Objective: To explore factors influencing participation and attrition in a family-led weight-management programme for obese Pacific children. Design: Qualitative study used bilingual in-depth interviews at exit and end of an 8-week weight-management programme. Setting: New Zealand. Subjects: Forty-two parents/primary caregivers of obese children who were randomised in the intervention weight-management programme. Results: Programmatic factors that enhanced retention included: simultaneous delivery to both children and parents as participants; delivery of the programme in small group settings at local community venues; enabling trustworthy and accountable relationships; providing resources for travel to venues and regular telephone/text messaging follow-up calls reinforcing programme goals; and day and time scheduling. Suggested programme improvements included having ethnic-specific Island-language delivery and practical sessions like cooking classes and shopping expeditions at local food stores. The research found that unpredictable external life crises like extended family deaths, a change in job shift, family illnesses (both acute and those requiring chronic management) and long-term family visitations affected participation and momentum. A loss of momentum through managing life crises was often difficult to overcome for participants, leading them to drop out of the weight-management programme. Most drop-out participants preferred to defer their programme participation with hopes of re-committing to future programmes at another time. Conclusions: In order for weight-management programmes to be effective, participants must be able to complete them. Identifying factors that predict participation and attrition may serve as a basis for programme improvement.

No abstract

IntroductionAotearoa/New Zealand (NZ) is officially recognised as a bicultural country composed of Māori and non-Māori. Recent estimations have projected a threefold increase in dementia prevalence in NZ by 2050, with the greatest increase in non-NZ–Europeans. The NZ government will need to develop policies and plan services to meet the demands of the rapid rise in dementia cases. However, to date, there are no national data on dementia prevalence and overseas data are used to estimate the NZ dementia statistics. The overall aim of the Living with Dementia in Aotearoa study was to prepare the groundwork for a large full-scale NZ dementia prevalence study.Methods and analysisThe study has two phases. In phase I, we will adapt and translate the 10/66 dementia assessment protocol to be administered in Māori, Samoan, Tongan and Fijian–Indian elders. The diagnostic accuracy of the adapted 10/66 protocol will be tested in older people from these ethnic backgrounds who were assessed for dementia at a local memory service. In phase II, we will address the feasibility issues of conducting a population-based prevalence study by applying the adapted 10/66 protocol in South Auckland and will include NZ–European, Māori, Samoan, Tongan, Chinese and Fijian–Indian participants. The feasibility issues to be explored are as follows: (1) how do we sample to ensure we get accurate community representation? (2) how do we prepare a workforce to conduct the fieldwork and develop quality control? (3) how do we raise awareness of the study in the community to maximise recruitment? (4) how do we conduct door knocking to maximise recruitment? (5) how do we retain those we have recruited to remain in the study? (6) what is the acceptability of study recruitment and the 10/66 assessment process in different ethnic groups?Ethics and disseminationThe validity and feasibility studies were approved by the New Zealand Northern A Health and Disability Ethics Committee (numbers 17NTA234 and 18NTA176, respectively). The findings will be disseminated through peer-reviewed academic journals, national and international conferences, and public events. Data will be available on reasonable request from the corresponding author.

This paper examines the oral stories of Pacific people attending addiction treatment services in Auckland, New Zealand who were participating in a larger study exploring the validity of the Alcohol, Smoking and Substance Involvement Screening Test. (ASSIST). A Talanoa approach was used by interviewers to help gain an understanding of the factors associated with participants' substance misuse. Interviewers made notes of the stories they heard. Fifty participants were interviewed and expressed concerns related to how their substance use was influenced by their peers (66%, n = 33), the environment they were living in (60%, n = 30), and their family (50%, n = 25). Sixteen participants provided detailed narratives of their lived experiences that permitted further in-depth analysis. Thematic analysis of these narratives revealed five interrelated themes; introduction to drugs and alcohol, family dynamics access to drugs, attempts at giving up, and motivation to stop. The use of a Talanoa approach, whilst administering a screening tool, such as the ASSIST, allows for a more in-depth exploration of an individual's substance use. The information gathered would allow those working with Pacific people who misuse alcohol and/or drugs to develop culturally appropriate interventions.

No abstract