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Stable, healthy families are the loto or heart of strong Pacific communities. This paper addresses the problem of a decline in the strength of Pacific families. It introduces and discusses the Tongan concept of O'ofaki , as the way in which shared, core relational commitments can bring Pasifika peoples together to support one another for health and community development. This process is based on a reciprocal sharing of social capital to promote cultural solidarity and social justice. We describe two studies by the lead author, through which the concept of O'ofaki emerged. The first study utilized an action research model while the second study focused on two Pasifika-centric research approaches: talanga , which is a Tongan word for interactive talking for a purpose, and the kakala (Tongan garland) research approach. The latter approach is incorporated within a general inductive methodology as well as luva— the dissemination of the results. Finally, the paper focuses on the components of O'ofaki and its application to Pasifika communities. [ABSTRACT FROM AUTHOR]

Services offering on-demand delivery of unhealthy commodities, such as fast food, alcohol and smoking/vaping products have proliferated in recent years. It is well known that the built environment can be health promoting or harmful to health, but there has been less consideration of the digital environment. Increased availability and accessibility of these commodities may be associated with increased consumption, with harmful public health implications. Policy regulating the supply of these commodities was developed before the introduction of on-demand services and has not kept pace with the digital environment. This paper reports on semi-structured interviews with health policy experts on the health harms of the uptake in on-demand delivery of food, alcohol and smoking/vaping products, along with their views on policies that might mitigate these harms. We interviewed 14 policy experts from central and local government agencies and ministries, health authorities, non-Government Organisations (NGOs) and university research positions in Aotearoa New Zealand using a purposive sampling strategy. Participants concerns over the health harms from on-demand services encompassed three broad themes—the expansion of access to and availability of unhealthy commodities, the inadequacy of existing restrictions and regulations in the digital environment and the expansion of personalized marketing and promotional platforms for unhealthy commodities. Health policy experts' proposals to mitigate harms included: limiting access and availability, updating regulations and boosting enforcement and limiting promotion and marketing. Collectively, these findings and proposals can inform future research and public health policy decisions to address harms posed by on-demand delivery of unhealthy commodities. [ABSTRACT FROM AUTHOR]

As well as serving as a critic and conscience for societies, universities are elite sites of privilege which, at a surface level, are unlikely locations for health promotion interventions. This paper provides a critical review of the existing health promoting universities (HPU) approaches which is informed by health promotion values. It explores the silence in the global literature around issues of structural discrimination such as the sexism, homophobia and institutional racism that can thrive within university settings. The existing literature also reveals a very limited engagement about positive mental health or indigeneity. In response, this paper brings together these three factors—structural discrimination, mental health, and indigeneity—all of which the authors consider are criterial to health and its promotion. The authors introduce the New Zealand university landscape, in which there are eight Western universities and three whare wānanga (Māori universities), and, drawing on a survey of their Charters and other official statements, offer a moemoeā (vision or dream) of an HPU that addresses structural discrimination, is based on holistic conceptions of health, and is centred on indigenous worldviews and concerns. [ABSTRACT FROM AUTHOR]

Public health problems are often complex and 'wicked' in nature. Wicked problems have multi-factorial causation, are dynamic and often understood and acted upon differently by different actors. Multi-sectoral collaboration is increasingly emphasized for tackling wicked problems through developing a strategic multi-sectoral plan and then taking collective action. Critical systems thinking can support the development of a shared perspective of the problem, strengthen participation in collective action and foster reflective practices to continuously improve both problem understanding and action. In this paper, we present a critical collaboration model, drawing together two complementary theoretical frameworks, as well as insights from three case studies from New Zealand, to offer a systematic approach to adopting a critical systems perspective in public health collaboration. The model provides six questions to make explicit individuals' understandings or assumptions about how others perceive an issue, problem or evidence, and the process of identifying answers strengthens the dialogical and reflective aspects of the collaboration. We indicate some potential areas for the application of the model to integrate critical systems thinking in collaborative practices. [ABSTRACT FROM AUTHOR]

