Demographic discrepancies between administrative-prioritisation and self-prioritisation of multiple ethnic identifications.

Ethnic classification is an inherently subjective process, especially when multiple ethnic identifications are involved. There are two methods commonly used to classify multiple ethnicities into single categories: administrative-prioritisation (assignment via a predetermined hierarchy) and self-prioritisation (where individuals select their "main" ethnicity). Currently, little is known about whether the demographic composition of outputted ethnic groups differs by prioritisation method. This study utilised large-scale data of multi-ethnic children (N = 1,860), adolescents (N = 2,413), and adults (N = 1,056) from Aotearoa New Zealand to examine individual and contextual demographic characteristics associated with discrepancies between administratively-prioritised and self-prioritised ethnicity. Results showed that discrepancy rates, which exceeded 50%, were systematically associated with neighbourhood ethnic composition and socioeconomic deprivation, but largely not associated with gender, age, and birthplace. The contextual nature of self-prioritisation highlights the importance of researchers' choice of ethnic classification method. Implications are discussed in the context of increasing multi-ethnic prevalence.

Assessing youth empowerment and co-design to advance Pasifika health: a qualitative research study in New Zealand.

OBJECTIVES: The Pasifika Prediabetes Youth Empowerment Programme (PPYEP) was a community-based research project that aimed to investigate empowerment and co-design modules to build the capacity of Pasifika youth to develop community interventions for preventing prediabetes. METHODS: This paper reports findings from a formative evaluation process of the programme using thematic analysis. It emphasises the adoption, perceptions and application of empowerment and co-design based on the youth and community providers' experiences. RESULTS: We found that the programme fostered a safe space, increased youth's knowledge about health and healthy lifestyles, developed their leadership and social change capacities, and provided a tool to develop and refine culturally centred prediabetes-prevention programmes. These themes emerged non-linearly and synergistically throughout the programme. CONCLUSIONS: Our research emphasises that empowerment and co-design are complementary in building youth capacity in community-based partnerships in health promotion. Implications for public health: Empowerment and co-design are effective tools to develop and implement culturally tailored health promotion programmes for Pasifika peoples. Future research is needed to explore the programme within different Pasifika contexts, health issues and Indigenous groups.

Pasifika Prediabetes Youth Empowerment Programme: learnings from a youth-led community-based intervention study.

AIM: Using a co-design approach, we describe exploratory findings of a community-based intervention to mobilise Pasifika communities into action, with the intent of reducing the risk factors of prediabetes. METHOD: A group of 25 Pasifika youth aged 15-24 years from two distinctive Pasifika communities in New Zealand were trained to lead a small-scale, community-based intervention programme (among 29 participants) over the course of eight weeks. The intervention, which targeted adults aged 25-44 years who were overweight or obese, employed both an empowerment-based programme and a co-design approach to motivate community members to participate in a physical-activity-based intervention programme. RESULTS: Findings show significant reductions in total body weight and waist circumference, as well as improved physical activity. CONCLUSIONS: The strength of this intervention was evident in the innovative approach of utilising Pasifika-youth-led and co-designed approaches to motivate communities into healthier lifestyles. The approaches used in this project could be utilised in a primary healthcare setting as a community-wide strategy to reduce diabetes risk, particularly among Pasifika peoples.

Young Pacific Male Rugby Players' Perceptions and Experiences of Mental Wellbeing.

Recent studies and increased media reporting across Australasia have linked young Pacific maleelite athletes to depression, suicide, and other adverse mental health-related events. Despite these accounts,little is known about the way this group experience emotions and mental wellbeing. The aim of this studywas to explore young Pacific male athletes' perceptions and experiences of emotions and mental wellbeing.This qualitative study involved 20 face-to-face interviews with young Pacific males (16⁻24 years) engaged inelite rugby union and rugby league programmes in Auckland, New Zealand. The results identified thatathletes defined mental wellbeing in a holistic and relational manner and perceived and mental wellbeing asthe culmination of several interconnected factors, including: Family support, reciprocating family support,living a 'well-balanced' life, athletic performance, and personal development away from sports. Themaintenance of a well-balanced athletic identity and positive social relations were deemed central tosustaining mental wellbeing for these young men.

Health and wellbeing of Maori secondary school students in New Zealand: Trends between 2001, 2007 and 2012.

OBJECTIVE: To describe the health status over time of Maori secondary school students in New Zealand compared to European students. METHODS: Anonymous representative health surveys of New Zealand secondary school students were conducted in 2001, 2007 and 2012 (total n=27,306 including 5,747 Maori). RESULTS: Compared to 2001, Maori students in 2012 experienced improved health, family and school connections. However, considerable inequity persists with Maori students reporting poorer health, greater exposure to violence and socioeconomic adversity compared to European students. When controlling for socioeconomic deprivation, inequity was substantially reduced, although worse Maori health outcomes remained for general health, mental health, contraceptive use, healthy weight, substance use, access to healthcare and exposure to violence. There was some evidence of convergence between Maori and European students on some indicators. CONCLUSIONS: There have been significant improvements for Maori youth in areas of health where there has been investment. Priority areas identified require adequate resourcing alongside addressing systematic discrimination and poverty. Implications for public health: Socioeconomic contexts, discrimination, healthcare access and identified priority health areas must be addressed to improve equity for Maori youth. Building on these gains and hastening action on indicators that have not improved, or have worsened, is required.

