Pacific fathers cultivating the future: the health of Pacific fathers and their influence upon and involvement with their children

Background: Pacific men’s health, and particularly the health of Pacific fathers, is a significant health priority which in recent years has become a largely neglected yet important area for health researchers and policy makers in New Zealand to consider. Moreover, it is being increasingly recognised that fathers and their involvement have a significant impact on the development and well-being of their children; both positively and negatively. Aims: The overarching study aim is to identify how Pacific fathers impact and influence the development of their children. Two major components are used: Phase I, a quantitative component which seeks to: (1) Identify and investigate key social, behavioural, and psychological aspects of health and fathering amongst Pacific fathers using data collected from the Pacific Islands Families (PIF) Study. Phase II, a qualitative component, informed by the quantitative component, and which seeks to: (2) Examine how these key aspects influence the fathering behaviours and practices among Samoan and Cook Islands fathers; and, (3) Explore the ways that these aspects and fathering behaviours or practices of Samoan and Cook Islands fathers shape and influence the development of their children. Methods: To achieve aim (1), a secondary data analysis of key social, behavioural, and psychological measures of health among a cohort of Pacific fathers in the PIF Study was undertaken. Pacific fathers of a cohort of Pacific infants born at a large tertiary hospital in South Auckland in 2000 were interviewed at 1-year, 2-years and 6-years postpartum. The specific choices of variables investigated were informed by consultation with Pacific stakeholders and a review of the literature. To achieve aims (2) and (3), focus group interviews were conducted by the doctoral candidate with a subset of Samoan and Cook Islands fathers from the overall cohort of PIF fathers. These interviews were conducted to examine how the aspects of health investigated in Phase I of this research, influence the fathering practices of these fathers. The interviews also examined how these fathering practices influence the progress and development of their children. Informed by the results of Phase I, discussions during the focus groups and interviews with Pacific fathers included subjects such as the influence of their own childhood upbringing, religious involvement, the influence of culture and acculturation, risk-taking behaviours such as tobacco smoking, and the impact of these influences on the fathering behaviours of participants. The Fonofale model was used as a Pacific framework for developing the questions for the focus group interviews, and elements of the Talanoa method, were also incorporated to provide a Pacific-centred approach for interviewing participants. Using a thematic analysis methodology, the focus group transcripts were examined and analysed to identify the dominant themes articulated by the fathers. In doing so, the analysis identified how these themes are made apparent in the participants fathering practices, and the subsequent child outcomes that are a result. Results: At the 1-year, 2-years, and 6-years interview, 825 (83%), 757 (81%), and 591 (64%) of eligible fathers consented and completed the interview, respectively. Within our cohort of participant Pacific fathers, the rates of mental health symptomatic indications were low. However, there is a significant increasing trend over time, from 3.9% at the 1-year phase to 6.7% and 9.8% in the 2-years and 6-years postpartum phases respectively. Pacific fathers who were regular smokers, unemployed, separated or single, or were of Cook Islands and Tongan ethnicity, had a significantly increased likelihood of being symptomatic for potential psychological disorder. Smoking rates for Pacific fathers in this study (40.3%) were relatively high compared to results (35% for Pacific males) from other tobacco surveys. Moreover, fathers who had lower Pacific cultural alignment, no formal educational qualifications, and drank alcohol at least once a month were significantly associated with being a current smoker. Pacific fathers that had stronger alignment or affinity with their traditional culture had a decreased likelihood of being a current smoker. Pacific fathers in the study reported high levels of involvement with their children, and increased father involvement was significantly associated with a lower risk of child behaviour problems. Pacific fathers with less affinity with their traditional Pacific culture exhibited lower levels of father involvement, compared to fathers with strong affinity with their Pacific culture. In terms of the qualitative results, 10 Samoan fathers and 7 Cook Islands fathers participated in focus group or individual interviews. The qualitative findings demonstrated that Samoan and Cook Islands fathers in this study face numerous challenges in raising their children. Overall fathers described themselves as eager and enthusiastic to be great, highly competent, and involved fathers, despite some of the challenges with migration and acculturation which they may face. The fathers also identified their inability to spend more time with their children as a major challenge, and provisions concerning flexible work hours, and adequate information and fathering support services may help to address this. Conclusion: Findings from this study suggest that health issues such as mental well-being and smoking are playing an increasingly significant part in the lives of the Pacific fathers. Efforts to curb the negative impacts of these health issues will be beneficial for the well-being of both Pacific fathers and their families. As suggested by the participant fathers, the implementation of strategies designed to accommodate their needs concerning flexible work hours, and the availability of appropriate support services, are likely to be successful in increasing effective father involvement and engagement for Pacific fathers, and lead to improved outcomes for Pacific children. Findings also highlight the influence of acculturation and culture on the health and fathering practices of Pacific fathers in New Zealand. Pacific fathers that maintain a strong affinity with their traditional Pacific culture generally fared better across all domains investigated, excluding father involvement. In addition, historical experiences or exposure to recent migration and relocation to New Zealand appears to influence certain culture-specific fathering practices, with many participants attempting to modify their fathering to adapt to their new homeland. These findings emphasize the need to develop empirically based and considered ways to approach these complex phenomena

Sociodemographic and Built Environment Associates of Travel to School by Car among New Zealand Adolescents: Meta-Analysis.

