Journal of primary health care最新文献

{"title":"Physical activity and glycaemic control among adults with type 2 diabetes in Suva, Fiji: a cross sectional pilot study.","authors":"Elizabeth Mundia, Ramneek Goundar, Kissinger Marfoh","doi":"10.1071/HC25096","DOIUrl":"10.1071/HC25096","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus is a major health burden in Fiji (19.3% prevalence). Evidence suggests increased physical activity improves glycaemic control and health outcomes; however, this remains unstudied in Fiji's population.</p><p><strong>Aim: </strong>This study aimed to assess physical activity levels and explore its relationship with glycaemic control among diabetic patients.</p><p><strong>Methods: </strong>A quantitative, cross-sectional pilot study was conducted at Samabula Health Center, Fiji, from September to November 2022 using convenience sampling for 174 adults with diabetes. The International Physical Activity Questionnaire, short form, assessed physical activity, whereas capillary fasting and random blood sugar assessed glycaemic control targets. Logistic regression analysed associations.</p><p><strong>Results: </strong>The study found 64% of participants were physically inactive, with females significantly less active than males (odds ratio (OR) = 0.49, 95% confidence interval (CI) = 0.25-0.98). Poor glycaemic control was common (75%), although adherence to lifestyle and pharmacological management plans were significantly associated with good control (OR = 2.37, 95% CI: 1.05-5.37). Increased physical activity levels were not significantly associated with meeting glycaemic control targets.</p><p><strong>Discussion: </strong>Despite clinic attendance, patients with diabetes remained inactive, had poor glycaemic control and were non-adherent to lifestyle and drug treatment. Contradicting previous evidence, physical activity was not associated with meeting glycaemic control targets, possibly reflecting point-of-care glucose variability compared to the gold-standard glycated hemoglobin measure (HbA1c), and cross-sectional study design limiting causal interpretation. Future research should investigate glycaemic control and physical activity barriers, especially among women, physician practices and test culturally adapted interventions. Fiji's National Wellness Policy and Non-Communicable Disease (NCD) Strategic Plan must consider strengthening diabetes management guidelines, clinician training and patient support to address systemic gaps.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"295-302"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Pacific Health Services: the growth and innovation of Pacific providers in Aotearoa.","authors":"Debbie Ryan, Lisa Kitione, Harriette Kimiora, Gerard Sonder, Jacqueline Cumming","doi":"10.1071/HC25051","DOIUrl":"10.1071/HC25051","url":null,"abstract":"<p><strong>Introduction: </strong>Pacific health providers have worked to improve access to care and outcomes for Pacific communities in Aotearoa New Zealand since the 1980s. Although now an integral part of the health system (their role exemplified during the COVID-19 pandemic), providers' characteristics and service models are poorly understood and under theorised.</p><p><strong>Aim: </strong>This study aimed to strengthen evidence about Pacific health providers for policy development by examining the evolution of the sector, identifying key provider organisational features and service delivery patterns, and developing a framework to categorise providers.</p><p><strong>Methods: </strong>A stocktake was conducted to collect descriptive data on 43 Pacific health providers identified using specific criteria. Public material about providers was reviewed, and all providers were invited to complete an online survey and phone interview.</p><p><strong>Results: </strong>Four categories were established representing the range of services delivered by Pacific health providers across general practice, primary health care, health promotion and support, and non-frontline 'enabler' settings. These providers operated in 88 different locations nationwide. Revenue data indicated significant growth from 2019 to 2023, partly due to COVID-19 funding. Survey results showed that most providers managed multiple, short-term contracts. Providers reported that 83% of their workforce was of Pacific ethnicity, highlighting their role as significant employers of Pacific health workers.</p><p><strong>Discussion: </strong>This comprehensive stocktake provides insights about the contributions of Pacific health providers, while also highlighting the data gaps that have constrained understanding of their development. The proposed categorisation framework reflects the diverse activities of Pacific health providers, offering a foundation for ongoing assessment of their impact on Pacific health outcomes.