Beloved, I pray that you may prosper in all things and be in health, just as your soul prospers 3 John 1:2

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Pasefika LotuMoui Health Programme Operations PLAN 2006-2010 Beloved, I pray that you may prosper in all things and be in health, just as your soul prospers 3 John 1:2 To strengthen partnerships between the Counties Manukau District Health Board and Pacific churches, working together to improve the health status and wellbeing of Pacific peoples.

Participants at the Tongan Kai Lelei Community Nutrition Session, June 2006.

Founding Scripture for LotuMoui: Beloved, I pray that you may prosper in all things and be in health, just as your soul prospers 3 John 1:2 Definition of LotuMoui Lotu means church or prayer in most Pacific languages, while Moui is a Tongan and Niuean term that generally means good health that encompasses mind, body and soul. The mind, body, spirit approach to health is holistic and inclusive. Importantly, it is consistent with Pacific people s concepts of health and wellbeing. Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 3

ACKNOWLEDGEMENT Counties Manukau District Health Board would like to thank all of the LotuMoui churches that participated in the development of the LotuMoui Operations Plan. In particular we would like to acknowledge the Minister s Forum participants and of the LotuMoui Health Committees for their advice and endorsement of the LotuMoui Operations Plan. We would also like to acknowledge the contributions and endorsement of the Pacific Health Advisory Committee and the CMDHB Consumer Panel. A final acknowledgement is given to the participants of the 2004 LotuMoui Symposium as the ideas, aspirations and vision for health and wholeness discussed at that Symposium have provided the basis for the development of this document. Copyright Published by the Counties Manukau District Health Board Private Bag 94052 S.A.M.C Manukau City Auckland New Zealand This book is copyright. Except for the purpose of fair reviewing, no part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording or any information storage and retrieval system, without permission in writing from the publisher. Infringers of copyright render themselves liable to prosecution. Design and layout by Ethnic Communications Limited. Printed in New Zealand. Contact Details If you would like more information on the LotuMoui Health Programme, please contact: Pacific Health Division LotuMoui Health Programme Counties Manukau District Health Board Private Bag 94052 S.A.M.C Manukau City Auckland New Zealand Telephone: (09) 262-9500 Website Link: www.cmdhb.org.nz/counties/service_areas/pacific-health 4 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

CONTENTS 1.0 Introduction................................................................... 6 2.0 Background.................................................................. 7 2.1 The Church and Health..................................................... 7 3.0 LotuMoui Programme Framework................................................ 8 3.1 Programme Logic........................................................... 9 4.0 Programme Accountabilities and Responsibilities.................................. 10 5.0 Programme Linkages......................................................... 11 5.1 Counties Manukau District Health Board...................................... 11 5.2 Tupu Ola Moui............................................................ 11 5.3 Let s Beat Diabetes Programme (LBD).........................................11 5.4 Other Organisations........................................................ 12 6.0 Partnerships and Relationships................................................. 13 6.1 Biannual Symposium....................................................... 13 6.2 LotuMoui Ministers Forum...................................................13 6.3 Health Committee Fono.................................................... 13 7.0 LotuMoui Programme Grant Scheme............................................ 14 8.0 LotuMoui Evaluation Framework................................................. 15 8.1 Purpose of the Evaluation................................................... 16 9.0 LotuMoui Programme Key Performance Indicators............................... 17 9.1 Previous LotuMoui Programme Work (2004-2005)...............................17 Outcome One: Improve Food and Nutrition Practices...................................18 Outcome Two: Increase Physical Activity Levels.........................................19 Outcome Three: Promote Healthier Weight............................................20 Outcome Four: Reduce Smoking Prevalence..........................................21 Outcome Five: Improve Engagement with Health Systems...............................22 Outcome Six: Implement Community Education Modules............................23-24 Key Performance Indicators........................................................ 18 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 5

