Introducing Tala Pasifika and Pacific ABC Pacific Nurse

Introducing Tala Pasifika and Pacific ABC Pacific Nurse Leaders and Smoking Cessation Fono Waipuna Conferenc and Hotel Centre Auckland Thursday 03 November, 2011

Pacific people in NZ Many in state housing homes Many Beneficiaries Many in low paying jobs High hospital admission and readmission rates

Tobacco Use and Pacific people in NZ • 1 in 4 Pacific adults in NZ smoke (Mo. H 2008) • $72 million spent by Pacific people on tobacco products in 2000 (Mo. H 2004) • High rates of pregnant women smoking (Butler 2004) • Increased uptake after childbirth (Erick-Peleti, 2006) • Recent increase in prevalence amongst Pacific youth compared to European and Maori (ASH Year 10 Survey, 2010)

Pacific Tobacco Control • 2003, First Pacific Peoples Tobacco Control Action Plan developed • National, cross sector fono • Six priorities identified • A key goal of the plan was to ‘establish a process for highlighting Pacific peoples tobacco control issues’

Identified Challenges Access Workforce Research Cessation for youth Community/workforce mobilisation • Support for Pacific teams in mainstream services. • • • (2004, Pacific Peoples Tobacco Control Action Plan) Ø Lack of national coordination Ø Lack of a national strategy Ø Need for national strategic representation Ø Limited number of services Ø Limited workforce numbers Ø Dearth of evidence

The Tala Pasifika Service Established in 2008 to ensure Pacific peoples: • Have their say on tobacco issues • Are actively involved in eliminating tobacco from their communities • Have a way of coordinating important tobacco control information and activities

Service Structure Heart Foundation Advisory Group Pacific Heartbeat Tala Pasifika Community Action Group

Interim Steering Group Advice • Focus on elimination and not control • Be forward thinking • Consider the next generation • Emphasis on community champions and action • Add value to what Pacific providers are currently doing

Guiding Principles 1. Community Leadership 2. Advocacy 3. Responsiveness 4. Partnership 5. Evidence Based

Our Target Audience • Pacific Children • Pacific Adolescents (1319 yrs) • All Pacific Males • Pregnant Women • Cook Islands Females

Strategic Priorities • Eliminate exposure to second hand smoke • Prevent Pacific young people from smoking • Eliminate tobacco related disparities with a focus on our target audiences

Tala Pasifika services… ADVOCACY COMMUNITY RESEARCH WORKFORCE SUPPORT

Information Gathering Tuatua Tika Report • Responding to community and provider needs for information and evidence • Ethnic specific information • Regional information

Prevalence of Pacific Smokers Ministry of Health, 2007

New Zealand Smoking Trends Tobacco Trends, 2005

Pacific Motivation to Quit • Most smokers regret smoking and understand the health harms of the smoking. 2008 New Zealand Tobacco Use Survey Quitting Results. Ministry of Health (2009). • Among Pacific people – high motivation to quit and increased awareness of the burdens of smoking 2011 Cowie, N (In preparation) – Auckland University • High motivation to quit amongst Pacific youth compared to thers. 2011 Marsh, L. (In preparation) – Otago University

2025 Tobacco Free NZ Goal Future generations of New Zealand children will be free from exposure to tobacco and will enjoy tobacco free lives. Where by 2025 NZ will have a smoking prevalence rate of less than 5% for all NZers.

Introducing Pacific ABC

Key Audiences I. Primary health care workers II. Pacific communities

Development Principles • Pacific approach • Respectful • Evidence-based • Complementary • Flexible and adaptable

Talanoa – a Pacific approach • Adapted for Pacific ABC, Talanoa is… – Respectful – Collective – Reciprocal – Face to face – Storytelling – Student-centred – Interactive 1 Te Pou o te Whakaaro Nui. 2010. Talking Therapies for Pasifika peoples: best and promising practice guide for mental health and addiction services. Auckland

Pacific ABC • For Health Practitioners For Pacific Communities

Tools and resources Considerations when working with Pacific people Conversation starters/Leave behind resources Visual Aids Further Reading List Video Resources Key ABC Messages from the Ministry of Health Quit Card Information Flipchart with Teaching Notes (training resource) Power. Point Presentation with Teaching Notes (training resource) § Life Stories and Testimonies (training resource) § § § § §

Considerations when working with Pacific people • Building rapport • Involving family in decision making • Holistic approach including spirituality • Communication and languaging • Etc.

Conversation Starter/Reminder

Flipchart/Power. Point with Teaching Notes

Questions

Our Target Audience • Pacific Children • Pacific Adolescents (1319 yrs) • All Pacific Males • Pregnant Women • Cook Islands Females

THE FUTURE……. .

Keeping the pressure on: • • Pacific Leadership collectives Pacific MPs Community Action Groups Media – TV and radio Collaboration with mainstream Submissions Mobilising support Demonstrating support

Faith Erick-Peleti 5 year old Tobacco Control Advocate!!!

Pacific Tobacco Control in NZ Health Sector • Limited number of services • Limited workforce numbers • Lack of national coordination • Lack of a national strategy • Need for national strategic representation (2004, Pacific Peoples Tobacco Control Action Plan)

Developing a Strategic Plan Discussions Held with MOH Appointment of Interim Steering Group Considered Existing Information / Evidence Discussions with Key Stakeholders Develop Draft Framework Plan Community / Provider Involvement

Keeping the pressure on: • • Pacific Leadership collectives Pacific MPs Community Action Groups Media – tv and radio Collaboration with mainstream Submissions Mobilising support Demonstrating support

Thank you Faafetai tele lava - Samoa Malo Aupito - Tonga Meitaki Maata – Cook Islands Meitaki atu paka - Aitutaki Fakaue Lahi - Niue Vinaka vaka levu - Fiji Fakafetai – Tuvalu

Priority Groups • • • Pacific Children Pacific Adolescents (13 -19 yrs) All Pacific Males Pregnant Women Cook Islands Females

New Zealand Smoking Trends Tobacco Trends, 2005

Pacific Smoking by Age group Percent (95% CI) 15 -24 29. 2 (23. 3 - 35. 1) 25 -34 32. 3 (23. 9 - 40. 8) 35 -54 25. 8 (20. 8 - 30. 7) 55 -64 21. 5 (13. 3 - 31. 8) Ministry of Health, 2007

Pacific Adult Smoking Ministry of Health, 2007

The Establishment Process Discussions Held with MOH Appointment of Interim Steering Group Considered Existing Information / Evidence Discussions with Key Stakeholders Develop Draft Framework Plan Community / Provider Involvement

What the Evidence tells us…

urvey Pacific Smoking Prevalence Pacific % (95% CI) Non-Pacific % (95%CI) 35. 0 (25. 4 – 25. 2 (22. 9 -27. 4) Current Smoker Men 44. 5) Women 28. 1 (22. 8 -33. 4) 21. 8 (19. 8 -23. 9) Total 31. 4 (26. 3 -36. 5) 23. 4 (22. 0 -24. 9)