Voices of the Pacific: Pacific Peoples’ Conceptualisations of Anxiety in Aotearoa New Zealand—Findings from a Cross-Sectional Survey

Probably not a substantial claim.

The present study employs an inductive content analysis approach, allowing patterns and key ideas to be derived from the responses.

“Alternatively, the present study employs an inductive approach, allowing patterns and key ideas to be derived from the responses [33,34,35,36].”

• cites [33] Im, 2023, Qualitative Research in Healthcare: Data Analysis, J. Prev. Med. Public Health sourceSupported
• cites [34] Crowe, 2015, Conducting Qualitative Research in Mental Health: Thematic and Content Analyses, Aust. N. Z. J. Psychiatry sourceNot checked — no full text of the source
• cites [35] Nishio, 2023, Content Analysis of Health-Related Subjects in the K12 School Curricula of Japan, Indonesia, Philippines, Guam, Micronesia, Marshall Islands, Palau, and Fiji, Trop. Med. Health sourceCould not verify

  The Methods section (Development of questionnaires; page unavailable) describes selecting survey items and collecting partners’ answers, but does not describe an inductive approach or deriving patterns and key ideas from responses. A search for inductive content analysis and response coding found no passage in our copy that addresses the cited methodological claim. (LLM, conf=0.72)

  Experimental — accuracy not yet measured
• cites [36] Vaismoradi, 2013, Content Analysis and Thematic Analysis: Implications for Conducting a Qualitative Descriptive Study, Nurs. Health Sci. sourceSupported

It may state two separate claims as one.

Pacific worldviews locate wellbeing within relational harmony, where distress is often expected to be managed collectively through existing connections within family, church, or community contexts.

“Meanwhile, Pacific worldviews locate wellbeing within relational harmony, where distress is often expected to be managed collectively through existing connections within family, church, or community contexts [20,21,22].”

• cites [20] Tamasese, 2005, Ole Taeao Afua, the New Morning: A Qualitative Investigation Into Samoan Perspectives on Mental Health and Culturally Appropriate Services, Aust. N. Z. J. Psychiatry sourcePartly supported

  The paper describes Samoan wellbeing through relational harmony and identifies family, churches and communities as sources of support (pp. 4, 7–8). But the Discussion (p. 7) explicitly says its findings cannot be generalized to other Pacific Island communities, so it does not support the claim about Pacific worldviews broadly. (LLM, conf=0.90)

  Experimental — accuracy not yet measured
• cites [21] Whistler, W.A. (1996). Samoan Herbal Medicine: = `O Lā`au Ma Vai Fofō o Samoa, Isle Botanica.Not checked yet
• cites [22] Kapeli, 2024, Higher Levels of Social Support Predict Lower Psychological Distress for Pacific Peoples Living in Aotearoa New Zealand, Sci. Rep. sourcePartly supported

  The Introduction’s discussion of vā and the Conclusion describe Pacific wellbeing in relational terms. The Discussion links social support and community connections with lower psychological distress. But the paper does not say that distress is expected to be managed collectively through existing family, church, or community connections; it does not identify church as a setting for such management. Page numbers are unavailable in our copy. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

Content analysis is a systematic approach for identifying and analysing patterns in qualitative and quantitative research, widely used in healthcare, social and community psychological research.

“CA is a systematic approach for identifying and analysing patterns in qualitative and quantitative research, and is widely used in healthcare, social and community psychological research [33,34,35,36].”

• cites [33] Im, 2023, Qualitative Research in Healthcare: Data Analysis, J. Prev. Med. Public Health sourcePartly supported

  The Qualitative Content Analysis section (page unavailable) describes content analysis as a method using qualitative and quantitative approaches to identify categories, and says it is used in several fields, including public health. It does not establish that content analysis is widely used specifically in social or community psychological research. (LLM, conf=0.85)

  Experimental — accuracy not yet measured
• cites [34] Crowe, 2015, Conducting Qualitative Research in Mental Health: Thematic and Content Analyses, Aust. N. Z. J. Psychiatry sourceNot checked — no full text of the source
• cites [35] Nishio, 2023, Content Analysis of Health-Related Subjects in the K12 School Curricula of Japan, Indonesia, Philippines, Guam, Micronesia, Marshall Islands, Palau, and Fiji, Trop. Med. Health sourcePartly supported

  The Methods (Development of questionnaires; no page given) describe a structured survey of health-related topics in school curricula, so the paper provides an example of analysing health-related content. It does not state that content analysis identifies patterns in both qualitative and quantitative research or that it is widely used across healthcare, social, and community psychological research. (LLM, conf=0.78)

  Experimental — accuracy not yet measured
• cites [36] Vaismoradi, 2013, Content Analysis and Thematic Analysis: Implications for Conducting a Qualitative Descriptive Study, Nurs. Health Sci. sourcePartly supported

  The “Definition of content analysis and thematic analysis” section describes content analysis as a systematic approach for finding patterns in text. “Aim and focus of data analysis” says it can analyse data qualitatively while also quantifying it, and discusses its use in nursing. Our copy does not establish that it is widely used in social or community psychological research; page numbers were not available. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

It may state two separate claims as one.

