Pacific communities co-designing and leading interventions to prevent gout and rheumatic fever in New Zealand

<h3>Context:</h3> After a Samoan patient from New Zealand (NZ) attended a PACE workshop at NAPCRG in 2016 with her general practitioner, she was inspired to set up a Pacific community group to work towards better health outcomes for Pacific people living in South Auckland, NZ. Jointly the community group and a Pacific health professional network selected gout and rheumatic fever as two key health issues needing innovative approaches to address the inequitable health burdens Pacific people face. <h3>Objective:</h3> To co-design interventions with Pacific community group and health professional network aimed at 1) Improving the uptake of allopurinol in Pacific gout patients and 2) Reducing rheumatic fever infections in Pacific people. <h3>Study Design and Analysis:</h3> Five co-design workshops, framed by the Samoan Fa’afaletui model which weaves together different approaches, were conducted with the two Pacific groups to critically review existing interventions in NZ and co-design their own innovative approaches. <h3>Setting:</h3> South Auckland, NZ. <h3>Population Studied:</h3> A collaboration between a South Auckland Pacific People’s Health Advisory Group (Pacific community members), a South Auckland Pacific Practice-Based Research Network (health professionals), and University of Auckland researchers. <h3>Intervention/Instrument:</h3> A community-based participatory research approach. <h3>Outcome Measures:</h3> Interventions designed by and for Pacific communities. <h3>Results:</h3> Themes arising from the workshops were the need to improve access to primary care and increase community awareness. The groups co-generated a range of potential interventions for both gout and rheumatic fever and prioritised them by feasibility, cost, and impact. A panel of Pacific, Maori and clinical advisors were consulted to finalise one intervention for each health issue. For gout, a pharmacist-based intervention was co-designed that streamlines testing, prescribing and dispensing of allopurinol for Pacific people. For rheumatic fever, the groups decided on a social media intervention that could promote awareness among Pacific youth and their families. <h3>Conclusions:</h3> Further research projects 0are underway to implement and evaluate these co-developed interventions. Empowering the community to set research directions from the beginning ensures studies are relevant for the communities who are most affected. Innovative models of care designed and led by Pacific communities in NZ are needed to lead to improved health outcomes for Pacific people.