Identifying and overcoming barriers to healthier lives

Abstract

Understanding the key determinants of health from a community perspective is essential to address and improve the health and wellbeing of its members. This qualitative study aimed to explore and better understand New Zealand-based Pasifika communities’ sociocultural experiences and knowledge of health and wellbeing. Fifty-seven participants were involved in six separate focus groups. Community coordinators co-facilitated and transcribed the discussions and conducted thematic analysis. The findings suggested two overarching themes: (1) ‘Pasifika experiences on poor health and well-being’: were based on sub-themes: (i) ‘recognisable issues’ (e.g., poor diet and lifestyle behaviours); (ii) ‘systemic issues’ that support the perpetual health issues (e.g., lack of knowledge and education) and; (iii) ‘profound issues’ that are often unspoken of and create long-term barriers (e.g., cultural lifestyle and responsibilities). (2) ‘Hopes and dreams’ to improve health and well-being requires: (i) a family-centric approach to health; (ii) tackling systemic barriers; and (iii) addressing community social justice issues. This study provides deepened insights on Pasifika communities’ understanding healthier living in the context of their cultural environment and family responsibilities. If we are to develop effective, sustainable programmes that prioritises health and well-being based on the needs of Pasifika communities, the findings from this study highlight their needs as step forward in overcoming barriers to healthier lives.

The characteristics of behaviour change interventions used among Pacific people: a systematic search and narrative synthesis

“…The most popular BCT was instruction on how to perform a behaviour (4.1), used to demonstrate culturally appropriate meals, facilitate exercise classes and provide educational sessions around the targeted health conditions and behaviours; followed by social support (unspecified) (3.1). Providing social support resonates with Pacific values, drawing strength from socio-cultural relationships within their collective contexts, such as extended family, community, and church networks [17,22,28].…”

“…An individual's motivation to change behaviour is strongly interwoven with the socio-cultural roles and family responsibilities [20,[25][26][27]. Several studies have highlighted Pacific people to perceive health as being able to provide for their families and the wellbeing of their family unit, rather than the physical ailments of an individual [21,28,29]. Moreover, studies that have included family and social support have shown to be more effective than those requiring individuals to undertake behaviour change on their own accord [30].…”

“…Acknowledging the cultural differences, values, beliefs, structures, practices and worldviews of health and wellbeing unique to Pacific people can provide the contextual framework for developing health behaviour interventions [25,28]. Fundamental to the success of any programme centres around creating interventions that are acceptable and accessible for Pacific people, who have "the right to the highest attainable standard of health" in New Zealand [31].…”

“…Improving the health and wellbeing for Pacific people is an important equity issue [3,15,28]. Engaging meaningfully and negotiating the spaces between Eurocentric theoretical frameworks and Pacific cultural constructs of health and wellbeing [40] is needed if evidence-based and culturally contextualised behaviour change interventions are to be adopted and sustained.…”

A co-designed mHealth programme to support healthy lifestyles in Māori and Pasifika peoples in New Zealand (OL@-OR@): a cluster-randomised controlled trial

“…14 Co-design methods were used to understand the needs and aspirations of Māori and Pasifika communities. 15,16 Models of health and wellbeing that were specific to Māori and Pasifika peoples 17,18 were used to interpret focus group findings, and an mHealth tool was co-designed with these focus groups, that incorporated relevant content and features that aligned with the needs and wants of these communities. The theoretical domains framework 19 and behaviour change taxonomy 20 were then used to identify evidence-based behavioural determinants and behavioural change techniques that aligned with and could be incorporated into the content and features of the OL@-OR@ programme.…”