Project Updates

Te Maioha o Mamia

Te Maioha o Mamia, or Mamia, is Dr Aria Graham’s postdoc mahi. Aria is a registered nurse who is working for Whakauae as a researcher. Aria’s passion, and the incentive for her mahi, comes from her love of tamariki and wanting authentic and culturally grounded models of wellbeing derived from the voices of tamariki Māori and their mothers, for tamariki Māori and their mothers.

Aria graduated with her PhD, Tika Tonu: Young Māori Mothers’ Experiences of Wellbeing Surrounding the Birth of their First Tamaiti completed in 2018 through Victoria University of Wellington. Since then she has been awarded a prestigious three-year Health Research Council of New Zealand (HRC) Erihapeti Rehu-Murchie Postdoctoral Fellowship. During the term of the award, Aria is piloting, and investigating, a marae-based Māori child and maternal wellbeing model based on the findings of her PhD. This year, she started actualising the model by crafting the space, connections, and philosophical base of Mamia, drawing on local hapū and iwi constructs to earth, steer, and position the kaupapa. Aria’s doctoral research concluded that  for a Mamia model to ‘work’, the theory must go hand-in-hand with the environment. Her postdoctoral investigation is exploring the validity of that conclusion.

Mamia is a Kaupapa Māori model about nurture and empowerment and is being piloted from Waipatu Marae in Heretaunga (Hastings) in Te Matau-a-Māui (Hawke’s Bay). It relies on tikanga Māori and the contribution and love of ‘nannies’, ‘aunties’ and whānau from the community to guide and nurture young māmā and hapū wāhine. With the support of Whakauae, the HRC, Waipatu, the community, Aria’s whānau and networks, Mamia is taking shape. Whilst there was no funding to implement the Mamia model, aroha has breathed life into the intent.

Despite the restrictions surrounding Covid-19, mahi has continued and no time or opportunity has been spared in the development of the Mamia infrastructure. After a few months of grit and grind, and the recent submission of a research ethics application for review, Mamia is holding space waiting to welcome young māmā and hapū wāhine.  The model will then be implemented, and its effectiveness comprehensively investigated. Aria feels that the creation and progression of Mamia is paving the way for exciting rangahau Māori and is loving her mahi! To see the journey to date, visit Mamia on Facebook.

Humble beginnings - Te Kōkiri, Waipatu Marae March 2020

December 2020

Data, Decision-Making and Development (D3)

Description:

Routinely collected health data has been successfully used to describe ‘the problem’ of persisting inequalities and to inform potential solutions. Increasing attention is now being paid to the utility of data and to its relevance. Using a Kaupapa Māori approach, this three-year study is exploring how routinely collected Māori specific health data, gathered at the DHB level and reported by the Ministry of Health, can be optimally used by Māori leaders, DHB leaders and other decision-makers to stimulate improvements in health outcomes for Māori. Three case study DHBs  have taken part in the research which has been conducted over three phases: an examination of current data utilisation practices; understanding facilitators and barriers to using data in health services planning; and, in the translation phase, communicating successful strategies to the wider sector. The study aims to highlight the processes, resources, skills and time needed to transform DHB level data into decisions and actions that improve hauora Māori.

Outcomes / Achievements:

The study began late in 2017 and was expected to conclude in mid-2020. However, unavoidable delays, resulting from the COVID-19 global pandemic, have meant that the translation phase of the research has been extended to February 2021.  In the opening phase of the study, our DHB study partners each identified child health data as an important area of investigation with immunisation data and oral health data both being a focus. In the following phase, conducted during 2018-2019, we worked with our DHB study partners to further clarify the facilitators and barriers to the use of Māori child health data in health services planning in the context of each of the case studies. All data collection and analysis across the participating sites was carried out with results fed back in various ways including hui with Tumu Whakarae (National Reference Group of Māori Health Strategy Managers within DHBs), an oral presentation at the 11th International Health Services Research and Policy Conference in Auckland in December 2019, an oral presentation at the Healthier Lives National Science Challenge Kōrero Tahi Symposium and preliminary feedback to our site partners.