Dominant clinical frameworks often lack cultural alignment, and terms such as "anxiety" may not translate meaningfully into Pacific contexts, contributing to under-recognition of distress and delayed engagement with support services.

“Dominant clinical frameworks often lack this cultural alignment, where terms such as “anxiety” may not translate meaningfully into Pacific contexts and, instead, contribute to the under-recognition of distress and delayed engagement with support services [17,26].”

• cites [17] Snow, 2024, Mental Health Literacy in Polynesian Native Hawaiian and Other Pacific Islanders, Int. J. Ment. Health Nurs. sourcePartly supported

  The “Mental health of Native Hawaiian and Other Pacific Islanders” section identifies low mental health awareness, lack of knowledge, and a perceived lack of culturally responsive providers as barriers to treatment. The copy does not say that “anxiety” fails to translate meaningfully in Pacific contexts or that clinical terminology causes under-recognition of distress and delayed engagement. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites [26] Fleming, W. (2026, January 09). Dr Sarah Kapeli—Let’s Get Pre-Sifik Episode 10. Available online: https://www.youtube.com/watch?v=LQm42VXlC6A.Not checked yet

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

Snowball sampling is particularly effective for exploring sensitive topics and increasing participation through Pacific peoples' existing relational networks.

“This method is particularly effective for exploring sensitive topics and increasing participation through Pacific peoples’ existing relational networks [19,29,30].”

• cites [19] 2023, Complementing Cognitive Behavioral Therapy (CBT) for Pacific Peoples in New Zealand, J. Pac. Rim Psychol.Not checked yet
• cites [29] Kalsbeek, 2003, Sampling Minority Groups in Health Surveys, Stat. Med. sourceNot checked — no full text of the source
• cites [30] Ting, 2025, Snowball Sampling: A Review and Guidelines for Survey Research, Asian J. Bus. Res. sourcePartly supported

  The Introduction says snowball sampling is useful for sensitive topics because it uses trust within social connections to encourage participation. The Higher Response Rates section likewise describes increased participation through trusted referrals. Neither passage addresses Pacific peoples or establishes that the method is particularly effective within their relational networks. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

It may state two separate claims as one.

The analysis enabled insights into the conceptualisation of how anxiety is understood by Pacific peoples in Aotearoa NZ, the identification of preferences for managing anxiety, and the identification of perceived risk factors that cause anxiety.

“Specifically, the analysis enabled insights into (1) the conceptualisation of how anxiety is understood by Pacific peoples in Aotearoa NZ, (2) the identification of preferences for managing anxiety, and (3) the identification of perceived risk factors that cause anxiety.”

It may state two separate claims as one.

Participants did not reject formal mental health services, but viewed them as complementary to informal support.

“Additionally, participants did not reject formal mental health services, but viewed them as complementary to informal support.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Because each response could be coded across multiple categories, the analysis of Question 2 resulted in 890 coded segments.

“Given that each response could be coded across multiple categories, the analysis resulted in 890 coded segments.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Because each response could be coded across multiple categories, the analysis of Question 1 resulted in 1478 coded segments.

“Given that each response could be coded across multiple categories, the analysis resulted in 1478 coded segments.”

It may state two separate claims as one.

A smaller proportion of participants recognised anxiety as an illness (n = 51; 3%) or as a condition characterised by persistent symptoms (n = 34; 2%).

“A smaller proportion of participants recognised anxiety as an illness (n = 51; 3%) or as a condition characterised by persistent symptoms (n = 34; 2%).”

It may state two separate claims as one.

Perceived causes of anxiety were complex and evenly attributed to experiential, contextual, and health-related risk factors, highlighting the centrality of holism in Pacific worldviews.

“Perceived causes of anxiety were complex and evenly attributed to experiential, contextual, and health-related risk factors, highlighting the centrality of holism in Pacific worldviews.”

