Sarah-Jane Paine’s research while affiliated with University of Auckland and other places

What is this page?


This page lists works of an author who doesn't have a ResearchGate profile or hasn't added the works to their profile yet. It is automatically generated from public (personal) data to further our legitimate goal of comprehensive and accurate scientific recordkeeping. If you are this author and want this page removed, please let us know.

Publications (97)


Using Days Alive and Out of Hospital to measure inequities and explore pathways through which inequities emerge after coronary artery bypass grafting in Aotearoa New Zealand: a secondary data analysis using a retrospective cohort
  • Article

February 2025

·

2 Reads

BMJ Open

Luke Boyle

·

·

Sarah-Jane Paine

·

[...]

·

Alan Forbes Merry

Objectives To describe the use of days alive and out of hospital (DAOH) as a sensitive measure of equity of outcomes after surgery by comparing outcomes after a coronary artery bypass grafts (CABG) operation between Māori and non-Māori patients in Aotearoa New Zealand. Primary and secondary outcome measures We calculated unadjusted and risk-adjusted DAOH scores at three time points (30, 90 and 365 days) and compare values between Māori and non-Māori using data from the New Zealand Ministry of Health (MoH) over a 9 year period. To assess the impact of different risk factors on differences in outcome, we risk-adjust for multiple factors individually and collectively, to begin to elucidate possible pathways for equity gaps. Results After our comparisons, Māori patients experienced fewer unadjusted DAOH 90 at seven out of nine deciles. After risk-adjustment, the differences ranged from 8 days to 0 days when considering different risk factors. The equity gap was widest at the lower deciles and was most reduced after adjusting for the Measuring Multi Morbidity (M3) score. The equity gap widened as the time period extended from 30 to 90 to 365 days. Conclusion Māori patients who underwent a CABG operation experienced fewer DAOH than non-Māori patients even after adjusting for multiple possible explanatory variables, and this difference increased over time postoperatively. Importantly, our results illustrate the value of DAOH as a sophisticated outcome metric that can reflect the complex and accumulative impacts of disadvantage and discrimination faced by Indigenous peoples both here in New Zealand and worldwide. It has considerable potential to increase our understanding of how and where inequities arise on the entire patient journey.



O047 Associations between adolescent sleep, mental health and mental health inequities in Aotearoa New Zealand: Findings from the Youth19 Survey

November 2024

·

5 Reads

SLEEP Advances

Introduction Sleep and mental health are closely linked. In Aotearoa New Zealand, poor mental health is more prevalent for Māori and Pacific adolescents, who are disproportionately impacted by social and sleep inequities, raising the question of whether sleep contributes to adolescent mental health inequities. We aimed to (1) examine associations between sleep and mental health and (2) explore the contribution of sleep to associations between ethnicity and mental health, by conducting secondary analyses of cross-sectional Youth19 Survey data. Methods Multivariable logistic regression models were concurrently and sequentially adjusted for social determinants of health (e.g., housing deprivation), covariates (e.g., school year) and sleep (sleep duration; bedtime; waketime) to investigate independent associations between sleep and mental health (anxiety symptoms; depressive symptoms; attempted suicide) and the contribution of sleep to mental health inequities respectively. Results The sample comprised 7,721 12-18 year-olds. Independent associations (OR [95% CI]) were found between short sleep and anxiety (1.24 [1.06-1.46]) and depressive (1.75 [1.31-2.32]) symptoms; bedtime after midnight and attempted suicide (1.93 [1.13-3.30]); and waketime before 6am and attempted suicide (1.71 [1.12-2.62]). Māori and Pacific adolescents had increased odds of all mental health measures. Adjusting for social determinants and covariates fully attenuated these relationships for anxiety and depressive symptoms and partially for attempted suicide. Further adjustment for sleep reduced point estimates, although the inequity in attempted suicide remained for Pacific adolescents. Discussion Sleep may be a pathway linking social disadvantage to poor adolescent mental health. Sleep and social inequities must be addressed to support equitable adolescent mental health.


