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.
Technology and digital platforms have become essential for people and communities to interact because of COVID-19. Despite its benefits, digital exclusion disproportionately affects Pacific communities living in New Zealand. This article provides insights into how Niue mamatua (older adults) used their gifted mobile phones and mobile data as part of a COVID-19 digital inclusion initiative. It begins with an overview of the digital inclusion needs of older adults, followed by a description of the digital vā (relational space) and negotiating a new way of maintaining connection in an online world. The tutala (a Niue method of conversation anchored on respect) with 12 mamatua highlighted the benefits, support factors, and challenges of how they were able to use their mobile phone. Importantly, mobile phones provided the necessary access and connectivity to interact in a digitally connected world, namely the digital vā, when in-person connections were disrupted because of COVID-19.
Introduction: Digital health technologies are rapidly changing the landscape of how healthcare is being delivered globally.Many international health systems are using digital technology to assist with delivery of information and healthcare, to enable more affordable, accessible, and acceptable care to manage key health priorities pertaining to that population. The key to success for any digital health approach for Pacific and ethnic-specific communities is ensuring digital inclusion is considered alongside the wider influences of health (family, cultural, economic, social, environmental). Digital technology could be the enabler to reduce inequities in health outcomes in some populations. The aim of this paper is to explore how an intergenerational group of tau fifine Niue (Niue women) use digital health tools for health and wellbeing. Methods: Tutala (similar to talanoa in the Samaon language) a culturally appropriate method of conversation with Niue communities was used to guide the research approach with a tau fifine Niue (n=40). Six group tutala were undertaken with tau afine (young women), tau mamatua fifine (mothers), and tau mamatua tupuna fifine (older women). Results: Three overarching themes were identified: (1) convenience of mHealth tools; (2) access to health information and resources; and (3) digital disconnection. There were differences in the adoption and use of digital tools for health-related purposes, which varied from using the internet, text messaging and health monitoring apps. Although tau afine and tau mamatua fifine were more likely to utilise digital health tools, it was clear not all tau mamatua tupuna fifine experienced the same benefits. Conclusion: Supporting digital inclusion, digital skills, and digital health literacy for tau fifine Niue using an intergenerational approach can translate into health benefits for Niue families and communities. As more and more health services turn todigital technology to assist with delivering health information and care, it is critically important digital technology is delivered in an equitable way that benefits all people, including multi-ethnic populations in Aotearoa, New Zealand.
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