• AssumptionRests on an assumption: The survey sample is sufficiently representative of Pacific peoples in Aotearoa New Zealand for the findings to generalise to Pacific peoples.
• AssumptionRests on an assumption: Participants’ open-ended responses accurately reflect their conceptualisations of anxiety.

It may state two separate claims as one.

Findings revealed an almost equal distribution of perceived causes across environmental, experiential, and health-related factors, including academic or work pressures, past trauma, and existing health conditions.

“Findings revealed an almost equal distribution of perceived causes across environmental, experiential, and health-related factors, including academic or work pressures, past trauma, and existing health conditions.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

The analysis resulted in 898 coded segments.

“Given that each response could be coded across multiple categories, the analysis resulted in 898 coded segments.”

It may state two separate claims as one.

Barriers to mental health care for Pacific peoples include stigma, discrimination, socioeconomic deprivation, reliance on family-based support, conflicting priorities, historical mistrust in formal support services, and limited knowledge or access to culturally grounded mental health support.

“Such barriers include stigma, discrimination, socioeconomic deprivation, reliance on family-based support, conflicting priorities, historical mistrust in formal support services, and limited knowledge or access to culturally grounded mental health support [7,8,9,10].”

• cites [7] Cunningham, 2025, Psychological Distress and Diagnosed Mood and Anxiety Disorders in Pacific Adults: A Pooled Analysis of Five Consecutive New Zealand Health Survey Years, Kōtuitui N. Z. J. Soc. Sci. OnlineNot checked yet
• cites [8] Cartwright, 2021, Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services, J. Cross-Cult. Psychol. sourceNot checked — no full text of the source
• cites [9] Kapeli, 2020, Perceived Discrimination Is Associated with Poorer Health and Well-being Outcomes among Pacific Peoples in New Zealand, J. Community Appl. Soc. Psychol. sourceNot checked — no full text of the source
• cites [10] Kapeli, 2025, Pacific Peoples’ Conceptualisations of Depression in Aotearoa New Zealand: Findings from a Cross-Sectional Survey, J. R. Soc. N. Z. sourceNot checked yet

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Practical challenges such as cost or transport may accompany barriers to mental health care for Pacific peoples.

“These barriers may be accompanied by practical challenges like cost or transport [4,5,7,8,9,10,11,12].”

• cites [4] Oakley Browne, M.A., Wells, J.E., and Scott, K.M. (2006). Pacific People, Te Rau Hinengaro: The New Zealand Mental Health Survey.Not checked yet
• cites [5] Ministry of Health (2026, January 08). Annual Update of Key Results 2022/23: New Zealand Health Survey, Available online: https://www.health.govt.nz/publications/annual-update-of-key-results-202223-new-zealand-health-survey.Not checked yet
• cites [7] Cunningham, 2025, Psychological Distress and Diagnosed Mood and Anxiety Disorders in Pacific Adults: A Pooled Analysis of Five Consecutive New Zealand Health Survey Years, Kōtuitui N. Z. J. Soc. Sci. OnlineNot checked yet
• cites [8] Cartwright, 2021, Barriers and Supports Experienced by Pacific Peoples in Aotearoa New Zealand’s Mental Health Services, J. Cross-Cult. Psychol. sourceNot checked — no full text of the source
• cites [9] Kapeli, 2020, Perceived Discrimination Is Associated with Poorer Health and Well-being Outcomes among Pacific Peoples in New Zealand, J. Community Appl. Soc. Psychol. sourceNot checked — no full text of the source
• cites [10] Kapeli, 2025, Pacific Peoples’ Conceptualisations of Depression in Aotearoa New Zealand: Findings from a Cross-Sectional Survey, J. R. Soc. N. Z. sourceNot checked yet
• cites [11] StatsNZ (2026, January 08). Wellbeing Statistics: 2023 (Updated), Available online: https://www.stats.govt.nz/information-releases/wellbeing-statistics-2023/.Not checked yet
• cites [12] Kapeli, 2023, Pasifika Perceptions of Pacific Men and Women and Their Interrelationship with Mental Health in Aotearoa, Waka Kuaka J. Polyn. Soc. sourceNot checked — no full text of the source

It may state two separate claims as one.

Existing research on Pacific conceptualisations of anxiety has predominantly focused on prevalence, service utilisation, and structural barriers to care, and empirical evidence on how Pacific peoples define, interpret, or experience anxiety is limited.

“Despite these ongoing disparities, existing research on Pacific conceptualisations of anxiety (and mental health more broadly) has predominantly focused on prevalence, service utilisation, and structural barriers to care. Research on how anxiety is understood or conceptualised within Pacific communities is limited.”