Dr Heather Gifford presenting at  the December 2019 HSAANZ Conference

The translation phase, which continued in 2020, has included workshopping study results with DHB partners in sensemaking processes and exploring how the research results may be implemented in practice. The study has successfully highlighted the processes, resources, skills, and time needed to transform DHB level data into decisions and actions that improve hauora Māori. Several recommendations have been developed to strengthen decision-making that, if implemented, would stimulate improvements in health outcomes for Māori.  Among these are greater involvement of Māori in data interpretation, problem identification, and decision-making regarding health service changes; ensuring that closing of equity gaps becomes business as usual for DHBs, built into systems and not one off interventions reliant on individual champions and the need for greater recognition of mātauranga and Māori skills and knowledge as key to solutions for improving Māori health gain. Planning for the further communication of successful strategies to the wider sector has also been undertaken.

The first of a planned series of peer-reviewed journal papers was published mid-year (Gifford, Boulton, Cvitanovic, Neuwelt & Tenbensel. (2020). Making health data work for Māori: attitudes and current challenges. Policy Quarterly, 16 [2]), with a second currently under review and a third in the final stages of preparation for submission.

November 2020

Perceptions of Papakāinga

Brief Description:

The purpose of this project is to undertake the preliminary work necessary for a larger study that will explore how comparative views of “home” may relate to concepts such as identity, whakapapa, and hauora and how these concepts thereby impact decisions regarding access to (particularly) health services, as well as service utilisation and uptake in two areas – the Rangitīkei and Tāmaki Makaurau.

Outcomes / Achievements:

The project has started well with the completion of an annotated bibliography and comprehensive literature review, by student AUT Jana Nee, well in advance of our expected timeframe. Ethics approval was received from the Waipareira in-house ethical review board on 16 March 2020 and the New Zealand Ethics Committee (an ethics advisory committee serving social researchers not eligible for ethics review from the standing ethics committees for tertiary institutions or the health and disability sector www.nzethics.com) on 22 April 2020. As a consequence, fieldwork for the study began as planned in May 2020 and continued throughout June 2020.

With the country experiencing the constraints imposed by the Covid-19 lockdown levels, our interview method for the Ngāti Hauiti site was adapted. Whereas we had originally intended to undertake interviews kanohi ki te kanohi, this was impossible while the country was managing a pandemic. Instead all of the Ngāti Hauiti interviews were completed using Zoom. Our  urban-based partner, Wai Research meanwhile, were able to conduct all their interviews kanohi ki te kanohi as they were done during the month of  June when ‘lockdown’ restrictions had been relaxed. However, all participants were given the options of doing their interviews via telephone or Zoom if they preferred. The interviewer was also provided with a hygiene pack which contained disposable masks, hand sanitiser and wipes. All Wai Research staff were also required to undergo Covid-19 health and safety training including protocols for engaging with whānau. These protocols were applied by our interviewer where appropriate.

Team members from both sites are now in the process of analysing the interview transcripts with a view to conducting a face-to-face analysis hui in August. So far, despite of the challenges posed by Covid-19, we hope to complete the study as scheduled by the end of the year.

July 2020

Cultural, Ethical, Research, Legal and Scientific Guidelines Review

In 2018, the Cultural, Ethical, Research, Legal and Scientific (CERLS) Issues in Rongoā Maori Research Guidelines was launched as the result of Ngā Pae o te Māramatanga seeding funding research.  As a commitment to the ongoing pastoral care of these Guidelines, we committed to conducting a review every two years to monitor impact and influences on the Rongoā and research communities. A bi-annual meeting was held on Wednesday 03 June 2020, during which a planned review was conducted by Dr Amohia Boulton, Donna Kerridge and Dr Glenis Mark. The results of the review are as follows:

There were 100 printed copies of the guidelines distributed, and to date, there have been an additional 84 online downloads of this document.

The following points were discussed to show the impact of the guidelines on healers and researchers.

Impact on Healers

• The CERLS guidelines do appear to be useful to healers. Evidence from the sector indicated that healers are better informed about the role of researchers and what questions they should be asking of healers, prior to becoming involved in a study.  For example, healers will now ask whether researchers include Māori on their research teams.
• The CERLS guidelines have become a reference for healers.  Healers will now direct researchers with Rongoā research enquiries to the guidelines.  Healers have observed that doing so has led most researchers to abandon the subject, or the practitioner.

International interest

• Despite other countries having similar resources, the CERLS guidelines document has been a popular reference for  other Indigenous researchers.
• Researchers overseas involved in Indigenous studies have found the guidelines to be a valuable resource for informing culturally appropriate ways of researching with other Indigenous peoples.
• The guidelines were presented at the International Congress on Complementary Medicine Research Conference, held in Brisbane in May 2019 during the keynote presentation, Pathways and Partnerships for Researching Indigenous Medicine.  There was significant interest from international researchers at the conference wanting to access copies of the guidelines.

