Fiona Cram

Background Participating in prenatal screening for chromosomal conditions is premised on an informed choice to accept or decline. Aim The aims of this paper are to describe people's experiences of informed choice and how these relate to the experience of prenatal screening. Method Thirty‐eight people were recruited and their experiences were expl...

Background Being able to measure informed choice represents a mechanism for service evaluation to monitor whether informed choice is achieved in practice. Approaches to measuring informed choice to date have been based in the biomedical hegemony. Overlooked is the effect of epistemic positioning, that is, how people are positioned as credible knowe...

aim: To examine the impact of integrated employment support and mental health treatment (Individual Placement and Support, or “IPS”) on Aotearoa New Zealand participants’ employment, income, health, education and justice outcomes. method: De-identified linked data from the Stats NZ Integrated Data Infrastructure and propensity score matching were u...

Bhutan's overarching development paradigm of Gross National Happiness (GNH) promotes a harmonious balance between material and non-material dimensions. But Bhutan's evaluation practice has not yet adopted the principles of GNH, preventing evaluation findings and recommendations from aligning with the priorities of GNH. This article makes the case t...

In this article, each author describes the development of what we loosely refer to as Indigenous Evaluation (IE) within our homeplace, and how IE has contributed to and benefited from connecting with the larger stream of Culturally Responsive Evaluation (CRE). Like IE, CRE frames evaluation through a lens that privileges the worldviews of those who...

In this opening piece, Fiona Cram (Ngāti Pahauwera) reflects on her introduction to the new technology of her childhood—the television set. She intersperses her memories of how this device changed her whānau’s dynamics with advice for today’s young people as they clamour for new technology to think more deeply about the associated consequences.

Te Whare Pora a Hine-te-iwaiwa (Te Whare Pora), a Māori (Indigenous peoples of Aotearoa (New Zealand)) approach to the prevention of sudden infant death, posits that immersion in traditional knowledge and the weaving of the wahakura (woven flax bassinet) as a safe infant sleep space boosts the resilience of pregnant wāhine Māori (Māori women) and t...

The burden of health inequities borne by Indigenous peoples can be overwhelming, especially when mothers and newborns’ lives are at stake and health services seem slow to invest in responsiveness. In Aotearoa (New Zealand), urgent action is required to eliminate persistent systemic inequities for Māori (Indigenous) whānau (family collectives that e...

Purpose Within this paper we evaluate the inclusion of the family voice in the domestic homicide review process. We use an Indigenous rubric (Te Pou) developed to ensure a culturally appropriate framework for conducting fatality reviews. We further draw on the creative potential of Indigenous knowledge systems, applying them alongside Western under...

The M.E.K.E (Move, Engage, Konnect, Evolve) Initiative is a pro-equity intervention developed by Māori for Māori that utilised a holistic, culture- centred community-based approach which built on an existing community partnership. The M.E.K.E Initiative was borne out of a desire by Levi Armstrong (Ngāti Kahungunu) to bring health and fitness to the...

An infant arriving early disrupts the birth imaginary of whānau (family collectives) and situates them in unfamiliar health environments that may not be culturally safe. Regaining a sense of familiarity enables whānau to cope with their unexpected preterm trajectory. He Tamariki Kokoti Tau: Babies Born Prematurely was the first Kaupapa Māori prospe...

Aims To describe a body of Māori translational research responses that challenge colonialised systems. Methods To delineate and link ongoing Kaupapa Māori and Māori-led translational research. Results He Tapu Te Whare Tangata explores human papilloma virus (HPV) screening. Te Hā o Whānau presents a culturally responsive framework of maternity car...

Young Māori (Indigenous peoples of Aotearoa New Zealand) women and their babies experience more health disparities than their non-Māori counterparts. These disparities arise from multiple determinants, including racism and stigmatization. This chapter explores the pregnancy, birth, and motherhood journeys of 15 young Māori women using a Foucauldian...

In the context of New Zealand's tenure change and ageing population, we explore the experiences of older renters who were former homeowners. These renters' trajectories reflect a societal shift to complex and risky housing pathways. We identify typical pathways out of homeownership: sudden shock, tenure churn and planned choice. We also extend the...

