Our Publications

2021 Authors Anna K Rolleston , Judy Bowen, Annika Hinze, Erina Korohina and Rangi Matamua Abstract We describe a collaboration between Māori (Indigenous people of Aotearoa/New Zealand) and Tauiwi (non-Māori) researchers on a software engineering project. Te Tiriti o Waitangi (The Treaty of Waitangi) provides the basis for Māori to lead research that involves Māori as participants or intends to impact Māori outcomes. Through collaboration, an extension of the traditional four-step software design process was created, culminating in a nine-step integrated process that included Kaupapa Māori (Māori ideology) principles. The collaboration experience for both Māori and Tauiwi highlighted areas of misunderstanding within the research context based on differing worldviews and our ability to navigate and work through this. This article provides context, guiding principles, and recommended research processes where Māori and Tauiwi aim to collaborate.  Publication Link https://journals.sagepub.com/doi/10.1177/11771801211043164

2021 Authors Anna Rolleston, Marama McDonald, Philippa Miskelly Abstract This kaupapa Māori qualitative study explores the concept of flourishing for whānau Māori (Māori families) and how this is enacted in their everyday lives. Fourteen semi-structured interviews were conducted with whānau groups comprising at least two generations of the same family, and thematic analysis was based on Māori understandings of the world using NVivo software. Eight main themes emerged, depicted as ‘pou’ or markers that whānau considered intrinsic to flourishing: uaratanga (values); whanaungatanga (kinship relationships); manaakitanga (support); hauora (health and wellbeing); whakapāwera (hardship); kai (food); tikanga (customs), and hangarau (technology).  The findings offer a counter-narrative to negative discourses about Māori deprivation and inequities. The study provides information which could support the strategic development of programmes for Māori, as well as accountability measures, underpinned by the principles of flourishing whānau, at national and local government and community-based levels. Publication Link https://www.tandfonline.com/doi/full/10.1080/1177083X.2021.1981955

2022 Authors Sue Lord, Ruth Teh, Rosie Gibson, Moira Smith, Wendy Wrapson, Murray Thomson, Anna Rolleston , Stephen Neville, Lyn McBain, Silvia Del Din, Lynne Taylor, Nicola Kayes, Andrew Kingston, Rebecca Abey-Nesbit & Ngaire Kerse Abstract Maintaining independence is of key importance to older people. Ways to enable health strategies, strengthen and support whanāu (family) at the community level are needed. The Ageing Well through Eating, Sleeping, Socialising and Mobility (AWESSOM) programme in Aotearoa/New Zealand (NZ) delivers five integrated studies across different ethnicities and ages to optimise well-being and to reverse the trajectory of functional decline and dependence associated with ageing. Well-being, independence and the trajectory of dependence are constructs viewed differently according to ethnicity, age, and socio-cultural circumstance. For each AWESSoM study these constructs are defined and guide study development through collaboration with a wide range of stakeholders, and with reference to current evidence. Themes or target areas of sleep, physical activity, oral health, and social connectedness complement social capital and community integration in a balanced programme involving older people across the ability spectrum. Outcomes and process analysis from this research will inform about novel approaches to implement relevant, socio-cultural interventions to optimise well-being and health, and to reverse the trajectory of decline experienced with age. Publication Link https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-022-02845-7

2022 Authors Anna Rolleston, Philippa Miskelly, Marama McDonald, Janine Wiles, Katrina Poppe, Rob Doughty Abstract We examined the importance of understanding and incorporating cultural context within Aotearoa/New Zealand when engaging in clinical research and practice. This paper reports on the qualitative findings of a mixed methods study aimed at determining what effect a cardiac risk reduction exercise and lifestyle management programme, embedded within a kaupapa Māori methodological approach, had on Māori participants. Our study revealed how the kaupapa Māori approach empowered participants to examine and evaluate not only their own health and lifestyle choices, but those of family and the wider community. Combining biomedical and kaupapa Māori components into the programme was found to benefit participants’ mental, physical, spiritual and family well-being. Publication Link https://academic.oup.com/heapro/article-abstract/37/3/daac065/6631488?redirectedFrom=fulltext

2022 Authors Anna K. Rolleston PhD, Erina Korohina BSc, Marama McDonald PhD  Abstract It is well known that the health system in Aotearoa/New Zealand does not provide culturally responsive services, programmes or approaches. Indigenous, remote and vulnerable populations that are not well served by medical and scientific models would be better served by the underlying premise of co-design methodology. However, co-design is a Western methodology. Mahitahi is presented here as a culturally responsive method of co-design that builds approaches by utilising the worldview of the people that the health system most needs to have impact upon. Co-design and mahitahi have synergies, and working at the interface between Western and Māori knowledge systems can provide innovative solutions that draw on the strengths of both approaches. The use of Indigenous knowledge systems, using Māori as the case example, will be outlined. Recommendations will be provided to guide researchers, health professionals and policy makers when planning a co-design approach with remote and vulnerable communities. Publication Link https://onlinelibrary.wiley.com/doi/10.1111/ajr.12916

