School of Community and Public Health
Permanent link for this collectionhttps://hdl.handle.net/10292/10764
The School of Community and Public Health includes the following groups:
• Public Health
• Hauora Māori
• Disaster Risk Management and Development
• Pacific Health
• Violence and Trauma
• Health Law and Ethics
• Psychotherapy
• Counselling
• Mental Health & Addictions
• Lived Experience
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Item 'Siri, should I take this pill?' — Assessing Which AI-driven Assistant is Best(Tōpūtanga Tapuhi Kaitiaki o Aotearoa | New Zealand Nurses Organisation, 2026-05-19) Lessing, Charon; McKay, Marie; Foster, Shannon; Johnston, Deon[From introduction] As clinicians and members of the public gain increasing access to artificial intelligence (AI)–enabled tools such as the notetaking applications recently approved by Te Whatu Ora-Health NZ 1 (HNZ) and systems capable of rapidly synthesising emerging evidence, older adults are frequently unable to benefit from these innovations. Barriers including complex password requirements, visual limitations such as small font sizes, concerns about damaging the device, and exposure to overwhelming volumes of unsolicited content can restrict older adults’ ability to use digital technologies to find reliable health information.2 Voice assistants (VAs) have been available in Aotearoa since 2011, beginning with the release of Siri on the iPhone 4, followed by the wider availability of Amazon’s Alexa as a standalone Echo smart speaker from 2017.3 These technologies gained particular uptake among older adults due to their simplicity, hands-free operation and capacity to support everyday tasks such as setting reminders, accessing weather updates, listening to radio content and answering general knowledge queries.Item Culpable Ignorance and Causal Deviance(Wiley, 2025-09-05) Yates, ThomasI argue that tracing theorists of culpability for ignorant wrongdoing should reject the widely accepted principle that culpability for ignorant wrongdoing should always be traced through culpability for the ignorance itself. Two kinds of cases are considered in which culpability for ignorant wrongdoing ultimately traces back to culpability for a benighting act, but where it appears that culpable ignorance is not part of the explanation of the ignorant wrongdoing's culpability. These are (1) cases in which the ignorant wrongdoing is a foreseeable consequence of a culpable benighting act and yet the ignorance is an unforeseeable consequence of that act (making the ignorance blameless), and (2) cases in which the ignorance is the foreseeable consequence of a culpable benighting act (making it culpable) but where the connection between the ignorance and the foreseeable wrongdoing from it is itself unforeseeable. I contend that culpability for the ignorant wrongdoing in neither kind of case requires an appeal to culpable ignorance. Both kinds of cases appear to involve causal deviance. However, I draw upon recent work on causal deviance to argue that any causal deviance in these cases does not fully excuse given the lack of intervening causes.Item ‘We Gout Your Back’: A Qualitative Study to Co-design Educational Gout Resources With Pacific People in Aotearoa New Zealand(Oxford University Press (OUP), 2026-05-22) Tu’akoi, S; Ofanoa, S; Tohi, M; Pauuvale, A; Heather, M; Lutui, H; Lamont, R; Goodyear-Smith, F; Ofanoa, MPacific peoples in Aotearoa New Zealand experience some of the highest rates of gout worldwide. Although understanding gout and urate-lowering therapy is a key component of ensuring uptake and adherence to medication, Pacific communities have identified a lack of resources and tools to support this. The objective of this qualitative study was to co-design education resources for Pacific patients and communities in Aotearoa New Zealand, aiming to increase awareness of gout and of urate-lowering therapy. A Pacific Research Collective, comprising Pacific community members, health professionals, and researchers, led this study. Guided by the Samoan Fa’afaletui model, six co-design workshops were undertaken using semistructured talanga (interactive talk with a purpose), and this paper presents the results from the latter three workshops. Participants included Pacific community members and health professionals aged 20–75 years and included Samoan, Tongan, Cook Islands Māori, and Niuean ethnicities. Participants reviewed existing gout resources, developed prototypes, and provided iterative feedback. Data was collated in NVIVO, and reflexive thematic analysis was used to inductively develop five key themes: (i) a disconnect between existing gout resources and community needs, (ii) Pacific-centred approaches to improve understanding of gout, (iii) benefits of video resources, (iv) recognizing diverse Pacific audiences, and (v) reflections on final co-designed resources. This co-design process prioritized Pacific views and lived experiences to develop culturally grounded gout education resources that can be utilized in healthcare settings and community outreach programmes. Future research should continue to partner with communities to ensure education approaches are relevant, appropriate, and impactful.Item Can Wegovy move the needle on NZ’s obesity crisis, or simply treat its symptoms?