Background Physical inactivity rates have remained high worldwide since 2001. Public policies are an essential upstream lever to target individual physical activity (PA) behaviour. However, implementers have different strategies and face implementation challenges that are poorly understood. The present study analyzes the implementation processes of public policies to promote PA in terms of: (i) the policies covered and their legal quality, (ii) the actors and stakeholders involved in the implementation process and (iii) the used implementation strategies (vertical, horizontal or a mix). Methods A scoping review was systematically conducted (registered Open Science Framework: osf.io/7w84q/), searching 10 databases and grey literature until March 2022. Of the 7741 titles and abstracts identified initially, 10 studies were included. Results The current evidence includes high-income countries (USA, n  = 7; UK, New Zealand and Oman, n  = 1 each). Policy areas covered are education (school sector) and PA promotion in general (national PA plans or city-wide approaches). The legal classification ranges from laws (school sector) to coordination and budgeting to non-legally binding recommendations. The jurisdictions covered were federal (n  = 4), state (n  = 1), county (n  = 1), school district (n  = 1) and city (n  = 3). Implementation strategies for city-wide approaches are characterized by a coordinated approach with vertical and horizontal integration; federal PA policies by a mix of implementation strategies; and the school sector by a strict horizontal top-down integration without the involvement of other actors. Conclusion Implementation strategies differ by policy field. Therefore, continuous evaluation of the implementation process is necessary to align policy implementation with policy goals to promote individual PA behaviour. [ABSTRACT FROM AUTHOR]

Rangatahi Tū Rangatira (R2R) is a national health promotion programme in Aotearoa New Zealand which aims to promote cultural and physical wellbeing for rangatahi (young people) and their whānau (family). Grounded in tikanga Māori, the programme focuses on total wellbeing, leadership and cultural awareness providing rangatahi opportunities to increase their participation in physical activity and cultural knowledge through ngā taonga tākaro (Māori ancestral games). This paper focuses on an evaluation of this innovative health promotion programme focussing on the delivery of R2R by a local iwi provider in a rural area. Kanohi ki te kanohi (face-to-face) interviews and focus groups were used to collect data from a range of stakeholders including rangatahi, whānau, programme developers, and collaborating community organizations. A whānau ora (holistic) framework incorporating five core outcomes and key indicators specific to the programme was developed to assess the impact of delivery. Results demonstrated that rangatahi and their whānau were living healthier lifestyles through being more physically active; had gained an increased desire to succeed in their education and extra curriculum activities; and felt more connected to their community and te ao Māori. This demonstrates the importance of incorporating cultural elements to support improved lifestyle changes for rangatahi and their whānau and the connection between enhanced cultural identity and good health. [ABSTRACT FROM AUTHOR]

This article highlights the significance of prioritizing Indigenous voices and knowledge systems, using whānau-centred initiatives (a concept that encompasses the broader family and community) as a foundation for health promotion within an Indigenous context. Tū Kahikatea, a conceptual framework, is used to demonstrate the relationship between the values underpinning different whānau-centred initiatives and their corresponding outcomes. The framework highlights the capacity of whānau-centred initiatives to support whānau in attaining mana motuhake, which represents collective self-determination and the ability to exercise control over their own future. By doing so, these initiatives contribute to the improvement of whānau health outcomes. With recent changes to Aotearoa New Zealand's health system, the findings underscore the benefits and potential of whānau-centred initiatives in enhancing whānau health outcomes, and advocate for continued strengths-based practices in Aotearoa New Zealand's health system. By bridging the gap between academia and grassroots community action, the article demonstrates the potential of whānau-centred initiatives and contributes to a global call for integrating Indigenous viewpoints and practices into Westernized healthcare, in order to improve Indigenous health outcomes. [ABSTRACT FROM AUTHOR]

Alcohol labelling laws and policy are contentious and highly politicized. Very few countries have been able to implement health warnings on alcohol labels due to complex legal and governance systems and coordinated industry lobbying. In 2020, Australia and New Zealand implemented a mandatory and evidence-based legal standard for pregnancy warning labels on alcohol products. This article discusses some of the challenges faced in achieving policy change and how these barriers were overcome by public health advocacy groups to build the evidence, counter industry conflicts of interest, consumer test health messages, mobilize community support and gather political support. Reflecting on the decades of ineffective regulation and politicization of this health issue, lessons for other countries include the importance of creating and maintaining relationships with decision makers and regularly updating them with evidence and recommendations, highlighting industry failures and tactics, building broad-based coalitions and sharing lived-experiences. [ABSTRACT FROM AUTHOR]

Summary: A transformative approach to maternal health promotion should be mother-centred, context-driven and grounded in lived experiences. Health promotion can achieve this by drawing on its disciplinary roots to extend and reorient maternal health promotion towards an approach of non-stigmatizing and equitable health promotion that has mothers' well-being at the centre, particularly giving credit to marginalized, 'non-normative' maternities. This article draws on data from 18 workshops EN conducted across Aotearoa New Zealand, including 268 maternal health stakeholders. Drawing on design thinking, participants reimagined what a maternal health promotion approach informed by the Ottawa Charter action areas could comprise. The five themes included building connected systems close to home, developing mothering/parenting skills, addressing upstream determinants, mother-centred care and funding, and creating a collective mothering village. We discuss how these areas could better meet the unique challenges of transitioning to motherhood. Rather than focussing only on individual behaviours, many ideas reveal broader environmental and structural determinants. We link the themes to current literature and advance the agenda for centring the maternal in maternal health promotion. [ABSTRACT FROM AUTHOR]