• Also stated in: § 1. Introduction · plain

  “Consequently, there remains limited empirical evidence exploring Pacific conceptualisations of anxiety, their help-seeking preferences, and perceptions of what causes anxiety [7,14].”

• cites [7] Cunningham, 2025, Psychological Distress and Diagnosed Mood and Anxiety Disorders in Pacific Adults: A Pooled Analysis of Five Consecutive New Zealand Health Survey Years, Kōtuitui N. Z. J. Soc. Sci. OnlineNot checked yet
• cites [14] Kapeli, S.A. (2022). Exploring Pasifika Mental Health Literacy in Aotearoa New Zealand. [Ph.D. Thesis, The University of Auckland].Not checked yet

It may state two separate claims as one.

Among Pacific adults in Aotearoa New Zealand diagnosed with a mood and/or anxiety disorder, only 25% had sought support from mental health services, compared to 58% of the general population.

“While 8% of Pacific adults in Aotearoa NZ are diagnosed with a mood and/or anxiety disorder, only 25% of those diagnosed had sought support from mental health services, compared to 58% of the general population [4].”

• Also stated in: § Abstract · plain

  “However, while informal relational support is strongly utilised, formal or professional help-seeking remains comparatively low.”

• cites [4] Oakley Browne, M.A., Wells, J.E., and Scott, K.M. (2006). Pacific People, Te Rau Hinengaro: The New Zealand Mental Health Survey.Not checked yet

It may state two separate claims as one.

Western frameworks classify anxiety as a discrete clinical disorder based on neurochemical and cognitive dysfunction, with treatment through psychotherapeutic or pharmacological interventions.

“Instead, Western frameworks classify anxiety as a discrete clinical disorder based on neurochemical and cognitive dysfunction, with treatment through psychotherapeutic or pharmacological interventions [18,19].”

• cites [18] Stein, 2015, Generalized Anxiety Disorder, N. Engl. J. Med. sourceNot checked — no full text of the source
• cites [19] 2023, Complementing Cognitive Behavioral Therapy (CBT) for Pacific Peoples in New Zealand, J. Pac. Rim Psychol.Not checked yet

Probably not a substantial claim. It may state two separate claims as one.

Although these findings may not represent the wider Pacific population in Aotearoa NZ, they successfully provided a snapshot of how anxiety is understood within the present sample.

“Although these findings may not represent the wider Pacific population in Aotearoa NZ, they successfully provided a snapshot of how anxiety is understood within the present sample.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Any coding discrepancies were resolved by reaching consensus.

“Any coding discrepancies were resolved by reaching consensus.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

Coding definitions were developed iteratively through repeated engagement with the data, with regular review from co-authors, to enhance rigour and minimise bias.

“To enhance rigour and minimise bias, coding definitions were developed iteratively through repeated engagement with the data, and regular review from the co-authors.”

Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

The identification of formal support (14%) further suggests that professional services are recognised as important but may be most effective when delivered in a complementary way.

“The identification of formal support (14%) further suggests that professional services are recognised as important but may be most effective when delivered in a complementary way.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Voluntary submission of the survey constituted informed consent.

“As outlined in the PIS, the voluntary submission of the survey constituted informed consent.”

Probably not a substantial claim.

With 59% of participants endorsing 'Seeking Informal Support', strengthening interventions that operate within existing relational networks may be particularly relevant.

“With 59% of participants endorsing ‘Seeking Informal Support’, strengthening interventions that operate within existing relational networks may be particularly relevant.”

It may state two separate claims as one.

Together, these findings are consistent with holistic and relational models of wellbeing worldwide and are pertinent to Pacific communities.

“Together, these findings are consistent with holistic and relational models of wellbeing worldwide and are pertinent to Pacific communities (see The Fonofale Model) [27].”

• cites [27] Pulotu-Endemann, F.K. (2026, January 09). Fonofale Model of Health. Available online: https://hpfnz.org.nz/assets/Fonofalemodelexplanation.pdf.Not checked yet

It may state two separate claims as one.

Pacific peoples value seeking support, but the preference for support through existing relational networks, such as family and friends, is much stronger.

“These findings suggest an awareness of anxiety as a health condition requiring some specialised or professional care, and that while Pacific peoples value seeking support, the preference for support through existing relational networks, such as family and friends, is much stronger.”

It may state two separate claims as one.

While participants' responses were coded individually and do not imply that each person endorsed all domains, the overall pattern is consistent with holistic understandings of wellbeing.

