Mana Motuhake Research Articles

Registered Nurses in Policy: The Betwixt and Between of Self-Employment and Contracting

Nursing offers multiple career choices in a variety of settings, both clinical and non-clinical. A very small number of registered nurses choose to become self-employed, continuing to work as nurses in non-clinical environments, such as policy. This study aimed to explore the experiences of registered nurses transitioning into, and practising as, solo self-employed contractors within the practice area of professional advice and policy. Thirteen registered nurses participated in this ethnographic qualitative study. Data were collected in 2018, with a specific focus on exploring the transitional elements of nurses as they moved from traditional nursing employment models to being self-employed as contractors, working from home. The findings identified various reasons for this change to self-employment, including as an exit option from a challenging employment situation, feeling ‘burned out’, or searching for a healthier lifestyle. Amid their move to a new way of working they experienced challenges in managing finances and navigating the complex dynamics of profession, home, and their own gendered subjectivities. This novel research offers an insight into the experiences of registered nurses who, at watershed moments in their careers, recognised their agency and chose to shift to solo self-employment, ultimately persisting in a liminal, or transitioning relationship between belonging to nursing and business, home and work. Te reo Māori translation Ngā Tapuhi Rēhita i roto i ngā Kaupapa Here: Te noho i waenga pū i te mahi whaiaro me te mahi kirimana Ngā Ariā Matua He maha ngā whiringa ara mahi i te ao tapuhi, i te huhua o ngā horopaki, ahakoa taurima tūroro, ahakoa mahi kē. Tērā te rōpū tapuhi rēhita iti kia kōwhiri i te ara mahi whaiaro, kia mahi tonu hei tapuhi i ngā horopaki i waho i te taurima tūroro, pēnei i ngā mahi kaupapa here. Ko te whāinga o tēnei tirohanga he tūhura i ngā wheako o ngā tapuhi rēhita e whakawhiti ana ki te ao mahi o te kirimana mahi whaiaro takitahi, i roto i te wāhanga mahi o te whakamaherehere ngaio me ngā kaupapa here. Tekau mā toru ngā tapuhi rēhita i whai wāhi mai ki tēnei tirohanga kounga momo iwi. I kohia he raraunga i te tau 2018 me te arotahi pū ki te tūhura i ngā āhuatanga whakawhiti o ngā tapuhi, i a rātou e anga kē atu ana i ngā ritenga whiwhinga mahi tuku iho o mua, kia mahi hei kaikirimana mahi takitahi, mahi i te kāinga. Kei ngā kitenga i tohua ētahi take mō tēnei huringa ki te mahi whaiaro, tae atu ki te rapunga putanga ki waho i tētahi wāhi mahi uaua, te whakaaro ‘kua whati te tuarā’, te rapunga ara mahi hauora kē atu rānei. I roto i ā rātou ahunga ki ēnei tikanga mahi hou, i tūpono rātou ki ngā uauatanga whakahaere moni, whakatere hoki i te ao umanga, ao o te kāinga, me te kawe anō i ō rātou tuakiri ira tangata. Tā tēnei rangahau hou he tāpae māramatanga mō ngā wheako o ētahi tapuhi rēhita i kōwhiri i te ara mana motuhake whaiaro, i tētahi pekanga nui o te huarahi, arā, kia hīkoi i te ara mahi whaiaro takitahi, me te noho i tētahi ao whakawhiti i waenga i te mahi tapuhi, i te pakihi, i te kāinga me te mahi. Ngā kupu matua mana motuhake, mātai momo iwi, tū ā-whakawhiti, mahi whaiaro, tapuhi, kaupapa here, whakawhitinga

