Health Promotion International, 2023, 38, 1–13 https://doi.org/10.1093/heapro/daad070 Article © The Author(s) 2023. Published by Oxford University Press. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/ by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Article Understanding how whānau-centred initiatives can improve Māori health in Aotearoa New Zealand Angelique Reweti (Ngāpuhi nui tonu)*, Massey University, College of Health, Private Bag 11 222, Palmerston North 4442, New Zealand *Corresponding author. E-mail: a.reweti@massey.ac.nz Abstract This article highlights the significance of prioritizing Indigenous voices and knowledge systems, using whānau-centred initiatives (a concept that encompasses the broader family and community) as a foundation for health promotion within an Indigenous con- text. Tū Kahikatea, a conceptual framework, is used to demonstrate the relationship between the values underpinning different whānau-centred initiatives and their corresponding outcomes. The framework highlights the capacity of whānau-centred initia- tives to support whānau in attaining mana motuhake, which represents collective self-determination and the ability to exercise control over their own future. By doing so, these initiatives contribute to the improvement of whānau health outcomes. With recent changes to Aotearoa New Zealand’s health system, the findings underscore the benefits and potential of whānau-cen- tred initiatives in enhancing whānau health outcomes, and advocate for continued strengths-based practices in Aotearoa New Zealand’s health system. By bridging the gap between academia and grassroots community action, the article demonstrates the potential of whānau-centred initiatives and contributes to a global call for integrating Indigenous viewpoints and practices into Westernized healthcare, in order to improve Indigenous health outcomes. Keywords: community health promotion, capacity building, health promotion, Indigenous health, Māori health and wellbeing INTRODUCTION A global call has been issued to prioritize Indigenous voices and Indigenous knowledge systems in health promotion (IUHPE, 2019; Ratima et al., 2019; Walters et al., 2020; Watego et al., 2021). Indigenous health promotion serves as a bridge between Indigenous development and general health promotion, giving Indigenous peoples a vehicle to realize their hopes for a healthy, proud and self-assured future (Durie, 2004; Ratima et al., 2019). Despite differences in historical context and cultural orientation, the concepts of health and wellbeing among Indigenous peoples are embed- ded in their worldview, culture and language. These notions are influenced by their pursuit of self-determi- nation, diverse identities, aspirations and the complex realities shaped by colonization (Ratima et al., 2019; Redvers et al., 2020; Walters et al., 2020; Reweti et al., 2022). Indigenous health promotion frameworks uphold a holistic and relational approach to wellbe- ing including spiritual and social aspects alongside the more biomedical focus of physical and mental wellbe- ing. The centrality of relationships with the environ- ment to health and wellbeing is emphasized, as well as the significance of having meaningful opportuni- ties to engage in activities that secure cultural identity (Panelli and Tipa, 2007; Kingsley et al., 2009; Tu’itahi and Lima, 2015; Redvers et al., 2020; Severinsen and Reweti, 2021). Consistent with values, aspirations and self-determination of the people, an Indigenous health promotion approach focuses on building community strength and resilience (Durie, 2004; IUHPE, 2019; Walters et al., 2020). This type of approach facilitates healthy lifestyles while also strengthening cultural identity and the spiritual connection between wellbe- ing and the environment (Durie, 2004; Kingsley et al., 2009; Tu’itahi and Lima, 2015; Redvers et al., 2020; D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/ https://orcid.org/0000-0002-9509-1069 mailto:a.reweti@massey.ac.nz 2 A. Reweti Severinsen and Reweti, 2021). An Indigenous approach to health promotion also recognizes the importance of focussing on the collective community as opposed to focussing on individuals (Tu’itahi and Lima, 2015; Redvers et al., 2020; Walters et al., 2020). From a te ao Māori (the Māori world) perspective, health and wellbeing are based on connections and the concept of whanaungatanga (process of forming and maintaining relationships) with an understanding that health extends beyond that of individuals, disease and illness (Wilson et al., 2021b). The term ‘hauora’, com- monly used to describe Māori perspectives on health, is a holistic concept that encompasses all dimensions of a person, including their spirituality and cultural identity, alongside physical and mental wellbeing. If we break down the kupu (word), one of the meanings of hau is the vital essence embodied in all persons and living things according to a Māori worldview (Henare, 2001; Moorfield, 2021). An expression of hau in peo- ple is breath, while ora is about health, life and vitality (Moorfield, n.d. a). Therefore, ‘hauora’ can be under- stood as representing the complete set of vital elements that contribute to a