Skip to main content Accessibility help
×
Home

Kaumātua mana motuhake in action: developing a culture-centred peer support programme for managing transitions in later life

  • Mary Louisa Simpson (a1), Hineiti-Moana Greensill (a2), Sophie Nock (a2), Pare Meha (a3), Truely Harding (a1), Pita Shelford (a1), Brendan Hokowhitu (a2), John Oetzel (a1) and Rangimahora Reddy (a3)...

Abstract

New Zealand's ageing population and health inequities for Māori (Indigenous peoples) have prompted calls for innovative, culturally based approaches to improving health and wellbeing, and managing transitions in later life. This is particularly important for kaumātua (Māori elders) who, despite cultural strength and resilience, carry a significant burden in health, economic and social inequities. This paper describes the culture-centred development of a ‘tuakana‒teina’ (elder sibling‒younger sibling) peer support education programme designed to help kaumātua support other kaumātua experiencing transitions in later life. Taking a strengths-based approach that highlights ‘kaumātua mana motuhake’ (elder independence and autonomy), the study used kaupapa Māori (Māori approach, knowledge, skills, attitudes and values) and community-based participatory research methodology, to develop and pilot a culture-centred tuakanateina/peer education programme. Methods included establishing two advisory groups (one of kaumātua and one of sector experts); holding five focus groups with kaumātua; and running a pilot programme with 21 kaumātua. The findings demonstrate the value in a strengths-based approach that centralises Māori culture and kaumātua potential, capacity and ability, and recognises the continuing value and contribution of kaumātua to society. The study helps shift the focus from dominant stereotypes of ageing populations as a burden on society and shows the value of kaumātua supporting others during transitions in later life.

