<h2>Te Maioha o Mamia</h2>

<p>&nbsp;</p>

<p>Te Maioha o Mamia, or Mamia, is Dr Aria Graham&rsquo;s postdoc mahi. Aria is a registered nurse who is working for Whakauae as a researcher. Aria&rsquo;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&nbsp;<em>of</em>&nbsp;tamariki M&#257;ori and their mothers,&nbsp;<em>for</em>&nbsp;tamariki M&#257;ori and their mothers.</p>

<p>Aria graduated with her PhD,&nbsp;<em>Tika Tonu: Young M&#257;ori Mothers&rsquo; Experiences of Wellbeing Surrounding the Birth of their First Tamaiti</em>&nbsp;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 M&#257;ori 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 hap&#363; and iwi constructs to earth, steer, and position the kaupapa. Aria&rsquo;s doctoral research concluded that &nbsp;for a Mamia model to &lsquo;work&rsquo;, the theory must go hand-in-hand with the environment. Her postdoctoral investigation is exploring the validity of that conclusion.</p>

<p>Mamia is a Kaupapa M&#257;ori model about nurture and empowerment and is being piloted from Waipatu Marae in Heretaunga (Hastings) in Te Matau-a-M&#257;ui (Hawke&rsquo;s Bay). It relies on tikanga M&#257;ori and the contribution and love of &lsquo;nannies&rsquo;, &lsquo;aunties&rsquo; and wh&#257;nau from the community to guide and nurture young m&#257;m&#257; and hap&#363; w&#257;hine. With the support of Whakauae, the HRC, Waipatu, the community, Aria&rsquo;s wh&#257;nau and networks, Mamia is taking shape. Whilst there was no funding to implement the Mamia model, aroha has breathed life into the intent.</p>

<p>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 m&#257;m&#257; and hap&#363; w&#257;hine.&nbsp; 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 M&#257;ori and is loving her mahi! To see the journey to date, visit Mamia on Facebook.</p>

<p>&nbsp;</p>

<p><img alt="" src="/uploads/images/Te-Maioha-o-Mamia_1.jpg" style="height:488px; width:650px" /></p>

<p style="text-align:center"><em><span style="font-size:12px">Humble beginnings - Te K&#333;kiri, Waipatu Marae March 2020</span></em></p>

<p><img alt="" src="/uploads/images/Te-Maioha-o-Mamia_2.jpg" style="height:488px; width:650px" /></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">December 2020</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Data, Decision-Making and Development (D3)</h2>

<p>&nbsp;</p>

<h4>Description:</h4>

<p>Routinely collected health data has been successfully used to describe &lsquo;the problem&rsquo; 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 M&#257;ori approach, this three-year study is exploring how routinely collected M&#257;ori specific health data, gathered at the DHB level and reported by the Ministry of Health, can be optimally used by M&#257;ori leaders, DHB leaders and other decision-makers to stimulate improvements in health outcomes for M&#257;ori. Three case study DHBs&nbsp; 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 M&#257;ori.</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>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. &nbsp;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 M&#257;ori 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 M&#257;ori 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 K&#333;rero Tahi Symposium and preliminary feedback to our site partners.</p>

<p>&nbsp;</p>

<p style="text-align:center"><img alt="" src="/uploads/images/Heather-October-D3-Research-Project.jpg" style="height:773px; width:650px" /><br />
<span style="font-size:12px"><em>Dr Heather Gifford presenting at &nbsp;the&nbsp;December 2019 HSAANZ Conference</em></span></p>

<p>&nbsp;</p>

<p>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 M&#257;ori. Several recommendations have been developed to strengthen decision-making that, if implemented, would stimulate improvements in health outcomes for M&#257;ori.&nbsp; Among these are greater involvement of M&#257;ori 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 m&#257;tauranga and M&#257;ori skills and knowledge as key to solutions for improving M&#257;ori health gain. Planning for the further communication of successful strategies to the wider sector has also been undertaken.</p>

<p>The first of a planned series of peer-reviewed journal papers was published mid-year (Gifford, Boulton, Cvitanovic, Neuwelt &amp; Tenbensel. (2020). Making health data work for M&#257;ori: attitudes and current challenges.&nbsp;<em>Policy Quarterly</em>, 16 [2]), with a second currently under review and a third in the final stages of preparation for submission.</p>

<p>&nbsp;</p>

<p><span style="font-size:12px">November 2020</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Perceptions of Papak&#257;inga</h2>

<p>&nbsp;</p>

<h4>Brief Description:</h4>

<p>The purpose of this project is to undertake the preliminary work necessary for a larger study that will explore how comparative views of &ldquo;home&rdquo; 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 &ndash; the Rangit&#299;kei and T&#257;maki Makaurau.</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>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&nbsp;<a href="http://www.nzethics.com" target="_blank">www.nzethics.com</a>) on 22 April 2020. As a consequence, fieldwork for the study began as planned in May 2020 and continued throughout June 2020.</p>

<p>&nbsp;</p>

<p>With the country experiencing the constraints imposed by the Covid-19 lockdown levels, our interview method for the Ng&#257;ti 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 Ng&#257;ti Hauiti interviews were completed using Zoom. Our&nbsp; 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&nbsp; June when &lsquo;lockdown&rsquo; 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 wh&#257;nau. These protocols were applied by our interviewer where appropriate.</p>

<p>&nbsp;</p>

<p>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.</p>

<p>&nbsp;</p>

<p><span style="font-size:12px">July 2020</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Cultural, Ethical, Research, Legal and Scientific Guidelines Review</h2>

<p>&nbsp;</p>

<p>In 2018, the Cultural, Ethical, Research, Legal and Scientific (CERLS) Issues in Rongo&#257; Maori Research Guidelines was launched as the result of Ng&#257; Pae o te M&#257;ramatanga seeding funding research.&nbsp; 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 Rongo&#257; 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:</p>

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

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

<p>&nbsp;</p>

<h4>Impact on Healers</h4>

<ul>
	<li>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. &nbsp;For example, healers will now ask whether researchers include M&#257;ori on their research teams.</li>
	<li>The CERLS guidelines have become a reference for healers. &nbsp;Healers will now direct researchers with Rongo&#257; research enquiries to the guidelines. &nbsp;Healers have observed that doing so has led most researchers to abandon the subject, or the practitioner.</li>
</ul>

<p>&nbsp;</p>

<h4>International interest</h4>

<ul>
	<li>Despite other countries having similar resources, the CERLS guidelines document has been a popular reference for&nbsp; other Indigenous researchers.</li>
	<li>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.</li>
	<li>The guidelines were presented at the&nbsp;International Congress on Complementary Medicine Research Conference, held in Brisbane in May 2019&nbsp;during the keynote presentation, Pathways and Partnerships for Researching Indigenous Medicine.&nbsp; There was significant interest from international researchers at the conference wanting to access copies of the guidelines.</li>
</ul>

<p>&nbsp;</p>

<h4>Impact on Researchers</h4>

<ul>
	<li>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 Rongo&#257; elements in their research.</li>
</ul>

<p>&nbsp;</p>

<h4>Issues in Rongo&#257; research</h4>

<ul>
	<li>Since the CERLS document was released, healers have observed the following behaviours:</li>
	<li>researchers making enquires of Rongo&#257; practitioners about potential future Rongo&#257; research, and when asked to refer to the CERLS document, make no further contact;</li>
	<li>researchers asking Rongo&#257; Practitioners for letters of support but not showing those practitioners the final project grant application documentation, which contained elements that contradict Rongo&#257; healing principles. Had healers been aware of the research findings contradicting Rongo&#257; principles, the healers would have withdrawn support from such studies;</li>
	<li>Rongo&#257; Practitioners being involved in an advisory capacity with Rongo&#257; research but researchers not communicating openly or showing a strong commitment to Rongo&#257; healing principles. In these instances, Rongo&#257; practitioners have withdrawn their support for the study; and</li>
	<li>Rongo&#257; 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 &ldquo;didn&rsquo;t put it in the budget&rdquo;.&nbsp; Rongo&#257; practitioners are being expected to give of their knowledge and time with zero thought for their compensation.</li>
</ul>

<p>&nbsp;</p>

<p>In response to the issues that continue to arise in relation to Rongo&#257; research, we have decided to contact the Health Research Council to articulate that this document would be very valuable to the research community.&nbsp; We recommend that the HRC includes reference to this document in all M&#257;ori health funding documentation, in case of Rongo&#257; inclusion in funding applications.</p>

