the US-Affiliated Pacific Islands, 2008-2013. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:99-107. [PMID: 32596686 PMCID: PMC7311947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cancer-related mortality in the US-Affiliated Pacific Island (USAPI) jurisdictions is unknown. This is the first ever reporting of cancer-related mortality in the USAPI using cancer registry data. The individual USAPI jurisdictions collected incident cancer data and submitted it to the Pacific Regional Central Cancer Registry (PRCCR). All cases reported to PRCCR (n = 3,118) with vital status of dead (n = 1,323) during 2008-2013 were examined. Cause of death was coded based on clinical information provided in the cancer registry. Incidencebased mortality (IBM) rates were calculated using SEER*Stat software and age adjusted to the US standard population. Total cancer IBM rates among males were highest in Palau (151.5 per 100,000), Republic of the Marshall Islands (RMI, 142.0), and Guam (133.2); rates were lowest in American Samoa (21.7), the Commonwealth of the Northern Mariana Islands (CNMI, 22.7), and the Federated States of Micronesia (FSM, 28.9). Total cancer IBM rates among females were highest in RMI (120.3 per 100,000), Palau (107.7), and Guam (72.2); rates were lowest in CNMI (19.0), FSM (23.2), and American Samoa (42.8). The median time from cancer diagnosis to death was 8-28 days in the Freely Associated States and 102-128 days in the Flag Territories. IBM rates were higher among individuals in USAPI jurisdictions than among Asian/ Pacific Islanders in Hawai'i for many cancers preventable through vaccination, smoking cessation, overweight and obesity prevention, and cancer screening. Geographic remoteness, underreporting, delay in reporting, and challenges with accurate death registration and certification led to lower IBM rates for some jurisdictions. These mortality data can help prioritize evidence-based interventions to reduce cancer-related deaths through risk factor reduction, early detection, and improved quality of life after a cancer diagnosis through palliative care.
Collapse
Affiliation(s)
- Elizabeth A. Van Dyne
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Arica White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Daniel Novinson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Virginia Senkomago
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Lee Buenconsejo-Lum
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| |
Collapse
|
22
|
Diet and childhood obesity in small island developing states. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 3:445-447. [PMID: 31178025 DOI: 10.1016/s2352-4642(19)30149-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 05/08/2019] [Indexed: 12/28/2022]
|
23
|
Win Tin ST, Kubuabola I, Ravuvu A, Snowdon W, Durand AM, Vivili P, Passmore E. Baseline status of policy and legislation actions to address non communicable diseases crisis in the Pacific. BMC Public Health 2020; 20:660. [PMID: 32398159 PMCID: PMC7216373 DOI: 10.1186/s12889-020-08795-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-Communicable Diseases (NCD) are the leading cause of death in the Pacific Island Countries and Territories (PICTs) accounting for approximately 70% of mortalities. Pacific leaders committed to take action on the Pacific NCD Roadmap, which specifies NCD policy and legislation. To monitor progress against the NCD Roadmap, the Pacific Monitoring Alliance for NCD Action (MANA) was formed and the MANA dashboard was developed. This paper reports on the first status assessment for all 21 PICTs. METHODS The MANA Dashboard comprises 31 indicators across the domains of leadership and governance, preventive policies, health system response and monitoring processes, and uses a 'traffic light' rating scheme to track progress. The dashboard indicators draw on WHO's best-buy interventions and track highly cost-effective interventions for addressing NCDs. The MANA coordination team in collaboration with national NCD focal points completed Dashboards for all 21 PICTs between 2017 and 2018 in an agreed process. The data were analysed and presented within each area of the MANA dashboard. RESULTS This assessment found that PICTs are at varying stages of developing and implementing NCD policy and legislation. Some policy and legislation are in place in most PICTs e.g. smoke free environment (18 PICTs), alcohol licensing (19 PICTs), physical education in schools (14 PICTs), reduction of population salt consumption (14 PICTs) etc. However, no PICTs has policy or legislation on tobacco industry interference, controlling marketing of foods and drinks to children, and reducing trans-fats in the food supply, and only 7 PICTs have policies restricting alcohol advertising. Eighteen PICTs implement tobacco taxation measures, however only five were defined as having strong measures in place. Nineteen PICTs have alcohol taxation mechanisms and 13 PICTs have fiscal policies on foods to promote healthier diets. CONCLUSION This baseline assessment fills a knowledge gap on current strengths and areas where more action is needed to scale up NCD action in a sustained 'whole of government and whole of society approach' in PICTs. The findings of this assessment can be used to identify priority actions, and as a mutual accountability mechanism to track progress on implementation of NCD policy and legislation at both national and Pacific level.
