Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Ethnic (pay) disparities in public sector leadership from 2001-2016 in Aotearoa New Zealand(Queensland University of Technology, 2020-08-21) Came H; Badu E; Ioane J; Manson L; McCreanor TNew Zealand governments have longstanding policy commitments to equal employment practices. Little attention has been paid to ethnic pay disparities in recent years. Informed by a series of Official Information Act requests, we were interested to find out to what extent ethnic pay disparities existed at senior levels within the core public sector and district health boards (DHBs). We examined the number of employees who earned more than NZ$100,000 by determining the total full-time equivalent staff (FTEs) and the respective proportions of the three ethnicities compared- Māori, Pasifika and Other. The analyses revealed a pattern of ethnic pay disparities across the public sector over the period reviewed. There were fewer Māori and Pasifika staff employed in DHBs than their population proportion. The failure to promote Māori and Pasifika to the upper tiers of the public sector is consistent with definitions of institutional racism. The authors call for more research to understand the dynamics of ethnic pay disparity and the drivers of this disparity.Item Exploring mathematical wellbeing across cultures: insights from diverse students(Springer Nature, 2024-09-18) Hunter J; Hill JLAcross many countries, including New Zealand, diverse groups including indigenous, migrant, and marginalised communities, are under-represented in mathematics, as evidenced by achievement disparities and disengagement from higher-level mathematics. Both research and policy have focused on developing equitable education outcomes for all students. A key aspect of this is wellbeing, including within mathematics classrooms, which includes identifying classroom environments that enable wellbeing. This study examines mathematical wellbeing (MWB) across different ethnicities and genders, with a case study focus on students from Pacific heritages. Analysing qualitative responses from over 12,000 diverse students revealed that positive relationships in the mathematics classroom were most commonly associated with students’ MWB. Accomplishment and cognitive factors, including mathematical accuracy, learning new things, and understanding, were also identified as important. Minor gender differences emerged, with female students emphasising mathematical understanding, accuracy, and relationships more than male students. The Pacific student case study highlighted the importance of both cognitive aspects (learning new things and understanding) and relationships (peer and teacher support), uncovering an alignment between cultural values and MWB. This study empirically confirms seven universal values supporting student MWB, previously identified in Australian and Chinese contexts, suggesting that teachers internationally may align pedagogical practices with these values to support most students’ MWB. However, the instrumental values serving these universal values appear culturally unique. This research contributes novel insights to the field by examining wellbeing with a subject-specific focus through student-generated responses, offering implications for developing more equitable and culturally inclusive mathematics classrooms.Item Sleep as a social and cultural practice in Aotearoa: a scoping review(Taylor and Francis Group, 2024-09-22) Ross I; Signal L; Tassell-Matamua N; Meadows R; Gibson RTraditionally, sleep science is grounded in biology, physiology, and medicine. But socio-cultural considerations provide a crucial lens into sleep health. Exploring the sociology of sleep in Aotearoa New Zealand (AoNZ) could broaden our understandings and better represent sleep-related practices among our diverse communities. This scoping review represents the pre-existing literature concerning sleep as a social or cultural practice in AoNZ. The initial search (via Discover and Scopus) search yielded 2,442 results. Of these results, 113 manuscripts were characterised of interest, but only 20 were directly related and included in the review. This literature was presented in relation to Meadows’ (2005) modes of ‘sleep embodiment’ including sleep practice norms, the pragmatics of sleep and social roles, individual experiences and feelings related to sleep, and the visceral need for sleep. The findings highlight the progress of sleep literature in AoNZ. This covers diverse sleep practices, perspectives and experiences of sleep and sleeping, as well as the broader socio-cultural factors and unique AoNZ context that influence sleep. However, gaps in the field of local sleep research are also identified. Findings lay the foundation for further research in AoNZ to explore sleep-related discourses and practices that will ultimately broaden existing perspectives.Item Perception is reality: qualitative insights into how consumers perceive alcohol warning labels(Oxford University Press on behalf of the Medical Council on Alcohol, 2024-09) Kemper J; Rolleston A; Matthews K; Garner K; Lang B; Jiang Y; Ni Mhurchu C; Walker NAIMS: This study explores perspectives of on-pack alcohol warning labels, and how they might influence alcohol purchase and/or consumption behavior to inform culturally appropriate label design for effective behavior change. METHODS: New Zealand participants ≥18 years, who reported having purchased and consumed alcoholic beverages in the last month were recruited via a market research panel and grouped into 10 focus groups (n = 53) by ethnicity (general population, Māori, and Pacific peoples), age group, and level of alcohol consumption. Participants were shown six potential alcohol health warning labels, with design informed