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Palu E, McBride KA, Simmons D, Thompson R, Cavallaro C, Cooper E, Felila M, MacMillan F. Adequacy of health message tailoring for ethnic minorities: Pasifika communities in Sydney, Australia, during COVID-19. Health Promot Int 2024; 39:daad197. [PMID: 38365189 DOI: 10.1093/heapro/daad197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Abstract
Ethnic minorities, such as Pasifika, residing in high-income countries were at higher risk of COVID-19 infection during the pandemic. To understand the experiences of Pasifika, including message dissemination and barriers to tailored public health messaging during the pandemic, a qualitative study was undertaken, underpinned by Laswell's Model of Communication and Bandura's social cognitive theory with data collected using Pasifika methods. Pasifika adults (n = 65) were recruited across Sydney from July 2020 to March 2022. Health care professionals (HCP) (n = 17) employed by four local health districts (LHDs) and Pasifika community-based organizations delivering multicultural COVID-19-related work within the study catchment, were also recruited. Five themes were constructed from the data of: (i) prevailing fear and uncertainty over COVID-19 infection and losing employment; (ii) limited knowledge of government perpetuating distrust in Government as a benevolent source of information; (iii) faith and trust as priorities for health decision-making; (iv) 'Coconut wireless'-the role of family, friends and community in disseminating public health messages through word of mouth; and (v) limited health literacy affecting compliance with public health orders. Community members identified important messages and resources had not been sufficiently distributed. Most HCPs understood the necessity of grassroots-level engagement but reported existing approaches were inadequate to navigate challenges. These findings highlight the need for public health promotion and communication strategies that consider both the social and cultural determinants of health. We propose a 7-point checklist as a cultural appropriateness lens to assist the development and rating of existing or new health promotion messaging and resources.
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Affiliation(s)
- Elizabeth Palu
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Kate A McBride
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Diabetes Obesity Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - David Simmons
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Diabetes Obesity Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- Macarthur Clinical School, Western Sydney University, Campbelltown, NSW, Australia
| | - Ronda Thompson
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | | | - Ellen Cooper
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Makeleta Felila
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Western Sydney Local Health District, Westmead, NSW, Australia
| | - Freya MacMillan
- Diabetes Obesity Metabolism Translational Research Unit, Western Sydney University, Campbelltown, NSW, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- Macarthur Clinical School, Western Sydney University, Campbelltown, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
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Nakamura N, Wainimala P, Ratuyawa M, Tawakedina F, Waqa E. Dietary Patterns of iTaukei (indigenous) Fijians: Preliminary Findings From a Five-Day Dietary Record in Rural Communities. Asia Pac J Public Health 2024; 36:123-126. [PMID: 37994557 DOI: 10.1177/10105395231212796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
This article presents the preliminary findings from a five-day dietary record of 105 iTaukei (indigenous) Fijians in seven rural communities on remote islands, Fiji. Although the literature on noncommunicable diseases (NCDs) has discussed the potential reasons for the NCD increase in Fiji, research has relied on secondary data on the consumption patterns of limited food items. Hence, this research is one of the first in the country to analyze detailed dietary patterns. A high body mass index rate in the case study communities is observed. We also find that carbohydrate sources dominate the diet of the participants, while the consumption of protein sources (including canned products) and vegetables/fruits is limited. In addition, the diversity of food items is limited. Meanwhile, the major carbohydrate sources are locally produced cassava, although rice and flour products are also consumed. We suggest integrating these factors into the determination of the cause of the NCD increase.
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Affiliation(s)
- Naohiro Nakamura
- School of Agriculture, Geography, Environment, Ocean and Natural Sciences, The University of the South Pacific, Suva, Fiji
| | - Peni Wainimala
- School of Agriculture, Geography, Environment, Ocean and Natural Sciences, The University of the South Pacific, Suva, Fiji
| | - Metia Ratuyawa
- School of Agriculture, Geography, Environment, Ocean and Natural Sciences, The University of the South Pacific, Suva, Fiji
| | - Fulori Tawakedina
- School of Agriculture, Geography, Environment, Ocean and Natural Sciences, The University of the South Pacific, Suva, Fiji
| | - Elisabeta Waqa
- School of Agriculture, Geography, Environment, Ocean and Natural Sciences, The University of the South Pacific, Suva, Fiji
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Bertrand-Protat S, Chen J, Jonquoy A, Frayon S, Thu Win Tin S, Ravuvu A, Caillaud C, Galy O. Prevalence, causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review. OPEN RESEARCH EUROPE 2023; 3:52. [PMID: 38031554 PMCID: PMC10685071 DOI: 10.12688/openreseurope.15361.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/01/2023]
Abstract
Background Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children's weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children's socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.
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Affiliation(s)
- Solene Bertrand-Protat
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Juliana Chen
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Aurélie Jonquoy
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Stéphane Frayon
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Si Thu Win Tin
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Amerita Ravuvu
- Pacific Community, 95 Promenade Roger Laroque, Noumea, New Caledonia
| | - Corinne Caillaud
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Olivier Galy
- Interdisciplinary Laboratory of Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Abstract
The prevalence of preobesity and obesity is rising globally, multiple epidemiologic studies have identified preobesity and obesity as predisposing factors to a number of noncommunicable diseases including type 2 diabetes (T2DM), cardiovascular disease (CVD), and cancer. In this review, we discuss the epidemiology of obesity in both children and adults in different regions of the world. We also explore the impact of obesity as a disease not only on physical and mental health but also its economic impact.
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Affiliation(s)
- Nasreen Alfaris
- King Fahad Medical City, 3895 Susah, Alwurud, Riyadh 12252-7111, Saudi Arabia.
| | | | - Naji Alamuddin
- RCSI Bahrain, King Hamad University Hospital, Alsayh, Sheikh Eisa Bin Salman Bridge, 7J62+X92, Bahrain
| | - Georgia Rigas
- St George Private Hospital, 1 South Street, Kogarah, New South Wales 2217, Australia
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Yan W, Qin C, Tao L, Guo X, Liu Q, Du M, Zhu L, Chen Z, Liang W, Liu M, Liu J. Association between inequalities in human resources for health and all cause and cause specific mortality in 172 countries and territories, 1990-2019: observational study. BMJ 2023; 381:e073043. [PMID: 37164365 PMCID: PMC10170610 DOI: 10.1136/bmj-2022-073043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To explore inequalities in human resources for health (HRH) in relation to all cause and cause specific mortality globally in 1990-2019. DESIGN Observational study. SETTING 172 countries and territories. DATA SOURCES Databases of the Global Burden of Disease Study 2019, United Nations Statistics, and Our World in Data. MAIN OUTCOME MEASURES The main outcome was age standardized all cause mortality per 100 000 population in relation to HRH density per 10 000 population, and secondary outcome was age standardized cause specific mortality. The Lorenz curve and the concentration index (CCI) were used to assess trends and inequalities in HRH. RESULTS Globally, the total HRH density per 10 000 population increased, from 56.0 in 1990 to 142.5 in 2019, whereas age standardized all cause mortality per 100 000 population decreased, from 995.5 in 1990 to 743.8 in 2019. The Lorenz curve lay below the equality line and CCI was 0.43 (P<0.05), indicating that the health workforce was more concentrated among countries and territories ranked high on the human development index. The CCI for HRH was stable, at about 0.42-0.43 between 1990 and 2001 and continued to decline (narrowed inequality), from 0.43 in 2001 to 0.38 in 2019 (P<0.001). In the multivariable generalized estimating equation model, a negative association was found between total HRH level and all cause mortality, with the highest levels of HRH as reference (low: incidence risk ratio 1.15, 95% confidence interval 1.00 to 1.32; middle: 1.14, 1.01 to 1.29; high: 1.18, 1.08 to 1.28). A negative association between total HRH density and mortality rate was more pronounced for some types of cause specific mortality, including neglected tropical diseases and malaria, enteric infections, maternal and neonatal disorders, and diabetes and kidney diseases. The risk of death was more likely to be higher in people from countries and territories with a lower density of doctors, dentistry staff, pharmaceutical staff, aides and emergency medical workers, optometrists, psychologists, personal care workers, physiotherapists, and radiographers. CONCLUSIONS Inequalities in HRH have been decreasing over the past 30 years globally but persist. All cause mortality and most types of cause specific mortality were relatively higher in countries and territories with a limited health workforce, especially for several specific HRH types among priority diseases. The findings highlight the importance of strengthening political commitment to develop equity oriented health workforce policies, expanding health financing, and implementing targeted measures to reduce deaths related to inadequate HRH to achieve universal health coverage by 2030.
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Affiliation(s)
- Wenxin Yan
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Chenyuan Qin
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Haidian District, Beijing, China
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Xin Guo
- Department of Institutional Reform, National Health Commission of the People's Republic of China, Xicheng District, Beijing, China
| | - Qiao Liu
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Min Du
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Lin Zhu
- Department of Health Policy, School of Medicine, Stanford University, Stanford, CA, USA
| | - Zhongdan Chen
- World Health Organization Representative Office for China, Chaoyang District, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Haidian District, Beijing, China
- Institute for Healthy China, Tsinghua University, Haidian District, Beijing, China
| | - Min Liu
- School of Public Health, Peking University, Haidian District, Beijing, China
| | - Jue Liu
- School of Public Health, Peking University, Haidian District, Beijing, China
- Institute for Global Health and Development, Peking University, Haidian District, Beijing, China
- Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health, Peking University, Haidian District, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Haidian District, Beijing, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
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Yip TCF, Vilar-Gomez E, Petta S, Yilmaz Y, Wong GLH, Adams LA, de Lédinghen V, Sookoian S, Wong VWS. Geographical similarity and differences in the burden and genetic predisposition of NAFLD. Hepatology 2023; 77:1404-1427. [PMID: 36062393 DOI: 10.1002/hep.32774] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 08/28/2022] [Accepted: 09/01/2022] [Indexed: 12/13/2022]
Abstract
NAFLD has become a major public health problem for more than 2 decades with a growing prevalence in parallel with the epidemic of obesity and type 2 diabetes (T2D). The disease burden of NAFLD differs across geographical regions and ethnicities. Variations in prevalence of metabolic diseases, extent of urban-rural divide, dietary habits, lifestyles, and the prevalence of NAFLD risk and protective alleles can contribute to such differences. The rise in NAFLD has led to a remarkable increase in the number of cases of cirrhosis, hepatocellular carcinoma, hepatic decompensation, and liver-related mortality related to NAFLD. Moreover, NAFLD is associated with multiple extrahepatic manifestations. Most of them are risk factors for the progression of liver fibrosis and thus worsen the prognosis of NAFLD. All these comorbidities and complications affect the quality of life in subjects with NAFLD. Given the huge and growing size of the population with NAFLD, it is expected that patients, healthcare systems, and the economy will suffer from the ongoing burden related to NAFLD. In this review, we examine the disease burden of NAFLD across geographical areas and ethnicities, together with the distribution of some well-known genetic variants for NAFLD. We also describe some special populations including patients with T2D, lean patients, the pediatric population, and patients with concomitant liver diseases. We discuss extrahepatic outcomes, patient-reported outcomes, and economic burden related to NAFLD.
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Affiliation(s)
- Terry Cheuk-Fung Yip
- Medical Data Analytics Center, Department of Medicine and Therapeutics , The Chinese University of Hong Kong , Hong Kong
- State Key Laboratory of Digestive Disease , The Chinese University of Hong Kong , Hong Kong
| | - Eduardo Vilar-Gomez
- Division of Gastroenterology and Hepatology, Department of Medicine , Indiana University School of Medicine , Indianapolis , Indiana , USA
| | - Salvatore Petta
- Section of Gastroenterology and Hepatology, Dipartimento Di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica Di Eccellenza (PROMISE) , University of Palermo , Palermo , Italy
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine , Recep Tayyip Erdogan University , Rize , Turkey
- Liver Research Unit , Institute of Gastroenterology , Marmara University , Istanbul , Turkey
| | - Grace Lai-Hung Wong
- Medical Data Analytics Center, Department of Medicine and Therapeutics , The Chinese University of Hong Kong , Hong Kong
- State Key Laboratory of Digestive Disease , The Chinese University of Hong Kong , Hong Kong
| | - Leon A Adams
- Department of Hepatology , Sir Charles Gairdner Hospital , Perth , Australia
- Medical School , University of Western Australia , Perth , Australia
| | - Victor de Lédinghen
- Hepatology Unit , Hôpital Haut Lévêque, Bordeaux University Hospital , Bordeaux , France
- INSERM U1312 , Bordeaux University , Bordeaux , France
| | - Silvia Sookoian
- School of Medicine, Institute of Medical Research A Lanari , University of Buenos Aires , Ciudad Autónoma de Buenos Aires , Argentina
- Department of Clinical and Molecular Hepatology, Institute of Medical Research (IDIM) , National Scientific and Technical Research Council (CONICET), University of Buenos Aires , Ciudad Autónoma de Buenos Aires , Argentina
| | - Vincent Wai-Sun Wong
- Medical Data Analytics Center, Department of Medicine and Therapeutics , The Chinese University of Hong Kong , Hong Kong
- State Key Laboratory of Digestive Disease , The Chinese University of Hong Kong , Hong Kong
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Hou X, Anderson I, Burton-Mckenzie EJ. The value of lost output and cost of illness of noncommunicable diseases in the Pacific. HEALTH POLICY OPEN 2022. [DOI: 10.1016/j.hpopen.2022.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Galy O, Frayon S, Goldin M, Zongo P, Wattelez G, Lameta S, Quartermain A, Fotsing JM, Bouard S. Generational issues in linking family farming production, traditional food in diet, physical activity and obesity in Pacific Islands countries and territories: the case of the Melanesian population on Lifou Island. OPEN RESEARCH EUROPE 2022; 1:135. [PMID: 37645099 PMCID: PMC10446099 DOI: 10.12688/openreseurope.13705.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/27/2022] [Indexed: 08/31/2023]
Abstract
In the Melanesian culture, traditional activities are organized around family farming, although the lifestyle transition taking place over the last several decades has led to imbalances in diet and physical activity, with both leading to obesity. The aim of this interdisciplinary study was to understand the links between family farming (produced, exchanged, sold, and consumed food), diet (focused on produced, hunted, and caught food), physical activity (sedentary, light, and moderate-to-vigorous physical activity) and obesity in Melanesian Lifou Island families (parents and children). Forty families, including 142 adults and children, completed individual food frequency questionnaires, wore tri-axial accelerometers for seven continuous days, and had weight and height measured with a bio-impedance device. A family farming questionnaire was conducted at the household level concerning family farming practices and sociodemographic variables. Multinomial regression analyses and logistic regression models were used to analyze the data. Results showed that family farming production brings a modest contribution to diet and active lifestyles for the family farmers of Lifou Island. The drivers for obesity in these tribal communities were linked to diet in the adults, whereas parental socioeconomic status and moderate-to-vigorous physical activity were the main factors associated to being overweight and obesity in children. These differences in lifestyle behaviors within families suggest a transition in cultural practices at the intergenerational level. Future directions should consider seasonality and a more in-depth analysis of diet including macro- and micro- nutrients to acquire more accurate information on the intergenerational transition in cultural practices and its consequences on health outcomes in the Pacific region.