Nursing Students’ Perceptions of Assisted Dying: A Qualitative Study

Assisted dying became a legal choice in November 2021 following the passing of the End of Life Choice Act (2019) in New Zealand. This new means of dying allows individuals to pursue the right to die should they meet the legislated criteria. The availability of assisted dying raises questions regarding nursing practices and responsibilities in relation to the service. The aim of this study was to gain insight into nursing students’ views about assisted dying in Aotearoa New Zealand. A qualitative descriptive study using a qualitative survey with a paper-based questionnaire was undertaken among nursing students enrolled in a Bachelor of Nursing (BN) programme at a single tertiary education organisation in 2019. Responses from 192 students were analysed using content analysis. Three categories were identified: supportive on the basis of personal choice; disapproval on the basis of personal beliefs; and taking a professional stand as a nurse. The categories present the distinct and opposing views expressed by nursing students regarding assisted dying, with the extent of support or disapproval being supported by their recognition of personal autonomy, their own belief systems and their views of roles expected of nurses. This research highlighted that nursing students’ views about assisted dying were influenced by both personal and professional factors, and at times these were dichotomous. Ethical and practice challenges concerning assisted dying must be recognised and acknowledged. The nursing education sector should include topics related to assisted dying in the curricula and work with students to, where necessary, reconcile any ethical issues that arise. This will ensure that future nurses are prepared and equipped with knowledge and skills in providing care to patients and families considering or requesting assisted dying. Te reo Māori translation Ngā whakaaro o ngā pia tapuhi ki te mate whakaahuru: He rangahau kounga Ngā Ariā Matua I whakamanaia ā-turetia te mate whakaahuru o te tangata i te marama o Nōema 2021 i muri i te pāhitanga o te Ture mō te Whiringa mō te Mutunga o te Oranga (2019) i Aotearoa. Mā tēnei ara hou ki te matenga ka taea e te tangata takitahi te whai i tana tika kia mate, ki te tutuki i a ia ngā paearu ā-ture. Nā te wāteatanga mai o te mate whakaahuru mō te tangata, ka ara ake ētahi pātai mō ngā tikanga mahi tapuhi me ō rātou haepapa mō te kaupapa āwhina hou. Te whāinga o tēnei rangahau he whai kia mārama ki ngā whakaaro o ngā pia tapuhi ki te mate whakaahuru o te tangata i Aotearoa. I mahia tētahi rangahau whakaahua kounga nā te whakamahi uiuinga kounga, ki tētahi rārangi pātai pepa i waenga i ngā pia tapuhi i rēhitatia ki tētahi akoranga Paetahi mō Te Tapuhitanga (BN) i tētahi whare whakaako kotahi i 2019. I tātaritia ngā whakautu mai i ngā ākonga 192 nā te whakamahi tātaritanga kōrero. E toru ngā kāwai i tautuhitia: ērā i tautoko i runga i te whiringa whaiaro; te korenga e whakaae i runga i ngā whakapono tāngata takitahi; me te tū hei tangata ngaio, arā, hei tapuhi. Ko ngā kāwai kei te whakaari i ngā tū motuhake, tauaro hoki i whakapuakina e ngā pia tapuhi mō te mate whakaahuru, me kī, kei te āhua o tō rātou whakaae ki te mana motuhake o te tangata mōna anō, o ō rātou pūnaha whakapono, me tō rātou titiro ki ngā mahi e tika ana mā te tapuhi, te kaha tautoko, te kaha whakahē rānei ki te ara hou. Tā tēnei rangahau he whakatairanga i te kawenga o ngā whakaaro o ngā pia tapuhi mō te mate whakaahuru e ngā pūtake whaiaro, me ngā pūtake ngaio, ā, i ētahi wā he noho tauwehe ēnei pūtake e rua. Me mātua kite, me mātua urupare ki ngā wero matatika me ngā wero i te wāhi mahi o te mate whakaahuru. Me uru ki te rāngai akoranga tapuhi ētahi kaupapa e pā ana ki te mate whakaahuru i roto i te marautanga me te mahi tahi ki ngā ākonga ki te tuitui tahi i ngā take matatika ka ara ake, i ngā wāhi e tika ana. Mā konei ka tika te whakangungu, te hoatu pūkenga hoki ki ngā tapuhi o āpōpō, ka whiwhi hoki i te mātauranga me ngā pūkenga e tika ana hei tiaki i ngā tūroro me ō rātou whānau e whiriwhiri nei, e inoi nei rānei, ki te mate whakaahuru mō rātou. Ngā kupu matua mate whakaahuru; te taurimatanga i te mutunga o te ora; ngā ture; te akoranga tapuhi; ngā pia tapuhi; te rangahau kounga

Tuakana-teina peer education programme to help Māori elders enhance wellbeing and social connectedness

BackgroundThere are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. This study used a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation) to develop a tuakana-teina (literally older sibling-younger sibling) peer education programme to assist kaumātua (elders) in addressing health and social needs. The purpose of this study was to test the impact on those receiving the programme. Three aims identify the impact on outcomes, resources received and the cost effectiveness of the programme.MethodsFive Kaupapa Māori (research and services guided by Māori worldviews) iwi (tribe) and community providers implemented the project using a partnership approach. Tuakana (peer educators) had up to six conversations each with up to six teina (peer learners) and shared information related to social and health services. A pre- and post-test, clustered staggered design was the research design. Participants completed a baseline and post-programme assessment of health and mana motuhake measures consistent with Māori worldviews. Open-ended questions on the assessments, five focus groups, and four individual interviews were used for qualitative evaluation.FindingsA total of 113 kaumātua were recruited, and 86 completed the programme. The analysis revealed improvements in health-related quality of life, needing more help with daily tasks, life satisfaction, paying bills and housing problems. Qualitative results supported impacts of the programme on mana motuhake and hauora (holistic health) through providing intangible and tangible resources. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times GDP per capita.ConclusionsA culturally-resonant, strengths-based programme developed through a participatory approach can significantly improve health and social outcomes in a cost-effective way.Trial RegistryClinical trial registry: Trial registration: (ACTRN12620000316909). Prospectively registered 06/03/2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379302&isClinicalTrial=False.