P023 A Longitudinal Analysis of the Sleep Health of Neurodivergent and Neurotypical Children in Aotearoa

November 2024

·

2 Reads

SLEEP Advances

Healthy sleep promotes physical, mental and neurobehavioural well-being, however it is widely acknowledged that neurodivergent children often experience sleep difficulties. We aimed to investigate the sleep health of neurodivergent (ND) children and neurotypical (NT) children in the Growing Up in New Zealand study over time. Methods Sleep duration, night wakings, and maternally reported sleep problems at 45-months, 2-years and 8-years were examined. Children were categorised into four groups based on Age-8 neurotype (ND/NT) and ethnicity (Māori/non-Māori) data and analysed using one-way ANOVA and chi square. Results Eight-year-old ND Māori had shorter average (mean [SD] hours) sleep (9.52 [1.30]) than NT non-Māori (9.76 [1.15], p=.016). At 2- and 8-years, a smaller proportion (% [95% CI]) of ND Māori (2-years 79.5% [72.6-85.2]; 8-years 77.0% [69.8-83.2]) and NT Māori (2-years 83.2% [80.6-85.6]; 8-years 80.0% [77.2-82.8]) had recommended sleep durations compared to NT non-Māori (2-years 87.2% [86.0-88.3]; 8- years 86.1% [84.9-87.3]). Similar patterns were observed for the other sleep measures, whereby a smaller proportion of ND children had an ‘appropriate’ number of night awakenings at 45-months and 8-years (Māori and non-Māori) compared to NT non-Māori. A larger proportion of ND children (Māori and non-Māori) had problematic sleep at 45-months and 8-years than NT children (Māori and non-Māori). This study adds to our knowledge of differences in sleep between Māori and non-Māori children, and the timeframe for the emergence of differences in sleep between ND and NT children.


Maternal depressive symptoms in and beyond the perinatal period: Associations with infant and preschooler sleep

October 2024

·

19 Reads

Sleep

Study Objectives (1) To describe sleep in infancy and early childhood among children born to mothers with and without clinically significant depressive symptoms, and (2) to explore the relationships between maternal depressive symptoms and sleep patterns and problems during infancy and early childhood. Methods Secondary analysis of longitudinal data from the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study. Data were collected in pregnancy (T1), 12 weeks postpartum (T2), and 3 years post-birth (T3). Participants were 262 Māori and 594 non-Māori mother–child dyads. Chi-square and independent t-tests measured bivariate associations between maternal mood (T1, T2, and T3) and child sleep characteristics (T2 and T3). Binary logistic regression models examined longitudinal and concurrent associations between maternal depressive symptoms and infant and preschooler sleep. Adjusted models accounted for key socio-demographic variables, as well as infant sleep variables in preschooler models. Results Bivariate associations were found between prior and concurrent depressive symptomology and many of the infant and preschooler sleep outcomes. In adjusted models, prenatal depressive symptoms remained independently associated with shorter-than-recommended sleep durations in preschoolers. In these models, concurrent depression was also associated with night waking, night LSRSP, and perceived sleep problems at 12 weeks postpartum, and CSHQ-determined and perceived sleep problems at 3 years post-birth. Conclusions Longitudinal and cross-sectional associations were found between maternal depressive symptoms and child sleep. Sleep appears to be one pathway by which maternal depression confers risk for suboptimal child health outcomes. Findings support the need for earlier and better maternal mental health services.


Validity of the Multigroup Ethnic Identity Measure for Māori, Pacific, Asian & European adolescents