Collapse
Affiliation(s)
- Si Thu Win Tin
- Public Health Division, Pacific Community (SPC), Suva, Fiji. .,The Boden Institute, the Sydney Medical School, The University of Sydney, Sydney, Australia.
| | | | - Amerita Ravuvu
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), College of Medicine, Nursing & Health Sciences, Fiji National University, Suva, Fiji
| | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organisation (WHO), Suva, Fiji
| | - A Mark Durand
- Pacific Islands Health Officials Association (PIHOA), Honolulu, HI, USA
| | - Paula Vivili
- Public Health, Division, Pacific Community (SPC), Noumea, New Caledonia
| | - Erin Passmore
- Public Health Division, Pacific Community (SPC), Suva, Fiji
| |
Collapse
|
24
|
Vandevijvere S, Mackay S, D'Souza E, Swinburn B. The first INFORMAS national food environments and policies survey in New Zealand: A blueprint country profile for measuring progress on creating healthy food environments. Obes Rev 2019; 20 Suppl 2:141-160. [PMID: 31483561 DOI: 10.1111/obr.12850] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/13/2019] [Accepted: 02/26/2019] [Indexed: 12/30/2022]
Abstract
The International Network for Food and Obesity/NCDs Research, Monitoring and Action Support aims to benchmark national food environments. This study proposes a blueprint country profile to measure progress on creating healthy food environments, based on the results of the first, comprehensive survey in New Zealand (NZ). We assessed the implementation of national food environment policies and food industry commitments to improve population nutrition and the strength and comprehensiveness of public sector settings' nutrition policies. The healthiness of the packaged food supply, including health-related labelling, was evaluated. Food environments were measured in 833 schools, 204 supermarkets, 1500 takeaway outlets, 28 hospitals, 70 sport centres, and around all NZ schools. Food swamps, defined as areas with high relative density of unhealthy food outlets, were identified, and food marketing to children on television, websites, social media and packages, in magazines, and in and around schools was measured. The cost differential between healthy and current household diets was calculated for different population groups. NZ's food environment profile is largely unhealthy, and there are inequalities in access to healthy food environments. It is anticipated that the proposed country profile can help other countries tackle unhealthy food environments through increasing accountability of governments and the industry.
Collapse
Affiliation(s)
- Stefanie Vandevijvere
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Sally Mackay
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Erica D'Souza
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| | - Boyd Swinburn
- School of Population Health, Department of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
25
|
The politics of food in the Pacific: coherence and tension in regional policies on nutrition, the food environment and non-communicable diseases. Public Health Nutr 2019; 23:168-180. [PMID: 31511108 DOI: 10.1017/s1368980019002118] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Our study analysed evolving regional commitments on food policy in the Pacific. Our aim was to understand regional priorities and the context of policy development, to identify opportunities for progress. DESIGN We analysed documentation from a decade of regional meetings in order to map regional policy commitments relevant to healthy diets. We focused on agriculture, education, finance, health, and trade sectors, and Heads of State forums. Drawing on relevant political science methodologies, we looked at how these sectors 'frame' the drivers of and solutions to non-communicable diseases (NCD), their policy priorities, and identified areas of coherence and tension. SETTING The Pacific has among the highest rates of non-communicable diseases in the world, but also boasts an innovative and proactive response. Heads of State have declared NCD a 'crisis' and countries have committed to specific prevention activities set out in a regional 'Roadmap'. Yet, diet-related NCD risk-factors remain stubbornly high and many countries face challenges in establishing a healthy food environment. RESULTS Policies to improve food environments and prevent NCD are a stated priority across regional policy forums, with clear agreement on the need for a multi-sectoral response. However, we identified challenges in sustaining these priorities as political attention fluctuated. We found examples of inconsistencies and tension in sectoral responses to the NCD epidemic that may restrict implementation of the multi-sectoral action. CONCLUSION Understanding the priorities and positions underpinning sectoral responses can help drive a more coherent NCD response, and lessons from the Pacific are relevant to public health nutrition policy and practice globally.