Settler/Invader Identity and Belonging in Aotearoa New Zealand

This Kaupapa Māori writing inquiry explores “Tāngata Tiriti” (People of the Treaty) as a settler/invader identity term in Aotearoa New Zealand. Derived from the failed policy platform of “biculturalism” and “Indigenous inclusion,” Tāngata Tiriti is a byproduct of neoliberalism and settler/invader colonialism that fails to provide for Indigenous inclusion, mana motuhake (Indigenous sovereignty) and tino rangatiratanga (self-determination). This article argues that Tāngata Tiriti should be abandoned due to the 2014 paradigm shift surrounding Te Tiriti o Waitangi (Te Tiriti) and mana motuhake from the Te Paparahi o Te Raki report and the author’s subsequent research on non-signatory hapū and iwi. Pākehā settler/invader perspectives on Tāngata Tiriti are compared with Tāngata Moana and Asian scholarly understandings. The author advocates adopting Tāngata Moana thinking around letting Māori as mana whenua lead “wayfinding” and “meaning-making” to define allyship and promote a “collective future” together based on Māori constitutional values that are generally universal throughout Pacific cultures. Instead of settler/invader identity constructs and the doctrine of the nation as a White possession, movement toward a collective future must begin from a place of sovereign relationality. The pedagogy of teaching Te Tiriti must change, the ill-conceived Tāngata Tiriti identity must be abandoned, and “New Zealand” as a settler/invader colonial enterprise must end. Our future must be post-settler/invader colonial and post-Tiriti and must recognize unceded mana motuhake or sovereignty.

Understanding how whānau-centred initiatives can improve Māori health in Aotearoa New Zealand.

This article highlights the significance of prioritizing Indigenous voices and knowledge systems, using whānau-centred initiatives (a concept that encompasses the broader family and community) as a foundation for health promotion within an Indigenous context. Tū Kahikatea, a conceptual framework, is used to demonstrate the relationship between the values underpinning different whānau-centred initiatives and their corresponding outcomes. The framework highlights the capacity of whānau-centred initiatives to support whānau in attaining mana motuhake, which represents collective self-determination and the ability to exercise control over their own future. By doing so, these initiatives contribute to the improvement of whānau health outcomes. With recent changes to Aotearoa New Zealand's health system, the findings underscore the benefits and potential of whānau-centred initiatives in enhancing whānau health outcomes, and advocate for continued strengths-based practices in Aotearoa New Zealand's health system. By bridging the gap between academia and grassroots community action, the article demonstrates the potential of whānau-centred initiatives and contributes to a global call for integrating Indigenous viewpoints and practices into Westernized healthcare, in order to improve Indigenous health outcomes.

Enacting Mana Māori Motuhake during COVID-19 in Aotearoa (New Zealand): "We Weren't Waiting to Be Told What to Do".

Māori, the Indigenous people of Aotearoa (New Zealand), were at the centre of their country's internationally praised COVID-19 response. This paper, which presents the results of qualitative research conducted with 27 Māori health leaders exploring issues impacting the effective delivery of primary health care services to Māori, reports this response. Against a backdrop of dominant system services closing their doors or reducing capacity, iwi, hapū and rōpū Māori ('tribal' collectives and Māori groups) immediately collectivised, to deliver culturally embedded, comprehensive COVID-19 responses that served the entire community. The results show how the exceptional and unprecedented circumstances of COVID-19 provided a unique opportunity for iwi, hapū and rōpū Māori to authentically activate mana motuhake; self-determination and control over one's destiny. Underpinned by foundational principles of transformative Kaupapa Māori theory, Māori-led COVID-19 responses tangibly demonstrated the outcomes able to be achieved for everyone in Aotearoa when the wider, dominant system was forced to step aside, to be replaced instead with self-determining, collective, Indigenous leadership.

The Critical Juncture in Aotearoa New Zealand and The Collective Future: Policy Issues in Settler/Invader Colonial Zombiism Found in “Biculturalism”

This theoretical Kaupapa Māori writing inquiry study seeks to explore the settler colonial nature of Aotearoa New Zealand. The research finds that biculturalism, as a neo-liberal and settler-colonial construct does not provide for either tino rangatiratanga or mana motuhake. Indeed, biculturalism fails to provide for indigenous inclusion and actively suppresses the recognition of mana motuhake. Biculturalism is found to fit Beck’s definition of Zombie Concepts. These are social concepts that are dead and yet kept alive in their use by scholars and society to describe the growing fiction of traditional social institutions and in being kept alive maintain, in this case, settler colonial and colonial power structures. The main argument is that Biculturalism is neoliberal and settler colonial public discourse, that needs to be unpacked and then discarded because it does not provide for tino rangatiranga or mana motuhake.