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"303-310"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using co-design to reduce Pacific health inequity: the example of NIU, a model to improve gout management.","authors":"Malakai Ofanoa, Siobhan Tu'akoi, Samuela Ofanoa, Felicity Goodyear-Smith","doi":"10.1071/HC25077","DOIUrl":"10.1071/HC25077","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"379-381"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teolosia 'oe Kili pokua (Caring for skin infections): an emerging grounded theory on how Tongan mothers care for children with skin infections.","authors":"Grace K Burton-McKeich, Siale A Foliaki, Malakai 'Ofanoa","doi":"10.1071/HC25076","DOIUrl":"10.1071/HC25076","url":null,"abstract":"<p><strong>Introduction: </strong>Pacific children in Aotearoa New Zealand (NZ), are four times more likely than non-Pacific and non-Māori children to be hospitalised for a skin infection. The Auckland region has the highest hospitalisation rates for skin infections in NZ. Tongan peopleare the second largest group of the Pacific diaspora in the Auckland region, yet they are underrepresented in research.</p><p><strong>Aim: </strong>The study aimed to understand how Tongan mothers living in Auckland care for skin infections affecting their children.</p><p><strong>Methods: </strong>A focus group with seven Tongan mothers was held. Constructivist Grounded Theory and the Kakala Framework informed the collection and analysis of the qualitative data.</p><p><strong>Results: </strong>The emerging theory, Teolosia 'oe Kili pokua (Caring for Skin Infections), posits that Tongan mothers rely on three key resources: their Community, their past Experiences, and Awareness of skin infections when making decisions concerning how to care for skin infections affecting their children. Caring for skin infections is a collective endeavour underpinned by cultural mainstays such as tauhi vā, in which many Tongan people participate.</p><p><strong>Discussion: </strong>Health systems can more effectively meet the needs of Tongan mothers and reduce health inequities by providing the Tongan community with culturally appropriate resources to prevent, recognise, and address skin infections.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"318-329"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fierce urgency of now: addressing inequities in health care for Pacific and Māori in Aotearoa New Zealand.","authors":"Felicity Goodyear-Smith, Tim Stokes","doi":"10.1071/HC25205","DOIUrl":"10.1071/HC25205","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"293-294"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ascending the Poutama: culturally responsive diabetes care for Māori communities.","authors":"Rebekah Crosswell, Hinetu Nikora, Ryan Paul, Cathy Buntting, Tom Roa, Rawiri Keenan, Apo Aporosa, Capri Paekau, Glenda Raumati, Suzanne Moorhouse, Anna Tiatia Fa'atoese Latu","doi":"10.1071/HC25066","DOIUrl":"10.1071/HC25066","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes (T2D) significantly impacts Māori populations in Aotearoa New Zealand (NZ) who experience health disparities including suboptimal disease management.</p><p><strong>Aim: </strong>To explore culturally responsive approaches to supporting Māori living with T2D from the perspective of healthcare providers.</p><p><strong>Methods: </strong>Nine semi-structured interviews were conducted with clinicians from various disciplines (general practitioner, podiatrist, exercise physiologist, three kaiāwhina, dietitian, two pharmacists); five clinicians identify as Māori, four as non-Māori. Kaupapa Māori inductive thematic analysis was used.</p><p><strong>Results: </strong>Four key themes emerged: empowering patient-centred communication, whānau involvement, interprofessional collaboration, and culturally appropriate analogies.</p><p><strong>Discussion: </strong>The findings underscore the need for holistic, culturally responsive T2D care that prioritises culturally appropriate communication to improve patient engagement, health outcomes and address Māori health disparities.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"338-346"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritising culturally appropriate interventions to increase antenatal immunisation in Aotearoa New Zealand: a Delphi study.","authors":"Louise Fangupo, Amber Young, Matt Hobbs, Gabrielle McDonald, Alesha Smith, Esther Willing","doi":"10.1071/HC25053","DOIUrl":"10.1071/HC25053","url":null,"abstract":"<p><strong>Introduction: </strong>Antenatal immunisation rates for influenza and pertussis in Aotearoa New Zealand (NZ) are low and inequitable. Culturally appropriate interventions are urgently needed.