“While participants’ responses were coded individually and do not imply that each person endorsed all domains, the overall pattern is consistent with holistic understandings of wellbeing.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

The survey was piloted with volunteers from Pacific communities, and their feedback was used to further refine it.

“The survey was then piloted with volunteers from Pacific communities, whose feedback was used to further refine it.”

Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

These proposals emerge directly from the observed results, suggesting that formal services may be strengthened through relational integration and cultural alignment.

“These proposals emerge directly from the observed results, suggesting that formal services may be strengthened through relational integration and cultural alignment.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

As Whistler suggests, this may look like incorporating and normalising traditional Pacific healing practices.

“As Whistler [21] suggests, this may look like incorporating and normalising traditional Pacific healing practices.”

• cites [21] Whistler, W.A. (1996). Samoan Herbal Medicine: = `O Lā`au Ma Vai Fofō o Samoa, Isle Botanica.Not checked yet

It may state two separate claims as one.

The sample was not fully representative of the wider Pacific population, with an overrepresentation of younger participants (<45 years), females, and Auckland-based participants.

“Given this, the sample was not fully representative of the wider Pacific population, with an overrepresentation of younger participants (<45 years), females, and Auckland-based participants.”

Probably not a substantial claim. It may be too vague to check against evidence.

These findings indicate a need for relational, community-based support measures that could enhance existing formal support.

“Furthermore, they indicate a need for relational, community-based support measures that could enhance existing formal support.”

Probably not a substantial claim. It may state two separate claims as one.

The content analysis framework aligned with the study's aim to privilege Pacific voices, ensuring that the findings remained culturally grounded and robust.

“The CA framework aligned with the study’s aim to privilege Pacific voices, ensuring that the findings remained culturally grounded and robust.”

It may state two separate claims as one.

Overall, these findings suggest that Pacific peoples value help-seeking, contrary to deficit-based assumptions about Pacific peoples' MHL and help-seeking behaviours.

“Overall, these findings suggest that Pacific peoples value help-seeking, contrary to deficit-based assumptions about Pacific peoples’ MHL and help-seeking behaviours.”

• AssumptionRests on an assumption: Deficit-based assumptions about Pacific peoples' mental health literacy and help-seeking behaviours exist.

Probably not a substantial claim. The paper’s conclusions may not depend on it.

The survey design choices ensured that the survey was more than just a data collection tool; it was a process reflective of Pacific values.

“These design choices ensured that the survey was more than just a data collection tool; it was a process reflective of Pacific values.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Of the 548 survey participants, 427 participants responded to the question 'What do you think 'anxiety' is?'.

“Of the 548 survey participants, 427 participants responded to this question.”

It may state two separate claims as one.

The findings indicate that Pacific peoples in Aotearoa NZ have a strong understanding of anxiety, most often conceptualising it as an everyday, transient experience.

“The findings indicate that Pacific peoples in Aotearoa NZ have a strong understanding of anxiety, most often conceptualising it as an everyday, transient experience.”

• AssumptionRests on an assumption: Pacific peoples in Aotearoa NZ can be described as a group with shared conceptualisations of anxiety, despite ethnic diversity.

Probably not a substantial claim.

Guided by Talanoa principles, the use of open-ended survey questions enabled participants to express their understandings in their own words.

“Guided by Talanoa principles, the use of open-ended survey questions enabled participants to express their understandings in their own words.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

This is evident in the Fonofale Model and Kapeli, where the model symbolises the wholeness of a Pacific person, drawing upon values of the broader Pacific community such as family, culture, and spirituality.

“This is evident in the Fonofale Model [27] and Kapeli [14], where the model symbolises the wholeness of a Pacific person, drawing upon values of the broader Pacific community such as family, culture, and spirituality (refer to Talanoa values in Survey Description).”

• cites [27] Pulotu-Endemann, F.K. (2026, January 09). Fonofale Model of Health. Available online: https://hpfnz.org.nz/assets/Fonofalemodelexplanation.pdf.Not checked yet
• cites [14] Kapeli, S.A. (2022). Exploring Pasifika Mental Health Literacy in Aotearoa New Zealand. [Ph.D. Thesis, The University of Auckland].Not checked yet

It may state two separate claims as one.

The survey sample included 291 Sāmoan (53.1% vs 49.3% of Pacific population), 156 Tongan (28.5% vs 20%), 62 Cook Island Māori (11.3% vs 19.1%), and 62 Niuean (11.3% vs 8.1%) participants.