(The Conversation, 2026-06-01) Trafford, JulieItem The Global Impact of Industrialisation and Climate Change on Antimicrobial Resistance: Assessing the Role of Eco-AMR Zones(Springer Science and Business Media LLC, 2025-05-05) Oyelayo, EA; Taiwo, TJ; Oyelude, SO; Alao, JOThis study examines the relationship between industrialisation, climate change, and antimicrobial resistance (AMR) gene prevalence. Data analysis from the top 20 highly industrialised and the top 20 least industrialised nations revealed that industrial activities significantly contribute to global warming, with temperature increases of up to 2 °C observed in highly industrialised regions. These environmental changes influence the distribution and evolution of AMR genes, as rising temperatures can affect bacterial resistance in a manner similar to antibiotics. Through a bioinformatics approach, a marked disparity in AMR gene frequencies was observed between highly industrialised and less industrialised nations, with developed countries reporting higher frequencies due to extensive antibiotic use and advanced monitoring systems. ‘Eco-AMR Zones’ is proposed as a solution to specialised areas by promoting sustainable industrial practices, enforcing pollution controls, and regulating antibiotic use to mitigate AMR’s environmental and public health impacts. These zones, supported by collaboration across various sectors, offer a promising approach to preserving antibiotic effectiveness and reducing environmental degradation. The study emphasises the importance of integrated global strategies that address both the ecological and public health challenges posed by AMR, advocating for sustainable practices, international collaboration, and ongoing research to combat the evolving threats of climate change and antimicrobial resistance.Item Resilience and Stigma Among Children With HIV, Tuberculosis, and Stunting: A Literature Review(Universitas Malahayati Bandar Lampung, 2026-01-31) Najmah, Najmah; Nurqanita, Ajeng Fathia; Samsuri, Ullya Fitri; Nindiyanti, Sasyi Friska; Verawaty, Marieska; Stiabudi, Iwan; Andajani, SariBackground: Health-related stigma is a social phenomenon closely linked to inequality and marginalization. Children living with HIV, tuberculosis (TB), and stunting are particularly vulnerable to intersecting forms of stigma, including discrimination related to illness, poverty, and family background. These overlapping stigmas often restrict social participation, affect mental well-being, and hinder access to health services, thereby reinforcing cycles of vulnerability. Purpose: This literature review aims to synthesize existing evidence on the manifestations of stigma and resilience among children affected by HIV, TB, and stunting within the Indonesian and broader Asian contexts. Method: A literature review was conducted using databases including Google Scholar, PubMed, and ScienceDirect. Articles published between 2019 and 2024 were screened based on predefined inclusion criteria. Eighteen relevant studies were selected and analyzed using a thematic approach to identify recurring patterns related to stigma and resilience. Results: The findings indicate that stigma operates across multiple levels. At the intrapersonal level, caregivers often experience self-stigma, shame, and psychological distress, which negatively influence health-seeking behaviors. At the interpersonal level, children encounter social exclusion, peer discrimination, and community stigma that reduce their quality of life. At the structural level, stigmatizing attitudes among some health workers and discriminatory practices within health systems create barriers to equitable care. These forms of stigma are frequently intensified by socioeconomic factors such as poverty and limited educational access. Conclusion: Stigma affecting children with HIV, TB, and stunting is a multi-dimensional issue shaped by personal, social, and structural determinants. Addressing this problem requires comprehensive