Impact on Researchers

• The guidelines have not been well utilised by researchers, as some have failed to reference this document, particularly in grant applications, even though they are incorporating Rongoā elements in their research.

Issues in Rongoā research

• Since the CERLS document was released, healers have observed the following behaviours:
• researchers making enquires of Rongoā practitioners about potential future Rongoā research, and when asked to refer to the CERLS document, make no further contact;
• researchers asking Rongoā Practitioners for letters of support but not showing those practitioners the final project grant application documentation, which contained elements that contradict Rongoā healing principles. Had healers been aware of the research findings contradicting Rongoā principles, the healers would have withdrawn support from such studies;
• Rongoā Practitioners being involved in an advisory capacity with Rongoā research but researchers not communicating openly or showing a strong commitment to Rongoā healing principles. In these instances, Rongoā practitioners have withdrawn their support for the study; and
• Rongoā Practitioners being expected to travel and contribute to research projects but not being compensated for their effort, time or travel. Often an excuse in these cases is that the researcher “didn’t put it in the budget”.  Rongoā practitioners are being expected to give of their knowledge and time with zero thought for their compensation.

In response to the issues that continue to arise in relation to Rongoā research, we have decided to contact the Health Research Council to articulate that this document would be very valuable to the research community.  We recommend that the HRC includes reference to this document in all Māori health funding documentation, in case of Rongoā inclusion in funding applications.

Recommended changes

There were several changes recommended to the CERLS guidelines:

• Funder understands that the community (or organisation) owns the research.  (Kenneth Ho, Hawaii, November 2018).
• Healers should be valued when consulted, for example, $500 per consultation.  That way their value will be set, similar to a market value, and all people will accept it in time (Fleur Palmer, Auckland, December 2018).
• Introduction to Rongoā:
• I think this needs to be greatly expanded. One of the big issues is that researchers come to research aspects of Rongoā knowing very little about what Rongoā actually is. That can be quite a handicap. A much more extensive description of what Rongoā is might help to overcome this, maybe? There are many references in the guidelines about the holistic view of healing that is important to Rongoā. The introduction needs to explain what that is much more fully.
• There is one sentence I disagree with on page 11: "We refer to this as  wairua, the invisible connections that bind all things in this world". That's not wairua; it's mauri. Wairua relates to the heavens; mauri is the connection between Ranginui and Papatuanuku, as in the saying from Whanganui: " Ko te wairua ki te Rangi, ko te tinana ki te Whenua, ko te mauri ki te takiwa".
• In many ways, mauri is the foundation of Rongoā - again a Whanganui teaching. I am surprised it is not included in the principles on page 18 - 19. Mauri is described very nicely on page 46: "The goal of Rongoā Māori is to restore and strengthen mauri, our life force. Mauri is the glue that maintains the balance between the physical and the spiritual world of which we are a part'. It is mentioned again on page 47; "Te essence of Rongoā Māori and its ability to heal one's mauri, to heal, resides in the connections that preceded its applications......". That's a thread that could be worked through the whole guidelines (Pa Robert McGowan, Tauranga, December 2018).

We are very grateful for, and acknowledge, these changes suggested to the CERLS guidelines.  Should the guidelines be reprinted, we will be able to incorporate these changes at that time.

General review

We were very pleased with the presentation and release of the CERLS guidelines which had a good response.  However, the target audience of researchers have yet to pick up and follow the guidelines. Although we know the CERLS guidelines make a valuable contribution to Rongoā research, it may take some time to filter through to any future researchers who wish to incorporate a Rongoā element in their research.

Next review

The next CERLS review will be held in 2022.

If you have any queries about this review or the guidelines, please contact amohia@whakauae.co.nz for more details.

The full CERLS document can be downloaded here.

July 2020

Rangatahi Innovation Evaluation

Evaluation Team:

Gill Potaka-Osborne, Lynley Cvitanovic, Mel Potaka-Osborne

Brief Description:

This is a rangatahi innovation project (link to https://www.teoranganui.co.nz/waiora-whanau) delivered by Te Oranganui Trust, a Māori Health and Social Services Provider in Whanganui. The innovation is funded through the Te Ao Auahatanga Hauora Māori: Māori Health Innovation Fund 2018-2022 from their Te Kākano/Seeding Innovation category.  