INTRODUCTION 1.0 Introduction Pacific people s perspective of health is often described as a balance between an individual s spiritual, social, mental and physical health and wellbeing. This is defined within the context of relationships with immediate and extended family, social groupings, village, district, and country. Many Pacific people draw their sense of health from the quality of their relationships within their collective contexts, including the environment in which they live as well as the values, beliefs and cultural practices that reinforce these connections. The Pasefika LotuMoui Health Programme is an initiative of the Counties Manukau District Health Board (CMDHB) in partnership with Pacific churches in the Counties Manukau District. LotuMoui represents a significant landmark in terms of reflecting a strengthened vision, commitment, and process of collaboration between CMDHB and the Pacific church community. LotuMoui is based on the premise that while partnerships and relationships are critical components of successful health initiatives, understanding and utilising channels familiar to particular communities are as equally important. For Pacific peoples, the church is central to Pacific families and communities, and plays an influential role in many community affairs in New Zealand. In this respect, the church is well positioned to lead a shift in Pacific people s social consciousness and to encourage healthy behavioural change to improve health outcomes for Pacific peoples. This document outlines the operational plan for the LotuMoui framework from 2006 to 2010. It draws on the discussions held during the inaugural LotuMoui symposium (2004), LotuMoui Ministers Forum (2005/2006), LotuMoui Health Committee fono (2006) as well as advice from the CMDHB Pacific Health Advisory Committee and other key stakeholders. The LotuMoui strategic priorities and key performance indicators are aligned to, and complement the CMDHB Tupu Ola Moui Pacific Health and Disability Action Plan (Tupu Ola Moui), the CMDHB District Service Plan (DSP) 2005 and other activities undertaken by CMDHB such as the Lets Beat Diabetes programme. In particular, this operations plan demonstrates how the CMDHB Pacific team in partnership with the Pacific churches in intends to achieve Health outcome 1.1 of Tupu Ola Moui: To implement LotuMoui to build healthier church environments. 6 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

BACKGROUND 2.0 Background Pacific spiritual health is heavily influenced by church and other religious organisations. In the 2001 census, 84% of Pacific people surveyed identified themselves as affiliated to a church or religious organisation. There are more than 100 Pacific churches in the Counties Manukau District with congregations ranging from 30 or fewer into the thousands. These organisations are sources of guidance, advice and solace for many Pacific people and have become a structure that is deeply imbedded within Pacific communities in New Zealand. The church is seen as being a place where Pacific peoples congregate, fellowship, share and receive information, and also as a place where relationships are maintained and connections are preserved with family, Pacific languages, culture and traditions. Pacific identity, culture and religious practice have become intertwined and in many ways are inseparable. With worship, prayer and religious discipline being interwoven into many Pacific people s daily lives, the challenge for LotuMoui is to move the social consciousness of the Pacific community, to extend this commitment to spiritual health to include physical or holistic wellbeing. 2.1 The Church and Health The delivery of church-based health and social services is well described in the international literature with evidence positively demonstrating their effectiveness in improving health outcomes. Churches in partnership with academic and health organisations also provide the opportunity to eliminate health disparities within populations. Some of the key elements identified in successful programmes have been based on: 1. Collaborative partnerships 2. Positive health values service and caring for others 3. Availability of church services in every community 4. Access to church facilities and health promotion trained 5. Community-focussed interventions 6. Health behaviour change, and 7. Supportive social relationships and networks A number of Pacific church based health programmes have been and/or are currently being implemented in New Zealand. They range from Parish nursing in the Auckland District Health Board (ADHB) area to the delivery of healthy lifestyle activities in the Church setting. CMDHB has funded several church based health programmes in the Counties Manukau area since 2000. However, health outcomes have been difficult to achieve for various reasons including challenges in developing capacity, supporting infrastructure, monitoring and reporting and ensuring sustainability. This issue highlighted the need for CMDHB to review the process and organisation of church based health service delivery which resulted in the replacement of these programmes with the LotuMoui programme. Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 7

LOTUMOUI PROGRAMME FRAMEWORK 3.0 LotuMoui Programme Framework The LotuMoui programme (LotuMoui) reflects CMDHB s shared vision to work in partnership with its communities to improve the health status of Pacific peoples. Vision A vision of prosperity: To have a good safe journey that holistically encompasses physical health, material wealth, emotional security, spiritual wholeness, and the wellbeing of families and the community. Overarching Themes - Shifting paradigms and changing mindsets towards healthier living - Healing and wholeness for Pacific peoples - Working collectively towards a shared vision of health and prosperity Goal Build healthier church environments Objectives 1. Improve food and nutrition practices 2. Increase physical activity levels 3. Promote healthier weight 4. Reduce smoking prevalence 5. Improve engagement with health systems 6. Implement community education modules Physical activity session at the Otara Samoan Methodist Church. 8 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

3.1 Programme Logic Approximately 80% of Pacific peoples in Counties Manukau are either overweight or obese while around 1 in 4 smoke. Additionally, between 80 to 90% of Pacific peoples reside in highly deprived areas. These factors place Pacific peoples at increased risk of ill health in particular, diabetes, cardiovascular disease, gout, cancer and arthritis. Activities aimed at alleviating this burden is reflected in Objectives 1 4. The intention of Objective 5 is to support the transfer of information, knowledge and empowerment to Pacific peoples by removing as many barriers for Pacific peoples to access health care information and services. This will be undertaken through a formal process of engagement to ensure that appropriate processes, protocols and practices are applied. Objective 6 demonstrates the capacity for LotuMoui to be flexible and responsive to topical issues and initiatives which may arise from time to time. For example, the introduction of new vaccination schedules or community preparation planning for pandemics. This programme also allows for new learnings such as those acquired from the Pacific diabetes modelling project to drive community health promotion and obesity prevention activities using the LotuMoui framework. (Figure 1) Figure 1: LotuMoui Programme Logic Components Resources Activities Outputs Impact (up to 2 years) Outcome (2to5years) Goal long term (5 to 20 years) Sustained community level changesand programmes Food and Nutrition module ARPHS NHF/LBD CMDHB Training Certificate Policy Number of: Activities Participants Resourcesdev. Policiesdeveloped. _Knowledge /awareness _intake fruitsand veges. _Healthier food and nutrition practices _BMI /Body fat _Food & nutrition policy Improved Food and Nutrition practices Build Healthier Church Environments Physical Activity module SPARC NHF/LBD CMDHB Training Certificate Policy Number of: Activities Participants Resourcesdev. Policiesdeveloped _Knowledge /awareness _Physical activity _Healthier physical activity practices _BMI /Body fat _Physical activitypolicy Increased Physical activity levels Andimprove thehealthandwellbeing Healthier Weight module NZGG NHF/LBD CMDHB Training Certificate Policy Number of: Activities Participants Resourcesdev. Policiesdeveloped _Knowledge /awareness _R isk assessment _Healthier weight management practices _BMI /Body fat _Healthier weight policy Healthier weight promoted of church and Pacific communities Smoking Cessation module ARPHS NHF CMDHB Training Certificate Policy Number of: Activities Participants Resourcesdev. Policiesdeveloped _Knowledge /awareness _Quit smoking _Smokefree environ. _Smoking prevalence _Smokefree churches R educe smoking prevalence Long termgoals - health indicators : Reduced hospital admissions Reduced DNArates Reduced hospitalstay Improved qualityof life healthywith disease Engagement with health Systems Primary Care LBD CMDHB Plan and conduct : MinistersForum Health Committee Fono Number of: Meetings Participants Newsletters Policiesapproved _Knowledge /awareness _Healthier church policies _Champions for healthier change _Partnershipsand relationships Improve engagement with health systems Reduced incidence of : Obesity Diabetes Cardiovascular disease Cancer Gout Arthritis Community Education modules CMDHB Training (Certificate ) Policy Number of: Activities Participants Resourcesdev. Policiesdeveloped _Knowledge /awareness _Healthier behavioural change _Healthier practices _Healthier church policies Implement community education moduless Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 9

