Clinical Scorecard: Enhancing Support for Pacific Patients in the Weight Loss Surgery Journey: A Collaborative Evaluation Study

At a Glance

Key Highlights

• Pacific populations have the highest obesity prevalence and related co-morbidities but lowest engagement and completion rates for publicly funded weight loss surgery in NZ.
• A Pacific-led preoperative program incorporating culturally safe spaces, Pacific role models, and financial support improved patient retention and satisfaction.
• Preoperative attrition rates for Pacific patients are disproportionately high, with up to 87% dropout among Pacific males in mainstream programs.

Guideline-Based Recommendations

Diagnosis

• Identify obesity-related co-morbidities and assess eligibility for weight loss surgery in Pacific patients.

Management

• Implement culturally tailored preoperative programs that reduce structural, social, and economic barriers.
• Provide group education sessions in community spaces led by bariatric teams alongside Pacific facilitators and role models.
• Incorporate group talanoa to facilitate open discussion of stigma, barriers, and enablers related to surgery.

Monitoring & Follow-up

• Track patient attendance and engagement through preoperative appointments and group sessions.
• Use patient feedback surveys and qualitative data to assess program satisfaction and retention.

Risks

• High preoperative attrition risks among Pacific patients if cultural and socioeconomic barriers are not addressed.

Patient & Prescribing Data

Pacific adults accepted into the Auckland City Hospital weight loss surgery program

Culturally adapted support and financial assistance during preoperative stage can improve retention and preparation for surgery.

Clinical Best Practices

• Co-design preoperative programs with Pacific health values and involve Pacific role models who have undergone surgery.
• Hold education sessions in culturally safe community venues rather than clinical settings.
• Provide financial support for travel, parking, childcare, and food to reduce economic barriers.
• Encourage family involvement during preoperative education to enhance support.
• Use group talanoa to foster meaningful patient engagement and address psychosocial factors.

References

• Obesity and weight loss surgery effectiveness
• Pacific population obesity and co-morbidity statistics
• Disparities in publicly funded weight loss surgery rates
• Attrition rates in Pacific patients pre-surgery
• Qualitative studies on barriers for Pacific patients
• Group talanoa methodology