Cultural values influencing iTaukei women's discussion of family planning in the home.

Pacific Sexual and reproductive health is influenced by cultural taboos and sensitivities. Although Pacific values are integral to family planning, open communication in the home is often difficult in the face of changing socio-cultural norms. This study explores the experiences of iTaukei Pacific women living in Fiji and Aotearoa New Zealand, and their discussion of family planning within the family setting. The study utilises talanoa methodology to understand women's realities and their navigation through shifting sexual and reproductive norms in both countries. The study found that although family may be seen as a place of 'truth' in which appropriate, culturally sensitive family planning communication should be available, this was challenged by cultural taboos or tabu which were persistent in family planning discussions. The study calls for greater reliance on holistic approaches to Pacific family planning perspectives and a greater examination of va or the spaces within which Pacific women's experiences are negotiated and informed.

Comparing and contrasting Tongan youth and service users' interpretations of mental distress.

BACKGROUND: In Aotearoa New Zealand (NZ), Pacific people have a higher prevalence of mental illness compared with the general population. Tongan people have high rates of mental illness and tend to not use mental health services. The risk for mental illnesses also differs between those born in Tonga and those born in NZ. AIM: This study presented the views of New Zealand-dwelling Tongan youth and mental health service users regarding the meaning of mental distress. METHODS: A Tongan cultural framework "talanoa" was used to inform the approach to the research. The youth talanoa group had seven participants and the service users talanoa group had twelve participants. Braun and Clarke's thematic analysis was used to analyse the data. RESULTS: Tongan youth and service users constructed mental distress from biopsychosocial perspectives and challenged traditional Tongan perspectives around being possessed by spirits, cursed and disruptions to social and spiritual relationships. CONCLUSIONS: The youth and service users construct mental distress from a biopsychosocial angle and there is a need for further information about Tongan perspectives of mental distress. This suggests that a biopsychosocial perspective is needed to ensure engagement by Tongan youth and service users in promoting mental health and alleviating distress.

Food havens not swamps: a strength-based approach to sustainable food environments.

The current paper provides a critical review of food environments' literature, with a focus on the metaphoric typology that has been developed over recent decades. This has tended to focus understandably on harmful food environments using well-known metaphors: that of food deserts, food swamps and food mirages. The purpose of the review was to consider the current typology in relation to what constitutes healthy food environments, and the implications for population groups in low socioeconomic environments who are often disadvantaged by current food systems and unhealthy food environments. The paper posits a new term, alongside the notion of the food oasis, that of food havens. Oasis indicates a small place of plenty in a setting of scarcity. Haven extends the boundaries of plenty in society by positing places and settings of refuge and safety, even sanctuary from which health and well-being can be attained and supported. We argue for focusing on creating such sustainable food environments so as to proliferate and promote examples of what needs to be done urgently in the fight to transform global food environments for the health of people particularly those that are vulnerable and the planet. Elements of the food haven as proposed in this paper have been drawn from indigenous perspectives-these include Maori and Pacific worldviews. Future research should consider what food environments might look like in different contexts and how we might move away from food swamps and deserts to food oases and havens; and utilize these positive motifs to go further in creating whole sustainable food environments encompassing all of society.

From individual behaviour strategies to sustainable food systems: Countering the obesity and non communicable diseases epidemic in New Zealand.

New Zealand is currently facing an obesity and non communicable diseases (NCDs) epidemic. Recent studies have largely attributed these health issues to insufficient food and low-quality diets that cause micronutrient deficiencies. Improving healthy diets requires broader thinking and collaboration, particularly around maintaining sustainable food systems, which signifies a shift from individualistic/behavioural approaches in health promotion. This paper aims to extend solutions addressing increasing rates of obesity and diet-related NCDs in New Zealand while considering diet and human health in concurrence with sustainability. In particular, the three pillars of sustainability-economic, environmental, and social-will be considered, alongside application of a food systems approach to analysing the epidemic and policy developments in New Zealand. Given its proximity to smaller Pacific islands in the region, New Zealand is in a unique position to work multisectorally and be a leader in considering food system approaches to tackling obesity and NCDs in the Pacific.

Fijian youth entrepreneurs: championing health through sustainable food systems.

