Our Publications

2025 Authors Tofi, U., Kayes, N., Wilson, B. Abstract To explore the perspectives and experiences of Māori and Pacific allied health professionals (AHPs) regarding what enables them to thrive or flourish in their first 2 years of practice, within a large public hospital setting. methods: A qualitative study grounded in shared Māori and Pacific peoples’ values and practices was undertaken, which drew on tenets of appreciative inquiry (AI) with thematic analysis of wānanga talanoa (referring to traditional and culturally informed Māori and Pacific processes, which provide a physically, spiritually and culturally safe space for discussion, knowledge sharing and co-creating meaning). Participants were Māori or Pacific AHPs (n=11) employed at a publicly funded, urban health organisation. results: Three interrelated themes were constructed, including: 1) valuing cultural intelligence, 2) surviving, rather than thriving, and 3) it takes a village. Participants provided a range of ideas for how things could be different, which underpin tangible recommendations for health organisations to support Māori and Pacific AHPs to thrive. conclusion: Informed by both Māori and Pacific peoples’ values and principles, this study highlighted experiences, challenges and opportunities relevant to thriving as Māori and Pacific AHPs in their first 2 years of practice. Rather than minimising the impact that negative experiences of ongoing colonisation and racism have on AHP wellbeing, the purposefully adopted strengths-based approach highlighted collective strengths and solutions for positive change. Publication Link https://nzmj.org.nz/journal/vol-138-no-1615/experiences-and-perspectives-of-thriving-or-not-as-maori-and-pacific-allied-health-professionals

2025 Authors Watson, G., Rodger, R., Buhler, M., Tofi, U., Gauld, R., Perry, M.A. Abstract Background Retaining physiotherapists is essential for addressing health workforce shortages and maldistribution. The limited amount of existing research has focused on what factors influence physiotherapists’ intent to stay. This review aimed to synthesise research measuring the impact of workforce strategies on the retention of allied health professionals (AHPs) and the implications for physiotherapy, with a secondary focus on workforce diversity and inclusion. Method A scoping review was conducted following PRISMA and JBI guidelines. Comprehensive searches of academic and grey literature databases were completed. Two reviewers independently screened and reviewed the studies for eligibility using Covidence®. Key characteristics of eligible studies were extracted into a data charting table. Results Of the 5957 studies retrieved, 22 met the eligibility criteria. Twelve studies recruited participants from a single discipline, including five uni-professional studies on physiotherapists. Ten studies involved participants from multiple AHP disciplines. Strategies were deductively themed into five core retention groupings. Fifteen studies reported strategies with positive effects, three found no effect, and four reported negative impacts on workforce retention. No studies included or reported on outcomes of retention interventions of allied health professionals who were Indigenous, ethnically diverse and/or disabled. Conclusions Workplace strategies can both positively and negatively impact AHP retention. Key recommendations for physiotherapy leaders are to optimise opportunities for personal growth; reduce workplace stressors such as workload, rostering and physical demands of the job; and measure workforce retention when implementing healthcare change or restructuring activities. Research is needed to examine strategies that could positively impact workforce diversity and inclusion. Publication Link https://www.tandfonline.com/doi/full/10.1080/21679169.2025.2469108#abstract

2025 Authors Korohina, E. Abstract Te Ara Poutama – Living Well with Heart Disease (TAP) is a Māori-led heart health research programme grounded in aspirations, values, and knowledge systems of Māori communities in Aotearoa New Zealand. Anchored at Manawaora Research, an integrated Indigenous health and research centre, this programme responds to the longstanding impacts of colonisation and systemic inequities in cardiovascular health for Māori. Rather than fitting Indigenous knowledge into pre-existing health systems, TAP reimagines these systems by centring Māori leadership, lived experiences, and worldviews. A multidisciplinary team—including clinicians, scientists, public health experts and data specialists—supports this Māori-led approach through collaborative, relational practice grounded in shared values and Indigenous self-determination. Partnerships with Māori health providers and communities have been crucial to building trust and relevance. Across four regions, a national co-design process unfolded through a series of community-led workshops, shaped by the cultural protocols of each host community. These gatherings created culturally safe spaces for Māori families to share experiences and shape research priorities. Alongside the co-design, two major initiatives sit at the heart of TAP. The Māori Heart Health Survey collected responses from over 1,000 Māori, creating one of the largest Indigenous-led heart health datasets in the country. The Kura Raumati internship supports the next generation of Māori heart health researchers by embedding students in community-based research grounded in Māori knowledge systems and scientific methods. TAP offers a compelling model of Indigenous-led, community-driven, multidisciplinary research that transforms systems, centres Indigenous voices, and creates solutions that are locally resonant and globally relevant. Publication Link https://www.heartlungcirc.org/article/S1443-9506(25)00346-4/fulltext