Collapse
|
26
|
Sarfati D, Dyer R, Sam FAL, Barton M, Bray F, Buadromo E, Ekeroma A, Foliaki S, Fong J, Herman J, Huggins L, Maoate K, Meredith I, Mola G, Palafox N, Puloka V, Shin HR, Skeen J, Snowdon W, Tafuna'i M, Teng A, Watters D, Vivili P. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncol 2019; 20:e475-e492. [PMID: 31395476 PMCID: PMC7746436 DOI: 10.1016/s1470-2045(19)30400-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 01/03/2023]
Abstract
This Series paper describes the current state of cancer control in Pacific island countries and territories (PICTs). PICTs are diverse but face common challenges of having small, geographically dispersed, isolated populations, with restricted resources, fragile ecological and economic systems, and overburdened health services. PICTs face a triple burden of infection-related cancers, rapid transition to lifestyle-related diseases, and ageing populations; additionally, PICTs are increasingly having to respond to natural disasters associated with climate change. In the Pacific region, cancer surveillance systems are generally weaker than those in high-income countries, and patients often present at advanced cancer stage. Many PICTs are unable to provide comprehensive cancer services, with some patients receiving cancer care in other countries where resources allow. Many PICTs do not have, or have poorly developed, cancer screening, pathology, oncology, surgical, and palliative care services, although some examples of innovative cancer planning, prevention, and treatment approaches have been developed in the region. To improve cancer outcomes, we recommend prioritising regional collaborative approaches, enhancing cervical cancer prevention, improving cancer surveillance and palliative care services, and developing targeted treatment capacity in the region.
Collapse
Affiliation(s)
- Diana Sarfati
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand.
| | - Rachel Dyer
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Filipina Amosa-Lei Sam
- Pathology Department, Tupua Tamasese Meaole Hospital, Private Bag National Health Services, Apia, Samoa
| | - Michael Barton
- Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Eka Buadromo
- Pathology Department, Vaiola Hospital, Nuku'alofa, Tonga
| | - Alec Ekeroma
- Department of Obstetrics and Gynaecology, National University of Samoa, Apia, Samoa; Department of Obstetrics and Gynaecology, University of Otago, Wellington, New Zealand
| | - Sunia Foliaki
- Centre for Public Health Research, Massey University-Wellington Campus, Wellington, New Zealand
| | - James Fong
- Obstetrics and Gynaecology Unit, Colonial War Memorial Hospital, Ministry of Health, Suva, Fiji; Department of Obstetrics and Gynaecology, Fiji National University, Suva, Fiji
| | | | - Linda Huggins
- Palliative Care Services, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
| | - Kiki Maoate
- Department of Paediatric Surgery, Christchurch Public Hospital, Christchurch, New Zealand
| | - Ineke Meredith
- Department of Surgery, Capital; Coast District Health Board, Wellington Regional Hospital, Wellington, New Zealand
| | - Glen Mola
- Department of Obstetrics, Gynaecology and Reproductive Health, Port Moresby General Hospital, Port Moresby, Papua New Guinea; School of Medicine and Health Sciences, University of Papua New Guinea, Boroko, Papua New Guinea
| | - Neal Palafox
- Pacific Regional Cancer Programs, Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA; Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Viliami Puloka
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand; Health Promotion Forum of New Zealand, Auckland, New Zealand
| | - Hai-Rim Shin
- Non-communicable Disease and Health Promotion, Western Pacific Regional Office, World Health Organization, Manila, Philippines
| | - Jane Skeen
- Starship Blood and Cancer Centre, Starship Children's Health, Auckland, New Zealand
| | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organization, Suva, Fiji
| | - Malama Tafuna'i
- Department of Obstetrics and Gynaecology, National University of Samoa, Apia, Samoa
| | - Andrea Teng
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - David Watters
- Deakin University and Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
| | - Paula Vivili
- Public Health Division, Pacific Community, Noumea, New Caledonia
| |
Collapse
|
27
|
O'Meara L, Williams SL, Hickes D, Brown P. Predictors of Dietary Diversity of Indigenous Food-Producing Households in Rural Fiji. Nutrients 2019; 11:E1629. [PMID: 31319537 PMCID: PMC6683282 DOI: 10.3390/nu11071629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/04/2019] [Accepted: 07/12/2019] [Indexed: 01/01/2023] Open