The innovation aims to better integrate cultural, social and health services for  rangatahi Māori in Whanganui with a single point of entry into a rangatahi health and well-being hub. The innovation targets rangatahi and their whānau who have multidimensional needs. These are addressed on an individual basis through supported pathways that allow them to make informed decisions on self-care; mentally, physically, emotionally and spiritually.

The programme extends current practice by including a specific mātauranga Māori approach and co-design methodology that rangatahi actively contribute to. It links rangatahi to the Awa and to Te Taiao, while also attending to the range of issues that they face by connecting/reconnecting them to whānau.

Outcomes / Achievements:

Hepi Ferris-Bretherton and Shade Tuaine-Whānau are the Kaitūruki for this innovation. At the end of 2019 they commenced working beside the first group. The group have completed activities and training such as working toward their forklift and scaffolding licences, work experience and developing maara kai. During the COVID 19 lockdown the kaitūruki have remained in contact with the rangatahi  using online communication methods such as ZOOM. The evaluation team is currently working with the kaitūruki to develop innovative methods that enable us to collect evaluation data during COVID 19 lockdown.

Rangatahi assisting with the development of a papakainga, through maara kai and riparian planting.

May 2020

Te Pae Herenga: An investigation of Māori whānau end of life cultural care customs

Lead researcher:

Tess Moeke Maxwell, University of Auckland

Whakauae researchers:

Dr Amohia Boulton

Description:

This three-year, HRC-funded study is investigating the traditional end-of-life Māori care customs that whānau draw on to strengthen their end-of-life caregiving activities and support palliative care service provision. The research is hosted by the Te Ārai Palliative Care and End of Life Research Group at the University of Auckland, where Principal Investigator Dr Tess Moeke-Maxwell (Ngāi Tai, Ngāti Porou) is based. She is supported by Te Ārai’s Kaumatua Roopu, led by Rawiri Wharemate (Ngātiwai, Ngāti Moerewa, Ngā Puhi). The research team brought together for the study include academics from the University of Auckland such as Professors Linda Nikora and Merryn Gott, Dr Amohia Boulton from Whakauae, health professionals such as Dr Keri Ratima, representatives from hospice, as well as other research assistants and students.

The research seeks to identify the barriers and facilitators Māori experience in using traditional care customs within different care settings (home, hospice, hospital and aged residential care). A number of  resources will be developed to share information about care customs with diverse Māori whānau, their communities and the palliative care sector. Planned resources include digital stories; an online educational resource; information on cultural care customs; helpful palliative care information; as well as peer reviewed articles.

Progress:

The research team met with members of the Te Pae Herenga researcher communities in August at Waipapa Marae at the University of Auckland and we had our last meeting for the year as a research team in October. So far, the research team have collected over 60 stories from whānau around Aotearoa - from Northland, to Hawkes Bay, Whanganui and Wellington. Many of these interviews have been turned into  digital stories. These digital stories will be made available to the wider public launch of Pae Herenga on 31 July 2020.  At the launch the Te Pae Herenga website will also go live, and the public will be able to access the many resources resulting for the study. Research team members will meet again in February 2020 to discuss and advance the analysis framework for the study’s publications. We will also start scoping out and writing the various papers emerging from this project.

Te Pae Herenga research team and researcher community members meet at Waipapa Marae, Auckland in August 2019

November 2019

Māori perspectives on care and protection in the Family Court

Lead researcher:

Tania Williams Blyth

Whakauae researchers:

Dr Amohia Boulton, Lynley Cvitanovic

 Description:

The research questions guiding this one-year study are:

• What would keep whānau who have come to the attention of Oranga Tamariki and of the Family Court better engaged in Family Court processes? and,
• What would support improved outcomes for these whānau and their tamariki?

To address these questions, we are exploring the Family Court processes that ‘work’ for whānau and those that do not. The commonalities and differences in the experiences whānau have with Family Court processes are also being identified.

This Kaupapa Māori study is drawing on a simple mixed methods approach to examine the understandings and experiences of 25 whānau. Data collection is primarily being conducted using a one-off survey that incorporates both closed and open-ended questions. Whānau have the opportunity to self-administer the survey online with the lead researcher available to assist where required. Alternatively, whānau can participate in a session with the lead researcher to together complete the survey.