2025 Authors Tohu‑Hapati, P., Camp, J., Russell‑Camp, T., Lyndon, M., Korohina, E. Abstract Aim The project aims to amalgamate the types of mauri from the environmental space and abridge these to the context of health based on whanau need and utility in the clinical interaction. Methods A literature review was conducted and the search terms used were: “Mauri” OR “Indigenous Health AND Cardiac Health”; “Mauri” AND Health Equity ; “Mauri” AND “Health OR Indigenous Health OR Mental Health”; “Mauri” AND “Health OR Indigenous Health”. The Ovid and Knowledge Basket databases were used. Results The research highlights important indicators for the implementation of mauri into health. These namely being: 1) clinician-patient communication; 2) patients health attitudes; 3) barriers to health access; 4) Māori health; and 5) Te Ao Māori. This research highlights the impact of colonisation on Māori and offers insight into a culturally appropriate management strategy that highlights and encourages cultural narratives into the clinical interaction. The research renders new mauri types pertinent to the continuation of mauri driven methods of health practice for Māori in Aotearoa and has potential to permeate into other indigenous narratives clinical practices as well. Conclusions As we foster models of health management beyond the biomedical and utilise the strengths of Kaupapa Māori (Māori methodologies) approaches can we begin to deconstruct the internal system barriers and beliefs that have deeply permeated into that same health system. If mauri-based models of care were consistently used and their cause effect measured we could then adopt a health modality approach that centres itself on traditional Māori knowledge synonymous with the Māori way of thinking to foster long lasting positive impacts on mauri tau and health outcomes that are self-determined by whānau. Publication Link https://www.heartlungcirc.org/article/S1443-9506(25)00398-1/fulltext

2025 Authors Eppel, E., Gear, C., Hape, H., Koziol‑McLain, J., Rolleston, A., Timutimu, N., Ahomiro, H., Healy, C., Hegarty, K., Isham, C. Abstract Family violence is an under-recognised contributor to ill-health. Atawhai, a three-year research project focusing on sustainable responses to family violence in primary healthcare services, suggests that relationships and networks among locality-based service providers and local communities will help in making New Zealand’s strategy to eliminate family violence a reality. More is needed than joining up the government agencies delivering services to those experiencing family violence. Building relationships between communities and healthcare providers to harness the contextual and cultural knowledge of those most affected has to be integral to a sustainable response that begins to address the causes of this wicked problem, along with developing place-based solutions. Publication Link https://ojs.victoria.ac.nz/pq/article/view/9730

2025 Authors Legget, M.E., Earle, N.J., Poppe, K.K., Bradbury, K.E., Pilbrow, A.P., Logue, G., Choi, Y., Devlin, G., Gladding, P.A., Grey, C., Harrison, W., Henare, K., Howson, J.M.M., Jones, G.T., Kerr, A.J., Lumley, T., Pera, V., Porter, G., Richards, A.M., Stewart, R., Troughton, R., Wihongi, H., Cameron, V.A., Rolleston, A., Doughty, R.N. Abstract Background and aims Lipoprotein(a) (Lp[a]) is an established predictor of cardiovascular risk but associations with secondary events are less certain, and data on understudied ethnic groups are scarce. This study aimed to assess the association between Lp(a) and secondary events and explore variation in Lp(a) levels by ethnicity in first-time acute coronary syndrome (ACS) patients, to inform future risk prediction models. Methods The Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) is a longitudinal multi-centre cohort study of 1900 patients enrolled during their ACS admission. Baseline plasma Lp(a) concentrations were measured using an isoform-insensitive assay measured in nmol/L. The primary outcome was a composite of all-cause mortality or cardiovascular readmission, ascertained through national health datasets. Cox regression models were used to assess the association between Lp(a) levels and outcomes, adjusted for clinical risk factors. Results The mean age was 61 years, 20 % were female, and 73 % were European, 14 % Māori, 5 % Pacific peoples, 4 % Indian and 3 % other ethnicities. Of 1890 alive at discharge, 493 (26 %) experienced the primary outcome over a median follow-up of 4.9 years. Higher Lp(a) levels were associated with increased risk of secondary events. Compared to the lowest quartile (≤7 nmol/L), the adjusted hazard ratio for the highest quartile (>92 nmol/L) was 1.46 (95 %CI 1.12–1.89, p = 0.004). In this ACS cohort, Lp(a) concentrations varied by ethnicity, being highest amongst Indian participants (median 27 nmol/L) and lowest amongst Māori participants (median 12 nmol/L). Conclusions Elevated Lp(a) concentrations are associated with secondary events following ACS. Further research is needed to define optimal thresholds for increased risk and explore ethnic-specific implications for secondary prevention. Publication Link https://www.atherosclerosis-journal.com/article/S0021-9150(25)01414-5/fulltext