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Affiliation(s)
- Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Stéphane Frayon
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Marco Goldin
- TERAU: Territoires, acteurs et usages, Institut Agronomique néo-Calédonien (IAC), Pouembout, New Caledonia
| | - Paul Zongo
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Noumea, New Caledonia
| | - Sonny Lameta
- School of Agriculture and Food Technology, The University South Pacific, Samoa Campus, Fiji
| | - Alan Quartermain
- School of Science & Technology, The University of Goroka, Goroka, 1078, Papua New Guinea
| | - Jean Marie Fotsing
- ISEA, University of New Caledonia, Noumea, New Caledonia, 98800, New Caledonia
| | - Séverine Bouard
- TERAU: Territoires, acteurs et usages, Institut Agronomique néo-Calédonien (IAC), Pouembout, New Caledonia
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Reeve E, Lamichhane P, McKenzie B, Waqa G, Webster J, Snowdon W, Bell C. The tide of dietary risks for noncommunicable diseases in Pacific Islands: an analysis of population NCD surveys. BMC Public Health 2022; 22:1521. [PMID: 35948900 PMCID: PMC9364577 DOI: 10.1186/s12889-022-13808-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/14/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To describe changes over time in dietary risk factor prevalence and non-communicable disease in Pacific Island Countries (PICTs). Methods Secondary analysis of data from 21,433 adults aged 25–69, who participated in nationally representative World Health Organization STEPs surveys in 8 Pacific Island Countries and Territories between 2002 and 2019. Outcomes of interest were changes in consumption of fruit and vegetables, hypertension, overweight and obesity, and hypercholesterolaemia over time. Also, salt intake and sugar sweetened beverage consumption for those countries that measured these. Results Over time, the proportion of adults consuming less than five serves of fruit and vegetables per day decreased in five countries, notably Tonga. From the most recent surveys, average daily intake of sugary drinks was high in Kiribati (3.7 serves), Nauru (4.1) and Tokelau (4.0) and low in the Solomon Islands (0.4). Average daily salt intake was twice that recommended by WHO in Tokelau (10.1 g) and Wallis and Futuna (10.2 g). Prevalence of overweight/obesity did not change over time in most countries but increased in Fiji and Tokelau. Hypertension prevalence increased in 6 of 8 countries. The prevalence of hypercholesterolaemia decreased in the Cook Islands and Kiribati and increased in the Solomon Islands and Tokelau. Conclusions While some Pacific countries experienced reductions in diet related NCD risk factors over time, most did not. Most Pacific adults (88%) do not consume enough fruit and vegetables, 82% live with overweight or obesity, 33% live with hypertension and 40% live with hypercholesterolaemia. Population-wide approaches to promote fruit and vegetable consumption and reduce sugar, salt and fat intake need strengthening. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13808-3.
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Affiliation(s)
- Erica Reeve
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Prabhat Lamichhane
- School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
| | - Briar McKenzie
- Food Policy Division, The George Institute for Global Health, UNSW, 1 King St, Newtown, Sydney, Australia
| | - Gade Waqa
- Pacific Research Centre for Prevention of Obesity and Non-Communicable Disease (C-POND), Fiji National University, Suva, Fiji
| | - Jacqui Webster
- Food Policy Division, The George Institute for Global Health, UNSW, 1 King St, Newtown, Sydney, Australia
| | - Wendy Snowdon
- Global Obesity Centre, Institute for Health Transformation, School of Health and Social Development, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - Colin Bell
- School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC, 3216, Australia
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Palu E, MacMillan DF, McBride DKA, Thomson DR, Zarora R, Simmons D. Effects of lifestyle interventions on weight amongst Pasifika communities: A systematic review and meta-analysis. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 25:100483. [PMID: 35669931 PMCID: PMC9162936 DOI: 10.1016/j.lanwpc.2022.100483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Pasifika populations experience high incidence and prevalence of obesity and T2DM. However, no international review of lifestyle intervention studies amongst Pasifika communities exists. This study seeks to identify the effect and translatability of lifestyle strategies on weight amongst Pasifika populations. METHODS Lifestyle studies involving ≥90% adult Pasifika participants measuring weight change were eligible for inclusion. Database searching was carried out up to December 2021. Databases searched were MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCOhost) and ProQuest Central. Risk of bias was assessed using RoB2 (RCTs) and the National Heart, Lung and Blood Institute (NHLBI) quality assessment tool. Meta-analysis and meta-regression used a bivariate random-effects model. Strategies were coded against pre-identified components of the newly proposed Cultural and Sustainability Assessment of Intervention (CSAI) framework. FINDINGS Twenty-three studies (n = 4258 participants) met inclusion and exclusion criteria. Thirty-two lifestyle strategies targeting weight loss (WL) and 7 targeting weight maintenance (WM) were extracted. Meta-analysis estimates small but significant effect of -0.26 standard deviations (95% CI -0.51 to -0.02), with RCTs demonstrating a non-significant effect of -0.23 standard deviations (95% CI -0.49 to 0.035). Culturally relevant strategies included community and peer support facilitators and team-based activities. The CSAI identified 14 out of 23 studies with low cultural competency and sustainability scores (<60%). INTERPRETATION Qualitative and quantitative analysis show tailored lifestyle interventions has had an estimated small but beneficial effect on WL amongst Pasifika communities. Potential for tailored interventions design to incorporate psychosocial and behavioural considerations. The CSAI has the potential for systematically identifying cultural and sustainability components of efficacy in interventions. FUNDING This review was funded under Western Sydney University's Postgraduate Research Scholarship.
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Pham BN, Abori N, Silas VD, Jorry R, Rao C, Okely T, Pomat W. Tuberculosis and HIV/AIDS-attributed mortalities and associated sociodemographic factors in Papua New Guinea: evidence from the comprehensive health and epidemiological surveillance system. BMJ Open 2022; 12:e058962. [PMID: 35772818 PMCID: PMC9247692 DOI: 10.1136/bmjopen-2021-058962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Tuberculosis (TB) and HIV/AIDS are public health concerns in Papua New Guinea (PNG). This study examines TB and HIV/AIDS mortalities and associated sociodemographic factors in PNG. METHOD As part of a longitudinal study, verbal autopsy (VA) interviews were conducted using the WHO 2016 VA Instrument to collect data of 926 deaths occurred in the communities within the catchment areas of the Comprehensive Health and Epidemiological Surveillance System from 2018 to 2020.InterVA-5 cause of deaths analytical tool was used to assign specific causes of death (COD). Multinomial logistic regression analyses were conducted to identify associated sociodemographic factors, estimate adjusted ORs (AOR), 95% CIs and p values. RESULT TB and HIV/AIDS were the leading CODs from infectious diseases, attributed to 9% and 8% of the total deaths, respectively.Young adults (25-34 years) had the highest proportion of deaths from TB (20%) and the risk of dying from TB among this age group was five times more likely than those aged 75+ years (AOR: 5.5 (95% CI 1.4 to 21.7)). Urban populations were 46% less likely to die from this disease compared rural ones although the difference was not significant (AOR: 0.54 (95% CI 0.3 to 1.0)). People from middle household wealth quintile were three times more likely to die from TB than those in the richest quintile (AOR: 3.0 (95% CI 1.3 to 7.4)).Young adults also had the highest proportion of deaths to HIV/AIDS (18%) and were nearly seven times more likely to die from this disease compared with those aged 75+years (AOR: 6.7 (95% CI 1.7 to 25.4)). Males were 48% less likely to die from HIV/AIDS than females (AOR: 0.52 (95% CI 0.3 to 0.9)). The risk of dying from HIV/AIDS in urban population was 54% less likely than their rural counterparts (AOR: 0.46 (95% CI 0.2 to 0.9)). CONCLUSION TB and HIV/AIDS interventions are needed to target vulnerable populations to reduce premature mortality from these diseases in PNG.
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Affiliation(s)
- Bang Nguyen Pham
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Norah Abori
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Vinson D Silas
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Ronny Jorry
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Chalapati Rao
- School of Population Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Tony Okely
- School of Health and Society, the University of Wollongong, Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Willie Pomat
- Population Health and Demography, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
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Horsey B, Taylor J, Hayman A, Underhill S, Burkhart S. Food literacy in Pacific Island countries: a scoping review protocol. JBI Evid Synth 2022; 20:1545-1552. [PMID: 35066560 DOI: 10.11124/jbies-21-00237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
OBJECTIVE The aim of this scoping review is to identify how food literacy is characterized and measured in the context of the Pacific Islands, and describe food literacy initiatives that may inform future policy, practice, and research. INTRODUCTION "Food literacy" is an emerging term used to describe the knowledge, skills, and behaviors required from individuals, households, communities, or nations to make healthy food choices. Given the complexity of changing food systems and the significant health challenges facing Pacific Island communities, understanding the evidence on food literacy in these communities may contribute to ensuring adequate nutrition for this population. INCLUSION CRITERIA The scoping review will examine all evidence that broadly defines, describes, measures, or explores food literacy and/or its components in residents of Pacific Island countries and territories, of any age or gender. Evidence on initiatives implemented to improve food literacy within this population will also be considered. Countries will be limited to member countries of "the Pacific Community." METHODS Key information sources to be searched for publications will include databases CABI, EBSCO, and Scopus, along with Google Scholar and Google for gray literature. Experts from relevant organizations and agencies will be contacted to locate additional sources. Results will be restricted to sources from the previous 30 years, available in English and French. Data will be extracted by two or more independent reviewers using a data extraction tool. Results will be presented with a narrative summary, accompanied by tabulated and/or charted results.
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Affiliation(s)
- Bridget Horsey
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Jane Taylor
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Ann Hayman
- Food and Agriculture Organization of the United Nations, Subregional Office for the Pacific Islands, Wellington, New Zealand
| | - Steven Underhill
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Sarah Burkhart
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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13
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Strengthening Food Systems Governance to Achieve Multiple Objectives: A Comparative Instrumentation Analysis of Food Systems Policies in Vanuatu and the Solomon Islands. SUSTAINABILITY 2022. [DOI: 10.3390/su14106139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Political leaders from around the world are demonstrating interest in adopting food policies that account for the economic, health, social and environmental dimensions of food. In the Pacific Islands, decades of experience in implementing multisectoral NCD and climate policy has indicated that operationalising food systems policies will be challenging. We aimed to identify opportunities for food systems sectors to more strongly promote nutrition and environmental sustainability in addition to economic objectives. We conducted a comparative documentary analysis of 37 food systems sector policies in Vanuatu and the Solomon Islands. We applied theories of agenda- setting to examine how the frames employed by different sectors, and evident in policy content, shaped policy priorities and activities. We identified a predominately economic framing of issues affecting food systems sectors. Though there were clear policy aims to produce enough food to meet population dietary requirements and to promote an environmentally resilient food supply, aims operationalised more predominately through policy content were those that increase the contribution of productive sectors to food exports and import substitution. Food systems sectors in the Pacific Islands have clear aims to promote nutritious and environmentally resilient food systems, but policy instruments could more strongly reflect these aims.
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Hart JD, Kwa V, Dakulala P, Ripa P, Frank D, Golpak V, Adair T, Mclaughlin D, Riley ID, Lopez AD. How advanced is the epidemiological transition in Papua New Guinea? New evidence from verbal autopsy. Int J Epidemiol 2022; 50:2058-2069. [PMID: 34999867 PMCID: PMC8743130 DOI: 10.1093/ije/dyab088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Reliable cause of death (COD) data are not available for the majority of deaths in Papua New Guinea (PNG), despite their critical policy value. Automated verbal autopsy (VA) methods, involving an interview and automated analysis to diagnose causes of community deaths, have recently been trialled in PNG. Here, we report VA results from three sites and highlight the utility of these methods to generate information about the leading CODs in the country. METHODS VA methods were introduced in one district in each of three provinces: Alotau in Milne Bay; Tambul-Nebilyer in Western Highlands; and Talasea in West New Britain. VA interviews were conducted using the Population Health Metrics Research Consortium (PHMRC) shortened questionnaire and analysed using the SmartVA automated diagnostic algorithm. RESULTS A total of 1655 VAs were collected between June 2018 and November 2019, 87.0% of which related to deaths at age 12 years and over. Our findings suggest a continuing high proportion of deaths due to infectious diseases (27.0%) and a lower proportion of deaths due to non-communicable diseases (NCDs) (50.8%) than estimated by the Global Burden of Disease Study (GBD) 2017: 16.5% infectious diseases and 70.5% NCDs. The proportion of injury deaths was also high compared with GBD: 22.5% versus 13.0%. CONCLUSIONS Health policy in PNG needs to address a 'triple burden' of high infectious mortality, rising NCDs and a high fraction of deaths due to injuries. This study demonstrates the potential of automated VA methods to generate timely, reliable and policy-relevant data on COD patterns in hard-to-reach populations in PNG.