Travelling to school by car diminishes opportunities for physical activity and contributes to traffic congestion and associated noise and air pollution. This meta-analysis examined sociodemographic characteristics and built environment associates of travelling to school by car compared to using active transport among New Zealand (NZ) adolescents. Four NZ studies (2163 adolescents) provided data on participants' mode of travel to school, individual and school sociodemographic characteristics, distance to school and home-neighbourhood built-environment features. A one-step meta-analysis using individual participant data was performed in SAS. A final multivariable model was developed using stepwise logistic regression. Overall, 60.6% of participants travelled to school by car. When compared with active transport, travelling to school by car was positively associated with distance to school. Participants residing in neighbourhoods with high intersection density and attending medium deprivation schools were less likely to travel to school by car compared with their counterparts. Distance to school, school level deprivation and low home neighbourhood intersection density are associated with higher likelihood of car travel to school compared with active transport among NZ adolescents. Comprehensive interventions focusing on both social and built environment factors are needed to reduce car travel to school

Acculturation of Pacific mothers in New Zealand over time: findings from the Pacific Islands Families study

Immigration and acculturation are increasingly recognized as important explanatory factors for health disparities, although their impact on oral health is less well understood. This study investigates the relationship between Pacific children's cultural orientation and oral health, after adjusting for potentially moderating and confounding variables

Mental health well-being amongst fathers within the Pacific Island Families Study

This article investigates the prevalence of potential psychological disorder amongst a cohort of primarily Pacific fathers in New Zealand over their child's first 6-years of life. The analysis is based on data collected at 12-months, 2-years and 6-years postpartum during the Pacific Islands Families Study, and uses the 12-item General Health Questionnaire (GHQ12) to assess the prevalence of psychological distress amongst participant fathers at each measurement wave. Various sociodemographic and potentially confounding variables were also investigated to determine their effect on the risk of developing potential mental health disorder. The majority of fathers within the study reported good overall health and well-being and their prevalence of 'symptomatic' disorder was initially low at 12-months (3.90%) but increased significantly at 2-years (6.6%) and at 6-years (9.80%) in crude and adjusted analyses (both P-values < 0.001). In the adjusted analysis, the odds of symptomatic cases at 2-years was 1.7 (95% confidence interval: 1.1, 2.8) times that observed at 12-months postpartum and at 6-years the odds was 3.2 (95% confidence interval: 1.9, 5.2) times that observed at 12-months. Moreover in the adjusted analysis, smoking status, marital status, employment status, and ethnicity, were all significantly associated with the risk of developing symptomatic mental health disorder

Acculturation and its impact on the oral health status of Pacific children in New Zealand: findings from the Pacific Islands Families study

Immigration and acculturation are increasingly recognized as important explanatory factors for health disparities, although their impact on oral health is less well understood. This study investigates the relationship between Pacific children's cultural orientation and oral health, after adjusting for potentially moderating and confounding variables.The Pacific Islands Families (PIF) study follows a cohort of Pacific infants born in 2000. PIF study participants' data from their last dental examination were extracted from service records, and matched to the cohort. A bi-directional acculturation classification, derived from maternal reports, was related to children's oral health indices in crude and adjusted analyses.1,376 children were eligible, of whom 922 (67.0 percent) had mothers born outside New Zealand. Matching was successful for 970 (70.5 percent) children, with mean age 12.2 years (range: 6.8, 15.4 years). Significant differences were found between acculturation groups for children's tooth brushing frequency and school dental service enrollments but these differences did not moderate relationships between acculturation and oral health status. Unmet treatment need was significantly different between acculturation groups, with children of mothers having higher Pacific orientation having worse unmet needs than those with lower Pacific orientation. No other significant differences were noted.Pacific children carry a disproportionate oral health burden, particularly amongst those with mothers more aligned to their Pacific culture. Strategies which enable Pacific people to re-shape their oral health understanding, together with reducing barriers to accessing dental health care, are needed to prevent a legacy of poor oral health in Pacific people within New Zealand