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He Pikinga Waiora Implementation Framework: A tool for chronic disease intervention effectiveness in Maori and other indigenous communities
He Pikinga Waiora Implementation Framework: A tool for chronic disease intervention effectiveness in Maori and other indigenous communities
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Abstract
Introduction: Health outcomes for Māori are significantly worse than non-Maori in New Zealand; these inequities mirror those found in indigenous communities elsewhere. Evidence-based interventions with established efficacy may not be effective in indigenous communities without addressing specific implementation challenges. We present an implementation framework for chronic condition interventions for Māori.
Theory/Methods: The He Pikinga Waiora Implementation Framework has indigenous self-determination at its core and consists of four elements: cultural-centeredness, community engagement, systems thinking, and integrated knowledge translation. All elements have demonstrated evidence of positive implementation outcomes. A coding scheme derived from the Framework was applied to 13 studies of diabetes prevention in indigenous communities from a systematic review.
Results: Cross-tabulations demonstrated that culture-centeredness (p=.008) and community engagement (p=.009) explained differences in diabetes outcomes and community engagement (p=.098) explained difference in blood pressure outcomes.
Discussion and Conclusions: The He Pikinga Waiora Implementation Framework is well suited to advance implementation science for Māori and other indigenous communities. The framework has promise as a policy and planning tool to evaluate and design effective interventions for chronic disease prevention.
Lessons Learned: We needed to revise the coding framework in order to make the implication framework concrete.
Limitations: This study has a limitation in that we coded information about interventions from the published articles and not the interventions themselves. Additionally, the study only included 13 interventions.
Suggestions for Future Direction: Further research should provide stronger evidence of the usefulness of the framework particularly with Māori end-users. There will also be a need to understand the differential contribution of each of the four elements to health outcomes.
Type
Journal Article
Type of thesis
Series
Citation
Oetzel, J., Scott, N., Hudson, M., Masters, B., Rarere, M., Foote, J., … Ehau, T. (2018). He Pikinga Waiora Implementation Framework: A tool for chronic disease intervention effectiveness in Maori and other indigenous communities. International Journal of Integrated Care, 18(S1). https://doi.org/10.5334/ijic.s1068
Date
2018
Publisher
UBIQUITY PRESS LTD