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INTRODUCTION: Obesity is disproportionately prevalent among Pacific population groups in New Zealand. Lifestyle behaviours of excessive consumption of high energy, unhealthy foods and inadequate physical activity are risk factors for obesity that can be modified. AIM: To identify and describe the risk factors for and protective factors against obesity among Pacific Island (PI) adolescents who attend church and compare them with PI adolescents who do not attend church. METHODS: We investigated the lifestyle behaviours of 2495 PI adolescents at six secondary schools in Auckland, New Zealand (NZ), 77% of whom attend a church or other place of worship. The cross-sectional survey was undertaken in 2005. Structured individual interviews and anthropometric measurements were undertaken. RESULTS: Church attendees had a higher mean body mass index (BMI) compared with non-attendees (BMI 27.4 vs BMI 26.6), adjusted for age, gender and PI ethnicity (p=0.01). The weight status of attendees was associated with less healthy breakfast and lunch sources, lower levels of physical activity, and limited knowledge of the risk factors for obesity (p

Introduction Participation in the health-care system is a key component of healthy ageing strategies. The number of Pacific people aged ≥65 years in Aotearoa New Zealand will increase significantly over the next decade. Addressing the considerable health inequities and unmet need for care Pacific Island people experience when compared to other ethnicities in Aotearoa New Zealand should be a priority. Aim To identify barriers to older Pacific people's participation in the health-care system in Aotearoa New Zealand. Methods A participatory action research design was utilised. In total, 104 Pacific co-researchers contributed to focus groups using Talanoa , a traditional method of conversational dialogue deeply rooted in Pacific Island culture. Data were collected in Pacific Island languages from storytelling and conversations shared within the focus groups. Data were translated into English and analysed using a collaborative approach. Results Three main themes captured older Pacific peoples' barriers to participation in the health-care system: accessing health care; relationships with health-care providers; and understanding the health-care system. Discussion Older Pacific people have the capacity to influence locally driven programmes to be more responsive to their needs and aspirations. Improving older Pacific peoples' participation in health care will require a commitment to partnership and inter-sectoral collaboration identified in recent ageing strategies. The findings will inform local communities, and policy and practice aimed at improving the health and wellbeing of Pacific peoples who are ageing in Aotearoa New Zealand.

Introduction Chronic disease such as cancer, cardiovascular, diabetes, mental health and obesity have debilitating effects on sufferers with impacts seen increasingly at a younger age. A whole-of-family approach to life-course research is essential to inform health and wellbeing policies and programmes that make a difference for children, youth, adults, and later in life. Aim The aim is to present the research protocol about a study to understand the impact of chronic conditions on families, with an emphasis on outcomes that have life-long benefits, and co-develop a sustainable and culturally centred life-course programme for overall health and wellbeing. Methods The qualitative study will assess the family, household and community strengths that allow people in the Tokelau community to thrive despite the challenges of living in households with chronic disease. A total of 200 participants will be involved in family group and stakeholder focus group interviews, digital storytelling and community-based participatory action workshops, and the implementation and evaluation of action plans. The study will be augmented by Pacific research models, and the New Zealand Health Research Council Pacific guidelines. Results Research findings will have implications for policy and primary health-care delivery, and the potential to upscale and construct life-enhancing pathways across the life-course. Discussion Understanding Tokelauan families' health status, exposure to health hazards, access to health services and medicines, and the strengths of the family unit and community that allows them to thrive despite the challenges of living with chronic conditions, can help to inform policy and practice, and achieve better health outcomes for them.