October 2024

·

7 Reads

The European Journal of Public Health

Background Ethnic identity is important for positive health and wellbeing outcomes, especially for Indigenous youth and adolescents from minoritised ethnic groups. The Multigroup Ethnic Identity Measure (MEIM) is widely used to examine ethnic identity as a general phenomenon across ethnic groups. However, evidence regarding its validity for adolescents from different ethnic backgrounds is mainly limited to the US context. This study investigated psychometric properties of the MEIM, for the first time, within a large ethnically diverse population-based sample in New Zealand. Methods We used data from the Growing Up in New Zealand study. Participants were 4500 12-year-olds and included 22.4% Māori (the Indigenous people of New Zealand), 16.7% Pacific, 14.8% Asian and 51.9% European young people. 45.7% were cisgender boy, 37.4% were cisgender girl, and 16.4% were non-binary, trans or unsure. We conducted factor analysis for the 12-item MEIM. Results Confirmatory factor analysis model fit tended to be best for a solution with two factors representing two ethnic identity subcomponents of Exploration and Affirmation/Belonging. A single ‘ethnic identity’ factor showed a slightly weaker model fit. Exploratory factor analysis revealed a 2-factor structure with a slightly different item composition as compared to the original MEIM subscales. The findings were largely comparable across ethnic groups. Conclusions The MEIM appears to be a valid measure for Māori, Pacific, Asian and European young people. However, nuances may exist due to unique contexts including structural factors, societal norms and challenges, opportunities and access to cultural engagement. Ethnic identity is strongly linked to health and wellbeing including quality of life, self-esteem and life satisfaction. Therefore, we recommend acknowledging nuances of ethnic identity during an important time of development within diverse cultural contexts, by applying subscales and subgroup analyses where possible. Key messages • The Multigroup Ethnic Identity Measure is valid and appropriate to use at age 12-years among diverse ethnic groups including Māori, Pacific, Asian and European. • Nuances of ethnic identity should be acknowledged as an important factor for health and wellbeing, especially during critical times of transition for adolescents within diverse cultural contexts.


The association between trajectories of structural disadvantage and mental wellbeing for Māori youth

October 2024

·

3 Reads

The European Journal of Public Health

Background Youth mental health is a major global concern with substantial inequities for Indigenous and other young people from minoritised ethnic groups. In New Zealand, Māori, the Indigenous people, experience poorer mental health than other young people, especially those living in high deprivation. Cultural connectedness is related to positive mental wellbeing, however, its potential to buffer against the harms of structural disadvantage for young Māori mental health has not been investigated. Methods We used data from 1224 Māori young people in the longitudinal Growing Up in New Zealand study. Structural disadvantage measures included material hardship, deprivation, employment, residential mobility. We conducted Latent Class Analysis and Social Sequence Analysis to identify clusters and longitudinal patterns of structural disadvantage. Cultural connectedness and mental wellbeing (depression & anxiety symptoms, quality of life) were measured at age 12. Linear regression analysis was used to determine associations between structural disadvantage, cultural connectedness and mental health. Results We identified 3 trajectories of structural disadvantage for Māori youth: 21% experienced persistent high structural disadvantage, 35% intermittent high structural disadvantage and 44% persistent relatively low structural disadvantage. Few differences in mental health were found between groups. Cultural connectedness was independently associated with positive mental wellbeing, yet there was mixed evidence it might buffer the impacts of structural disadvantage on mental health. Conclusions Our results highlight the importance of policies that uphold Indigenous rights to health and address structural disadvantage as a persistent threat to Indigenous wellbeing. Our findings call for holistic, early-life, family-centred strategies and to reduce barriers to accessing support. We highlight the need for policies that enable young people to flourish in their identity and culture. Key messages • Many Māori young people experience pervasive structural disadvantage starting before they are born, persisting throughout childhood and adolescence which is an omnipresent threat to their wellbeing. • Supporting cultural connectedness for Indigenous youth is important but cannot substitute for policies addressing structural disadvantages that contribute to health inequities.


FIGURE 1 | Recruitment flow diagram.
FIGURE 2 | Confirmatory factor analysis model (N = 890).
Feel the Fear and Do It Anyway-Beliefs About Compassion Predict Care and Motivation to Help Among Healthcare Professionals
  • Article
  • Full-text available