dynamic and thriving spirit of life (Reweti et al., 2022). Concepts such as mauri and mana help to explain a Māori view of hauora (Reweti et al., 2022). Mauri is the physical manifestation of hau binding the wairua (spiritual element) and tinana (physical element), mak- ing it the very essence of life (Henare, 2001). Mauri permeates all things, both animate and inanimate, including people, the environment, buildings, space and time, all of which are interconnected and have a direct impact on one another with the mauri of one thing influencing the mauri of another (Henare, 2001; Marsden and Royal, 2003). An understanding of mauri encourages people to pay attention to the vitality of their energy, the factors that motivate them to act and interact with the world around them and emphasizes the need for balance and harmony between all living things (Penehira et al., 2011). Mana is about spiritual vitality and is often described as power, authority or prestige (Barlow, 1991). There are many manifes- tations of mana and our experiences of it, such as mana tūpuna, a person’s inherited authority linked to whakapapa (genealogy), mana whenua, the authority derived from historic and territorial rights over land, and manaakitanga, the way in which mana is har- nessed through generosity and empathy to look after one another (Mutu, 2020). Another manifestation of mana is mana motuhake, which refers to Māori exert- ing their authority over their lives and living on their own terms and in line with Māori philosophy, beliefs and customs, which is viewed as crucial in realizing health and wellbeing for a people (Mutu, 2020; Oetzel et al., 2020). Despite broad awareness of Indigenous health sta- tus and increased study into risk factors, health ineq- uities between Indigenous and non-Indigenous peoples continue to exist (Wilson et al., 2021c). In Aotearoa New Zealand, the recent Wai 2575 report (Waitangi Tribunal, 2019) details a litany of health inequities between Māori and non-Māori that stem from colonial experience alongside a health system that systemati- cally fails to address the needs of Māori. Individual risk factors aligned with a conventional approach to health promotion are emphasized overlooking a more holis- tic perspective associated with a Māori view of health and wellbeing (Wilson et al., 2019). Furthermore, there has traditionally been a top-down approach to health efforts in Aotearoa New Zealand, limiting Māori par- ticipation in the design and implementation of services and strategies that directly affect their lives. Many health promotion strategies are targeted at address- ing the risk factors of an individual’s or community’s health status, such as obesity, smoking and diabetes, and take a deficit approach to health (Warbrick et al., 2016; Wilson et al., 2019). A deficit approach refers to a way of thinking that often frames and represents Indigenous peoples through the perspective of negativity, inadequacy and failure (Fogarty et al., 2018; Watego et al., 2021). This type of approach, which typically privileges Western forms of knowledge and existence over Indigenous forms (Bryant et al., 2021), exacerbates the margin- alization of Māori voices, attitudes and worldviews. Such an approach frequently overlooks the larger socio-economic structures within which inequities are Contribution to Health Promotion • Indigenous voices and knowledge are key to addressing health inequities experienced by Indigenous peoples. • Māori values and practices are the foun- dation of whānau-centred initiatives in Aotearoa New Zealand. • The Tū Kahikatea framework shows how whānau-centred initiatives can enhance health outcomes and achieve collective self-determination. • Aotearoa New Zealand's changing health system presents opportunities for whānau-centered initiatives to build capac- ity and improve health outcomes. • Service design and delivery should focus on the needs of whānau and those who use them to improve Indigenous health outcomes. D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 Understanding how whānau-centred initiatives can improve Māori health 3 embedded, with disadvantage becoming so established in reductionist narratives of failure that Māori are fre- quently viewed as the source of the problem. Critiquing a deficit approach is not about ignoring the well-docu- mented realities of disadvantage in health experienced by Māori (Palmer et al., 2019; Reid et al., 2019) how- ever, only looking at a situation from a deficit perspec- tive restricts the ability to see other possibilities that could lead to sustained growth and beneficial change in health and wellbeing. A strengths-based approach emphasizes the unique characteristics of individuals and communities, rather than stereotypes and deficiencies. It encourages the use of capabilities and resources to heal and become empowered, acknowledging that everyone possesses a variety of qualities and strengths that can be leveraged with support for a more fulfilling future. This approach does not deny the existence of difficulties or challenges but rather accepts that individuals can become resilient and resourceful through experiencing hardship and learning to overcome adversity (Pulla, 