Progress:

In mid-2019, we applied to the New Zealand Ethics Committee (Te Roopu Rapu I te Tika) for a review of the proposed study. Ethics approval was conferred by the Roopu in September 2019. Soon after, Tania Williams Blyth began whānau participant recruitment in conjunction with 14 Māori and iwi social services agencies in a number of North and South Island regions. She designed a participant recruitment poster for display at the premises of these agencies offering interested whānau the opportunity to opt into the study. Tania has now begun data collection and expects to complete this by mid-November 2019. Research team data analysis is scheduled for late November 2019 with preliminary results expected to be available to share with representatives of the Family Court before the end of the year.

Updated Oct 2019

Te Ara Auahi Kore (TAKE)

Researchers:

Anaru Waa, Dr Heather Gifford, Dr Amohia Boulton & Gill Potaka-Osborne, Bridget Robson, Dr Richard Edwards and Dr James Stanley.

Description:

Te Ara Auahi Kore (the TAKE Project) is a three-year Health Research Council of New Zealand funded research project seeking to understand-and reduce- disproportionally high rates of smoking among Māori. The TAKE Project will be delivered in partnership with Māori health organisations^[1] and includes three research studies:

1. surveys of tobacco control policies and interventions in participating locations (the PAI Study);
2. a cohort study of Māori smokers (the Cohort Study) and a
3. qualitative study of the whānau of Māori smokers (the Whānau Study).

^[1] The project has engaged with five PHOs. They are Te Tai Tokerau, National Hauora Coalition, Ngā Mataapuna Hauora, Ngāti Porou Hauora, and Ora Toa with Kokiri Marae & Takiri Mai te Ata Whānau Ora Collective.

Progress:

The PAI study is an online survey, designed to better help the research team understand the context of tobacco control services being offered in each participating location (Northland, Auckland, Bay of Plenty, East Coast /Gisborne, Wellington). Data collection for wave one is completed and will be followed by a second wave in 2020.

The Cohort study, a comprehensive online survey of Māori smokers in each of the participating locations was developed to help the research team understand how policies and interventions impact on Māori smoking behaviours.  The first six months of 2019 has been focussed on completion of wave one data collection, fine tuning the questionnaire for wave two and engaging Research New Zealand to collect data in two sites. Wave two data collection will be completed by early 2020. Some analysis of initial data is being conducted currently.

The Whānau study, now complete, interviewed 72 whānau members located in Eastcoast/Gisborne and Wellington. We talked about a range of national tobacco control policies such as tobacco tax, smokefree environments and harm reduction and quitting approaches such as vaping. We were ably supported in this work by two research assistants; Anania Kerehoma-Cook (Wellington) and Connie Henare (Eastcoast/Gisborne).  

The Whānau study helped us to identify what whānau were supportive of and what they found least supportive in terms of quitting. Our first action was to analyse the data and produce a brochure for our whānau participants letting them know the overall results from the study.

The results are also being shared with the Kaitiaki Roopu (participating partners and other advocates/advisors) as they emerge and being used to inform other tobacco control research work being undertaken by ASPIRE2025 (find out more here).  Anaru and Heather will also be presenting initial results at the Oceania Conference in Sydney later in 2019.

You can download the brochure here

Updated June 2019

Te Hao Nui, Te Hao Kōmārohi

Researchers:

The recently HRC-contracted Te Hao Nui, Te Hao Kōmārohi research project is being led by co-investigators, Andrew Sporle (McDonald Sporle Ltd) and Dr Amohia Boulton (Whakauae). Other members of the research team include Gill Potaka-Osborne (Whakauae) and Dr Reremoana Theodore (University of Otago).

Research Project Description:

This rangatahi wellbeing quantitative research project aims to improve the policy and service interventions that support rangatahi wellbeing by making high-quality information available to inform iwi and regional Māori development planning. The work is intended to contribute to the enhanced targeting of interventions and monitoring of rangatahi outcomes. The research seeks to link together data from Te Kupenga, the Integrated Data Infrastructure (IDI) and other government administrative databases to create the world’s largest and most comprehensive Indigenous youth longitudinal study. Focusing on informing local interventions and policy, the study will transform national statistical data into the locally accessible information, linked into service delivery planning and evaluation at the iwi, rohe and regional levels, that Māori providers and communities have been asking for. Three sites have been recruited to partner with us in the research; Te Oranganui Trust (Whanganui), the Auckland and Waitematā District Health Boards and Te Hiku o te Ika Iwi Development Trust (Northland).