Abstract
Fiji, like other Pacific Islands, are undergoing economic and nutrition transitions that increase the risk of noncommunicable diseases (NCDs) due to changes of the food supply and dietary intake. This study aimed to examine dietary diversity (DD) in indigenous food-producing households in rural Fiji. Surveys were conducted with households from the Nadroga-Navosa, Namosi and Ba Provinces of Western Fiji in August 2018. Participants reported on foods consumed in the previous 24 h per the Household Dietary Diversity Score. Data was analysed using multinomial logistic regression. Of the 161 households, most exhibited medium DD (66%; M = 7.8 ± 1.5). Commonly consumed foods included sweets (98%), refined grains (97%) and roots/tubers (94%). The least consumed foods were orange-fleshed fruits (23%) and vegetables (35%), eggs (25%), legumes (32%) and dairy (32%). Households with medium DD were more likely to be unemployed (OR 3.2, p = 0.017) but less likely to have ≥6 occupants (OR = 0.4, p = 0.024) or purchase food ≥2 times/week (OR = 0.2, p = 0.023). Households with low DD were more likely to have low farm diversity (OR = 5.1, p = 0.017) or be unemployed (OR = 3.7, p = 0.047) but less likely to have ≥6 occupants (OR = 0.1, p = 0.001). During nutrition transitions, there is a need for public health initiatives to promote traditional diets high in vegetables, fruits and lean protein and agricultural initiatives to promote farm diversity.
Collapse
Affiliation(s)
- Lydia O'Meara
- Department of Medical Sciences, School of Health, Medical and Applied Sciences, CQUniversity, Shield and Abbott Streets, Cairns QLD 4870, Australia.
| | - Susan L Williams
- Department of Physical Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, CQUniversity, Bruce Highway, Rockhampton QLD 4702, Australia
| | - David Hickes
- Secretariat of the Pacific Community, Sigatoka Agriculture Research Station, Sigatoka, Fiji
| | - Philip Brown
- Department of Agriculture, Science and the Environment, School of Health, Medical and Applied Sciences, CQUniversity, 6 University Drive, Bundaberg QLD 4670, Australia
| |
Collapse
|
28
|
Baugh Littlejohns L, Wilson A. Strengthening complex systems for chronic disease prevention: a systematic review. BMC Public Health 2019; 19:729. [PMID: 31185993 PMCID: PMC6558784 DOI: 10.1186/s12889-019-7021-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 05/21/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND While frameworks exist for strengthening health care systems and public health systems, there are no practical frameworks to describe, assess and strengthen systems for chronic disease prevention (CDP) using complex systems approaches. METHODS A systematic and integrative review of peer reviewed literature was conducted to answer the following questions: How can systems for CDP be defined? What are key attributes of effective systems? How are complex systems approaches discussed? Search terms were identified and the Medline, SCOPUS, and Global Health databases were searched December 2017 and January 2018. Reference lists and selected journals were hand searched. A working definition for a system for CDP was developed to provide a guideline for inclusion. Key exclusion criteria were literature did not address the research questions or working definition; was published in a language other than English and before 2000; focused on specific chronic diseases and/or risk factors and not CDP broadly; concentrated on the health care sector and clinical services and/or health status and surveillance data; and described evaluations of setting specific actions such as policies, programs, interventions, approaches, projects, laws, or regulations. Selected literature (n = 141) was coded in terms of the extent to which the research questions and the working definition of systems for CDP were addressed. Data was then analysed and synthesized to determine key themes. RESULTS A revised definition of systems for CDP and seven attributes of effective systems for CDP are reported (collaborative capacity, health equity paradigm, leadership and governance, resources, implementation of desired actions, information and complex systems paradigm). A framework was developed to provide a foundation for describing, assessing and strengthening systems for CDP. CONCLUSIONS The results of this literature review provide a strong foundation for a framework to help strengthen systems for CDP. The framework consolidates not only well-established attributes of effective CDP but also highlights theoretical and practical insights from complex systems perspectives.