<p>&nbsp;</p>

<h4>Recommended changes</h4>

<p>There were several changes recommended to the CERLS guidelines:</p>

<ul>
	<li>Funder understands that the community (or organisation) owns the research.&nbsp; (Kenneth Ho, Hawaii, November 2018).</li>
	<li>Healers should be valued when consulted, for example, $500 per consultation.&nbsp; 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).</li>
	<li>Introduction to Rongo&#257;:</li>
	<li>I think this needs to be greatly expanded. One of the big issues is that researchers come to research aspects of Rongo&#257; knowing very little about what Rongo&#257; actually is. That can be quite a handicap. A much more extensive description of what Rongo&#257; is might help to overcome this, maybe? There are many references in the guidelines about the holistic view of healing that is important to Rongo&#257;. The introduction needs to explain what that is much more fully.</li>
	<li>There is one sentence I&nbsp;disagree with on page 11: &quot;We refer to this as&nbsp; wairua, the invisible connections that bind all things in this world&quot;. That&#39;s not wairua; it&#39;s mauri. Wairua relates to the heavens; mauri is the connection between Ranginui and Papatuanuku, as in the saying from Whanganui: &quot; Ko te wairua ki te Rangi, ko te tinana ki te Whenua, ko te mauri ki te takiwa&quot;.</li>
	<li>In many ways, mauri is the foundation of Rongo&#257; - 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: &quot;The goal of Rongo&#257; M&#257;ori 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&#39;. It is mentioned again on page 47; &quot;Te essence of Rongo&#257; M&#257;ori and its ability to heal one&#39;s mauri, to heal, resides in the connections that preceded its applications......&quot;. That&#39;s a thread that could be worked through the whole guidelines (Pa Robert McGowan, Tauranga, December 2018).</li>
</ul>

<p>&nbsp;</p>

<p>We are very grateful for, and acknowledge, these changes suggested to the CERLS guidelines.&nbsp; Should the guidelines be reprinted, we will be able to incorporate these changes at that time.</p>

<p>&nbsp;</p>

<h4>General review</h4>

<p>We were very pleased with the presentation and release of the CERLS guidelines which had a good response.&nbsp; 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 Rongo&#257; research, it may take some time to filter through to any future researchers who wish to incorporate a Rongo&#257; element in their research.</p>

<p>&nbsp;</p>

<h4>Next review</h4>

<p>The next CERLS review will be held in 2022.</p>

<p>If you have any queries about this review or the guidelines, please contact&nbsp;<a href="mailto:amohia@whakauae.co.nz?subject=CERLS%20Enquiry%20from%20website">amohia@whakauae.co.nz</a>&nbsp;for more details.</p>

<p><a href="https://www.whakauae.co.nz/publications/technical-reports/5/">The full CERLS document can be downloaded here.</a></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">July 2020</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Rangatahi Innovation Evaluation</h2>

<p>&nbsp;</p>

<h4>Evaluation Team:</h4>

<p>Gill Potaka-Osborne, Lynley Cvitanovic, Mel Potaka-Osborne</p>

<p>&nbsp;</p>

<h4>Brief Description:</h4>

<p>This is a rangatahi innovation project (link to https://www.teoranganui.co.nz/waiora-whanau) delivered by Te Oranganui Trust, a M&#257;ori Health and Social Services Provider in Whanganui. The innovation is funded through the Te Ao Auahatanga Hauora M&#257;ori: M&#257;ori Health Innovation Fund 2018-2022 from their Te K&#257;kano/Seeding Innovation category.&nbsp;&nbsp;</p>

<p>The innovation aims to better integrate cultural, social and health services for&nbsp; rangatahi M&#257;ori in Whanganui with a single point of entry into a rangatahi health and well-being hub. The innovation targets rangatahi and their wh&#257;nau 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.</p>

<p>The programme extends current practice by including a specific m&#257;tauranga M&#257;ori 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 wh&#257;nau.</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>Hepi Ferris-Bretherton and Shade Tuaine-Wh&#257;nau are the Kait&#363;ruki 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 kait&#363;ruki have remained in contact with the rangatahi&nbsp; using online communication methods such as ZOOM. The evaluation team is currently working with the kait&#363;ruki to develop innovative methods that enable us to collect evaluation data during COVID 19 lockdown.</p>

<p>&nbsp;</p>

<p><img alt="Rangatahi assisting with the development of a papakainga, through maara kai and riparian planting." src="/uploads/images/Rangatahi-Innovation-Evaluation.jpg" style="height:316px; width:650px" /><br />
<em><span style="font-size:12px">Rangatahi assisting with the development of a papakainga, through maara kai and riparian planting.</span></em></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">May 2020</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Te Pae Herenga: An investigation of M&#257;ori wh&#257;nau end of life cultural care customs</h2>

<p>&nbsp;</p>

<h4>Lead researcher:</h4>

<p>Tess Moeke Maxwell, University of Auckland</p>

<p>&nbsp;</p>

<h4>Whakauae researchers:</h4>

<p>Dr Amohia Boulton</p>

<p>&nbsp;</p>

<h4>Description:</h4>

<p>This three-year, HRC-funded study is investigating the traditional end-of-life M&#257;ori care customs that wh&#257;nau draw on to strengthen their end-of-life caregiving activities and support palliative care service provision. The research is hosted by the Te &#256;rai Palliative Care and End of Life Research Group at the University of Auckland, where Principal Investigator Dr Tess Moeke-Maxwell (Ng&#257;i Tai, Ng&#257;ti Porou) is based. She is supported by Te &#256;rai&rsquo;s Kaumatua Roopu, led by Rawiri Wharemate (Ng&#257;tiwai, Ng&#257;ti Moerewa, Ng&#257; 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.</p>

<p>The research seeks to identify the barriers and facilitators M&#257;ori experience in using traditional care customs within different care settings (home, hospice, hospital and aged residential care). A number of &nbsp;resources will be developed to share information about care customs with diverse M&#257;ori wh&#257;nau, 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.</p>

<p>&nbsp;</p>

<h4>Progress:</h4>

<p>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 wh&#257;nau around Aotearoa - from Northland, to Hawkes Bay, Whanganui and Wellington. Many of these interviews have been turned into &nbsp;digital stories. These digital stories will be made available to the wider public launch of Pae Herenga on 31 July 2020.&nbsp; 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&rsquo;s publications. We will also start scoping out and writing the various papers emerging from this project.</p>

<p>&nbsp;</p>

<p style="text-align:center"><img alt="" src="/uploads/images/Te-Pae-Herenga.jpg" style="height:308px; width:650px" /><br />
<em><span style="font-size:12px">Te Pae Herenga research team and researcher community members meet at Waipapa Marae, Auckland in August 2019</span></em></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">November 2019</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>M&#257;ori perspectives on care and protection in the Family Court</h2>

<p>&nbsp;</p>

<h4>Lead researcher:</h4>

<p>Tania Williams Blyth</p>

<p>&nbsp;</p>

<h4>Whakauae researchers:</h4>

<p>Dr Amohia Boulton, Lynley Cvitanovic</p>

<p>&nbsp;</p>

<h4>&nbsp;Description:</h4>

<p>The research questions guiding this one-year study are:</p>

<ul>
	<li>What would keep wh&#257;nau who have come to the attention of Oranga Tamariki and of the Family Court better engaged in Family Court processes? and,</li>
	<li>What would support improved outcomes for these wh&#257;nau and their tamariki?</li>
</ul>

<p>To address these questions, we are exploring the Family Court processes that &lsquo;work&rsquo; for wh&#257;nau and those that do not. The commonalities and differences in the experiences wh&#257;nau have with Family Court processes are also being identified.</p>

<p>This Kaupapa M&#257;ori study is drawing on a simple mixed methods approach to examine the understandings and experiences of 25 wh&#257;nau. Data collection is primarily being conducted using a one-off survey that incorporates both closed and open-ended questions. Wh&#257;nau have the opportunity to self-administer the survey online with the lead researcher available to assist where required. Alternatively, wh&#257;nau can participate in a session with the lead researcher to together complete the survey.</p>

<p>&nbsp;</p>

<h4>Progress:</h4>

<p>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 wh&#257;nau participant recruitment in conjunction with 14 M&#257;ori 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 wh&#257;nau 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.</p>

<p>&nbsp;</p>

<p><img alt="" src="/uploads/images/FINAL%20Survey%20Poster%20130819.jpg" style="height:919px; width:650px" /></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">Updated Oct 2019</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Te Ara Auahi Kore (TAKE)</h2>

<p>&nbsp;</p>

<h4>Researchers:</h4>

<p>Anaru Waa, Dr Heather Gifford, Dr Amohia Boulton &amp; Gill Potaka-Osborne, Bridget Robson, Dr Richard Edwards and Dr James Stanley.</p>

<p>&nbsp;</p>

<h4>Description:</h4>

<p>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 M&#257;ori. The TAKE Project will be delivered in partnership with M&#257;ori health organisations<sup>[1]</sup>&nbsp;and includes three research studies:</p>

<ol>
	<li>surveys of tobacco control policies and interventions in participating locations (the PAI Study);</li>
	<li>a cohort study of M&#257;ori smokers (the Cohort Study) and a</li>
	<li>qualitative study of the wh&#257;nau of M&#257;ori smokers (the Wh&#257;nau Study).</li>
</ol>

<p><sup>[1]</sup>&nbsp;The project has engaged with five PHOs. They are Te Tai Tokerau, National Hauora Coalition, Ng&#257; Mataapuna Hauora, Ng&#257;ti Porou Hauora, and Ora Toa with Kokiri Marae &amp; Takiri Mai te Ata Wh&#257;nau Ora Collective.</p>

