š Rural Vaccination Ideas, Cultural Safety in Public Health, Online Tech for Pregnancy Care Among MÄori, and more
MÄori health research highlights from the past week
šš½ Kia ora, Iām George Gray, a public health physician doing my best to keep up with the latest health research that can help improve outcomes for MÄori. Hereās what Iāve learned this weekā¦
š¬ The Latest Research
Insights from Aotearoa's Rural Frontline on COVID-19 Vaccination
Blattner, K., Clay, L., Keenan, R., Taafaki, J., Crengle, S., Nixon, G., Fortune, K., & Stokes, T. (2024). He Aroka UrutÄ: Rural health provider perspectives of the COVID-19 vaccination rollout in rural Aotearoa New Zealand with a focus on MÄori and Pasifika communities: a qualitative study. Journal of Primary Health Care. https://doi.org/10.1071/HC23171
This study captures the experiences of rural health providers in Aotearoa during the COVID-19 vaccination rollout, focusing on MÄori and Pasifika communities. The results might be used to inform our measles vaccination efforts. Key findings reveal challenges like urban-centric solutions, logistical hurdles, and workforce shortages. Solutions proposed include community-centric approaches, integrated health services, and workforce development. To improve health outcomes for MÄori, readers can advocate for culturally anchored strategies, sustained investment in rural health services, and local ownership of health initiatives. The study underscores the importance of tailored, culturally aligned approaches for equitable vaccine delivery in rural areas.
Which Public Health Competencies Support Cultural Safety?
Veenstra, N., Kewene, F., Morgaine, K., & Crengle, S. (2024). What we do matters: Supporting anti-racism and decolonisation of public health teaching and practice through the development of MÄori public health competencies. Australian and New Zealand Journal of Public Health, 48(2), 100132.
This article explores the creation of MÄori hauora Ä-iwi/public health competencies in Aotearoa. Through a kaupapa MÄori research approach, key themes emerged among research participants, highlighting the significance of language revitalisation, strength-based strategies, and addressing structural racism. The authors produced a table of competency levels based on the Dreyfus model of skill acquisition. The competencies advocate for cultural safety, inclusivity, and consideration of socio-political determinants of health. These competencies could be integrated into training programs for students and specialists, professional development activities, along with ongoing practice and policy development, ensuring culturally safe care.
Empowering MÄori Women Through Online Technologies During Pregnancy
King, D. (2023). āIt really puts women in charge of what theyāre seekingā: WÄhine MÄori experiences of using online technologies in pregnancy [Masterās thesis, Massey University]. Albany, New Zealand.
This Masterās thesis explores the integration of online technologies with face-to-face maternity services. The integration of these approaches offers numerous benefits, such as improved access to information, enhanced communication between healthcare providers and MÄori women, increased efficiency in managing workload for midwives, and empowerment for women in decision-making. By combining online platforms with traditional services, healthcare professionals can provide culturally responsive and equitable maternity care. This integration enables women to engage with MÄori knowledge, connect with support networks, and actively participate in their maternity care journey. The health sector can take action by using these technologies to empower MÄori women, improve access to culturally appropriate information and services, and foster positive social and cultural support networks, ultimately contributing to better health outcomes for the MÄori population.
WhÄnau Pakari Program Evaluation: Positive Engagement to Address Obesity in Young People
Anderson, Y. C., Wild, C., Gilchrist, C. A., Hofman, P. L., Cave, T. L., Domett, T., Cutfield, W. S., Derraik, J. G. B., & Grant, C. C. (2024). A multisource process evaluation of a Community-Based Healthy Lifestyle Programme for Child and adolescent Obesity. Children (Basel), 11(2), 247. https://doi.org/10.3390/children11020247
This study evaluated the effectiveness of the WhÄnau Pakari program in addressing child and adolescent obesity in Aotearoa. Key findings revealed a significant increase in referral rates in the Taranaki region after implementing WhÄnau Pakari (~3x baseline levels for Green Prescription Families), indicating its positive impact on the community. The program demonstrated cost-effectiveness compared to conventional care models, leading to sustained improvements in health-related quality of life and healthy habits. B4 School Check specialist referrals for obesity were 99-100% compared with 31-32% nationally. Stakeholders credited the program's success to its multidisciplinary team, family-centered approach, and home-based assessments. To address overweight and obesity among young people, scaling the WhÄnau Pakari model to other regions and emphasising cultural responsiveness and accessibility should be considered.
š Chart of the Week
In a recent Public Health Communications Centre (PHCC) briefing, the authors highlighted the strong association between food poverty and Programme for International Student Achievement (PISA) scores for math, reading, and science in Aotearoa. The left vertical axis in the chart below indicates the proportion of children within the groups on the horizontal axis. The horizontal axis shows the number of times students miss a meal each week. The right-hand vertical axis shows PISA scores (higher is better). As the number of meals missed increases along the horizontal axis moving from left to right, there is a significant decrease in PISA scores, equivalent to 2-4 years in school achievement. This pattern held after adjustment for socioeconomic status. The Ka Ora Ka Ako school lunches program is currently under review.
š Achievements
Tylah Farani-Watene, a dedicated advocate for MÄori and Pasifika youth empowerment, has been honoured with the Global Citizen Youth Leaders Award, spotlighting her efforts to reduce inequality through leadership training and the promotion of indigenous knowledge. Her work is celebrated for advancing the United Nations Sustainable Development Goal aimed at diminishing inequality globally through the empowerment of MÄori and Pasifika youth.
ā In Brief
š§ COVID-19 Linked to Significant Cognitive Decline and Brain Health Risks. Recent studies in the New England Journal of Medicine reveal COVID-19's profound impact on cognitive function, showing severe cases can age the brain by 20 years and even mild infections lead to noticeable IQ drops. The XBB 1.5 strain vaccination becomes available here on Thursday.
š§ŖRapid Antigen Tests Reliable Against New COVID-19 Variants. A recent analysis by the National Institutes of Health in the United States reveals over 100 rapid antigen test kits effectively detect both new and previously known COVID-19 variants, affirming their reliability amidst evolving strains. Over 300 strains were tested.
š“Hawaiāians consider including Hawaiāian language in medical curriculum. Incorporating Ź»Ålelo HawaiŹ»i into medical education could provide cultural context, meet community support, and offer clinical benefits. Overall, the initial perspectives from medical education teachers and learners are positive
š» Computerised GP built by Google and found more accurate and empathetic than humans in text-based consultations. Large language models like AMIE could help to augment Healthline consultations or provide low-cost rapid health advice for other communities amid health workforce shortages.
āļø Te Rarawa collaborates on countryās largest solar farm project. Helps progress our move to more renewable energy and decrease carbon emissions.
š Pharmac discontinues influenza vaccine funding for MÄori and Pacific aged 55-64 years. States 2022-2023 funding was from COVID budget and is now gone. 2023 vaccination results are shown below (data source: Te Whatu Ora). It would be good if Pharmac could share any economic evaluation that preceded this decision.
š¬ End Notes
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