🍀 Tamariki vaccinations in pharmacies; surgical training wānanga; Parkrun for wellbeing; 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. Here’s what I’ve learned this week…
🔬 The Latest Research
Do Wānanga Enhance Surgical Training?
Rahiri, J.-L., Linton, T., Alpen, S., Cowan, S., Sprosen, H., Te'o, D., Dawson, B., Tuhoe, J., & Harwood, M. (n.d.). Establishing a Rural and Provincial Surgery (RAPS) Wānanga to Enhance the Provincial Surgical Experience for Registrars in Aotearoa, New Zealand (AoNZ). Available at SSRN. 2024. https://doi.org/10.2139/ssrn.4732722
In this (preprint) study conducted at Taranaki Base Hospital, surgical registrars participated in a Rural and Provincial Surgery (RAPS) Wānanga to enrich their training experience through cultural safety and wellbeing. The wānanga were utilised to address the need for cultural competence in surgical training. This qualitative research revealed that the wānanga fostered reflective practice, enhanced learning opportunities, and promoted unity among registrars. Importantly, it provided a culturally safe space for registrars to gain vital knowledge and skills necessary for culturally sensitive practice. The study advocates for the formal inclusion of wānanga in surgical training programmes, underscoring its potential to improve health outcomes for Māori and others by ensuring culturally competent care. Future research could include pre/post-wānanga measures of competence.
Can Health Equity Emerge Stronger Post-Pandemic?
Curtis, E., Jaung, R., Paine, S., McLeod, M., Tamatea, J., Atkinson, J., Jiang, Y., Robson, B., Reid, P., & Harris, R. B. (2024). Examining the impact of COVID-19 on Māori:non-Māori health inequities in Aotearoa, New Zealand: an observational study protocol. BMJ Open. https://doi.org/10.1136/bmjopen-2023-083564
In this study, researchers have outlined their approach to assess the COVID-19 pandemic's impacts on health disparities between Māori and non-Māori. The researchers plan to compare health outcomes for 2015-2019 with 2020 and then 2021 onwards. The study aims to illuminate the variances in healthcare access, quality, and outcomes experienced by Māori during the pandemic at a regional and District Health Board (DHB) level. The researchers hypothesise that the pandemic has not only underscored existing health inequities but may have further widened the gaps. Once completed, this research will highlight differences across DHBs and regions and how these developed over time and in response to COVID. The findings will help guide future pandemic preparedness and illuminate policy and practice interventions necessary to address the disparities that developed.
Do Nurse-Facilitated Parkrun Events Improve Adolescent Health?
Williams, T., Walker, R., & Dearing, C. (2024). Nurse facilitated 5000 m running at Parkrun improves vulnerable adolescent health in a high deprivation area: A matched pair randomized control trial. Public Health Nursing. https://doi.org/10.1111/phn.13295
This matched pair randomised controlled trial examined the effects of nurse-led 5km Parkrun events on the health of Māori and Pacific rangatahi aged 13 to 18 from an area with an NZDep 10 decile rating. Results revealed significant improvements in cardiorespiratory fitness, glycated hemoglobin levels (HbA1c), and body composition after the intervention. The findings suggest that regular participation in Parkrun can positively affect young people's health. Past research has shown that young people are more likely to participate in physical activity that is accessible, fun, and has peer support. To enhance health outcomes for rangatahi, health professionals, PHOs, and other providers might consider implementing similar accessible and supportive initiatives like nurse-facilitated Parkrun groups to promote physical activity and well-being among rangatahi. Parkrun is focused on participation and sociable physical activity rather than competition; events are held in most towns and cities in Aotearoa and worldwide.
How Can Sexual Health Services Become More Approachable?
Rose, S., Dunlop, A., Gardiner, T., Cole, M., Garrett, S., & McKinlay, E. (n.d.). “Every strategy needs to be contributing to erasing the stigma”: Māori and Pacific young people talk about overcoming barriers to testing for sexually transmitted infections. CSIRO PUBLISHING. https://www.publish.csiro.au/SH/justaccepted/SH23186
This article discusses the barriers faced by Māori and Pacific young people accessing testing for sexually transmitted infections (STIs). Through workshops with participants, key themes such as cultural values, family/friends, education gaps, psychological factors, and structural obstacles were identified. Strategies to overcome these barriers included the need for free and flexible services, culturally appropriate education and health promotion, and community-based approaches. Participants emphasized the importance of normalizing conversations around STIs and aligning messages with Māori and Pacific models of well-being to reduce stigma. These themes might be used to guide regional solutions to improve the utilisation of sexual health services.
How Do Trauma Outcomes for Māori Youth in Counties Manukau Compare with Non-Māori?
Sobhy, M. M., Brand, M., Henshall, K., & MacCormick, A. D. (2024). Investigating major trauma in Māori youth at Te Whatu Ora Counties Manukau. ANZ Journal of Surgery. https://doi.org/10.1111/ans.18948
This study compared service and outcome measures after major trauma for young people treated at Te Whatu Ora Counties Manukau. Previous national research had highlighted a threefold higher 30-day mortality rate for Māori. However, this study did not find statistically significant disparities in care and outcomes for Māori youth with major trauma, contrary to those found nationally. While minor differences were observed, they were not statistically significant. This study highlights the importance of auditing performance nationally, where significant disparities have been identified. The positive findings at Counties Manukau might serve as a template for other regions to improve the quality of care that is delivered and to reduce health disparities for Māori youth following major trauma. The researchers recommended that similar studies should be conducted in other regions.