Outcomes / Achievements:

Te Hao Nui, Te Hao Kōmārohi has now begun in earnest with the contracting of HRC funding, the negotiating of research relationships and  the letting of sub-contracts with key research partners. In mid-May 2019, Auckland-based Andrew Sporle travelled to Whanganui to meet with Te Oranganui Trust CEO, Wheturangi Walsh-Tapiata. Together with Dr Amohia Boulton and Gill Potaka-Osborne, they discussed the aims and benefits of the research, specifically to Te Oranganui  as a case study site. The Whanganui-based Maori health and social services provider will, as part of the project, be funded to employ their own part-time data researcher over a period of three years to participate in building the data portal, or hub, for the rohe. In the lead up to that appointment, the research team will work closely with Te Oranganui management and governance, along with selected community leaders, to explore local data requirements, issues and priorities.

Te Hao Nui, Te Hao Kōmārohi Research Team members. From left: Gill Potaka-Osborne, Dr Amohia Boulton and Andrew Sporle.

D3: Data, Decision-making and Development – Using Data to Improve Health Outcomes

Researchers:

Dr Heather Gifford, Dr Amohia Boulton, Gill Potaka-Osborne, Lynley Cvitanovic (Whakauae Research), Associate Professor Tim Tenbensel & Dr Pat Neuwelt (School of Population Health, University of Auckland), Teresa Taylor & Kiri Parata (Independent Researchers).

Research Project Description:

Routinely collected health data has been successfully used to describe “the problem” of persisting inequalities and to inform potential solutions. Increasing attention is now being paid to the utility of data and to its relevance. Taking a Kaupapa Māori approach, this three-year study is exploring how routinely collected Māori specific health data, gathered at the DHB level and reported by the Ministry of Health, can be optimally used by Māori leaders, DHB leaders and other decision-makers to stimulate improvements in health outcomes for Māori. Three case study DHBs - Taranaki, Whanganui and Waitematā – are taking part in the research. It is being conducted over three phases: an examination of current data utilisation practices; understanding facilitators and barriers to using data in health services planning; and, in the translation phase, communicating successful strategies to the wider sector. The study aims to highlight the processes, resources, skills and time needed to transform DHB level data into decisions and actions that improve hauora Māori.

Outcomes / Achievements:

The study began late in 2017 and was formally established, within each DHB case study site, during 2018. Detailed research planning, ethics approval and intensive work with participating DHBs to identify and define ‘the cases’ for consideration has since been completed. All three DHBs have identified child health data as an important area of investigation with two of the sites focusing the research on child health immunisation data and the third focusing on child oral health data.

The processes of engaging with DHBs, discussing the research and identifying data cases raised some very interesting issues and insights into current Māori data utilisation practices. The data we collected was analysed by the research team during September 2018 and discussed with our Expert Advisory Group. Dr Amohia Boulton then met with Tumu Whakarae, the National Reference Group of Māori Health Strategy Managers within DHBs, during March 2019 to present and discuss these early research results. A journal article exploring the results is also being prepared for submission later in 2019.

Members of the D3 Research Team and the D3 Expert Advisory Group. From back left: Associate Professor Tim Tenbensel,
Dr Pat Neuwelt, Riki Nia Nia. From front left: Andrew Sporle, Maria Poynter, Dr Doone Winnard,
Dr Heather Gifford and Karen Vercoe.

With D3 scheduled to conclude in the second half of 2020, we have now moved into the next phase of the research which seeks to further clarify the facilitators and barriers to the use of Māori child health data in health services planning in the context of each of the three case studies. We anticipate successfully completing this phase in September 2019.

Preventing Chronic Conditions Research Project

Researchers:

Drs Amohia Boulton, Heather Gifford, Melissa Cragg and Lesley Batten

Research Site Leads Gill Potaka-Osborne, Rachel Brown and Kiri Parata

Description:

Chronic conditions such as asthma, heart disease and diabetes are major health issues that significantly impact Māori. Preventing Chronic Conditions (PCC) was a three-year project funded by the Health Research Council of New Zealand (HRC). The project took a Māori-centred approach to carrying out comparative case studies in partnership with three Māori health providers: Te Oranganui Iwi Health Authority in Whanganui, Tui Ora in Taranaki and Poutini Waiora on the West Coast of the South Island. The research looked at prevention related activities within these providers to gain an understanding of how programmes can work to avoid conditions such as these from occurring in the first place.

