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'Intersectionality' describes the converging effects of ethnicity, gender, sexuality, disability, and other social group characteristics that influence life experiences. We draw on a representative study of year 9-13 students in Tai Tokerau, Tamaki Makaurau, and Waikato (Youth19) to explore differences in mental health and wellbeing outcomes for young people from a selection of intersectional identities (Maori, Pasifika, Rainbow, and young people with a Disabling Condition). We found a pervasive pattern of inequity for young people who have intersectional identities compared to those from the majority groups (i.e. Pakeha, non-disabled, cis-heterosexual youth). Intersectional youth had higher levels of inequity and faced a greater array of inequities. There was evidence of an additive effect for some indicators. Thematic analysis of open-text survey responses found the need for positive inclusive environments, and support for all young people, including those at the intersections of identity. Drawing on the findings, we offered several systems-level policy recommendations, including strategies to improve inclusiveness and reduce discrimination. Keywords: Intersectionality, Inequity, Maori, Pacific, Rangatahi, Rainbow, Takatapui, Disability, Youth, Wellb eing, Mental health, Di scrimination, INTRODUCTION Aotearoa New Zealand has an ethno-culturally diverse population of young people, foregrounded by a foundation of biculturalism, in the context of Te Tiriti o Waitangi (Came et al., 2021). [...]

: Objective: To investigate smoking and vaping in secondary school students (aged 13–18 years) in New Zealand (NZ) following the introduction of ‘pod’ e‐cigarettes, which have been associated with the rapid escalation of youth vaping elsewhere. Methods: Data on smoking and vaping were collected in 2019 as part of a comprehensive youth health survey (N=7,721). Results: Vaping was 2–3 times more prevalent than smoking, with 10% of students vaping regularly (monthly or more often), and 6% weekly or more often, compared with 4% and 2%, respectively, for tobacco smoking. Nicotine‐containing e‐cigarettes were sometimes or always used by 80% of regular and 90% of weekly vapers. Regular and weekly smoking was rare in low deprivation (affluent) areas, whereas regular and weekly vaping prevalence was similar across the socioeconomic spectrum. More than 80% of ever‐vapers (N=2732) reported they were non‐smokers when they first vaped, and 49% of regular vapers (N=718) had never smoked. Conclusions: A significant proportion of New Zealand adolescents, many of whom have never smoked, use nicotine‐containing e‐cigarettes regularly. Implications for public health: Vaping is less harmful than smoking, but it is not harmless. Public health action is needed to support young non‐smokers to remain smokefree and vape‐free., The advent of e‐cigarettes has brought both public health opportunities and risks.[sup.1,2] Vaping offers an alternative nicotine delivery system with lower health risks than combustible tobacco,[sup.3] so, for nicotine‐dependent smokers, [...]

Substantial progress in adolescent health research has been made over recent decades, but important knowledge gaps remain. Informed by targeted reviews of the literature, expert consultation, and authors' collective experiences, we propose future directions in adolescent health research. We identified five key principles on how future research must be approached alongside what technical investments are required to act on them. Principles: 1. Research with adolescents must be decolonizing in practice , dismantling systems of oppression, exploitation, and cultural dominance; 2. Research must recognize socio-political, structural, and commercial determinants of adolescent health ; 3. Research must be developmentally and contextually appropriate, reflecting adolescents' evolving capacities and increasingly complex and intersecting determinants of health; 4. Research must be strengths-based – moving away from problematizing adolescents and/or their behaviours toward focusing on their strengths as levers for change; and 5. Research must be built on a foundation of respectful partnerships as a right , and because adolescents have unique knowledge and skills to contribute. Technical investments: 1. Sampling techniques and approaches that provide equity of opportunity for all to participate; 2. High-quality descriptive studies from all nations to understand adolescents' ever-evolving contexts, needs and assets; 3. Investment in what works within each context and for whom through trials and robust assessments/evaluations; and 4. Implementation science research strategies. Adolescent health research will require reorientation and innovation in both how we approach research and what technical investments are required to improve the health and wellbeing of adolescents now and into the future. [ABSTRACT FROM AUTHOR]

The application of both Indigenous and Western knowledge systems in research may provide a well-rounded understanding of health, illness, and wellbeing for Indigenous communities in colonised societies. While many researchers have used a dual approach to researching Indigenous communities in colonised societies, tensions continue to exist around the use of Indigenous and Western ways of knowing together. There are also ongoing tensions between Indigenous methodologies and ethics processes rooted in Western understandings of research. Kaupapa Māori research is an Indigenous Māori approach to research that is about being Māori, is connected to Māori philosophy, culture and knowledge, and centres priorities for Māori. Grounded theory is a Western scientific approach to produce a theory grounded in qualitative data. This paper presents a novice researcher's reflections on using kaupapa Māori research and grounded theory to explore the relational aspects of acute health care in Aotearoa, New Zealand. The research design attempts to utilise the ethics of kaupapa Māori research and the essential methods of grounded theory to develop a research approach that is robust and culturally appropriate. Conforming to conventional Western science-based research methods while endeavouring to privilege Indigenous realities is challenging and, at times, impossible. However, grounded theory can be flexible enough to adapt to the ethics of kaupapa Māori research. Research at the interface between Indigenous and Western knowledge systems presents opportunities for innovation in research design and can provide an ethical foundation for conducting research with Indigenous communities. [ABSTRACT FROM AUTHOR]