by relevant literature, label framework, and stakeholder feedback. Interviews were transcribed and analyzed via qualitative (directed) content analysis. RESULTS: Effective alcohol labels should be prominent, featuring large red and/or black text with a red border, combining text with visuals, and words like "WARNING" in capitals. Labels should contrast with bottle color, be easily understood, and avoid excessive text and confusing imagery. Participants preferred specific health outcomes, such as heart disease and cancer, increasing message urgency and relevance. Anticipated behavior change included reduced drinking and increased awareness of harms, but some may attempt to mitigate warnings by covering or removing labels. Contextual factors, including consistent design and targeted labels for different beverages and populations, are crucial. There was a strong emphasis on collective health impacts, particularly among Māori and Pacific participants. CONCLUSIONS: Our findings indicate that implementing alcohol warning labels, combined with comprehensive strategies like retail and social marketing campaigns, could effectively inform and influence the behavior of New Zealand's varied drinkers.Item Nurses' work in relation to patient health outcomes: an observational study comparing models of primary care.(BioMed Central Ltd, 2024-10-04) Sheridan N; Hoare K; Carryer J; Mills J; Hewitt S; Love T; Kenealy T; Primary Care Models Study GroupBACKGROUND: Māori are over-represented in Aotearoa New Zealand morbidity and mortality statistics. Other populations with high health needs include Pacific peoples and those living with material deprivation. General practice has evolved into seven models of primary care: Traditional, Corporate, Health Care Home, Māori, Pacific, Trusts / Non-governmental organisations (Trust/NGOs) and District Health Board / Primary Care Organisations (DHB/PHO). We describe nurse work in relation to these models of care, populations with high health need and patient health outcomes. METHODS: We conducted a cross-sectional study (at 30 September 2018) of data from national datasets and practices at patient level. Six primary outcome measures were selected because they could be improved by primary care: polypharmacy (≥ 65 years), glucose control testing in adults with diabetes, immunisations (at 6 months), ambulatory sensitive hospitalisations (0-14, 45-64 years) and emergency department attendances. Analysis adjusted for patient and practice characteristics. RESULTS: Nurse clinical time, and combined nurse, nurse practitioner and general practitioner clinical time, were substantially higher in Trust/NGO, Māori, and Pacific practices than in other models. Increased patient clinical complexity was associated with more clinical input and higher scores on all outcome measures. The highest rates of preventative care by nurses (cervical screening, cardiovascular risk assessment, depression screening, glucose control testing) were in Māori, Trust/NGO and Pacific practices. There was an eightfold difference, across models of care, in percentage of depression screening undertaken by nurses and a fivefold difference in cervical screening and glucose control testing. The highest rates of nurse consultations afterhours and with unenrolled patients, improving access, were in PHO/DHB, Pacific, Trust/NGO and Māori practices. Work not attributed to nurses in the practice records meant nurse work was underestimated to an unknown degree. CONCLUSIONS: Transferring work to nurses in Traditional, Health Care Home, and Corporate practices, would release general practitioner clinical time for other work. Worse patient health outcomes were associated with higher patient need and higher clinical input. It is plausible that there is insufficient clinical input to meet the degree of patient need. More practitioner clinical time is required, especially in practices with high volumes of complex patients.Item Decolonising Qualitative Analysis: Collectively Weaving Understanding Using Talanoa and Fa’afaletui Pacific-Indigenous Research Methods(SAGE Publications, 2024-01-01) Mafile’o T; Vaka S; Leau K; Satele P; Alefaio-Tugia SSense-making processes shape the messages and impacts of qualitative research. Using qualitative data analysis methods embedded within a Pacific-Indigenous research paradigm decolonises research. This article discusses the Pacific-Indigenous data analysis processes of talanoa and fa’afaletui employed within a study of Pacific elder care in Aotearoa New Zealand, conducted by scholars of Pacific/Moana heritage. While research literature has primarily identified talanoa and fa’afaletui as data collection methods, we discuss our use of talanoa and fa’afaletui as methods of analysis. Talanoa and fa’afaletui were engaged as collective processes of orality weaving understanding from the researchers’ lived experiences and navigating across languages. Enhancing authenticity and actionability are identified as benefits of talanoa and fa’afaletui collective data analysis. Considerations for implementing these methods are language, logistics and location.Item Climate change, vulnerability and well-being in the Pacific region(Taylor and Francis Group on behalf of the New Zealand Association of Economists Incorporated, 2024-05-12) Gounder RThe Pacific region has experienced vast adverse effects from climate change impacting the peoples’ livelihoods both in these nations’ urban and rural areas. Countries association between socio-economic performance and livelihoods have been adversity impacted by climatic hazards and vulnerabilities on nations’ economic performance impacting the societal outcomes. An assessment of the Pacific’s climate change, vulnerability and well-being is presented in general and a case study of Fiji in particular. The Pacific islands require resources invested in environmental education, and climate change and trade policy linkages to benefit the islands, future returns to individuals and higher levels of satisfied basic needs to reduce vulnerabilities.Item Is there equity of patient health outcomes across models of general practice in Aotearoa New Zealand? A national cross-sectional study.