2012; Fogarty et al., 2018). It also recognizes that personal charac- teristics, as well as social and cultural factors, influence wellbeing and that people need to be involved in deter- mining goals to build on their own strengths (Pulla, 2012; Fogarty et al., 2018). Whānau ora exemplifies a strength-based approach, reframing Māori experiences and outcomes in a pos- itive light. Practiced by Māori for generations, this philosophy empowers whānau as a whole, recogniz- ing their inherent capacity to learn, grow and trans- form. It focusses on strengths and aspirations rather than deficits, upholding the concept of mana motu- hake, where whānau have the ability to define their own problems and devise solutions. While the cir- cumstances in which contemporary whānau live are diverse, encompassing a variety of social, economic and cultural contexts, the collective responsibility that whānau share remains a unifying factor (Durie et al., 2010; Lawson-Te Aho, 2010). Rather than a community passively waiting for top-down pub- lic health interventions, many whānau are actively pursuing health and wellbeing through several dif- ferent whānau-centred initiatives. These include activities such as Iron Māori which supports inclusive multisport events catering to a range of fitness lev- els (Pohatu, 2015; Jones et al., 2020); the Muriwai Sports Tournament combining sporting activities with a chance for whānau to reconnect to their ancestral heritage; whānau wānanga (discussion forum) held by the PS Haitana Whānau Trust centred around find- ing ways to more effectively respond to mental health issues within their whānau (Savage et al., 2019); Wero Warrior instigated by the S J Pikia Family Trust that supports whānau to overcome barriers that have affected their ability to lead and manage healthier lifestyles (Savage et al., 2020); and Awa Ora created by whānau at Whakatū Marae (ceremonial meeting house) which focuses on whānau cleaning up the local awa (river) to lift and restore the wairua and mauri of the whānau (Savage et al., 2018). These whānau ini- tiatives highlight the strength and resourcefulness of whānau and the ways that communities of people can work together to improve collective wellbeing. Aotearoa New Zealand is currently undergoing sig- nificant health reforms. A centralized health agency (Te Whatu Ora, Health NZ) has been established to replace 20 District Health Boards, as well as the devel- opment of an independent Māori Health Authority (Te Aka Whai Ora) to lead and monitor transformational change for the health and wellbeing needs of whānau Māori (Came and O’Sullivan, 2021; Eggleton et al., 2021). The partnership between the Māori Health Authority and Health NZ aims to invest in services grounded in te ao Māori and ensure the wider health system recognizes and is more responsive to Māori needs, alongside that of the wider population (Te Aka Whai Ora, 2023). This paper presents three case stud- ies showcasing diverse whānau-centred (family/com- munity centred) initiatives that highlight the essential role of whānau in improving health and wellbeing of Māori. According to the findings, initiatives devel- oped within whānau communities and based on Māori worldviews and values are more likely to positively influence Māori health outcomes than top-down, sin- gle-issue, time-limited health promotion programmes. METHODS Mātauranga (Māori epistemologies/ways of know- ing) informed the research practices used in this study, which prioritizes Māori ways of knowing and doing, as well as adopting techniques that take full cognisance of tikanga (Māori principles that inform practice) (Mead, 2012; Durie, 2021). Mātauranga is rooted in the spiritual health, culture and language of the people and cannot be compartmentalized or separated from the people who hold it (Royal, 2009, 2011; Doherty, 2012). Rather than dissecting knowledge into smaller pieces, mātauranga emerges from the interweaving of numerous sources, where links to greater dimensions and layers of knowledge are established (Durie, 2021). In this way, knowledge creation can be likened to the process of raranga (weaving) with each source of infor- mation symbolizing a single rau (leaf) that is woven together to create something new. The practice of raranga entails meticulous prepa- ration and embodies essential qualities like commit- ment, patience and creativity, all of which align with D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 4 A. Reweti the process of knowledge creation from a te ao Māori perspective (Reweti et al., 2022). To demonstrate the potential benefits of a whānau-centred approach to aiding Māori health and wellbeing, this article synthesizes results from three case studies about whānau-centred initiatives. As a platform for narratives to be heard, evaluated and studied, case studies permit in-depth investigation of an event or phenomenon (Crowe et al., 2011; Yin, 2014). Instead of using a single example to analyse and comprehend phenomena, a multiple case study approach makes use of a collection of cases to evaluate what those cases might reveal about the broader context of that issue (Crowe et al., 2011; Yin, 2014). Collectively, the case studies provide