Objective: The objective was to identify clinically meaningful groups of adolescents based on self-reported mental health and wellbeing data in a population sample of New Zealand secondary school students. Methods: We conducted a cluster analysis of six variables from the Youth19 Rangatahi Smart Survey (n = 7721, ages 13–18 years, 2019): wellbeing (World Health Organization Well-Being Index), possible anxiety symptoms (Generalized Anxiety Disorder 2-item, adapted), depression symptoms (short form of the Reynolds Adolescent Depression Scale) and past-year self-harm, suicide ideation and suicide attempt. Demographic, contextual and behavioural predictors of cluster membership were determined through multiple discriminant function analysis. We performed cross-validation analyses using holdout samples. Results: We identified five clusters (n = 7083). The healthy cluster (n = 2855, 40.31%) reported positive mental health across indicators; the anxious cluster (n = 1994, 28.15%) reported high possible anxiety symptoms and otherwise generally positive results; the stressed and hurting cluster (n = 667, 9.42%) reported sub-clinical depression and possible anxiety symptoms and some self-harm; the distressed and ideating cluster (n = 1116, 15.76%) reported above-cutoff depression and possible anxiety symptoms and high suicide ideation; and the severe cluster (n = 451; 6.37%) reported the least positive mental health across indicators. Female, rainbow, Māori and Pacific students and those in higher deprivation areas were overrepresented in higher severity clusters. Factors including exposure to sexual harm and discrimination were associated with increasing cluster severity. Conclusion: We identified high prevalence of mental health challenges among adolescents, with distinct clusters of need. Youth mental health is not 'one size fits all'. Future research should explore youth behaviour and preferences in accessing support and consider how to best support the mental health of each cluster. [ABSTRACT FROM AUTHOR]

The use of frequency-based criteria to detect harmful substance use in adolescents is rare despite its potential to identify young people at risk. We compared high school students who use high amounts of substances to students with lower levels (or nil) of use across health and well-being indicators to explore the feasibility of this kind of categorization. Based on survey questions from Youth'12, a cross-sectional adolescent health survey involving 3% (8,500) of New Zealand high school students, we selected criteria indicative of substance use that would warrant specialist alcohol and other drugs (AOD) treatment. Two sets of "high-use" criteria (e.g., drinking "alcohol most days a week or more") for both older and younger adolescents were selected. Eleven percent of students met criteria for "high use," with higher rates in males and older students. Rates of high use were similar across high-, medium- and low-deprivation neighborhoods. Binge alcohol use (9.2%) was the predominant form of "high use." Students with "high use" reported poorer health outcomes across numerous areas including mental health, physical health, risk behaviors, and access to health care. Only 5% of "high-use" students had accessed an AOD service. The wide range of negative health outcomes associated with a high level of substance use suggests that brief screening focusing on the level of substance use may help in identifying young people at risk. Simple and brief processes may improve the uptake and implementation of screening in primary care and other settings, and further research in this area is recommended.

The Statistics New Zealand Integrated Data Infrastructure (IDI) is a collection of de-identified whole-population administrative datasets. Researchers are increasingly utilising the IDI to answer pressing social and policy research questions. Our work provides an overview of the IDI, associated issues for Māori (the Indigenous peoples of New Zealand), and steps to realise Māori data aspirations. We first introduce the IDI including what it is and how it was developed. We then move to an overview of Māori Data Sovereignty. We consider the main issues with the IDI for Māori including technical issues and problems with ethnic identifiers, deficit-framed work, community involvement, consent, social licence, further data linkage, offshore access, and barriers to access for Māori. We finish with a set of recommendations around how to improve the IDI for Māori, making sure that Māori can get the most out of administrative data for our communities. These include the need to build data researcher capacity and capability for Māori; work with hapori Māori to increase utilisation; change accountability mechanisms, including greater co-governance of data; adequately fund alternatives; or potentially even abolishing the IDI and starting again. [ABSTRACT FROM AUTHOR]

This study examines the association between schools and student bullying behaviors and victimization among a nationally representative sample (N = 9,107) of New Zealand high school students. In particular, the study sought to explore the role of characteristics of schools and school culture with respect to bystander behavior, while controlling for individual student factors related to victimization and bullying behaviors. Results indicated that a total of 6% of students report being bullied weekly or more often and 5% of students reported bullying other students at least weekly. Results of multilevel analyses suggested that schools characterized by students taking action to stop bullying were associated with less victimization and less reported bullying among students. In contrast, in schools where students reported teachers take action to stop bullying, there was no decline in victimization or bullying. Overall, these findings support whole-school approaches that aid students to take action to stop bullying.