School of Public Health and Interdisciplinary Studies

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The School of Public Health and Interdisciplinary Studies research institutes and centres play an important role in specialist teaching and research conducted by academic staff and postgraduate students. This places AUT students at the forefront of much of the ground-breaking research undertaken in New Zealand in the field of Biostatistics and Epidemiology, Psychology, Psychotherapy and Counselling, and Public Health.

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    Challenges and Implications for Menopausal Health and Help-Seeking Behaviors in Midlife Women From the United States and China in Light of the COVID-19 Pandemic: Web-Based Panel Surveys.
    (JMIR Publications Inc., 2024-01-26) Lau, Bobo Hi Po; Tang, Catherine So Kum; Holroyd, Eleanor; Wong, William Chi Wai
    BACKGROUND: The global population of women of menopausal age is quickly increasing. The COVID-19 pandemic has led to an accelerated increase in the use of telehealth services, especially technological solutions targeting women's health. Understanding the factors behind midlife women's help-seeking behaviors amidst the pandemic will assist in the development of person-centered holistic telehealth solutions targeting menopausal and postreproductive health. OBJECTIVE: This study aimed to compare the factors underlying help-seeking for menopausal distress among midlife women in the United States and China. METHODS: We conducted 2 web-based panel surveys in the United States using Amazon Mechanical Turk and in China using Credamo between July and October 2022. A total of 1002 American and 860 Chinese women aged between 40 and 65 years took part in the survey. The survey was designed based on the Health Belief Model with questions related to their menopausal knowledge, perceived severity of menopausal symptoms, perceived susceptibility to menopausal distress, perceived benefits of help-seeking, perceived COVID-19- and non-COVID-19-related barriers against help-seeking, self-efficacy, and motivation to seek help. Structural equations models were fitted for the data using full information maximum likelihood to manage missing data. RESULTS: Knowledge was not directly related to help-seeking motivation in both samples. Among the Chinese sample, knowledge was negatively related to perceived severity but positively related to COVID-19-related barriers; in turn, higher perceived severity, benefits, COVID-19-related barriers, and self-efficacy and lower non-COVID-19-related barriers were related to more motivation to seek help. In the US sample, knowledge was negatively related to perceived severity, susceptibility, benefits, barriers (COVID-19- and non-COVID-19-related), and self-efficacy; in turn, higher self-efficacy, COVID-19-related barriers, and benefits were associated with more help-seeking motivation. The factors explained 53% and 45.3% of the variance of help-seeking motivation among the American and Chinese participants, respectively. CONCLUSIONS: This study revealed disparate pathways between knowledge, health beliefs, and the motivation for help-seeking among American and Chinese midlife women with respect to menopausal distress. Our findings show that knowledge may not directly influence help-seeking motivation. Instead, perceived benefits and self-efficacy consistently predicted help-seeking motivation. Interestingly, concern over COVID-19 infection was related to higher help-seeking motivation in both samples. Hence, our findings recommend the further development of telehealth services to (1) develop content beyond health education and symptom management that serves to enhance the perceived benefits of addressing women's multidimensional menopausal health needs, (2) facilitate patient-care provider communication with a focus on self-efficacy and a propensity to engage in help-seeking behaviors, and (3) target women who have greater midlife health concerns in the postpandemic era.
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    Enhancing Health Outcomes for Māori Elders Through an Intergenerational Cultural Exchange and Physical Activity Programme: A Cross-Sectional Baseline Study
    (Frontiers Media SA, 2023-12-12) Oetzel, JG; Zhang, Y; Nock, S; Meha, P; Huriwaka, H; Vercoe, M; Tahu, T; Urlich, J; Warbrick, R; Brown, G; Keown, S; Rewi, P; Erueti, B; Warbrick, I; Jackson, AM; Perry, T; Reddy, R; Simpson, ML; Cameron, MP; Hokowhitu, B
    Background: The study offers baseline data for a strengths-based approach emphasizing intergenerational cultural knowledge exchange and physical activity developed through a partnership with kaumātua (Māori elders) and kaumātua service providers. The study aims to identify the baseline characteristics, along with correlates of five key outcomes. Methods: The study design is a cross-sectional survey. A total of 75 kaumātua from six providers completed two physical functioning tests and a survey that included dependent variables based in a holistic model of health: health-related quality of life (HRQOL), self-rated health, spirituality, life satisfaction, and loneliness. Results: The findings indicate that there was good reliability and moderate scores on most variables. Specific correlates included the following: (a) HRQOL: emotional support (β = 0.31), and frequent interaction with a co-participant (β = 0.25); (b) self-rated health: frequency of moderate exercise (β = 0.32) and sense of purpose (β = 0.27); (c) spirituality: sense of purpose (β = 0.46), not needing additional help with daily tasks (β = 0.28), and level of confidence with cultural practices (β = 0.20); (d) life satisfaction: sense of purpose (β = 0.57), frequency of interaction with a co-participant (β = −0.30), emotional support (β = 0.25), and quality of relationship with a co-participant (β = 0.16); and (e) lower loneliness: emotional support (β = 0.27), enjoyment interacting with a co-participant (β = 0.25), sense of purpose (β = 0.24), not needing additional help with daily tasks (β = 0.28), and frequency of moderate exercise (β = 0.18). Conclusion: This study provides the baseline scores and correlates of important social and health outcomes for the He Huarahi Tautoko (Avenue of Support) programme, a strengths-based approach for enhancing cultural connection and physical activity.