insight into a diversity of whānau-cen- tred initiatives. Each of the original case studies focus on health promotion within an Indigenous context, where Māori values and practices are foundational. The research focussed on exploring the social, cultural and health benefits of whānau-centred initiatives. Case Study 1 focuses on an initiative established by a whakapapa (genealogical) whānau. Case Study 2 is an example of a kaupapa whānau initiative originating from within the community, while Case Study 3 was instigated through the support of a local District Health Board and a community sporting agency. In-depth arti- cles about each of the case studies, including two short films based on Case Studies 1 and 2, can be found else- where (Reweti, 2019, 2022a,b; Severinsen and Reweti, 2020, 2021). Ethics approval for the case studies were granted through a University Ethics Committee and guided by a kaupapa whānau ethics framework devel- oped by the researcher alongside whānau involved in Case Study 1. Case studies were analysed thematically from a te ao Māori perspective, using topic categories related to social, cultural and health benefits. Recurring pat- terns, themes and concepts across the case studies were identified and examined, with a focus on Māori val- ues and worldviews. The goal of this approach was to centre and highlight whānau perspectives and provide insights into their experiences, while also allowing space to acknowledge the diversity and dynamic nature of these different experiences. Collaboration with whānau was necessary to ensure that the analysis was culturally appropriate and meaningful. This resulted in the expansion of Tū Kahikatea (which was originally developed during the analysis of Case Study 3) as a framework for depicting the relationship between core principles and related outcomes of whānau-centred initiatives, as well as how this translates into whānau achieving mana motuhake. Tū Kahikatea (Figure 1) is a framework that repre- sents the importance of whānau and whanaungatanga in supporting health and wellbeing. Whanaungatanga is generated through shared experiences, a sense of belonging, and reciprocal rights and obligations. Likewise, the roots of Kahikatea trees are intertwined by standing close together, allowing them to fully with- stand any pressure that may be placed on them indi- vidually and collectively. The framework is composed of five core components: pakiaka (roots), representing physical vitality; kaupapa (purpose), requiring a unify- ing purpose; ngā rākau (the trees), representing differ- ent core values; ngā hua (the fruits), representing the outcomes experienced by whānau; and ngā manu (the birds), which disperse the seeds allowing new growth and self-determination (Reweti, 2019). Case Study 1: Reweti Whānau Hui Instigated by whānau in 2012, the Reweti Whānau Hui (RWH) provides an opportunity for whānau to strengthen connections with their ancestral marae and whenua (land) and to engage in te ao Māori while fostering and developing bonds of unity amongst extended whānau members. Together the whānau have been learning about their whakapapa and connections to the whenua and each other through learning their pepeha (form of introduction establishing identity), through waiata (song) and through haka (ceremonial dance or challenge), which in turn also increases their confidence using te reo (Māori language) (Reweti, 2022a, b). Another key kaupapa of the RWH is the chance for members of the whānau to discuss what they have been focussed on since their previous hui and to recognize and celebrate their successes. Data for this project were collated from 16 participants ranging in age from 15 to 80 years through kanohi ki te kanohi (face-to-face) interviews and video footage obtained from filming one of the RWH. Impact With most of the Reweti whānau living in an urban con- text away from their ancestral roots, the whānau hui has provided a safe environment for whānau to explore and further secure their cultural identity as Māori. Te reo Māori me ōna tikanga (Māori language and its cultural practices) has provided an environment for intergen- erational learning where values and skillsets impor- tant to the whānau are passed down (Reweti, 2022a, b). Through whānau role modelling, values such as aroha (love/compassion), kotahitanga (collective unity), manaakitanga (generosity and caring for others) and tuakana teina (mentorship) are all interwoven into the day-to-day experiences of being on the marae. The col- lective mana of the whānau has been enhanced through fostering physical, spiritual and emotional connections with each other, their cultural identity, their whenua and their marae (Reweti, 2022a, b). The RWH is an example D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 Understanding how whānau-centred initiatives can improve Māori health 5 Fig. 1: Tū Kahikatea framework. D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 6 A. Reweti of whānau exercising mana motuhake by developing their own aspirations and devising strategies to achieve them, providing an environment where whānau identity can be actively expressed and cultivated, and where for this whānau, being Māori is now