“Health is Wealth”: co-designing and piloting a respiratory winter preparedness intervention with a Samoan church community in Aotearoa New Zealand

In many parts of the world, the winter months bring a predictable rise in respiratory illnesses like the flu. For some communities, this seasonal burden is far heavier than for others. In New Zealand, people of Pacific Island heritage, particularly those of Samoan descent, face significantly higher rates of hospitalization from these infections compared to the general population. This disparity is not just a matter of biology; it is deeply tied to how health information is shared and where people feel safe seeking care. Traditional medical settings can sometimes feel distant or intimidating, especially when language barriers exist or when health advice feels disconnected from a person's daily life and cultural values. Researchers have long known that trust is the most critical ingredient in public health. When communities feel heard and respected, they are more likely to engage with health services. This understanding has led scientists to look beyond clinics and hospitals, seeking partnerships with the places where people already gather, live, and find strength.

In Aotearoa New Zealand, the church is a central pillar of life for many Pacific families, serving as a hub for social connection, cultural preservation, and mutual support. Recognizing this, a team of researchers from universities in Auckland and Otago, working alongside a Pacific-led organization called Moana Connect and leaders from a Samoan church in South Auckland, decided to try a different approach. Instead of bringing the community to a medical conference, they brought a health conference to the community. They co-designed an event called "Health is Wealth," held on a Saturday in June 2024, to prepare for the winter respiratory season. The goal was not just to hand out information, but to create a space where health education, medical services, and cultural celebration could happen together. The project was built on the idea that for health messages to stick, they must be delivered in a way that honors the community's language, values, and way of life.

The planning process began with a simple request from the church community itself. After a previous study on respiratory viruses, the church leaders asked the researchers to help organize a health conference focused on winter preparedness. However, the researchers did not simply impose a pre-made plan. Through a series of conversations, known in Samoan culture as talanoa, the team listened to what the community actually wanted. The church elders explained that while they were concerned about the flu, they also worried about other conditions that affected their families, such as gout, diabetes, and heart disease. They wanted the day to feel like a gathering, not a lecture. They asked for speakers who spoke their language, for interactive activities like Zumba, and for practical services like free vaccinations and dental checks for children. The researchers agreed to this holistic vision, shifting the focus from a narrow medical topic to a broader celebration of overall wellbeing.

On the day of the event, more than 300 church members and their families arrived at the church hall. The atmosphere was vibrant, filled with music, cultural performances by the youth group, and the smell of shared food. The conference featured six speakers who covered topics ranging from influenza and vaccinations to cardiovascular health and rheumatic fever. Crucially, the speakers communicated in both English and Samoan, ensuring that everyone could understand the complex medical advice. A free vaccination station was set up, offering all the vaccines available on the national schedule, including those for children and the flu. Dental health checks were also provided. The event was designed so that people could move between learning, socializing, and receiving care without feeling rushed or pressured.

To understand if this approach worked, the research team asked attendees to fill out short surveys before and after the conference. They also conducted brief, friendly interviews throughout the day and held a follow-up conversation with church elders two weeks later. The results showed a clear shift in what people knew and how they felt about their health. Before the event, many people held common misconceptions, such as believing that the flu vaccine could actually cause the flu, or that the vaccine was only for older people. After the conference, a significantly higher number of participants correctly understood that the vaccine is safe and recommended for children as young as six months. They also better understood the risks the flu poses to pregnant women. While the event did not change every single belief overnight, the data suggests that the community gained important, accurate knowledge about how to protect themselves and their families.

Perhaps even more telling than the numbers were the words of the people who attended. In their interviews, participants described the day as incredibly useful and well-organized. They specifically praised the fact that the speakers spoke Samoan, noting that this made the information feel personal and trustworthy. One attendee mentioned that hearing the explanation of the vaccine's usefulness in their own language made a huge difference in their understanding. The church leaders echoed this sentiment, expressing gratitude that their voices had been genuinely heard in the design of the event. They felt that the format created a safe space for open dialogue, where health advice came from within the community rather than being imposed from the outside. The presence of Pacific clinicians and the integration of cultural elements like music and dance were seen as essential to the day's success, making the health content feel relevant and accessible.

The study also highlighted the power of addressing health as a whole. By including topics like gout and diabetes alongside the flu, the conference resonated more deeply with the community's lived experience. Attendees felt that this holistic approach was more meaningful than a narrow focus on just one illness. During the follow-up conversations, participants offered constructive feedback for the future, suggesting that the event could be expanded to include two days, with the second day dedicated to social services like housing support and assistance with government agencies. They also expressed a desire to discuss topics that are often stigmatized or left unspoken, such as mental health and sexual health. These suggestions indicate that the community sees health as interconnected with their social and economic wellbeing, and they want future interventions to reflect that reality.

The researchers noted that this project was a pilot study, meaning it was a test to see if the model worked and to learn how to improve it. While the attendance was high and the initial results were positive, the team acknowledged that more work is needed to see if these changes in knowledge lead to long-term changes in behavior, such as higher vaccination rates over the entire winter season. They also pointed out that the study took place in one specific church community, so the results might look different in other groups with different leadership structures or languages. However, the success of the "Health is Wealth" conference offers a promising blueprint. It demonstrates that when researchers and communities work together as equal partners, designing interventions that respect cultural values and language, they can create a space where health education is not just heard, but embraced.

The project concluded with a celebration where the research findings were shared back with the community. This was not a formal academic presentation, but a communal gathering with food and song, reflecting the values of reciprocity and shared ownership. The community members reported that seeing the results of their participation deepened their understanding of the research process itself. They realized that their input mattered and that the data collected could help improve health for everyone. This sense of empowerment is a vital outcome, suggesting that such partnerships can build lasting capacity within communities to manage their own health challenges. The "Health is Wealth" model shows that addressing health disparities requires more than just medical facts; it requires building trust, honoring culture, and recognizing that true health is a collective effort.