Enablers and Challenges of Dietary Interventions and Change for Pacific Peoples Living in Aotearoa, New Zealand: A Scoping Review

Abstract

Abstract Background Pacific Peoples face increasing rates of metabolic diseases, yet interventions for healthy dietary change are rarely focused on Pacific communities or centered around the cultural values and socio-cultural environment of Pacific Peoples. Objective In this scoping review we aimed to systematically identify enablers and challenges of dietary change for Pacific Peoples in Aotearoa, New Zealand (AoNZ), and Australia. Data Sources Medline (OVID), Embase (OVID), Scopus, Indigenous health (informIT), CINAHL (EBSCO), NZ Research, and Web of Science databases were searched from inception until July 2021. Data Extraction We performed this review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist, Joanna Briggs Institute methodology. Of 10 963 articles identified, 19 were selected for review. Eight articles focused solely on Pacific Peoples and 11 included Pacific Peoples alongside other groups. Seventeen articles reported consultations with Pacific communities, utilized Pacific research methodology, or included authors of Pacific heritage. Data Synthesis The Pacific Health model “Kato Polopola” (food basket) was utilized to synthesize the findings. This model includes 12 domains reflecting values commonly shared across Pacific Island cultures: family, community, church, and concepts, impacting the relationship between Pacific Peoples and food. Results Key enablers to engaging in positive dietary change centered on cultural values of Pacific communities: inclusion of the whole family; use of a holistic approach to physical and spiritual health; the significance of food in preserving cultural traditions; and co-design and facilitation performed with the Pacific Community. Crucially, the main challenges identified were primarily related to the social determinants of health and well-being. Conclusion Despite alarming health outcomes for Pacific Peoples living in AoNZ, this scoping review highlights the paucity of research addressing healthy dietary change for Pacific communities. Pacific-led research, based on Pacific values, is essential to promote meaningful change, alongside addressing the social determinants of health. This review provides a valuable basis for future research.