2023 Authors Nikki J Earle, Katrina K Poppe, Anna Rolleston , Anna Pilbrow, Sara Aish, Kathryn Bradbury, Yeunhyang Choi, Gerry Devlin, Patrick A Gladding, Corina Grey, Wil Harrison, Kimiora Henare, Joanna Howson, Andrew Kerr, Thomas Lumley, Vijaya Pera, Graeme Porter, Ralph Stewart, Richard W Troughton, Helen Wihongi, A Mark Richards, Vicky A Cameron, Malcolm E Legget, Robert N Doughty Abstract The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) was established to investigate the drivers of secondary events after first-time acute coronary syndrome (ACS), including addressing inequitable outcomes by ethnicity. Herein, the first clinical outcomes and prognostic modelling approach are reported. Of the 2015 MENZACS participants (mean age 61 years, 79% male, 73% European, 14% Māori, 5% Pacific people), 2003 were alive at discharge. Of the 2003, 416 (20.8%) experienced all-cause death/cardiovascular readmission over a median of 3.5 years. In a simple model, age, male sex, Māori ethnicity and NT-proBNP levels were significant predictors of outcome. After adjustment for the clinical summary score, which includes age and sex, NT-proBNP and ethnicity were no longer statistically significant. In 2015 patients with first-time ACS, recurrent events were common (20.8%). Increasing NT-proBNP levels and Māori ethnicity were predictors of death/cardiovascular readmission, but not after adjustment for the 20 clinical risk factors represented by the clinical summary score. Publication Link https://heart.bmj.com/content/109/14/1088

2023 Authors Fiona E. Lithander, Amber Parry Strong, Andrea Braakhuis, Anna Worthington, Meika Foster, Anna Rolleston , Cheryl Davies, Jane Mullaney, Cecilia Ross, Denise Conroy, Troy L. Merry, Richard Gearry, Mark Weatherall, Jeremy D. Krebs Abstract Cardiometabolic diseases are highly prevalent in Aotearoa New Zealand. Dietary intake is a modifiable risk factor for such diseases and certain dietary patterns, specifically the Mediterranean diet (MedDiet), are associated with improved metabolic health. This study aims to test whether an intervention including a Mediterranean dietary pattern incorporating high quality New Zealand foods (NZMedDiet pattern) and behavior change science can improve the metabolic health of participants and their household/whānau. This is a multi-center, three-stage trial with two parallel group superiority randomized controlled trials (RCTs), and a longitudinal cohort study embedded within the trial design. The primary outcome measure for each stage is the metabolic syndrome severity score (MetSSS). The total recruitment target is 200 index participants and their household/whānau members who participate with them, and the primary analyses will be intention to treat on index participants. The trial will test whether the NZMedDiet pattern and behavior change support improves the cardiometabolic health of people in Aotearoa New Zealand. Publication Link https://www.frontiersin.org/articles/10.3389/fnut.2023.1298743/full

2023 Authors Mihi Nemani, Holly Thorpe, Keaka Hemi & Anna Rolleston Abstract Decades of research on Indigenous and culturally diverse young women in sport and exercise has been underpinned by deficit models where these groups are portrayed as ‘lacking’, ‘at risk’, and/or ‘vulnerable’. Such approaches have been heavily critiqued for ignoring broader structural and systemic inequities that have produced such health disparities. These approaches also reproduce racialised ideologies of Indigenous and culturally diverse women where they are seen as a ‘problem group’ in sport, exercise and health research. Over recent years, a growing body of research is advancing culturally appropriate methodologies and methods that aim to prioritise the voices and lived experiences of Indigenous and culturally diverse women. This paper contributes to this literature by providing an example of research that used Indigenous methodologies (Mana Wahine and Masi Methodology) to engage young Māori and Pasifika wāhine in Aotearoa New Zealand. We start by positioning this paper in relevant literature, then detail the cultural underpinnings of the methodological approach we used. We then outline the research and offer some practical considerations in, i) recruiting young women within one’s community, ii) using methods such as wānanga (meetings), digital diaries and kai (food), and iii) weaving care and reciprocity. In so doing, we highlight the importance of using locally specific feminist methodologies throughout research with, by and for young Indigenous and culturally diverse young women. Publication Link https://www.tandfonline.com/doi/full/10.1080/2159676X.2023.2250536