celebrated. Case Study 2: Waka Ama (outrigger canoe club) Case Study 2 involves research with a local waka ama rōpū (outrigger canoe club) from Heretaunga, Aotearoa New Zealand. Waka ama (outrigger canoe) is an increasingly popular sport in Aotearoa New Zealand utilizing Māori values and beliefs to improve the health of individual paddlers, their whānau and communities (Severinsen and Reweti, 2021; Reweti and Severinsen, 2022). A key com- ponent of the success of Waka Ama is the active involvement of members of the local community that generously contribute their time and energy to sup- port the group’s activities and participation in club and national competitions. In addition to the phys- ical act of paddling, Waka Ama provides opportu- nities for involvement in governance, kaitiakitanga (guardianship) activities and leadership and educa- tional development (Reweti and Severinsen, 2022). Sixteen participants were directly involved in the research through a series of loosely structured con- versational kanohi ki te kanohi (face-to-face) inter- views and video footage of paddlers obtained from following two morning training sessions (Severinsen and Reweti, 2021). Impact As well as offering physical health benefits to paddlers, waka ama fosters cultural identity, social connected- ness, intergenerational participation and community cohesion (Severinsen and Reweti, 2021; Reweti and Severinsen, 2022). Involvement encouraged the use of te reo through karakia (incantations) and wai- ata and learning about tikanga associated with waka ama. Many participants have taken advantage of the opportunity to increase their knowledge of tikanga and further their education through courses offered by local institutions. By fostering a reciprocal relation- ship between paddlers and the environment, waka ama encourages members to recognize their responsibilities as kaitiaki in caring for the environment (Severinsen and Reweti, 2021; Reweti and Severinsen, 2022). This has led to increased involvement in conserva- tion efforts. The culture of waka ama also promotes healthy lifestyle choices by encouraging smoke-free, alcohol-free and fizzy (sugar sweetened beverage). Paddlers have reported increased self-confidence due to improved physical ability, with links to improved mental wellbeing. Case Study 3: Sport Manawatū WhānauTri Instigated in 2013 in partnership with the local MidCentral District Health Board, WhānauTri is a community-based physical exercise and health ini- tiative, created for whānau to become more active through a 10-week programme that culminates with a whānau triathlon (Sport Manawatū, 2019). The pro- gramme’s purpose is to teach whānau how to train for and complete a triathlon, as well as how to create long- term lifestyle changes by improving their knowledge of physical fitness, nutrition and goal-setting abilities. On the day of the event, a vibrant festival atmosphere is created to celebrate both health and culture. The festivities include health-related stalls, entertainment, spot prizes and a wide range of additional activities and competitions for whānau to partake in and enjoy (Reweti, 2019). Encouraging participation across all age groups, the WhānauTri has become an annual event for many whānau in the Manawatū region which includes intergenerational teams of kaumātua (grand- parents), mātua (parents), whaea kēkē and mātua kēkē (aunts and uncles), tamariki (children) and mokopuna (grandchildren) (Reweti, 2019). Data for this project came from engagement with six whānau groups incor- porating 30 whānau members. Impact The WhānauTri programme fostered connections among whānau, strengthening interpersonal rela- tionships and creating a sense of social responsibil- ity. It facilitated opportunities for whānau to expand their networks of support and engage in outdoor activities, leading to positive lifestyle changes and increased wellbeing. Many participants experienced their first positive sporting and health experience through the programme, boosting their self-es- teem and self-worth. By the end of the programme, whānau felt confident in their abilities to engage in local community resources and other hauora activi- ties (Reweti, 2019). The WhānauTri served as a cata- lyst for pursuing other healthy lifestyle ventures and realizing their dreams, with participants citing it as a motivating factor for expanding their vision of what was possible. FINDINGS These case studies illustrate several commonalities that are implicit in a whānau-centred approach. Each of the case studies provided opportunities for inter- generational engagement strengthening interpersonal relationships and social cohesion between whānau members and/or within the community. Whānau were able to develop a sense of connection to te taiao (the natural environment), as well as learn about and D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 Understanding how whānau-centred initiatives can improve Māori health 7 actively participate in a reciprocal relationship with the environment. Whānau spoke about increased lev- els of self-confidence which positively impacted on their physical and mental wellbeing. Two of the ini- tiatives provided a gateway into te ao