El-Shadan Tautolo

The development of a model of community garden benefits to wellbeing

Community gardens contribute to community wellbeing by influencing the nutritional and social environment. The aim of this research was to develop a model that communicates the many benefits of community garden participation as described in the academic literature, to a diverse audience of laypersons. This model is an example of effective knowledge translation because the information is able to be more than simply understood but also practically applied. From April to August 2015, a model depicting the many benefits of community garden participation was prepared based on a global, critical literature review. The wellbeing benefits from community garden participation have been grouped into factors influencing the nutritional health environment and factors influencing the social environment. The graphic chosen to form the basis of the model is a fractal tree of life. In October 2015, to test the models comprehension and to obtain stakeholder feedback this model was presented to a diverse group of community members, leaders and workers from the Tāmaki region of Auckland, New Zealand. The model we present here effectively and clearly translates knowledge obtained from the academic literature on the benefits to wellbeing from community garden participation into a tool that can be used, adapted and developed by community groups, government agencies and health promoters.

Acculturation of Pacific mothers in New Zealand over time: findings from the Pacific Islands Families study

BackgroundThe epidemiological investigation of acculturation has often been hampered by inconsistent definitions and measurement, and methodological short-comings. Adopting a bi-directional model, with good theoretical and psychometric properties, this study aimed to describe the temporal, ethnic and socio-demographic influences of acculturation for a group of Pacific mothers residing in New Zealand.MethodsPacific mothers of a cohort of Pacific infants born at a large tertiary hospital in South Auckland in 2000 were interviewed at 6-weeks, 4-years and 6-years postpartum. At each measurement wave a home interview lasting approximately 90 minutes was conducted with each mother. Adapting the General Ethnicity Questionnaire, two scales of acculturation were elicited: one measuring New Zealand cultural orientation (NZAccult) and one measuring Pacific Islands cultural orientation (PIAccult). Acculturation scores were standardised and analysed using random intercept polynomial and piecewise mixed-effects regression models, accounting for the longitudinal nature of the repeated measured data. Mothers who immigrated to New Zealand and those who lived their lives in New Zealand were investigated separately.ResultsOverall, 1276 Pacific mothers provided 3104 NZAccult and 3107 PIAccult responses over the three measurement waves. Important and significant differences were observed in both bi-directional acculturation measures between the two maternal groups studied. New Zealand cultural orientation increased, on average, linearly with years lived in New Zealand both for immigrant mothers (0.013 per year, 95% CI: 0.012, 0.014), after adjusting for maternal age, and for mothers who lived their lives in New Zealand (0.008 per year, 95% CI: 0.06, 0.010). Immigrant mothers maintained their Pacific cultural orientation for, on average, 12 years before it began to linearly decrease with each year lived in New Zealand thereafter (-0.009 per year, 95% CI: -0.010, -0.008), after adjusting for maternal age. Mothers who lived their lives in New Zealand had a Pacific orientation that was, on average, unchanged regardless of the number of years lived in New Zealand. Significant ethnic and socio-demographic variations were noted.ConclusionsUnderstanding the patterns and trajectories of acculturation over time, and its key determinants, is necessary for the development of appropriate targeted health policy and care in typically vulnerable and marginalised immigrant populations.

Smoking as an ‘informed choice’: implications for endgame strategies

Objective Tobacco companies often assert that adults should be free to make an ‘informed choice’ about smoking; this argument influences public perceptions and shapes public health policy agendas by promoting educative interventions ahead of regulation. Critically analysing ‘informed choice’ claims is pivotal in countries that have set endgame goals and require new, more effective policies to achieve their smoke-free aims. Methods In-depth interviews with 15 New Zealand politicians, policy analysts and tobacco control advocates examined how they interpreted ‘informed choice’ arguments. We used a thematic analysis approach to review and explicate interview transcripts. Results Participants thought ‘informed choice’ implied that people make an active decision to smoke, knowing and accepting the risks they face; they rejected this assumption and saw it as a cynical self-justification by tobacco companies. Some believed this rhetoric had countered calls for stronger policies and thought governments used ‘informed choice’ arguments to support inaction. Several called on the government to stop allowing a lethal product to be widely sold while simultaneously advising people not to use it. Conclusions ‘Informed choice’ arguments allow the ubiquitous availability of tobacco to go unquestioned and create a tension between endgame goals and the strategies used to achieve these. Reducing tobacco availability would address this anomaly by aligning governments actions with its advice.

