Browsing by Author "Firestone R"

Now showing 1 - 9 of 9
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    A better start national science challenge: supporting the future wellbeing of our tamariki E tipu, e rea, mō ngā rā o tō ao: grow tender shoot for the days destined for you
    (Taylor and Francis Group, 2023-02-22) Maessen SE; Taylor BJ; Gillon G; Moewaka Barnes H; Firestone R; Taylor RW; Milne B; Hetrick S; Cargo T; McNeill B; Cutfield W; Moton TM; King PT; Dalziel S; Merry S; Robertson S; Day A
    The majority of children and young people in Aotearoa New Zealand (NZ) experience good health and wellbeing, but there are key areas where they compare unfavourably to those in other rich countries. However, current measures of wellbeing are critically limited in their suitability to reflect the dynamic, culture-bound, and subjective nature of the concept of ‘wellbeing’. In particular, there is a lack of measurement in primary school-aged children and in ways that incorporate Māori perspectives on wellbeing. A Better Start National Science Challenge work in the areas of Big Data, Healthy Weight, Resilient Teens, and Successful learning demonstrates how research is increasing our understanding of, and our ability to enhance, wellbeing for NZ children. As we look ahead to the future, opportunities to support the wellbeing of NZ young people will be shaped by how we embrace and mitigate against potential harms of new technologies, and our ability to respond to new challenges that arise due to climate change. In order to avoid increasing inequity in who experiences wellbeing in NZ, wellbeing must be monitored in ways that are culturally acceptable, universal, and recognise what makes children flourish.
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    A scoping review of non-pharmacological perinatal interventions impacting maternal sleep and maternal mental health
    (BioMed Central Ltd, 2022-12) Ladyman C; Sweeney B; Sharkey K; Bei B; Wright T; Mooney H; Huthwaite M; Cunningham C; Firestone R; Signal TL
    BACKGROUND: A woman's vulnerability to sleep disruption and mood disturbance is heightened during the perinatal period and there is a strong bidirectional relationship between them. Both sleep disruption and mood disturbance can result in significant adverse outcomes for women and their infant. Thus, supporting and improving sleep in the perinatal period is not only an important outcome in and of itself, but also a pathway through which future mental health outcomes may be altered. METHODS: Using scoping review methodology, we investigated the nature, extent and characteristics of intervention studies conducted during the perinatal period (pregnancy to one-year post-birth) that reported on both maternal sleep and maternal mental health. Numerical and descriptive results are presented on the types of studies, settings, sample characteristics, intervention design (including timeframes, facilitation and delivery), sleep and mood measures and findings. RESULTS: Thirty-seven perinatal interventions were identified and further described according to their primary focus (psychological (n = 9), educational (n = 15), lifestyle (n = 10), chronotherapeutic (n = 3)). Most studies were conducted in developed Western countries and published in the last 9 years. The majority of study samples were women with existing sleep or mental health problems, and participants were predominantly well-educated, not socio-economically disadvantaged, in stable relationships, primiparous and of White race/ethnicity. Interventions were generally delivered across a relatively short period of time, in either the second trimester of pregnancy or the early postnatal period and used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep and the Edinburgh Postnatal Depression Scale (EPDS) to measure mood. Retention rates were high (mean 89%) and where reported, interventions were well accepted by women. Cognitive Behavioural Therapies (CBT) and educational interventions were largely delivered by trained personnel in person, whereas other interventions were often self-delivered after initial explanation. CONCLUSIONS: Future perinatal interventions should consider spanning the perinatal period and using a stepped-care model. Women may be better supported by providing access to a range of information, services and treatment specific to their needs and maternal stage. The development of these interventions must involve and consider the needs of women experiencing disadvantage who are predominantly affected by poor sleep health and poor mental health.
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    Association between recruitment methods and attrition in Internet-based studies.