<div>&nbsp;</div>

<h4>Progress:</h4>

<p>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.</p>

<p>The Cohort study, a comprehensive online survey of M&#257;ori smokers in each of the participating locations was developed to help the research team understand how policies and interventions impact on M&#257;ori smoking behaviours. &nbsp;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.</p>

<p>The Wh&#257;nau study, now complete, interviewed 72 wh&#257;nau 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). &nbsp;</p>

<p>The Wh&#257;nau study helped us to identify what wh&#257;nau 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 wh&#257;nau participants letting them know the overall results from the study.</p>

<p>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 (<a href="https://aspire2025.org.nz/" target="_blank">find out more here</a>).&nbsp; Anaru and Heather will also be presenting initial results at the&nbsp;<a href="https://otcc.org.au/2019/" target="_blank">Oceania Conference</a>&nbsp;in Sydney later in 2019.</p>

<p>&nbsp;</p>

<p><a href="/uploads/files/WHAKAUAE_TAKe%20E-panui%20providers%20brochure_LR.pdf" target="_blank">You can download the brochure here</a></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">Updated June 2019</span></p>

<div>&nbsp;</div>

<hr />
<p>&nbsp;</p>

<h2>Te Hao Nui, Te Hao K&#333;m&#257;rohi</h2>

<p>&nbsp;</p>

<h4>Researchers:</h4>

<p>The recently HRC-contracted Te Hao Nui, Te Hao K&#333;m&#257;rohi 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).</p>

<p>&nbsp;</p>

<h4>Research Project Description:</h4>

<p>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 M&#257;ori 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&rsquo;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 M&#257;ori 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 Waitemat&#257; District Health Boards and Te Hiku o te Ika Iwi Development Trust (Northland).</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>Te Hao Nui, Te Hao K&#333;m&#257;rohi has now begun in earnest with the contracting of HRC funding, the negotiating of research relationships and &nbsp;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 &nbsp;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.</p>

<p>&nbsp;</p>

<p style="text-align:center"><img alt="Te Hao Nui, Te Hao K&#333;m&#257;rohi Research Team members" src="/uploads/images/Te-Hao-Nui-Te-Hao-Komarohi-Research-Team-members.jpg" style="height:427px; width:650px" /><br />
<em><span style="font-size:12px">Te Hao Nui, Te Hao K&#333;m&#257;rohi Research Team members. From left: Gill Potaka-Osborne, Dr Amohia Boulton and Andrew Sporle.</span></em></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>D3: Data, Decision-making and Development &ndash; Using Data to Improve Health Outcomes</h2>

<p>&nbsp;</p>

<h4>Researchers:</h4>

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

<p>&nbsp;</p>

<p><img alt="D3 - Data, Decision-Making, Development" src="/uploads/images/d3-logo.png" style="height:139px; width:651px" /></p>

<p>&nbsp;</p>

<h4>Research Project Description:</h4>

<p>Routinely collected health data has been successfully used to describe &ldquo;the problem&rdquo; 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 M&#257;ori approach, this three-year study is exploring how routinely collected M&#257;ori specific health data, gathered at the DHB level and reported by the Ministry of Health, can be optimally used by M&#257;ori leaders, DHB leaders and other decision-makers to stimulate improvements in health outcomes for M&#257;ori. Three case study DHBs - Taranaki, Whanganui and Waitemat&#257; &ndash; 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 M&#257;ori.</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>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 &lsquo;the cases&rsquo; 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.</p>

<p>The processes of engaging with DHBs, discussing the research and identifying data cases raised some very interesting issues and insights into current M&#257;ori 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 M&#257;ori 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.</p>

<p>&nbsp;</p>

<p style="text-align:center"><img alt="Members of the D3 Research Team and the D3 Expert Advisory Group." src="/uploads/images/D3-Temp.jpg" style="height:391px; width:650px" /><br />
<em><span style="font-size:12px">Members of the D3 Research Team and the D3 Expert Advisory Group. From back left: Associate Professor Tim Tenbensel,<br />
Dr Pat Neuwelt, Riki Nia Nia. From front left: Andrew Sporle, Maria Poynter, Dr Doone Winnard,<br />
Dr Heather Gifford and Karen Vercoe.</span></em></p>

<p>&nbsp;</p>

<p>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 M&#257;ori 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.</p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Preventing Chronic Conditions Research Project</h2>

<p>&nbsp;</p>

<h4>Researchers:</h4>

<p>Drs Amohia Boulton, Heather Gifford, Melissa Cragg and Lesley Batten</p>

<p>Research Site Leads Gill Potaka-Osborne, Rachel Brown and Kiri Parata</p>

<p>&nbsp;</p>

<h4>Description:</h4>

<p>Chronic conditions such as asthma, heart disease and diabetes are major health issues that significantly impact Ma&#772;ori. Preventing Chronic Conditions (PCC) was a three-year project funded by the Health Research Council of New Zealand (HRC). The project took a Ma&#772;ori-centred approach to carrying out comparative case studies in partnership with three Ma&#772;ori 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.</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>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 M&#257;ori; and wh&#257;nau-centred services. &nbsp;Furthermore, all three Ma&#772;ori health and social service providers dealt with wh&#257;nau who had complex and multiple issues, high needs and were most vulnerable. The issues for wh&#257;nau 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. &nbsp;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:</p>

<p>&nbsp;</p>

<ul>
	<li>All three providers were taking numerous opportunities to try and meet the needs of their communities;</li>
	<li>Prevention of long term conditions is consistent with Wh&#257;nau Ora however not explicit in the current service arrangements;</li>
	<li>Achieving long-term wellbeing, through health service delivery, is highly complex especially if programmes are going to be sustainable; and,</li>
	<li>The broader national policy environment is not necessarily conducive to local level implementation.</li>
</ul>

<p>&nbsp;</p>

<p>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 M&#257;ori 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, wh&#257;nau stories as well as challenges and transformation.</p>

<p>&nbsp;</p>

<p><img alt="Whakauae Physical Outcomes Programmes Posters" src="/uploads/images/04348_Whakauae-Physical-Outcomes-Programmes-Posters_2.jpg" style="height:914px; width:650px" /></p>

<p>&nbsp;</p>

<p><img alt="Whakauae MTM Programme" src="/uploads/images/04291_Whakauae-MTM-Programme_singles-10.png" style="height:651px; width:650px" /></p>

<p>&nbsp;</p>

<p><img alt="Whakauae Whanau Kaiarahi poster" src="/uploads/images/04315_WHAKAUAE_Whanau-Kaiarahi-poster.jpg" style="height:460px; width:650px" /></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">Updated March 2018</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Strengthening Evaluation Practices and Strategies (STEPS) in Indigenous settings in Australia and New Zealand</h2>

<p>&nbsp;</p>

<p>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).</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>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.</p>

<p>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 &ldquo;regions&rdquo;. Following discussion with the Project Advisory Group, in February 2018, the research team has consolidated the final cluster maps.</p>

<p>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 M&#257;ori Evaluation Expertise; (3) Integrity in M&#257;ori 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 &lsquo;grow&rsquo; evaluation that works for Indigenous communities.</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p><img alt="Strengthening Evaluation Practices and Strategies (STEPS) in Indigenous settings in Australia and New Zealand" src="/uploads/images/steps-image.jpg" style="height:359px; width:650px" /></p>

<p><em><span style="font-size:12px">Facilitating the collection of data in the sorting phase of the STEPS research</span></em></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">Updated March 2018</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>He Tomokanga Hou Research Project</h2>

<p>&nbsp;</p>

<h4>Brief Description:</h4>

<p>Many M&#257;ori writers contend that there is a link between wellbeing and how closely you are connected to your M&#257;ori culture. They suggest that if you strongly identify as M&#257;ori, and actively take part &lsquo;in things M&#257;ori&rsquo;, you are more likely to feel good about being M&#257;ori and are more likely to have a positive sense of wellbeing. Anecdotally, Ng&#257;ti Hauiti wh&#257;nau experience a sense of wellbeing associated with identifying as Hauiti and being active &lsquo;in things M&#257;ori&rsquo;.</p>

<p>In January 2017, a collaboration between Whakauae Research for M&#257;ori Health and Development, the research arm of Ng&#257;ti Hauiti, and Te R&#363;nanga o Ng&#257;ti 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 R&#257;t&#257; 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 R&#363;nanga, He Whetu Arataki (the Youth Leadership Programme) along with wider wh&#257;nau members recruited through Ng&#257;ti Hauiti networks. Participants have been exposed to the research process and had &nbsp;an opportunity to explore how important whakairo, whakapapa, waiata and other &ldquo;tangible&rdquo; taonga are, to both young and old.</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>Since the project began, &nbsp;key research related activities have included:</p>