Māori, foster- ing strategies for securing cultural identity. Achieving sustainable lifestyle gains was established in all case studies. Initiatives gave whānau the opportunity to assume leadership roles and/or be a part of creating and working towards achieving their own personal aspirations. These findings are aligned with Māori concepts of manaakitanga, kotahitanga, kaitiaki- tanga, whakamana (empowerment), he taonga tuku iho (ancestral treasures passed down through the generations), toiora (enduring wellbeing) and mana motuhake. Using Tū Kahikatea framework as a guide, findings are discussed in conjunction with verbatim comments collected from whānau as a means of rein- forcing central ideas. Pakiaka (roots): represent the mauri (life force) of the kaupapa Mauri is the life spark or essence that binds and ani- mates everything in the physical world (Henare, 2001). It underpins the Tū Kahikatea framework to indicate that all living things, including our endeavours, have a mauri that influences and is influenced by the surround- ing environment. In this context, mauri embodies the energies required to fulfil the interests, objectives and aspirations of those involved in these whānau-centred initiatives. Kaupapa (purpose): represents the purpose that brings whānau together Kaupapa refers to the collective vision, aspiration and purpose of the whānau-centred initiatives. While each of the three case studies in this research are diverse, they all focus on strengthening whānau capability and advancing whānau towards improved health and wellbeing. Ngā rākau (the trees): represents overarching values underpinning initiatives Core values of manaakitanga, kotahitanga and kai- tiakitanga are evident in all of the case studies. Manaakitanga is about nurturing relationships and is concerned with the protection of a person’s mana through acts of kindness, support and encouragement (Mead, 2003; Mutu, 2020). A fundamental principle of manaakitanga is cooperating with others in a spirit of reciprocity, holding everyone to a high standard of conduct towards one another. Examples of manaaki- tanga in practice are expressed in the following state- ments from whānau: It’s a very pleasant experience to come here and unplugging, and getting back to core values and traditional tikanga, for example, we had young boys 10 to 14 preparing food for their elders and as simple as that is, it instils a core value that we really want our children, the next gen- eration, to firstly just be good people, and what greater way to teach that then through service, so that’s one of the fundamental tenants of tikanga Māori, is manaakitanga, or taking care of people, so as simple an action of gutting and scaling a fish, and cooking, then serving it, then doing the dishes, those are the types of things that we really want to teach the next generation (C1., M) What does it mean to me? Well, it’s actually a life- style for me … It’s not only the sport, that keeps you healthy, but this other side of it, the camaraderie, all this is really good for the soul and the spirit of our guys, aye (C2., M) Yeah, it’s just like bringing others onto the jour- ney, and they will benefit too eh, sharing the load, picking each other up …it motivated me, it made me accountable, it made me accountable that I had to do my part for us to succeed … so yeah it was all about commitment, being committed, being accountable (C3., F) Kotahitanga is a term that refers to collective unity and cohesion (Barlow, 1991). Recognizing the diversity within whānau and among individual members, kota- hitanga encourages an attitude of inclusiveness and cooperation, establishing a common sense of belong- ing and solidarity with one another and with the envi- ronment. The case studies demonstrate the benefits of intergenerational interaction and the increased social cohesion participants experienced because of their involvement. I like the taha Māori [oneness] that is practiced here, it’s part of marae life…you have babies, you have children, you have parents, you have grand- parents, and in our lucky situation we have great grandparents, and so those are the aspects that we really look forward (C1., M) It brings a really strong rhythm into your life because you’re in a team, so you have to turn up to practice and you’ve made that commitment, and I have this amazing group of women that I pad- dle with that are just, they are all sorts of ages and all sorts of people, and we just, we really get there. There’s just really beautiful gelling of who we are, and we have a lot of fun, we’re quite silly some- times, and that’s really good when you’re getting older (C2., F) D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 8 A. Reweti All of this just brings us closer together and it keeps that bond and that kotahitanga…I feel safe and wanted and welcome and that we’re all in it together (C3., F) Kaitiakitanga acknowledges that health is inextri- cably linked to the environment. In this framework, kaitiakitanga emphasizes reciprocity with the envi- ronment, encouraging whānau to recognize their responsibility as kaitiaki (guardians) of the natural environment This was evident across the case studies with whānau being provided