Outcomes / Achievements:

Findings revealed that all three cases had similar principles: cross-sector collaboration; integrated health services; improved health service access; emphasis on health outcomes; increased responsiveness to Māori; and whānau-centred services.  Furthermore, all three Māori health and social service providers dealt with whānau who had complex and multiple issues, high needs and were most vulnerable. The issues for whānau are explicitly linked to the social determinants of health therefore, dealing with broader determinants such as housing or education needs plays an important role within health service delivery. Effective partnerships particularly related to District Health Boards (DHB) and service providers were found critical to effective prevention.  With health promotion no longer evident as a government priority, it was found that prevention was primarily occurring in small pockets related to specific areas such as obesity, smoking and alcohol. Additional findings highlight:

• All three providers were taking numerous opportunities to try and meet the needs of their communities;
• Prevention of long term conditions is consistent with Whānau Ora however not explicit in the current service arrangements;
• Achieving long-term wellbeing, through health service delivery, is highly complex especially if programmes are going to be sustainable; and,
• The broader national policy environment is not necessarily conducive to local level implementation.

Dissemination has occurred throughout the duration of the project, in varying ways and at different levels (local, national, provider and policy). Examples include, keeping Tumu Whakarae (the national reference group of Māori health strategy Managers within DHBs) informed and involved through presentations at meetings. Consistent contact with this group enabled both informal and formal discussions and debates as well as the provision of on-going guidance. Earlier this year, a hui was held that included bringing together all three providers and DHB representatives. The findings and discussions from all meetings were then presented to the Ministry of Health, policy and decision makers. Publications have also been submitted and findings will be presented at a range of conferences in this coming year. More recently as an end to the research journey, the team presented back to providers and participants using posters and booklets that captured the research processes, whānau stories as well as challenges and transformation.

Updated March 2018

Strengthening Evaluation Practices and Strategies (STEPS) in Indigenous settings in Australia and New Zealand

The collaborative STEPS research project started in 2014 and is being carried out by a team comprising Indigenous and non-Indigenous partners on both sides of the Tasman. The team is led by Dr Amohia Boulton and Associate Professor Margaret Cargo (University of Canberra). A fuller description of the STEPS research has previously been posted (refer below).

Outcomes / Achievements:

As previously reported, mixed-method concept mapping methodology was used in 2016 to brainstorm practices and strategies with participants that support culturally safe evaluation. The strategies generated were successfully consolidated, in the first half of 2017, resulting in a final set of 106. In the next phase of the research, we engaged participants in sorting these 106 strategies into conceptually meaningful groups or clusters. The rating phase of the study followed and involved each of the strategies being rated on their relative importance and achievability. Approximately 400 participants, on both sides of the Tasman, were involved in the STEPS data collection which was conducted in a series of waves using small group, one on one and online methods. Data collection concluded late in the year with preliminary analysis beginning prior to this.

Using multi-dimensional scaling and hierarchical cluster analyses, concept mapping software generated concept cluster maps for each country. Aotearoa New Zealand team members further analysed the NZ map with Australian team members similarly analysing the Australia data. During January 2018, we recruited a small group of Indigenous and non-Indigenous study participants in Aotearoa New Zealand to contribute to refining the NZ map. Refinement included reviewing cluster groupings and the cluster labels generated by the concept mapping software as well as determining thematic map “regions”. Following discussion with the Project Advisory Group, in February 2018, the research team has consolidated the final cluster maps.

The 12 cluster Australia map reflects three thematic regions: (1) An Evaluation Approach that Honours Community; (2) Core Heart of the Evaluation; and, (3) Cultural Integrity of the Evaluation. The 11 cluster New Zealand map reflects four regions: (1) Authentic Evaluation Practice; (2) Building Māori Evaluation Expertise; (3) Integrity in Māori Evaluation; and, (4) Putting Community First. Differences between the maps are being explored in the ongoing analysis along with commonalities. Later in 2018, results of the research will be shared with evaluation conference participants. Translating results into practice will be a key focus of dissemination taking in to account how resources can best be harnessed to ‘grow’ evaluation that works for Indigenous communities.

Facilitating the collection of data in the sorting phase of the STEPS research

Updated March 2018

He Tomokanga Hou Research Project

Brief Description:

Many Māori writers contend that there is a link between wellbeing and how closely you are connected to your Māori culture. They suggest that if you strongly identify as Māori, and actively take part ‘in things Māori’, you are more likely to feel good about being Māori and are more likely to have a positive sense of wellbeing. Anecdotally, Ngāti Hauiti whānau experience a sense of wellbeing associated with identifying as Hauiti and being active ‘in things Māori’.