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Affiliation(s)
- John D Hart
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Viola Kwa
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Paison Dakulala
- National Department of Health, Islander Drive, Port Moresby, Papua New Guinea
| | - Paulus Ripa
- Western Highlands Provincial Health Authority, Mt Hagen, Papua New Guinea
| | - Dale Frank
- Milne Bay Provincial Health Authority, Alotau, Papua New Guinea
| | - Victor Golpak
- West New Britain Provincial Health Authority, Kimbe, Papua New Guinea
| | - Timothy Adair
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Deirdre Mclaughlin
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Ian D Riley
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Alan D Lopez
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
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15
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Pham BN, Jorry R, Abori N, Silas VD, Okely AD, Pomat W. Non-communicable diseases attributed mortality and associated sociodemographic factors in Papua New Guinea: Evidence from the Comprehensive Health and Epidemiological Surveillance System. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000118. [PMID: 36962128 PMCID: PMC10021879 DOI: 10.1371/journal.pgph.0000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 01/09/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Papua New Guinea (PNG) is undergoing an epidemiological transition with increased mortality from NCDs. This study examined NCDs-attributed mortality and associated sociodemographic factors in PNG. METHOD Using WHO 2016 instrument, 926 verbal autopsy (VA) interviews were conducted in six major provinces from January 2018 to December 2020. InterVA-5 tool was used to assign causes of death (COD). Multivariable logistic regression analysis was performed to identify sociodemographic factors associated with mortalities from emerging and endemic NCDs. FINDING NCDs accounted for 47% of the total deaths, including 20% of deaths attributed to emerging NCDs and 27% of deaths due to endemic NCDs. Leading CODs from emerging NCDs were identified including cardiac diseases, stroke, and diabetes. The risk of dying from emerging NCDs was significantly lower among populations under age 44y compared with population aged 75+y (OR: 0.14 [0.045-0.433]; p-value: 0.001). People living in urban areas were twice likely to die from emerging NCDs than those in rural areas (OR: 1.92 [1.116-3.31]; p-value: 0.018). People in Madang province were 70% less likely to die from emerging NCDs compared to those from East New Britain province (OR: 0.314 [0.135-0.73]; p-value: 0.007). Leading CODs from endemic NCDs included digestive neoplasms, respiratory neoplasms, and other neoplasms. Only children aged 0-4y had significant lower risk of dying from endemic NCDs compared to the population aged 75+y (OR: 0.114 [95% CI: 0.014-0.896]; p-value: 0.039). CONCLUSION Public health interventions are urgently needed, prioritizing urban population and those aged over 44y to reduce premature mortality from NCDs.
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Affiliation(s)
- Bang Nguyen Pham
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Ronny Jorry
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Nora Abori
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Vinson D Silas
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Anthony D Okely
- School of Health & Society and Early Start, University of Wollongong, Wollongong, Australia
| | - William Pomat
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
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16
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Bell C, Latu C, Na'ati E, Snowdon W, Moodie M, Waqa G. Barriers and facilitators to the introduction of import duties designed to prevent noncommunicable disease in Tonga: a case study. Global Health 2021; 17:136. [PMID: 34838081 PMCID: PMC8626938 DOI: 10.1186/s12992-021-00788-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 11/16/2021] [Indexed: 11/11/2022] Open
Abstract
Background In Tonga, import duties were lowered on tinned fish and seafood in 2013 and raised on soft drinks, dripping and other animal fats. Additional import duties were applied to soft drinks and dripping and other fats in 2016 and duties were also applied to high fat meats, mutton flaps and turkey tails. The objective of this study was to describe barriers to and facilitators of these import duties from a policy-maker perspective. Methods A case study was conducted to analyse implementation of policies originally modelled by the Pacific Obesity Prevention in Communities project to reduce mortality in the Kingdom of Tonga. Policymakers (n = 15) from the Ministries of Revenue, Health, Finance and Labour and Commerce involved in the development and implementation of Tonga’s food-related policies participated in key-informant interviews. Results The main facilitator of import duties were strong leadership and management, cross-sector collaboration, awareness raising and advocacy, nature of the policy, and the effective use of data to model policy impacts and inform the general public. The absence of clear lines of responsibility and a decline in collaboration over time were identified as barriers to implementation of the import duties. Conclusion In a small Island state implementing import duties to prevent non-communicable disease can be straight forward providing policymakers and the community have a shared understanding of the health and economic costs of NCDs.
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Affiliation(s)
- Colin Bell
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Catherine Latu
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases, WHO Collaborating Centre for Obesity Prevention and Management, Fiji Institute of Pacific Health Research (FIPHR), Suva, Fiji
| | - Elisiva Na'ati
- Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | - Wendy Snowdon
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Marj Moodie
- Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Australia.,Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Gade Waqa
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases, WHO Collaborating Centre for Obesity Prevention and Management, Fiji Institute of Pacific Health Research (FIPHR), Suva, Fiji
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17
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Di Michiel J, Gawthorne J, Shivam A, Maruno K, Cohn S, Lemon C, Liu Z, Byrne A. Lung Health in the Solomon Islands: A Mixed Methods Study. Int J Chron Obstruct Pulmon Dis 2021; 16:3093-3103. [PMID: 34795480 PMCID: PMC8594620 DOI: 10.2147/copd.s331734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/20/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Objectives Despite a population of 600,000 people from 900 islands, there is little published data on the prevalence of lung disease in the Solomon Islands. We sought to 1) estimate the prevalence of obstructive lung disease (OLD) in Gizo, Solomon Islands, 2) identify risk factors for respiratory disease in this population and 3) review current management practices for respiratory disease through an audit of local emergency department (ED) presentations. Methods A two-part mixed methods study was performed between March and May 2019; the first was a population-based, cross-sectional study conducted in Gizo, Solomon Islands, with a random sample undergoing questionnaires and spirometry. The second was an audit of Gizo Hospital ED records to assess presentation numbers, diagnoses and outcomes. Results A total of 104 patients were randomly selected for spirometry. The mean age was 46.9 years. Current smoking rates were high (24.0% overall, 43.3% age < 40, 16.2% age ≥ 40) as was regular (>10h/week) exposure to indoor/enclosed wood fire ovens (51.5%). The prevalence of COPD was 3.2% overall. A further 9.7% of participants demonstrated significant bronchodilator responsiveness suggestive of possible asthma. Most patients seen in ED presented with a respiratory condition or fever/viral illness, but spirometry was not available. Only four outpatients were prescribed salbutamol and two patients inhaled corticosteroid. Conclusion There appears to be a high burden of obstructive lung disease in the Solomon Islands with high smoking rates, indoor smoke exposure and bronchodilator responsiveness. Respiratory symptoms are common amongst hospital ED presentations; however, inhaled asthma treatments are infrequently prescribed to outpatients.
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Affiliation(s)
- James Di Michiel
- Department of Thoracic Medicine, St Vincent's Hospital, Sydney, NSW, 2010, Australia
| | - Julie Gawthorne
- Department of Emergency Medicine, St Vincent's Hospital, Sydney, NSW, 2010, Australia
| | - Aruna Shivam
- Department of Emergency Medicine, St Vincent's Hospital, Sydney, NSW, 2010, Australia
| | - Kevin Maruno
- Department of Emergency Medicine, St Vincent's Hospital, Sydney, NSW, 2010, Australia.,University of New South Wales, St Vincent's Medical School, Sydney, NSW, 2010, Australia.,University of Notre Dame, St Vincent's Medical School, Sydney, NSW, 2010, Australia
| | - Sarah Cohn
- University of New South Wales, St Vincent's Medical School, Sydney, NSW, 2010, Australia.,Department of Psychiatry, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Christopher Lemon
- University of New South Wales, St Vincent's Medical School, Sydney, NSW, 2010, Australia.,Department of Psychiatry, St Vincent's Hospital, Sydney, NSW, 2010, Australia
| | - Zhixin Liu
- Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Anthony Byrne
- Department of Thoracic Medicine, St Vincent's Hospital, Sydney, NSW, 2010, Australia.,University of New South Wales, St Vincent's Medical School, Sydney, NSW, 2010, Australia
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18
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Generating cause of death information to inform health policy: implementation of an automated verbal autopsy system in the Solomon Islands. BMC Public Health 2021; 21:2080. [PMID: 34774055 PMCID: PMC8590305 DOI: 10.1186/s12889-021-12180-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background Good quality cause of death (COD) information is fundamental for formulating and evaluating public health policy; yet most deaths in developing countries, including the Solomon Islands, occur at home without medical certification of cause of death (MCCOD). As a result, COD data in such contexts are often of limited use for policy and planning. Verbal autopsies (VAs) are a cost-effective way of generating reliable COD information in populations lacking comprehensive MCCOD coverage, but this method has not previously been applied in the Solomon Islands. This study describes the establishment of a VA system to estimate the cause specific mortality fractions (CSMFs) for community deaths that are not medically certified in the Solomon Islands. Methods Automated VA methods (SmartVA) were introduced into the Solomon Islands in 2016. Trained data collectors (nurses) conducted VAs on eligible deaths to December 2020 using electronic tablet devices and VA responses were analysed using the Tariff 2.0 automated diagnostic algorithm. CSMFs were generated for both non-inpatient deaths in hospitals (i.e. ‘dead on/by arrival’) and community deaths. Results VA was applied to 914 adolescent-and-adult deaths with a median (IQR) age of 62 (45–75) years, 61% of whom were males. A specific COD could be diagnosed for more than 85% of deaths. The leading causes of death for both sexes combined were: ischemic heart disease (16.3%), stroke (13.5%), diabetes (8.1%), pneumonia (5.7%) and chronic-respiratory disease (4.8%). Stroke was the top-ranked cause for females, and ischaemic heart disease the leading cause for males. The CSMFs from the VAs were similar to Global Burden of Disease (GBD) estimates. Overall, non-communicable diseases (NCDs) accounted for 73% of adult deaths; communicable, maternal and nutritional conditions 15%, and injuries 12%. Six of the ten leading causes reported for facility deaths in the Solomon Islands were also identified as leading causes of community deaths based on the VA diagnoses. Conclusions NCDs are the leading cause of adult deaths in the Solomon Islands. Automated VA methods are an effective means of generating reliable COD information for community deaths in the Solomon Islands and should be routinely incorporated into the national mortality surveillance system. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12180-y.
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Physical activity and sitting time in occupational groups from Papua New Guinea. Int Arch Occup Environ Health 2021; 95:621-628. [PMID: 34633484 DOI: 10.1007/s00420-021-01796-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess physical activity and sitting time in workers from varied occupations in a regional urban population of Papua New Guinea (PNG), to identify priorities for worker health in a country experiencing rapid industrial development. METHODS PNG workers from a variety of settings (office [n = 213], blue-collar [n = 131], and retail [n = 52]) completed an interviewer-administered demographic questionnaire, the International Physical Activity Questionnaire-short form (IPAQ) and the Occupational Sitting and Physical Activity Questionnaire (OSPAQ); and had height and weight measured. Comparison of activity and sitting time between occupational groups was undertaken using generalised linear equations, with models including demographic variables and sitting time/physical activity as appropriate. RESULTS Participants reported median total physical activity (walking, moderate and vigorous PA) of 5025 MET-min/week (80% constituting walking) and over 97% of participants met physical activity guidelines (> 600 MET-min/week). Total sitting time was 7 hours/day (IPAQ) and workers sat for 50% of working hours (OSPAQ). There was no difference between groups total physical activity. Office workers reported more total sitting time and a greater proportion of their work time spent sitting than blue-collar and retail workers reported significantly less total sitting time both p < 0.001) and retail workers reported a greater proportion of their work hours standing than office workers and blue-collar workers. CONCLUSIONS Sitting time in PNG office workers was high, similar to findings from high-income countries, but total physical activity was also high in all groups. As the PNG economy develops and office-based work becomes more prevalent, the challenge will be to minimise sitting time at work whilst maintaining high total physical activity.
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20
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Sharma ND, Khan W. Effects of a Longitudinal Peer to Peer Support Group Foot Care Intervention Program in a Prospective Cohort of Patients with Diabetes Mellitus. ENDOCRINE AND METABOLIC SCIENCE 2021. [DOI: 10.1016/j.endmts.2021.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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21
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Fraser-Hurt N, Naseri LT, Thomsen R, Matalavea A, Ieremia-Faasili V, Reupena MS, Hawley NL, Pomer A, Rivara AC, Obure DC, Zhang S. Improving services for chronic non-communicable diseases in Samoa: an implementation research study using the care cascade framework. Aust N Z J Public Health 2021; 46:36-45. [PMID: 34309937 DOI: 10.1111/1753-6405.13113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/01/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. METHODS The mixed-methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chronic non-communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and healthcare providers. RESULTS Hypertension prevalence was 38.1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio-cultural, economic and service delivery constraints. CONCLUSIONS In Samoa, care for chronic non-communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions and health service redesign, with a focus on primary healthcare and effective patient and community engagement. Implications for public health: The proposed actions can improve the reach, accessibility, quality and effectiveness of Samoa's chronic care services. Health system redesign is necessary to ensure continuity of care and more effective primary prevention. The findings are useful for other countries in the region facing similar challenges.
