Impetigo trial

This project was led by Dr. Alison Leversha, Auckland DHB in partnership with National Hauora Coalition. Impetigo is a contagious superficial bacterial skin infection, predominantly affecting children. New Zealand experiences a particularly high burden of skin and soft tissue infections with as many as 11% of NZ children aged under 15 years consulting their general practitioner for skin infections annually. The highest rates of which are seen in children under 10 years of age and Māori and Pacific children. These ailments are treated with topical antibiotics such as fusidic acid. However there is growing concern about increasing antibiotic resistance driven by the wide-spread community usage of topical antibiotics. Alternative therapies must be urgently found to prevent increasing resistance. This project aimed to compare two alternative treatments with the current standard of care treatment for mild-to-moderate impetigo among school children. Data collection wrapped up in April 2021.

Paracetamol project

The paracetamol project collected data from 1000 participants who were parents/caregivers to tamariki Māori aged 0 -14 years. This project analysed the dosing accuracy of participants when using a 5ml plastic syringe and whānau informed label compared to a standard prescription label and common conventional measuring apparatuses including dessert spoons, 40mL measuring cups and the paracetamol bottle cap. This project found that parent/caregivers were more precise with the intervention syringe and label compared to the standard prescription label and conventional measuring techniques. Additionally, this project also identified that parent/caregivers to tamariki are more likely to underdose their child than overdose their child with liquid paracetamol. The study provides compelling evidence that the tested syringe and label can significantly improve paracetamol dosing accuracy and reduce the risk of overdosing errors. Scaling up these solutions could have a significant impact on tamariki Māori health outcomes. The study also highlights the need for increased education and clear communication between health practitioners and caregivers to ensure the safe and effective use of paracetamol.

Sensors Project

This is a National Hauora Coalition led study. The project used sensors in the homes of whānau in South Auckland to better understand the potential influences that the interventions coordinated through AWHI healthy housing initiative may have on the indoor temperature and humidity of a home. High humidity, poor insulation, poor maintenance practices, and relatively low levels of heating mean that many New Zealand families live in damp and cold homes. Dampness can lead to mould growth which leads to health consequences including respiratory illnesses. Māori and Pacific peoples and those living in lower socioeconomic quintiles tend to live in areas with poor quality housing contributing further to health inequities. This project collected quantitative data on indoor temperature and humidity in AWHI homes both pre- and post- interventions in the home to influence indoor temperature and humidity alongside increases in healthy homes education with whānau. 40 whānau were onboarded to this project in the end of 2019 and this project is slated to finish in early 2021.

Reference: This is an Original Manuscript of an article published by Taylor & Francis in Kōtuitui: New Zealand Journal of Social Sciences Online on 31 August, available at http://wwww.tandfonline.com 

Read the publication: Substandard South Auckland housing: findings from a healthy homes initiative temperature study

Te Puna Rongoā : Achieving medicines access equity for Māori – pharmacists’ role

This project is led by Dr Joanna Hikaka and is a partnership project between Ngā Kaitiaki o Te Puna Rongoā o Aotearoa (the Māori Pharmacists’ Association) and National Hauora Coalition. The study is a multi-phase, mixed methods Kaupapa Māori project that aims to explore how Ngā Kaitiaki o Te Puna Rongoā o Aotearoa can support equitable access to medicines and to understand Māori experiences and drivers of medicines adherence and non-adherence. It is intended that this study could be used to inform health intervention and service development in the future.

Read our press release about this study here >>

Lockdown Doctors: Reducing health care inequities for Māori using virtual clinics and online platforms (a real-time response to COVID-19)

This is a collaborative study by National Hauora Coalition, The University of Auckland, Papakura Marae, Royal New Zealand College of General Practitioners, Te Rōpū Whakakaupapa Urutā, Te Ohu Rata o Aotearoa (Māori Doctors Association) and the University of Otago. Māori continue to experience significant barriers to accessing primary healthcare that contribute to ongoing health inequities. In direct response to COVID-19, primary healthcare practices quickly adopted virtual (online/video/phone) GP clinic models in order to continue to provide primary healthcare to New Zealand communities. Feedback from Māori health professionals involved with COVID-19 lockdown responses suggests that the ‘virtual clinic’ experience inadvertently removed barriers to healthcare for Māori patients in particular. For example, attending GP visits through virtual clinics (online) eliminated transport costs, travel and waiting times for consultation. This research aims to investigate and inform the use of virtual healthcare clinics within Māori communities as a catalyst to reducing barriers to accessing healthcare, and thereby reducing health inequities.

Haumaru Panuku Oranga

In Aotearoa New Zealand, Kaumātua and their whānau (family) are underserved by the transport system and are less able to get around urban and rural settings. Kaumātua Māori fulfil crucial roles that sustain the societal units of whānau and hapori. Participation is dependent on accessible transport options even when driving private vehicles is no longer possible. However, there is a dirth of research concerning the kaumātua experience of transport, especially using a kaupapa Māori perspective. Haumaru Panuku Oranga was a Māori-led qualitative research project that sought to understand kaumātua perspectives about their transport needs in Aotearoa. This project fell under the umbrella of the longitudinal transport study NZPaths led by the University of Otago. Using kaupapa Māori and qualitative methodology, researchers conducted fifty wānanga and face-to-face interviews with kaumātua and whānau from across Aotearoa to gain a better understanding of unique experiences and needs. Data was collected in both te reo Māori and English and transcribed by te reo Māori speaking transcribers. The findings developed by Māori-led researchers have shown that kaumātua feel forgotten, isolated and are struggling to be part of their own society due to travel constraints. Researchers found an overarching theme of resistance in the data where kaumātua found ways to resist and circumnavigate systemic issues that prohibited their access to transport. Kaumātua are conscious of the relationship between travel and power, specifically that Pakeha have the power to fund travel for all but not for kaumātua Māori. Kaumātua resisted the concept of individuality that underscores transport policy and preferred to be transported with people they knew. Outcomes of this study will add to the currently limited body of research around kaumātua Māori and transport.

Bridging the gaps: applying rangatahi Māori and Pacific patient-centered models of care to inform acute rheumatic fever and rheumatic heart disease service delivery

This Kaupapa Māori research is funded by Cure Kids and is being undertaken in collaboration with the National Hauora Coalition, the University of Auckland, the University of Otago, and Waikato DHB. The research aims to develop a rangatahi Māori, Pacific patient, and whānau-centered model to improve acute rheumatic fever (ARF) secondary prophylaxis health services, treatment, and management. ARF is an autoimmune response to an untreated group A streptococcus (GAS) infection, usually in the throat. The most severe sequela is rheumatic heart disease (RHD), which may require cardiac surgery. Significant ethnic disparities exist in ARF, with disproportionate rates among Māori and Pacific children between 5 and 14 years of age. To prevent ARF patients from suffering further heart damage, secondary prophylaxis is recommended. This involves monthly intramuscular penicillin injections for a minimum of 10 years. Recent research on Māori and Pacific Peoples’ experiences of ARF prophylaxis identified mismatches between ARF services and patient/whānau expectations of care, particularly for rangatahi (adolescents/young adults between 15-24 years). Furthermore, whānau and health providers reported difficulties with prophylaxis provision, identifying significant challenges in transitioning from pediatric to adult ARF/RHD services. Collectively, these studies highlight notable gaps in culturally responsive, age-appropriate care for rangatahi Māori and Pacific. This research aims to bridge these gaps by developing a rangatahi Māori and Pacific patient-centered model to improve ARF secondary prophylaxis health services and treatment. This project is mid-implementation with a model that reflects lived experiences, elevating whānau voices and narratives with interventions to meet these.