Health inequities among Indigenous and non-Indigenous communities are well documented and the research literature includes robust discussions about innovative ways to reduce inequities including co-design. Co-designing health promotion interventions with Indigenous communities presents many benefits and challenges for researchers, health professionals and communities involved in the process. The purpose of this study was to identify the facilitators and barriers of co-designing a health promotion intervention with Māori communities. Additionally, this study considers a specific Māori co-design framework, He Pikinga Waiora (HPW). HPW is a participatory approach to creating interventions emphasizing community engagement, systems thinking and centred on Kaupapa Māori (an approach grounded in Māori worldviews). The research design for this study was Kaupapa Māori. Participants (n  = 19) in this study were stakeholders in the New Zealand health sector. Participants were interviewed using an in-depth, semi-structured protocol. Thematic analysis was employed to analyse the data. Facilitators for co-designing health promotion interventions with Māori communities were collaboration and community voice. Barriers identified were mismanaged expectations and research constraints. Finally, facilitators for the HPW framework included providing clear guidelines and being grounded in Māori perspectives, while barriers included limited concrete case studies, jargon and questions about sustainability. Collaboration and inclusion of community voice supports the development of more effective co-design health promotion interventions within Māori communities which may address health inequities. The HPW framework offers clear guidelines and Māori perspectives which may assist in the development of effective co-design health promotion interventions, although areas for improvement were suggested. [ABSTRACT FROM AUTHOR]

This article presents the findings from the first 3 years of the evaluation of Healthy Families NZ, a systems-change intervention to prevent chronic diseases in 10 communities. The initiative, which builds on existing prevention activities, aims to strengthen the health prevention system through evidence-driven action to enable people to make good food choices, be physically active, smoke-free and free from alcohol-related harm. Key investment areas are a dedicated systems thinking and acting health promotion workforce, and activating leaders who can influence transformational change. The evaluation to date has found the initiative is being implemented with integrity. Evidence indicates a shift towards greater action on prevention, and the prevention system being strengthened. Māori ownership has been enabled, and prioritizing equity has led teams to utilize methods that amplify diverse local perspectives. There is progress on developing a flexible workforce through adaptive learning, flexible resources, professional development and a responsive National team. There is also progress in activating local leadership and empowering local teams. The initiative design has explicitly taken into account the context of complexity within which it is being implemented. It has evolved to focus on action that can accelerate sharing information and practices within communities, and between policy and decision-makers. Healthy Families NZ and its evaluation have been refunded to 2022. This provides an important opportunity to gather further insight into effective ways to strengthen the community agency and trust needed to promote and deliver evidence-based action on prevention. [ABSTRACT FROM AUTHOR]

The All Right? campaign was developed as a mental health promotion campaign following the 2010–2011 Canterbury earthquakes. One aspect of the overall campaign was the utilisation of social media as a means of promoting wellbeing messages. This research evaluates the use of the All Right? Facebook page as a means of promoting wellbeing after a major natural disaster. Quantitative and qualitative methods were used to gather data about the social media component of the All Right? campaign. Findings indicate that the All Right? Facebook page has become a valued source of consistent wellbeing tips and advice -' the place that I go '. Wellbeing reminders posted on the page were especially valued following earthquake aftershocks. High proportions of respondents to a survey (n  = 212) linked from the All Right? Facebook page agreed that the page was helpful (98%), gave people ideas of things that they can do to help themselves (96%), and made people think about their wellbeing (93%). Over four fifths (85%) of respondents had done activities as a result of what they saw on the All Right? Facebook page. Success factors for the Facebook page often mirrored those for the campaign itself, including: local research to inform the use of appropriate language for translating evidence-based wellbeing messages into a local setting; not being marketed as a government message; and effectively combining public health and communications expertise. Success factors specific to the Facebook page included: regular posts with a focus on issues that affect everyone in Canterbury post-disaster; timely posts, especially immediately following aftershocks; a consistent tone for the All Right? Facebook page; and balancing wellbeing facts and tips with other content that was relevant to the Canterbury population. The overall success of the All Right? Facebook page was reliant on being part of a trusted population-wide mental health promotion campaign. [ABSTRACT FROM AUTHOR]

The authors discuss their study on the nature of multidisciplinarity in health promotion. Topics discussed include how multidisciplinarity affects the growth of health promotion as a theoretical perspective, field of action, and academic institution, the need for health promoters to continue advocating for health equity in the academic, policy, and civic domains, and participation of health promoters in scientific platforms such as the IUHPE World conference and Health Promotion International.

