L22 - A Pacific Islands' Perspective

• What is Pacific?

  • Pacific = often used to refer to migrants from neighbouring Pacific countries
  • Often used within the health sector
  • Pasifika = often used within the education sector
• What is Pacific?

  • Pasifika or Pacific refers to individual or people from one of the many ethnic groups from the Pacific region (Oceania)
  • Each ethnic groups has its own distinct culture, language, protocols and unique cultural context
• What is Pacific?

  • Umbrella term for someone from pacific nations/countries
  • No letter s or f in Māori language
  • All terms refer to same group of people, but when writing using the same one, be consistent
• Pacific:

  • Huge area, so all have own languages, cultures, political rule, customs, and understanding of the world
  • Polynesia - representation of most, NZ part of it, majority of NZ Pacific from Polynesia
  • Melanesia - fijian
  • Further north = Micronesia
  • Lines designed / broken down by someone else
  • Sea of Islands - lots of movement bw/ them, sea as highway for resources
• Is ‘Pacific’ an ethnicity with a universal language?

  No
• Diverse Population:

  • Ethnicity
  • Different
  • Language
  • Multiple languages within those people
  • (different dialects even within NZ)
  • Age
  • Age is massive in how understand/see world - determines how convey different values (how do it will be different)
  • Gender
  • What's normal for some genders (huge - to do with customs & practices)
  • Customs & Practices
  • Birthplace
  • Someone born there vs in NZ
  • Diversity within ethnic groups
• Diverse Population:

  • Has large number of Polynesians in NZ
  • Lots of Pacific people in NZ, & are very young (55% Pacific people under 25 yrs)
• Pacific Values:

  • Common values of Pacific people (main values that drive or centre of Pacific people)
  • Understanding of wellness & wellbeing
  • Determines what is important for engagement
• Family:

  • Foundation & the centre of Pacific people’s world
  • Can mean extended family, friends of family, church groups
  • A marker of identity which creates & strengthens a sense of belonging
  • Important for engagement & wellbeing
  • Lots of decisions made as family, community being affected as well
  • Not just nuclear family, village is part of family, strengthens sense of belonging
• Collectivism & Communitarianism:

  • The way Pacific people see the world
  • Where Pacific people thrive
  • Individuals & families are part of communities in the diaspora
  • Being able to function & contribute to community leads to overall health
  • More in terms of understanding motivations in why they do what they do
  • Flow on affect on to their village
  • Especially for those moving away from home nation, go to where ethnic group is
• Spirituality:

  • Shapes Pacific peoples values & beliefs
  • The role of the church is to provide spiritual guidance & protocols
  • Approx 80% of Pacific population are affiliated or belong to a religious denomination, mostly Christianity
  • Traditional spiritual beliefs & practices still practised
  • Traditional - such as traditional healers on own or in conjunction with western
  • Understanding of people coming from long lineage of people who make you who you are
• Respect:

  • A foundation is tone of Pacific culture
  • A key component in ‘teu le va’ or nurturing space
  • Ultimate way to care for space bw/ people
  • An expected behaviour
  • Learnt from a young age (ie ‘tulou’, eye contact, table manners, decision making)
  • ‘Tulou’ - walking by bending down, acknowledge you are there, care that you are getting in the way
  • Eye contact - when speaking or listening
  • Look down on someone showing dominance
  • When looking up = challenging them
  • Decision making - decision made by family, family involved in process
• Reciprocity:

  • Acknowledges the importance of relationships in Pacific context
  • See this practised during cultural or family events
  • Interdependence & sharing the load is seen as more effective than individualism
  • Group/community over individual
  • Every relationship you have
  • Don’t take advantage
  • Pacific very giving
  • Transgression across generations - look after those older, all involved
• Creating the ‘Va’:

  • The space bw/ people & living things
  • How you feel, the energy bw/ you & that thing
  • Everything you understand/your background help determine interaction
  • Understand what things to bring to table & what to hold back
  • Your role as practitioner is to nurture that va - one of main things want to be doing
• Tivaivai Research Framework:

  • Te ōroma - Vision
  • Ascending Community Aspirations
  • Ko’iko’i - Gathering the resources
  • Background information
  • PA in Pacific Islands communities
  • Creating the right environment
  • Tuitui - Stitching the patterns to the backing cloth
  • Implementation
  • Orongo’anga - Gifting the Tivaivai
  • Results
  • Future implications
• Te Ōrama:

  • Community Aspirations
  • Extensive Community Consultation
  • Dunedin
  • Pacific Trust Otago
  • Pacific Development Office
  • Church Congregations
  • Pacific Islands Centre
  • Rarotonga
  • Te Marae Ora
  • Village Church Congregations (Vaine Tini)
  • Vain Tini - group of women, eyes & ears of communities + gossip
  • Public Sector Workers - OPM, OPSC, MFAT, MOC
  • MOC - ministry of culture
  • Private Sector - Bluesky, CISNOC
  • Bluesky = vodafone
• Ko’iko’i - Shaping the Program:

  • What are the barriers to PA in Pacific communities?
  • Low confidence
  • Lack of access
  • Lack of experience
  • Cultural factors
  • Lack of time due to community functions
  • If don’t know how to do something less likely to do it
  • Cultural factors - can or can’t
  • Lack of time: specific to community functions, don’t feel able to do PA
• Ko’iko’i - Shaping the Program

  • What are the facilitators?
  • Longevity/Quality of life
  • Fun
  • Ability to contribute to community
  • Main one
  • Be active part of community, be there for future generations
• Creating the right environment:

  • Building Rapport
  • Volunteering, involved in community, offering services
  • Social
  • Families involved (extended families)
  • Sustainable
  • Minimal cost
  • Capacity Building
  • Who will take charge once he leaves
  • Community Focused
  • Consultation with end users
• PA Interventions in Pacific Islands Communities:

  • Small Sided Games:
  • 3 sessions per week for 4 weeks
  • N = 20 overweight & untrained Pacific adults
  • VO2 peak mean increase of 0.9 L/m,in (p - 0.03)
  • Increase in maximal quadriceps extension (p = 0.04)
  • After School Care Games:
  • Overweight, sedentary Pacific Islands & Māori teenagers
  • 3 sessions per week for 6 weeks
  • Increase in Rockport 1 mile test (p = 0.02) & decrease in SBP (p = 0.003)
  • Doesn’t have to be structured, do less structured PA
• The ‘Niu’ Movement:

  • The ‘Niu’ is recognisable to most Pacific nations
  • Accessible & inclusive (Exercises Based on recommendations from the National Institute on Aging)
  • Aerobic exercise is Cook Islands dance
  • 4 phases of making coconut cream:

  1. Climbing the tree
  2. Picking the coconut from the tree
  3. Huskung/Grating the coconut
  4. Squeezing the coconut milk from the meat

  • Design programme at level to suit most people capabilities
  • Resistance exercise - making coconut cream, contextualise some of the movements (what muscle is it strengthening, plane etc) - helps with understanding/long term learning
• Methods:

  • Accessible Venues
  • Dunedin (School of Phys Ed & Pacific Trust Otago)
  • Rarotonga (CISNOC, Apii Avarua, Sinal Hall, Te Punanga Nui Market, Bluesky)
  • Pre-Post Quantitative Design
  • Short Physical Performance Battery (SPBB)
  • 6 Minute Walk Test (6MWT)
  • Physiological & Anthropometric measures
  • Post Intervention Satisfaction Questionnaire
  • Energy Expenditure
  • Create comfortable space, parking can be a barrier (provide a van - help w/ accessibly)
  • Field tests - can do anywhere
  • Can do at any level
  • When say exercise testing - people don’t wanna come, until told by others that they are simple tests
• Methods continued:

  • Exercise Program (Dunedin & Rarotonga)
  • 2 times per week for 8 or 12 weeks
  • OMNI-RPE 7-8
  • 1-2 sets of 10-15 repetitions on 12 exercises
  • Apply appropriate progression
  • RPE scale, took a while for some to understand
  • Cool downs - notices about community would come out
• Results

  • Perceived as effective & acceptable in all community members
  • 93 completed (85 female)
  • Average age were 41 years old
  • Weight, BP, Waist & Hip Circumference decreased
  • Performance increased
  • Why mostly female?
  • Men came bc/ someone else they knew were going partner or mother
  • Statistically significant improvement for each of them
  • Set up Dance Fit in Dunedin
  • Aka Uka Dance Fitness in Rarotonga
  • CISNOC advisor on all PA policy
  • Dance is affective PA