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Affiliation(s)
| | | | | | | | | | | | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Alysa Pomer
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Anna C Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | | | - Shuo Zhang
- The World Bank Group, Washington DC, USA
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22
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Guell C, Brown CR, Iese V, Navunicagi O, Wairiu M, Unwin N. "We used to get food from the garden." Understanding changing practices of local food production and consumption in small island states. Soc Sci Med 2021; 284:114214. [PMID: 34274709 DOI: 10.1016/j.socscimed.2021.114214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 02/11/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
Many Small Island Developing States (SIDS) lead global rates in obesity and non-communicable chronic diseases (NCDs). Drivers for this are complex and include lack of food sovereignty, evidenced by an increasing reliance on cheap nutrient-poor food imports and a focus on export orientated cash crop production for much local agriculture. To better inform SIDS' policy goals of improving nutrition through increased local food production, we explored in two SIDS current practices of food production and consumption. Teams of researchers from the two main regional universities conducted 28 focus groups in Fiji in the Pacific and Saint Vincent and the Grenadines in the Caribbean with rural and urban communities of different socio-economic or land-owning status. In both countries home gardens were still common, valued as providing staple foods to households and contributing to health and livelihoods. Yet social changes had been experienced over the life course and across generations, such as increased purchase of foods, consumption of processed and often imported foods, and fast foods. While participants associated local foods with better nutrition and health outcomes than imported foods, some local foods were also acknowledged as unhealthy (e.g. locally produced tinned products, pesticide contaminated fresh produce). Finally, as food and related health advice moves globally, crossing national boundaries, and through formal and informal channels, local experiences can be confusing and contested. We suggest the need to understand temporal and spatial aspects of social practices, as social practices and their meaning change over time, travel globally and are experienced locally. To enhance and support re-localising food to counteract unhealthy consumption of ultra-processed, shop-bought, often imported foods, it is vital to understand these lived experiences of changes and resulting uncertainties, and to explicitly build on the longstanding positive relationships that people continue to express about home gardens and local food.
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Affiliation(s)
- Cornelia Guell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK.
| | - Catherine R Brown
- George Alleyne Chronic Disease Research Centre, The University of the West Indies, Bridgetown, Barbados
| | - Viliamu Iese
- Pacific Centre for Environment and Sustainable Development, The University of the South Pacific, Suva, Fiji
| | - Otto Navunicagi
- Pacific Centre for Environment and Sustainable Development, The University of the South Pacific, Suva, Fiji
| | - Morgan Wairiu
- Pacific Centre for Environment and Sustainable Development, The University of the South Pacific, Suva, Fiji
| | - Nigel Unwin
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Teng A, Snowdon W, Win Tin ST, Genç M, Na'ati E, Puloka V, Signal L, Wilson N. Progress in the Pacific on sugar-sweetened beverage taxes: a systematic review of policy changes from 2000 to 2019. Aust N Z J Public Health 2021; 45:376-384. [PMID: 34097355 DOI: 10.1111/1753-6405.13123] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/01/2021] [Accepted: 04/01/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To systematically characterise sugar-sweetened beverage (SSB) tax policy changes in Pacific Island countries and territories (PICTs) from 2000 to 2019. METHODS Medline, Google Scholar, Pacific Islands Legal Information Institute database, Factiva and news and government websites were systematically searched up to October 2019. Information was extracted on the date and SSB tax level change, tax type, included beverages, and earmarking; and checked for consistency with local experts. RESULTS Three-quarters of PICTs had an SSB tax (n=16/21) and 11 of these were excise taxes that included both imported and locally produced beverages. The level of tax was over 20% in 14 jurisdictions. SSB tax was increased by more than 20 percentage points in eight PICTs. Most taxes were ad valorem or volumetric, three were earmarked and only two taxes targeted sugar-sweetened fruit juices. The majority of countries (14/21) had different tax rates for imported and locally produced beverages. CONCLUSIONS More than three-quarters of PICTs have SSB taxes. More than one-third increased these taxes since 2000 at an amount that is expected to reduce soft drink consumption. Implications for public health: Despite high-quality tax design elements in some PICTs, SSB control policies could generally be strengthened to improve health benefits, e.g. by targeting all SSBs and earmarking revenue for health.
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Affiliation(s)
- Andrea Teng
- Department of Public Health, University of Otago Wellington, New Zealand
| | - Wendy Snowdon
- Centre for Obesity Prevention, Deakin University, Victoria
| | | | - Murat Genç
- Otago Business School, University of Otago, New Zealand
| | | | - Viliami Puloka
- Department of Public Health, University of Otago Wellington, New Zealand
| | - Louise Signal
- Department of Public Health, University of Otago Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago Wellington, New Zealand
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Hart JD, Mahesh P, Kwa V, Reeve M, Chowdhury HR, Jilini G, Jagilly R, Kamoriki B, Ruskin R, Dakulala P, Ripa P, Frank D, Lei T, Adair T, McLaughlin D, Riley ID, Lopez AD. Diversity of epidemiological transition in the Pacific: Findings from the application of verbal autopsy in Papua New Guinea and the Solomon Islands. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 11:100150. [PMID: 34327359 PMCID: PMC8315473 DOI: 10.1016/j.lanwpc.2021.100150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/17/2021] [Accepted: 03/30/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cause of death data are essential for rational health planning yet are not routinely available in Papua New Guinea (PNG) and Solomon Islands. Indirect estimation of cause of death patterns suggests these populations are epidemiologically similar, but such assessments are not based on direct evidence. METHODS Verbal autopsy (VA) interviews were conducted at three sites in PNG and nationwide in Solomon Islands. Training courses were also facilitated to improve data from medical certificates of cause of death (MCCODs) in both countries. Data were categorised into broad groups of endemic and emerging conditions to aid assessment of the epidemiological transition. FINDINGS Between 2017 and 2020, VAs were collected for 1,814 adult deaths in PNG and 819 adult deaths in Solomon Islands. MCCODs were analysed for 662 deaths in PNG and 1,408 deaths in Solomon Islands. The VA data suggest lower NCD mortality (48.8% versus 70.3%); higher infectious mortality (27.0% versus 18.3%) and higher injury mortality (24.5% versus 11.4%) in PNG compared to Solomon Islands. Higher infectious mortality in PNG was evident for both endemic and emerging infections. Higher NCD mortality in Solomon Islands reflected much higher emerging NCDs (43.6% vs 21.4% in PNG). A similar pattern was evident from the MCCOD data. INTERPRETATION The cause of death patterns suggested by VA and MCCOD indicate that PNG is earlier in its epidemiological transition than Solomon Islands, with relatively higher infectious mortality and lower NCD mortality. Injury mortality was also particularly high in PNG.This study was funded by Bloomberg Philanthropies.
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Affiliation(s)
- John D Hart
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
| | - Pkb Mahesh
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
| | - Viola Kwa
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
| | - Matthew Reeve
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
| | | | | | | | | | - Rodley Ruskin
- CRVS country coordinator, D4H Initiative, Solomon Islands
| | | | - Paulus Ripa
- Western Highlands Provincial Health Authority, Papua New Guinea
| | - Dale Frank
- Milne Bay Provincial Health Authority, Papua New Guinea
| | - Theresa Lei
- West New Britain Provincial Health Authority, Papua New Guinea
| | - Tim Adair
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
| | - Deirdre McLaughlin
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
| | - Ian D Riley
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
| | - Alan D Lopez
- The University of Melbourne, Melbourne School of Population and Global Health, Australia
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Craven DL, Vogliano C, Horsey B, Underhill S, Burkhart S. Dietary assessment methodology and reporting in Pacific Island research: a scoping review protocol. JBI Evid Synth 2021; 19:1157-1163. [PMID: 33186291 DOI: 10.11124/jbies-20-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This scoping review aims to identify and describe the methods used to collect and analyze dietary intake data in residents of Pacific Island countries. INTRODUCTION Dietary assessment explores associations between dietary factors and health outcomes. In regions, including the Pacific Islands, where diet-related, non-communicable diseases are increasing, this is a growing area of research. As this information is used to inform food and nutrition policies and practice, accurate collection, analysis, and interpretation of dietary assessment data relies on robust methods. A greater understanding of how nutrition studies are designed can strengthen the evidence on nutrition and health in Pacific Island settings and inform future research approaches. INCLUSION CRITERIA The scoping review will consider studies published in peer-reviewed journals, including quantitative and qualitative study designs and gray literature, including government reports, research and technical reports, theses and dissertations that measure and/or assess dietary intake in resident populations of the Pacific Island member countries of the Secretariat of the Pacific Community: American Samoa, Commonwealth of the Northern Mariana Islands, the Cook Islands, the Federated States of Micronesia, French Polynesia, Guam, the Independent State of Papua New Guinea, the Independent State of Samoa, the Kingdom of Tonga, New Caledonia, Niue, Pitcairn Islands, the Republic of Fiji, the Republic of Kiribati, the Republic of the Marshall Islands, the Republic of Nauru, the Republic of Palau, the Republic of Vanuatu, Solomon Islands, Tokelau, Tuvalu, and Wallis and Futuna. METHODS There will be no time limit and searches will be conducted in PubMed, CINAHL, CABI, Scopus, Cochrane Library, and Web of Science. Results will be limited to English-language articles. Data will be extracted independently by two reviewers into a charting table. Results will be presented graphically and with tables accompanied by a narrative summary.
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Affiliation(s)
- Dana Louise Craven
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Chris Vogliano
- School of Food and Advanced Technology, Massey University, Wellington, New Zealand
| | - Bridget Horsey
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Steven Underhill
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Sarah Burkhart
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Sippy Downs, QLD, Australia
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Kammholz G, Craven D, Boodoosingh R, Akeli Amaama S, Abraham J, Burkhart S. Exploring Food Literacy Domains in an Adult Samoan Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073587. [PMID: 33808339 PMCID: PMC8036961 DOI: 10.3390/ijerph18073587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 11/16/2022]
Abstract
Samoan food systems have undergone a dramatic nutrition transition, with dietary patterns changing concurrently with increased rates of obesity and non-communicable disease. Whilst policy action and environmental interventions play an important role in improving access to and consumption of healthy food, the success of these relies on a greater understanding of individuals’ food knowledge and behaviours. This study aimed to explore these behaviours using the construct of food literacy in an adult Samoan population. A cross-sectional interviewer-administered questionnaire of a convenience sample of 150 adult Samoans (≥20 years) assessed the four domains of food literacy: plan/manage, select, prepare, and eat. Participants generally plan to include healthy food (87%) and budget money for food (87%). The majority know where to find nutrition labels (68%), of which 43% always use them to inform their food choices. Participants were mostly confident with cooking skills, although food storage practices require further investigation. Over 90% agreed or strongly agreed that food impacts health, although understanding of the Pacific Guidelines for Healthy Living was lacking. Understanding the ability of Samoans to plan/manage, select, prepare, and eat food is an important consideration for future interventions aiming to assist this population in navigating the modern-day food system.
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Affiliation(s)
- Grace Kammholz
- School of Health and Behavioural Sciences ML41, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia; (G.K.); (D.C.)
| | - Dana Craven
- School of Health and Behavioural Sciences ML41, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia; (G.K.); (D.C.)
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia
| | - Ramona Boodoosingh
- Faculty of Health Science, School of Nursing, National University of Samoa, Apia, Western Samoa;
- Correspondence: (R.B.); (S.B.)
| | - Safua Akeli Amaama
- Centre for Samoan Studies, National University of Samoa, Apia, Western Samoa;
| | - Jyothi Abraham
- Faculty of Health Science, School of Nursing, National University of Samoa, Apia, Western Samoa;
| | - Sarah Burkhart
- School of Health and Behavioural Sciences ML41, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia; (G.K.); (D.C.)
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia
- Correspondence: (R.B.); (S.B.)
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Equity of expenditure changes associated with a sweetened-beverage tax in Tonga: repeated cross-sectional household surveys. BMC Public Health 2021; 21:149. [PMID: 33461511 PMCID: PMC7812720 DOI: 10.1186/s12889-020-10139-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 12/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to examine changes in beverage expenditure patterns before and after a T$0.50/L sweetened-beverage (SB) excise was introduced in Tonga in 2013, by household income, household age composition and island of residence. Methods Two cross-sectional surveys involved households being randomly sampled (the Household Income and Expenditure Surveys in 2009 (n = 1982) and 2015/16 (n = 1800)). Changes in soft drink (taxed), bottled water, and milk (both untaxed) expenditure were examined namely: (i) prevalence of households purchasing the beverage; (ii) average expenditure per person (inflation-adjusted); (iii) expenditure as a proportion of household food budget; and (iv) expenditure per person as a proportion of equivalised income. Results The pattern found was of decreases in all soft drink expenditure outcomes and these appeared to be greater in low-income than high-income households for purchasing prevalence (− 30% and − 25% respectively, t-test p = 0.98), per-capita expenditure (− 37% and − 34%, p = 0.20) and food budget share (− 27% and − 7%, p = 0.65), but not income share (− 6% and − 32%, p = 0.71). The large expenditure increases in bottled water appeared to be greater in low-income than high-income households for purchasing prevalence (355 and 172%, p = 0.32) and food budget share (665 and 468%, p = 0.09), but greater in high-income households for per-capita expenditure (121 and 373%, p < 0.01) and income share (83 and 397%, p = 0.50). Conclusions The sweetened-beverage tax was associated with reduced soft drink purchasing and increased bottled water expenditure. Low-income households appeared to have slightly greater declines in soft drink expenditure. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-10139-z.