PROGRAMME ACCOUNTABILITIES AND RESPONSIBILITIES 4.0 Programme Accountabilities and Responsibilities The LotuMoui programme will be implemented by the Pacific Health Team with accountabilities and reporting lines to the Ministers Forum and CMDHB management and governance. CMDHB Board Pacific Health Advisory Committee Chief Executive General Manager Pacific Tupu Ola Moui Tupu Ola Moui Outcome 1 Improve Pacific c o mmu n ity h e alth an d wellbeing Church Ministers Foru m Programme Manager Imple me n t Lo tu M o u i to bu ild h e alth ie r church environments Improve Pacific child and youth health Church Health Committees Community Development Officer Improve Food and Nu trition practices Promote healthier Pacific family e n viron me n ts for patie n ts w ith h igh health needs Improve the management of priority conditions for Pacific populations Pacific Health Team Increase physical activity levels Promote healthier cultural practices Reduce health In e qu alitie s fo r P ac ific peoples Promote healthier weight Improve the capacity Reduce smoking prevalence of the Health Sector deliver quality services to pacific populations Improve engagement with health systems Improve sector re s pon s ive n e s s to individual and family need Implement community education modules Figure 2: LotuMoui Accountabilities and Responsibilities 10 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE PROGRAMME LINKAGES 5.0 Programme Linkages New Zealand has made significant progress in the primary care sector with the recent establishment of Primary Health Organisations (PHO) and policy that encourages closer links between health providers and their community. This work has occurred within the District Health Board environment with particular guidance from the Primary Health Care Strategy and also the Pacific Health and Disability Action Plan. 5.1 Counties Manukau District Health Board At a District level, community participation and engagement continues to progress. The CMDHB District Strategic Plan(2005) articulates six health outcomes: 1 Improve community wellbeing 2 Improve child and youth health 3 Reduce the incidence and impact of priority conditions 4 Reduce inequalities of health status 5 Improve health sector responsiveness to individual and family/whanau need 6 Improve the capacity of the health sector to deliver quality services 5.2 Tupu Ola Moui The CMDHB Tupu Ola Moui - Pacific Health and Disability Action Plan (Tupu Ola Moui) is aligned to the CMDHB DSP (2005) and informs much of the work that the Pacific Health Team will undertake beginning 2006 though to 2010. The first Health Outcome sought by Tupu Ola Moui is: To improve Pacific community health and wellbeing There are three goals: 1. Implement LotuMoui to build healthier church environments 2. Promote healthier Pacific family environments for people with high health needs 3. Promote healthier cultural practices 5.3 Let s Beat Diabetes Programme (LBD) The Lets Beat Diabetes (LBD) is a District-wide initiative that comprises ten distinct but interrelated action areas aimed at preventing and/or managing Type 2 Diabetes Mellitus. The LotuMoui programme has strong linkages with the LBD work programme for 2006/07 particularly in relation to the implementation of health promotion activities in the Pacific community and Pacific early childhood centers. These are summarised in Table 1. Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 11