    (PUBLIC LIBRARY SCIENCE, 2014) Bajardi P; Paolotti D; Vespignani A; Eames K; Funk S; Edmunds WJ; Turbelin C; Debin M; Colizza V; Smallenburg R; Koppeschaar C; Franco AO; Faustino V; Carnahan A; Rehn M; Merletti F; Douwes J; Firestone R; Richiardi L
    Internet-based systems for epidemiological studies have advantages over traditional approaches as they can potentially recruit and monitor a wider range of individuals in a relatively inexpensive fashion. We studied the association between communication strategies used for recruitment (offline, online, face-to-face) and follow-up participation in nine Internet-based cohorts: the Influenzanet network of platforms for influenza surveillance which includes seven cohorts in seven different European countries, the Italian birth cohort Ninfea and the New Zealand birth cohort ELF. Follow-up participation varied from 43% to 89% depending on the cohort. Although there were heterogeneities among studies, participants who became aware of the study through an online communication campaign compared with those through traditional offline media seemed to have a lower follow-up participation in 8 out of 9 cohorts. There were no clear differences in participation between participants enrolled face-to-face and those enrolled through other offline strategies. An Internet-based campaign for Internet-based epidemiological studies seems to be less effective than an offline one in enrolling volunteers who keep participating in follow-up questionnaires. This suggests that even for Internet-based epidemiological studies an offline enrollment campaign would be helpful in order to achieve a higher participation proportion and limit the cohort attrition.
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    Dietary Fibre Intake, Adiposity, and Metabolic Disease Risk in Pacific and New Zealand European Women
    (MDPI (Basel, Switzerland), 2024-10-07) Renall N; Merz B; Douwes J; Corbin M; Slater J; Tannock GW; Firestone R; Kruger R; Te Morenga L; Brownlee IA; Feraco A; Armani A
    BACKGROUND/OBJECTIVES: To assess associations between dietary fibre intake, adiposity, and odds of metabolic syndrome in Pacific and New Zealand European women. METHODS: Pacific (n = 126) and New Zealand European (NZ European; n = 161) women (18-45 years) were recruited based on normal (18-24.9 kg/m2) and obese (≥30 kg/m2) BMIs. Body fat percentage (BF%), measured using whole body DXA, was subsequently used to stratify participants into low (<35%) or high (≥35%) BF% groups. Habitual dietary intake was calculated using the National Cancer Institute (NCI) method, involving a five-day food record and semi-quantitative food frequency questionnaire. Fasting blood was analysed for glucose and lipid profile. Metabolic syndrome was assessed with a harmonized definition. RESULTS: NZ European women in both the low- and high-BF% groups were older, less socioeconomically deprived, and consumed more dietary fibre (low-BF%: median 23.7 g/day [25-75-percentile, 20.1, 29.9]; high-BF%: 20.9 [19.4, 24.9]) than Pacific women (18.8 [15.6, 22.1]; and 17.8 [15.0, 20.8]; both p < 0.001). The main source of fibre was discretionary fast foods for Pacific women and whole grain breads and cereals for NZ European women. A regression analysis controlling for age, socioeconomic deprivation, ethnicity, energy intake, protein, fat, and total carbohydrate intake showed an inverse association between higher fibre intake and BF% (β= -0.47, 95% CI = -0.62, -0.31, p < 0.001), and odds of metabolic syndrome (OR = 0.91, 95% CI = 0.84, 0.98, p = 0.010) among both Pacific and NZ European women (results shown for both groups combined). CONCLUSIONS: Low dietary fibre intake was associated with increased metabolic disease risk. Pacific women had lower fibre intakes than NZ European women.
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    Frequent Use of Baby Food Pouches in Infants and Young Children and Associations with Energy Intake and BMI: An Observational Study.
    (MDPI (Basel, Switzerland), 2024-09-19) McLean NH; Bruckner BR; Heath A-LM; Haszard JJ; Daniels L; Conlon CA; von Hurst PR; Beck KL; Te Morenga LA; Firestone R; McArthur J; Paul R; Cox AM; Jones EA; Katiforis I; Brown KJ; Casale M; Jupiterwala RM; Rowan MM; Wei A; Fangupo LJ; Healey M; Pulu V; Neha T; Taylor RW; Fernandez M-L
    OBJECTIVE: Most wet commercial infant foods are now sold in squeezable 'pouches'. While multiple expert groups have expressed concern about their use, it is not known how commonly they are consumed and whether they impact energy intake or body mass index (BMI). The objectives were to describe pouch use, and determine associations with energy intake and BMI, in infants and young children. METHODS: In this observational cross-sectional study of 933 young New Zealand children (6.0 months-3.9 years), pouch use was assessed by a questionnaire ('frequent' use was consuming food from a baby food pouch ≥5 times/week in the past month), usual energy intake using two 24-h recalls, and BMI z-score calculated using World Health Organization standards. RESULTS: The sample broadly represented the wider population (27.1% high socioeconomic deprivation, 22.5% Māori). Frequent pouch use declined with age (infants 27%, toddlers 16%, preschoolers 8%). Few children were both frequent pouch users and regularly used the nozzle (infants 5%, toddlers 13%, preschoolers 8%). Preschoolers who were frequent pouch users consumed significantly less energy than non-users (-580 kJ [-1094, -67]), but infants (115 [-35, 265]) and toddlers (-206 [-789, 378]) did not appear to have a different energy intake than non-users. There were no statistically significant differences in the BMI z-score by pouch use. CONCLUSIONS: These results do not support the strong concerns expressed about their use, particularly given the lack of evidence for higher energy intake or BMI.