strategies, including community education, strengthening family and social support, and ensuring that health services are delivered in a non-discriminatory and child-centered manner.Item The Role of Serious Games and Youth as Co-Designers in the ‘Ideal City’: Considering a Healthy and Sustainable Auckland(Tuwhera Open Access, 2026-03-24) Bodmer, Sarah; Conn, CathSerious games are an innovative means of contributing to complex problem-solving today. They provide opportunities to consider the many variables involved in each problem and to develop innovative solutions. City-building games, such as SimCity and Cities: Skyline, are widely used in various settings, including education, helping learners and facilitators understand cities as complex systems. Many of the urban issues presented in these games (traffic, pollution, natural disasters, waste accumulation, activity spaces) relate to health outcomes as well as the urban environment. As such, although not designed for health, they often reflect the determinants of health challenges and fit well with a 21st century planetary health model. This small-scale exploratory study, conducted in Auckland, Aotearoa New Zealand, aimed to advance the healthy cities agenda by creating a collaborative space where university students could envision and design sustainable urban futures. The study used a codesign workshop to elicit ideas for future healthy and sustainable cities, modelling themes which could inform the creation of serious games. The study was undertaken as part of a student summer research project which included the codesign workshop, a review, and a poster presentation at the Planetary Health Alliance annual meeting (https://planetaryhealthalliance.org/). Four student codesigners, considered issues and solutions for an ideal or reimagined future city. World-building, a key feature of games, serves as a valuable ‘thought experiment’, going beyond the status quo to alternative futures, to the potential of new technologies alongside traditional values, such as indigenous Kaitiakitanga (Māori guardianship of the natural environment). Serious games’ codesign offers a more creative space than normative education for youth to explore key strategies and ideas, yet it is less commonly used in urban health or public health. World-building allows those involved to move away from siloed disciplinary and sectoral norms. Further research would benefit from exploring the disruptive, fun, challenging, capacity-building, and wicked problem-solving potential of serious games in public health.Item Public Genomic Visibility of Lassa Virus in West Africa: Mapping Sequence Availability, Ecological Risk, and Surveillance Gaps(Informa UK Limited, 2026-05-27) Alao, Jude OluwapelumiLassa fever is a major zoonotic infection in West Africa, but its true epidemiology is difficult to define because diagnostic access, reporting systems, and surveillance capacity vary across countries. Although substantial work has examined LASV ecology, epidemiology, diagnostics, and outbreak response, less is known about how regional burden/risk evidence aligns with publicly visible genomic data. This study distinguishes LASV transmission risk from public genomic visibility, viewing sequence availability as the product of ecology, laboratory systems, bioinformatics capacity, governance, research partnerships, and sustained financing. Public LASV sequence metadata were retrieved from NCBI Nucleotide and summarised across 16 West African countries. Countries were classified by sequence visibility, burden/risk evidence, ecological context, and public genomic surveillance gap category. CHIRPS rainfall data were included as contextual ecological descriptors. A systematic review of 31 studies identified structural, technical, and policy barriers to LASV genomic surveillance. Public LASV sequences were identified for 9 of 16 countries, totalling 1818 validated records. Sequence visibility was highly concentrated: Nigeria accounted for 71.3% of all records, while Nigeria, Sierra Leone, Guinea, and Liberia accounted for 94.3%. Seven countries had no publicly identifiable sequences despite documented, probable, or ecologically plausible risk. Public LASV genomic visibility does not reflect the broader regional risk landscape. Strengthening surveillance will require integrated genomic systems linked to diagnostics, One Health surveillance, local bioinformatics capacity, equitable data sharing, and sustained long-term investment.Item ‘Special Treatment’ a 30-year Case Study Exploring Whether Pacific Peoples as an Ethnic Minority Are Being Privileged in Public Policy(Victoria University of