“Of the four largest represented Pacific ethnic groups in Aotearoa NZ according to the latest Census [32], the survey responses included 291 participants who identified as Sāmoan (53.1% of survey sample versus 49.3% of Pacific population), 156 participants who identified as Tongan (28.5% of survey sample versus 20% of Pacific population), 62 participants who identified as Cook Island Māori (11.3%”

• cites [32] StatsNZ (2025, June 15). 2023 Census Population Counts (by Ethnic Group, Age, and Māori Descent) and Dwelling Counts. Available online: https://secure.livechatinc.com/customer/action/open_chat?license_id=6093951&group=0&embedded=1&widget_version=3&unique_groups=0&organization_id=5ab41134-d743-41a7-a32a-5057096f4195&use_parent_storage=1&x-region=us-south1.Not checked yet

Probably not a substantial claim. The paper may give no reason why it holds.

Open-ended questions were prioritised in the survey to enable self-disclosure and deeper thought than tick-box responses allow.

“For instance, open-ended questions were prioritised in the survey to enable self-disclosure and deeper thought than what tick-box responses allow.”

Probably not a substantial claim. It may state two separate claims as one.

Inductive content analysis allowed new insights to surface without being constrained by existing frameworks, providing a culturally responsive method for working with Pacific data.

“CA also allowed for new insights to surface without being constrained by existing frameworks, providing a culturally responsive method for working with Pacific data.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Of the 548 survey participants, 402 participants responded to this question.

“Of the 548 survey participants, 402 participants responded to this question.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Participants were informed that the survey was voluntary, anonymous, and confidential via a Participant Information Sheet.

“Participants were informed that the survey was voluntary, anonymous, and confidential via a Participant Information Sheet (PIS).”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

In Pacific research, researcher positionality is integral to methodological transparency because it informs the analytical approach and interpretation of findings.

“Accordingly, researcher positionality is not peripheral, but integral to methodological transparency as it informs the analytical approach and interpretation of the findings [28].”

• cites [28] Keil, M., Sisifa, S., Thomsen, P., Baice, T., Veukiso-Ulugia, A., Manuela, S., Kapeli, S., McLean-Orsborn, S., Uasike Allen, J., and McRobie, S. (2026). “Operating in the Margins”: Pacific Researchers’ Reflections on Positionality in Pacific Research. Altern. Int. J. Indig. Peoples, 1–12. sourceNot checked — no full text of the source

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Of the 548 survey participants, 411 participants responded to the question 'If you or someone you know has anxiety, what do you think is the best thing to do?'.

“Of the 548 survey participants, 411 participants responded to this question.”

Probably not a substantial claim.

A key strength of this study is its non-invasive, culturally grounded design, which centres Pacific voices rather than imposing external Western frameworks.

“A key strength of this study is its non-invasive, culturally grounded design, which centres Pacific voices rather than imposing external Western frameworks.”

It may state two separate claims as one.

The diverse, large sample (n = 548) represented a range of demographics, including Pacific ethnic groups, age cohorts, and qualifications, offering perspectives on anxiety and mental health that are seldom captured in mainstream research.

“The diverse, large sample (n = 548) represented a range of demographics, including Pacific ethnic groups, age cohorts, and qualifications, offering perspectives on anxiety and mental health that are seldom captured in mainstream research.”

It may state two separate claims as one.

The survey included 548 Pacific peoples (14.6% men, 84.8% women, 0.6% gender diverse) with an age range from 16 to 83 years (Median = 25; Mean = 27; SD = 9.98).

“The survey included responses (99% completed online via Qualtrics) from 548 Pacific peoples (14.6% men, 84.8% women, 0.6% gender diverse) with an age range from 16 to 83 years (Median = 25; Mean = 27; and Standard Deviation = 9.98).”

Probably not a substantial claim. It may be too vague to check against evidence.

The findings from Question 2 provide a clear basis for shaping culturally aligned support pathways.

“The findings from Question 2 provide a clear basis for shaping culturally aligned support pathways.”

Probably not a substantial claim. It may state two separate claims as one.

The Fonofale model conceptualises Pacific wellbeing as holistic and relational, with distress understood as a disruption of balance across relational domains rather than as an isolated psychological pathology.

“Although not a diagnostic tool, the Fonofale model provides a culturally grounded guide for understanding distress as a disruption of balance across these relational domains rather than as an isolated psychological pathology [27].”

• cites [27] Pulotu-Endemann, F.K. (2026, January 09). Fonofale Model of Health. Available online: https://hpfnz.org.nz/assets/Fonofalemodelexplanation.pdf.Not checked yet

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Paper copies were available to make the survey more accessible.

“Paper copies were also available to make the survey more accessible.”