Adaptation and implementation processes of a culture-centred community-based peer-education programme for older Māori

BackgroundHealth inequities experienced by kaumātua (older Māori) in Aotearoa, New Zealand, are well documented. Examples of translating and adapting research into practice that identifies ways to help address such inequities are less evident. The study used the He Pikinga Waiora (HPW) implementation framework and the Consolidated Framework for Implementation Research (CFIR) to explore promising co-design and implementation practices in translating an evidence-based peer-education programme for older Māori to new communities.MethodsThe study was grounded in an Indigenous methodology (Kaupapa Māori) and a participatory research approach. Data were collected from research documentation, community meeting and briefing notes, and interviews with community researchers.ResultsThe data analysis resulted in several key promising practices: Kaumātua mana motuhake (kaumātua independence and autonomy) where community researchers centred the needs of kaumātua in co-designing the programme with researchers; Whanaungatanga (relationships and connectedness) which illustrated how community researchers’ existing and emerging relationships with kaumātua, research partners, and each other facilitated the implementation process; and Whakaoti Rapanga (problem-solving) which centred on the joint problem-solving undertaken by the community and university researchers, particularly around safety issues. These results illustrate content, process, and relationship issues associated with implementation effectiveness.ConclusionsThis study showed that relational factors are central to the co-design process and also offers an example of a braided river, or He Awa Whiria, approach to implementation. The study offers a valuable case study in how to translate, adapt, and implement a research-based health programme to Indigenous community settings through co-design processes.Trial registrationThe project was registered on 6 March 2020 with the Australia New Zealand Clinical Trial Registry: ACTRN12620000316909. Prospectively registered.

‘Never-ending beginnings’: a qualitative literature review of Māori temporal ontologies

ABSTRACT Our experiences of temporality are defined and shaped by our experiential reality. For Māori, our experiences of time have been marginalised by hegemonic western-centric temporal understandings that are privileged and embedded into structures and institutions. Modelling is a commonly-used tool for estimating the benefits of interventions to inform decision-making. In addition to taking little account of health equity, western-centric modelling methods generally omit Indigenous time concepts. This paper presents findings from a qualitative literature review of Māori temporal ontologies and considers implications for modelling within the context of addressing hauora Māori aspirations. Of the total of 5,677 potential records identified, 78 texts were included in the knowledge synthesis. We identified six overlapping themes: Tohu; Hurihanga; Te Taiao; Whakapapa; Pūtahi; and, Mana Motuhake. In contrast with colonial time (understood as flowing uniformly in one direction throughout the universe), Māori temporal concepts were interconnected, interdependent and complex, with multi-layered and multi-faceted dimensions. If modelling approaches are to have utility for hauora Māori, we need to be open to interrogating and critiquing how colonial time shapes statistical assumptions and assigns value to a broader range of epidemiological methods commonplace in health and disability research, including the reification of colonial time in modelling methods.Glossary of Māori words: āmua: hereafter; āmuri: hereafter; anamata: hereafter; ātea: be clear, free from obstruction; hau ora: healthy, well; hurihanga: changing, turning, cycle; kaitiaki: guardian; kaupapa Māori: Māori agenda, Māori principles, Māori ideology; a philosophical doctrine, incorporating the knowledge, skills, attitudes, and values of Māori society; koru: spiral motif; onamata: ancient times; mana: spiritual power; mana motuhake: authority and capacity to be autonomous; Māori: name for Indigenous peoples of New Zealand; mua: former; muri: after; pākehā: foreign; Papatūānuku: Earth Mother; pūtahi: meeting place, intersection; takiwā: period of time, space; te ao Māori: the Māori world; te reo Māori: the Māori language; te taiao: the natural world, environment; tohu: sign, symbol; tūpuna: ancestors; wā: period of time, interval; wānanga: to meet, discuss, deliberate, consider; whakairo: carving; whakapapa: ancestry, familial relationships; whaikōrero: oratory; whakataukī: to utter a proverb; whānau: to be born, extended family, family group

