Enhancing Support for Pacific Patients in Weight Loss Surgery Programs

Overview

Pacific populations in Aotearoa New Zealand face significant disparities in obesity-related health outcomes and have low engagement with publicly funded weight loss surgery programs. A Pacific-led preoperative program was developed and evaluated to improve retention and patient experience by addressing cultural, social, and economic barriers.

Background

Weight loss surgery is highly effective for treating obesity-related co-morbidities, including type 2 diabetes remission and improvements in sleep apnoea and hypertension. Pacific peoples in New Zealand have the highest obesity prevalence and related health conditions but show disproportionately high attrition rates during the preoperative stage of weight loss surgery programs. Barriers include clinical environment discomfort, financial burdens, and lack of culturally appropriate support. Previous qualitative research identified these challenges, informing the development of a Pacific-led preoperative program to enhance engagement and outcomes.

Data Highlights

In a major Auckland City Hospital program from 2007 to 2016, 73% of Pacific patients dropped out before surgery, with an 87% attrition rate among Pacific males. Another study found only 28% of Pacific patients underwent surgery after acceptance, compared to 63% of NZ Europeans. The new Pacific-led program included community-based sessions, Pacific facilitators and role models, travel cost coverage, and family inclusion to reduce barriers and improve retention.

Key Findings

• Pacific patients have the highest obesity and related co-morbidity rates but the lowest publicly funded weight loss surgery engagement in NZ.
• Preoperative attrition rates for Pacific patients are disproportionately high, with up to 87% dropout among Pacific males.
• The Pacific-led program relocated education sessions to community spaces and incorporated Pacific facilitators and role models to provide culturally safe support.
• Financial barriers were addressed by covering travel and parking costs and allowing family attendance to support patients.
• Group talanoa sessions facilitated open, culturally relevant discussions about surgery, stigma, and barriers, enhancing patient satisfaction and engagement.

Clinical Implications

Implementing culturally tailored preoperative programs that incorporate Pacific health values and community engagement can reduce attrition and improve patient experience for Pacific populations. Addressing structural and economic barriers, such as travel costs and clinical environment discomfort, is essential to optimize surgical outcomes and equity in obesity treatment. Healthcare providers should consider integrating Pacific role models and culturally safe communication methods in bariatric care pathways.

Conclusion

The Pacific-led preoperative weight loss surgery program demonstrates potential to improve retention and satisfaction among Pacific patients by addressing key cultural, social, and economic barriers. Such tailored interventions are critical to reducing health disparities and enhancing equity in obesity treatment outcomes.

References

1. Source Article 2024 -- Enhancing Support for Pacific Patients in the Weight Loss Surgery Journey