Health services need to do more to help Samoans at risk of heart disease

A Victoria University of Wellington researcher has developed a number of recommendations that she says are needed to improve Samoans' understanding of cardiovascular disease to help lower rates of the disease in this high-risk demographic group.

Tua Taueetia-Su’a

Tua Taueetia-Su’a, an experienced practice nurse and primary health organisation researcher, has dedicated the last three and a half years to researching Samoan people’s knowledge and understanding of cardiovascular disease (CVD), its risks, risk assessments, and the reasons behind their decisions to undertake or abstain from making necessary lifestyle changes.

“Cardiovascular disease is prevalent among Samoans, and in fact all Pacific people. For my research, I interviewed 16 Samoan patients and seven practice nurses in the Wellington region about their experiences.”

Tua found poor comprehension of English and low health literacy created barriers to many Samoan patients’ understanding of CVD, which resulted in a low uptake of management strategies such as exercise, a healthy diet and regular risk assessments.

“I found a lot of people would get a CVD risk assessment done, but not know why they were there or what the results meant.

“The disease is known as the ‘silent killer’ because patients might not know they are at risk. They feel fine, they feel strong, and if they aren’t fully informed, they may not think it’s necessary to make lifestyle changes.”

In addition to the language barrier, Tua says cultural differences also impeded Samoan patients’ understanding and adoption of lifestyle changes.

“Samoan culture is very much centred on the family, community and village, not the individual. If the health system is to effectively motivate the patients to lower their CVD risk by eating healthy and exercising, it needs to involve the whole family. Family members should be invited to attend risk assessments to hear from the doctor or nurse because it’s likely the mum is doing the cooking and the family can support lifestyle changes.”

Tua says training more health professionals with a knowledge of fa’a Samoa—the Samoan way of doing things— as well as Samoan language would be a major step forward in improving health education.

She also recommended developing an easy and practical plan to deliver health education on CVD and its assessments to New Zealand’s Samoan community, and emphasising the importance of a healthy lifestyle to minimise risks.

She suggested written communications should use simple language, with diagrams and translated text to ensure the content is understood. In-person consultations should allow extra time for questions and to ensure the patient and their support people are fully informed.

Tua further suggests healthcare services should complete follow-up assessments to check that patients have adopted necessary lifestyle changes.

Health Services Research Centre director Professor Jackie Cumming says Tua’s research identifies some key issues that health services need to take into account to work better for Samoan people in relation to CVD.

Professor Cumming says although Tua’s research focuses on one nationality, her findings are much more widely applicable.

“Tua’s research highlights the very real need to improve health services in a way that responds and works with all Pacific communities in New Zealand to improve their overall health.”

Tua graduates today with a PhD in Public Policy. Her research can be viewed online.