2025 Authors Robertson, J., Burton, T., Rolleston, A. Abstract Purpose In 2023, researchers from Tauranga, Aotearoa New Zealand (hereinafter referred to as Aotearoa) carried out a study to explore the unique strengths of Māori (Indigenous people of Aotearoa) services in addressing the needs of their communities during the COVID-19 pandemic. Methods Two case studies of Māori providers in the North Island’s Bay of Plenty region were undertaken. A qualitative kaupapa Māori (philosophical doctrine) approach was utilised across three methods to inform the research: 1) review of community materials, 2) whakawhiti kōrero (reciprocal discussions), and 3) whānau (family) narratives. The research included 34 participants, sourced from three groups: kaiwhakahaere (leadership), kaimahi (workforce), and whānau. Main findings Community-led pandemic responses within Māori communities included a drive for coordinated, localised and Indigenous leadership, and a need for urgent community-led action that interrupted the trajectory of Crown-determined processes. Successful health interventions leveraged local knowledge, whakapapa (genealogical) connections, and services through community-led action. This required levels of leadership and self-determination that cannot be replicated through Crown-led, Crown-determined responses to healthcare. This research provides an evidence-based framework consisting of 23 strategies to increase equitable health outcomes for Indigenous and other marginalised and/or isolated communities. Principal conclusions This research underscores the importance of enabling communities to lead through their own models of leadership and community development, recognising that they possess the intimate knowledge and understanding necessary to effectively respond to the specific needs of their people at whānau, hāpori (community), hapū and iwi (tribal) levels. Six generations of evidence show that the health system is not working equally for all parts of Aotearoa. It is time for an urgent response to those everyday health issues that have become an area of pandemic need. This research concluded to seriously consider the evidence that Māori communities, Māori providers and Māori clinicians led the way during the pandemic. As a nation, if we want to genuinely change the trajectory of Māori health outcomes and health outcomes for all, we need to utilise the evidence that is before us in terms of recognising the value added in having Indigenous, community-led solutions. Publication Link https://www.lowitjajournal.org.au/article/S2949-8406(25)00038-5/fulltext

2025 Authors Rolleston, A., Jones, G.T., Earle, N.J., Gibbs, S., Pilbrow, A., Faatoese, A., Poppe, K.K., Henare, K., Cameron, V.A., Macartney‑Coxson, D., Legget, M.E., Doughty, R.N. Abstract Epigenetic research, particularly DNA methylation (DNAm), holds significant potential for improving cardiovascular disease (CVD) risk prediction, yet its application must be guided by ethical and culturally responsive considerations. This paper examines the integration of a values-based framework to ensure the culturally safe conduct of DNAm research within the Multi-Ethnic New Zealand Study of Acute Coronary Syndromes (MENZACS) cohort. Grounded in Te Tiriti o Waitangi principles and kaupapa Māori methodologies, this study emphasises equity, social accountability, and indigenous data sovereignty. This study was not designed as a discovery epigenome wide analysis, but rather performed, as an exemplar, a SWOT analysis that identified both the potential of DNAm markers, such as cg05575921 in AHRR for smoking exposure assessment, and key risks, including genetic confounding, population-specific variation, and the potential for individual and transgenerational stigma. Findings underscore the importance of ensuring multi-ethnic validation of DNAm markers to prevent exacerbation of health inequities. This paper advocates for the adoption of ethical, culturally attuned research frameworks in epigenetics to enhance equitable health outcomes and support Māori health advancement. Publication Link https://www.sciencedirect.com/science/article/pii/S2352827325001430?via%3Dihub