Copyright

Corresponding author

*Corresponding author. Email: mary.simpson@waikato.ac.nz

References

Hide All
Ageing Well National Science Challenge (nd) Ageing Well National Science Challenge Kia eke kairangi ki te taikaumātuatanga. Available at https://www.ageingwellchallenge.co.nz/.
Anderson, I, Robson, B, Connolly, M, Al-Yaman, F, Bjertness, E, King, A, Tynan, M, Madden, R, Bang, A, Coimbra, C, Pesantes, M, Amigo, H, Andronov, S, Armien, B, Obando, D, Axelsson, P, Bhatti, Z, Bhutta, Z, Bjerregaard, P, Bjertness, M, Briceno-Leon, R, Broderstad, A, Bustos, P, Chongsuvivatwong, V, Chu, J, Deji, J, Gouda, R, Harikumar, T, Htay, A, Htet, C, Izugbara, M, Kamaka, M, King, M, Kodavanti, M, Lara, A, Laxmaiah, C, Lema, A, Taborda, T, Liabsuetrakul, A, Lobanov, M, Melhus, I, Meshram, J, Miranda, T, Mu, B, Nagalla, A, Nimmathota, A, Popov, A, Poveda, F, Ram, H, Reich, R, Santos, A, Sein, C, Shekhar, L, Sherpa, P, Skold, S, Tano, A, Tanywe, C, Ugwu, F, Ugwu, P, Vapattanawong, X, Wan, J, Welch, G, Yang, Z, Yang, L and Yap, L (2016) Indigenous and tribal peoples’ health (The Lancet–Lowitja Institute Global Collaboration): a population study. The Lancet 388, 131157.
Antonucci, TC, Birditt, KS, Sherman, CW and Trinh, S (2011) Stability and change in the intergenerational family: a convoy approach. Ageing & Society 31, 10841106.
Associate Minister of Health (2016) Healthy Ageing Strategy. Wellington: Ministry of Health.
Baker, M, Zhang, J, Blakely, T, Crane, J, Saville-Smith, K and Howden-Chapman, P (2016) Collaborating with a social housing provider supports a large cohort study of the health effects of housing conditions. BMC Public Health 16. doi:10.1186/s12889-016-2730-9.
Basu, A and Dutta, MJ (2009) Sex workers and HIV/AIDS: analyzing participatory culture-centered health communication strategies. Human Communication Research 35, 86114.
Braun, V and Clarke, V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.
Dennis, C-L (2003) Peer support within a health care context: a concept analysis. International Journal of Nursing Studies 40, 321332.
Dulin, PL, Stephens, C, Alpass, F, Hill, RD and Stevenson, B (2011) The impact of socio-contextual, physical and lifestyle variables on measures of physical and psychological wellbeing among Māori and non-Māori: the New Zealand Health, Work and Retirement Study. Ageing & Society 3, 14061424.
Durie, M (1985) A Māori perspective of health. Social Science and Medicine 20, 483486.
Durie, M (2003) Ngā Kāhui Pou: Launching Māori Futures. Auckland: Huia.
Dutta, MJ (2007) Communicating about culture and health: theorizing culture-centred and cultural sensitivity approaches. Communication Theory 17, 304328.
Dutta, MJ (2008) Communication Health: A Culture-centered Approach. Malden, MA: Polity Press.
Dutta, MJ, Anaele, A and Jones, C (2013) Voices of hunger: addressing health disparities through the culture-centered approach. Journal of Communication 63, 159180.
Dwyer, J, Boulton, A, Lavoie, JG, Tenbensel, T and Cumming, J (2013) Indigenous peoples’ health care: new approaches to contracting and accountability at the public administration frontier. Public Management Review 16, 10911112.
Elder, H and Kersten, P (2015) Whakawhiti Kōrero, a method for the development of a cultural assessment tool, Te Waka Kuaka, in Māori traumatic brain injury. Behavioural Neurology 2015, 18.
Erickson, D (2009) Learning in retirement peer instructors: in over their heads or swimming comfortably? Educational Gerontology 35, 393408.
Hayman, KJ, Kerse, N, Dyall, L, Kepa, M, Teh, R, Wham, C, Wright-St Clair, V, Wiles, J, Keeling, S, Connolly, M, Wilkinson, T, Moyes, S, Broad, J and Jatrana, S (2012) Life and living in advanced age: a cohort study in New Zealand – Te Puawaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ: study protocol. BMC Geriatrics 12. doi:10.1186/1471-2318-12-33.
Hokowhitu, B (2003) Te tāminga o te mātauranga Māori: colonisation in education. In Ka'ai, T, Moorfield, J and Reilly, M (eds), Ki te Whaiao: An Introduction to Māori Society. Auckland: Pearson, pp. 190200.
Hokowhitu, B (2010) Indigenous studies: research, identity, resistance. In Hokowhitu, B, Kermoal, N, Andersen, C, Reilly, M, Rewi, P and Petersen, A (eds), Indigenous Identity and Resistance: Researching the Diversity of Knowledge. Dunedin, New Zealand: University of Otago Press, pp. 922.