<ul>
	<li>Preparation of an ethics application, since approved by New Zealand Ethics Committee;</li>
	<li>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 Ng&#257;ti Hauiti and the wider M&#333;kai P&#257;tea confederation, community members, the local Mayor and other dignataries;</li>
	<li>Delivery of a &nbsp;series of w&#257;nanga 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 wh&#257;nau lines;</li>
	<li>Composition of a &nbsp;waiata, celebrating the creation of the tomokanga, by female iwi members and performed for the first time at the unveiling;&nbsp;</li>
	<li>Preliminary analysis of data collected from participants throughout the course of the research. This analysis suggests that participation has strengthened iwi members ties to Ng&#257;ti Hauiti and to R&#257;t&#257; marae. Whakawhanaungatanga, the opportunity to learn whakapapa and the rare chance to physically participate in mahi whakairo were seen as particular benefits of participation.</li>
</ul>

<p>&nbsp;</p>

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

<p>&nbsp;</p>

<p><img alt="He Tomokanga Hou Research Project" src="/uploads/images/He-Tomokanga-Hou-Research-Project.jpg" style="height:545px; width:650px" /></p>

<p><em><span style="font-size:12px">Inspired by He Tomokanaga Hou, Ng&#257;ti 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 .</span></em></p>

<p>&nbsp;</p>

<p><span style="font-size:12px">Updated March 2018</span></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Strengthening Evaluation Practices and Strategies (STEPS) in Indigenous settings in Australia and New Zealand&nbsp;</h2>

<p>&nbsp;</p>

<p>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.</p>

<p>&nbsp;</p>

<h4>Outcomes / Achievements:</h4>

<p>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 M&#257; te Rae M&#257;ori 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.</p>

<p>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.&nbsp;</p>

<p>&nbsp;</p>

<p style="text-align:center"><img alt="STEPS sorting data collection tools" src="/uploads/images/steps-collection-tools.jpg" style="height:485px; width:650px" /><br />
<em><span style="font-size:12px">STEPS sorting data collection tools</span></em></p>

<p>&nbsp;</p>

<p>We anticipate that the collection of sorting and rating data will be completed within the next two &ndash; 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.&nbsp;</p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h2>Hospital Transfers &ndash; Wh&#257;nau Involvement in the healing equation</h2>

<p>&nbsp;</p>

<p>Whakauae Research Services, the University of Auckland and Waikato University have partnered to undertake research looking at hospital transfers for M&#257;ori. The project is funded through Ng&#257; Pae o te M&#257;ramatang&#257; and is titled: Hospital Transfers, wh&#257;nau involvement in the healing equation. The project has four distinct phases.</p>

<p>&nbsp;</p>

<h4>1. Description:</h4>

<p>Phase one is to gain a comprehensive understanding of patterns of hospital transfers and experiences of wh&#257;nau who wish to stay actively engaged in care. Three pieces of work are currently being completed; Statistical Analysis, Wh&#257;nau interviews and an Environmental Scan.</p>

<p>The statistical analysis is well underway with work undertaken by Dr Arama Rata (NIDEA) and Waikato University Biostatistician Ms Lyn Hunt. Utilising publicly available (e.g. from DHB reports), the analysis provides important information on specific patterns of M&#257;ori &lsquo;away from home&rsquo; hospital care. The analysis will include hospital transfers and flows of patients between facilities and identify patterns in these flows for M&#257;ori at national and regional levels.</p>

<p>Twenty-two wh&#257;nau interviews, focusing on the wh&#257;nau experiences of hospital transfers and hospitalisations &lsquo;away from home&rsquo; have been completed. Wh&#257;nau recruitment occurred through researcher networks as well as the community &ldquo;kumara vine&rdquo;. The circulation of an artistically tailored poster caught the eye of many wh&#257;nau. &nbsp;Wh&#257;nau replied by text highlighting their willingness to be involved in the project. Each interview has been transcribed, cleaned and summarised ready to be given back to participants. Participants will receive a summary on a template incorporating the art used in the recruitment poster. Analysis of interviews has commenced with the team coming together to undertake a mahi-a-roopu analysis (analysis as a team) in mid-August.</p>

<p>The environmental scan will assist the team to gain a deeper understanding of the current environment within which wh&#257;nau who wish to remain actively engaged in care operate. The scan focuses on publicly available data on current policies, programmes or interventions associated with hospital transfers and hospitalisation &lsquo;away from home&rsquo;. We are just starting this phase of data collection.</p>

<p>&nbsp;</p>

<h4>2. Engagement:</h4>

<p>This phase includes engagement of stakeholders, partnering activities (agreements, terms of reference) and progressing proposals for funding. Gaining stakeholder buy-in will assist the research team better understand how the hospital system and broader policy contexts facilitate or hinder active wh&#257;nau involvement.&nbsp; Current engagement has included: Waikato DHB clinicians; research-active clinicians at the University of Auckland; the Ministry of Health through the development of specifications for the National Minimum Data Set; and a range of experts who comprise the Health Experts Advisory Group.&nbsp; A Terms of Reference document has been confirmed and engagement has been agreed with relevant parties. Proposals for additional funding are in progress. Two proposals for interns have been successful as well as proposals to attend and present at national and international conferences.</p>

<p>&nbsp;</p>

<h4>3. Uptake:</h4>

<p>The uptake phase incorporates mapping and identifying strategies or environments that promote active wh&#257;nau participation in care. It is a work in progress and reliant on data from the earlier phases.</p>

<p>&nbsp;</p>

<h4>4. Dissemination:</h4>

<p>This phase involves discussion, debate and generating awareness of the impacts of hospital transfers on both sides of the healing equation by making sure research findings continue to be distributed through multiple forums.</p>

<p>&nbsp;</p>

<p>Dissemination has occurred through different avenues. Research team members have presented at both local event (research symposiums, meetings and community hui) as well as at international fora such as the Race, Whiteness and Indigeneity International Conference on the Gold Coast, Australia; the International Indigenous Research Conference,&nbsp; Auckland; and He Manawa Whenua, Waikato.&nbsp;</p>

<p>&nbsp;</p>

<p><img alt="Hospital Transfers ? Wh&#257;nau Involvement in the healing equation" src="/uploads/images/hospital-transfers-poster.png" style="height:920px; width:650px" /></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3>Te Puawai o te Ahi Kaa</h3>

<p>In 2014, the three-year Te Puawai o Te Ahi (TPoTAK) project was awarded funding through the MoH M&#257;ori Innovations Fund. A collaboration between Raetihi Pah and Te Oranganui Trust, the project aim was to strengthen the health and wellbeing of those wh&#257;nau who maintain the Ahi Kaa to ensure the future sustainability of the paepae and marae. Whakauae was commissioned to complete the evaluation component of the innovation project.&nbsp;&nbsp; A general process and outcomes approach to the evaluation was taken underpinned by Kaupapa M&#257;ori methodology. The use of a Kaupapa M&#257;ori methodology reflects Whakauae&rsquo;s commitment, as an iwi-owned research centre, to working with M&#257;ori communities in a way that resonates with M&#257;ori beliefs and traditions maintaining a focus on transparency, building purposeful and respectful relationships, recognising strengths and contributing to positive social change.</p>

<p>&nbsp;</p>

<h4>&nbsp;Outcomes / Achievements</h4>

<p>The evaluation identified that TPoTAK has contributed to empowering wh&#257;nau to be proactive about understanding and managing their own health and that of their wh&#257;nau. Wh&#257;nau valued the time and effort that the project kaimahi had put into building social capital in the Raetihi Pah community. There is no doubt that the whakapapa links of the kaimahi, and their membership of the Raetihi community, were instrumental in the their successfully gaining community &lsquo;buy in&rsquo; for the TPoTAK innovation. The Advisory Group, established to guide the project, proved to be indispensable. The Group sealed the working relationship between Raetihi Pah and Te Oranganui Trust, provided cultural oversight for the project and involved wh&#257;nau in a role that would help prepare them for future involvement in service delivery contracting arrangements.</p>

<p>Increased positive health behaviours among wh&#257;nau, highlighted by the evaluation, included participation in physical and nutrition related activities such as Tri-M&#257;ori, Zumba, boot-camps and the development of maara kai. In addition, networking by the project kaimahi produced valuable collaborations with other service providers. These collaborations have supported the delivery of health and wider social services to the Raetihi Pah community that better meet their needs in terms of both cultural relevance and accessibility.</p>

<p>Capability building was possible through the Health Research Council Independent Research Organisation Funding and was an important component of this project for both the wh&#257;nau and the kaimahi. Increasing capability in the M&#257;ori health services workforce was demonstrated at many points throughout the project from workshops at wh&#257;nau hui to upskilling and formal training&nbsp;sessions. In addition, kaimahi were supported to attend evaluation conferences and evaluation training workshops. In June 2017, funding for the project ceased however TPoTAK has supported Raetihi Pah wh&#257;nau to develop further knowledge and skills to enhance their health and wellbeing.</p>