Accelerometer data treatment for adolescents: Fitting a piece of the puzzle.

This study aimed to assess the differences in participant retention and associations between physical activity and key variables when a range of accelerometer data inclusion criteria are employed. Data were drawn from 204 adolescents of Pacific Island heritage (survey, body composition, 7-day accelerometry) and their parents (date of birth, socioeconomic status) between October 2014 and February 2016 in Auckland, New Zealand. Data wear time criteria for inclusion were as follows: A) > = 10 h/weekday or > = 8 h weekend day, > = 5 days (at least one weekend day); B) > = 10 h/weekday or > = 8 h weekend day, > = 4 days; C) > = 7 h/day, > = 3 days; D) > = 10 h/day, > = 1 day. Overall, 49%, 62%, 88%, and 96% of participants met the criteria, respectively. Adjusted odds of meeting each criterion were examined using a multivariable logistic regression model. Almost 50% of participants were excluded by the most stringent inclusion criteria. Increased body fat percentage and proportion of time in moderate-to-vigorous activity were associated with decreased odds of meeting Criterions A and B. This research contributes to a growing understanding of the impact of differing accelerometer reduction approaches to sample retention and bias in adolescent physical activity research.

Cohort profile: Pacific Islands Families (PIF) growth study, Auckland, New Zealand

Purpose This article profiles a birth cohort of Pacific children participating in an observational prospective study and describes the study protocol used at ages 14–15 years to investigate how food and activity patterns, metabolic risk and family and built environment are related to rates of physical growth of Pacific children. Participants From 2000 to 2015, the Pacific Islands Families Study has followed, from birth, the growth and development of over 1000 Pacific children born in Auckland, New Zealand. In 2014, 931 (66%) of the original cohort had field measures of body composition, blood pressure and glycated haemoglobin. A nested subsample (n=204) was drawn by randomly selecting 10 males and 10 females from each decile of body weight. These participants had measurement of body composition by dual-energy X-ray absorptiometry, food frequency, 6 min walk test and accelerometer-determined physical activity and sedentary behaviours, and blood biomarkers for metabolic disease such as diabetes. Built environment variables were generated from individual addresses. Findings to date Compared to the Centres for Disease Control and Prevention (CDC) reference population with mean SD scores (SDS) of 0, this cohort of 931 14-year-olds was taller, weighed more and had a higher body mass index (BMI) (mean SDS height >0.6, weight >1.6 and BMI >1.4). 7 of 10 youth were overweight or obese. The nested-sampling frame achieved an even distribution by body weight. Future plans Cross-sectional relationships between body size, fatness and growth rate, food patterns, activity patterns, pubertal development, risks for diabetes and hypertension and the family and wider environment will be examined. In addition, analyses will investigate relationships with data collected earlier in the life course and measures of the cohort in the future. Understanding past and present influences on child growth and health will inform timely interventions to optimise future health and reduce inequalities for Pacific people.

Distinguishing transient versus stable aspects of depression in New Zealand Pacific Island children using Generalizability Theory

BACKGROUND The distinction between temporary versus enduring or state/trait aspects of depression is important. More precise distinction would improve understanding of the aetiology of depression and those aspects most amenable to intervention thus identifying more homogeneous, dynamic targets for clinical trials. Generalizability Theory has been proposed as useful for disentangling state and trait components of psychopathology. METHODS We applied Generalizability Theory to determine the relative contributions of temporary and enduring aspects of depression in a widely used screening measure of depression the - 10-item Childrens Depression Inventory (CDI-10; Kovacs, 1985). Participants were children of Pacific Island descent living in New Zealand (n = 668). Data were collected at ages - 9, 11, and 14 years. RESULTS The CDI-10 demonstrated acceptable generalizability across occasions (G = 0.79) with about one third of variance in total scores attributed to temporary and two thirds to more enduring aspects of depression. There were no other significant sources of error variance. Two items were identified as more sensitive than the remaining eight to more dynamic symptoms. LIMITATIONS Studies with briefer test-retest intervals are warranted. Use of this Pacific Island cohort limits generalizability of findings to other cultures and ethnicities. No data were collected on whether participants had received intervention for depression. CONCLUSIONS While the CDI-10 reliably measures both stable and transient aspects of depression in children, the scale does not permit clear distinction between them. We advocate application of Generalizability Theory for developing state/trait depression measures and determining which existing measures are most suitable for capturing modifiable features of depression.