‘It feels special when you’re Māori’—voices of mokopuna Māori aged 6 to 13 years

ABSTRACT Mokopuna Māori and their whānau have the right to be involved meaningfully in the health and disability system, through genuine commitments to participation and self-determination. This Kaupapa Māori qualitative study explored mokopuna Māori concepts of wellbeing in relation to health and disability services, contextualised within broader tāngata whenua rights to health and wellbeing, and continued Crown failure to recognise these rights. Informed by a Kaupapa Māori research paradigm privileging worldviews and experiential knowledge of mokopuna Māori, we carried out focus group interviews with 26 mokopuna aged 6 to 13 years. Using thematic analyses we identified ten themes from the data analysis: (1) Aro ki te hā; (2) Kupu; (3) Mātauranga; (4) Mauri; (5) Utu; (6) Mana motuhake; (7) Hau Ora; (8) Kaitiakitanga; (9) Ūkaipō; and (10) Tika. The narratives of mokopuna Māori in this study reaffirm the critical importance of recognising mokopuna as knowledge holders, creators, and makers of meaning to participate in, and articulate their views on, their own wellbeing, their environments, and other matters important to them. Privileging their views and perspectives supports mokopuna to navigate their own processes of self-determination and sovereignty for themselves, their whānau and their communities. Glossary of Māori words: Aotearoa: Māori name for the North Island of New Zealand, often used as a name for New Zealand; Aro ki te hā: the awareness of the essence of one's breath; Hau Ora: healthy, well; He Wakaputanga o te Rangatiratanga o Nu Tīreni: the Declaration of Independence of the United Tribes of New Zealand; Hinapōuri: to be very dark, very sad; Iwi: extended kinship group, tribe, nation, people, bone; Kai: to eat, food, meal; Kaitiakitanga: guardianship; Kākāriki: be green (in colour); Karaka: be orange (in colour); Kaupapa Māori: Māori agenda, Māori principles, Māori ideology; a philosophical doctrine, incorporating the knowledge, skills, attitudes, and values of Māori society; Kia ora: be well, hello, cheers, best wishes; Koha: gift, offering; Kōrero: speak, speech, address; Kōwhai: be yellow (in colour); Kupu: word, saying, utterance; Mana Motuhake: authority and capacity to be autonomous; Māori: name for Indigenous peoples of New Zealand; Mātauranga: knowledge, wisdom; Mauri: life principle, life force, vital essence; Māwhero: be pink (in colour); Mokopuna: grandchild, grandchildren, descendant; Oranga: health, wellbeing, vitality; Pākehā: foreign; Papatūānuku: Earth Mother; Pēpi: baby, infant; Rangatahi: younger generation: Rangatira: chief/chieftainess; Rohe: boundary, territory; Rongoā: remedy, medicine; Tamariki: children; Tāngata whenua: people born of the land; Taniwha: powerful creature; Taonga: treasure, anything prized; Te Ao Māori: the Māori world; Te Komiti Rakahau ki Kāi Tahu: Kāi Tahu Research Consultation Committee; Te Kore: The Void, realm of potential being; Te reo Māori: the Māori language; Te Tiriti o Waitangi 1840: the Māori version of the Treaty of Waitangi; forms the foundation of the contractual relationship between two internationally recognised sovereign nations, Māori, as tāngata whenua (people of the land), and the British Crown; Tika: what is right/good for any particular situation; Tikanga Māori: customary system of values and practices developed over time; Tūpuna: ancestors; Ūkaipō: the suckling of a child on their mother's breast at night, one's ancestral land; Utu: balance, reciprocity; Waiata: song; Wairua: spirit; Wānanga: to meet, discuss, deliberate, consider; Whaikōrero: oratory; Whakairo: carving; Whakapapa: ancestry, familial relationships; Whānau: to be born, extended family, family group; Whanaunga: relative, relation; Whenua: placenta, ground, land.

Mana motuhake, Indigenous biopolitics and health

The majority of Indigenous health models do not directly acknowledge that health is a contested political space. Providing a Foucauldian analysis, this article suggests a function of biopower is to naturalise discourses such as the poor Māori health statistic to appear based on factual evidence and thus are apolitical. Employing Foucault’s triad of power—sovereign, disciplinary and biopower—to understand the genealogy of Māori health, this article proffers mana motuhake (Māori political self-governance) as an appropriate health analytic because it, first, identifies Indigenous health as political and, second, because it recognises the disempowering role that colonialism has played in relation to Māori biopolitical self-governance. Hence, we suggest Māori health will be enhanced by mana motuhake and that research underpinned by Indigenous agency and self-governance resists biopower. The article references two Ageing Well National Science Challenge–funded research projects because they innovatively fundamentalise mana motuhake and politics to Indigenous health.