<p>&nbsp;</p>

<p style="text-align:center"><img alt="Te Puawai o te Ahi Kaa" src="/uploads/images/Te-Puawai-o-te-Ahi-Kaa.jpg" style="height:458px; width:650px" /><br />
<em><span style="font-size:12px">Wh&#257;nau members from TPOTAK project participating in a Mystery Bus Tour to Huka Falls.</span></em></p>

<h3>&nbsp;</h3>

<hr />
<h3>&nbsp;</h3>

<h3><strong>Whaia Te Ahi Kaa: Ahi Kaa and its role in Hauora&nbsp;</strong></h3>

<p style="text-align:justify">Dr Heather Gifford was approached by Kiri Parata and her iwi, Te Atiawa ki Waikanae to assist in the development of an HRC application to the Ng&#257; Kanohi Kitea fund. The application was successful and Dr Gifford supported Ms Parata as she led this project for her wh&#257;nau. The study aimed to explore the impact of active participation in marae and iwi activities on the health, wellbeing and sense of connectedness of iwi members.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4>Outcomes / Achievements</h4>

<p style="text-align:justify"><img alt="" src="/uploads/images/Whakarongotai2.jpg" style="float:right; height:250px; margin:10px; width:250px" />There have been a number of distinct research outcomes from the research. First, the results from the research are directly informing the longer-term oranga strategy for the iwi. Researchers and iwi leaders are using the images and voices of the participants to clearly communicate positive messages to iwi members about maintaining their hauora. Secondly, as a consequence of the opportunity to participate in the research, members of the iwi now have increased confidence about undertaking future research. Third, the research provided two opportunities to directly mentor emerging researchers. Ms Parata was able to undertake her first research project as a principal investigator (with close support by Dr Heather Gifford) and in turn she mentored a research assistant who gained skills in a number of research areas. Finally iwi members have participated fully in the research and, through very skilled dissemination activities by the lead researcher, have experienced positive messages about themselves.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p style="text-align:justify">&nbsp;</p>

<h3><span style="font-size:22px"><strong>Maternity Quality and Safety Programme Evaluation&nbsp;</strong></span></h3>

<p style="text-align:justify">Whakauae was subcontracted by Allan and Clarke to contribute to the evaluation of the progress and effectiveness of the Ministry of Health&rsquo;s Maternity Quality and Safety Programme (MQSP). The MQSP programme has been operating in each DHB since 2012, with initial funding provided until 30 June 2015, after which time DHBs were expected to operate MQSPs as business as usual. The Ministry of Health sought an evaluation which would inform decisions regarding continued funding of the programme, and improvements to the programme. The evaluation particularly focused on what has worked at a local (District Health Board) level to improve the safety and quality of maternity services.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4>Outcomes / Achievements</h4>

<p style="text-align:justify">The Ministry of Health has been provided with a final report containing a number of recommendations to inform future development for the MQSP programme. Members of the research team presented the final report at the four yearly Maternity Conference where it was officially launched by Minister Dunn. As Allen and Clarke have noted on their website: the evaluation evidence showed that the programme had considerable merit, and in time, would likely provide significant returns. The programme had started to deliver meaningful improvements and there was significant value in continued Ministry of Health investment and support. A full copy of the report is available on the Ministry of Health website.</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3><span style="font-size:22px"><strong>Smokefree Wellington&nbsp;</strong></span></h3>

<p style="text-align:justify">This project aimed to:&nbsp;</p>

<p style="text-align:justify">1) Identify potential benefits and challenges of smokefree outdoor policies,</p>

<p style="text-align:justify">2) Propose relevant policy options and recommendations for smokefree outdoor areas in public spaces, using Wellington City as a case study.</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">In 2015 we used data from documents, in-depth interviews, small workshops and a symposium to develop options and recommendations for extending smokefree outdoor areas in Wellington. Our research participants represented a mix of sectors including the business (particularly hospitality and retail); local government (politicians and staff); iwi; union; and health sectors. Policymaker workshops were conducted in 2015 to further explore the results from the research and discuss a mix of policy options. Results are intended to be used by Wellington City Council to inform smokefree bylaws for the city in 2016.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3><span style="font-size:22px"><strong>Enjoy Nicotine Replacement Therapy&nbsp;</strong></span></h3>

<p style="text-align:justify">The University of Otago led this project, which was successful in being awarded funding for the study from the Ministry of Health Innovation Fund. The project tested the latest advanced, rapid-acting, nicotine replacement therapies (NRT), taking these direct to smokers in localities such as shopping malls. As part of the study Whakauae&nbsp;provided advice on engagement with M&#257;ori and relevant research methods and analysis.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">The results of this study suggest that more effective and more attractive NRTs, and more effective methods of encouraging smokers to use NRT are required. Current NRTs, with their medicalised packaging, and highly restrictive rules around their provision and use, are not sufficiently attractive to smokers. It is possible that smoking cessation staff, who are very well connected to their community, may have better success in encouraging smokers to use NRT and continue to engage in quitting behaviour. The methods used to engage with smokers in the present trial were successful in reaching a large number of smokers, many of whom were M&#257;ori, almost half of whom had neutral or no motivation to quit smoking in the short-term and were therefore unlikely to enrol in a conventional smoking cessation service. This method of reaching smokers in high priority populations, if combined with access to a wider range of more effective and free-of-charge NRTs, is likely to help New Zealand achieve the SmokeFree2025 Vision.</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3><span style="font-size:22px"><strong>Smoking an Informed Choice&nbsp;</strong></span></h3>

<p style="text-align:justify">Whakauae has been subcontracted by the University of Otago to lead the M&#257;ori stream of this three-year project. The overall aim of the research is to determine how young adult smokers and social smokers&nbsp;define &ldquo;informed choice&rdquo;, and to develop and evaluate methods of estimating &ldquo;informed choice&rdquo;.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">Data collection is complete for this project and results have been disseminated widely. The research has adapted existing informed choice frameworks to better recognise the wider social and behavioural context of smoking. Tobacco control policy makers will be invited to a symposium in 2016 to share and discuss final results.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3><span style="font-size:22px"><strong>Evaluation of the Early Pregnancy Assessment Approach&nbsp;</strong></span></h3>

<p style="text-align:justify">We carried out an intensive process and short-term outcomes evaluation of the Whanganui Regional Health Network&rsquo;s locally developed Early Pregnancy Assessment Approach (EPAA) in the first half of 2015. This evaluation was commissioned by the Health Promotion Agency (HPA), a Crown entity established under the New Zealand Public Health and Disability Amendment Act 2012. The evaluation aimed to determine how the EPAA &lsquo;works&rsquo;, who it works for and why in order to support both the Regional Health Network&rsquo;s refinement of the intervention and the HPA&rsquo;s critical assessment of EPAA potential for implementation by other primary health care providers nationally. Key informant interviews with service users informed the evaluation results along with interviews with the Regional Health Network&rsquo;s staff and service delivery partners. Document review was also carried out.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">A detailed service model description was developed in the early stages of the evaluation. That description provides a template for other primary health care providers looking to put an EPAA in place in their own areas of the country. The final evaluation report includes practical recommendations for further refinement of the EPPA locally, which have been taken into account by the Regional Health Network as it continues&nbsp;to fine-tune the intervention. The HPA has made the evaluation material available on its website.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p style="text-align:justify">&nbsp;</p>

<h3><span style="font-size:22px"><strong>Tapuhi T&#363; Toa: a Kaupapa M&#257;ori Tobacco Cessation Intervention&nbsp;</strong></span></h3>

<p style="text-align:justify">This work builds on results from a previous Whakauae research project, M&#257;ori Nurses and Smoking; Exploring the opportunities for change. In this new project we are piloting an intervention in four nursing schools which is aimed at ensuring all M&#257;ori nurses who graduate are smokefree. The intervention uses a supportive w&#257;nanga approach to bring smokers together to&nbsp;discuss tensions, evidence for quit and link participants with a range of services and support systems.&nbsp;</p>

<p style="text-align:justify"><img alt="" src="/uploads/images/NZNO%20Conf(1).jpg" style="height:400px; width:600px" /></p>

<h4 style="text-align:justify">&nbsp;</h4>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">A significant amount of background work took place in 2015 in preparation for the intervention rolling out in 2016 including; engaging support from the wider nursing sector, ethics approval, engaging the sites and establishing a new advisory team. In addition an evaluation team has been established to test effectiveness of the intervention. It is intended that the pilot will be in the field in the first half of 2016.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3 style="text-align:justify"><span style="font-size:22px"><strong>Mana Tamariki Mokopuna Mana Wh&#257;nau Project Evaluation&nbsp;</strong></span></h3>

<p style="text-align:justify">Mana Tamariki Mokopuna Mana Wh&#257;nau (MTMMW) is an intervention that represents a new model of service delivery. It focuses on addressing the needs of vulnerable young M&#257;ori women, their p&#275;pi, tamariki and wh&#257;nau who reside on the West Coast of the South Island. In 2014, Poutini Waiora engaged Whakauae to develop and implement a process and outcomes evaluation of the intervention.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">During 2015 the evaluator worked alongside the provider as the intervention developed and unfolded. Evaluation activities included finalising an evaluation plan including a project logic model. The evaluator also provided feedback on project activities such as action plans and data collection tools. During this phase a focus group interview of kaimahi was completed and initial data analysis completed. The evaluation has contributed to building community capacity, which in turn, has strengthened understanding of the project and subsequent implementation.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

