ObjectiveChild and adolescent obesity continues to be a major health issue internationally. This study aims to understand the views and experiences of caregivers and participants in a child and ...adolescent multidisciplinary programme for healthy lifestyle change.DesignQualitative focus group study.SettingCommunity-based healthy lifestyle intervention programme in a mixed urban–rural region of Aotearoa/New Zealand.ParticipantsParents/caregivers (n=6) and children/adolescents (n=8) who participated in at least 6 months of an assessment and weekly session, family-based community intervention programme for children and adolescents affected by obesity.ResultsFindings covered participant experiences, healthy lifestyle changes due to participating in the programme, the delivery team, barriers to engagement and improvements. Across these domains, four key themes emerged from the focus groups for participants and their caregivers relating to their experience: knowledge-sharing, enabling a family to become self-determining in their process to achieve healthy lifestyle change; the importance of connectedness and a family-based programme; the sense of a collective journey and the importance of a nonjudgemental, respectful welcoming environment. Logistical challenges and recommendations for improvement were also identified.ConclusionsPolicymakers need to consider the experiences of participants alongside quantitative outcomes when informing multidisciplinary intervention programmes for children and adolescents affected by obesity.Trial registration number Australian New Zealand Clinical Trials Registry (ANZCTR):12611000862943; Post-results.
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.
Examines caregiver perceptions relating to the acceptability of weight screening at New Zealand’s B4 School Check (B4SC), and the accessibility and acceptability of a healthy lifestyle programme ...(Whānau Pakari) for preschool children (Whānau Pakari preschool programme) identified with weight issues. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
This paper describes issues, strengths and challenges experienced by elderly Māori accessing influenza vaccination, during the first Level 4 COVID-19 lockdown in 2020. We also obtained views about ...the introduction of COVID-19 vaccines, and the social restrictions of lockdown. A sampling frame of four Māori elders speaking on behalf of themselves and their communities in Northland was recruited from health sector network connections and interviews were undertaken and recorded. The rich narratives highlighted an awareness of the generational impact of illness and vaccination and concern about the impact of COVID-19 on vulnerable populations. Despite initial fear about COVID-19, communities described 'safety and comfort' from 'lockdown' creating community resilience and marae, hapu and iwi making major contributions to local crisis response. The well-developed views of these Māori kaumātua about influenza, vaccination and COVID-19 occurred within an environment of contrasting health beliefs and trust/distrust about government and Pākehā-led health services. There was support for the style and content of local health services and recognition and that Pākehā-led health services can be effective when complemented by traditional Māori health values approaches and beliefs. We also noted that the lockdown provided opportunities for these elders to adapt to new technology within a health context.
To understand facilitators and barriers to engagement in a multidisciplinary assessment and intervention program for children and adolescents with obesity, particularly for Māori, the Indigenous ...people of New Zealand.
Whānau Pakari participants and caregivers (n = 71, 21% response rate) referred to the family-based healthy lifestyles program in Taranaki, New Zealand, were asked to participate in a confidential survey, which collected self-reported attendance levels and agreement with statements around service accessibility and appropriateness and open-text comments identifying barriers and facilitators to attendance.
Self-reported attendance levels were higher when respondents reported sessions to be conveniently located (P = .03) and lower when respondents considered other priorities as more important for their family (P = .02). Māori more frequently reported that past experiences of health care influenced their decision to attend (P = .03). Facilitators included perceived convenience of the program, parental motivation to improve child health, and ongoing support from the program.
Program convenience and parental and/or self-motivation to improve health were facilitators of attendance. Further research is required to understand the relationship between past experiences with health care and subsequent engagement with services.
To explore the perceptions and experiences of caregivers of preschool children with weight issues referred from New Zealand’s preschool check (the B4 School Check) to a healthy lifestyle programme. ...Second, to understand determinants of engagement with the programme for families post referral.
Semi-structured focus groups and interviews were conducted with caregivers of preschool children referred from the national preschool check (the B4 School Check) to the Whānau Pakari healthy lifestyle programme. A purposeful sampling approach ensured the opinions of Māori (New Zealand’s indigenous population) and non-Māori caregivers were included. Those who engaged and did not engage with the programme were included from across Taranaki (a semi-rural region of New Zealand). Focus groups and interviews were run separately for Māori and non-Māori participants.