Public health messages are traditionally disseminated using mass media that typically are unidirectional or one-way communication. Consequent to the current media proliferation, two-way communication channels are also available for publishing health messages. Though they differ in operation, they co-exist which is explained by the media complementarity theory. This study reports research that identified the sources that women of childbearing age in New Zealand prefer when seeking information concerning alcohol and pregnancy. Service-dominant logic provided a framework for simultaneously examining the media that were fundamentally different. The information sources were formulated into a media-mix based on the theory of dynamic transactional model (DTM). DTM accounted for media complementarity, combining the one-way and two-way communication channels into a unified communication process and is recommended for use in health promotion. [ABSTRACT FROM AUTHOR]

Wellbeing and vitality in education (WAVE) is an education setting based health promotion initiative in South Canterbury, New Zealand. A mixed method approach was used for assessing change over time. Over ninety percent of education settings (94%) were participating in WAVE (n  = 95). A total of 73 education settings completed the questionnaire at both baseline and follow-up. Evaluation of the WAVE programme shows that a robust partnership between health and education sectors can provide the basis for high levels of participation and significant changes in practice across all levels of education and a whole province. Evaluation results included that professional development for staff in some health related topics had improved. There was evidence of increasing partnerships between schools and community. Teachers had become role models for health messages and students had taken on leadership roles. Although the approach was based on health promoting schools literature, early engagement with education settings allowed the development of a local programme and branding. The overall outcome of WAVE has been a culture change in South Canterbury, where promoting the health of students, staff and families is becoming part of normal business for education settings. The results provide reason for optimism regarding the careful use of a health promoting schools framework, working in partnership with a range of stakeholders towards improving the health and subsequent life chances of young people. [ABSTRACT FROM AUTHOR]

Background This article outlines the methods being used to evaluate a community-based public health intervention. This evaluation approach recognizes that not only is the intervention, Healthy Families NZ, complex, but the social systems within which it is being implemented are complex. Methods To address challenges related to complexity, we discuss three developing areas within evaluation theory and apply them to an evaluation case example. The example, Healthy Families NZ, aims to strengthen the prevention system in Aotearoa/New Zealand to prevent chronic disease in 10 different geographic areas. Central to the evaluation design is the comparative case method which recognizes that emergent outcomes are the result of 'configurations of causes'. 'Thick', mixed-data, case studies are developed, with each case considered a view of a complex system. Qualitative Comparative Analysis is the analytical approach used to systematically compare the cases over time. Conclusions This article describes an approach to evaluating a community-based public health intervention that considers the social systems in which the initiative is being implemented to be complex. The evaluation case example provides a unique opportunity to operationalize and test these methods, while extending their more frequent use within other fields to the field of public health. [ABSTRACT FROM AUTHOR]

Little has been written about interviewing policy-makers in health promotion and public health research. This article explores the process, pitfalls and profits of semi-structured interviews with policy-makers in 10 research projects conducted in New Zealand. Key members of each research team were surveyed about their research and findings verified against research publications. Key aspects of the process of policy-maker interviews include gaining ethical approval, navigating gatekeepers, using personal contacts and multiple research dissemination methods. Pitfalls of interviewing policy-makers include interviewers not having enough knowledge of the topic so efforts were made to use knowledgeable researchers or up-skill others. Interviews provide access to specialist knowledge of the policy process which cannot be obtained by other methods. While this study was conducted in one jurisdiction, it has implications for other countries. Effective policy-maker interviews in health promotion policy research could contribute to improvements in the quality of data collected and uptake of research by policy-makers. [ABSTRACT FROM AUTHOR]

Youth have the highest crash injury risk in New Zealand. Maori and Pacific youth have an even higher risk. Highlighting and promoting benefits of modal shift from cars to active and public transport may increase health and safety. We aimed to create a discussion surrounding transport issues to gain a better understanding of attitudes and behaviours of non-driving youth, to empower our participants and to promote health and social change by making participants' opinions and experiences known to the broader community through a public exhibition. We engaged nine non-drivers aged 16-24 years in photovoice. Through sharing their photos and stories, participants used the power of the visual image to communicate their experiences. This method is an internationally recognized tool that reduces inequalities by giving those who have minimal decision-making power an opportunity to share their voice. By the end of the project, it was clear that the participants were comfortable with their non-driving status, noting that public and active transport was more cost-effective, easy and convenient. This attitude reflects recent studies showing a marked decrease in licensure among young people in developed countries. This project uniquely prioritized young Maori, Pacific and Asian non-drivers. [ABSTRACT FROM AUTHOR]