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<p>&nbsp;</p>

<h3 style="text-align:justify"><span style="font-size:22px"><strong>Te Puawai o te Ahi Kaa Project Evaluation&nbsp;</strong></span></h3>

<p style="text-align:justify">Te Puawai o Te Ahi Kaa (TPoTAK) Project is being collaboratively undertaken by Raetihi Pah and Te Oranganui Iwi Health Authority. This innovative Kaupapa M&#257;ori initiative is based on the role of the marae as the house of the hap&#363;; the place of cultural sustenance and vitality for wh&#257;nau. It recognises that the health and wellbeing of those wh&#257;nau who maintain the ahi kaa is critical to the sustainability of the paepae and marae. The project commenced in mid-2014 and shortly afterwards Whakauae Research Services was engaged to evaluate it. The evaluation design is based on a participatory research approach to &ldquo;evaluate with&rdquo; rather than carry out an &ldquo;evaluation of &rdquo; Te Puawai o Te Ahi Kaa. Whilst the design uses methods described in Western research literature it draws primarily on qualitative approaches using a M&#257;ori worldview.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify"><img alt="" src="/uploads/images/Whanau%20day%20Dec%2015%20(16).jpg" style="float:left; height:218px; margin:10px; width:200px" />At the beginning of 2015 Phase Two of the evaluation commenced. Evaluation activities included development of rubrics tables as a tool to help make evaluation assessments (regarding project activities and outcomes) transparent. A focus group interview, a survey of project participants, kaimahi recording of photo narratives and muralling methods were used. In the initial data analysis phase key findings and themes were identified. The evaluators shared these results with wh&#257;nau in a data &lsquo;sense-making&rsquo; process which was part of the December 2015 wh&#257;nau day held at the marae. The day provided an opportunity for the evaluators to meet face to face with the wider wh&#257;nau.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3 style="text-align:justify"><span style="font-size:22px"><strong>Taranaki M&#257;m&#257; P&#275;p&#275; Hauora Programme Evaluation&nbsp;</strong></span></h3>

<p style="text-align:justify">We carried out a process and short &ndash; medium term outcomes evaluation of the Taranaki M&#257;m&#257; P&#275;p&#275; Hauora (MPH) Programme, which we completed in the second half of 2015. The MPH Programme was initiated in mid-2013 following a successful response by the Taranaki District Health Board, and its strategic partners, to a Ministry of Health request for proposals. The Programme seeks to improve the health and wellbeing of mothers and their children through better nutrition, including breastfeeding, and regular physical activity. Tui Ora Ltd, based in New Plymouth, is delivering the Programme that focuses on priority Taranaki communities. The evaluation aimed to determine how effective the Programme was in reaching priority audiences. It also assessed positive changes in participant awareness, understanding and behaviour with respect to nutrition and physical activity.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify">An MPH Programme Interim Evaluation Report was completed in March 2015 using data collected from programme participants, kaimahi and governance group members along with the review of key programme documentation. The findings and recommendations made in that report were used by the evaluation commissioner, and the provider, to refine the second phase of the Programme rollout which began in July 2015.&nbsp;</p>

<p style="text-align:justify">Using further data collected in the first half of 2015, a Final MPH Programme Evaluation Report was completed in September 2015. Results and recommendations included in the Final Evaluation Report have since been used to further inform the fine-tuning of phase two of the MPH Programme which is scheduled to conclude in mid-2016.</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p style="text-align:justify">&nbsp;</p>

<h3 style="text-align:justify"><span style="font-size:22px"><strong>Huarahi rongo&#257; ki a ng&#257;i t&#257;tou: M&#257;ori views on rongo&#257; M&#257;ori and primary health&nbsp;</strong><strong>(Postdoctoral Research)&nbsp;</strong></span></h3>

<p style="text-align:justify">In this project, the views of M&#257;ori were explored in relation to health, experience of rongo&#257; M&#257;ori, experience of primary health services and the integration of rongo&#257; M&#257;ori with primary health care. Two groups of M&#257;ori health services consumers, one which used rongo&#257; in addition to primary health treatment and one which only used primary health treatment, were interviewed. Consumers also participated in the use of a methodology termed &ldquo;M&#257;ori-voice&rdquo; by Dr Mark; giving expression to M&#257;ori worldviews of hauora through photographs. In undertaking the research, it was hoped to establish the ways in which M&#257;ori beliefs about health and illness contribute to health treatment choices along with how the health treatment experiences of participants can be used to inform integration of rongo&#257; and primary health services for the benefit of M&#257;ori.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">Dr Glenis Mark completed her postdoctoral studies in February 2015. A key achievement was the production of a booklet for her research participants, based on the photographs they took as part of the study. The booklet, Huarahi rongo&#257; ki a ng&#257;i t&#257;tou: M&#257;ori views on rongo&#257; M&#257;ori and primary health - Results of research conducted with M&#257;ori patients of rongo&#257; and primary health, was presented to participants and Project Advisory Group members at a research dissemination hui in November 2014. An important component of Dr Mark&rsquo;s postdoctoral work was the production of academic journal articles and, in addition to the research she undertook, she was successful in having two articles accepted for publication in 2015, with a further two currently under review.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3 style="text-align:justify"><span style="font-size:22px"><strong>Preventing Chronic Conditions: Learnings from Participatory Research with M&#257;ori&nbsp;</strong></span></h3>

<p style="text-align:justify">In this 42-month study, we are examining how the primary and secondary prevention of chronic conditions is being modelled, practiced and measured in three case study sites; to define what short term outcomes are being achieved; and enable naturalistic generalisation to be made to inform wider health service development. A collective case study design, utilising qualitative and evaluation-based research methods, will examine the three case studies. Data will be interrogated across three levels, policy (government), practice (provider) and wh&#257;nau (community).&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify">Phase One of the study was completed at the close of 2015. The three case study sites are each implementing models of care to improve M&#257;ori health outcomes for chronic conditions. All have similar principles: cross sector collaboration; integrated health services; improved health service access; emphasis on health outcomes; increased responsiveness to M&#257;ori; and wh&#257;nau-centred services.&nbsp;</p>

<p style="text-align:justify">The early results from this project will be presented to Tumu Whakarae, the National Reference Group of M&#257;ori Strategy Managers within DHBs, in early 2016.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3 style="text-align:justify"><span style="font-size:22px"><strong>HRC Writing Workshops&nbsp;</strong></span></h3>

<p style="text-align:justify">The HRC Writing Workshops have been run by Whakauae since 2009, in a variety of formats and locations, but always with the same primary objective, namely to increase the number and quality of applications made by M&#257;ori researchers to the HRC&rsquo;s various funding rounds. In 2015, two workshops were held; one at the offices of Te Wh&#257;nau o Waipereira Trust in Auckland and a second at Te P&#363;tahi &#257; Toi, Massey University, Palmerston North. A workshop specifically focused on applying for the Ng&#257; Kanohi Kitea (NKK) round of community-led research grants was held in Whanganui, after a number of requests from the local&nbsp;community. This workshop was held in conjunction with, and hosted by, Te Atawhai o te Ao.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4 style="text-align:justify"><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify"><img alt="" src="/uploads/images/NKK2.jpg" style="float:left; height:167px; line-height:20.8px; margin:10px; width:250px" /></p>

<p style="text-align:justify">All workshops were well attended with the rise in interest amongst community and iwi members in both research funding and the work of the HRC, being particularly noticeable. This community interest in the activity of &ldquo;research&rdquo; is heartening and can be put down in large part to the success of the HRC&rsquo;s Ng&#257; Kanohi Kitea grant round. The NKK Investigator Briefing Meeting (IBM) was well attended and participants remained very engaged throughout the day. From the feedback we receive through our formal evaluation forms, and un-solicited comments, we know that community members who attend the writing workshops get real value from their attendance. We have noticed greater interest on the part of community members participating in, and eventually leading their own research projects for their own people. In addition, the presentation on Career Development Awards (CDA) is always well received, and we are aware that this interest has translated directly into&nbsp;a growth in CDA applications to the HRC over the years we have been conducting the workshops.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

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<p>&nbsp;</p>

<h3><span style="font-size:22px"><strong>Supporting Traditional Rongo&#257; Practice in Contemporary Health Care Settings&nbsp;</strong></span></h3>

