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Objective Maori (indigenous New Zealand) women have the highest smoking prevalence rates in New Zealand and whilst pregnant. We hypothesized that community health workers ('Aunties') could find pregnant Maori women who smoke, recruit them into a study and deliver an acceptable cessation intervention. The aim of the study was to test the feasibility of such an intervention. Method A community health organization was engaged to, using a participatory approach, conduct a feasibility study. Participants were ten Aunties and the pregnant women the Aunties recruited. The Aunties advised their participants to abstain from smoking, offered a Quitcard (for subsidized nicotine replacement) or referral to local cessation providers. A booklet on healthy eating for pregnancy was given and discussed and the Aunties offered help if needed to register with a lead maternity carer (LMC). All women completed a baseline questionnaire. Semi-structured follow up face-to-face interviews were conducted with a subsample of women and hospital birth records were examined. Descriptive statistics were produced using quantitative data. Qualitative data was deductively analysed. Results During 4 months eight Aunties recruited 67 pregnant women who smoked, 88 % were Maori, 84 % were of low socio economic status and 73 % had up to high school education. Only 36 % of the recruited women had registered with an LMC. The participants described the Aunties as supportive, nice and non-judgmental. The only criticism was a lack of follow up. Aspects of the intervention that the Aunties thought worked well were knowing and being involved with their community, and being able to give a gift pack to the participating women. Insufficient follow up was one aspect that didn't work well. The infant's birth record was found for 54 % of the participants. Conclusion Aunties were able to identify and recruit pregnant Maori women who smoked. The study method and intervention were acceptable to Aunties and participants and it was feasible to collect data from the participants' hospital birth records. Based on this study, with a similar number of Aunties recruiting, it would take 2 years to recruit over 300 participants, which would be sufficient for a stronger controlled trial., Author(s): Marewa Glover[sup.1] , Anette Kira[sup.1] , Tracey Cornell[sup.2] , Ces Smith[sup.3] Author Affiliations: (1) School of Public Health, Massey University, Private Bag 102904, North Shore, 0745, AucklandNew Zealand (2) [...]

Smoking during pregnancy increases the risk of many adverse health outcomes for both the mother and the unborn child (Morton et al. 2010 (See CR1)). Indigenous people often have a higher smoking prevalence during pregnancy than non-Indigenous populations. In New Zealand (NZ), the smoking rates among Indigenous Maori women who are pregnant have reduced since 1991 (68 %) but still remains high in 2007 (34 %) (Morton et al. 2010 (See CR1)). The success rate of most smoking cessation interventions for pregnant smokers is low at, Author(s): Marewa Glover[sup.1] , Anette Kira[sup.1] , Natalie Walker[sup.2] , Linda Bauld[sup.3] Author Affiliations: (1) Centre for Tobacco Control Research, School of Population Health, University of Auckland, 261 Morrin Road, [...]

Maori (the indigenous people of New Zealand) women have high rates of smoking during pregnancy and 42 % register with a lead maternity carer (LMC) after their first trimester, delaying receipt of cessation support. We used a participatory approach with Maori community health workers ("Aunties") to determine their willingness and perceived ability to find pregnant Maori smokers early in pregnancy and to provide cessation support. Three meetings were held in three different regions in New Zealand. The aunties believed they could find pregnant women in first trimester who were still smoking by using their networks, the 'kumara-vine' (sweet potato vine), tohu (signs/omens), their instinct and by looking for women in the age range most likely to get pregnant. The aunties were willing to provide cessation and other support but they said they would do it in a "Maori way" which depended on formed relationships and recognised roles within families. The aunties' believed that their own past experiences with pregnancy and/or smoking would be advantageous when providing support. Aunties' knowledge about existing proven cessation methods and services and knowledge about how to register with a LMC ranged from knowing very little to having years of experience working in the field. They were all supportive of receiving up-to-date information on how best to support pregnant women to stop smoking. Aunties in communities believe that they could find pregnant women who smoke and they are willing to help deliver cessation support. Our ongoing research will test the effectiveness of such an approach. Keywords Community health workers * Lay health workers * Pregnancy * Smoking cessation * Indigenous, Introduction Tobacco smoking during pregnancy contributes to a range of adverse pregnancy outcomes [1]. Maternal smoking increases ill-health risks for offspring during childhood, adolescence and adulthood and it also has [...]

