Student: Duncan Edwards
Supervisor: Ann Richardson
Sponsor: National Heart Foundation

Pacific people in New Zealand have high rates of illnesses, including heart disease and diabetes. These seem likely to be caused by their low levels of physical activity, high rates of smoking and a diet that is high in fats and sugars. Improving these factors is likely to reduce rates of these illnesses. Another factor influencing the rates of illness is that most Pacific people view contributions to family and the Pacific community as being more important than caring for their own health. This is encouraged by a hierarchal structure in the Pacific community. Pacific people also have low average incomes, which mean that giving to others severely limits the resources they have to care for their own health. In addition there is inconsistent health service provision to compensate for this.

As such this project aims to improve health by increasing rates of exercise, improving diet and reducing smoking in the Pacific community. This will occur via a programme encouraging the community to take on the service provision themselves. A series of meetings and consultations with service providers and the community have been ongoing since July 2004 to determine how this will happen. The accumulation of this process is a pilot programme being run in the Christchurch Tongan community. If successful, it is intended to later run similar programmes in other Pacific communities. To ensure the programme is effective, measures of change during the programme will be taken. These will mostly be questions, though may also include such measures as height and weight. As this is an evaluation of programme formation and implementation, there are not yet conclusive results. However, the following has so far been found. By encouraging change in families higher in the hierarchy, they can provide role models for change in the rest of the community. There is also a hierarchy within families and by separating families into men, women and children, hierarchal controls over each member's communication will be reduced, allowing their unfettered participation in the programme. Also providing members of the community with health skills training relating to exercise or diet allows the community to become less reliant on other, inconsistent health services.

However, while the programme has determined needs and likely means of addressing these, it may be less effective than intended as there are other unaddressed aspects of the community. These include values and beliefs related to health which differs from those on which that mainstream health promotion is based. Though the programme has room for such improvement in later applications.

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