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Impact of sugar-sweetened beverage taxes on price, import and sale volumes in an island: interrupted time series analysis. Public Health Nutr 2021; 24:1828-1835. [PMID: 33455614 DOI: 10.1017/s1368980021000185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the impact of changes in import tariffs on sweetened beverages. DESIGN Interrupted time series analysis was used to examine sweetened beverage tariff increases of 40-60 % in 2008 and to 75 % in 2012, and an approximately 11 % decrease in 2014 when an excise tax replaced the tariff. Post-tax trends were compared with a counterfactual modelled on the pre-tax trend for: quarterly price of an indicator beverage, monthly beverage import volumes (both 2001-2017) and quarterly sales volumes (2012-2017). In a controlled analysis, taxed beverage imports were compared with a sugary snacks control. SETTING Cook Islands. PARTICIPANTS NA. RESULTS In the first year, after the 2008 tariff increase the price of the selected indicator soft drink increased by 7·3 % (95 % CI 6·3 %, 8·3 %) but after the 2012 tariff increase it decreased by 13·9 % (95 % CI -14·9 %, -12·8 %). At the same time, the import volumes of taxed beverages decreased by 13·2 % (95 % CI -38·1 %, 17·8 %) and 2·9 % (95 % CI -41·6 %, 72·5 %), respectively, and decreased by 24·8 % (95 % CI -36·9, -9·8) and 10·2 % (95 % CI -37·1, 37·5) in the controlled analysis. After the 2014 tax decrease, the price of the indicator soft drink decreased by 23·6 % (95 % CI -26·0 %, -21·1 %), sweetened beverage imports increased by 4·5 % (95 % CI -39·5 %, 156·0 %) and sales of full-sugar soft drinks increased by 31 % (95 % CI -21 %, 243 %). CONCLUSIONS The increased import tariffs on sweetened beverages appeared to be effective for reducing import volumes, but this was partly reversed by the reduced tax/tariff in 2014.
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Chottanapund S, Chamroonsawasdi K, Tunyasitthisundhorn P, Aekplakorn W, Silpasuwan P, Anantachoti P, Rojroongwasinkul N, Damapong S, Sornpaisarn B, Rojanapithayakorn W, Ungchusak K. Modifiable Factors and Colon Cancer Risk in Thai Population. Asian Pac J Cancer Prev 2021; 22:37-43. [PMID: 33507677 PMCID: PMC8184197 DOI: 10.31557/apjcp.2021.22.1.37] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Indexed: 11/25/2022] Open
Abstract
To demonstrate the possible impact of modifiable factors on colon cancer development in Thai population, we conducted this case-control study from June 2016 until June 2017. The study was conducted in 11 Thai provincial hospitals. The hospitals in this study were selected by stratification by regions. Patients included 504 ones who were newly diagnosed with colon cancer within 1 month. In the control group, 997 health individuals were enrolled. Both case and control were adjusted by age. The results of this study showed that age and socioeconomic factors were associated with colon cancer risk. In addition, it was found that family history of colon cancer had very high association with colon cancer risk. Behavioral factors, including smoking, inadequate physical exercise, and salty food consumption were associated with colon cancer. We detected no association between obesity, alcohol consumption, and colon cancer. The results suggested that colon cancer might have higher association with genetic factors than behavioral factors among Thai patients. Based on the results of this study, stop smoking and promote adequate physical activity are suggested to reduce the incidence of colon cancrr among Thai patients.
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Affiliation(s)
- Suthat Chottanapund
- Bamrasnaradura Infectious Disease Institute, Ministry of Public Health, Nontaburi 11000, Thailand
| | - Kanittha Chamroonsawasdi
- Department of Family Health, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | | | | | - Pimpan Silpasuwan
- Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | - Puree Anantachoti
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330 Thailand
| | | | - Sanga Damapong
- Bureau of Health Promotion, Department of Health, Ministry of Public Health, Nonthaburi, 11000, Thailand
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Van Dyne EA, Saraiya M, White A, Novinson D, Senkomago V, Buenconsejo-Lum L. Cancer Mortality in the US-Affiliated Pacific Islands, 2008-2013. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:99-107. [PMID: 32596686 PMCID: PMC7311947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cancer-related mortality in the US-Affiliated Pacific Island (USAPI) jurisdictions is unknown. This is the first ever reporting of cancer-related mortality in the USAPI using cancer registry data. The individual USAPI jurisdictions collected incident cancer data and submitted it to the Pacific Regional Central Cancer Registry (PRCCR). All cases reported to PRCCR (n = 3,118) with vital status of dead (n = 1,323) during 2008-2013 were examined. Cause of death was coded based on clinical information provided in the cancer registry. Incidencebased mortality (IBM) rates were calculated using SEER*Stat software and age adjusted to the US standard population. Total cancer IBM rates among males were highest in Palau (151.5 per 100,000), Republic of the Marshall Islands (RMI, 142.0), and Guam (133.2); rates were lowest in American Samoa (21.7), the Commonwealth of the Northern Mariana Islands (CNMI, 22.7), and the Federated States of Micronesia (FSM, 28.9). Total cancer IBM rates among females were highest in RMI (120.3 per 100,000), Palau (107.7), and Guam (72.2); rates were lowest in CNMI (19.0), FSM (23.2), and American Samoa (42.8). The median time from cancer diagnosis to death was 8-28 days in the Freely Associated States and 102-128 days in the Flag Territories. IBM rates were higher among individuals in USAPI jurisdictions than among Asian/ Pacific Islanders in Hawai'i for many cancers preventable through vaccination, smoking cessation, overweight and obesity prevention, and cancer screening. Geographic remoteness, underreporting, delay in reporting, and challenges with accurate death registration and certification led to lower IBM rates for some jurisdictions. These mortality data can help prioritize evidence-based interventions to reduce cancer-related deaths through risk factor reduction, early detection, and improved quality of life after a cancer diagnosis through palliative care.
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Affiliation(s)
- Elizabeth A. Van Dyne
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Mona Saraiya
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Arica White
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Daniel Novinson
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Virginia Senkomago
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
| | - Lee Buenconsejo-Lum
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA (EAVD, MS, AW, VS)
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Edwards P, Buenconsejo-Lum LE, Tangka FK, Jeong Y, Baksa J, Pordell P, Saraiya M, Subramanian S. Costs and Resources Used by Population-based Cancer Registries in the US-Affiliated Pacific Islands. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2020; 79:89-98. [PMID: 32596685 PMCID: PMC7311929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background: The costs of cancer registration have previously been estimated for registries in the continental United States and many international registries; however, to date, there has been no economic assessment of population-based registries in the US-Affiliated Pacific Islands. This study estimates the costs and factors affecting the operations of US-Affiliated Pacific Island population-based cancer registries. Methods: The web-based International Registry Costing Tool1 was used to collect costs, resources used, cancer cases processed, and other registry characteristics from the Pacific Regional Central Cancer Registry (PRCCR), Federated States of Micronesia National Cancer Registry, and nine satellite jurisdictional registries within the US Pacific Islands. The registries provided data on costs for June 30, 2016-June 29, 2017, and cases processed during 2014. Results: Local host institutions provided a vital source of support for US-Affiliated Pacific Islands registries, covering substantial fixed costs, such as management and overhead. The cost per cancer case processed had an almost tenfold variation across registries, with the average total cost per case of about $1,413. The average cost per inhabitant in the US-Affiliated Pacific Islands was about $1.77 per person. Discussion: The challenges of collecting data from dispersed populations spread across multiple islands of the US-Affiliated Pacific Islands are likely leading factors driving the magnitude of the registries' cost per case. The economic information from this study provides a valuable source of activity-based cost data that can both help guide cancer control initiatives and help registries improve operations and efficiency.
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Affiliation(s)
| | - Lee E. Buenconsejo-Lum
- Pacific Regional Central Cancer Registry (PRCCR), University of Hawai‘i at Manoa, Honolulu, HI (LEB-L, YJ, JB)
| | - Florence K.L. Tangka
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA (FKLT, PP, MS)
| | - Youngju Jeong
- Pacific Regional Central Cancer Registry (PRCCR), University of Hawai‘i at Manoa, Honolulu, HI (LEB-L, YJ, JB)
| | - Janos Baksa
- Pacific Regional Central Cancer Registry (PRCCR), University of Hawai‘i at Manoa, Honolulu, HI (LEB-L, YJ, JB)
| | - Paran Pordell
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA (FKLT, PP, MS)
| | - Mona Saraiya
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA (FKLT, PP, MS)
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Gouda HN, Hazard RH, Maraga S, Flaxman AD, Stewart A, Joseph JC, Rarau P, Wangnapi R, Poka H, Serina P, Phuanukoonnon S, Pham BN, Vano M, Lupiwa S, Sie A, Kave H, Lehmann D, Siba P, Lopez AD, Riley ID. The epidemiological transition in Papua New Guinea: new evidence from verbal autopsy studies. Int J Epidemiol 2020; 48:966-977. [PMID: 30915430 DOI: 10.1093/ije/dyz018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent economic growth in Papua New Guinea (PNG) would suggest that the country may be experiencing an epidemiological transition, characterized by a reduction in infectious diseases and a growing burden from non-communicable diseases (NCDs). However, data on cause-specific mortality in PNG are very sparse, and the extent of the transition within the country is poorly understood. METHODS Mortality surveillance was established in four small populations across PNG: West Hiri in Central Province, Asaro Valley in Eastern Highlands Province, Hides in Hela Province and Karkar Island in Madang Province. Verbal autopsies (VAs) were conducted on all deaths identified, and causes of death were assigned by SmartVA and classified into five broad disease categories: endemic NCDs; emerging NCDs; endemic infections; emerging infections; and injuries. Results from previous PNG VA studies, using different VA methods and spanning the years 1970 to 2001, are also presented here. RESULTS A total of 868 deaths among adolescents and adults were identified and assigned a cause of death. NCDs made up the majority of all deaths (40.4%), with the endemic NCD of chronic respiratory disease responsible for the largest proportion of deaths (10.5%), followed by the emerging NCD of diabetes (6.2%). Emerging infectious diseases outnumbered endemic infectious diseases (11.9% versus 9.5%). The distribution of causes of death differed across the four sites, with emerging NCDs and emerging infections highest at the site that is most socioeconomically developed, West Hiri. Comparing the 1970-2001 VA series with the present study suggests a large decrease in endemic infections. CONCLUSIONS Our results indicate immediate priorities for health service planning and for strengthening of vital registration systems, to more usefully serve the needs of health priority setting.
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Affiliation(s)
- Hebe N Gouda
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Riley H Hazard
- University of Melbourne, School of Population and Global Health, Melbourne, VIC, Australia
| | - Seri Maraga
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Abraham D Flaxman
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Andrea Stewart
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Jonathan C Joseph
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Patricia Rarau
- University of Melbourne, School of Population and Global Health, Melbourne, VIC, Australia.,Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Regina Wangnapi
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Harry Poka
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Peter Serina
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Suparat Phuanukoonnon
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea.,Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Bang N Pham
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Miriam Vano
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Sebeya Lupiwa
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Albert Sie
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Helen Kave
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Deborah Lehmann
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Peter Siba
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands, Papua New Guinea
| | - Alan D Lopez
- University of Melbourne, School of Population and Global Health, Melbourne, VIC, Australia
| | - Ian D Riley
- University of Melbourne, School of Population and Global Health, Melbourne, VIC, Australia
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Fuka F, Osuagwu UL, Agho K, Gyaneshwar R, Naidu S, Fong J, Simmons D. Factors associated with macrosomia, hypoglycaemia and low Apgar score among Fijian women with gestational diabetes mellitus. BMC Pregnancy Childbirth 2020; 20:133. [PMID: 32111183 PMCID: PMC7048039 DOI: 10.1186/s12884-020-2821-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 02/18/2020] [Indexed: 11/19/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) in Fiji is a serious public health issue. However, there are no recent studies on GDM among pregnant women in Fiji. The aim of this study was to examine prevalence of, and sociodemographic factors associated with adverse neonatal outcomes among Fijian women with GDM. Methods We used cross-sectional data of 255 pregnant women with GDM who gave birth to singleton infants at Colonial War Memorial Hospital (CWMH) in Suva city. Women underwent testing for GDM during antenatal clinic visits and were diagnosed using modified International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. Multivariable logistic regression analysis was used to investigate factors associated with neonatal outcomes. Results Women with a previous baby weighing > 4 kg were 6.08 times more likely to experience neonatal macrosomia (Adjusted odds ratio (AOR) = 6.08; 95%CI: 2.46, 15.01). Compared to unmarried women, the odds of macrosomia among married women reduced by 71% (AOR = 0.29; 95%CI: 0.11, 0.77). Compared with delivery before 38 weeks of gestation, the infants of women who delivered between 38 and 41 weeks of gestation were 62 and 86% less likely to experience neonatal hypoglycaemia and Apgar score < 7 at 5 mins, respectively. The offspring of women who were overweight and obese had higher odds of neonatal hypoglycaemia. Late booking in gestation (≥28 weeks) was significantly associated with Apgar score < 7 at 5 min (AOR = 7.87; 95%CI: 1.11, 55.75). Maternal pre-eclampsia/pregnancy induced hypertension was another factor associated with low Apgar score in infants. Conclusions The study found high rates of adverse neonatal outcomes among off springs of Fijian women with GDM and showed that interventions targeting pregnant women who are overweight, had a previous baby weighing > 4 kg, had pre-eclampsia, delivered before 38 weeks of gestation, and those who booked later than 13 weeks in gestation, are needed to improve pregnancy outcomes.