Public Rāhui and Road Blocks in Aotearoa: Navigating Iwi/Hapū Perspectives and Mana Motuhake

During the COVID-19 pandemic there have been wide-spread public debates over public access for walkers, cyclists and vehicles in relation to the land rights and the safety of iwi/hapu (Māori tribes and sub-tribes) in Aotearoa/New Zealand. This includes checkpoints or road blocks set up by iwi/hapu in rural areas to stop the spread of the pandemic (Harris and Williams, 2020; Ngata, 2020), and the ongoing rāhui or temporary ban on all forms of public access in regional conservation forests by Te Kawerau ā Maki iwi of Tāmaki Makaurau/Auckland to stop the growth of the ecological pest kauri dieback by visitors. This article reflects on the complexities of these bans by considering public responses to them, including settler politics, discourses of rights and freedoms, and white supermacy. Consideration is given to the perspectives of iwi/hapu themselves and contingent histories (for instance Te Kawerau a Maki, 2020). This is reflected on through mana motuhake (authority, self-determination and agency), alongside Te Tiriti o Waitangi (Māori perspectives of the Treaty of Waitangi; Orange, 1987; Walker, 2004) and mātauranga Māori (Māori knowledge).

Identifying the Facilitators and Barriers in Disseminating and Adopting a Health Intervention Developed by a Community-Academic Partnership.

The literature regarding implementation science of evidence-based health interventions in Māori communities is limited, and there is a push for new and innovative delivery methods of health interventions in New Zealand. The purpose of the study was to identify the facilitators and barriers in implementing a health intervention designed by others and was framed by the Consolidated Framework for Implementation Research (CFIR). This study explored general perceptions of the implementation process and also included a case study, the Kaumātua Mana Motuhake (older people's autonomy and self-actualization) project; a codesigned peer education intervention for older Māori. Semistructured interviews (N = 17) were conducted via face-to-face, phone, or Zoom with health and social service professionals with experience working with Māori communities. Thematic analysis was used to analyze the data. The facilitators included community engagement, program structure, program adaptability and creators' experience. The barriers consisted of funding access, funding constraints and organizational constraints. The findings support key elements within the CFIR, highlighting the importance of community engagement and adaptability. Additionally, this study identified nuanced aspects of funding and resources that constrain organisations in employing health interventions designed by others.

Te Tiriti o Waitangi, the UN Declaration on the Rights of Indigenous Peoples and Constitutional Change: What is the Role of Judges and Adjudication?

My focus is on realising tino rangatiratanga/mana motuhake for Māori under te Tiriti o Waitangi, sometimes understood as New Zealand’s founding constitutional document, and Indigenous peoples’ self-determination in the Declaration. I am interested in the ways in which states recognise Māori authority, often expressed through the practice and application of tikanga Māori, or Māori law. To achieve greater Indigenous peoples’ self-determination, at least to the extent required by te Tiriti o Waitangi and the UN Declarartion, would require constitutional change. So the topics overlap. I have 3 foci: 1. Adjudication and interpretation of the UN Declaration, including our right to self-determination, and Indigenous women’s rights at the international level; 2. Recent recommendations for constitutional change in Aotearoa/New Zealand: based on the Declaration and te Tiriti o Waitangi; 3. How New Zealand courts, and possibly other state courts, should address Indigenous authority and sovereignty. If there are any overarching theses, it would be that: - Judges have an important role in interpreting Indigenous peoples’ rights under the UN Declaration and in te Tiriti consistently with Indigenous peoples’ interpretations i.e., not deferring exclusively to state interpretations – from the Executive, legislature – or their own without reference to Indigenous peoples’ voices. - Judges need not feel they are undermining the state or their own authority when recognising and realising Indigenous peoples’ self-determination, or tino rangatiratanga, or mana motuhake.

Kaum\u0101tua Mana Motuhake P\u014di: a study protocol for enhancing wellbeing, social connectedness and cultural identity for M\u0101ori elders