Hook, G, Waaka, T and Raumati, LP (2007) Mentoring Māori within a Pākehā framework. MAI Review 3. Available at http://www.review.mai.ac.nz/index.php/MR/article/view/70.
Hung, LI, Kempen, G and De Vries, N (2010) Cross-cultural comparison between academic and lay views of healthy ageing: a literature review. Ageing & Society 30, 13731391.
Isherwood, LM, Luszcz, MA and King, DS (2015) Reciprocity in material and time support within parent–child relationships during late-life widowhood. Ageing & Society 36, 16681689.
Kearns, R and Dyck, I (1996) Cultural safety, biculturalism and nursing education in Aotearoa/New Zealand. Health and Social Care in the Community 4, 371380.
Kendig, H, Browning, CJ, Thomas, SA and Wells, Y (2014) Health, lifestyle, and gender influences on aging well: an Australian longitudinal analysis to guide health promotion. Frontiers in Public Health 2, 19.
Kennedy, V and Cram, F (2010) Ethics of researching with whānau collectives. MAI Review 3. Available at http://www.review.mai.ac.nz/MR/article/view/381/560.html.
Kensington-Miller, B and Tatima, M (2015) Māori in partnership: a peer mentoring model for tertiary indigenous staff in New Zealand. Race, Ethnicity and Education 18, 813833.
Kēpa, M, Kēpa, CA, McPherson, B, Kameta, H, Kameta, F, Port, W, Loughlin, H, Smith, P and Reynolds, L (2014) E kore e ngāro ngā kākano I ruia mai i rangiātea: the language and culture from Rangiātea will never be lost in health and ageing research. AlterNative: An International Journal of Indigenous Peoples 10, 276287.
Khong, L, Farringdon, F, Hill, K and Hill, A (2015) ‘We are all one together’: peer educators’ views about falls prevention education for community-dwelling older adults – a qualitative study. BMC Geriatrics 15, 28. doi:10.1186/s12877-015-0030-3.
Kocken, PL and Voorham, AJ (1998) Effects of a peer-led senior health education program. Patient Education and Counseling 34, 1523.
Layne, J, Sampson, S, Mallio, C, Hibberd, P, Griffith, J, Krupa, D, Flanagan, W and Castaneda-Sceppa, C (2008) Successful dissemination of a community-based strength training programme for older adults by peer and professional leaders: the people exercising program. Journal of the American Geriatrics Society 56, 23232329.
Lee, J, Hoskins, T and Doherty, W (2005) Māori cultural regeneration: pūrākau as pedagogy. Paper presented at the Centre for Research in Lifelong Learning Conference, Stirling, UK, 24–26 June. Available at http://www.rangahau.co.nz/assets/lee_J/purakau%20as%20pedagogy.pdf.
Levack, WM, Jones, B, Grainger, R, Boland, P, Brown, M and Ingham, TR (2016) Whakawhanaungatanga: the importance of culturally meaningful connections to improve uptake of pulmonary rehabilitation by Māori with COPD – a qualitative study. International Journal of Chronic Obstructive Pulmonary Disease 11, 489501.
MacFarlane, A, Glynn, T, Cavanagh, T and Bateman, S (2007) Creating culturally-safe schools for Māori students. Australian Journal of Indigenous Education 36, 6576.
Mane, J (2009) Kaupapa Māori: a community approach. MAI Review 3. Available at http://www.review.mai.ac.nz/MR/article/view/243/282.html.
McClintock, K, Mellsop, G, Moeke-Maxwell, T and Merry, S (2012) Pōwhiri process in mental health research. International Journal of Social Psychiatry 58, 96–97.
Marsden, M (1992) God, man and universe: a Māori view. In King, M (ed.), Te Ao Hurihuri. Auckland: Reed, pp. 117137.
Masters-Awatere, B (2015) ‘That's the Price We Pay’: Kaupapa Maori Programme Stakeholder Experiences of External Evaluation (PhD thesis). University of Waikato, Hamilton, New Zealand.
Mead, H (2003) Tikanga Māori: Living by Māori Values. Wellington: Huia.
Ministry of Health (2016) Health Loss in New Zealand: A Report from the New Zealand Burden of Diseases, Injuries and Risk Factors Study, 1990–2013. Wellington: Ministry of Health. Available at https://www.health.govt.nz/#system/files/documents/publications/health-loss-in-new-zealand-1990-2013-aug16.pdf.
Ministry of Social Development (2010) Whānau Ora: Report of the Taskforce on Whānau-centred Initiatives. Wellington: Ministry of Social Development. Available at https://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/planning-strategy/whanau-ora/whanau-ora-taskforce-report.pdf.