The health of Pacific people is known to be at risk because of the onset of non-communicable diseases (NCDs), such as diabetes. The scale of the problem requires innovative approaches to bring about change. One such approach is the development of a sustainable food system in combination with the leadership of Pacific youth. This study sought to engage Pacific youth as part of the solution to reducing NCDs through social enterprise and championing of sustainable food systems. Four young Fijian vegetable and fruit entrepreneurs shared their stories as part of a participatory action research of Talanoa/storytelling, with social media workshops, networking and promotional opportunities. Findings revealed that youth entrepreneurs are passionate about food and health, family and tradition; some are already food influencers and champions and they are keen to grow their businesses. Yet, there is limited support for small business development with a social purpose and youth-led campaigns. The study indicates a growing potential to develop local youth-led social entrepreneurship and innovation to address NCDs in exciting new ways. There is an urgent need to support innovation interventions to advocate for sustainable food systems for the Pacific, that promote positive human health needs and address, more broadly, climate change effects.

Awareness and use of family planning methods among iTaukei women in Fiji and New Zealand.

OBJECTIVE: iTaukei women's awareness and practice of family planning methods was investigated in New Zealand and Fiji to ascertain differences in behaviour within the context of changing developmental settings. METHODS: The study was cross-sectional in nature and recruited women aged 18 years and over from three suburbs in Suva, Fiji, and five cities in New Zealand. RESULTS: Overall, 352 women participated in the study, 212 in Fiji and 140 in New Zealand. The study found that living in New Zealand was significantly associated with lower odds of being aware of family planning (OR 0.4, 95%CI 0.2-0.9, p=0.029) and using family planning methods (OR 0.5, 95%CI 0.2-0.9, p=0.027). Tertiary education was found to increase the odds of being aware (OR 2.8, 95%CI 1.3-6.2, p=0.009) and of using (OR 3.9, 95%CI 1.9-7.8, p=0.000) family planning. CONCLUSIONS: Despite the greater availability of services and higher standards of living experienced in New Zealand compared with Fiji, there was no improvement in awareness and use of family planning among New Zealand participants. Implications for public health: Reduced awareness and use of family planning in New Zealand indicates a need for better targeting of services among minority Pacific ethnic groups.

Family planning unmet need and access among iTaukei women in New Zealand and Fiji.

AIM: The aim of the study was to identify unmet need and family planning access among indigenous Fijian or iTaukei women living in New Zealand and Fiji. METHOD: A cross-sectional survey was undertaken between 2012-2013 in five major cities in New Zealand: Auckland, Hamilton, Wellington, Christchurch and Dunedin; and in three suburbs in Fiji. Women who did not want any (more) children but were not using any form of contraception were defined as having an unmet need. Access experiences involving cost and health provider interactions were assessed. RESULTS: Unmet need in New Zealand was 26% and similar to the unmet need found in Fiji (25%). Cost and concern over not being seen by a female provider were the most problematic access factors for women. CONCLUSION: There is a need for better monitoring and targeting of family planning services among minority Pacific groups, as the unmet need found in New Zealand was three times the national estimate overall and similar to the rate found in Fiji. Cost remains a problem among women trying to access family planning services. Gendered traditional roles in sexual and reproductive health maybe an area from which more understanding into cultural sensitivities and challenges may be achieved.

An assessment of an outcome of injury questionnaire using a Pacific model of health and wellbeing.

AIM: To use a Pacific model of health to describe relationships between questions within a structured questionnaire developed for a prospective study of injured New Zealand residents' outcomes and important elements of Pacific people's health; and identify health issues of particular importance for Pacific peoples that future studies may consider including. METHOD: The Fonofale model of Pacific health identifies culture, family, physical, spiritual, and 'other' elements (e.g. socioeconomic status and service use) as important. In consultation with Pacific researchers, each question from a Prospective Outcomes of Injury Study (POIS) questionnaire was assessed. Relationship between the type and number of POIS questions were considered in relation to each of the Fonofale elements. RESULTS: Two-thirds of the POIS questions were able to be placed within a single element of the Fonofale model; remaining questions were placed into multiple elements. The POIS questionnaire strongly addressed the physical, mental and 'other' Fonofale elements. Culture, spirituality and family elements were not strongly addressed. CONCLUSIONS: The Fonofale model identified areas of strength in the POIS questionnaire, and areas of limitation. Researchers undertaking population studies or surveys could consider using a Pacific model to help inform structured questionnaire development.