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    Exploring the Impact of the COVID-19 Pandemic on Perceptions of National Scheduled Childhood Vaccines Among Māori and Pacific Caregivers, Whānau, and Healthcare Professionals in Aotearoa New Zealand
    (Taylor and Francis, 2024-01-11) Charania, Nadia; Tonumaipe’a, Daysha; Barbarich-Unasa, Te Wai; Iusitini, Leon; Davis, Georgina; Pacheco, Gail; Wilson, Denise
    In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. “We go with the norm” reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants’ acceptance of routine vaccines before the pandemic. “Everything became difficult” explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. “It needed to have an ethnic-specific approach” highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. “People are now finding their voice” expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.
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    Exploring Mobile Mixed Reality for Critical Thinking in Nursing and Healthcare Education: A Systematic Review
    (Elsevier, 2023-12-16) Stretton, Todd; Cochrane, Thomas; Sevigny, Charles; Rathner, Joseph
    Background: The shortage of nursing and healthcare clinical placements has prompted the investigation of ways to supplement authentic learning. Mobile mixed reality has become increasingly available as the ubiquity of the technology improves, however, the affordances and design principles for the facilitation of critical thinking is yet to be explored. Objective: To examine the state of the art of how mobile mixed reality facilitates critical thinking in nursing and healthcare higher education. Design: Systematic review. Review Methods: A search in seven databases (MEDLINE, PsychINFO, AMED, ERIC, Scopus, Cochrane, and Web of Science) was conducted with 3488 titles and abstracts screened according to pre-determined inclusion and exclusion criteria. The quality of included studies was evaluated using the Mixed Methods Assessment Tool (MMAT). Results: A total of 12 studies with 1,108 participants were included. The breadth of healthcare disciplines was limited to dentistry, medicine, nursing, midwifery, and paramedicine who mainly utilised bespoke scenarios on head mounted displays. Most scenarios were emergency or critical response by nature, with limited time provided for pre-brief, debrief, or overall user time. Only two studies directly measured critical thinking, with others indirectly referring to development of ‘decision making’ by conducting diagnoses, interpretation, analysis, or evaluation of healthcare scenarios in a mixed reality environment. Affordances and design principles for future development of mobile mixed reality for critical thinking in nursing and healthcare higher education are identified. Conclusions: While some pedagogical affordances of mobile mixed reality can be identified in a narrow number of healthcare disciplines; there remains to be limited valid measure of critical thinking used to quantify effectiveness. Future studies would benefit to consider scenarios beyond emergency and critical responses, include longitudinal studies that reflect development of critical thinking over time, and exploration of co-designed scenarios with and by nursing and allied healthcare students.
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    Factors Influencing Rural Timor-Leste Women’s Utilisation of Family Planning Services
    (Child and Youth Health Research Centre, Auckland University of Technology https://cyhrc.aut.ac.nz/, 2023-12-03) Gomes, Angelita Maria; Lees, Amanda B; Shrestha-Ranjit, Jagamaya
    In Timor-Leste, maternal fertility and mortality rates have been reducing over the past two decades; however, unmet family planning needs remain. Family planning is especially relevant for women with low socio-economic status as they often have unmet family planning needs, which is pertinent for Timor-Leste as its population experiences high rates of poverty and primarily lives rurally. Our qualitative descriptive study explores rural Timorese women’s knowledge, attitudes, and family planning practices to determine factors influencing their family planning decision-making. Purposive sampling resulted in twenty-five women from the rural Suai-Covalima district participating in three focus groups. While rural women preferred family planning, many lacked knowledge about specific methods, including misunderstandings about side effects and impact on fertility. Health literacy is central to improving understanding of family planning. Therefore, enhancing service providers’ capacity to provide accurate and up-to-date information and training is necessary to build rural women's understanding of family planning. The patriarchal nature of the Timorese society strongly influenced women’s family planning decisions. Hence, including men in future family planning education is essential. Despite the historical influence of the Catholic Church in Timor-Leste, women in this study did not feel its teachings influenced their family planning decisions. Further research exploring the role of the Church in reproductive decision-making and encompassing broader rural Timorese populations, including men, would increase understanding of family-planning decision-making and its influences.
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