October 2024

·

52 Reads

Journal of Clinical Nursing

Aims To develop and preliminarily validate a measure of beliefs about compassion in health care and assess whether and which beliefs may predict compassion. Design Pre‐registered cross‐sectional online survey study with a repeated‐measures vignette component. Method Exploratory and Confirmatory Factor analyses were performed on a split sample of 890 healthcare professionals in Aotearoa New Zealand (NZ). Links with fears of compassion for others, burnout, trait compassion, compassion competency and ability and self‐efficacy were used to assess convergent and divergent validity. Linear mixed model regression analyses were used to assess relationships between beliefs and compassion. In writing this report, we adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results Four‐factor structure featuring three negative (compassion as harmful, not useful, draining) and one positive (compassion is important) type of beliefs was established. Confirmatory factor analysis indicated a good fit and subscales indicated good measures of validity. Internal consistency was achieved for the subset of beliefs (harmful, not useful). Regression analyses indicated negative effects of the belief that compassion is draining on caring, motivation to help and compassion overall; negative effects of the belief that compassion is not useful on the motivation to help and a positive effect of the belief that compassion is important on caring and compassion overall. There was no effect of beliefs that compassion is harmful on compassion measures. Conclusion This report extends prior qualitative studies of beliefs about compassion in a large healthcare sample, offering a way to measure these potentially malleable factors that might be targeted in education, interventions and future research. Patient or Public Contribution The study was designed in consultation with healthcare and compassion research professionals, including substantial input from Indigenous Māori healthcare professionals.

Download

Māori Sleep Health Across the Lifespan: Scoping Review of New Zealand Research

October 2024

·

5 Reads

Indigenous communities globally experience poorer health outcomes in comparison to non-Indigenous people. This holds true for Māori, the Indigenous people of Aotearoa New Zealand and these inequities include sleep health. We aimed to collate and summarise peer reviewed literature to understand where sleep health equity gaps lay to inform policy and future research. We conducted a systematic search of widely used literature databases using keywords including “sleep” and “Māori”. Eighty seven studies provided data on Māori sleep health versus non-Māori sleep health. Inequities were identified at all life stages and over all sleep health dimensions of sleep duration, efficiency, timing, alertness, and sleep quality. Socio-economic deprivation and unemployment were associated with poorer sleep health outcomes. We concluded that a public health policy for sleep that prioritises Māori and targets long-term, sustainable achievement of sleep health equity goals is required. Future sleep health research should aim to involve Māori at all stages.



Citations (60)


... ○ The compassion beliefs scale presented in this report can be used to assess healthcare professional beliefs, identifying targets for intervention. compassion might be impacted by different factors in healthcare (Fernando, Skinner, and Consedine 2017;Pavlova et al. 2024;Reynolds et al. 2019). We treat this as an exploratory question. ...

Reference:

Feel the Fear and Do It Anyway-Beliefs About Compassion Predict Care and Motivation to Help Among Healthcare Professionals
Do I care for you more when you really need help? An experimental test of the effect of clinical urgency on compassion in health care

British Journal of Health Psychology

... Children who observe instances of racism directed at others (vicarious racism) could have an increased risk of mental health problems themselves. 6 Within healthcare and scientific realms more generally, racism is particularly incomprehensible and inexcusable as scientists are highly educated people who are expected to behave in a fair and rational manner. However, this is not always the case. ...

Caregiver experiences of racism and child mental health outcomes: cross-sectional analysis from Aotearoa New Zealand
  • Citing Article
  • August 2023

The New Zealand medical journal

... Recommendations in literature highlighted the need to continue preventative measures and implement targeted interventions for rural communities and earlier screening for children residing in lower socioeconomic areas. A greater understanding of middle ear disease and hearing loss risk factors including the fundamental determinants of ear and hearing health inequities (Curtis et al. 2023) is therefore urgently required (McCallum et al. 2015). Policy interventions that improve equitable access to the social determinants of health, could reduce risk factors for otitis media and hearing loss, increase access to interventions, and alleviate pressure on the health system. ...

Indigenous adaptation of a model for understanding the determinants of ethnic health inequities

Discover Social Science and Health

... Many learners describe losing their sense of self during medical training [8], a phenomenon that disproportionally affects women and individuals underrepresented in medicine [9][10][11][12]. Increasingly, physicians find their work environments threatening to their identities [13], contributing to lower job satisfaction and higher burnout [14,15]. It seems, therefore, that socialization into organizations with dysfunctional norms and practices is a factor contributing to physician burnout [16]. ...