Māori (Indigenous peoples of Aotearoa New Zealand) bear an unequal burden of poor perinatal health outcomes, including preterm birth. An infant arriving preterm disrupts the birth imaginary of whānau (family collectives) and situates them in a foreign health environment that may not be culturally safe and nurturing. A cross-sectional interpretative...

The Family Violence Death Review Committee (FVDRC) is one of five Mortality Review Committees (MRCs) that sit within the Health Quality & Safety Commission, Aotearoa, New Zealand. A key goal of the work of these committees is the reduction of the unequal burden of disparities shouldered by Māori (Indigenous peoples). Guidance to the committees on i...

Objective To explore preterm birth among Māori indigenous peoples through Kaupapa Māori research of preterm birth in Aotearoa New Zealand. Methods Linked maternity, mortality, and hospital data were analyzed for women and their infants born between January 1, 2010 and December 31, 2014. Relative risks (RR) were calculated for each ethnic group for...

Objective To develop an in‐depth understanding of HPV self‐testing cervical screening clinical pathways for never‐/under‐screened Māori women. Methods Based on a community‐based cluster randomized controlled trial in Aotearoa (New Zealand), a Kaupapa Māori (by Māori, for Māori) qualitative study enrolled Māori women who met the eligibility criteri...

The provision of good quality housing for young families is a key way of supporting health and well-being, and this is especially important for young Māori (Indigenous) mothers and their children, who experience a greater burden of social and health inequities. Low-quality housing can negatively affect health, safety, employment, education, social...

INTRODUCTION: A Kaiwhakatere position funded as part of Te Taitimu Trust’s Ngā Moko Ā Ngā Tūpuna initiative has created a space for a navigation practice model within the context of suicide prevention. The Kaiwhakatere is akin to a “professional auntie” who draws on her knowledge of whakapapa, whenua and whānau to engage rangatahi and whānau and bu...

In this call to action, a coalition of Indigenous and non-Indigenous researchers from Australia, Aotearoa New Zealand, United States and Canada argue for the urgent need for adequately funded Indigenous-led solutions to perinatal health inequities for Indigenous families in well-resourced settler-colonial countries. Authors describe examples of suc...

In 2010 and 2011 the Canterbury earthquakes prompted expressions of mahi aroha – work done by Māori (Indigenous peoples of Aotearoa New Zealand) out of a love for the people – in the emergency context of a natural disaster. Similarly, the Covid-19 level 4 lockdown that began in the last week of March 2020 showcased Māori caring for one another in t...

From 2009 to 2014 Foundation North, a philanthropic trust serving Auckland and Northland, funded a Māori and Pacific Education Initiative (MPEI) designed to facilitate Māori and Pacific students’ educational achievement. The longitudinal study, Ngā Tau Tuangahuru, described here was funded in late 2014 to explore what happened next for families and...

Background: Indigenous women in the high-income countries of Canada, Australia, New Zealand and USA, have a higher incidence and mortality from cervical cancer than non-Indigenous women. Increasing cervical screening coverage could ultimately decrease cervical cancer disparities. Aims: To increase cervical screening for under-screened/never-scre...

E Hine was a longitudinal qualitative Kaupapa Māori (by Māori, for Māori) research study involving 44 young Māori women who were first interviewed in 2012‐2013 and followed through their pregnancies and until their babies were 2 years old. The present analysis of the E Hine database examines the young women's experiences of accessing welfare benefi...

Objective: To improve consistency in New Zealand's Mortality Review Committees' (MRCs) analysis, interpretation, and recommendations, specifically related to equity and Māori (the Indigenous peoples of Aotearoa New Zealand) mortality. Design: A qualitative Plan-Do-Check-Act design informed by Māori expertise to develop a rubric and guidelines. T...

Aim: A nuanced healthcare framework, Te Hā o Whānau, aims to make the maternal-infant healthcare system more accessible and culturally responsive for Māori following unexpected events that led to the harm or loss of their baby. Method: Te Hā o Whānau was developed from three components. Firstly, it was grounded and informed by Kaupapa Māori qual...

The International Papillomavirus Society (IPVS) supports best practice and evidence-based research, strategies, and policies to prevent HPV-related diseases worldwide. With the recent call from the World Health Organization (WHO) to global entities to work towards the elimination of cervical cancer globally as a public health problem, a call suppo...