BackgroundThe Aotearoa New Zealand population is ageing accompanied by health and social challenges including significant inequities that exist between Māori and non-Māori around poor ageing and health. Although historically kaumātua (elder Māori) faced a dominant society that failed to realise their full potential as they age, Māori culture has remained steadfast in upholding elders as cultural/community anchors. Yet, many of today’s kaumātua have experienced ‘cultural dissonance’ as the result of a hegemonic dominant culture subjugating an Indigenous culture, leading to generations of Indigenous peoples compelled or forced to dissociate with their culture. The present research project, Kaumātua Mana Motuhake Pōī (KMMP) comprises two interrelated projects that foreground dimensions of wellbeing within a holistic Te Ao Māori (Māori epistemology) view of wellbeing. Project 1 involves a tuakana-teina/peer educator model approach focused on increasing service access and utilisation to support kaumātua with the greatest health and social needs. Project 2 focuses on physical activity and cultural knowledge exchange (including te reo Māori--Māori language) through intergenerational models of learning.MethodsBoth projects have a consistent research design and common set of methods that coalesce around the emphasis on kaupapa kaumatua; research projects led by kaumātua and kaumātua providers that advance better life outcomes for kaumātua and their communities. The research design for each project is a mixed-methods, pre-test and two post-test, staggered design with 2–3 providers receiving the approach first and then 2–3 receiving it on a delayed basis. A pre-test (baseline) of all participants will be completed. The approach will then be implemented with the first providers. There will then be a follow-up data collection for all participants (post-test 1). The second providers will then implement the approach, which will be followed by a final data collection for all participants (post-test 2).DiscussionTwo specific outcomes are anticipated from this research; firstly, it is hoped that the research methodology provides a framework for how government agencies, researchers and relevant sector stakeholders can work with Māori communities. Secondly, the two individual projects will each produce a tangible approach that, it is anticipated, will be cost effective in enhancing kaumātua hauora and mana motuhake.Trial registrationAustralia New Zealand Clinical Trial Registry (ACTRN12620000316909). Registered 6 March 2020.

The Potential of Anti-Diabetic Rākau Rongoā (Māori Herbal Medicine) to Treat Type 2 Diabetes Mellitus (T2DM) Mate Huka: A Review.

T2DM (type 2 diabetes mellitus, or Māori term “mate huka”) is a major long-term health issue in New Zealand particularly among the Māori community. Non-insulin drugs commonly used in New Zealand for the treatment of T2DM have limits to their efficacy as well as side effects, which are of concern for diabetics. As such, the potential for natural products such as traditional rākau rongoā are of interest for potentially preventing the development of T2DM or improving the treatment of the disease. In particular, anti-diabetic effects have been reported for rākau rongoā such as karamu, kūmarahou, and kawakawa. Natural products have been identified in karamu, kūmarahou, and kawakawa that have documented potential effects on glucose metabolism that could contribute to the anti-diabetic effect of these rākau rongoā. As such, this could provide scientific insight into the mātauranga (traditional knowledge) developed over generations by Māori. However, detailed laboratory based and clinical studies would be required to understand and validate these properties of karamu, kūmarahou, and kawakawa, and to understand how they can be used in T2DM treatment. Social determinants of indigenous health such as language, culture, traditional knowledge, and identity, are important in understanding the relationship Māori have with their land and the mātauranga they developed of the medicinal properties within their rākau rongoā, over many centuries. Interestingly, traditional Māori views towards scientific research using animal models to test rākau rongoā are varied but supportive. Furthermore, cultural issues surrounding Māori mana motuhake (self-determination) of traditional rongoā Māori healing practices and the inequity faced by many kairongoā (rongoā Māori practitioners) and tohunga (healers) compared to mainstream health are a current issue within the New Zealand health system. As such, a cultural holistic approach for T2DM care among Māori would be advantageous. This review will outline the available evidence supporting the anti-diabetic efficacy of karamu, kūmarahou, and kawakawa. Currently though there is a lack of molecular research to understand the mechanisms of this efficacy, as such this review will also outline Te Reo Tipu Research, a kaupapa Māori framework for molecular and genomic research on taonga flora.

Kaum\u0101tua Mana Motuhake: peer education intervention to help M\u0101ori elders during later-stage life transitions

BackgroundAotearoa/New Zealand has a population that is ageing and there are challenges to health and social outcomes related to related to key life transitions (e.g., retirement, change in health conditions, loss of spouse). Further, there are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. The purpose of this study was to test the impacts and cost effectiveness of a tuakana/teina (peer education) intervention on kaumātua (elders) receiving the intervention. This study was framed by a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation).MethodsThis study was grounded in principles of Kaupapa Māori and community-based participatory research to bring together a diverse group of stakeholders to co-develop and co-evaluate the intervention. The intervention had tuakana (peer educators) having conversations with up to six teina (recipients) and providing information related to health and social services. The research design was a pre- and post-test, clustered staggered design. Participants completed a baseline assessment of health and mana motuhake measures consistent with Māori worldviews along with two follow-up assessments (one after the first intervention group completed its activities and a second after the second intervention group completed its activities). Additionally, five focus groups and open-ended questions on the assessments were used to provide qualitative evaluation.FindingsA total of 180 kaumātua were recruited to the intervention with 121 completing it. The analysis revealed improvements over time in the expected direction on most of the variables. However, only three of the variables had statistically significant intervention effects: received support, tribal identity, and trouble paying bills. Qualitative results supported impacts of the intervention on mana motuhake, social connectedness, and tangible/information support related to services. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times gross domestic product per capita.ConclusionsThe findings support the relevancy and importance of kaumātua knowledge to create a strengths-based approach to improve health and social outcomes. This study demonstrates that a contextually based and culturally safe age-friendly environments can facilitate engagement and participation by kaumātua for kaumātua.Trial registryAustralia New Zealand Clinical Trial Registry (ACTRN12617001396314); Date Registered: 3 October 2017 (retrospectively registered); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373733&isClinicalTrial=False

