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    Loto Malie (Contented Heart) : understanding Pacific youth mental wellbeing : a thesis by publication presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Albany, New Zealand
    (Massey University, 2024) Auva'a-Alatimu, Taulaga Monica
    The voices and perspectives of Pacific young people can often be overlooked, yet they are instrumental in shaping the future of today’s society; their voices need to be amplified. Pacific youth, a diverse and vibrant group in Aotearoa New Zealand, are facing growing mental health concerns and are less likely than youth of other ethnicities to seek psychological help due to stigma and a lack of mental health awareness. The paucity of culturally appropriate psychological interventions may contribute to Pacific youth’s reluctance to seek help. The Ministry of Health has encouraged the implementation of Pacific worldviews when promoting the wellbeing of Pacific youth. This study aimed to contribute to the development of new knowledge in Pacific Mental health research and psychological interventions for Pacific youth. To date, there has been limited published research on psychological approaches which integrate spirituality, culture and a digital intervention for promoting mental wellbeing in Pacific youth. This research explores Pacific youth’s experiences of engaging with mental health tools, specifically a Pacific mental health intervention developed for the very purpose of meeting the needs of Pacific youth, Loto Malie (contented heart). In exploring youth experiences and perspectives on mental health, prioritising Pacific-Indigenous knowledge in the research methodology was fundamental. Consequently, the Fa’afaletui and Talanoa frameworks, which draw on Pacific-Indigenous methodologies, provided culturally sound processes for engagement with Pacific youth which allowed them to share their stories and experiences authentically. The findings highlight the key themes that formulate and conceptualise the Loto Malie therapeutic framework, revealing the importance of interweaving culture and spirituality within the therapeutic environment, especially as this strengthened Pacific youth engagement with this approach. At the outset, the aim of this PhD was to explore digital mental health tools with youth, given the low uptake of such tools specifically among Pacific youth. The primary researcher developed an innovative cultural digital mental health intervention, Loto Malie 2.0 Mukbang + mental health, as an interim measure during the pandemic. This innovative approach was shared privately (upon invitation) via YouTube and Facebook. Loto Malie 2.0 aimed to provide accessible cultural and clinical examples that promoted mental health awareness and meaningful connections with the viewers, who were predominantly young adults. Overall, developing the Loto Malie programme and Loto Malie 2.0 allowed young people to attain mental health knowledge and equipped them with relevant tools for wellbeing improvement. Therefore, this newfound knowledge and wisdom provided initial evidence that Pacific youth engage effectively with mental health tools when they are grounded in a Pacific therapeutic approach embedded within their worldviews. The Loto Malie therapeutic framework aims to serve as a guide for Pacific therapeutic approaches to enhance the overall wellbeing of Pacific youth.
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    Pacific media’s portrayal of type two diabetes : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Health Psychology, Massey University, Palmerston North, New Zealand
    (Massey University, 2024) Eden, Chelsea
    Pacific countries experience the highest rates of type two diabetes (T2D) in the world. Type two diabetes is a chronic health condition, resulting from the bodies inability to regulate insulin, and when left untreated can result in serious health consequences. Diabetes is the nineth leading cause of death worldwide, and T2D is the most prevalent, accounting for 90% of diabetes cases. Little is known about how media frames T2D across New Zealand and the Pacific. This study used reflexive thematic analysis to examine Pacific print media, to identify the messages about T2D. Specifically, it looked into how T2D is described and portrayed, and the causes, effects, and solutions that are reported across the articles. The study analysed 103 online Pacific print media articles. Key themes were: the description of what T2D is, and the causes, effects and solutions of T2D. New Zealand articles tended to present a broader perspective, considering wider factors such as globalisation, neoliberalism and determinants of health, and the differing impact this has on populations. Contrastingly, the majority of articles originating in the Pacific, focussed on a specific aspect of T2D, such as a specific, cause, effect or solution. Articles varied in framing of T2D, its impacts, and explanations regarding its causes and effects. These framings included T2D being presented as a life-long condition, a treatable illness, a disease, and a lifestyle issue. However, the articles tended to lack depth of discussion, such as framing healthy eating as a solution and cure but not unpacking what this means. Western, neoliberal ideology dominated the media articles with no articles covering Pacific models of health. Many of the causes of T2D and its more serious consequences were attributed to the individual’s choices and globalisation. The effects across articles were often presented as dire and extreme, with articles generally focused on one effect (such as amputation). Solutions across articles again very much focused on what the individual should do, with articles focused on a single solution with little justification or alternative provided. There were few articles examining sustainable and value aligning changes that could be made to reduce the incidence of T2D and its consequences. Overall, the media portrayed T2D as a serious noncommunicable disease that is a burden on society with Pacific people positioned at risk.