Wellington Library, 2026-05-25) Tuesday, Ruby; Kingi-Uluave, Denise; Siataga, Philip; Fa’alili-Fidow, Malaetogia Jacinta; Fidow, Tuaopepe Abba; Vaka, Sione; Boon, JulietThis article interrogates claims of ‘special treatment’ for ethnic minorities by examining the alignment between documented Pacific mental health need and 30 years of public mental health and Pacific health policy (alongside relevant estimates of appropriations). Using frequency analysis and close reading, it finds that despite longstanding and well‑evidenced inequities, Pacific mental health is inconsistently addressed, rarely prioritised, and seldom supported through targeted investment. Analysis by governing party shows that both inclusion and prioritisation are generally lower under National‑led governments. While Labour‑led governments have adopted more inclusive rhetoric, this has not consistently translated into substantive policy action or resourcing. Overall, the study finds that claims of special treatment for Pacific peoples as an ethnic minority are supported by neither policy content nor investment.Item Longitudinal and Life Course Research: Pacific Birth Cohort Study(Living Places Publishing, 2026-03-06) Tautolo, El-Shadan; Iusitini, LeonThis chapter focuses on longitudinal and lifecourse research in Aotearoa New Zealand. Our brief unpacking of the Pacific Islands Families Study as a longitudinal and lifecourse research takes into consideration today’s context. A longitudinal lifecourse approach recognises the significant developmental factors across childhood, adolescence, and adulthood that affect Pacific health and wellbeing outcomes. The Pacific Islands Families Study utilises this understanding to support Pacific families to be successful and lead fulfilling and productive lives in Aotearoa New Zealand.Item Positive Mental Health and Its Promotion: A Bicultural Perspective and Narrative Synthesis from Aotearoa New Zealand(LIDSEN Publishing Inc, 2026-05-18) Tudor, Keith; Haenga-Collins, MariaPositive mental health frameworks in Aotearoa New Zealand have largely been shaped by Western individualist assumptions and have given limited attention to Indigenous and bicultural understandings of wellbeing. This article examines positive mental health and its promotion in Aotearoa New Zealand, through a bicultural lens grounded in <em>Te Tiriti o Waitangi.</em> It reports on two cross-cultural mental health searches and discusses several models of health from te Ao Māori (the Māori world). Based on the view that positive mental health (and, indeed, health as a whole) is both constructed and contextual, our understanding of it in Aotearoa New Zealand must reflect the nation’s bicultural foundation and obligations. Māori models of wellbeing are advanced as offering holistic, culturally grounded, relational, and equity-oriented frameworks for understanding positive mental health, challenging Western atomism and individualism while aligning with international calls for inclusive, contextual, and culturally responsive approaches to wellbeing. Drawing on <em>Te Tiriti o Waitangi</em>, the article proposes a meta‑theoretical framework for positive mental health that is both locally grounded and globally relevant, suggesting that Tiriti-informed approaches may offer valuable insights for culturally responsive mental health thinking in other national and Indigenous contexts.Item Experiential Classes Plus Digital Logging in Antenatal Care for Pregnant Women in China: Mixed Methods Study(JMIR Publications Inc., 2026-04-21) Sun, Zhenfeng; Yang, Fuwen; Wang, Xi; Sun, Yin; Zhang, Suhan; Ma, LiangkunBACKGROUND: Maternal health during the perinatal period is a global public health priority. While antenatal education is widely implemented, conventional lecture-based models often fail to achieve sustained behavior change. Innovative approaches that integrate experiential learning with digital support may enhance maternal knowledge, self-management, and pregnancy outcomes. OBJECTIVE: The aim of this study is to evaluate the feasibility and preliminary effectiveness of a combined experiential class and online logging intervention for pregnant women in China and to explore the mechanisms underpinning its impact on health practices and service experiences. METHODS: A mixed methods design was used in a district-level maternal and child health hospital in Beijing. In the quantitative arm, 40 women (intervention group, n=20; control group, n=20) were enrolled in a quasi-experimental comparison. Outcomes included knowledge-attitude-practice indicators, service satisfaction, and clinical birth outcomes. Given the limited sample size, a