Pacific Islands Families Study: psychological distress among mothers of Pacific children living in New Zealand.

Objective: This study investigated: 1) the prevalence of psychological distress among a cohort of mothers of Pacific children; and 2) the socio‐demographic and lifestyle variables associated with psychological distress.

A gift and a burden: the purchase and distribution of duty-free tobacco and its potential impact upon Pacific people in New Zealand

Background High smoking rates among Pacific people living within New Zealand (26.9%) are a significant and poorly understood problem. A proposed approach to tobacco control is to enhance restrictions on or ban duty-free sales, a pertinent notion for Pacific people given their frequent travel between New Zealand and the Pacific Islands. This study examines the purchase and distribution of duty-free tobacco by Pacific people, whether it is being used as a strategy to circumvent the tobacco excise tax increases and how duty-free cigarette sales are perceived within the Pacific community. Methods We undertook a qualitative research study using six focus groups with Pacific smokers and non-smokers aged between 18 and 54 years. Half of the focus groups consisted of smokers and half non-smokers. We used a thematic analysis approach to identify, explore and report key themes within the data. Results Pacific smokers and non-smokers frequently purchase duty-free tobacco when travelling, and the usage of duty-free cigarettes for gift giving is a strongly embedded cultural value for Pacific peoples. However, nearly all participants strongly supported a proposal to reduce or ban duty-free tobacco sales. Conclusions The findings suggest a ban on duty-free sales could be an important measure to help achieve the smokefree 2025 goal among Pacific communities in New Zealand. This measure would eliminate duty-free tobacco as a cheap form of supply, and efforts to denormalise the practice of gifting duty-free tobacco among Pacific people may also be helpful in reducing high prevalence rates within these communities.

Cultural, individual, and familial risk and protective factors associated with depressive symptoms in Pacific youth living in New Zealand

ABSTRACT This article examines cultural, individual, and familial risk and protective factors associated with depressive symptoms in Pacific youth living in New Zealand. At ages 11 (n = 950) and 14 (n = 931), Pacific youth participated in multidisciplinary interviews that included the Children’s Depression Inventory. Across time points, factors significantly associated with higher depressive symptoms were involvement in bullying and gang activities. Positive parenting was significantly associated with lower depressive symptoms, and Tongan youth were significantly less likely to report depressive symptoms than Samoan youth. Time-varying factors were gender, problem behaviour syndromes, and maternal education. Gaining more knowledge about modifiable risk and protective factors that contribute to depression in Pacific youth is an important tool to support new approaches that promote adaptive psychological adjustment during adolescence.

Patterns of early primary school-based literacy interventions among Pacific children from a nationwide health screening programme of 4 year olds

Literacy success is critical to unlocking a child’s potential and enhancing their future wellbeing. Thus, the early identification and redressing of literacy needs is vital. Pacific children have, on average, the lowest literacy achievement levels in New Zealand. However, this population is very diverse. This study sought to determine whether the current national health screening programme of pre-school children could be used as an early detection tool of Pacific children with the greatest literacy needs. Time-to-event analyses of literacy intervention data for Pacific children born in years 2005–2011 were employed. A multivariable Cox proportional hazard model was fitted, and predictive assessment made using training and test datasets. Overall, 59,760 Pacific children were included, with 6,861 (11.5%) receiving at least one literacy intervention. Tongan (hazard ratio [HR]: 1.33; 95% confidence interval [CI]: 1.23, 1.45) and Cook Island Māori (HR: 1.33; 95% CI: 1.21, 1.47) children were more likely to receive an intervention than Samoan children; whereas those children with both Pacific and non-Pacific ethnic identifications were less likely. However, the multivariable model lacked reasonable predictive power (Harrell’s c-statistic: 0.592; 95% CI: 0.583, 0.602). Regardless, important Pacific sub-populations emerged who would benefit from targeted literacy intervention or policy implementation.