Probably not a substantial claim. It may state two separate claims as one.

According to the APA, chronicity is central to DSM-5-TR definitions of anxiety disorders, rendering anxiety as debilitating and problematic.

“According to the APA [2], chronicity is central to DSM-5-TR definitions of anxiety disorders, rendering anxiety as debilitating and problematic.”

• cites [2] American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association Publishing. [5th ed.]. sourceNot checked — no full text of the source

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

In Aotearoa New Zealand, the legal age for informed consent to participate in research is 16 years, so individuals aged 16 years and older were eligible to provide consent independently.

“In Aotearoa NZ, the legal age for informed consent to participate in research is 16 years; therefore, individuals aged 16 years and older were eligible to provide consent independently [31].”

• cites [31] Auckland Academic Health Alliance (2019). Auckland Health Research Ethics Committee (AHREC) Applicant’s Manual, Auckland Health Research Ethics Committee (AHREC).Not checked yet

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Such multidimensional understandings of wellbeing recognise that many interconnected factors shape experiences of anxiety, and wellbeing overall.

“Such multidimensional understandings of wellbeing recognise that many interconnected factors shape experiences of anxiety, and wellbeing overall [27].”

• cites [27] Pulotu-Endemann, F.K. (2026, January 09). Fonofale Model of Health. Available online: https://hpfnz.org.nz/assets/Fonofalemodelexplanation.pdf.Not checked yet

Probably not a substantial claim. It may be too vague to check against evidence.

Together, these findings suggest that clinical practices may benefit from holistic assessment and treatment pathways that align with Pacific worldviews.

“Together, these findings suggest that clinical practices may benefit from holistic assessment and treatment pathways that align with Pacific worldviews.”

Probably not a substantial claim. It may state two separate claims as one.

The researchers' Pacific positioning ensures the findings remain grounded in Pacific lived realities and are reflective of their cultural context.

“Specifically, this positioning ensures the findings remain grounded in Pacific lived realities and are reflective of their cultural context.”

It may state two separate claims as one.

Pacific peoples widely recognise anxiety symptoms and tend to conceptualise anxiety as an everyday, transient experience.

“Together, these findings suggest that Pacific peoples widely recognise anxiety symptoms and tend to conceptualise anxiety as an everyday, transient experience.”

• Also stated in: § Abstract · hedged

  “The findings suggest that anxiety was understood as a transient, everyday experience, rather than a prolonged mental health condition.”

• AssumptionRests on an assumption: The survey sample is sufficiently representative of Pacific peoples in Aotearoa New Zealand for the findings to generalise to Pacific peoples.
• AssumptionRests on an assumption: Participants’ open-ended responses accurately reflect their conceptualisations of anxiety.

Probably not a substantial claim.

The present study addressed its stated objectives.

“The present study addressed its stated objectives.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

Participants represented many Pacific nations, in many cases identifying with more than one Pacific ethnicity.

“Participants represented many Pacific nations; in many cases, identifying with more than one Pacific ethnicity.”

It may state two separate claims as one.

Prior research in the area has employed standardised assessment tools and guides such as the DSM-5-TR, which may increase the risk of missing cultural nuances due to their largely clinical, symptom-based approach.

“Moreover, prior research in the area has employed standardised assessment tools and guides, such as the DSM-5-TR [2], which may increase the risk of missing cultural nuances due to their largely clinical, symptom-based approach.”

• cites [2] American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association Publishing. [5th ed.]. sourceNot checked — no full text of the source

Probably not a substantial claim. It may state two separate claims as one.

The study also examined multiple interconnected dimensions of anxiety, and the survey was collaboratively designed with a Pacific advisory group.

“The study also examined multiple interconnected dimensions of anxiety, and the survey was collaboratively designed with a Pacific advisory group.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

The University of Auckland Human Participants Ethics Committee approved the survey and supporting documents (reference 022137).

“The University of Auckland Human Participants Ethics Committee (UAHPEC) approved the survey and supporting documents from 29 October 2018 until 29 October 2021. Reference number: 022137.”

It may state two separate claims as one.

The research team comprises Pacific researchers with ethnic links to Fiji, Tonga, and Sāmoa, allowing the research to be grounded in Pacific ways of knowing and being.

“The research team comprises Pacific researchers with ethnic links to Fiji (Chandra), Tonga (Kapeli), and Sāmoa (McLean-Orsborn & Tone-Graham), allowing this research to be grounded in Pacific ways of knowing and being.”