qualitative arm was conducted to complement statistical findings: semistructured interviews with 20 women (10 per group) were analyzed thematically. Quantitative and qualitative results were integrated during interpretation to provide a comprehensive evaluation. RESULTS: Compared with the experiential class alone, the combined intervention was associated with higher knowledge scores (mean difference 1.6 points, 95% CI 0.8-2.4), stronger adherence to recommended health practices (composite adherence score difference 1.0, 95% CI 0.4-1.6), and higher overall service satisfaction (mean difference 0.6, 95% CI 0.2-1.0). Across multiple domains, a higher proportion of participants in the intervention group met dietary, exercise, and supplementation recommendations. Clinical outcome differences were exploratory, as the study was not powered for these end points. Qualitative analysis revealed 3 mechanisms, such as empowerment and self-efficacy, practice and persistence, and systemic/environmental support, through which the intervention influenced experiences and practices. CONCLUSIONS: The experiential class plus online logging model is feasible and acceptable in a real-world antenatal setting. Although limited by a small sample size, findings suggest that the intervention improves maternal knowledge, health practices, and service experiences and may inform future adequately powered trials to evaluate pregnancy outcomes. Qualitative insights highlight mechanisms of health practice change and provide contextual depth, underscoring the value of mixed methods designs in maternal health research.Item Assessing the Institutional Provision of Maternal Nutrition Services in Antenatal Clinics in Beijing(Informa UK Limited, 2026-02-22) Li, Yini; Wang, Xi; Wang, Dongjun; Zhang, Suhan; Li, Ye; Hu, Mingyue; Sun, Yin; Ma, LiangkunOBJECTIVE: To evaluate the availability, quality, and delivery of maternal nutrition services in antenatal clinics across Beijing, focusing on service types, provider qualifications, resource adequacy, and barriers to effective service delivery. The study also aims to identify factors influencing service availability and institutional variation and propose a framework for improving maternal nutrition care in urban China. METHODS: A cross-sectional study was conducted across 110 antenatal clinics in Beijing, using structured surveys targeting institutional characteristics, service coverage, personnel qualifications, and service delivery methods, supplemented by qualitative insights from open-ended responses. RESULTS: Among 104 valid responses, 56% of institutions offered prenatal nutrition education classes. Provision varied descriptively by facility type (e.g. 12.5% in private hospitals vs ∼55-57% in other facility types), but the facility-type comparison was not statistically significant (chi-square = 5.72, df = 3, p = 0.13). While 76% of institutions reported having personnel with formal nutrition qualifications, gaps in training and reliance on non-specialized staff were common. Resource constraints (e.g. space, equipment, and limited digital support) were frequently reported as barriers. Institutional respondents reported high perceived patient satisfaction and the presence of feedback systems, but no patient-level outcomes were measured. CONCLUSION: This city-wide institutional survey suggests that maternal nutrition services in Beijing antenatal clinics are broadly available but heterogeneous in delivery, staffing, and resources. Observed contrasts across facility types should be interpreted as descriptive patters rather than confirmed group differences. Future work should evaluate whether standardization, workforce development, infrastructure strengthening, and digital support improve service quality and equity, using patient-level and implementation indicators.Item Clinical Consensus Statements on Intervention Content for Gambling Treatment: A Contextualised Delphi Study With Clinical Researchers(Springer Science and Business Media LLC, 2026-01-30) Keshani, Imran; Merkouris, Stephanie; Rodda, Simone; Abbott, Max; Aubin, Henri-Jean; Bellringer, Maria; Berman, Anne; Billieux, Joel; Bowden-Jones, Henrietta; Browning, Colette ; Carlbring, Per; Castrén, Sari; Chamberlain, Samuel; Christensen, Darren; Demetrovics, Zsolt; Derevensky, Jeffrey; Fernandez-Aranda, Fernando; Gainsbury, Sally; Ginley, Meredith K; Griffiths, Mark D; Håkansson, Anders; Hodgins, David C; Jackson, Alun; Jimenez-Murcia, Susana; King, Daniel L; Landon, Jason; Luquiens, Amandine; Molander, Olof; Nilsson, Anders; Odlaug, Brian L; Potenza, Marc N; Thomas, Shane A; Whelan, James; Dowling, Nicki AThere is little