Minkler, M, García, A, Williams, J, LoPresti, T and Lilly, J (2010) Sí Se Puede: using participatory research to promote environmental justice in a Latino Community in San Diego, California. Bulletin of the New York Academy of Medicine 87, 796812.
Oetzel, J, Simpson, M, Berryman, K, Iti, T and Reddy, R (2015) Managing communication tensions and challenges during the end-of-life journey: perspectives of Māori kaumātua and their whānau. Health Communication 30, 350360.
Office for Senior Citizens (2014) 2014 Report on the Positive Ageing Strategy. Available at http://www.superseniors.msd.govt.nz/documents/msd-17470-2014-ageing-strategy-report-final.pdf.
Patton, MQ (2002) Qualitative Research and Evaluation Methods. Thousand Oaks, CA: Sage.
Pérez-Escamilla, R, Hromi-Fiedler, A, Vega-López, S, Bermúdez-Millán, A and Segura-Pérez, S (2008) Impact of peer nutrition education on dietary behaviors and health outcomes among Latinos: a systematic literature review. Journal for Nutrition Education and Behavior 40, 208225.
Peterson, JC (2010) CBPR in Indian country: tensions and implications for health communication. Health Communication 25, 5060.
Philis-Tsimikas, A, Fortmann, A, Lleva-Ocana, L, Walker, C and Gallo, LC (2011) Peer-led diabetes education programmes in high-risk Mexican Americans. Diabetes Care 34, 19261931.
Pohatu, TW (2004) Āta: growing respectful relationships. He Pukenga Kōrero 8, 18.
Ramadurai, V, Sharf, BF and Sharkey, JR (2012) Rural food insecurity in the United States as an overlooked site of struggle in health communication. Health Communication 27, 794805.
Ramsden, I (2002) Cultural safety: implementing the concept – the social force of nursing and midwifery. In Whaiti, PT, McCarthy, A and Durie, M (eds), Mai I Rangiatea. Auckland: Auckland University and Bridget Williams Books, pp. 113125.
Ramsden, I and Spoonley, P (1993) The cultural safety debate in nursing in Aotearoa. NZ Annual Review Education 3, 161174.
Ratima, M and Grant, B (2007) Thinking about difference across and within mentoring. MAI Review, 3. Available at http://www.review.mai.ac.nz/index.php/MR/article/view/71/89.
Rawlings, C and Wilson, K (2003) Tuakana-Teina E-belonging Report. Wellington: Ako Aotearoa.
Resnicow, K, Braithwaite, RL, Dilorio, C and Glanz, K (2002) Applying theory to culturally diverse and unique populations. In Glanz, G, Rimer, B and Lewis, F (eds), Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: Jossey-Bass, pp. 485509.
Rowan, M, Poole, N, Shea, B, Gone, JP, Mykota, D, Farag, M, Hopkins, C, Hall, L, Mushquash, C and Dell, C (2014) Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study. Substance Abuse Treatment Prevention and Policy 9, 34. doi:10.1186/1747-597X-9-34.
Seymour, J, Almack, K, Kennedy, S and Froggatt, K (2011) Peer education for advance care planning: volunteers’ perspectives on training and community engagement activities. Health Expectations 16, 4355.
Simpson, ML, Berryman, K, Oetzel, J, Iti, T and Reddy, R (2016) A cultural analysis of New Zealand palliative care brochures. Health Promotion International 31, 839848.
Smith, PC (2009) Everything You Know About Indians is Wrong. Minneapolis, MN: University of Minnesota Press.
Stevens, Z, Barlow, C and Iliffe, S (2015) Promoting physical activity among older people in primary care using peer mentors. Primary Health Care Research and Development 16, 201206.
Taylor, R (2003) An indigenous perspective on evaluations in the inter-cultural context: how far can one throw a Moree boomerang? Evaluation Journal of Australasia 3, 4453.
Tervalon, M and Murray-García, J (1998) Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved 9, 117125.
Wallerstein, N and Duran, B (2010) Community-based participatory research contributions to intervention research: the intersection of science and practice to improve health equity. American Journal of Public Health 100, S40S46.
Wallerstein, N, Duran, B, Oetzel, JG and Minkler, M (2018) Community-based Participatory Research for Health: Advancing Social and Health Equity, 3rd Edn. San Francisco, CA: Jossey-Bass.
Winitana, M (2012) Remembering the deeds of Māui: what messages are in the tuakana-teina pedagogy for tertiary educators. MAI Journal 1, 2937.
Wyeth, E, Derrett, S, Hokowhitu, B, Langely, J and Hall, C (2010) Rangatiratanga and Oritetanga: responses to the Treaty of Waitangi in a New Zealand study. Ethnicity and Health 15, 303316.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed