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|a Background: Pacific men's health, and particularly the health of Pacific fathers, is a significant health priority which in recent years has become a largely neglected yet important area for health researchers and policy makers in New Zealand to consider. Moreover, it is being increasingly recognised that fathers and their involvement have a significant impact on the development and well-being of their children; both positively and negatively. Aims: The overarching study aim is to identify how Pacific fathers impact and influence the development of their children. Two major components are used: Phase I, a quantitative component which seeks to: (1) Identify and investigate key social, behavioural, and psychological aspects of health and fathering amongst Pacific fathers using data collected from the Pacific Islands Families (PIF) Study. Phase II, a qualitative component, informed by the quantitative component, and which seeks to: (2) Examine how these key aspects influence the fathering behaviours and practices among Samoan and Cook Islands fathers; and, (3) Explore the ways that these aspects and fathering behaviours or practices of Samoan and Cook Islands fathers shape and influence the development of their children. Methods: To achieve aim (1), a secondary data analysis of key social, behavioural, and psychological measures of health among a cohort of Pacific fathers in the PIF Study was undertaken. Pacific fathers of a cohort of Pacific infants born at a large tertiary hospital in South Auckland in 2000 were interviewed at 1-year, 2-years and 6-years postpartum. The specific choices of variables investigated were informed by consultation with Pacific stakeholders and a review of the literature. To achieve aims (2) and (3), focus group interviews were conducted by the doctoral candidate with a subset of Samoan and Cook Islands fathers from the overall cohort of PIF fathers. These interviews were conducted to examine how the aspects of health investigated in Phase I of this research, influence the fathering practices of these fathers. The interviews also examined how these fathering practices influence the progress and development of their children. Informed by the results of Phase I, discussions during the focus groups and interviews with Pacific fathers included subjects such as the influence of their own childhood upbringing, religious involvement, the influence of culture and acculturation, risk-taking behaviours such as tobacco smoking, and the impact of these influences on the fathering behaviours of participants. The Fonofale model was used as a Pacific framework for developing the questions for the focus group interviews, and elements of the Talanoa method, were also incorporated to provide a Pacific-centred approach for interviewing participants. Using a thematic analysis methodology, the focus group transcripts were examined and analysed to identify the dominant themes articulated by the fathers. In doing so, the analysis identified how these themes are made apparent in the participants fathering practices, and the subsequent child outcomes that are a result. Results: At the 1-year, 2-years, and 6-years interview, 825 (83%), 757 (81%), and 591 (64%) of eligible fathers consented and completed the interview, respectively. Within our cohort of participant Pacific fathers, the rates of mental health symptomatic indications were low. However, there is a significant increasing trend over time, from 3.9% at the 1-year phase to 6.7% and 9.8% in the 2-years and 6-years postpartum phases respectively. Pacific fathers who were regular smokers, unemployed, separated or single, or were of Cook Islands and Tongan ethnicity, had a significantly increased likelihood of being symptomatic for potential psychological disorder. Smoking rates for Pacific fathers in this study (40.3%) were relatively high compared to results (35% for Pacific males) from other tobacco surveys. Moreover, fathers who had lower Pacific cultural alignment, no formal educational qualifications, and drank alcohol at least once a month were significantly associated with being a current smoker. Pacific fathers that had stronger alignment or affinity with their traditional culture had a decreased likelihood of being a current smoker. Pacific fathers in the study reported high levels of involvement with their children, and increased father involvement was significantly associated with a lower risk of child behaviour problems. Pacific fathers with less affinity with their traditional Pacific culture exhibited lower levels of father involvement, compared to fathers with strong affinity with their Pacific culture. In terms of the qualitative results, 10 Samoan fathers and 7 Cook Islands fathers participated in focus group or individual interviews. The qualitative findings demonstrated that Samoan and Cook Islands fathers in this study face numerous challenges in raising their children. Overall fathers described themselves as eager and enthusiastic to be great, highly competent, and involved fathers, despite some of the challenges with migration and acculturation which they may face. The fathers also identified their inability to spend more time with their children as a major challenge, and provisions concerning flexible work hours, and adequate information and fathering support services may help to address this. Conclusion: Findings from this study suggest that health issues such as mental well-being and smoking are playing an increasingly significant part in the lives of the Pacific fathers. Efforts to curb the negative impacts of these health issues will be beneficial for the well-being of both Pacific fathers and their families. As suggested by the participant fathers, the implementation of strategies designed to accommodate their needs concerning flexible work hours, and the availability of appropriate support services, are likely to be successful in increasing effective father involvement and engagement for Pacific fathers, and lead to improved outcomes for Pacific children. Findings also highlight the influence of acculturation and culture on the health and fathering practices of Pacific fathers in New Zealand. Pacific fathers that maintain a strong affinity with their traditional Pacific culture generally fared better across all domains investigated, excluding father involvement. In addition, historical experiences or exposure to recent migration and relocation to New Zealand appears to influence certain culture-specific fathering practices, with many participants attempting to modify their fathering to adapt to their new homeland. These findings emphasize the need to develop empirically based and considered ways to approach these complex phenomena.
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