‘Not a short fix’: a participatory approach to exploring challenges and opportunities for rheumatic fever prevention with Pacific people in South Auckland, New Zealand

Objectives: Pacific people in New Zealand experience the greatest burden of rheumatic fever compared to other ethnic groups. Despite significant investment into rheumatic fever prevention, inequities remain. This qualitative study aimed to explore Pacific perspectives on the challenges and opportunities for rheumatic fever prevention, ultimately with a view to co-designing an innovative intervention. Design: Using the Fa’afaletui model and a community-based participatory approach, two focus group workshops were conducted. Fourteen Pacific participants aged 20–80 years took part in two workshops. Notes and transcripts were analysed via a reflexive thematic analysis approach. Results: Thematic analyses identified four key themes: Pacific people’s experiences of rheumatic fever, access to healthcare, understanding and awareness of rheumatic fever, and the need for an innovative, Pacific-led intervention. Key intervention opportunities include social media-based strategies, increasing community access points for screening and ensuring Pacific patients are aware of and supported to utilise available services. Conclusion: This study will contribute to the implementation and evaluation of a co-designed intervention, with the hope that it is more appropriate and impactful for Pacific communities in NZ. The findings also have broader implications, emphasising the need for more community-led and informed approaches across health equity research, practice and policies.