<p style="text-align:justify">In this three-year project, we sought to identify the health service arrangements that best support traditional rongo&#257; M&#257;ori practice in a contemporary setting. Using a M&#257;ori-centred approach, and a mix of qualitative and quantitative methods, the research aimed to identify the features of health service arrangements that are both consistent with principles of rongo&#257; practice and that ensure cultural integrity. The project represented a collaboration between researchers from Whakauae and two different universities (Canterbury and Waikato) as well as the involvement of the Chair of Te K&#257;hui Rongo&#257; as a researcher on the project. Te K&#257;hui Rongo&#257;, the national body for rongo&#257; M&#257;ori practitioners, played an active role in the project. As well as acting in an advisory capacity for the project team, Te K&#257;hui Rongo&#257; assisted the&nbsp;research team to make sense of the findings before they were released to the wider sector.&nbsp;</p>

<p style="text-align:justify">&nbsp;</p>

<h4><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">The results of our research have shown a number of significant issues must be addressed by the rongo&#257; sector to ensure rongo&#257; M&#257;ori continues as a vital part of Te Ao M&#257;ori. Key amongst these issues include how to ensure the sustainability of an ageing workforce; that this workforce is receiving the training it requires; and that the sector has access to the raw materials and m&#257;tauranga it requires to be effective. To date, the research team has produced two peer-reviewed journal articles on these and other issues, and further articles are being prepared for publication. We have also been able to share our findings with the sector through peer reviewed conference papers; six separate oral conference papers and presentations to local communities. Local presentations have culminated in a keynote address on the importance of the rongo&#257; sector driving its own research agenda at the National Rongo&#257; Symposium and Expo, held in Whanganui in October 2015.</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<h3><img alt="" src="/uploads/images/TKTA%20Title.jpg" style="height:202px; width:650px" /></h3>

<p style="text-align:justify">The Rangit&#299;kei Iwi of Ng&#257;ti Apa and M&#333;kai P&#257;tea identified a collective need to access good quality information about their individual iwi populations. Te Kete T&#363; &#256;tea Phase 2 study builds on previous HRC funded research that developed an information framework for each iwi, namely, Te Kete T&#363; &#256;tea. Whakauae has funded Phase 2 implementation of the framework testing utility and impact of the framework using data from the economic domain. The intended outcome will be iwi leaders and governors utilising information to achieve evidence-informed decisions.</p>

<p style="text-align:justify">This research is conducted with iwi participating as active research partners and uses a mixed methods approach of both qualitative in-depth interviews and quantitative statistical data.&nbsp;&nbsp; The aim is to:</p>

<ol>
	<li style="text-align:justify">Determine how economic information is able to be accessed, analysed and disseminated to iwi leaders in a meaningful and efficient manner,</li>
	<li style="text-align:justify">To observe and discuss how economic information is received and can be used to exercise Kaitiakitanga, and</li>
	<li style="text-align:justify">To analyse how, or if, information results in decision-making that future-proofs iwi.</li>
</ol>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify">It is intended that this research provide evidence to inform the future progression of the framework across all five domains for the Collective.</p>

<p style="text-align:justify">&nbsp;</p>

<h4><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify"><img alt="" src="/uploads/images/TKTA%20Goals.jpg" style="float:right; height:221px; margin:10px; width:300px" />The project is progressing well and in particular is seen as a flagship for other iwi when it comes to collecting, analysing and utilising quantitative data at an iwi level. There are a number of data initiatives happening across government, coinciding with the timing of this project. As a result, the team were asked to present at the Iwi/M&#257;ori data hui initiated by the Minister of Finance, and facilitated by Treasury and Statistics New Zealand in September 2015. Kirikowhai Mikaere was also invited to an Advisory Group Hui (following the first Iwi/M&#257;ori data hui of the Minister of Finance), to provide further advice and guidance as to next steps for Treasury and Statistics New Zealand. Because of these meetings, the NZ Data Futures project, and the creation of an Integrated Data Infrastructure, or IDI, an independent M&#257;ori Data Sovereignty network has been initiated. A first hui on the topic of M&#257;ori Data Sovereignty was held in Hopuhopu in October 2015 and attracted some 30 M&#257;ori with interests in this kaupapa. Kirikowhai Mikaere and Dr Tahu Kukutai are the interim co-leaders of the network.</p>

<h4 style="text-align:center"><span style="font-size:18px"><em>Iwi Information + Iwi Analysis = Better Iwi Futures</em></span></h4>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3><span style="font-size:22px">Care and Protection of our M&#257;ori Children, our Future: A Wh&#257;nau Perspective</span></h3>

<p style="text-align:justify"><img alt="" src="/uploads/images/Tania.jpg" style="float:left; height:324px; margin:0px 10px; width:250px" />M&#257;ori overrepresentation in care and protection of tamariki/mokopuna is continuing to rise, increasing the risk of incidents of child abuse and removal of mokopuna from wh&#257;nau. However, resources for the care and protection of mokopuna have tended to overlook the contribution of positive change models initiated by M&#257;ori parents and grandparents. The aim of this research is to ascertain and articulate the positive contribution that can be made by M&#257;ori parents and grandparents to the care and protection of their tamariki/mokopuna. The qualitative research design used a narrative inquiry in semi-structured kanohi-ki-te-kanohi interviews to elicit stories from 10 M&#257;ori wh&#257;nau parents and grandparents. Preliminary findings from the analysis indicate that there are a number of ways in which M&#257;ori parents and grandparents can better be supported to meet the needs of their children, once they have come to the attention of Child, Youth &amp; Family Services (CYFS) and the Justice system. Preliminary findings also indicate that further training of the iwi/community social service sector, who work with parents and grandparents at the time of first contact and subsequently is required.</p>

<p>&nbsp;</p>

<h4><span style="font-size:20px"><strong>Outcomes / Achievements</strong></span></h4>

<p style="text-align:justify">The research provided valuable insight into the positive contribution made by M&#257;ori parents and grandparents to the care and protection of tamariki/mokopuna. Subsequently, the research has used the stories gathered from wh&#257;nau to set up a pilot study offering navigator services for wh&#257;nau. The pilot, Mokopuna Ora, is a partnership between Waikato-Tainui and CYFS and seeks to address some of the key issues identified by wh&#257;nau including the lack of information, knowledge and communication when interacting with the CYFS/Family Court system. Research results will be disseminated at a Research Hui in Whanganui early in 2016.</p>

<p style="text-align:justify">&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3><span style="font-size:22px">Te Puawai o Te Ahi Kaa: a MoH Innovation Project</span></h3>

<p style="text-align:justify">At Raetihi Pah, local hap&#363; members are leading a four-year Ministry of Health funded Innovation project; Te Puawai o Te Ahi Kaa (TPoTAK). This project is in partnership with Te Oranganui Iwi Health Authority and Whakauae Research (as evaluation support). TPoTAK seeks to enhance the wellbeing of wh&#257;nau who have remained living locally by mapping the historical wellbeing of wh&#257;nau as well as identifying the current health and wellbeing status of members. To date, the team has completed a health needs assessment and developed a wh&#257;nau-informed programme of action. The aim of this is to increase health literacy and positively change health behaviours to enhance wh&#257;nau well-being. Now in the final year of the project, the team is working on implementation of these strategies with the ultimate aspiration of strengthening Ahi Kaa and keeping the paepae strong.</p>

<p style="text-align:justify">&nbsp;</p>

<p style="text-align:justify">Whakauae is committed to working collaboratively with project kaimahi and the wider community and seeks to build the evaluation skills of kaimahi throughout the project. Examples of this have included:</p>

<ul>
	<li style="text-align:justify">kaimahi administration and collection of evaluation data;</li>
	<li style="text-align:justify">kaimahi generated photo narratives that provide project activities a voice; and</li>
	<li style="text-align:justify">support with applications to the Australasian Evaluation Society conference support grant fund.</li>
</ul>

<p style="margin-left:38.5pt; text-align:justify">&nbsp;</p>

<p style="text-align:justify">In December 2015, evaluators attended a wh&#257;nau day so they could share initial data analysis and key findings with the community. Results show that the project is providing members with a vehicle to better understand the health issues within their wh&#257;nau and the community.&nbsp; This greater understanding has resulted in a plan of action whereby health information is being shared, services are better integrated with the community and community&nbsp;<img alt="" src="/uploads/images/TPoTAK1(6).jpg" style="float:left; height:244px; margin:10px; width:250px" />members are upskilled in issues such as chronic conditions self-management and caring for vulnerable children. During the wh&#257;nau day, participants were encouraged to take part in sessions where &lsquo;muralling&rsquo; techniques were used to make sense of data. Wh&#257;nau enjoyed the interactive wh&#257;nau-friendly sessions and are keen to utilise some of these in their workplace. The day provided an opportunity for the evaluators to meet face to face with the wider wh&#257;nau and other community groups.&nbsp;</p>

<p><img alt="" src="/uploads/images/TPoTAK2(3).jpg" style="height:271px; width:650px" /></p>

<p>&nbsp;</p>

<hr />
<p>&nbsp;</p>

<h3><span style="font-size:22px">Preventing Chronic Conditions: &nbsp;Learnings from Participatory Research with M&#257;ori</span></h3>

<p>In this 42-month, HRC-funded study, we are examining how the primary and secondary prevention of chronic conditions is being modelled, practiced and measured in three case study sites.&nbsp; Read on for the latest update on this project.</p>