with different opportu- nities to experience and strengthen that relationship first-hand. It’s that engrained, cultural identity, that if we don’t have a connection to some land, somewhere, then we’re lost (C1., M) Well, it is a lifeforce. If we stuff it up, we’re in trou- ble. Last time I went out on a single [waka], I came back and filled a plastic container…because it was all floating around so we just picked it up (C2., M) I feel a stronger connection to the environment… you know I see the greenery, I hear the tui, so yeah, it is lovely, it is nice, and it makes you, for me it makes me pay more attention to nature…you become more in tune, more in tune with nature (C3., F) Ngā hua (the fruits): represents outcomes experienced by whānau While ngā rākau (values) laid the foundation for whānau experiences, ngā hua (fruits of success) dis- cusses the key outcomes experienced by whānau. Common outcomes experienced by whānau engaging in these whānau-centred initiatives can be character- ized as whakamana, he taonga tuku iho and toiora. Whakamana is a concept about enabling and empow- ering potential (Durie, 2011). The case studies demon- strate that when whānau feel supported and valued, it can help them develop a sense of self-confidence and belief in their own abilities. I think as well that confidence has grown because we’re surrounded by our ancestors…through the encouragement of our whānau hui I’ve noticed that we’re more confident and we’ll stand up and talk and say who we are and where we’re from and what we’re doing, that’s a big, big step for us (C1., F) It’s a very inclusive environment…I feel like I’m fit- ter and stronger than I’ve been all my life really. And it’s [given] me a huge amount more confidence in myself (C2., F). Because I became more confident and healthier, I felt better about myself…last summer I went to the beach a few times…I just used to not sort of do things like that so yeah that really stems from the whānau tri, it’s just that confidence for me has been the most amazing thing (C3., F). He taonga tuku iho refers to ancestral treasures that have been transmitted through successive generations, providing a sense of identity and continuity (Marsden and Royal, 2003). In this context, he taonga tuku iho represents the ability for whānau to secure their cul- tural identity. This was evident in two of the case stud- ies where whānau spoke about how the experiences of the whānau-centred initiative helped secure their cul- tural identity as Māori. I love learning the new waiata, the new songs, and to listen to the kids doing the haka and to listen to them do their pepeha and I watch them feel very comfortable being in Parewahawaha and staying there and learning, and these are the big benefits that I see (C1., F). I just like coming together and I feel more con- nected to my Māori side (C1., F). It’s given me a doorway into the Māori world (C2., F) You know, it’s part of what we do, we need to appraise ourselves of local customs and stories of the local iwi [tribe] and hapū [subtribe], so yeah, so that’s a more active sphere for me exploring that (C2., F) While there was no explicit discussion of cultural identity among whānau in the third case study, whānau did recognize the benefits of participating in a pro- gramme based on te ao Māori values. I actually just really loved the whole family whānau style of it. It’s not about who’s better or whose got the flashiest stuff. It’s just about everyone being included and everyone doing it, you know (C3., M) It’s kotahitanga, whanaungatanga and it’s all of that encompassing into one (C3., F) Toiora is a Māori concept encompassing holistic well- being and balance across physical, mental, spiritual and social aspects of life (Moorfield, n.d. b). It emphasizes the pursuit of enduring wellbeing, rooted in cultural identity, connection to land, and a vibrant sense of vital- ity and purpose. In this context, it is used to discuss ben- eficial lifestyle changes whānau have made as a result of their participation in the whānau-centred initiative. You feel like you’re doing something to keep the revitalisation of the Māori language and culture going, I feel like that’s something that we’re doing D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 Understanding how whānau-centred initiatives can improve Māori health 9 in amongst our hui… it’s a chance to incorporate te reo Māori into everything that we do (C1., M) I feel like I’m fitter and stronger than I’ve been all my life really…it’s an exercise without thinking you’re exercising (C2., M) It’s a lifestyle change, and then my whole entire whānau went on this change (C3., F). Just seeing all those unhealthy things that have been left behind, no cigarettes, no alcohol, um, just such positive role models, you know, they’re pretty amazing (C3., F) Ngā manu (the birds): represents the seed dispersal process, which allows for new growth and self-determination It is through the birds who eat the fruits of the tree and disperse the seeds, that kahikatea trees are prop- agated (Burke, 1974; Dawson et al., 2020). Likewise, the seeds of achievement sown through the participa- tion in these whānau-centred initiatives are dispersed throughout