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Wong G.,Auckland University of Technology | Whittaker R.,University of Auckland | Chen J.,Auckland Regional Public Health Service | Cowling L.,Harbour Health | And 2 more authors.
Journal of Smoking Cessation | Year: 2010

Language, culture and not knowing how to access services are barriers to the use of health services for Asian migrants. Asian Smokefree Communities (ASC) pilot-tested a novel Asian-specific service model to address these issues for Asian smokers. Korean-and Chinese-speaking coordinators delivered home-, workplace-or clinic-based interventions to support smokers with cessation and create smoke-free environments with families. A prior planned evaluation investigated the acceptability of the service, quit rates and exposure to second-hand smoke. The methods included analysis of ASC service records, a client satisfaction survey and key informant interviews. Clients were satisfied with factors associated with culture, such as being comfortable when talking to coordinators (88.9%) and family involvement in treatment (79.4%). Appointment attendance was high (97%). The self-reported quit rate for the 93 cessation clients was 72% at 1 month, 53.8 % at 3 months and 40.9 % at 6 months. All homes (100%) were smoke-free after the intervention, an increase of 18% from preintervention levels. The ASC model was acceptable to Asian clients. It helped them stop smoking and increased household protection from second-hand smoke. The model could make an effective contribution to smoke-free services for Asian populations in western countries.

Yu R.,Whangarei Base Hospital | Jarrett P.,Dermatology | Holland D.,Infectious Diseases | Sherwood J.,Institute of Environmental Science and Research | Pikholz C.,Auckland Regional Public Health Service
New Zealand Medical Journal | Year: 2015

AIM: To examine the current epidemiological trends of leprosy in New Zealand and raise awareness of this disease in the health professional community. METHOD: Epidemiological data of leprosy, a notifiable disease in New Zealand, was accessed for the 10 year time period 2004 to 2013. Using an illustrative case as an introduction, all 38 case reports from the study period are summarised. RESULTS: Most cases of leprosy in New Zealand notified during the study period are immigrants from countries with endemic leprosy, reflecting the origin of disease. Delay to diagnosis is common. Conclusion: Leprosy remains a clinical problem in New Zealand. Cases are more likely to arise in geographical areas with higher numbers of immigrants from endemic countries. © NZMA.

Wilson D.,University of Auckland | Koziol-Mclain J.,University of Auckland | Garrett N.,University of Auckland | Sharma P.,Auckland Regional Public Health Service
International Journal for Quality in Health Care | Year: 2010

Objective: Refine instrument for auditing hospital-based child abuse and neglect violence intervention programmes prior to field-testing. Design: A modified Delphi study to identify and rate items and domains indicative of an effective and quality child abuse and neglect intervention programme. Experts participated in four Delphi rounds: two surveys, a one-day workshop and the opportunity to comment on the penultimate instrument. Setting: New Zealand. Participants: Twenty-four experts in the field of care and protection of children. Main Outcome Measures. Items with panel agreement ≥85% and mean importance rating ≥4.0 (scale from 1 (not important) to 5 (very important)). Results: There was high-level consensus on items across Rounds 1 and 2 (89% and 85%, respectively). In Round 3 an additional domain (safety and security) was agreed upon and cultural issues, alert systems for children at risk, and collaboration among primary care, community, non-government and government agencies were discussed. The final instrument included nine domains ('policies and procedures', 'safety and security', 'collaboration', 'cultural environment', 'training of providers', 'intervention services', 'documentation' 'evaluation' and 'physical environment') and 64 items. Conclusions: The refined instrument represents the hallmarks of an ideal child abuse and neglect programme given current knowledge and experience. The instrument enables rigorous evaluations of hospital-based child abuse and neglect intervention programmes for quality improvement and benchmarking with other programmes. © The Author 2010. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Williams D.,Community and Public Health | Garbutt B.,Rehabilitation and Population Health | Peters J.,Auckland Regional Public Health Service
New Zealand Medical Journal | Year: 2015

This special article defines the public health principles and core public health functions that are combined to produce the public health services essential for a highly-functioning New Zealand health system. The five core functions are: health assessment and surveillance; public health capacity development; health promotion; health protection; and preventive interventions. The core functions are interconnected and are rarely delivered individually. Public health services are not static, but evolve in response to changing needs, priorities, evidence and organisational structures. The core functions describe the different ways public health contributes to health outcomes in New Zealand and provide a framework for ensuring services are comprehensive and robust. © NZMA.

Priest P.,University of Otago | Sadler L.,National Womens Health | Sykes P.,University of Otago | Marshall R.,University of Auckland | And 2 more authors.
Cancer Causes and Control | Year: 2010

Objective The aim of this study is to assess whether ethnic inequalities in cervical cancer mortality are due to differences in survival independent of stage and age at diagnosis, and to assess the contribution of screening to stage at diagnosis. Methods Demographic data and cervical screening history were collected for 402 women with histologically proven primary invasive cervical cancer, diagnosed in New Zealand between 1 January 2000 and 30 September 2002. Date of death was available for women who died up to 30 September 2004. Results A Cox proportional hazard model showed that, after adjusting for age, the Maori mortality rate was 1.80 times (95% CI 1.07-3.04) that of non-Mãori. This reduced to 1.25 (95% CI 0.74-2.11) when stage at diagnosis was also adjusted for. Among determinants of late stage at diagnosis, older age and being Maori significantly increased the risk, while screening was protective. Conclusions These results indicate that later stage at diagnosis is the main determinant of Maori women's higher mortality from cervical cancer. Improving cervical screening among Maori women would reduce stage at diagnosis and therefore ethnic inequalities in mortality.

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