Table 1: LotuMoui Programme Linkages to Lets Beat Diabetes Programme Action Area Linkage to LotuMoui 1. Supporting Community Leadership and Action Action Area 1.1 Community Action Fund Action Area 1.4 Supporting Pacific churches to develop and implement nutrition and physical activity initiatives. Action Area 1.5 Empowering self-identified and community identified leaders and organisations. Because the funding for the LotuMoui Grant Scheme has been utilised to capacity, funding from the CAF will be used for additional churches wanting to implement their activities. Pacific Health Team is developing a nutrition education course for LotuMoui churches that will also be accessible to ethnic specific groups. Minister s Forum will have Diabetes on its agenda for discussion. 5. Strengthening Health Promotion coordination and activity Action Area 5.4 Improving communications resources for Diabetes for use in health promotion and primary care. Diabetes / healthy lifestyle toolkits to be developed as part of LotuMoui. 7. Developing a Schools Accord to ensure children are fit, healthy and ready to learn Action Area 7.2 Supporting Pacific Language Nests to enhance or develop and implement nutrition guidelines. Resources developed will be utilised with LotuMoui Health Committees and Sunday Schools to support nutrition education for Pacific children. 8. Supporting Primary Care-based prevention and early intervention Action Area 8.1 Diabetes management (SME) To be developed by the CMDHB SME team and made available to LotuMoui churches. 5.4 Other Organisations A range of organisations will assist in the planning and implementation of some of the LotuMoui activities such as, the Auckland Regional Public Health Service, Sport and Recreation New Zealand (SPARC), New Zealand Guidelines Group (NZGGG), National Heart Foundation (NHF), and the Pacific Islands Heartbeat (PIH), 12 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE PARTNERSHIPS AND RELATIONSHIPS 6.0 Partnerships and Relationships The success of LotuMoui relies on the strengthening of partnerships between the Pacific churches and CMDHB within a supportive and collaborative environment. This will include regular meetings and/or forums to allow Church ministers and health committee to discuss, debate, feedback on progress and decide on the direction of the LotuMoui programme. Some of these activities are: 6.1 Biannual Symposium As part of the LotuMoui Programme, a biannual symposium will be held with Pacific church communities in Counties Manukau. The purpose of having biannual symposiums is to bring the Pacific church community together to discuss key health issues pertaining to Pacific peoples, and to share information and key learnings from the implementation of LotuMoui activities. The inaugural LotuMoui Symposium (2004) saw over 400 people attend both days, with a range of workshops held as well as ethnic specific forums and denomination breakout sessions. The second symposium will occur in November 2006. 6.2 LotuMoui Ministers Forum In preparation for the first LotuMoui symposium, a steering committee consisting of Church ministers from various denominations and Pacific ethnic groups, assisted in the planning and implementation of the early phase of the LotuMoui programme. This steering committee recommended the need for the group to be more inclusive of other church ministers and denominations resulting in the establishment of the LotuMoui Ministers Forum. This Forum now serves as the formal channel for communicating and engaging with Pacific church ministers in Counties Manukau and is held 6 monthly. 6.3 Health Committee Fono To ensure that Pacific health committees are well supported to implement their health programmes, CMDHB will facilitate quarterly meetings with health committee to disseminate information back to Pacific churches and to provide a network for churches to share information about how their healthy lifestyle activities are progressing. Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 13

LOTUMOUI GRANT SCHEME 7.0 LotuMoui Programme Grant Scheme The Pasefika LotuMoui Grant was launched at the Symposium in 2004. The purpose of the grant was to support Pacific churches to kick-start healthy lifestyle activities that would contribute to improved health outcomes for congregational. The Programme made available two levels of funding at $3,000 and $5,000. Around 50 Pacific churches within the Counties Manukau District have accessed this funding and are at various stages in implementing their activities. The key priorities identified by Pacific churches in their activity plans were as follows: Exercise Programmes Diet and nutrition education Weight reduction Training of Church to deliver own programmes Information on disease prevention, body awareness, disease states Quit Smoking Programmes As part of the programme grant scheme, Pacific churches are required to submit 6-monthly monitoring reports on progress of programme implementation and financial spend. This information will be stored on a database and made available for the evaluation of LotuMoui. Cook Island Participants at the Kai Lelei Community Nutrition Session April 2006. 14 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE LOTUMOUI EVALUATION FRAMEWORK 8.0 LotuMoui Evaluation Framework The LotuMoui evaluation framework is based on the principles of the United States Centers for Disease Control and Prevention (CDC) framework for the evaluation of public health programmes (1999). (Figure 3) Figure 3: LotuMoui Evaluation Framework Steps Engage stakeholders LotuMoui, SOPH, Other Key stakeholders Ensure use and share lessons learned Findings and recommendations inform policy and disseminated appropriately to all stakeholders Standards Describe the programme Develop a Programme logic for LotuMoui Justify conclusions Appropriate interpretation of findings to reflect Pacific values and beliefs Utility Feasibility Propriety Accuracy Focus the evaluation design Design to reflect to meet the information needs of stakeholders Gather credible evidence Use of appropriate indicators and high quality of data Adapted from US CDC Framework The LotuMoui programme logic (Figure 1) identifies key inputs and outputs (process, impact and outcome measures) to evaluate. Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 15