• Also stated in: § 2.1. Researcher Positioning · plain

  “This study was undertaken by a team of Pacific mental health researchers whose cultural and genealogical ties to Pacific communities inform the epistemological grounding of the methodology.”

It may state two separate claims as one.

Limited alignment with DSM-based frameworks should not be interpreted as poor mental health literacy; it may reflect different ways of understanding wellbeing, recognising that everyday expressions of anxiety may not always mirror formal diagnostic terms.

“Limited alignment with DSM-based frameworks should not be interpreted as poor MHL. Instead, it may reflect different ways of understanding wellbeing, recognising that everyday expressions of anxiety may not always mirror formal diagnostic terms.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

The principles of Talanoa were drawn upon in the survey design to ensure culturally safe, accessible, and authentic ways of representing Pacific voices.

“The principles of Talanoa were drawn upon in the survey design to ensure culturally safe, accessible, and authentic ways of representing Pacific voices.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

Anonymity was important to ensure participants felt safe and confident.

“Anonymity was important to ensure participants felt safe and confident.”

Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

Inductive content analysis strengthened methodological rigour by minimising researcher-imposed biases and capturing diverse responses.

“Inductive content analysis strengthened methodological rigour by minimising researcher-imposed biases and capturing diverse responses.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

The resulting coded categories were refined collaboratively to ensure clarity and internal consistency, rather than being analysed in parallel.

“The resulting coded categories were refined collaboratively to ensure clarity and internal consistency, rather than being analysed in parallel.”

It may state two separate claims as one.

While holistic perspectives are evident across diverse cultural contexts, Pacific understandings are unique in their view of distress as a disruption of balance across these dynamic connections.

“While holistic perspectives are evident across diverse cultural contexts, Pacific understandings [27,39,40] are unique in their view of distress as a disruption of balance across these dynamic connections.”

• cites [27] Pulotu-Endemann, F.K. (2026, January 09). Fonofale Model of Health. Available online: https://hpfnz.org.nz/assets/Fonofalemodelexplanation.pdf.Not checked yet
• cites [39] Tualaulelei, 2019, The Pacific Research Paradigm: Opportunities and Challenges, MAI J.Not checked yet
• cites [40] Health Promotion Forum of New Zealand (2026, January 25). Pacific Health Models. Available online: https://hpfnz.org.nz/pacific-health-promotion/pacific-health-models.Not checked yet

It may state two separate claims as one.

The online, English-language survey design may have introduced self-selection and language biases, excluding individuals with limited digital access or English proficiency.

“The online, English-language survey design may have introduced self-selection and language biases, excluding individuals with limited digital access or English proficiency.”

Probably not a substantial claim. The paper’s conclusions may not depend on it.

Reliance on survey data limited the depth of insight achievable through Talanoa-based qualitative methods.

“Reliance on survey data limited the depth of insight achievable through Talanoa-based qualitative methods.”

Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

These insights challenge deficit-based assumptions about MHL in Pacific communities, highlighting the need for community-based, culturally responsive mental health approaches that recognise and meaningfully integrate Pacific values, needs, and lived experiences.

“These insights challenge deficit-based assumptions about MHL in Pacific communities, highlighting the need for community-based, culturally responsive mental health approaches that recognise and meaningfully integrate Pacific values, needs, and lived experiences.”

• AssumptionRests on an assumption: Deficit-based assumptions about Pacific peoples' mental health literacy and help-seeking behaviours exist.

It may state two separate claims as one.

The findings reveal a strong understanding of anxiety as an everyday, transient experience, rather than a persistent or prolonged condition, alongside a strong preference for informal, relational support measures to best manage and address anxiety, complemented by professional services.

“The findings reveal a strong understanding of anxiety as an everyday, transient experience, rather than a persistent or prolonged condition, alongside a strong preference for informal, relational support measures to best manage and address anxiety, complemented by professional services.”

• AssumptionRests on an assumption: Pacific peoples in Aotearoa NZ can be described as a group with shared conceptualisations of anxiety, despite ethnic diversity.

Probably not a substantial claim.

The present study centres Pacific voices, providing insight into how Pacific peoples in Aotearoa NZ understand, experience, and respond to anxiety disorders.

“The present study centres Pacific voices, providing insight into how Pacific peoples in Aotearoa NZ understand, experience, and respond to anxiety disorders.”

Probably not a substantial claim. It may be too vague to check against evidence.

The findings reiterate that effective mental health support is never an individual pursuit, but a collective responsibility towards sustained wellbeing.

“Moreover, the findings reiterate that effective mental health support is never an individual pursuit, but a collective responsibility towards sustained wellbeing.”