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Affiliation(s)
- Falahola Fuka
- Ministry of Health, Vaoila Hospital, Nuku'alofa, Tongatapu, Tonga
| | - Uchechukwu L Osuagwu
- Diabetes, Obesity and Metabolism Translational Research Unit (DOMTRU), School of Medicine, Western Sydney University, Campbelltown, 2560, NSW, Australia.
| | - Kingsley Agho
- School of Health Sciences, Western Sydney University, Campbelltown, 2560, NSW, Australia.,African Vision Research Institute, University of KwaZulu-Natal Durban, Durban, South Africa
| | - Rajat Gyaneshwar
- Department of Obstetrics and Gynaecology, Lautoka Hospital, Lautoka, Fiji
| | - Swaran Naidu
- Department of Obstetrics and Gynaecology, Lautoka Hospital, Lautoka, Fiji
| | - James Fong
- Department of Obstetrics and Gynecology, CWM Hospital, Suva, Fiji
| | - David Simmons
- Diabetes, Obesity and Metabolism Translational Research Unit (DOMTRU), School of Medicine, Western Sydney University, Campbelltown, 2560, NSW, Australia
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Tanielu H, McCool J, Umali E, Whittaker R. Samoan Smokers Talk About Smoking and Quitting: A Focus Group Study. Nicotine Tob Res 2019; 20:1132-1137. [PMID: 28673031 DOI: 10.1093/ntr/ntx152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 06/28/2017] [Indexed: 11/12/2022]
Abstract
Introduction Samoa, like other Pacific Island countries, faces a persistent challenge to reduce smoking use with relatively limited resources. As a signatory to the WHO FCTC, Samoa is obligated to introduce measures to reduce tobacco use and is currently trialing a text message smoking cessation programme (mCessation) to achieve this outcome. Cigarettes remain relatively cheap and are widely available, but little is known about how smoking is initiated or why and how people quit smoking in the Samoa. Methods Six focus groups with smokers and ex-smokers were conducted in Apia, Samoa. Groups were homogenous according to age, gender and smoking status. Focus groups were conducted in Samoan and transcribed and translated to English for analysis. Results Smoking is initiated most commonly in late teens and early twenties and most frequently in (non-family) social contexts. Smoking reflects a widely held (mis)perceptions of tangible benefits, including aiding feelings of strength and energy, relief from indigestion and as a means to accelerate the effects of alcohol. Smoking was deeply connected to social life in Samoa among friends and for some, with family members. Drivers to quit originate out of concern regarding health effects, concern for family and the costs of purchasing tobacco. Conclusions Smoking is well entrenched in Samoan society; efforts to reduce smoking need to be based on implicit understanding of Samoan cultural norms and priorities around family, social networks and culture. Efforts to support quitting are important, alongside other well validated measures to reverse the trajectory of smoking related disease. Implications This study offers an insight into smoking as a behavior and as cultural practice perceived by smokers and non-smokers in Samoa. A thorough understanding of smoking behaviors and cessation patterns is critical in efforts to reduce smoking especially in resource-limited settings. The results from this study was used to inform the development of a Samoan mHealth smoking cessation programme.
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Affiliation(s)
| | - Judith McCool
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, New Zealand
| | - Elaine Umali
- Epidemiology and Biostatistics, School of Population Health, University of Auckland, New Zealand
| | - Robyn Whittaker
- National Institute for Health Innovation, School of Population Health, University of Auckland, New Zealand
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Sarfati D, Dyer R, Sam FAL, Barton M, Bray F, Buadromo E, Ekeroma A, Foliaki S, Fong J, Herman J, Huggins L, Maoate K, Meredith I, Mola G, Palafox N, Puloka V, Shin HR, Skeen J, Snowdon W, Tafuna'i M, Teng A, Watters D, Vivili P. Cancer control in the Pacific: big challenges facing small island states. Lancet Oncol 2019; 20:e475-e492. [PMID: 31395476 PMCID: PMC7746436 DOI: 10.1016/s1470-2045(19)30400-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 01/03/2023]
Abstract
This Series paper describes the current state of cancer control in Pacific island countries and territories (PICTs). PICTs are diverse but face common challenges of having small, geographically dispersed, isolated populations, with restricted resources, fragile ecological and economic systems, and overburdened health services. PICTs face a triple burden of infection-related cancers, rapid transition to lifestyle-related diseases, and ageing populations; additionally, PICTs are increasingly having to respond to natural disasters associated with climate change. In the Pacific region, cancer surveillance systems are generally weaker than those in high-income countries, and patients often present at advanced cancer stage. Many PICTs are unable to provide comprehensive cancer services, with some patients receiving cancer care in other countries where resources allow. Many PICTs do not have, or have poorly developed, cancer screening, pathology, oncology, surgical, and palliative care services, although some examples of innovative cancer planning, prevention, and treatment approaches have been developed in the region. To improve cancer outcomes, we recommend prioritising regional collaborative approaches, enhancing cervical cancer prevention, improving cancer surveillance and palliative care services, and developing targeted treatment capacity in the region.
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Affiliation(s)
- Diana Sarfati
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand.
| | - Rachel Dyer
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Filipina Amosa-Lei Sam
- Pathology Department, Tupua Tamasese Meaole Hospital, Private Bag National Health Services, Apia, Samoa
| | - Michael Barton
- Collaboration for Cancer Outcomes Research and Evaluation, Ingham Institute for Applied Medical Research, University of New South Wales, Liverpool, NSW, Australia
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Eka Buadromo
- Pathology Department, Vaiola Hospital, Nuku'alofa, Tonga
| | - Alec Ekeroma
- Department of Obstetrics and Gynaecology, National University of Samoa, Apia, Samoa; Department of Obstetrics and Gynaecology, University of Otago, Wellington, New Zealand
| | - Sunia Foliaki
- Centre for Public Health Research, Massey University-Wellington Campus, Wellington, New Zealand
| | - James Fong
- Obstetrics and Gynaecology Unit, Colonial War Memorial Hospital, Ministry of Health, Suva, Fiji; Department of Obstetrics and Gynaecology, Fiji National University, Suva, Fiji
| | | | - Linda Huggins
- Palliative Care Services, Middlemore Hospital, Counties Manukau Health, Auckland, New Zealand
| | - Kiki Maoate
- Department of Paediatric Surgery, Christchurch Public Hospital, Christchurch, New Zealand
| | - Ineke Meredith
- Department of Surgery, Capital; Coast District Health Board, Wellington Regional Hospital, Wellington, New Zealand
| | - Glen Mola
- Department of Obstetrics, Gynaecology and Reproductive Health, Port Moresby General Hospital, Port Moresby, Papua New Guinea; School of Medicine and Health Sciences, University of Papua New Guinea, Boroko, Papua New Guinea
| | - Neal Palafox
- Pacific Regional Cancer Programs, Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA; Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Viliami Puloka
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand; Health Promotion Forum of New Zealand, Auckland, New Zealand
| | - Hai-Rim Shin
- Non-communicable Disease and Health Promotion, Western Pacific Regional Office, World Health Organization, Manila, Philippines
| | - Jane Skeen
- Starship Blood and Cancer Centre, Starship Children's Health, Auckland, New Zealand
| | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organization, Suva, Fiji
| | - Malama Tafuna'i
- Department of Obstetrics and Gynaecology, National University of Samoa, Apia, Samoa
| | - Andrea Teng
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - David Watters
- Deakin University and Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
| | - Paula Vivili
- Public Health Division, Pacific Community, Noumea, New Caledonia
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Ekeroma A, Dyer R, Palafox N, Maoate K, Skeen J, Foliaki S, Vallely AJ, Fong J, Hibma M, Mola G, Reichhardt M, Taulung L, Aho G, Fakakovikaetau T, Watters D, Toliman PJ, Buenconsejo-Lum L, Sarfati D. Cancer management in the Pacific region: a report on innovation and good practice. Lancet Oncol 2019; 20:e493-e502. [PMID: 31395474 DOI: 10.1016/s1470-2045(19)30414-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 12/12/2022]
Abstract
Pacific island countries and territories (PICTs) face the challenge of a growing cancer burden. In response to these challenges, examples of innovative practice in cancer planning, prevention, and treatment in the region are emerging, including regionalisation and coalition building in the US-affiliated Pacific nations, a point-of-care test and treat programme for cervical cancer control in Papua New Guinea, improving the management of children with cancer in the Pacific, and surgical workforce development in the region. For each innovation, key factors leading to its success have been identified that could allow the implementation of these new developments in other PICTs or regions outside of the Pacific islands. These factors include the strengthening of partnerships within and between countries, regional collaboration within the Pacific islands (eg, the US-affiliated Pacific nations) and with other regional groupings of small island nations (eg, the Caribbean islands), a local commitment to the idea of change, and the development of PICT-specific programmes.
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Affiliation(s)
- Alec Ekeroma
- National University of Samoa, Le Papaigalagala Campus, To'omatagi, Samoa; Department of Obstetrics and Gynaecology, University of Otago, Wellington, Wellington, New Zealand.
| | - Rachel Dyer
- Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
| | - Neal Palafox
- Pacific Regional Cancer Programs, Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HA, USA; Population Sciences in the Pacific Program (Cancer Prevention in the Pacific), University of Hawaii Cancer Center, Honolulu, HA, USA
| | - Kiki Maoate
- Pacific Islands Programme, Royal Australasian College of Surgeons, Melbourne, VIC, Australia; Department of Paediatric Surgery, Christchurch Public Hospital, Christchurch, New Zealand
| | - Jane Skeen
- Starship Blood and Cancer Centre, Starship Children's Health, Auckland, New Zealand
| | - Sunia Foliaki
- Centre for Public Health Research, Massey University-Wellington Campus, Wellington, New Zealand
| | - Andrew J Vallely
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea; Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - James Fong
- Obstetrics and Gynaecology Unit, Colonial War Memorial Hospital, Ministry of Health, Suva, Fiji; Fiji National University, Suva, Fiji
| | - Merilyn Hibma
- Cervical Cancer Prevention in the Pacific Alliance, Dunedin, New Zealand; Department of Pathology, University of Otago, Dunedin, New Zealand
| | - Glen Mola
- Department of Obstetrics, Gynaecology and Reproductive Health, Port Moresby General Hospital, Port Moresby, Papua New Guinea; School of Medicine and Health Sciences, University of Papua New Guinea, Boroko, Papua New Guinea
| | - Martina Reichhardt
- Cancer Council of the Pacific Islands, Yap State Department of Health Services, Yap State, Federated States of Micronesia
| | - Livinston Taulung
- Cancer Council of the Pacific Islands, Kosrae State Department of Health Services, Kosrae State, Federated States of Micronesia
| | - George Aho
- Department of Paediatrics, Vaiola Hospital, Nuku'alofa Tonga
| | | | - David Watters
- Deakin University and Barwon Health, University Hospital Geelong, Geelong, VIC, Australia
| | - Pamela J Toliman
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea; Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Lee Buenconsejo-Lum
- Pacific Regional Cancer Programs, Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HA, USA
| | - Diana Sarfati
- Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
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Samuels TA, Murphy MM, Unwin N. Validating the self-reported annual monitoring grid for the 2007 Caribbean Community Declaration of Port-of-Spain on noncommunicable diseases. Rev Panam Salud Publica 2019; 42:e189. [PMID: 31093216 PMCID: PMC6386129 DOI: 10.26633/rpsp.2018.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/30/2018] [Indexed: 11/27/2022] Open
Abstract
Objectives In 2007, the Caribbean Community (CARICOM) convened the world's first-ever heads of government summit on noncommunicable diseases (NCDs) and issued the landmark Declaration of Port-of-Spain: Uniting to Stop the Epidemic of Chronic NCDs. Since then, ministry of health (MoH) focal points in each country have self-reported annually on their NCD efforts, using a 26-indicator grid created to assess implementation of the Declaration. Our objective was to assess the validity of those grid responses, as compared to information from in-depth interviews and document reviews. Methods Seven national case studies on policy responses to the Declaration were undertaken in 2015. In-depth, semistructured interviews were conducted with stakeholders from multiple sectors, including the MoH. Policy documents were also identified and reviewed. The results from the 2015 case studies were compared to the 2014 MoH focal point grid responses. Kappa statistics evaluated chance agreement. Results The information from the grid and from the case studies agreed closely. Out of a total of 182 indicators (26 each for seven countries), there was a lack of agreement on just 9 (4.9%). All the differences were between policy statements and implementation. Except for physical activity, kappa statistics indicated that agreement was good to excellent for all the clusters of the grid and for the grid as a whole, but with wide confidence intervals. Conclusions In general, the monitoring grid accurately assessed the national situation, but with a possible tendency to overstate performance in some areas. These findings contributed to the design of a new, 50-indicator monitoring grid in 2016. Alongside these improvements, CARICOM countries face a substantial burden from having to complete many other required NCD reports, mainly for the Pan American Health Organization and the World Health Organization.
