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Lung cancer screening can significantly reduce mortality from lung cancer. Further evidence about how to optimize lung cancer screening for specific populations, including Aotearoa New Zealand (NZ)'s Indigenous Māori (who experience disproportionately higher rates of lung cancer), is needed to ensure it is equitable. This community-based, pragmatic cluster randomized trial aims to determine whether a lung cancer screening invitation from a patient's primary care physician, compared to from a centralized screening service, will optimize screening uptake for Māori. Participating primary care practices (clinics) in Auckland, Aotearoa NZ will be randomized to either the primary care-led or centralized service for delivery of the screening invitation. Clinic patients who meet the following criteria will be eligible: Māori; aged 55–74 years; enrolled in participating clinics in the region; ever-smokers; and have at least a 2% risk of developing lung cancer within six years (determined using the PLCOM2012 risk prediction model). Eligible patients who respond positively to the invitation will undertake shared decision-making with a nurse about undergoing a low dose CT scan (LDCT) and an assessment for Chronic Obstructive Pulmonary Disease (COPD). The primary outcomes are: 1) the proportion of eligible population who complete a risk assessment and 2) the proportion of people eligible for a CT scan who complete the CT scan. Secondary outcomes include evaluating the contextual factors needed to inform the screening process, such as including assessment for Chronic Obstructive Pulmonary Disease (COPD). We will also use the RE-AIM framework to evaluate specific implementation factors. This study is a world-first, Indigenous-led lung cancer screening trial for Māori participants. The study will provide policy-relevant information on a key policy parameter, invitation method. In addition, the trial includes a nested analysis of COPD in the screened Indigenous population, and it provides baseline (T0 screen round) data using RE-AIM implementation outcomes. [ABSTRACT FROM AUTHOR]

Anonymous self-report health and wellbeing surveys were completed by alternative education (AE) students in the Auckland and Northland regions of New Zealand, and 11 semi-structured interviews were conducted with key informants about their perceptions of health issues for AE students. Both groups reported concerning health-risk behaviours among AE students, including drug and alcohol abuse, depressive symptoms and dangerous driving. Health services have consistently failed to engage AE students in effective primary and preventative care that includes their whānau/family. Significant changes to the current New Zealand health system are required to provide appropriate and effective health care for students attending AE facilities. [ABSTRACT FROM AUTHOR]

Objective: To estimate the prevalence of and risk factors for vitamin D deficiency in young urban children in Auckland, New Zealand, where there is no routine vitamin D supplementation. Design: A random sample of urban children. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D <27.5 nmol/l (<11 ng/ml). Logistic regression analysis was used to calculate odds ratios and, from these, relative risks (RR) and 95% confidence intervals were estimated. Setting: Auckland, New Zealand (36°52′S), where the daily vitamin D production by solar irradiation varies between summer and winter at least 10-fold. Subjects: Children aged 6 to 23 months enrolled from 1999 to 2002. Results: Vitamin D deficiency was present in forty-six of 353 (10 %; 95% CI 7, 13 %). In a multivariate model there was an increased risk of vitamin D deficiency associated with measurement in winter or spring (RR=7.24, 95% CI 1.55, 23.58), Pacific ethnicity (R=57.60, 95% CI 1.80, 20.11), not receiving any infant or follow-on formula (RR=5.69, 95% CI 2.66, 10.16), not currently receiving vitamin supplements (RR=5.32, 95% CI 2.04, 11.85) and living in a more crowded household (RR=2.36, 95% CI 1.04, 4.88). Conclusions: Vitamin D deficiency is prevalent in early childhood in New Zealand. Prevalence varies with season and ethnicity. Dietary factors are important determinants of vitamin D status in this age group. Vitamin D supplementation should be considered as part of New Zealand's child health policy. [ABSTRACT FROM AUTHOR]

Aim: Previous prevalence estimates of iron deficiency (ID) in young New Zealand children are inaccurate because of sampling bias and imprecise definition of ID. The aim of this study was to estimate the prevalence of ID in children aged 6–23 months and the factors associated with ID. Methods: An ethnically stratified sample identified from random residential address start points. Children resident in Auckland, New Zealand were enrolled from 1999 to 2002. Children with elevated C-reactive protein (>4 mg/L) were excluded. Iron status was determined in 324 (78%) of 416 enrolled children. Analyses adjusted for clustering and weighted for ethnic stratification. ID defined as abnormal values for two or more of serum ferritin (<10 µg/L), iron saturation (<10%) and mean cell volume (<73 fl). Results: ID was present in 14% (95% confidence interval (CI) 9–17%). ID prevalence varied with ethnicity (Maori 20%, Pacific 17%, other 27%, New Zealand European 7%, P = 0.005), but not with social deprivation. In a multivariate analysis that adjusted for low birthweight, there was an increased risk of ID associated with a body mass index ≥ 18.5 kg/m2 (RR = 4.34, 95% CI 1.08–10.67), and with receiving no infant or follow on formula (RR = 3.60, 95% CI 1.56–6.49). Conclusions: ID is prevalent in young New Zealand children. Variance in ID prevalence with ethnicity but not social deprivation implies that cultural practices influence iron status. Young children with more rapid growth are at increased risk of ID as are those receiving milk other than that specifically modified for them. [ABSTRACT FROM AUTHOR]