Introduction: Obesity and low levels of physical activity are increasing among Pacific and Maori adolescents in New Zealand., Aim: To assess the feasibility of an after-school exercise and lifestyle programme to improve cardiorespiratory fitness, health and usual activity in less-active Pacific and Maori adolescents over six weeks., Methods: Eighteen less-active secondary school students participated. The six-week programme included 3 x 1.5 hour exercise and healthy lifestyle sessions per week. Outcomes included estimated cardiorespiratory fitness (VO2max), insulin resistance (Homeostasis Model Assessment), physical activity, glycated haemoglobin (HbA1c), fasting plasma glucose, blood pressure, waist circumference and fasting lipids, measured at baseline and six weeks. Programme attendance and qualitative comments were also recorded. Student's t-tests were used., Results: Of the 18 students enrolled, 16 (89%) completed six-week follow-up, 14 (78%) were female, 13 (72%) were Pacific ethnicity and 5 (28%) were Maori . At baseline, mean age was 16.3 (standard deviation [SD] 1.0) years, body mass index (BMI) 35.2 (SD 6.7) kg/m2, VO2max 31.5 (SD 4.3) mL/kg/min, systolic blood pressure 125.0 (SD 12.9) mm Hg, HbA1c 39.9 (SD 3.8) mmol/mol, fasting serum insulin 28.3 (SD 27.8) μU/mL. At follow-up, improvements had occurred in VO2max (3.2 mL/kg/min; p=0.02), systolic blood pressure (-10.6 mm Hg; p=0.003), HbA1c (-1.1 mmol/mol; p=0.03) and weekly vigorous (4 hours, p=0.002) and moderate (2 hours, p=0.006) physical activity, although waist circumference increased (p=0.005). Programme attendance was over 50%. Comments were mostly positive., Discussion: The after-school exercise and lifestyle programme and study methods were feasible. Such programmes have the potential to improve health outcomes for Pacific and Maori adolescents.

Introduction: Hearing impairment (HI) affects an estimated 538 million people worldwide, with 80% of these living in developing countries. Untreated HI in childhood may lead to developmental delay and in adults results in social isolation, inability to find or maintain employment, and dependency. Early intervention and support programmes can significantly reduce the negative effects of HI., Aim: To estimate HI prevalence and identify available hearing services in some Pacific countries - Cook Islands, Fiji, Niue, Samoa, Tokelau, Tonga., Methods: Data were collected through literature review and correspondence with service providers. Prevalence estimates were based on census data and previously published regional estimates., Results: Estimates indicate 20-23% of the population may have at least a mild HI, with up to 11% having a moderate impairment or worse. Estimated incidence of chronic otitis media in Pacific Island nations is 3-5 times greater than other Australasian countries in children under 10 years old. Permanent HI from otitis media is substantially more likely in children and adults in Pacific Island nations. Several organisations and individuals provide some limited hearing services in a few Pacific Island nations, but the majority of people with HI are largely underserved., Discussion: Although accurate information on HI prevalence is lacking, prevalence estimates of HI and ear disease suggest they are significant health conditions in Pacific Island nations. There is relatively little support for people with HI or ear disease in the Pacific region. An investment in initiatives to both identify and support people with hearing loss in the Pacific is necessary.

Introduction: Rates of obesity, Type 2 diabetes and cardiovascular disease are high among Pacific people in New Zealand. Physical activity is recommended in the prevention and management of these conditions. Community-based, 'small-sided game' group activities may be an effective and culturally appropriate way to promote physical activity within Pacific communities., Aim: To assess the effectiveness of small-sided games-based exercise on fitness and health parameters among Pacific adults over four weeks., Methods: Twenty untrained (13 female) Pacific adults were randomised to intervention or control. Intervention participants were offered 45 minutes of small-sided games three times per week for four weeks. Control participants were offered one-month gym membership after the trial. Primary outcomes included cardiorespiratory fitness (VO₂peak) and leg strength (maximal concentric force of quadriceps at 60°/second) measured at baseline and four weeks. Secondary outcomes included glycaemia, lipid profile, blood pressure (BP), and inflammatory markers. Multivariable regression models were used to assess differences between groups, adjusting for baseline values, age and gender., Results: At baseline, mean age was 34.8 years (SD 12.6), BMI 36.3 (6.7), systolic BP 127.7 mmHg (12.1), HbA1c 6.1% (1.9), VO₂peak 2.5 L/min (0.6) and leg strength 170.0 N.m (57.4). Sixteen participants completed the trial. Change in outcomes were greater in intervention than control participants in absolute VO₂peak (0.9 L/min (p=0.003)), leg strength (17.8 N.m (p=0.04)) and HDL (0.12 mmol/L (p=0.02)). There were no other significant differences., Discussion: Small-sided games appear to be a promising means for improving the health and cardiorespiratory fitness and reducing the risk of diabetes and cardiovascular disease in Pacific adults.