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Affiliation(s)
- T Alafia Samuels
- George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Bridgetown, Barbados
| | - Madhuvanti M Murphy
- Faculty of Medical Sciences, Cave Hill campus, University of the West Indies, Bridgetown, Barbados
| | - Nigel Unwin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
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Rarau P, Pulford J, Gouda H, Phuanukoonon S, Bullen C, Scragg R, Pham BN, McPake B, Oldenburg B. Socio-economic status and behavioural and cardiovascular risk factors in Papua New Guinea: A cross-sectional survey. PLoS One 2019; 14:e0211068. [PMID: 30673755 PMCID: PMC6343927 DOI: 10.1371/journal.pone.0211068] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/07/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Risk factors for cardiovascular disease (CVD) are negatively correlated with socio-economic status (SES) in high-income countries (HIC) but there has been little research on their distribution by household SES within low-and middle-income countries (LMICs). Considering the limited data from LMICs, this paper examines the association between behavioural and cardiovascular risk factors and household SES in Papua New Guinea (PNG). METHODS Reported here are results of 671 participants from the 900 randomly selected adults aged 15-65 years. These adults were recruited from three socioeconomically and geographically diverse surveillance sites (peri-urban community, rural Highland and an Island community) in PNG in 2013-2014. We measured their CVD risk factors (behavioural and metabolic) using a modified WHO STEPS risk factor survey and analysis of blood samples. We assessed SES by education, occupation and creating a household wealth index based on household assets. We calculated risk ratios (RR) and their 95% confidence intervals (CI) using a generalized linear model to assess the associations between risks and SES. FINDINGS Elevated CVD risk factors were common in all SES groups but the CVD metabolic risk factors were most prevalent among homemakers, peri-urban and rural highlands, and the highest (4th and 5th) wealth quintile population. Adults in the highest wealth quintile had high risks of obesity, elevated HbA1c and metabolic syndrome (MetS) that were greater than those in the lowest quintile although those in the highest wealth quintiles were less likely to smoke tobacco. Compared to people from the Island community, peri-urban residents had increased risks of increased waist circumference (WC) (RR: 1.67, 95%CI: 1.21-2.31), hypertension (RR: 2∙29, 95%CI: 1∙89-4.56), high cholesterol (RR: 2∙22, 95%CI: 1∙20-4∙10), high triglycerides (RR: 1∙49, 95%CI: 1∙17-1∙91), elevated HbA1c (RR: 5∙54, 95%CI: 1∙36-21∙56), and Metabolic syndrome (MetS) (RR: 2∙04, 95%CI: 1∙25-3∙32). Similarly, Rural Highland residents had increased risk of obesity (Waist Circumference RR: 1∙70, 95%CI: 1∙21-3∙38, Waist-Hip-Ratio RR:1∙48, 95%CI: 1∙28-1∙70), hypertension (RR: 2∙60, 95%CI: 1∙71-3∙95), high triglycerides (RR: 1∙34, 95%CI: 1∙06-1∙70) and MetS (RR: 1∙88, 95%CI: 1∙12-3∙16) compared to those in the rural Island site. INTERPRETATION CVD risk factors are common in PNG adults but their association with SES varies markedly and by location. Our findings show that all community members are at risk of CVD weather they are part of high or low SES groups. These results support the notion that the association between CVD risk factors and SES differ greatly accordingly to the type of SES measure used, risk factors and the population studied. In addition, our findings contribute further to the limited literature in LMIC. Longitudinal studies are needed to monitor changes in rapidly changing societies such as PNG to inform public health policy for control and prevention of NCDs in the country.
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Affiliation(s)
- Patricia Rarau
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Justin Pulford
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Hebe Gouda
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Suparat Phuanukoonon
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Chris Bullen
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Bang Nguyen Pham
- Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea
| | - Barbara McPake
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Brian Oldenburg
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Latu C, Moodie M, Coriakula J, Waqa G, Snowdon W, Bell C. Barriers and Facilitators to Food Policy Development in Fiji. Food Nutr Bull 2018; 39:621-631. [DOI: 10.1177/0379572118797083] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Gade Waqa
- Fiji National University, Suva, Fiji
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Linhart C, Naseri T, Lin S, Taylor R, Morrell S, McGarvey ST, Magliano DJ, Zimmet P. Continued increases in blood pressure over two decades in Samoa (1991-2013); around one-third of the increase explained by rising obesity levels. BMC Public Health 2018; 18:1122. [PMID: 30219049 PMCID: PMC6139166 DOI: 10.1186/s12889-018-6016-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/04/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To analyse trends over the period 1991-2013 in systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension in adults aged 25-64 years in Samoa; and to assess the contribution of rising obesity levels to period trends. METHODS Unit record data from seven population-based surveys (n = 10,881) conducted between 1991 and 2013 were included for analysis. Surveys were adjusted to the nearest previous census to improve national representativeness. Hypertension was defined as SBP ≥140 mmHg and/or DBP ≥90 mmHg and/or on medication for hypertension. Obesity was measured by body mass index (BMI). Poisson, linear and meta-regression were used to assess period trends. RESULTS Over 1991-2013 mean SBP and DBP (mmHg), and the prevalence of hypertension (%) increased in both sexes. Increases in hypertension were: from 18.3 to 33.9% (p < 0.001) in men (mean BP from 122/74 to 132/78); and from 14.3 to 26.4% (p < 0.001) in women (mean BP from 118/73 to 126/78). The estimate of the age-adjusted mean SBP and DBP over 1991-2013, and the relative risk for hypertension in 2013 compared to 1991, were attenuated after adjusting for BMI: by 22% (men) and 32% (women) for mean SBP; 37% (men) and 32% (women) for mean DBP; and 19% in both sexes for hypertension. CONCLUSIONS Significant increases have occurred in SBP/DBP and hypertension prevalence in both sexes in Samoa during 1991-2013, which would contribute significantly to premature mortality from cardiovascular disease. Obesity accounts for around one-third of the rising trend in blood pressure in the Samoan population. Strengthening of population control of hypertension through reduction in obesity and salt intake, and case detection and treatment through primary care, is required to reduce premature mortality from cardiovascular disease in Samoa.
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Affiliation(s)
- Christine Linhart
- Public and International Health, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | | | - Sophia Lin
- Public and International Health, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Richard Taylor
- Public and International Health, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Stephen Morrell
- Public and International Health, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Stephen T. McGarvey
- International Health Institute, Department of Epidemiology, Brown University School of Public Health, Providence, USA
| | | | - Paul Zimmet
- Baker IDI Heart & Diabetes Institute, Melbourne, Australia
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Hoy DG, Raikoti T, Smith E, Tuzakana A, Gill T, Matikarai K, Tako J, Jorari A, Blyth F, Pitaboe A, Buchbinder R, Kalauma I, Brooks P, Lepers C, Woolf A, Briggs A, March L. Use of The Global Alliance for Musculoskeletal Health survey module for estimating the population prevalence of musculoskeletal pain: findings from the Solomon Islands. BMC Musculoskelet Disord 2018; 19:292. [PMID: 30115055 PMCID: PMC6097436 DOI: 10.1186/s12891-018-2198-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/17/2018] [Indexed: 12/13/2022] Open
Abstract
Background Musculoskeletal (MSK) conditions are common and the biggest global cause of physical disability. The objective of the current study was to estimate the population prevalence of MSK-related pain using a standardized global MSK survey module for the first time. Methods A MSK survey module was constructed by the Global Alliance for Musculoskeletal Health Surveillance Taskforce and the Global Burden of Disease MSK Expert Group. The MSK module was included in the 2015 Solomon Islands Demographic and Health Survey. The sampling design was a two-stage stratified, nationally representative sample of households. Results A total of 9214 participants aged 15–49 years were included in the analysis. The age-standardized four-week prevalence of activity-limiting low back pain, neck pain, and hip and/or knee pain was 16.8, 8.9, and 10.8%, respectively. Prevalence tended to increase with age, and be higher in those with lower levels of education. Conclusions Prevalence of activity-limited pain was high in all measured MSK sites. This indicates an important public health issue for the Solomon Islands that needs to be addressed. Efforts should be underpinned by integration with strategies for other non-communicable diseases, aging, disability, and rehabilitation, and with other sectors such as social services, education, industry, and agriculture. Primary prevention strategies and strategies aimed at self-management are likely to have the greatest and most cost-effective impact. Electronic supplementary material The online version of this article (10.1186/s12891-018-2198-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- D G Hoy
- University of Sydney, Sydney, Australia. .,Global Alliance for Musculoskeletal Health, Truro, UK. .,Pacific Community (SPC), Noumea, New Caledonia.
| | - T Raikoti
- Pacific Community (SPC), Noumea, New Caledonia
| | - E Smith
- University of Sydney, Sydney, Australia
| | - A Tuzakana
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - T Gill
- University of Adelaide, Adelaide, Australia
| | - K Matikarai
- Pacific Community (SPC), Noumea, New Caledonia
| | - J Tako
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - A Jorari
- Pacific Community (SPC), Noumea, New Caledonia
| | - F Blyth
- University of Sydney, Sydney, Australia
| | - A Pitaboe
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | | | - I Kalauma
- Solomon Islands National Statistics Office, Honiara, Solomon Islands
| | - P Brooks
- University of Melbourne, Melbourne, Australia
| | - C Lepers
- Pacific Community (SPC), Noumea, New Caledonia
| | - A Woolf
- Global Alliance for Musculoskeletal Health, Truro, UK.,Royal Cornwall Hospital, Truro, UK
| | - A Briggs
- Curtin University, Perth, Australia
| | - L March
- University of Sydney, Sydney, Australia.,Global Alliance for Musculoskeletal Health, Truro, UK
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Marques SRL, Lemos SMA. LETRAMENTO EM SAÚDE E FATORES ASSOCIADOS EM ADULTOS USUÁRIOS DA ATENÇÃO PRIMÁRIA. TRABALHO, EDUCAÇÃO E SAÚDE 2018. [DOI: 10.1590/1981-7746-sol00109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O objetivo da pesquisa foi investigar o letramento em saúde e associação com fatores sociodemográficos, autopercepção da saúde e qualidade de vida em adultos. Tratou-se de estudo transversal com adultos entre 20 e 59 anos, usuários da atenção primária à saúde, realizado em unidades básicas de saúde, de fevereiro a maio de 2015 – amostra probabilística. O letramento em saúde foi avaliado pelo Short Assessment of Health Literacy for Portuguese-Speaking Adults. Realizou-se análise estatística descritiva, análise bivariada (p ≤ 0,20) e regressão logística múltipla (p ≤ 0,05). O letramento em saúde inadequado foi frequente e inicialmente associado a sexo, escolaridade, última série cursada com aprovação, estudo formal mínimo, Critério de Classificação Econômica Brasil, plano de saúde, arranjo familiar, importância atribuída à saúde, nota atribuída à própria saúde, frequência de comparecimento à unidade básica de saúde e aos domínios relações sociais e ambiental do teste World Health Organization Quality of Life. No modelo final da regressão logística, somente a escolaridade permaneceu associada ao letramento em saúde, e indivíduos com menor escolaridade tiveram mais chance de ter letramento em saúde inadequado. Os achados sugerem a necessidade do desenvolvimento de estratégias de educação em saúde para os adultos usuários da atenção primária.
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Szwergold B. A Hypothesis: Moderate Consumption of Alcohol Contributes to Lower Prevalence of Type 2 Diabetes Due to the Scavenging of Alpha-Dicarbonyls by Dietary Polyphenols. Rejuvenation Res 2017; 21:389-404. [PMID: 28891383 DOI: 10.1089/rej.2017.1974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The world is experiencing an epidemic of type-2-diabetes mellitus (T2DM). This has led to increased morbidity and mortality, explosive growth in health care budgets, and an even greater adverse, if indirect, impact on societies and economies of affected countries. While genetic susceptibility to T2DM is a major determinant of its prevalence, changes in lifestyles also play a role. One such change has been a transition from traditional diets characterized by low caloric and high nutrient density to calorie-rich but nutrient-poor Western diets. Given this, one solution to the epidemic of T2DM would be to abandon Western diets and revert to traditional eating patterns. However, traditional diets cannot provide enough calories for the increasing global population, so transition from traditional to Western foodstuffs appears to be irreversible. Consequently, the only practical solution to problems caused by these changes is to modify Western diets, possibly by supplementing them with functional foods containing nutrients that would compensate for these dietary deficits. I present in this study a hypothesis to explain why shifts from traditional to Western diets have been so problematic and to suggest nutrients that may counteract these adverse effects. I postulate that the components of traditional diets that may compensate for deficiencies of Westerns diets are scavengers of reactive α-dicarbonyls produced as unavoidable by-products of glucose and lipid metabolism. Most important among these scavengers are some plant secondary metabolites: polyphenols, phlorotannins, and carotenoids. They are found in alcoholic beverages and are abundant in seasonings, cocoa, coffee, tea, whole grains, pigmented vegetables, fruits, and berries.
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Frayon S, Cavaloc Y, Wattelez G, Cherrier S, Lerrant Y, Galy O. Self-Reported Height and Weight in Oceanian School-Going Adolescents and Factors Associated With Errors. Asia Pac J Public Health 2017; 29:526-536. [PMID: 28905662 DOI: 10.1177/1010539517731362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examined the accuracy of self-reported weight and height in New Caledonian school-going adolescents. Self-reported and measured height and weight data were collected from 665 adolescents of New Caledonia and were then compared. Multivariable logistic regressions identified the factors associated with inaccurate self-reports. Sensitivity and specificity of self-reported body mass index values to detect overweight or obesity were evaluated. Self-reported weight was significantly lower than measured weight (boys, -3.56 kg; girls, -3.13 kg). Similar results were found for height (boys, -2.51 cm; girls, -3.23 cm). Multiple regression analyses indicated that the difference between self-reported and measured height was significantly associated with ethnicity and pubertal status. Inaccurate self-reported weight was associated with socioeconomic status, place of residence, body-size perception and weight status. Screening accuracy of self-reported body mass index was low, particularly in the Melanesian subgroup. These findings should be considered when overweight is estimated in the Melanesian adolescent population at individual scale.