8.1 Purpose of Evaluation Aim To evaluate the effectiveness of the LotuMoui programme for Pacific communities (for Churches registered within the LotuMoui programme). Essentially, this evaluation seeks to: 1. Gain insight 2. Change practice 3. Assess effects, and 4. Affect participants (US CDC framework) There will be particular emphasis to address: 1. The impact of LotuMoui on indicators of health status 2. The effectiveness of LotuMoui to engage the Pacific community 3. To gather qualitative reflections of LotuMoui participants in relation to CMDHB activities and the penetration of key messages to influence healthy behavioural change Method Evaluation design is almost finalised and will be undertaken by external evaluators from the School of Population Health, University of Auckland, with possible oversight provided by other experts in this field. Both quantitative and qualitative data will be collected and ethics applications processed by the University team. The LotuMoui programme logic also assists with identifying key measures linking programme activities to funding streams and monitoring reports for internal evaluation. Evaluation is to continue at least into the third year of implementation of the LotuMoui programme. 16 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE LOTUMOUI PROGRAMME KEY PERFORMANCE INDICATORS 9.0 LotuMoui Programme Key Performance Indicators The LotuMoui programme sits within the context of CMDHB s vision and values for Pacific peoples and communities with commitment to strengthen collaborative community partnerships. This is reflected in the shared vision, overarching themes, goals and objectives for LotuMoui and provides a pathway for ensuring continuous partnerships between CMDHB and Pacific churches. LotuMoui provides an exciting opportunity to empower Pacific peoples and communities to take control of and determine their health outcomes. Overall, there are approximately 50 churches with a combined population of around 15,000 Pacific people registered. This is almost a quarter of the estimated population of Pacific peoples in Counties Manukau and demonstrates the potential reach of this programme particularly for future health initiatives. More importantly, it highlights the requirement to ensure that relationships are strengthened and maintained and that a robust infrastructure is established to ensure support the planning and implementation of programme activities. 9.1 Previous LotuMoui Programme Work (2004 2005) It is important to highlight the work undertaken in 2004 and 2005 prior to the completion of this Operations plan. (Table 2) Table 2: LotuMoui milestones achieved (2004-2005) Milestone Date achieved Pasefika LotuMoui Health Symposium December 2004 LotuMoui Grants Scheme established December 2004 Launch of LotuMoui programmes, LotuMoui symposium document and July 2005 smokefree churches toolkit Smokefree Health Promotion training with Pacific Islands Heart Beat for October 2005 LotuMoui Churches completed Health Committee Fono Monitoring and Governance Training November 2005 Pacific Church Ministers Forum established November 2005 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 17

KEY PERFORMANCE INDICATORS Outcome One: Improve Food and Nutrition Practices Goal Commitments 2005/2006 Pacific Churches in Counties Manukau are implementing healthier food and nutrition practices for Pacific families. By 1st July 2006, CMDHB will provide all LotuMoui churches a food and nutrition toolkit to support the development and practice of healthier food and nutrition practices. 25 LotuMoui churches participating (10,000 in total) By 1st July 2008, all LotuMoui churches will implement a healthy food and nutrition policy. Pacific Churches in Counties Manukau will have increased knowledge and awareness on healthier food and nutrition practices By 1st July 2006, CMDHB will make available a food and nutrition education module targeting Pacific people. By 30 June 2010, all LotuMoui church health committee will attend the food and nutrition education module. Pacific Churches in Counties Manukau will have increased access to specialised training in food and nutrition. By 1st July 2006, CMDHB will support LotuMoui churches to begin specialised training as part of the Pacific Island Heartbeat Certificate in Nutrition training. By 30th June 2010, all LotuMoui churches will have at least one congregation member who has a Certificate in Nutrition. 2006/2007 50 LotuMoui churches participating (20,000 in total) Target 2007/2008 80 LotuMoui churches participating (30,000 in total) 2008/2009-2009/2010 90% LotuMoui church participation 18 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE Outcome Two: Increase Physical Activity Levels Goal Commitments Pacific Churches in Counties Manukau promote increased physical activity levels for Pacific families. By 1st March 2007, CMDHB will provide LotuMoui churches with a physical activity toolkit to support the development of regular physical activity policies and programmes. By 1st July 2008, all LotuMoui churches will have in place a physical regular activity schedule for their congregation. Pacific Churches in Counties Manukau will have increased knowledge and awareness on healthier, regular physical activity practices. By 1st March 2007, CMDHB will make available a physical activity education module targeting Pacific people. By 30th June 2010, all LotuMoui church health committee will attend the physical education module. Pacific Churches in Counties Manukau will have increased access to specialised training in physical activity. By 30th June 2007, CMDHB will support LotuMoui churches to begin specialised physical activity training at a nominated training facility. By 30th June 2010, all LotuMoui churches will have at least one congregation member who has completed specialised physical activity training. 2005/2006 2006/2007 50 LotuMoui churches participating (20,000 in total) Target 2007/2008 80 LotuMoui churches participating (30,000 in total) 2008/2009-2009/2010 90% LotuMoui church participation Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 19