Working in value-discrepant environments inhibits clinicians' ability to provide compassion and reduces well-being: A cross-sectional study

Journal of Internal Medicine

... Examining relationships between sleep inequities and well-being has also been identified as a research priority [1]. Concerningly, associations have been identified between poor sleep health and poor mental health for preschool-aged children [11] and adults [12] in NZ; however, these relationships are less well understood for school-aged children. ...

The role of sleep in health and health inequities in early childhood in Aotearoa New Zealand
  • Citing Article
  • August 2022

Journal of the Royal Society of New Zealand

... As I expanded my knowledge and engaged in regular wairua practices, such as karakia and whakawātea, I began to receive more messages via vision, which provided me with the resources, tools, and knowledge I needed to complete my research and heal my trauma. 18,44 Te Pūtake: An Origin Analysis Te Pūtake was also developed for my PhD, with its creation inspired by the Takarangi Double Spiral, a Māori art motif which visually narrates the creation of the universe. 54 There are four dimensions that comprise the IA, all of which are named after realms within Māori cosmology: Te Ao Mārama (the realm of light), Te Pō (the realm of darkness), Te Kore (the realm of infinite potential) and Te Ao Wairua (the spiritual realm). ...

‘Never-ending beginnings’: a qualitative literature review of Māori temporal ontologies

Kōtuitui New Zealand Journal of Social Sciences Online

... 2,3 PFD may particularly impact on the nurturing aspect of feeding for Māori, 3,4 and there are known barriers to accessing public health system care and support. 2,5,6 Extant literature does little to address the cost of PFD in Aotearoa. Canadian studies identified most families of children with disabilities were unable to engage in paid work to the same extent as families of typically developing children. ...

The economic cost of Indigenous child health inequities in Aotearoa New Zealand-an updated analysis for 2003-2014

The New Zealand medical journal

... There is substantial evidence indicating a lack of compliance with ethnicity protocols throughout the New Zealand health and disability system. [8][9][10] Several barriers to compliance have been mentioned, such as IT systems and the range of systems in use, the cost of changing non-compliant systems, inadequate training and support in proper data collection and use and poor understanding of the rationale for high-quality ethnicity data. 9,11 Researchers who use ethnicity data from health databases or who collect ethnicity for original research must ensure they understand the ethnicity protocols and treat ethnicity with the same rigour as any other variable. ...

We still don't count: the under-counting and under-representation of Māori in health and disability sector data
  • Citing Article
  • December 2022

The New Zealand medical journal

... In contemporary society, such beliefs are still upheld but much of the landscape has changed, distorting Māori interactions with the environment. Research has demonstrated that Māori are more likely to live in deprived areas (Loring et al., 2022), and that deprived urban areas are more likely to be health-constraining environments with an abundance of potentially negative exposures including alcohol outlets, fast-food outlets and takeaway stores (Marek et al., 2021;Sushil et al., 2017;Wiki et al., 2019). Deprived urban areas in Aotearoa New Zealand have also been shown in previous research to have an abundance of other stores, however, including those that are health-promoting such as fruit and vegetable stores and supermarkets (Marek et al., 2021;Sushil et al., 2017;Wiki et al., 2019). ...

Analysis of deprivation distribution in New Zealand by ethnicity, 1991-2013

The New Zealand medical journal

... The significance of compassion in enhancing health outcomes and quality care ratings of patients [20][21][22] and healthcare providers' (HCPs) workplace well-being has been broadly reported in the healthcare literature [5,6,23]. Providing compassionate care has been reported to increase HCP job satisfaction and retention, while also reducing moral distress, burnout, and occupational stress [24,25]. While there is emerging evidence that HCP compassion can be cultivated [4,[12][13][14], there still remains a lack of evidence-based clinically relevant training that focuses on both enhancing HCPs compassion competence and importantly, creating the organizational conditions for their compassion to flourish [7,11,26]. ...

Working in values-discrepant environments inhibits clinicians ability to provide compassion and reduces wellbeing: a cross-sectional study
  • Citing Preprint
  • November 2022