consensus on the optimal components of gambling psychological treatments. This study aimed to identify clinical consensus statements regarding the perceived effectiveness of gambling intervention content (change techniques, participant/recruitment characteristics, delivery characteristics, and evaluation characteristics) from a panel of researchers with psychological gambling treatment expertise across 11 countries. A two-round modified Delphi study was conducted. Thirty-five panellists rated the perceived effectiveness of 96 gambling intervention components for achieving clinically helpful change, which was defined as “reduction in gambling severity, expenditure, and frequency”. Consensus criteria on effectiveness and ineffectiveness were defined a priori. Consensus statements were identified for four of 19 change techniques (motivational enhancement, relapse prevention, cognitive restructuring, and plan social support), five of 23 participant/recruitment characteristics (e.g. eligibility screening took place), 17 of 47 delivery characteristics (e.g. the therapy goal was to reduce time and/or money spent gambling), and three of seven evaluation characteristics (e.g. specific process or mediators are targeted by the intervention). These statements, when interpreted with consideration of contextual factors, can inform the selection of likely effective components to employ in gambling treatment programs and indicate where future research efforts may be most beneficial.Item Newborn Enrolment, Engagement, and Immunisation in Primary Care: A Qualitative Study on Healthcare Providers’ Perspectives(CSIRO Publishing, 2026-04-23) Young, A; McIntosh, C; Ware, F; Best, E; Turner, N; Charania, Nadia; Campbell, A; Davis, TA; Marsh, SINTRODUCTION: Childhood immunisation coverage in Aotearoa New Zealand (NZ) is not meeting recommended targets. Enrolment and engagement with primary care are associated with timely immunisation uptake, yet enrolment and immunisation are inequitable, with Māori and Pacific children less likely to be enrolled and receive their 6-week vaccinations on time. AIM: This study aimed to understand healthcare providers' perceptions of barriers and enablers to primary healthcare enrolment from birth and provide recommendations to support enrolment, engagement, and immunisation, particularly for Māori whānau (families). METHODS: This qualitative study, guided by a Kaupapa Māori-aligned methodology, involved interviews and focus groups to explore barriers and enablers to enrolment from the perspective of people working within the NZ healthcare sector (n = 27). Analysis was undertaken using qualitative content analysis. RESULTS: Many participants expressed that the current system was contributing to inequitable enrolment and immunisation of pēpi (infants). Four categories were constructed: health services may not be accessible or practical for whānau; perceived complexity and skill shortages; the need to prioritise communication and engagement; and services must be built on cultural safety and trust. DISCUSSION: Reasons for inadequate enrolment include poorly designed systems, limited resourcing, and inconsistent approaches. Enrolment needs to be simplified, with integrated and automated systems to reduce administrative burden for staff. Flexible whānau-centred practices can help support enrolment, engagement, and immunisation of pēpi.Item Associations Between Body Mass Index and Body Composition Among Pacific Adolescents in Aotearoa New Zealand(Nature Portfolio, 2026-05-21) Dai, Yajun; Howe, Anna S; Iusitini, Leon; Tautolo, El-Shadan; Whitcombe-Dobbs, Sarah; Mohammed, Jalal; Schlüter, Philip JBMI and BMI z-scores are widely used to classify adolescent overweight and obesity (OWOB), but they do not distinguish fat from fat-free mass and may misclassify adiposity. This study aimed to examine how BMI and BMI z-scores relate to body composition among Pacific adolescents in Aotearoa New Zealand (A-NZ). Cross-sectional data from an A-NZ Pacific birth cohort were analysed, assessing body size, body composition, and demographics in 871 adolescents (median age 14.2 years). Body composition was estimated using conventional and vector bioelectrical impedance analysis. Sex-stratified analytical comparisons included fractional polynomial regression of BMI z-scores with fat mass index (FMI) and fat-free mass index (FFMI), Hattori plots, and vector analysis parameters. From BMI z-scores, OWOB was defined in 337 (80.3%) females and 342 (75.8%) males. BMI z-scores fitted FFMI well, but important nonlinear patterns emerged between BMI z-scores and FMI. At any given BMI, Pacific adolescents displayed