Thematic analysis yielded one sub-theme related to caregiver perceptions of weight: societal beliefs about childhood weight, and three sub-themes related to determinants of engagement: referral experience, competing life demands, and caregiver resistance to and motivation for accepting external support. A negative referral experience to Whānau Pakari often resulted in caregivers declining to engage with the programme. Themes were similar across both Māori and non-Māori caregivers.
This study confirmed that caregiver perceptions influence their acceptance and management of their child’s weight issues. The experience of the referral to a healthy lifestyle programme is important for determining future engagement, and is likely to be facilitated by providing improved training and support to health professionals around discussing childhood weight issues with caregivers of young children.
Audits the proportion of referred preschool children who engaged with and completed at least a baseline assessment of the Whānau Pakari preschool intervention programme for Taranaki children with ...obesity, and, for those children who did engage, determines the effect of the Whānau Pakari preschool programme on body mass index (BMI) standard deviation score (SDS) after six and 12 months. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.
wellbeing is a central tenet in the Aotearoa New Zealand government's Transport Outcomes Framework. Yet considerations of how place mediates diverse opportunities for wellbeing seldom identify how ...decision-making on transport and pedestrian infrastructure affects these opportunities. Considering the lived realities of older people and people with disabilities with a specific focus on Indigenous people, we argue it is particularly important to identify the role infrastructure plays in enhancing or undermining wellbeing for diverse communities. We also highlight state or sector responsibility for neglectful, wellbeing-diminishing infrastructure.
we ground this argument in community-based participatory research findings of qualitative interviews conducted at home and during neighbourhood walks with 62 older or mobility impaired people in socio-demographically diverse neighbourhoods in Auckland, Aotearoa New Zealand. The interviews explore community perceptions of mobility and wellbeing as experienced through the losses, stresses and joys of everyday life contexts and places.
we find that people seek experiences of beauty, joy, belonging, fitness, and sociality when going out, but the pursuit of these are curtailed by significant infrastructural impediments with attendant emotional costs, burdens, and risks. Historical decisions shape contemporary possibilities for wellbeing in place, and historical infrastructural injustices impacting on transport and mobility particularly affect Indigenous people's opportunities for mobility-based wellbeing.
drawing on place-specific history and experiences of risk, we shift focus from individualized capacities to live well to conceptualizing wellbeing at a collective level, exploring place-based possibilities for a good life. These elaborations allowed us to identify signs of policy and practice abandonment and neglect, and articulate a vision for more inclusive, equitable transport infrastructure that enables the wellbeing of people differently challenged by urban environments.
The philosophical assumptions that underpin the way in which health states are valued within economic measures of health are rarely made explicit and fail to capture the experiences of Indigenous ...peoples. Within a Kaupapa Maori theoretical paradigm, in-depth interviews were conducted with six Maori key informants who had cared for whanau (family) members through illness to give voice to dimensions of health and illness that Western economic measures of health fail to capture. An Indigenous measure of health needs to consider the individual within the context of the collective and the environment that they are connected to. Economic measures of health are widely used to inform decisions about resource allocation that have significant impacts on Indigenous health outcomes. This article sets out to start a conversation around what an Indigenous measure of health might look like and how it might value key dimensions of health.
•Aotearoa New Zealand has recentralised publicly funded health services, with two new lead agencies overseeing health.•Health New Zealand merges all publicly owned hospital services and planning ...functions into a single entity.•The Māori Health Authority will lead and monitor improvements in indigenous health.•Reforms also aim to integrate health and social services locally, with local Māori and community co-design.•Aspirations for change present major challenges for a stressed health system.
Aotearoa New Zealand has restructured its health system with the objective of addressing inequitable access to health services and inequitable health outcomes, particularly those affecting the indigenous Māori population. In July 2022, two new organisations were created to centralise planning, funding and provision responsibilities for publicly funded health services in Aotearoa New Zealand. Health New Zealand and the Māori Health Authority have been created to drive transformational change within the national health system and monitor and improve the health and wellbeing of Māori. At the local level, new Localities are to be formed with the aim of integrating services between government and non-government health and social services providers, while incorporating local Māori and local communities in co-design of services. These changes will be of interest to those in many other countries who are grappling with their own colonial histories and struggling to provide health services in ways that are equitable and contribute to positive health outcomes for their whole population. Although key aspects of the reforms are well supported within the health sector, the ambitious scope and timing of their introduction in the context of the COVID-19 pandemic and health workforce shortages can be expected to generate significant implementation challenges.
PDF