In January 2017, a collaboration between Whakauae Research for Māori Health and Development, the research arm of Ngāti Hauiti, and Te Rūnanga o Ngāti Hauiti saw the development of He Tomokanga Hou, a 17-month research study. The aim of the study, launched soon after, is to explore the link between culture and wellbeing by investigating the process of restoring the tomokanga whakairo at Rātā marae. Supported and sponsored by the iwi leadership, rangatahi have been encouraged to take an active role in the research. Subsequently, rangatahi have been recruited through Te Rūnanga, He Whetu Arataki (the Youth Leadership Programme) along with wider whānau members recruited through Ngāti Hauiti networks. Participants have been exposed to the research process and had  an opportunity to explore how important whakairo, whakapapa, waiata and other “tangible” taonga are, to both young and old.

Outcomes / Achievements:

Since the project began,  key research related activities have included:

• Preparation of an ethics application, since approved by New Zealand Ethics Committee;
• Conceptualising, designing and carving of the new tomokanga, He Ara ki Puanga, unveiled at a dawn ceremony on 19 November 2017. The unveiling was attended by members of Ngāti Hauiti and the wider Mōkai Pātea confederation, community members, the local Mayor and other dignataries;
• Delivery of a  series of wānanga that have included supporting participants associated with the project to gain a deeper understanding of their individual connection to the eponymous ancestor Hauiti, as well as to their respective descent and whānau lines;
• Composition of a  waiata, celebrating the creation of the tomokanga, by female iwi members and performed for the first time at the unveiling; 
• Preliminary analysis of data collected from participants throughout the course of the research. This analysis suggests that participation has strengthened iwi members ties to Ngāti Hauiti and to Rātā marae. Whakawhanaungatanga, the opportunity to learn whakapapa and the rare chance to physically participate in mahi whakairo were seen as particular benefits of participation.

Analysis of He Tomokanga Hou data is continuing with results to be written up for publication in late 2018.

Inspired by He Tomokanaga Hou, Ngāti Hauiti artist Mina Bourke (nee Potaka) created Tomokanga: Te Kore (above) a work included in the Mixed Media, UCOL 2017 Bachelor of Design and Arts exhibition .

Updated March 2018

Strengthening Evaluation Practices and Strategies (STEPS) in Indigenous settings in Australia and New Zealand 

STEPS is a collaborative research project involving Indigenous and non-Indigenous partners, on both sides of the Tasman, all of whom independently fund their participation. The project, led by Dr Amohia Boulton and Associate Professor, Dr Margaret Cargo (University of Canberra), began in 2014 with a systematic review of the literature to identify principles to guide programme evaluation in Indigenous settings in Australia and Aotearoa New Zealand. The search came up with 15 evaluation-specific documents from which an initial set of 14 principles were distilled. These principles were presented to colleagues at the Australasian Evaluation Conference (AES) held in Darwin, Northern Territory in 2014. The following year, the principles were refined further generating a final set of 10 principles along with the development of a dynamic overarching conceptual framework. That work was presented at the 2015 AES Conference in Melbourne.

Outcomes / Achievements:

Following on from conference presentations, stakeholders with an interest in commissioning or carrying out evaluations were recruited to take part in STEPS concept mapping work. That work began with a brainstorming phase involving Aotearoa New Zealand Evaluation Association (ANZEA) conference and AES conference participants in 2016. Additional brainstorming data was collected through on-line and small group exercises, the latter facilitated in Aotearoa New Zealand by Mā te Rae Māori Evaluation Association. This phase of the concept mapping process focussed on identifying strategies integral to the design and evaluation of Indigenous programmes by Indigenous and non-Indigenous evaluators. More than 300 strategies were put forward by participants in the research.

During the first half of the year, the proposed strategies were refined by the research team, through a process of intensive iteration cycles, into a set of 106 statements. These statements have additionally been reviewed by the Project Advisory Group established to guide the research. We have since developed sorting and rating tools for use in the next phase of STEPS concept mapping with the testing of these tools carried out during June 2017. 

STEPS sorting data collection tools

We anticipate that the collection of sorting and rating data will be completed within the next two – three months. A total of 48 Indigenous and non-Indigenous evaluators and commissioners of evaluation will have the opportunity to participate in a face to face statement sorting activity with members of the research team at a variety of locations on each side of the Tasman. The rating activity to follow will be conducted online in most instances.