🔬 Other Research
Is Streaming Widening the Gap? Exploring the Impact of Mathematics Tracking on Māori and Pacific Students
Pomeroy, D., Gibson, L., & Manning, R. (2024). How streaming (Tracking) in eighth grade mathematics reinforces racialized social class inequalities in Aotearoa New Zealand. Peabody Journal of Education, 1–19. https://doi.org/10.1080/0161956x.2024.2310461
Education is a social determinant of health. In this study, the researchers took a long-term historical approach to help understand the differences in socioeconomic status and educational outcomes in the present day. The research was conducted across three diverse urban secondary schools; researchers explored the longstanding issue of socioeconomic inequities between Pākehā, Māori, and Pacific students and how these influence outcomes at secondary school. The focal point of this investigation was the practice of streaming in eighth-grade mathematics and its potential role in either perpetuating or disrupting socioeconomic divisions. The findings reveal that students' future career aspirations are already significantly influenced by modelling and stereotyping related to ethnicity, gender, and socioeconomic status upon entering secondary school and are further stratified through streamed mathematics classes. This streaming system mirrors and exacerbates existing inequalities by creating a self-reinforcing loop between students' aspirations and mathematics achievement. In a knowledge economy where value is created by innovative thinking and creativity, it is important to help students develop their abilities and reduce limitations. This study highlights how social determinants become intergenerationally entrenched and how streaming affects students’ aspirations and perceived ability.
Kawakawa Leaves Contain Anti-inflammatory & Insulin Sensitivity Mediators
Senilaite Tautuiaki, Jerusha Gojer, Ramya Jayaprakash et al. Kawakawa tea Intake and its anti-diabetic and anti-inflammatory effects: An integrative microRNA and mRNA analysis, 29 February 2024, PREPRINT (Version 1) available at Research Square [https://doi.org/10.21203/rs.3.rs-3979738/v1]
The Kawakawa plant has had a historic medicinal role for Māori. Liggins Institute researchers have illuminated the potential health benefits of Kawakawa tea, particularly its anti-inflammatory effects and influence on insulin signalling pathways. Using a crossover two-arm randomised controlled trial with 26 healthy volunteers, researchers investigated the impact of Kawakawa tea consumption on postprandial plasma levels of microRNAs (miRNA) involved in metabolic pathways. The results showed differences in the abundance of nine miRNAs following the consumption of Kawakawa tea compared to water. These miRNAs are known to play roles in inflammation and insulin signalling. Furthermore, the study observed a reduction in the postprandial expression of inflammatory markers such as IL-8, IL-6, and PPAR-γ following Kawakawa tea intake. These findings help to explain some of the medicinal properties of the Kawakawa plant and its cultural significance. Future research might offer new approaches to managing inflammation and insulin resistance using the plant or its extracts.
📈 Chart of the Week
🍎 Food Security - StatsNZ data indicated that food prices in Aotearoa saw their smallest annual increase since March 2021, with a 2.1% rise in the 12 months to February 2024. This increase is significantly lower than the 12.5% rise in the 12 months to July 2023. The decrease was mainly due to cheaper fruit and vegetable prices, while other food groups showed varying increases. The February 2024 annual increase of 2.1% was lower than the pre-COVID era result for the year ending February 2020, where a 3.1% annual increase occurred. The contribution of food security to health was discussed in a recent Tomaiora seminar.
✅ In Brief
🏝️ Cultural reclamation improves Hawai’ians’ well-being - This study explored how cultural identity can help address health disparities within the Hawai’ian community. It emphasises the importance of cultural reclamation for Indigenous Peoples' well-being and highlights the significance of Hawaiian identity, sense of belonging, and engagement with cultural practices. The study suggests that cultural identity can serve as a protective factor for health disparities.
💉 Pharmac and Te Whatu Ora approve childhood vaccinations in pharmacies. Free vaccinations will be available from participating pharmacies for tamariki from 6 weeks of age. Pharmacists must complete a funded training program to take part. This change is aligned with the first priority in the National Immunisation Taskforce Report - expanding the vaccination workforce (see page 33).
📈 Indigenous leadership and successful COVID vaccination - those article describes some of the models used in Canada and Australia to increase the levels of COVID vaccination among indigenous communities in those countries.
💻 Microsoft AI summarises patient consultations—a new artificial intelligence tool from Microsoft that listens to and summarises the key points of consultations for clinicians and patients. This tool helps reduce clinicians' administrative workload, enabling them to spend more quality time with the people they see.
📺 Tomaiora Māori Health Research Group at the University of Auckland will host a seminar on Monday, March 25, at 12 p.m., exploring the history of equity terminology in healthcare and how it has been used and evolved over past decades. Join the mailing list on the Tomaiora website.
🎬 End Notes
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