The proportion of older Māori (55+ years) living in rental accommodation is set to rise as home ownership has become less attainable. To anticipate what the future of rental accommodation may hold for older Māori, 42 older Māori (18 men, 24 women) renters in the Hawke’s Bay region of Aotearoa New Zealand were asked about their experiences. Particip...

BACKGROUND Maternal and infant health inequities between Māori (the Indigenous peoples of Aotearoa New Zealand) and New Zealand European (NZE) women are well documented and cannot be explained solely by socioeconomic status. This research centre-iwi (tribal) partnership aims to address these disparities and improve maternal and infant health outcom...

Background Maternal and infant health inequities between Māori (the Indigenous peoples of Aotearoa New Zealand) and New Zealand European women are well documented and cannot be explained solely by socioeconomic status. A research center-iwi (tribal group) partnership aims to address these disparities and improve maternal and infant health outcomes...

Advances in molecular technologies have the potential to help remedy health inequities through earlier detection and prevention; if, however, their delivery and uptake (and therefore any benefits associated with such testing) are not more carefully considered, there is a very real risk that existing inequities in access and use will be further exac...

This article explores the impact on whänau wellbeing following wähine being transferred to either secondary or tertiary care hospitals to receive health care for themselves or their baby during the birthing journey. It was found that throughout this process, the wähine and whänau faced a series of challenges that compromised their wellbeing. Feelin...

Understanding the lived realities of Māori patients with long-term health conditions (LTCs) is essential if the health system in Aotearoa New Zealand is to eliminate current Māori health disparities and support Māori patients appropriately. Culturally responsive researchers can gain insights by ensuring the inclusion of Māori participants in resear...

A research partnership between Iwi (tribal group) Ngāti Pāhauwera and a university-based research centre specialising in Kaupapa Māori (by Māori, for Māori) research was formed in response to an invitation from Ngāti Pāhauwera. The initial partnership goal was to address health inequities experienced by Māori women and infants in Te Wairoa (the hom...

Aotearoa New Zealand’s high rates of intimate partner violence (IPV) and child abuse and neglect point to a clear need to develop and resource equitable mental health and addiction practices that are responsive both to people experiencing and using violence, and to their families. Current responses to IPV in mental health and addiction settings in...

Background: Human papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Māori women who suffer a greater burden of cervical disease than New Zealand European women. Aims: This study aimed to explore the potential acceptabi...

Young Māori (Indigenous peoples of Aotearoa New Zealand) women and their babies experience more health disparities than their non-Māori counterparts. These disparities arise from multiple determinants, including racism and stigmatization. This chapter explores the pregnancy, birth, and motherhood journeys of 15 young Māori women using a Foucauldian...

Young Māori mothers in Aotearoa/New Zealand are disproportionately vulnerable to intimate partner violence (IPV) due to multiple intersecting factors, such as relationship dynamics during youth, pregnancy, and racialized Māori (Indigenous) identity. An enduring legacy of settler colonialism has resulted in Māori being overrepresented as victims and...

Severe acute maternal morbidity (SMM) is a near-death experience during pregnancy, childbirth or termination of a pregnancy. Nine women recruited from hospital intensive care or high dependency units following the birth of their baby participated in two qualitative interviews about their SMM experience. The interpretative phenomenological analysis...

Background: Significant health inequities exist around maternal and infant health for Māori, the indigenous people of Aotearoa New Zealand - and in particular around a premature (preterm) delivery. Māori babies are more likely to be born preterm (8.1%, compared to an overall rate of 7.4%) and they are more likely to have a preterm death. An essent...

Tackling Wicked Problems in Complex Ecologies is a call to action, focusing on the role that evaluators can play in addressing social and economic problems. Evaluation extends beyond theories and methods, encompassing a range of proven approaches for addressing ecological complexities that drive inequities around the globe. Bringing together leadin...

Background Non-invasive prenatal testing (NIPT) is a relatively new screen for congenital conditions – specifically, common fetal aneuploidies including Down Syndrome. The test is based on isolating freely circulating fragments of fetal-placental DNA that is present in the mother’s blood. NIPT has a superior clinical performance compared to current...

Despite improved access to health services in Aotearoa New Zealand there remains a significant socio-economic and health gap between Maori (Indigenous New Zealanders) and Pakeha (non-Maori). E Hine (Girl) is a qualitative Kaupapa Maori (by Maori, for Maori) research project seeking to identify barriers and facilitators to positive health outcomes f...