(BioMed Central Ltd, 2023-05-04) Sheridan N; Love T; Kenealy T; Primary Care Models Study GroupBACKGROUND: Primary care in Aotearoa New Zealand is largely delivered by general practices, heavily subsidised by government. Te Tiriti o Waitangi (1840) guarantees equal health outcomes for Māori and non-Māori, but differences are stark and longstanding. Seven models of primary care have evolved. We hypothesised that patient health outcomes would differ between models of care; and that Māori, Pacific peoples and those living in material deprivation would have poorer outcomes from primary care. METHODS: We conducted a cross-sectional study of patient-level data from national datasets and practices, at 30 September 2018, using multilevel mixed effects regression analyses (patients clustered within practices). Primary outcomes, considered to be measures of unmet need for primary care, were polypharmacy (≥ 65 years), HbA1c testing in adults with diabetes, childhood immunisations (6 months), ambulatory sensitive hospitalisations (0-14, 45-64 years) and emergency department attendances. Explanatory variables adjusted for patient and practice characteristics. Equity, by model of care, ethnicity and deprivation, was assumed if they showed no significant association with patient outcomes. Patient characteristics included: age, ethnicity, deprivation, multi-morbidity, first specialist assessments and practice continuity. Practice characteristics included: size, funding and doctor continuity. Clinical input (consultations and time with nurses and doctors) was considered a measure of practice response. RESULTS: The study included 924 general practices with 4,491,964 enrolled patients. Traditional practices enrolled 73% of the population, but, on average, the proportion of Māori, Pacific and people living with material deprivation was low in any one Traditional practice. Patients with high health needs disproportionately enrolled in Māori, Pacific and Trust/NGO practices. There were multiple associations between models of care and patient health outcomes in fully adjusted regressions. No one model of care out-performed others across all outcomes. Patients with higher health need received more clinical input but this was insufficient to achieve equity in all outcomes. Being a Māori or Pacific patient, or living in material deprivation, across models of care, remained associated with poorer outcomes. CONCLUSIONS: Model-level associations with poor patient outcomes suggest inequity in measures that might be used to target investment in primary care.Item Optimising function and well-being in older adults: protocol for an integrated research programme in Aotearoa/New Zealand.(BioMed Central Ltd, 2022-03-16) Lord S; Teh R; Gibson R; Smith M; Wrapson W; Thomson M; Rolleston A; Neville S; McBain L; Del Din S; Taylor L; Kayes N; Kingston A; Abey-Nesbit R; Kerse N; AWESSoM Project TeamBackground 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. Methods 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. The Compression of Functional Decline model (CFD) underpins aspects of the programme. Interventions vary to optimise engagement and include a co-developed whānau (family) centred initiative (Ngā Pou o Rongo), the use of a novel LifeCurve™App to support behavioural change, development of health and social initiatives to support Pacific elders, and the use of a comprehensive oral health and cognitive stimulation programme for cohorts in aged residential care. Running parallel to these interventions is analysis of large data sets from primary care providers and national health databases to understand complex multi-morbidities and identify those at risk of adverse outcomes. 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. Discussion AWESSoM delivers a programme of bespoke yet integrated studies. 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. Trial registration The At-risk cohort study was registered by the Australian New Zealand Clinical Trials registry on 08/12/2021 (Registration number ACTRN 12621001679875).Item Pacific peoples and the pandemic: exploring multiple well-beings of people in tourism-dependent communities(Taylor and Francis Group, 2023-01-01) Scheyvens RA; Movono A; Auckram SThis article aims to examine how the border closures due to Covid-19 have impacted the well-being of Pacific peoples. Many women, men and children living on islands around the South Pacific live in households that depend on tourism income to provide for the majority of their cash needs, thus the pandemic has delivered a devastating financial blow to them. Nevertheless, an online survey combined with interviews in five Pacific countries shows that many people have drawn on their traditional skills combined with cultural systems, social capital and access to customary land to ensure that their well-being is maintained despite major decreases in household income. Others, however, have been more vulnerable, struggling with reductions in their mental health and increases in household conflict, for example. As well as this, the research data reveals that there needs to be a consideration of the spiritual aspect of well-being as something that is of deep importance for Pacific peoples and can provide them with great comfort and support during times of shocks. We will elucidate what can be learned from this in terms of planning for more just, sustainable tourism.