Outcome Three: Promote Healthier Weight Goal Commitments Pacific Churches in Counties Manukau promote healthier weight measurements for Pacific families. By 1st July 2006, CMDHB will support LotuMoui churches to promote healthier weight programmes by providing height, weight and waist measuring equipment. By 1st July 2008, all LotuMoui churches will record height, weight and waist measurements as part of their programme monitoring Increase access to knowledge around healthier weight measurements and cardiovascular risk assessment. By 1st July 2008 CMDHB will make available a healthier weight and cardiovascular risk assessment education module targeting Pacific people. By 30th June 2010, all LotuMoui church health committee will attend the healthier weight and cardiovascular risk assessment education module. Increase access to specialised training in healthier weight measurements and cardiovascular risk assessment. By 1st December 2007, CMDHB will support LotuMoui churches to begin specialised training in the use and application of the NZGG cardiovascular risk assessment tool. By 30th June 2010, LotuMoui Churches will each have at least one congregation member who has completed specialised cardiovascular risk assessment training. 2005/06 2006/07 Target 2007/08 80 LotuMoui churches participating (30,000 in total) 2008/09-2009/10 90% LotuMoui church participation 20 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE Outcome Four: Reduce Smoking Prevalence Goal Commitments Pacific Church buildings and grounds in Counties Manukau are smokefree. By 1st July 2006, CMDHB will support LotuMoui churches to promote smokefree environments by providing smokefree signage and smokefree toolkits. By 1st December 2006, all LotuMoui Churches will have a smokefree church building and grounds policy and signage in place. Increase access to knowledge and awareness around smokefree environments. By 1st July 2007 CMDHB will make available a smokefree environments education module targeting Pacific people. By 30th June 2010, all LotuMoui church health committee will attend the smokefree environments education module. Increase access to specialised training in smoking cessation. By 1st December 2008, CMDHB will support LotuMoui churches to begin specialised training in smokiefree health promotion. By 30th June 2010, LotuMoui Churches will each have at least one congregation member who has completed specialised smoking cessation training. 2005/2006 25 LotuMoui churches participating (10,000 in total) 2006/2007 50 LotuMoui churches participating (20,000 in total) Target 2007/2008 80 LotuMoui churches participating (30,000 in total) 2008/2009-2009/2010 90% LotuMoui church participation Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 21

