The interface of gambling and cultural practices: a Tongan male perspective in Aotearoa | New Zealand.

Introduction: For over 30 years, Pacific people have been identified as more at risk of developing problem gambling behaviors than the general population. That observation has not changed despite the increase in treatment service providers, Pacific gambling literature and problem-gambling literature, which are primarily quantitative-based. This article explores the interface of gambling and cultural practices from a Tongan male perspective to consider whether status advancement and rank contribute to the problem-gambling statistics and the qualitative reasons why Tongan peoples engage in gambling activities. Methods: A phenomenological approach using the talanoa research method was employed to carry out this study. A total of 46 Tongan males participated in this study. Interpretative Phenomenological Analysis was employed to interpret the data. The ethical approval reference number 16/452 for this research was granted by the Auckland University of Technology Ethics Committee (AUTEC). Results: Participants noted the concept of fatongia as a motivating factor for Tongans to engage in gambling activities, which, in turn, elevates family and village status and rank. Discussion: Strategies and recommendations around raising cultural awareness with treatment providers are critical to understanding Tongan gambling in New Zealand.

Community pharmacists' roles in providing contraceptive services: views and experiences of adolescents in urban Khon Kaen, Northeast Thailand.

OBJECTIVES: Adolescent pregnancy is a national public health priority in Thailand. While contraceptive methods are available to prevent adolescent pregnancy, Thai adolescent contraceptive usage is low. Community pharmacists are likely the first health professionals to contact adolescents engaged in unprotected sex and needing emergency contraception. However, there is limited research on Thai pharmacists' roles in promoting sexual and reproductive health. This study examines Thai adolescents' perspectives on community pharmacists' roles in promoting contraceptives and preventing unwanted pregnancies. METHOD: This qualitative study recruited 38 adolescents aged 15-19 from one vocational school and one secondary school in Khon Kaen, Thailand. Data were collected from focus group discussions and in-depth interviews and analysed using thematic analysis. KEY FINDINGS: Participants felt community pharmacists had potentially critical roles in promoting adolescent contraceptive use. Community pharmacists had relevant knowledge of effective contraceptive methods, the risks and benefits of each method, and the quality of different condoms available. Community pharmacists, at times, also provided emotional support to distressed adolescents who came to their store. However, participants reported pharmacists' age, gender, and non-empathetic and judgemental attitudes could be barriers to adolescents' ease of access to contraceptive services. CONCLUSION: This study highlights the potentially crucial role community pharmacists could play in providing contraceptive information for adolescents. It suggests the need for changes in government policies and education and training of community pharmacists to enhance their soft skills - empathetic and non-judgemental attitudes - and their roles in delivering youth-friendly sexual and reproductive health services.

Culture, church, and collective: a qualitative study about gambling harm prevention and reduction in Aotearoa/New Zealand-a Tongan male perspective.

BACKGROUND: In New Zealand, Pacific people continue to be more at risk of gambling harm than the general population, despite increasing public health efforts and treatment service provisions introduced to address this social and health issue. In looking at why this is so, our first concern was to ask why the delivery of the prevailing gambling-focussed programmes was not influencing Pacific gambling behaviours. In seeking to answer this question, it was important to explore ethnic-Pacific-specific factors of gambling harm prevention and reduction. METHODS: The research design was interpretivist/constructivist and phenomenological, applied through the lens of a Tongan worldview. Participants comprised Tongan male elders and youth. Recruitment of participants was through snowball sampling from churches and kava-drinking circles. A total of 28 elders and 18 youth participated through focus group talanoa and individual talanoa. This study employed descriptive thematic analysis. RESULTS: Participants were not aware of any policy document or problem-gambling preventative programmes. Four key themes were raised, which include raising the awareness of existing gambling harm treatment providers, the church influence in addressing gambling harm, community-based strategies, and cultural-based approaches. CONCLUSIONS: This study proposes several recommendations such as more awareness of gambling harm providers in community, increasing cultural spaces and church engagements, and calls for further research in addressing the prevention and reduction of gambling harm amongst the Tongan community in New Zealand.

Overcoming Barriers to Cervical Screening Among Pacific Women: A Narrative Review.

Purpose: This narrative review explores the barriers and facilitators for Pacific women accessing the cervical screening pathway. Despite organized cervical screening in New Zealand, Pacific women still face significant health disparities in regard to cervical cancer incidence and mortality and access to colposcopy services. Providing a narrative synthesis of the available literature examining Pacific women and the barriers and facilitators to the cervical screening pathway may provide some insight into the provision of primary and secondary health services for Pacific women. Methods: Four electronic databases were searched for articles published between January 1990 and June 2017 and included bibliographies of key journal articles and gray material. A narrative review and synthesis were undertaken of qualitative, quantitative, and mixed methods research. Results: The literature is focused on the cervical screening aspect of the cervical screening pathway. There was a paucity of literature that examines the barriers and facilitators Pacific women experience accessing colposcopy services. Barriers to cervical screening for Pacific women are multifaceted and interrelated. Factors such as culture, fear, practical issues, health care experiences, and knowledge/education influence screening practices. Facilitators to cervical screening are also multifaceted and included knowledge, health care experience, culture, and practical issues. Culturally tailored approaches improve access to cervical screening for Pacific women. Conclusion: Understanding Pacific women's experiences, facilitators, and barriers to the cervical screening pathway is essential in assisting health care professionals, policy makers, and funders provide culturally appropriate services. Further research is required to examine Pacific women's experiences of navigating colposcopy services and the interface between primary and secondary care services.

Traumatic brain injury within Pacific people of New Zealand.

AIMS: Previous research has suggested there are ethnic disparities in the incidence of traumatic brain injury (TBI). This study aimed to: identify the incidence of TBI for Pacific people; describe the injury profile in this population; and determine if there were disparities in healthcare service use. METHODS: All TBI cases that occurred within a 1-year period in the Hamilton and Waikato regions of New Zealand were identified using multiple case ascertainment methods as part of a population-based incidence study. Demographic and injury data from people who self-identified as a Pacific person (N=76) were extracted and compared to New Zealand (NZ) Europeans (N=794). Differences in injury severity, mechanism of injury and acute healthcare service use were explored between the two ethnic groups. RESULTS: The total crude incidence of TBI in Pacific people was 1242 cases per 100,000 person-years, significantly higher than NZ Europeans (842 per 100,000). Peaks in incidence for Pacific people and NZ Europeans were observed between 0-4 and 15-24 years of age, with males at greater risk of injury than females. There were no statistically significant differences in TBI severity, mechanism of injury and acute healthcare use between the two groups. CONCLUSION: Pacific people are at a significantly higher risk of experiencing a TBI than NZ Europeans and targeted prevention efforts are needed.

Maternal childhood parental abuse history and current intimate partner violence: data from the Pacific Islands Families Study.

Pacific peoples are a rapidly growing but socially disadvantaged segment of New Zealand society. Within this context, individuals may be particularly vulnerable to the experience of intimate partner violence (IPV). The aim of the study was to establish the association between the experience of maternal and/or paternal emotional or physical abuse and current severe physical partner violence perpetration or victimization among a cohort of Pacific women. Paternal physical abuse was the only statistically significant risk factor from childhood parenting history that was independently associated with severe physical perpetration and victimization within the mother's current intimate partner relationship (RR 2.6). These findings highlight the deleterious effect of paternal physical violence on subsequent IPV and contribute to the development of empirically based and considered ways to approach these complex phenomena.