<p>&nbsp;</p>

<h4><strong>Why is this work important now?</strong></h4>

<p>Extensive work is underway in the health sector to&nbsp;<em>manage</em>&nbsp;chronic conditions including service and workforce redesign, and clinical guideline development. Key health service approaches include quality management, primary and secondary care integration, care coordination and multidisciplinary teamwork. For those with chronic conditions, emphasis is often placed on&nbsp;<em>self-management</em>&nbsp;as an outcome of interventions, education and support. These approaches however contribute little to the&nbsp;<em>prevention&nbsp;</em>of chronic conditions and commonly inadequately address the needs of M&#257;ori, under-utilise broader wh&#257;nau engagement in prevention and struggle to achieve and maintain cross sector collaboration.</p>

<p>Our research aims to:</p>

<ul>
	<li>Examine how the prevention (both primary and secondary) of chronic conditions is being modelled, practiced and measured in three unique iwi health provider sites (Poutini Waiora, Westcoast); Te Oranganui Iwi Health Authority, Whanganui; and Tui Ora Ltd, Taranaki);</li>
	<li>Define what short term outcomes are being achieved; and to,</li>
	<li>Enable naturalistic generalisations to be made to inform wider health service development.</li>
</ul>

<p>&nbsp;</p>

<p>Under the umbrella of a M&#257;ori-centred approach a collective case study design, utilising qualitative and evaluation-based research methods, is being used to examine a chronic condition prevention case study in each of the health provider sites. Data is being interrogated across three levels, policy (government), practice (provider) and wh&#257;nau (community). Multilevel, comparative exploration will produce results that demonstrate the diversity in perspectives, priority setting, and intervention practices and experiences between key actors.</p>

<p>Phase One of the study was completed at the close of 2015. That Phase included identifying and defining each chronic condition prevention case along with addressing research questions about how prevention is modelled and priorities are defined.&nbsp;</p>

<h4>&nbsp;</h4>

<h4><strong>What have we found out so far?</strong></h4>

<p>Our three research sites are each implementing models of care to improve M&#257;ori health outcomes for chronic conditions. All have similar principles: cross sector collaboration; integrated health services; improved health service access; emphasis on health outcomes; increased responsiveness to M&#257;ori; and wh&#257;nau-centred services.</p>

<p>Data collected from the three sites and analysed in Phase One highlights the following:</p>

<ul>
	<li>Providers are taking opportunities to meet the needs of their communities;</li>
	<li>Achieving long-term wellbeing, through health service delivery, is complex especially if you want a programme to be sustainable; and,</li>
	<li>The broader national policy environment is not necessarily conducive to local level implementation.</li>
</ul>

<p>Providers know their communities in-depth and have some degree of flexibility to be able to re-orient themselves to better meet those needs. That provider responsiveness however, demands a mix of staff and skills that may not necessarily be readily available. &nbsp;Negotiating constant flux, exacerbated by ongoing changes in organisational funding and contracting, contributes to some lack of clarity with regard to organisational vision, roles and responsibilities. Ongoing organisational change therefore has impacts that can undermine the momentum to keep moving forward.</p>

<p>Commitment to working at wh&#257;nau level is being articulated, but is not readily facilitated by the wider national policy environment which conditions funding and contracting. For example, whilst key players may identify multi-sector collaboration as being integral to delivery of services which promote wellness much of the existing wider policy environment remains tuned to delivery &lsquo;in silos&rsquo;. Such delivery is directed towards separately addressing each of an individual&rsquo;s specific medical conditions in isolation.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p>

<p>There are a range of impediments to achieving wellbeing through health service delivery. The dominant individualistic, medical conditions focused discourse noted above is a driver of service delivery norms. There are examples of shifts in organisational structure, skill mix focus and delivery configurations that demonstrate that these norms are being challenged and reframed, in some form, by the providers. Early indications are that promising wh&#257;nau focussed, integrated models of care are being developed and implemented by providers though significant hurdles exist.</p>

<p>&nbsp;</p>

<h4><strong>Where to from here?</strong></h4>

<p>Phase Two (15 months) of the study is exploring how the chronic condition prevention cases identified in Phase One are being implemented in each site. In this Phase, we will also determine the outcome frameworks being utilised. Phase Three (late 2017 to January 2018) will then identify short term outcomes achieved, with respect to the implementation of each of the case study&nbsp; interventions, over the period of the research. Using the results and knowledge gained from each phase, Phase Three will inform broader health service development.</p>

<p>In the long-term this research has the potential to reduce chronic conditions for M&#257;ori through a number of interlinked pathways including the modelling of effective prevention along with using a combination of evidence and M&#257;ori models of practice. It will also contribute to Indigenous models of chronic condition prevention globally.&nbsp;</p>

<p>&nbsp;</p>

<h3>Health Promotion Evaluation&nbsp;</h3>

<p>During 2014, Whakauae was commissioned by&nbsp;<em>jigsaw whanganui</em>&nbsp;to carry out an evaluation of the agency&rsquo;s White Water Years Parenting Programme. The evaluation was largely funded through a Lotteries Board grant with the final report being completed in November 2014.</p>

<p>A collaborative approach was taken to carrying out the evaluation mahi. Whakauae worked alongside&nbsp;<em>jigsaw whanganui&nbsp;</em>staff to clarify Programme intent, to determine how Programme quality and success would be judged and to collect and &lsquo;make sense&rsquo; of evaluation data.&nbsp;<em>jigsaw whanganui&nbsp;</em>has already taken on board evaluation recommendations and is working towards further strengthening the already well rated White Water Years Parenting Programme. Programme developments influenced by the evaluation were outlined at a luncheon hosted by&nbsp;<em>jigsaw whanganui</em>&nbsp;to mark the completion of the evaluation.</p>

<p>Whakauae evaluators, Gill Potaka-Osborne and Lynley Cvitanovic joined&nbsp;<em>jigsaw whanganui&rsquo;s</em>&nbsp;staff at the luncheon on 03 February 2015.</p>

<p>&nbsp;</p>

<p><img alt="Whakauae &amp; jigsaw whanganui staff celebrate completion of the White Water Years Parenting Programme evaluation." src="/uploads/images/Jpeg-011.jpg" style="height:488px; width:650px" /><br />
Whakauae &amp;&nbsp;<em>jigsaw whanganui</em>&nbsp;staff celebrate completion of the White Water Years Parenting Programme evaluation.</p>

<p>&nbsp;</p>

<p><img alt="Whakauae evaluators with jigsaw whanganui programme facilitators, 03 February 2015." src="/uploads/images/Jpeg-009.jpg" style="height:488px; width:650px" /><br />
Whakauae evaluators with&nbsp;<em>jigsaw whanganui</em>&nbsp;programme facilitators, 03 February 2015.</p>

<p>&nbsp;</p>

<h3>Health Promotion Evaluation</h3>

<p>Whakauae Research staff belong to evaluation professional associations and take part in regular evaluation professional development activities. Gill Potaka-Osborne and Lynley Cvitanovic are both members of the Aotearoa New Zealand Evaluation Association (ANZEA), Dr Heather Gifford is an American Evaluation Association (AEA) member and Dr Amohia Boulton is an Australasian Evaluation Society (AES) member as well as being a member of the AES Board.</p>

<h4>Evaluation which Whakauae is currently carrying out, or which has been completed this year, includes that of:&nbsp;&nbsp;&nbsp;</h4>

<ul>
	<li>Te Oranganui Iwi Health Authority (Whanganui) and the Raetihi Pa&rsquo;s collaborative project, Te Puawai o Te Ahi Kaa with evaluation commissioned by the Ministry of Health through Te Ao Auahatanga Hauora M&#257;ori &ndash; M&#257;ori Health Innovations Fund 2013-2017;</li>
	<li>Poutini Waiora&rsquo;s (West Coast) Mana Tamariki Mokopuna, Mana Wh&#257;nau o Te Tai o Poutini project commissioned by the Ministry of Health through Te Ao Auahatanga Hauora M&#257;ori &ndash; M&#257;ori Health Innovations Fund 2013-2017;</li>
	<li>The M&#257;m&#257; P&#275;p&#275; Hauora Programme 2013-2015 delivered by Tui Ora in Taranaki with evaluation commissioned by the Taranaki District Health Board;</li>
	<li>The Early Pregnancy Assessment Approach developed and being delivered by the Whanganui Regional Health Network with evaluation commissioned by the national Health Promotion Agency (HPA);</li>
	<li>The national Maternity and Quality Safety Programme. We have been sub-contracted by Allan and Clarke to contribute to this programme evaluation commissioned by the Ministry of Health.</li>
</ul>

<p>As well as carrying out health promotion programme evaluation research locally, regionally and nationally, Whakauae has developed resource material to support community level practitioners to evaluate their own health promotion project work. This self-directed learning material, Building Evaluation Competence: Workbooks One, Two and Three is available on the Publications page of this website under the heading Technical Reports.</p>
