Parents play key role for hearing-impaired Pacific children

The importance of parental involvement with Pacific children with hearing loss is revealed in a review by University of Auckland academics.

PhD candidate Linda Palavi, Dr Elizabeth Holt and Professor Vili Nosa have authored ‘A scoping review on the nature of parental involvement among Pacific and minority populations with hearing loss’. Published in the Journal of the Royal Society of New Zealand, it focuses on the under-researched area of parental involvement, offering a new perspective in reviewing health service delivery in Aotearoa, New Zealand.

In Aotearoa, Māori and Pacific children and youth are over-represented in severity and prevalence of impaired hearing. Despite universal, government-funded hearing screening and hearing surveillance before entering primary school, Māori and Pacific families still experience inequitable hearing health outcomes. 

The role of family, and women were pivotal in the perceptions of hearing loss and the hearing experiences of children. Parents reported that hearing care services were not family-centred and had limited social and parental support.

New Zealand-born Tongan Palavi, who hails from the villages of Kolofo’ou and Kolomotu’a in Nuku’alofa, is in the final year of her doctoral studies at the School of Population Health. She says improving services and empowering parents will make a positive difference for children suffering from hearing loss.

The study found that various factors like poverty, religion, socioeconomic status, and stigma significantly influence how Pacific parents engage with their children's hearing loss. Cultural and family values play a crucial role in shaping parental behaviours and practices. For instance, the role of women and the overall family dynamics are pivotal in how hearing loss is perceived and managed within Pacific communities in New Zealand. 

"I hope the research empowers Pacific families and highlights their voices, experiences and struggles as they deal with children’s hearing impairments; as well as focus on service improvements for Pacific families to navigate the health system with confidence."

The paper reveals that hearing care services often do not cater adequately to the needs of these families. Parents felt that the services were not family-centred and lacked sufficient social and parental support. The study suggests that understanding and improving parental involvement could be a key strategy to address the disparities in hearing health services for Pacific and minority populations. 

Palavi says there is potential for enhanced parental involvement in services and in hearing loss research to contribute to reducing inequities in hearing health outcomes between Pacific and non-Pacific populations in New Zealand.

She adds that Pacific parents stand as the first point of contact for their children’s health and there are benefits in a shift towards a family-centred approach. 

In the Pacific region, a holistic perspective of hearing loss was common across Pacific cultures, with spirituality playing an important role in how disability and hearing loss are understood.

The presence of disease is attributed to spiritual causes such as misdeeds or failure to fulfil responsibilities. A qualitative study among Niuean community members found superstitious beliefs were more prevalent among the older Niuean generation than younger Niueans. However Pacific community members living in New Zealand recognised the causes of hearing loss not to be spiritual, reflecting the New Zealand context of hearing loss and its causes. 

The complexity of cultural understandings of hearing loss and strong cultural ideals surrounding Pacific children, parents and family means parental involvement provides an important perspective.

Palavi says it could be used to address inequitable outcomes in hearing health service provision among Pacific and minority populations. 

About the researcher

Palavi has spent much of her life in central Auckland raised by her parents alongside three brothers. She recalls starting out with Professor Vili Nosa as her lecturer and now her research supervisor. During the final year of her Bachelor of Health Science, Professor Nosa encouraged her to pursue postgraduate studies.

However, she wasn’t entirely convinced until she completed a postgraduate diploma in Public Health, developing a keen interest in learning about the health system and the role research played within it.

“I did my Masters of Public Health where I found the value of being Pacific, and using research as a vessel to improve health equity for our people.

"Throughout my academic journey I have been surrounded by Pacific people who are trailblazers in research so seeing that has inspired me to know that it is achievable. Doing a PhD is a stepping stone to getting there. 

“What I’ve achieved so far is a testament to my faith and the village I have behind me. My family and the sacrifices my parents and brothers have made and continue to make to support me, especially in this last leg of my PhD journey is something I will always be grateful for. 

“My PhD supervisors, Professor Vili Nosa and Dr Elizabeth Holt have been amazing mentors and have continued to encourage and support me in solidifying my place and voice within the research space.” 

She also acknowledged her clinical advisors Dr Renee Hislop and Dr Michelle Pokorny welcoming her into the hearing health space and continuing to support her research among Pacific children within the Counties Manukau region.