🍀 Toitū Te Tiriti; Māori-led contact tracing; training medical students; vaping ads targeting rangatahi; and more
Māori health research highlights from the past week
👋🏽 Kia ora, I’m George Gray, a public health physician doing my best to keep up with the latest health research that can help improve outcomes for Māori. This is the first edition of a weekly research summary, sent February 6th at 1840 hours. Here’s what I’ve learned this week…
🔬 The Latest Research
A Pioneering Māori-Led Public Health Model for COVID Case Management
Curtis, E., Loring, B., Latham, K., Jordan, A., Chee, N., Hunia, R., ... & Mckree Jansen, R. An innovative Indigenous-led model for integrated COVID-19 case management in Auckland, New Zealand: lessons from implementation. Frontiers in Public Health, 12, 1324239.
This article presents an innovative Māori-led service delivery model that was implemented to improve the case and contact management of Māori with COVID-19 in Auckland. The article outlines the context in which the conventional public health approach was failing Māori, describes the details of the model, and shares qualitative and quantitative data on its impact. The Māori Regional Coordination Hub (MRCH) model offers a valuable alternative to the conventional approach and provides lessons that could be applied to the delivery of other health and social services for Māori. (Note: the abstract is available at present, but the full journal article will be published in the near future. Until then, here’s a link to slides summarising the project.)
Addressing Ethnic Bias in Medical Students: A Promising Intervention
Hsu, C. W., & Akuhata-Huntington, Z. (2024). I have a dream: Altering medical students’ ethnic bias towards the Indigenous population (NZ Māori) using a digital training called cognitive bias modification. Stigma and Health.
This article discusses a study that aimed to address ethnic bias in medical students towards the Māori population. The authors developed a digital bias intervention called cognitive bias modification for stereotype (CBM-S), which used an implicit learning task to encourage a less biased interpretation of Māori patients in healthcare scenarios. The effectiveness of the CBM-S training was tested through pre- and post-training measures of interpretation bias and beliefs. The results showed a reduction in stereotype interpretation bias scores and post-training stereotype bias scores, indicating the potential of CBM-S as a tool to address bias in medical education.
Vaping Visibility: Protecting Rangatahi Health
Lyons, A., Barnes, A. M., Goodwin, I., Carah, N., Young, J., Spicer, J., & McCreanor, T. (2024). Exposure to digital vape marketing among young people in Aotearoa New Zealand. New Zealand Medical Journal, 137(1589).
This study revealed that Māori and Pasifika youth are more likely to be exposed to vape product advertising on social media platforms. This is concerning, as it may indicate targeted marketing efforts towards these groups. The study found that 50% had seen vape marketing online, with higher exposure to Māori and Pasifika youth, and most commonly on Instagram. Over a quarter of the participants engaged with vape marketing online, with Māori and Pasifika respondents being more likely to do so. These findings raise concerns about the impact of digital vape marketing on young people's perceptions and behaviours. The study also highlighted the need for transparency in social media platforms' advertising practices to address inequitable targeting. (see below for a chart describing the prevalence of daily vaping captured by the New Zealand Health Survey)
An Equity-Focused Implementation Framework to Address Health Inequities
Gustafson, P., Lambert, M., Bartholomew, K. et al. Adapting an equity-focused implementation process framework with a focus on ethnic health inequities in the Aotearoa New Zealand context. Int J Equity Health 23, 15 (2024).
This article presents the development of an equity-focused implementation framework for health interventions in the Aotearoa New Zealand context, with a specific focus on addressing ethnic health inequities for Māori and Pasifika. The framework is based on the principles of Te Tiriti o Waitangi and aims to support the planning and delivery of equitable implementation pathways for health interventions. It includes four main steps: implementation planning, pathway design, monitoring, and outcomes and evaluation. The framework is intended for use by mainstream health services/providers and is the first equity-focused process-type implementation framework adapted for the Aotearoa NZ context.
Unlocking the Secrets to Kaumātua Wellbeing: Transformative Urban Papakāinga
Smith, D. L., Oetzel, J. G., Simpson, M. L., Wilson, Y., Nock, S., & Reddy, R. (2024). Kaumātua needs and perspectives regarding urban papakāinga: a mixed methods observational study. Kōtuitui: New Zealand Journal of Social Sciences Online, 1-22.
In this study, researchers unveiled the cultural components vital for thriving kaumātua within urban papakāinga. The study revealed that housing developments infused with whanaungatanga (connections), kaitiakitanga (environmental guardianship), manaakitanga (care for others), rangatiratanga (leadership/autonomy), and haumarutanga (safety/security) significantly enhance kaumātua wellbeing. These elements, alongside housing suitability, community ties, and neighbourhood safety, surfaced as fundamental well-being correlates. For health professionals seeking actionable insights into housing, this article highlights pathways to elevate kaumātua health outcomes with culturally resonant housing solutions.
📈 Chart of the Week
The latest update to the New Zealand Health Survey was published in December. The trends in vaping were described in this excellent summary from the Public Health Communications Centre; a graph from that article is shown below. The rise in daily vaping among (mostly young) Māori and Pasifika over the past three years is alarming. The rise in vaping is occurring mainly among young non-smokers.
The high prevalence of daily vaping found in the NZ Health Survey links back to the targeted advertising described in the research article above.
📝 Other Articles
NZMJ Editorial: Embracing "Toitū Te Tiriti" for Health Equity
Pitama, S., Haitana, T., Patu, M., Robson, B., Harris, R., McKerchar, C., Clark, T., & Crengle, S. (2024). Toitū Te Tiriti. New Zealand Medical Journal, 137(1589).
In the wake of the new coalition Government's 100-day plan, the call of "Toitū Te Tiriti" has gained prominence, urging a commitment to Te Tiriti o Waitangi. This editorial emphasises that honouring Te Tiriti is central to addressing health disparities. The article reminds readers of inequities in health, education, employment, and housing, before outlining five ways the coalition Government’s actions undermine efforts to improve outcomes. The editorial references Māori-led approaches as protective factors that have improved health service delivery and outcomes. The article ends with a call to action: health professionals must align with Te Tiriti principles and engage in political advocacy to ensure better outcomes for the Māori population. This involves partnering with iwi and Māori health groups to monitor government adherence to Te Tiriti and advocating for policies that support equitable health outcomes.
✅ In Brief
👊🏾 Big shout-out to the Pasifika Medical Association for making the NZMJ completely free to read; just subscribe to the journal (for free) and read all past and present issues in full.
📞 This Public Health Communications Centre article compared comments made by politicians with statements made by tobacco companies, highlighting the similarity in their arguments. To comply with the WHO framework on tobacco control, the authors recommend coalition Government members declare any past or current engagement with tobacco companies and commit to transparency in their interactions.
📝 The Briefings to the Incoming Ministers (BIM) for health and mental health respectively have been published by the Ministry of Health, Te Whatu Ora and Te Aka Whai Ora.
🎓 Otago University’s Public Health Summer School has a range of courses available between 12-23 February.
⚖️ Hapai te Hauora (Māori Public Health) has lodged an urgent claim with the Waitangi Tribunal, challenging the planned repeal of the Smokefree Environments and Regulated Products Act.
🎬 End Note
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