Co-designing an intervention to prevent rheumatic fever in Pacific People in South Auckland: a study protocol

• Published in: International journal for equity in health Vol. 21; no. 1; pp. 1 - 101
• Main Authors: Tu'akoi, Siobhan, Ofanoa, Malakai, Ofanoa, Samuela, Lutui, Hinamaha, Heather, Maryann, Jansen, Rawiri McKree, van der Werf, Bert, Goodyear-Smith, Felicity
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 21.07.2022; BioMed Central; BMC
• Subjects: Autoimmune diseases; Cardiovascular disease; Children; Co-design; Community; Community involvement; Community participation; Community-based research; Congestive heart failure; Ethnic factors; Fever; Health aspects; Health disparities; Heart; Heart valves; Infections; Intervention; Maoris; Medical personnel; Medical research; Medicine, Experimental; Minority & ethnic groups; Pacific; Participatory; Pasifika; Patients; Prevention; Recurrent infection; Research methodology; Rheumatic fever; Streptococcus infections; Study Protocol; New Zealand
• ISSN: 1475-9276; 1475-9276
• DOI: 10.1186/s12939-022-01701-9

Rheumatic fever is an autoimmune condition that occurs in response to an untreated Group A Streptococcus throat or skin infection. Recurrent episodes of rheumatic fever can cause permanent damage to heart valves, heart failure and even death. Maori and Pacific people in Aotearoa New Zealand experience some of the highest rates globally, with Pacific children 80 times more likely to be hospitalised for rheumatic fever and Maori children 36 times more likely than non-Maori, non-Pacific children. Community members from the Pacific People's Health Advisory Group, research officers from the Pacific Practice-Based Research Network and University of Auckland researchers identified key health priorities within the South Auckland community that needed to be addressed, one of which was rheumatic fever. The study outlined in this protocol aims to co-design, implement, and evaluate a novel intervention to reduce rheumatic fever rates for Pacific communities in South Auckland. This participatory mixed-methods study utilises the Fa'afaletui method and follows a three-phase approach. Phase 1 comprises a quantitative analysis of the rheumatic fever burden within Auckland and across New Zealand over the last five years, including sub-analyses by ethnicity. Phase 2 will include co-design workshops with Pacific community members, families affected by rheumatic fever, health professionals, and other stakeholders in order to develop a novel intervention to reduce rheumatic fever in South Auckland. Phase 3 comprises the implementation and evaluation of the intervention. This study aims to reduce the inequitable rheumatic fever burden faced by Pacific communities in South Auckland via a community-based participatory research approach. The final intervention may guide approaches in other settings or regions that also experience high rates of rheumatic fever. Additionally, Maori have the second-highest incidence rates of rheumatic fever of all ethnic groups, thus community-led approaches 'by Maori for Maori' are also necessary.