Philosophic tensions arise in bringing together research agendas associated with the transformative paradigm and Indigenous peoples because of the latter’s history of colonization and betrayal. The alliance between the transformative and Indigenous agendas is therefore not an entirely comfortable fit. However, we argue that Indigenous voices can be...

This paper explores the birthing experiences of 16 pregnant Māori women under 20 years of age who were involved in E Hine, a Kaupapa Māori (by Māori, for Māori) longitudinal qualitative research study of young Māori women's journeys through pregnancy and into motherhood that ran from 2010 to 2013. This study provided these young women with an oppor...

Kaupapa Maori is literally a Maori way. It is a reclaiming by Maori (Indigenous peoples of Aotearoa New Zealand) of a future that is founded within a Maori worldview; a future where cultural knowledge and values inform understandings of and responses to Maori needs, priorities, and aspirations. Selfdetermination, cultural aspirations, and the impor...

INTRODUCTION: Timely and equitable access to contraception enables teenage mothers to make informed choices about their sexual and reproductive health. This study aimed to identify barriers and facilitators to contraception for Māori teenagers who become mothers. METHODS: ‘E Hine’ is a longitudinal qualitative Kaupapa Māori (by Māori, for Māori) st...

Kaupapa Māori is literally a Māori way. It is a reclaiming by Māori (Indigenous peoples of Aotearoa New Zealand) of a future that is founded within a Māori worldview; a future where cultural knowledge and values inform understandings of and responses to Māori needs, priorities, and aspirations. Selfdetermination, cultural aspirations, and the impor...

The case study of Māori housing downsizing experiences, outcomes and needs was a component of the Finding the Best Fit: Housing, Downsizing and Older People in a Changing Society research programme. This research programme had two objectives: 1. Getting Best Fit: Optimising Older People’s Use of the Housing Assets, and 2. Stay, Go, Downsize: Tools...

Child welfare data collected for administrative purposes are often used as a source of information for understanding the population impact of child abuse and neglect (CA/N). This study used administrative data linked at the individual level for a cohort of Aotearoa New Zealand (NZ) children to follow and extend a model developed by Drake et al. In...

Indigenous peoples are decolonizing research methodology so it serves their peoples’ needs and aspirations. These needs are rooted in trauma created by colonial agendas that remove tribes from their land, break family bonds, and disrupt identity. Aspirations are about justice, the return of lands, and living as indigenous peoples. This panel of Ind...

To explore the lived realities of pregnant Maori women <20 years through pregnancy and motherhood, to identify barriers to, and facilitators of, access to maternity care. Using a Kaupapa Maori research paradigm, 44 pregnant or recently pregnant Maori woman <20years of age were recruited in two case study sites. Participants completed a series of in...

Recently I went to a university graduation ceremony. It began with an orchestral introduction, with the lead taken by three trumpeters. A traditional Maori welcome by the university's Maori staff and students then followed. This welcome was a combination of karanga (ceremonial calling), haka (posture dancing), and waiata (singing). After this welco...

Next month I'm going to my granddaughter's graduation. Many of our family will be there to celebrate her accomplishment. Maori family members are travelling from the coast, Pasifika family members are gathering from the greater Auckland area, and Pakeha family members are flying home from Australia for the ceremony. It's like this when anyone from...

Young Māori mothers experience stigma and their babies experience poor health outcomes. Interventions to reduce these health disparities need to understand the lives of these young women. This paper describes consultation to seek agreement for research with young Māori mothers to be conducted in two regions. Consultation occurred with tribal author...

Background The prevalence of asthma for Indigenous New Zealand Māori is amongst the highest in the world. Recent evidence shows ethnic differences in asthma symptom prevalence in New Zealand have widened, with asthma symptoms and hospitalisation rates consistently higher for Māori across all age-groups, especially children and adolescents. This pap...

The development of Māori (Indigenous New Zealanders) research capacity over the past 20 years now begs the question of how Māori and Tauiwi (non-Māori) researchers might authentically partner and undertake transdisciplinary research that upholds the integrity and aspirations of both parties. In this article, the notion of interstitial space is sugg...