Collapse
Affiliation(s)
- Lori Baugh Littlejohns
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, The Australian Prevention Partnership Centre, D17 Charles Perkins Centre, University of Sydney, Sydney, NSW 2006 Australia
| |
Collapse
|
29
|
Samuels TA, Murphy MM, Unwin N. Validating the self-reported annual monitoring grid for the 2007 Caribbean Community Declaration of Port-of-Spain on noncommunicable diseases. Rev Panam Salud Publica 2019; 42:e189. [PMID: 31093216 PMCID: PMC6386129 DOI: 10.26633/rpsp.2018.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/30/2018] [Indexed: 11/27/2022] Open
Abstract
Objectives In 2007, the Caribbean Community (CARICOM) convened the world's first-ever heads of government summit on noncommunicable diseases (NCDs) and issued the landmark Declaration of Port-of-Spain: Uniting to Stop the Epidemic of Chronic NCDs. Since then, ministry of health (MoH) focal points in each country have self-reported annually on their NCD efforts, using a 26-indicator grid created to assess implementation of the Declaration. Our objective was to assess the validity of those grid responses, as compared to information from in-depth interviews and document reviews. Methods Seven national case studies on policy responses to the Declaration were undertaken in 2015. In-depth, semistructured interviews were conducted with stakeholders from multiple sectors, including the MoH. Policy documents were also identified and reviewed. The results from the 2015 case studies were compared to the 2014 MoH focal point grid responses. Kappa statistics evaluated chance agreement. Results The information from the grid and from the case studies agreed closely. Out of a total of 182 indicators (26 each for seven countries), there was a lack of agreement on just 9 (4.9%). All the differences were between policy statements and implementation. Except for physical activity, kappa statistics indicated that agreement was good to excellent for all the clusters of the grid and for the grid as a whole, but with wide confidence intervals. Conclusions In general, the monitoring grid accurately assessed the national situation, but with a possible tendency to overstate performance in some areas. These findings contributed to the design of a new, 50-indicator monitoring grid in 2016. Alongside these improvements, CARICOM countries face a substantial burden from having to complete many other required NCD reports, mainly for the Pan American Health Organization and the World Health Organization.
Collapse
Affiliation(s)
- T Alafia Samuels
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Bridgetown, Barbados
| | - Madhuvanti M Murphy
- Faculty of Medical Sciences, Cave Hill campus, University of the West Indies, Bridgetown, Barbados
| | - Nigel Unwin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
30
|
Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, De Schutter O, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika SK, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed A, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet 2019; 393:791-846. [PMID: 30700377 DOI: 10.1016/s0140-6736(18)32822-8] [Citation(s) in RCA: 1218] [Impact Index Per Article: 243.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/10/2018] [Accepted: 10/29/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand; Global Obesity Centre, School of Health & Social Development, Deakin University, Geelong, VIC, Australia.