Outcome Five: Improve Engagement with Health Systems Goal Commitments 2005/06 Culturally acceptable and appropriate channels of communication will be in place between Pacific Churches in Counties Manukau and CMDHB. Biannually, CMDHB will hold a health SYMPOSIUM with Pacific Churches in the Counties Manukau District. LotuMoui churches will encourage of their congregations and denomination to attend the biannual health symposium. Six monthly, CMDHB will convene a FORUM with church ministers to discuss key health issues for Pacific people. Six Monthly Wherever possible, LotuMoui church ministers will make themselves available to participate at the Minister s forum., CMDHB will convene FONO with LotuMoui Health Committee to support them with the implementation of their healthy lifestyle programmes. Health Committee will be present at quarterly FONO to support the implementation of the LotuMoui health programme., CMDHB will disseminate a newsletter to update the Pacific community on developments in the health sector. Will support a Summit to discuss the LotuMoui Evaluation and future direction of the programme. 2006/07 Biannual Symposium Six Monthly Target 2007/08 Six Monthly 2008/09 Biannual Symposium Six Monthly 2009/10 Six Monthly Summit 22 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE Outcome Six: Implement Community Education Modules Goal Commitments 2005/06 LotuMoui Health Committees have appropriate infrastructure and reporting mechanisms in place. CMDHB will make available governance and monitoring training to Pacific Health Committees. Annual LotuMoui churches will ensure that Health Committee attend at least one governance and monitoring workshop. LotuMoui churches in Counties Manukau have increased knowledge and skills on first aid and basic life support courses. By 1st Decmber 2006, CMDHB will facilitate and support access to first aid and basic life support courses for LotuMoui churches in Counties Manukau. By 30th June 2010, all LotuMoui churches will have at least two congregation who are trained in first aid and basic life support. LotuMoui churches will have increased knowledge and awareness of priority health conditions and how to prevent and/or manage these. CMDHB will facilitate linkages between providers and LotuMoui churches to ensure that churches have access to up to date and accurate information on the following priority conditions: -Diabetes -CVD -Cancer -Mental Health -Reproductive Heath LotuMoui churches will work with CMDHB to ensure that they have access to specialist medical information on priority conditions. LotuMoui Churches have increased knowledge and awareness of health priorities and health services for Pacific children and young people. By 1st January 2008, CMDHB will support LotuMoui churches to have access to information on priority child health issues and child health services in the Counties Manukau District. By 30th June 2008, all LotuMoui churches will promote healthier lifestyle activities targeting Pacific children as part of their LotuMoui programmes. 2006/07 Annual 20 LotuMoui churches participating (10,000 in total) Target 2007/08 Annual 50 LotuMoui churches participating (20,000 in total) 2008/09 Annual 80 LotuMoui churches participating (30,000 in total) 2009/10 Annual 90% LotuMoui church participation Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 23

Outcome Six: Implement Community Education Modules - continued Goal Commitments 2005/06 LotuMoui Churches have increased knowledge and awareness of healthier lifestyles for Pacific children and young people. By 1st December 2006, CMDHB will scope the establishment of a one stop shop for Pacific young people in Counties Manukau and will ensure that LotuMoui churches are consulted on the service development. By 1st December 2006, LotuMoui churches will provide advice on the development of a one stop shop concept for Pacific young people in Counties Manukau. CMDHB By 1st August 2006, CMDHB will make available resources for Sunday schools of LotuMoui churches to promote healthy lifestyle activities. This will include information on better oral health practices for children. LotuMoui Churches By 31st March 2008, LotuMoui churches will ensure that church attend training on implementing healthy lifestyle activities appropriate for Pacific children and their families in church settings. LotuMoui churches will have increased knowledge and awareness relating to mental health priorities and services including other cross-sectoral issues that impact on health. CMDHB By 31st December 2008, CMDHB will hold a forum with LotuMoui churches to discuss issues and solutions, to address the burden of mental illness among Pacific people. LotuMoui Churches By 31st December 2008, LotuMoui churches will ensure that their are available to participate in a Mental health forum. CMDHB By 31st December 2008, CMDHB will hold a forum with LotuMoui churches to discuss issues, and disseminate information on the harmful effects of alcohol, drugs and other addictions (including gambling). LotuMoui Churches By 31st December 2008, LotuMoui churches will participate in health education workshops aimed at increasing community knowledge about alcohol, drugs and addictions. CMDHB By 31st December 2008, CMDHB will make available education modules to increase knowledge and awareness on the prevention of family violence in Pacific communities. LotuMoui Churches By 31st December 2008, LotuMoui churches will ensure that representatives attend a forum to discuss key issues pertaining to family violence for Pacific peoples. LotuMoui Churches have increased knowledge and awareness of health priorities and health services for Pacific families with disabilities. CMDHB By 31st March 2009, CMDHB will work with LotuMoui churches to ensure that their congregations have access to information, education and support on how to care for older family and with disabilities. LotuMoui Churches By 31st March 2009, LotuMoui churches will encourage their congregation who are affected by disability issues or who cares for older family, to attend a workshop on disability services and supports available in Counties Manukau. 2006/07 Target 2007/08 2008/09 2009/10 24 Pasefika LotuMoui Health Programme - Operations Plan 2006-2010

HEADLINE Living longer, healthier and prosperous lives. Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 25

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HEADLINE Pasefika LotuMoui Health Programme - Operations Plan 2006-2010 27