Mana Tangata: The Five Optimal Cultural Conditions for Māori Student Success

A growing number of Māori students are attaining educational success, even thriving in the schooling context. Indigenous education has much to learn from these students, and it behooves researchers to empirically analyze the drivers of student success. While research demonstrates that self-concept, self-esteem, and self-efficacy affect the academic engagement of Māori students, few studies have examined the social-psychological drivers of success for Māori students. This study focuses on how self-perceptions about the value of their ethnic identity and family support affect the motivation and academic engagement of successful Māori students in Aotearoa, New Zealand. Little will be done to improve Māori students' academic engagement and social-emotional well-being until educators focus on the development of students' connectedness to their ethnic identity and their sense of mana tangata (cultural status and pride). This study offers solutions for change using a Mana Model developed as part of the 2014 Ka Awatea study. The Ka Awatea project was codesigned with the Te Arawa community in 2014 and examined the connection between Māori identity and characteristics of educational success among a selection of successful Māori high school students from Rotorua, New Zealand. Five key components concerning the optimal personal, familial, school, and community conditions for Māori student success compose the resultant Mana Model: Mana Whānau (familial pride), Mana Motuhake (personal pride and a sense of embedded achievement), Mana Tū (tenacity and self-esteem), Mana Ūkaipo (belonging and connectedness), and Mana Tangatarua (broad knowledge and skills). The Mana Model is an unapologetically Māori-centric model of student thriving; a strengths-based model utilizing the principles of social psychology and Māori worldview to explain how Māori students can thrive when afforded a broad range of academic, cultural, and social opportunities. This model broadens the research theorizing of those researchers, educators, and other stakeholders who desire to see Māori students attain their full potential.

Mana Tangata: The Five Optimal Cultural Conditions for Māori Student Success

A growing number of Māori students are attaining educational success, even thriving in the schooling context. Indigenous education has much to learn from these students, and it behooves researchers to empirically analyze the drivers of student success. While research demonstrates that self-concept, self-esteem, and self-efficacy affect the academic engagement of Māori students, few studies have examined the social-psychological drivers of success for Māori students. This study focuses on how self-perceptions about the value of their ethnic identity and family support affect the motivation and academic engagement of successful Māori students in Aotearoa, New Zealand. Little will be done to improve Māori students' academic engagement and social-emotional well-being until educators focus on the development of students' connectedness to their ethnic identity and their sense of mana tangata (cultural status and pride). This study offers solutions for change using a Mana Model developed as part of the 2014 Ka Awatea study. The Ka Awatea project was codesigned with the Te Arawa community in 2014 and examined the connection between Māori identity and characteristics of educational success among a selection of successful Māori high school students from Rotorua, New Zealand. Five key components concerning the optimal personal, familial, school, and community conditions for Māori student success compose the resultant Mana Model: Mana Whānau (familial pride), Mana Motuhake (personal pride and a sense of embedded achievement), Mana Tū (tenacity and self-esteem), Mana Ūkaipo (belonging and connectedness), and Mana Tangatarua (broad knowledge and skills). The Mana Model is an unapologetically Māori-centric model of student thriving; a strengths-based model utilizing the principles of social psychology and Māori worldview to explain how Māori students can thrive when afforded a broad range of academic, cultural, and social opportunities. This model broadens the research theorizing of those researchers, educators, and other stakeholders who desire to see Māori students attain their full potential.

Mana Motuhake o Ngāti Porou: Decolonising Health Literacy

This paper explores decolonising health literacy by reclaiming historical practices shared by Māori to develop a kaupapa Māori health literacy evaluation framework. The work is based on a research innovation within a Primary Health Organisation – Ngāti Porou Hauora – that defines health literacy within the context of the community. This research promotes reclamation of health literacy as a space for Māori to be ourselves; a space that is negotiated, adaptive, and shaped by people, whānau (family group) and communities. The framework attempts to reflect participants’ voices, perceptions, understandings and experiences. Its design was informed by a kaupapa Māori praxis, and aspires to co-ownership, mutually beneficial outcomes and shared power through prioritising participants’ voices to shape and develop the criteria for determining the goals and action areas related to health literacy. The framework includes overall goals and action areas for practicing effective health literacy at individual, whānau, health professional, intervention/programme, and organisational levels. This paper is an example of how Māori can promote and practice health literacy in the context of our histories, honouring a pathway of transformation through decolonising methods.