| | - Vivica I Kraak
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Steven Allender
- Global Obesity Centre, School of Health & Social Development, Deakin University, Geelong, VIC, Australia
| | | | - Phillip I Baker
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Jessica R Bogard
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | | | | | - Olivier De Schutter
- Institute for Interdisciplinary Research in Legal Sciences, Catholic University of Louvain, Louvain-la-Neuve, Belgium
| | - Raji Devarajan
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India
| | - Majid Ezzati
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Sharon Friel
- School of Regulation and Global Governance, Australian National University, Canberra, ACT, Australia
| | - Shifalika Goenka
- Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India
| | - Ross A Hammond
- Center on Social Dynamics & Policy, The Brookings Institution, Washington, DC, USA; Public Health & Social Policy Department, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Gerard Hastings
- Institute for Social Marketing, University of Stirling, Stirling, UK
| | - Corinna Hawkes
- Centre for Food Policy, City University, University of London, London, UK
| | - Mario Herrero
- Commonwealth Scientific and Industrial Research Organisation, Brisbane, QLD, Australia
| | - Peter S Hovmand
- Social System Design Lab, Brown School, Washington University in St Louis, St Louis, MO, USA
| | - Mark Howden
- Climate Change Institute, Australian National University, Canberra, ACT, Australia
| | - Lindsay M Jaacks
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ariadne B Kapetanaki
- Department of Marketing and Enterprise, Hertfordshire Business School, University of Hertfordshire, Hatfield, UK
| | - Matt Kasman
- Center on Social Dynamics & Policy, The Brookings Institution, Washington, DC, USA
| | - Harriet V Kuhnlein
- Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Montreal, QC, Canada
| | | | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Michael W Long
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Victor K R Matsudo
- Physical Fitness Research Laboratory of São Caetano do Sul, São Caetano do Sul, São Paulo, Brazil
| | - Susanna D H Mills
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | - Alexandra Morshed
- Prevention Research Center, Brown School, Washington University in St Louis, St Louis, MO, USA
| | | | - An Pan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | - Gary Sacks
- Global Obesity Centre, School of Health and Social Development, Deakin University, Melbourne, VIC, Australia
| | - Meera Shekar
- Health, Nutrition, and Population Global Practice, The World Bank, Washington, DC, USA
| | | | - Warren Smit
- African Centre for Cities, University of Cape Town, Cape Town, South Africa
| | - Ali Tootee
- Diabetes Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Stefanie Vandevijvere
- School of Population Health, University of Auckland, Auckland, New Zealand; Scientific Institute of Public Health (Sciensano), Brussels, Belgium
| | - Wilma E Waterlander
- Department of Public Health Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Luke Wolfenden
- School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - William H Dietz
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| |
Collapse
|
31
|
Abstract
OBJECTIVE Pacific Island countries are experiencing a high burden of diet-related non-communicable diseases; and consumption of fat, sugar and salt are important modifiable risk factors contributing to this. The present study systematically reviewed and summarized available literature on dietary intakes of fat, sugar and salt in the Pacific Islands. DESIGN Electronic databases (PubMed, Scopus, ScienceDirect and GlobalHealth) were searched from 2005 to January 2018. Grey literature was also searched and key stakeholders were consulted for additional information. Study eligibility was assessed by two authors and quality was evaluated using a modified tool for assessing dietary intake studies. RESULTS Thirty-one studies were included, twenty-two contained information on fat, seventeen on sugar and fourteen on salt. Dietary assessment methods varied widely and six different outcome measures for fat, sugar and salt intake - absolute intake, household expenditure, percentage contribution to energy intake, sources, availability and dietary behaviours - were used. Absolute intake of fat ranged from 25·4 g/d in Solomon Islands to 98·9 g/d in Guam, while salt intake ranged from 5·6 g/d in Kiribati to 10·3 g/d in Fiji. Only Guam reported on absolute sugar intake (47·3 g/d). Peer-reviewed research studies used higher-quality dietary assessment methods, while reports from national surveys had better participation rates but mostly utilized indirect methods to quantify intake. CONCLUSIONS Despite the established and growing crisis of diet-related diseases in the Pacific, there is inadequate evidence about what Pacific Islanders are eating. Pacific Island countries need nutrition monitoring systems to fully understand the changing diets of Pacific Islanders and inform effective policy interventions.
Collapse
|