Marginalisation occurs when a group of people are pushed to the periphery of society. One key push in the marginalisation of indigenous peoples was the arrival of colonisers in our lands. Colonisation turned our worlds upside- down in many ways and has made what we considered to be normal into something 'different' and marginal to the mainstream of...

In April 2010 the Taskforce on Whānau-Centred Initiatives presented its report, 'Whānau Ora', to the Minister for the Community and Voluntary Sector, the Hon Tariana Turia. Six goals for whānau were outlined in the report, with their achievement resting upon a foundation of Whānau Ora principles; good governance and management; whānau-centred provi...

Appreciative Inquiry (AI) is a reconfiguration of action research that has found particular traction within organisational settings and is explored here for its potential use within whānau (Māori family) research. Rather than focusing on what is wrong, AI practitioners ask affirming questions and encourage participants to focus on what works. The a...

An ethical framework is required for researching with whānau (family/families) that not only considers respect for Māori knowledge and ways of being, but also reflects the diversity of whānau. Consultation hui were held for participants of the “Research With Whānau Collectives” project (RWWC). Concerns voiced by hui participants queried the notion...

Much of what is known about whānau (Māori families) is sourced from key informants within a whānau, or from the aggregation of data on individuals within a household or whānau. The ‘Researching with Whānau Collectives’ project (RWWC) described here was initiated in recognition that understanding whānau as a collective would support whānau developme...

Whānau Tuatahi facilitates community–researcher partnerships as a way of giving voice to the concerns whānau have about their health and the aspirations they have for their wellness. This research framework was developed in the context of a Kaupapa Māori research project for the exploration of whānau experiences of tamariki with asthma. Four method...

In his target article, Professor Raumati Hook (2009) has harnessed the power of science and politics to ask questions about the ‘discovery’ of the ‘warrior gene’ in a small number of Māori. Hook however, begins his paper with the seemingly casual dismissal of explanations for the high rate of Māori acts of violence. The present commentary begins wi...

Possessions allow us to understand and to express our self-identity. For the elderly, possessions are also important repositories of memories of one's self-identity in the past, especially when opportunities for the external validation of self are limited, for example, as a result of institutionalisation. The present study explored the relationship...

The Amokura Family Violence Prevention Strategy (Amokura) is an integrated community-based, initiative to address family violence in Northland (Tai Tokerau) New Zealand. The initiative is led by the Tai Tokerau Iwi Chief Executives Consortium (Consortium) which is made up of the Chief Executives of seven iwi (tribal) authorities. The initiative con...

In 1984 Mason Durie documented a framework for understanding Māori health, Te Whare Tapa Wha, which has subsequently become embedded in Māori health policy. In addition, the adoption of this framework is now widespread among Māori and Iwi health and disability service providers and clinicians. Within psychological practice Te Whare Tapa Wha forms t...

Les enfants doivent acquérir des capacités appropriécs en matière de consommation, d'orientations comportementales et des attitudes pour prendre part de façon effective au marche des adultes. La socialisation du consommateur avant l'age adulte est aussi nécessaire pour que les enfants traitent les problèmes pratiques qui se posent dans leur marché...

The study of inequities in health is a critical component of monitoring government obligations to uphold the rights of Indigenous Peoples. In Aotearoa/New Zealand the indigenous Māori population has a substantially younger age structure than the non-indigenous population making it necessary to account for age differences when comparing population h...

Shared histories of "discovery" and colonization have made us wary and weary of evaluation practices that disregard indigenous worldviews and ways of knowing, which we absolutely know are valid. Even though we have been marginalized within our lands, we remain sovereign and insist on the right to develop our own evalua- tion methodology. We have do...

The purpose of this paper is to examine the nature of talk and its place within kaupapa Māori research. Just as many Māori occasions rely on talk¹ to define context and kaupapa, so do research and principles often seek to represent the talk of participants as defining their context and their kaupapa. Within these research processes there are ample...

This paper documents the beginning of a conversation about what it means to be Maori within a larger, mainstream research project. This larger project was conceived by a team of researchers that included a Maori principal investigator, and funding was gained from a funding agency that has established criteria for Maori responsiveness. The Maori com...

Despite significant changes in the social landscape over the past two decades, much ethnographic research suggests that young women's negotiations of (hetero)sexuality remain dominated by the sexual double standard. Within the sexual double standard, an active, desiring sexuality is positively regarded in men, but denigrated and regulated by negati...