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This research explored the facilitators and barriers to physical activity engagement for people of Pacific Island heritage. From an experiential constructionist position, we inductively applied thematic analysis to data collected via individual fully transcribed semi-interviews. Participants were five academics or tutors of Pacific Island descent interested in physical activity for Pacific peoples. The themes developed were: Centrality of community, Physical activity is something you do and It depends on the ‘environment’. Centrality of community was a prominent theme that spoke to the high value placed on collectivism and communitarianism by Pacific communities, which may limit individual choices of physical activity participation. Such collective principles may, however, facilitate physical activity through collective responsibility for all to engage in health endeavours. Optimal facilitators of physical activity may be (i) mobilising a community response to participation in physical activity by motivating through improved understanding of the health benefits of physical activity for the community as a whole, (ii) a response role-modelled and championed by community leaders (such as church leaders) and (iii) choosing activity programmes that are group- and community-based, fun and social occasions. Approaches that target the individual, both in health benefits and individually based activities, may be less successful.

The impact of stroke is lifelong; affecting independence and quality of life. Stroke survivors need support to manage their recovery. The Bridges stroke self-management approach (Bridges) empowers stroke survivors and facilitates self-management within usual rehabilitation. We implemented Bridges into a New Zealand stroke service, aiming to identify context-specific delivery factors and long-term sustainability strategies. Using a case study design, data were collected from multiple sources, including meeting and training notes, researcher observations, workshop evaluations, and in-depth semi-structured interviews (n = 7). Data were compared for congruency or disparity, and integrated to develop a comprehensive case description. Overall, 69 health professionals were trained. Collectively, the data found Bridges to be conceptually acceptable and contextually appropriate, raising awareness of self-management support across the service. Identified key factors that would assist with the implementation of this new intervention, including the need for time and sustained support for staff; an initial small, contained inter-professional team; ongoing communication to staff by managers about their expectations and endorsement of the intervention; and staff “champions”, requiring training, resources, and managerial support. Whilst staff may value Bridges, they needed time and the opportunity to develop knowledge, skills, and self-efficacy to support patient self-management.

Non-motor symptoms, namely cognitive and affective domain function, may impact the physical functioning and perceived health status of people with Parkinson’s disease (PD). The aim of this cross-sectional observational study was to explore the relationship between the severity of non-motor symptoms (cognitive and affective) and physical function in individuals with PD living in the community. The outcome measures were completed in 19 participants diagnosed with PD, with or without affective symptoms and cognitive impairments. The main constructs included in the bivariate statistical analyses were: self-reported non-motor experiences of daily living (Movement Disorder Society – Unified Parkinson’s Disease Rating Scale [MDS-UPDRS] Part I); self-reported motor experiences of daily living (MDS-UPDRS Part II); clinician-rated impression of motor symptoms (MDS-UPDRS Part III); motor fluctuations (MDS-UPDRS Part IV); self-reported anxiety and depression symptoms (Hospital Anxiety and Depression Rating Scale [HADS] – a total score comprising sub-scores for “anxiety” [HADS-A] and “depression” [HADS-D]); global cognitive function (Montreal Cognitive Assessment [MoCA]); functional gait and balance performance (Dynamic Gait Index [DGI]); and perceived quality of life (European Quality of Life – Visual Analogue Scale [EQ-VAS]). Significant positive correlations (p ≤ 0.05) were observed between the MDS-UPDRS Part II and MDS-UPDRS Part I (p < 0.01), HADS, HADS-A, and HADS-D (p < 0.05). The Hoehn and Yahr (H & Y) scale was the only variable to significantly correlate with the DGI (p < 0.01). Cont...

We conducted a mixed method study to explore the environmetal factors affecting leisure participation of children with movement impairments aged six to 12 years in Aotearoa/New Zealand. Families of children with movement impairments completed the “Craig’s Hospital Inventory of Environmental Factors for Children-Parent Version” questionnaire and in-depth individual interviews of children, along with their parents or guardian, were undertaken. Fifty-nine families participated in the survey, with 22 of these also participating in the interview. We used descriptive statistics for quantitative data and the general inductive approach to analyse the qualitative data. The findings of each were then integrated. We found a mismatch between a child’s ability and existing leisure activity opportunities/choices at various settings. Restrictions to participation included non-inclusive school-based physical education programmes, limited tailoring of community-based programmes and inaccessible neighbourhood environments. To maximise the leisure activity opportunities in Aotearoa/New Zealand, concerted efforts are required by health professionals, including physiotherapists, schools, disability organisations and policymakers, to create and offer adaptive and/or inclusive leisure activity programmes to children of all ages and abilities at their school, community and local neighbourhood.

Self-management approaches towards stroke rehabilitation are gaining more attention due to emerging evidence of their impact on patient outcomes. This mixed methods study explored the attitudes of healthcare professionals (HCPs) towards stroke self-management. The Bridges Stroke Self-Management Programme (Bridges SSMP) training was delivered to 51 HCPs in New Zealand. Questionnaires were completed by consenting participants (n = 43) prior to administration of the Bridges SSMP training. In-depth, semi-structured interviews were conducted with three participants. The General Inductive Approach was used for thematic analysis of the qualitative data. The resulting overarching theme was “integrating the self-management concept into practice”, which encompasses organisational, contextual and individual factors that HCPs feel are challenges when applying self-management. Two contributors to this theme – “education” and “facilitating empowerment” – emerged as barriers or enablers, respectively, to putting self-management into practice. Questionnaire data showed HCPs were confident in their capability of self management concepts yet did not frequently use them in practice. Healthcare professionals were mostly positive about the concept of self-management but challenges and barriers were evident when applying this to practice. Hence, they may require a deeper understanding of the principles of self-management and become more familiar with the process by applying the principles of self-management in their own lives.

We report and discuss the findings of a survey of a range of health care providers serving hauā (disabled) Māori in the Murihiku (Southland) region of Aotearoa New Zealand. To explore hauā Māori access to health services, we used a mixed methods approach beginning with a quantitative survey and followed by qualitative interviews. Twenty-nine (58%) completed surveys were returned and we interviewed representatives from 15 organisations. We found all organisations were disability accessible in the physical sense, but were less accessible from a cultural perspective. There appeared a misunderstanding between what could be deemed a non-racial, human rights approach of respect for all people, no matter the ethnicity (“We treat everyone who walks through the door the same”) and the importance of tikaka (customary Māori practice), for services provided for Māori. The most significant proposal resulting from this research was for organisations to have a local, trusted, cultural advisor to regularly discuss and review Māori clients. Individually, health facilities that provide services to Māori should evaluate their cultural awareness, service access and promotion, health information, and service effectiveness. This paper provides insights and suggestions to health organisations, such as physiotherapy services, on how they can improve their service accessibility to hauā Māori.