</p><p><strong>Aim: </strong>This study aims to identify and prioritise culturally appropriate, equitable interventions to improve antenatal immunisation rates in NZ.</p><p><strong>Methods: </strong>A three-round Delphi study was conducted. In the first round, interventions to increase antenatal immunisation rates were identified in qualitative interviews with 40 healthcare professionals. In the second and third rounds, 21 panellists (healthcare professionals and health policy and practice experts) rated 10 interventions for their feasibility, equity and impact on a five-point Likert scale. Median and interquartile ranges (IQRs) were calculated. For each parameter, consensus was defined as an interquartile range ≤1. In the third round, panellists selected their 'top three' prioritised interventions for NZ.</p><p><strong>Results: </strong>Panellists rated all interventions arising from the first round highly for feasibility, equity and impact. Consensus for all parameters was achieved at the strongest level for 5 of the 10 interventions in the second round. At the completion of the third round, consensus had been achieved for all parameters for 8 of the 10 interventions. The introduction of outreach immunisation services for hapū māmā appeared most frequently in participants' 'top three' (selected by 55% of panellists).</p><p><strong>Discussion: </strong>The 10 interventions identified by participants in the first round were rated highly for their feasibility, equity and impact by panellists in the second and third rounds of this Delphi study. These interventions should be considered by those developing interventions to increase antenatal immunisation rates in NZ.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"363-371"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145390575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What effect does semaglutide have on those living with obesity?","authors":"Vanessa Jordan","doi":"10.1071/HC25208","DOIUrl":"10.1071/HC25208","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"385-386"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'It's more than just kale (cough)'. New Zealand Sāmoan attitudes to living with chronic cough and healthcare access.","authors":"Sarah Mooney, Jessee Tanu Fia'Ali'i, Eti Televave, Angela Upsdell","doi":"10.1071/HC25114","DOIUrl":"10.1071/HC25114","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic cough is burdensome for individuals and healthcare providers and is a symptom common to a number of health conditions, including bronchiectasis. The prevalence of respiratory conditions, particularly bronchiectasis, is disproportionately high among Pacific people residing in Counties Manukau. Barriers to healthcare access and engagement, both practical and cultural, contribute to delayed presentation and advanced illness.</p><p><strong>Aim: </strong>This study aims to explore attitudes to cough and healthcare access by Sāmoan adults living in Counties Manukau.</p><p><strong>Methods: </strong>Semi-structured interviews guided by Talanoa, a Pacific-specific method, were conducted focusing on cough duration and characteristics, treatment-seeking behaviours, and healthcare experiences. Data were analysed thematically and framed using the Fonofale Model of Health.</p><p><strong>Results: </strong>Two overarching themes were constructed from seven Talanoa: 'Understanding my cough' and 'healing, curing and coping with cough'. Chronic kale/cough was found to impact on all pou (posts) of the Fonofale health model. Kale/cough management strategies were drawn from Sāmoan and Western health paradigms, perceived as complementary. Access to specialist services was valued and extended participants' coping repertoire further. Respect and trust shaped relationships with healthcare providers and influenced engagement.</p><p><strong>Discussion: </strong>Models such as the Fonofale health model provide a framework for healthcare providers to better understand the multi-dimensional impact of cough. Recognising the cultural perspectives of populations underrepresented in the health workforce provides valuable insights to re-frame healthcare practice and service to optimise engagement with on-going symptoms such as cough and to support chronic conditions.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"330-337"},"PeriodicalIF":1.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Red yeast rice.","authors":"Xin Yi Lim, E Lyn Lee, Joanne Barnes","doi":"10.1071/HC25197","DOIUrl":"10.1071/HC25197","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"387-389"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}