The management of young people who self-harm by New Zealand Infant, Child and Adolescent Mental Health Services: cutting-edge or cutting corners?

OBJECTIVES: Self-harm is common in New Zealand (NZ) young people and can have short-term and long-term consequences, including suicide. This study was undertaken to examine the extent to which evidence-based approaches for addressing self-harm are offered by Infant, Child and Adolescent Mental Health Services (ICAMHS). METHODS: A national survey of ICAMHS practitioners working with young people who self-harm was undertaken between May and July 2016. RESULTS: Responses from 23 out of 30 ICAMHS confirmed self-harm was a familiar presentation and most commonly associated with diagnoses of depression, anxiety and borderline personality disorder. Cognitive behavioural therapy (47.1%, n = 8), dialectical behaviour therapy (47.1%, n = 8) and acceptance and commitment therapy (5.9%, n = 1) were the treatments of choice, but variably delivered. There were significant training gaps for all types of therapy. CONCLUSIONS: Although it is reassuring that many ICAMHS are using evidence-based approaches to address self-harm in young people, there is concerning variability in the way these therapies are delivered. Improvement in training in key modalities, further research into therapist performance and continuous evaluation of workforce development are needed to maximise the effectiveness of proven interventions and provide NZ young people with the state-of-the-art service they deserve.

Morbidity from intentional self-harm among Pacific peoples in New Zealand 1996-2015.

AIM: The aim of this study was to describe trends in intentional self-harm for Pacific peoples in New Zealand by reviewing official data over the period 1996-2015. METHOD: Publicly funded hospitalisations where the external cause was intentional self-harm were examined and areas of interest were identified and are presented. RESULTS: Over a 19-year period (1996-2015), there were 1,608 intentional self-harm events for Pacific peoples (2.8%) out of 58,643 intentional self-harm events nationally for New Zealand's total population. CONCLUSION: This study has been able to delineate Pacific ethnic-specific information not previously available for a prolonged period of 19 years. There are differences in Pacific peoples' experiences between ethnic groups. Furthermore, disparities persist between Pacific and non-Pacific. This study exposes priority areas for more targeted interventions according to ethnic, socioeconomic status, gender and age variations.

Suicide mortality among Pacific peoples in New Zealand, 1996-2013.

AIM: The aim of this study was to describe trends in suicide mortality for Pacific peoples in New Zealand by reviewing official data over the period 1996-2013. METHOD: Death registrations where the underlying causes of death were intentional self-harm was examined and area of interest was identified and presented. RESULTS: Over a 17-year period (1996-2013), there were 380 total Pacific suicides (4.1%) out of 9,307 suicides nationally for New Zealand's total population. CONCLUSION: Priority areas for effective suicide prevention include: Pacific young males, Pacific ethnic foci, clear ethnic disparities and inequalities for Pacific suicide mortality when compared to New Zealand's total population; safe, ethical and culturally appropriate messaging around suicide methods; the importance of the role of mental health and addictions in suicide prevention. On average, there are at least 22 Pacific suicides annually in New Zealand. Irrespective of small numbers, further Pacific ethnic breakdown is needed other than Samoan, Cook Islands and Tongan, as this is problematic for suicide prevention efforts for the exclusion of other Pacific groups.

Risk and Protective Factors for Suicidal Behaviors Among Pacific Youth in New Zealand.

BACKGROUND: New Zealand has the second highest youth suicide rate in the OECD and particularly among Pacific New Zealanders, who have a threefold higher risk of suicide attempt compared with the general population. AIMS: Protective and risk factors for suicide attempts among New Zealand Pacific adolescents were assessed using data from Youth'12, an adolescent health and well-being survey. METHOD: This randomly selected nationally representative sample of New Zealand secondary school students included 1,445 Pacific high school students aged 12-17 years. RESULTS: One in 10 (11.6%) Pacific adolescents reported attempting suicide. Risk factors for suicide included: being female, household food insecurity, low levels of family connections and family monitoring, life dissatisfaction, having a religious affiliation, and previous suicide by a family member or friend. Of those who had made a suicide attempt, 71% also experienced both suicide ideation and self-harm. CONCLUSION: This study suggests that given the high rates of suicide ideation and attempts among Pacific young people, targeted trials for new ways of support should be prioritized for this high-risk group. The Pacific family environment, which continues to be the critical space for intervening, and the school environment, as a provider of health services, were both protective of suicide attempt.