Access to healthy food is important to reduce risk of illness 1,2. This paper describes fruit and vegetable (FV) consumption and perception of access to FV by food bank users (40 households) in a New Zealand city. Data collected via interviews showed that cost was the greatest influence on FV consumption. Data on meeting the fruit (2 + a day) and vegetable (3 + a day) recommendations were: adults F: 57% and V: 62%; children F: 86% and V: 59%. Households wanted to consume more FV. Future interventions need to consider enabling people that live in high deprivation to purchase FV. [ABSTRACT FROM AUTHOR]

Māori (the indigenous people of New Zealand) women have high rates of smoking during pregnancy and 42 % register with a lead maternity carer (LMC) after their first trimester, delaying receipt of cessation support. We used a participatory approach with Māori community health workers ('Aunties') to determine their willingness and perceived ability to find pregnant Māori smokers early in pregnancy and to provide cessation support. Three meetings were held in three different regions in New Zealand. The aunties believed they could find pregnant women in first trimester who were still smoking by using their networks, the 'kumara-vine' (sweet potato vine), tohu (signs/omens), their instinct and by looking for women in the age range most likely to get pregnant. The aunties were willing to provide cessation and other support but they said they would do it in a 'Māori way' which depended on formed relationships and recognised roles within families. The aunties' believed that their own past experiences with pregnancy and/or smoking would be advantageous when providing support. Aunties' knowledge about existing proven cessation methods and services and knowledge about how to register with a LMC ranged from knowing very little to having years of experience working in the field. They were all supportive of receiving up-to-date information on how best to support pregnant women to stop smoking. Aunties in communities believe that they could find pregnant women who smoke and they are willing to help deliver cessation support. Our ongoing research will test the effectiveness of such an approach. [ABSTRACT FROM AUTHOR]

Issue: Many randomized controlled trials (RCTs) are conducted each year but only a small proportion is specifically designed for Indigenous people. In this review we consider the challenges of participation in RCTs for Indigenous peoples from New Zealand, Australia, Canada and the United States and the opportunities for increasing participation., Approach: The literature was systematically searched for published articles including information on the barriers and facilitators for Indigenous people's participation in health-related RCTs. Articles were identified using a key word search of electronic databases (Scopus, Medline and EMBASE). To be included, papers had to include in their published work at least one aspect of their RCT that was either a barrier and/or facilitator for participation identified from, for example, design of intervention, or discussion sections of articles. Articles that were reviews, discussions, opinion pieces or rationale/methodology were excluded. Results were analysed inductively, allowing themes to emerge from the data., Key Findings: Facilitators enabling Indigenous people's participation in RCTs included relationship and partnership building, employing Indigenous staff, drawing on Indigenous knowledge models, targeted recruitment techniques and adapting study material. Challenges for participation included both participant-level factors (such as a distrust of research) and RCT-level factors (including inadequately addressing likely participant barriers (phone availability, travel costs), and a lack of recognition or incorporation of Indigenous knowledge systems., Implication: The findings from our review add to the body of knowledge on elimination of health disparities, by identifying effective and practical strategies for conducting and engaging Indigenous peoples with RCTs. Future trials that seek to benefit Indigenous peoples should actively involve Indigenous research partners, and respect and draw on pertinent Indigenous knowledge and values. This review has the potential to assist in the design of such studies., (© The Author(s) 2014.)

Aim: To examine the prevalence of and reasons for smoking roll-your-own (RYO) cigarettes in a population of South Auckland adults., Method: Cross-sectional survey of the parents of 2,973 children at four South Auckland Intermediate Schools in 2007-2009., Result: Just over a quarter (813; 27%) of parents were smokers. Most (82%) were Māori or Pacific peoples (47% and 34% respectively) of whom 47% smoked only factory-made (FM) and 38% smoked only RYO cigarettes. Exclusive RYO smoking was more common among European (53%) than Māori (40%), Pacific (38%) and Asian ethnic groups (23%). The most common reasons for preferring RYO over FM cigarettes were lower cost (50%), lasting longer (42%), and taste (8%). A few chose RYO because they perceived them to be less harmful (5%)., Conclusion: Reducing the cost benefit of RYO should lessen the potential use of RYOs as an alternative to quitting. Health education campaigns are needed to counter incorrect beliefs surrounding RYO. Such programmes should include awareness in schools, churches and Pacific communities.

Despite a concerted, sustained and comprehensive tobacco control effort, smoking is prevalent among young people in New Zealand, particularly for Māori and Pacific Island teenagers. Many took up smoking in their pre-teen years. New Zealand research has shown that daily smoking by children aged 14-15 years is strongly influenced by parental smoking. The Keeping Kids Smokefree study is investigating whether changing parental smoking behavior and attitudes via a community-partnership approach with parents, schools, and local health providers can reduce smoking initiation by 11-12 year olds. It is a quasi-experimental trial involving four schools in an urban area of high social deprivation with large numbers of Māori and Pacific Islands families. Schools were allocated to intervention or control and the intervention was developed through a process of engagement with the schools, parents of children and local healthcare organizations. This article describes the rationale, context, methodology and methods involved in establishing the study. Building Māori and Pacific Islander research capacity was a secondary objective of the study.