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    Pacific peoples’ perspectives on spiritual health : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Public Health in Public Health at Massey University, Wellington, New Zealand
    (Massey University, 2024) Hitti, Penina Ruhiyyih
    This research investigates Pacific peoples’ perspectives on spiritual health and how this perspective contributes to the discourse on social determinants of health for inclusion in public health programmes and approaches. Pacific views on the value of holistic health and cultural principles are fundamental in addressing health inequities for Pacific people. Within the context of public health, the aim of the research examines the relationship between spirituality and wellbeing, acknowledging the interconnectedness of spiritual health with physical, mental, and social health. The research methods of inquiry includes an extensive literature review to identify a definition of spiritual health, considering historical influences and the potential challenges that present themselves when efforts are made to fit indigenous knowledge into existing health frameworks. The study also uses a qualitative methodology and adopts Pacific Talanoa for its focus group discussion among Pacific peoples representing different religious backgrounds. The findings highlight four main themes as a result of the focus group (1) interconnectedness of spiritual health with other areas of health; (2) importance of spiritual health practices; (3) influence of religious and cultural factors; and (4) interdependence of spiritual health on individual, familial, communal, and environmental health. In conclusion, this study found that spiritual health has a significant role in promoting holistic wellbeing and health for Pacific peoples. By including and incorporating cultural and religious elements into health interventions, public health professionals and researchers may be able to develop more effective strategies to address health disparities and promote equitable health outcomes for Pacific people.
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    Co-designing a community-based intervention for prediabetes among Tongan youths in New Zealand : a thesis presented in partial fulfilment of the requirements of Doctor of Philosophy in Public Health at Massey University, Wellington Campus, New Zealand
    (Massey University, 2023) Pulu, Veisinia
    The Tongan population is the second largest Pacific ethnic group in New Zealand, and they have a high rate of prediabetes, characterised by high obesity, hypertension, sedentary behaviours, and unhealthy diets. Addressing this condition through a Tongan community centred based programme, the progression of type 2 diabetes and future health complications can be prevented. Aim: The overall objective of this study was to investigate the Tongan youths and adults’ understanding of prediabetes by mobilising them into collective actions to lead healthier lives. Methods: There were three phases of this study. Phase one explored the perception and understanding of prediabetes and its impact on health and well-being among 8 youth and 11 adults. Phase two applied the Bratteteig co-design methodology to co-develop and implement a community-based intervention called Polokalama mo’ui lelei to address the main characteristics of prediabetes (diet, physical activity, weight management and enhanced knowledge about prediabetes). Phase three involved two online focus groups (youth group=4, adult group = 3) to evaluate the effectiveness of the Polokalama mo’ui lelei. Findings: Phase one findings highlighted that the Tongan youth and adults have limited knowledge of prediabetes which was attributed to the lack of understanding and access to health promotion services. This was compounded by generational health information that had been conceptualized within families, further enhancing their limited understanding. Phase two of the co-designed program showed improvements in weight management measurements; however, the number of participants was too small (n=10) to infer meaningful findings. Phase three findings highlighted key barriers for accessing the program, such as household income, education and motivation factors, and socio-cultural and economic factors. Conclusion: Education and knowledge about prediabetes was viewed as a major issue for the Tongan community members when they had learnt about it. The co-design approach in phase two was demonstrably a socially relevant approach to undertake with the Tongan community, but the method used was not a culturally relevant approach. As a result, a major development from this study was the establishment of the Fengaueaki Fakataha model, a new Tongan model of health. This model provides Tongan cultural insights and protocols which help explain the findings, and it could be used as a guide for conducting future research when working with Tongan communities.
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    A challenge of 28-day, a Pasifika way intervention to reduce free sugar consumption : a thesis presented in partial fulfilment of the requirements for the degree of Masters in Public Health at Massey University, Wellington Campus, New Zealand
    (Massey University, 2020) Vea, Telusila Moala
    Background: The direct link between excess free sugar consumption with negative health effects including dental caries, heart disease, diabetes and obesity is well documented. Pacific people in New Zealand experience a disproportionate burden from the above said health conditions in term of morbidity and mortality. The World Health Organization defines free sugar as – monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices, and fruit juice concentrated. A group-based brief intervention for sugar consumption reduction was piloted among a group of Pacific participants. Aim: This study aimed to assess the feasibility of a group-based intervention for sugar reduction with Pacific people. Methods: This study explored the feasibility of a brief group-based intervention aimed at reducing sugar consumption within the Pacific community. Participants were recruited via word of mouth from the Auckland community. The pre-post intervention delivered two group based sessions plus ongoing support via social media over a 28 day period. The intervention was grounded on self-determination theory which supports autonomy, competence and relatedness. It delivered goal setting and a simple set of planning techniques (action planning and coping planning) plus self-monitoring. Participants completed baseline assessment via Qualtrics and then again 28 days post-intervention. Data analysis involved a mixed methods approach which involved both quantitative and qualitative data collection. Results: Twenty four participants were recruited for the study. Quantitative analysis indicated a significant reduction in sugar consumption and a significant increase in self-efficacy. The majority of participants were mostly or very satisfied with the program materials. Generally they agreed action plans were initially developed and participants knew how, where and when they would reduce sugar consumption. Qualitative data indicated the majority of participants found the plans very helpful. Interestingly, participants stated they would have liked more ownership of peer support. Conclusion: In conclusion, the study findings support the feasibility of a group-based intervention for sugar reduction with Pacific people. Future research can build on these findings to develop improved group-based interventions. Future studies might also ensure recruitment from all Pacific ethnic groups and from the wider Pacific community in New Zealand.