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    Identifying and overcoming barriers to healthier lives
    (Pasifika Medical Association, 30/09/2018) Firestone R; Funaki T; Dalhousie S; Henry A; Vano M; Grey J; Jull A; Whittaker R; Te Moringa L; Ni Mhurchu C
    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 wellbeing’: 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 Pasifikacommunities, the findings from this study highlight their needs as step forward in overcoming barriers to healthier lives.
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    Investigating principles that underlie frameworks for Pacific health research using a co-design approach: learnings from a Tongan community based project
    (Pasifika Medical Association, 22/06/2021) Pulu V; Tiatia-Seath J; Borman B; Firestone R
    The New Zealand Tongan peoples’ worldview leans more towards a traditional and indigenous paradigm that encompasses the importance of family, spirituality or Christian beliefs and connection with their environment. These priorities align with core principles and values of co-design, and therefore, co-designed interventions will be better used and accepted in addressing health issues prevalent in the Tongan community. Co-design methods adapt to the cultural setting they are applied to, prioritizes the Tongan peoples’ cultural values and world views and captures the needs of the Tongan community to inform the development of the intervention. It supports family members to stand with authority, as well as place the Tongan participants at the centre of the research by including families, employing culturally safe practices, addressing the broader determinants of health, and focusing on system issues rather than on individuals.The generation of discussion in co-design further aligns with the Pacific knowledge of systems, creation stories and oral stories which provide a culturally empowering way to generate discussion and insights from the Tongan community
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    Pasifika prediabetes youth empowerment programme: evaluating a co-designed community-based intervention from a participants’ perspective
    (Taylor and Francis Group on behalf of the Royal Society of New Zealand, 4/02/2021) Firestone R; Faeamani G; Okiakama E; Funaki T; Henry A; Prapaveissis D; Filikitonga J; Firestone J; Tiatia-Seath J; Matheson A; Brown B; Schleser M; Kaholokula JKA; Ing C; Borman B; Ellison-Loschmann L
    This paper provides insights from a community-centre intervention study that was co-designed by youth, health providers and researchers. The aims of the paper were to highlight the effectiveness of a co-designed community centred diabetes prevention intervention, and to determine whether a culturally tailored approach was successful. The study participants (n = 26) were at risk of developing prediabetes and represented the working age group of Pasifika peoples in NZ (25–44-year olds). The community-centre intervention consisted of 8 weeks of community physical activity organised and led by the local youth, a community facilitator, and the community provider. Semi-structured interviews with each of the intervention participants using a Pasifika narrative approach (talanoa) was carried out. Each interview was transcribed, coded and analysed and compared using thematic analyses. The study highlights four major themes illuminating positive successes of the community-centre intervention programme, and conclude that co-designing interventions for Pasifika peoples, should be culturally tailored to meet the realities of the communities and require strong support from associated community providers.
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    Trajectories and Transitions in Childhood and Adolescent Obesity
    (2015-01-01) Howe LD; Firestone R; Tilling K; Lawlor DA
    The last few decades have seen a dramatic rise in the prevalence of overweight and obesity in most high-income countries. This rise has been seen across all ages, even in very young children. Childhood obesity has both immediate and long-term health consequences and is now recognised as one of the most important public health concerns of our time. In this chapter, we take a life course perspective to review the evidence on trajectories and transitions in childhood and adolescent obesity. Understanding the life course aetiology of obesity is essential to inform prevention strategies – for example, knowing how the incidence of obesity changes across childhood and adolescence can be informative about the potential impact of intervening in different age groups. In this chapter, we review the evidence on the ages at which children tend to become overweight or obese, and the degree to which obesity persists once established. We then go on to discuss the importance of applying a life course perspective to the study of childhood and adolescent obesity, including the possibility that distinct adiposity trajectories have different long-term health consequences and the fact that longitudinal studies enable a finer analysis of the determinants of obesity than is possible from cross-sectional studies, improving aetiological insight. In the concluding part of this chapter, we reflect on the importance of a life course perspective in studies of childhood and adolescent obesity, and discuss future directions for life course studies in this area.