wide variation in FMI and FFMI combinations, with greater variability among males than females. Mean vector length shortened progressively with increasing body size. Phase angle increased from normal weight to overweight but plateaued from overweight to obesity. BMI-defined OWOB inadequately captured adiposity in this population.Item Knowledge and Decisions About Maternal Immunisation by Pregnant Women in Aotearoa New Zealand(Springer Science and Business Media LLC, 2022-06-14) Young, A; Charania, NA; Gauld, N; Norris, P; Turner, N; Willing, EBackground: Maternal vaccinations for influenza and pertussis are recommended in New Zealand to protect mothers and their infant from infection. However, maternal immunisation coverage in New Zealand is suboptimal. Furthermore, there is unacceptable inequitable maternal immunisation rates across the country with Māori and Pacific women having significantly lower maternal immunisation rates than those of other New Zealanders. Methods: This research set out to explore what pregnant/recently pregnant Māori and Pacific women knew about immunisation during pregnancy and what factors influenced their decision to be vaccinated. A semi-structured interview guide was developed with questions focusing on knowledge of pertussis and influenza vaccination during pregnancy and decision-making. Māori and Pacific women aged over 16 years were purposively sampled and interviewed in Dunedin and Gisborne, New Zealand between May and August 2021. Interviews were analysed following a directed qualitative content approach. Data were arranged into coding nodes based on the study aims (deductive analysis) informed by previous literature and within these participant experiences were inductively coded into themes and subthemes. Results: Not all women were aware of maternal vaccine recommendations or they diseases they protected against. Many underestimated how dangerous influenza and pertussis could be and some were more concerned about potential harms of the vaccine. Furthermore, understanding potential harms of infection and protection provided by vaccination did not necessarily mean women would choose to be vaccinated. Those who decided to vaccinate felt well-informed, had vaccination recommended by their healthcare provider, and did so to protect their and their infant’s health. Those who decided against vaccination were concerned about safety of the vaccines, lacked the information they needed, were not offered the vaccine, or did not consider vaccination a priority. Conclusions: There is a lack of understanding about vaccine benefits and risks of vaccine-preventable diseases which can result in the reinforcement of negative influences such as the fear of side effects. Furthermore, if vaccine benefits are not understood, inaccessibility of vaccines and the precedence of other life priorities may prevent uptake. Being well-informed and supported to make positive decisions to vaccinate in pregnancy is likely to improve vaccine coverage in Māori and Pacific Island New Zealanders.Item An Exploration of Sexual and Reproductive Health of Australian Women Living With Inflammatory Bowel Disease: A Mixed Methods Study(Taylor and Francis Group, 2026-02-11) O’Reilly, Kate; Holroyd, Eleanor; You, Wenpeng; Peters, KathInflammatory bowel disease (IBD) is an unpredictable condition that is more prevalent in females (57%) and commonly presents during reproductive years. This study explored the sexual and reproductive health of women who live with IBD in Australia using an online survey and interviews (March–November 2024). Survey responses from 64 women and qualitative data from 14 interviews highlighted menstrual changes, misinformation received regarding fertility, and the impact of IBD on women’s sexuality. Findings from this study highlight the need to ensure discussions about sexuality are more actively incorporated into clinical care for women with IBD.Item Sexual and Reproductive Service Interventions for Menstrual Regulation, Safe Abortion, and Post-Abortion Care and Their Effectiveness During Disaster Response: A Global Systematic Review(Springer Science and Business Media LLC, 2024-06-12) Ray-Bennett, NS; Ekezie, W; Biswas, I; Choudhary, NI; Cowie, D; Dissanayake, L; Macleod, L; Nnaji, A; Sahoo, MSexual and reproductive health (SRH) services are crucial for women especially during disasters, to reduce maternal mortality and morbidity from miscarriages, unsafe abortions, and post-abortion complications. This study explored the SRH interventions provided during disaster response. A systematic review was conducted to identify what menstrual regulation (MR), safe abortion (SA), and post-abortion care (PAC) approaches/interventions exist to promote resilience in the health system in disaster settings; what intervention components were most effective; and challenges and opportunities to meeting SRH rights. Five electronic databases were searched, resulting in 4194 records. Following the screening process, seven publications were included. The intervention-related information in each publication was assessed based on availability, accessibility, acceptability, and quality. Two SRH approaches/interventions were found. The effectiveness of intervention components could not be conducted due to the limited number of relevant studies. Challenges were found at facility and community levels, and opportunities included overcoming them, making MR, SA, and PAC integral to the mitigation phase, and policy change to overcome barriers related to unaffordability and inaccessibility. Recommendations are provided to encourage research and policy towards improving neglected SRH in disaster settings to realize Sustainable Development Goal 3 and the Global Strategy and Sendai Framework’s priority to promote disaster-resilient health systems.Item Improving Fitness Professional Education in Working With Older Adults — A Case Study From a Therapeutic Relationship Perspective(Emerald, 2026-04-29) Ting, Chien Ju; Bercades, LuigiPurpose As populations around the world, including Aotearoa New Zealand (NZ), continue to age, supporting the well-being of older adults has become increasingly important. Regular physical activity (PA) is a key contributor to healthy ageing and enhancing well-being. Fitness instructors play a crucial role in engaging older adults in ongoing PA; however, many trainers lack adequate training and support to work effectively with this population to sustain their long-term engagement. This study aims to explore the role of the therapeutic relationship (TR) in facilitating long-term and sustained engagement in PA among older adults. Specifically, it examines how fitness professionals (FPs) construct trust, negotiate power and foster adherence in ways that go beyond physical training alone. Design/methodology/approach In this case study, we focus on “expert voice” and interviewed two veteran trainers from the never2old exercise programme. We explore the aspects that contribute to the establishment of a TR, which is characterised by collaboration and trust. A Foucauldian discourse analysis approach is used to explain how power and trust can be co-constructed and shared. Findings The findings show how FPs construct trust, negotiate power and engage with older adults. The paper identifies concrete facilitators (self-disclosure, joint decision-making, communication strategies, innovation and autonomy), and makes practical recommendations to the current curricula for trainer education beyond creating a workout plan. Research limitations/implications This study highlights the need to reframe frailty discourse within FP education, moving beyond age-based deficit models towards strengths-based, self-determination approaches. It also shows that as NZ becomes more diverse in population, training needs to foster cultural awareness. While the research only contains expert interviews from two participants, their experience provided rich data to explore the case study. Further studies could draw on the older clients’ perspectives and co-design what is needed for the future curriculum. Practical implications Training should integrate motivational interviewing, intercultural competence and age-appropriate communication strategies to better support Aotearoa New Zealand’s super-diverse and ageing population. Institutional cultures that privilege narrow notions of “Kiwiness” require critical reflection to avoid exclusion. Promoting workplace autonomy and innovation may enhance practitioner engagement and client trust. The principle of the TR should be part of the curriculum. Social implications Socially, this study suggests that FP education can either reinforce or disrupt ageism and cultural exclusion. Reframing frailty as resilience challenges deficit-based views of older adults and supports dignity and participation. Strengthening intercultural competence is critical in Aotearoa New Zealand’s super-diverse context to ensure equitable access. Promoting autonomy and shared decision-making further enhances older adults’ agency, voice and social inclusion in later life. Originality/value This study presents a unique methodological approach, combining the theoretical lens of the TR with a Foucauldian approach, to offer evidence-informed implications for fitness trainers’ education.