"It Can Hurt Your Heart": A Co-Designed Cross-Sectional Survey Exploring Pacific People's Understanding of Rheumatic Fever in Auckland, New Zealand.

Background/Objectives: Rheumatic fever is preventable and can be treated successfully; however, a lack of understanding of the disease and barriers to timely healthcare can impact outcomes. Pacific people in Aotearoa New Zealand experience inequitable burdens, and a Pacific community group and health professional network are working together to co-design education initiatives. This descriptive, mixed-methods study aimed to (1) explore Pacific people's awareness and understanding of rheumatic fever, (2) describe where Pacific people access health information. Methods: An online survey co-developed with Pacific community members was run from December 2024 to February 2025. Questions related to sore throats, rheumatic fever, medication adherence, long-term outcomes and where Pacific people access health information. Quantitative data was analyzed descriptively using SPSS version 28 and open-ended qualitative responses were analyzed using an inductive content analysis approach. Results: A total of 400 Pacific respondents were included: 34% were aged 16-24 years and 66% were female. Based on the analysis, 71% of Pacific participants knew that a sore throat should always be checked by a health professional and 65.3% had heard of rheumatic fever. Fever and sore throats were commonly identified as symptoms of rheumatic fever, with joint pain, body aches and chest pain mentioned less. Barriers to health services such as cost, long waiting times and cultural factors were discussed as reasons why many Pacific people often utilize social media and online forums for health information. Conclusions: This study highlights gaps in rheumatic fever knowledge and thus opportunities for health education initiatives for Pacific communities, potentially utilizing social media and online platforms.