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Affiliation(s)
- Stéphane Frayon
- 1 Laboratory for Research in Education, School of Education and Teacher Training, University of New Caledonia, Noumea, New Caledonia
| | - Yolande Cavaloc
- 1 Laboratory for Research in Education, School of Education and Teacher Training, University of New Caledonia, Noumea, New Caledonia
| | - Guillaume Wattelez
- 1 Laboratory for Research in Education, School of Education and Teacher Training, University of New Caledonia, Noumea, New Caledonia
| | - Sophie Cherrier
- 1 Laboratory for Research in Education, School of Education and Teacher Training, University of New Caledonia, Noumea, New Caledonia
| | - Yannick Lerrant
- 1 Laboratory for Research in Education, School of Education and Teacher Training, University of New Caledonia, Noumea, New Caledonia
| | - Olivier Galy
- 1 Laboratory for Research in Education, School of Education and Teacher Training, University of New Caledonia, Noumea, New Caledonia
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Rarau P, Vengiau G, Gouda H, Phuanukoonon S, Kevau IH, Bullen C, Scragg R, Riley I, Marks G, Umezaki M, Morita A, Oldenburg B, McPake B, Pulford J. Prevalence of non-communicable disease risk factors in three sites across Papua New Guinea: a cross-sectional study. BMJ Glob Health 2017; 2:e000221. [PMID: 29242751 PMCID: PMC5584489 DOI: 10.1136/bmjgh-2016-000221] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 02/21/2017] [Accepted: 03/13/2017] [Indexed: 12/19/2022] Open
Abstract
Papua New Guinea (PNG) is a culturally, environmentally and ethnically diverse country of 7.3 million people experiencing rapid economic development and social change. Such development is typically associated with an increase in non-communicable disease (NCD) risk factors. AIM To establish the prevalence of NCD risk factors in three different regions across PNG in order to guide appropriate prevention and control measures. METHODS A cross-sectional survey was undertaken with randomly selected adults (15-65 years), stratified by age and sex recruited from the general population of integrated Health and Demographic Surveillance Sites in West Hiri (periurban), Asaro (rural highland) and Karkar Island (rural island), PNG. A modified WHO STEPS risk factor survey was administered along with anthropometric and biochemical measures on study participants. RESULTS The prevalence of NCD risk factors was markedly different across the three sites. For example, the prevalences of current alcohol consumption at 43% (95% CI 35 to 52), stress at 46% (95% CI 40 to 52), obesity at 22% (95% CI 18 to 28), hypertension at 22% (95% CI 17 to 28), elevated levels of cholesterol at 24% (95% CI 19 to 29) and haemoglobin A1c at 34% (95% CI 29 to 41) were highest in West Hiri relative to the rural areas. However, central obesity at 90% (95% CI 86 to 93) and prehypertension at 55% (95% CI 42 to 62) were most common in Asaro whereas prevalences of smoking, physical inactivity and low high-density lipoprotein-cholesterol levels at 52% (95% CI 45 to 59), 34% (95% CI 26 to 42) and 62% (95% CI 56 to 68), respectively, were highest in Karkar Island. CONCLUSION Adult residents in the three different communities are at high risk of developing NCDs, especially the West Hiri periurban population. There is an urgent need for appropriate multisectoral preventive interventions and improved health services. Improved monitoring and control of NCD risk factors is also needed in all regions across PNG.
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Affiliation(s)
- Patricia Rarau
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
- PNG Institute of Medical Research, Goroka, Papua New Guinea
| | - Gwendalyn Vengiau
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Hebe Gouda
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health Treatment, Research and Education, Wacol, Queensland, Australia
| | - Suparat Phuanukoonon
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Isi H Kevau
- School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
| | - Chris Bullen
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Ian Riley
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Geoffrey Marks
- School of Public Health, The University of Queensland, Herston, Brisbane, Queensland, Australia
| | - Masahiro Umezaki
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ayako Morita
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Brian Oldenburg
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Barbara McPake
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Justin Pulford
- PNG Institute of Medical Research, Goroka, Papua New Guinea
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
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Medicine shortages in Fiji: A qualitative exploration of stakeholders' views. PLoS One 2017; 12:e0178429. [PMID: 28582409 PMCID: PMC5459560 DOI: 10.1371/journal.pone.0178429] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 05/13/2017] [Indexed: 12/31/2022] Open
Abstract
Objectives Medicine access is a human right; yet, concerningly, there are international instances of shortages. Quantitative data has allowed WHO to propose global solutions; however, individualised understanding of specific regions is still required to work towards national solutions. Fiji has an established issue with medication supply and the aim of this study was to use qualitative methods to gain a fuller understanding of this context. Methods Semi-structured interviews were used to gain the perspective of key stakeholders involved in the Fijian medicine supply chain in regards to causes, impacts and possible solutions of medicine shortages. Thematic analysis was used to analyse the interview data. Results In total, 48 stakeholders participated and the information was synthesised into three main themes, causes, impacts and solutions and the sub-themes including; political, system and patient causes, adverse health effects on patients, professional dissatisfaction, monetary loss and loss of faith in the health system, workarounds, operation improvements, government intervention and education and training. Conclusions The situation in Fiji is not dissimilar to other instances of shortages around the world and hence international solutions like that proposed by WHO are feasible; however, they must be modified to be uniquely Fijian to work in this context.
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Tolley H, Snowdon W, Wate J, Durand AM, Vivili P, McCool J, Novotny R, Dewes O, Hoy D, Bell C, Richards N, Swinburn B. Monitoring and accountability for the Pacific response to the non-communicable diseases crisis. BMC Public Health 2016; 16:958. [PMID: 27613495 PMCID: PMC5018177 DOI: 10.1186/s12889-016-3614-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/30/2016] [Indexed: 11/10/2022] Open
Abstract
Background Non-communicable diseases (NCD) are the leading cause of premature death and disability in the Pacific. In 2011, Pacific Forum Leaders declared “a human, social and economic crisis” due to the significant and growing burden of NCDs in the region. In 2013, Pacific Health Ministers’ commitment to ‘whole of government’ strategy prompted calls for the development of a robust, sustainable, collaborative NCD monitoring and accountability system to track, review and propose remedial action to ensure progress towards the NCD goals and targets. The purpose of this paper is to describe a regional, collaborative framework for coordination, innovation and application of NCD monitoring activities at scale, and to show how they can strengthen accountability for action on NCDs in the Pacific. A key component is the Dashboard for NCD Action which aims to strengthen mutual accountability by demonstrating national and regional progress towards agreed NCD policies and actions. Discussion The framework for the Pacific Monitoring Alliance for NCD Action (MANA) draws together core country-level components of NCD monitoring data (mortality, morbidity, risk factors, health system responses, environments, and policies) and identifies key cross-cutting issues for strengthening national and regional monitoring systems. These include: capacity building; a regional knowledge exchange hub; innovations (monitoring childhood obesity and food environments); and a robust regional accountability system. The MANA framework is governed by the Heads of Health and operationalised by a multi-agency technical Coordination Team. Alliance membership is voluntary and non-conditional, and aims to support the 22 Pacific Island countries and territories to improve the quality of NCD monitoring data across the region. In establishing a common vision for NCD monitoring, the framework combines data collected under the WHO Global Framework for NCDs with a set of action-orientated indicators captured in a NCD Dashboard for Action. Summary Viewing NCD monitoring as a multi-component system and providing a robust, transparent mutual accountability mechanism helps align agendas, roles and responsibilities of countries and support organisations. The dashboard provides a succinct communication tool for reporting progress on implementation of agreed policies and actions and its flexible methodology can be easily expanded, or adapted for other regions.
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Affiliation(s)
- Hilary Tolley
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Wendy Snowdon
- World Health Organisation, Western Pacific Regional Office, Suva, Fiji
| | - Jillian Wate
- Pacific Research Centre for the Prevention of Obesity and Non-Communicable Diseases (C-POND), Fiji National University, Suva, Fiji
| | - A Mark Durand
- Pacific Islands Health Officers Association, Honolulu, HI, USA
| | | | - Judith McCool
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | | | - Ofa Dewes
- School of Population Health & Department of Molecular Medicine, University of Auckland, Auckland, New Zealand
| | - Damian Hoy
- Pacific Community, Noumea, New Caledonia
| | - Colin Bell
- School of Medicine, Deakin University, Geelong, Australia
| | - Nicola Richards
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Boyd Swinburn
- Department of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
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Kessaram T, McKenzie J, Girin N, Roth A, Vivili P, Williams G, Hoy D. Tobacco Smoking in Islands of the Pacific Region, 2001-2013. Prev Chronic Dis 2015; 12:E212. [PMID: 26632953 PMCID: PMC4675401 DOI: 10.5888/pcd12.150155] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We provide an overview of tobacco smoking patterns in Pacific island countries and territories to facilitate monitoring progress toward the goal of a Tobacco-Free Pacific by 2025. We examined data from 4 surveys conducted in the region between 2001 and 2013, including the STEPwise approach to surveillance for adults (25–64 years); the Global School-Based Student Health Survey and the Global Youth Tobacco Survey (students 13–15 years); and the Youth Risk Behavior Surveillance System (grade 9–12 students) in United States affiliated Pacific Islands (USAPIs). Adult smoking prevalence ranged from less than 5% of women in Vanuatu to almost 75% of men in Kiribati. Smoking prevalence among students (13–15 years) ranged between 5.6% and 52.1%. There were declines in smoking among youths in many USAPIs. To achieve the tobacco-free goal and reduce disease burden, accelerated action is needed to align national legislation with international agreements and build capacity for tobacco control at all levels.
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Affiliation(s)
- Tara Kessaram
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848, Noumea, New Caledonia.
| | - Jeanie McKenzie
- Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | - Natalie Girin
- Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | - Adam Roth
- Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | - Paula Vivili
- Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
| | - Gail Williams
- University of Queensland, Brisbane, Queensland, Australia
| | - Damian Hoy
- Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia
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Gouda HN, Richardson NC, Beaglehole R, Bonita R, Lopez AD. Health information priorities for more effective implementation and monitoring of non-communicable disease programs in low- and middle-income countries: lessons from the Pacific. BMC Med 2015; 13:233. [PMID: 26391337 PMCID: PMC4578613 DOI: 10.1186/s12916-015-0482-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 09/04/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) place enormous burdens on individuals and health systems. While there has been significant global progress to guide the development of national NCD monitoring programs, many countries still struggle to adequately establish critical information systems to prioritise NCD control approaches. DISCUSSION In this paper, we use the recent experience of the Pacific as a case study to highlight four key lessons about prioritising strategies for health information system development for monitoring NCDs: first, NCD interventions must be chosen strategically, taking into account local disease burden and capacities; second, NCD monitoring efforts must align with those interventions so as to be capable of evaluating progress; third, in order to ensure efficiency and sustainability, NCD monitoring strategies must be integrated into existing health information systems; finally, countries should monitor the implementation of key policies to control food and tobacco industries. Prioritising NCD interventions to suit local needs is critical and should be accompanied by careful consideration of the most appropriate and feasible monitoring strategies to track and evaluate progress.
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Affiliation(s)
- Hebe N. Gouda
- />School of Public Health, University of Queensland, Brisbane, QLD Australia
| | | | - Robert Beaglehole
- />School of Population Health, University of Auckland, Auckland, New Zealand
| | - Ruth Bonita
- />School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alan D. Lopez
- />Melbourne School of Population and Global Health, the University of Melbourne, Melbourne, VIC Australia
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Kessaram T, McKenzie J, Girin N, Merilles OEA, Pullar J, Roth A, White P, Hoy D. Overweight, obesity, physical activity and sugar-sweetened beverage consumption in adolescents of Pacific islands: results from the Global School-Based Student Health Survey and the Youth Risk Behavior Surveillance System. BMC OBESITY 2015; 2:34. [PMID: 26401344 PMCID: PMC4572651 DOI: 10.1186/s40608-015-0062-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 08/18/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Overweight, obesity and their consequences are challenges to sustainable social and economic development in Pacific island countries and territories (PICTs). Complementing previous analyses for adults, the purpose of this paper is to synthesise available data on overweight, obesity and their risk factors in adolescents in the region. The resulting Pacific perspective for the younger generation will inform both the national and regional public health response to the crisis of noncommunicable diseases. METHODS We examined the prevalence of overweight, obesity, physical activity and carbonated sugar-sweetened beverage (SSB) consumption, by using published results of two cross-sectional surveys: the Global School-Based Student Health Survey (GSHS) and the Youth Risk Behavior Surveillance System (YRBSS). GSHS was conducted in ten PICTs between 2010 and 2013 and provided results for 13-15 year olds. YRBSS surveys, conducted repeatedly in five PICTs between 1999 and 2013, provided results for grade 9-12 students (approximately 14-18 years) and enabled examination of trends. RESULTS Obesity prevalence ranged from 0 % in female students in Vanuatu to 40 % in males in Niue (GSHS). Among grade 9-12 students (YRBSS), obesity was highest in American Samoa (40 % of males; 37 % of females). Approximately 60 % of students in the Cook Islands, Niue and Tonga (GSHS) and American Samoa (YRBSS), were overweight. In both surveys, less than half of students reported engaging in sixty minutes of physical activity on at least 5 days of the past week. Daily consumption of carbonated SSBs in the past month was reported by over 42 % of students in six PICTs (GSHS), and in the past week by more than 18 % of students in three PICTs (YRBSS). In PICTs conducting YRBSS, obesity prevalence remained high or increased within the period 1999-2013. CONCLUSION There is a need for urgent action on overweight, obesity and their risk factors in Pacific youth. The multiple social, economic and physical determinants of this public health crisis must be addressed. This requires all sectors within government and society in PICTs to implement and evaluate policies that will protect and promote the health of their populations across the life course.
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Affiliation(s)
- Tara Kessaram
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Jeanie McKenzie
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Natalie Girin
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | | | - Jessica Pullar
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Adam Roth
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Paul White
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
| | - Damian Hoy
- Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia
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