the whānau community, providing new opportunities for growth. This aligns to the concept of mana motuhake, or Māori self-determination, which can be defined as the ability to choose one’s own path in life through increased self-reliance. I think these hui can take us anywhere, anywhere that we want to go with it, I think it can take us there (C1., F) It’s really challenged me in lots of ways, all the dif- ferent relationships, different types of people, being on the committee, so it’s brought a lot of growth in lots of ways (C2., F) I loved the whānau tri, I just loved it, so I loved going and then from there I was like yeah I’m actu- ally enjoying it, I’m liking it, so I’m carrying on this journey now, you know I actually look forward to going to Crossfit (C3., F) It [whānau tri] was a ricochet of ‘what can I do now? (C3., F) DISCUSSION The success of these case studies redirects our attention from a narrow clinical approach towards a holistic per- spective of health that is more in keeping with Indigenous health practices. By emphasizing the foundational val- ues that underpin successful whānau initiatives, the Tū Kahikatea framework demonstrates the connection between values and outcomes, as well as the way in which whānau-centred initiatives can pave the way for whānau self-determination. For example, if projects are embedded in foundations that are relevant to whānau, they are more likely to experience favourable outcomes, which are more likely to help them reach a level of self-determination. Throughout these case studies, values such as whanaungatanga, manaakitanga, kotahitanga and kaiti- akitanga played an important role in engaging and retain- ing whānau. Numerous studies, including those on the advantages of kapa haka (Pihama et al., 2014; Thompson et al., 2017) and Māori participation in physical activ- ity (Pohatu, 2015; Warbrick et al., 2016) substantiate these findings. Clinical studies examining strategies to improve the lives of cancer survivors (Koia, 2019; Kidd et al., 2020) as well as research on how whānau per- ceive encounters with neurorehabilitation (Elder, 2017; Wilson et al., 2021a) also provide additional evidence for the importance of foundational values discussed in these case studies. This highlights the importance of develop- ing authentic and respectful relationships with whānau to secure their participation, as well as the importance of developing programmes that are led by whānau and based on core values that are relatable to participants. As a result of the core values that underpinned these initiatives, whānau gained social, cultural and health benefits, including whakamana (enhanced self-confi- dence), he taonga tuku iho (secure cultural identity) and toiora (enduring wellbeing). Whānau gained confi- dence in their abilities as a result of their efforts, which increased their self-esteem and sense of self-worth. More opportunities for healthy living and social par- ticipation opened up for whānau as they gained the self-confidence to use new services or take on leadership roles within their whānau and/or community. This sup- ports the findings of Masters-Awatere and Graham’s (Masters-Awatere and Graham, 2019) study, which found that participation in a kaupapa Māori-centred initiative enhanced whānau sense of self-determination and confidence in accessing different health services. Additionally, the case studies illustrate practical ways in which whānau were given the opportunity to par- ticipate in te ao Māori, thereby securing their cultural identity. This builds on research showing how secure cultural identity can protect Māori against a range of negative outcomes such as depression, suicidality and economic hardship, all of which are decreased when one has a strong connection to te ao Māori (Durie, 2001; Waiti and Kingi, 2014; Houkamau and Sibley, 2015). Whānau also discussed making healthier life- style choices, such as limiting sugary drinks, increasing their exercise levels and incorporating te reo into their daily lives. These measures instilled in whānau a sense of self-determination and commitment to improving health outcomes showing the perpetual and sustaina- ble nature of these types of initiatives. From a te ao Māori perspective, self-determination can be referred to as mana motuhake which emphasizes collective determination and autonomy in defining prob- lems and identifying solutions (Motu, 2020; Oetzel et al., 2020). These case studies, like those from Te Pūtahitanga D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 10 A. Reweti o Te Waipounamu (Savage et al., 2018, 2020, 2021) and Te Whānau o Waipareira (Te Pae Herenga o Tāmaki, 2017) show whānau expressing mana motuhake by developing their own ambitions and devising ways to achieve them. Increased personal agency and control over one’s life is associated with better health and social results, as evidenced by studies demonstrating how improving whānau self-determination results in greater whānau wellbeing (Murphy, 2014; McMeeking and Pierre, 2019). As a result of colonization processes that gradually eroded Māori self-determination, whānau now need to re-establish self-determination as a cultural practice in their own respective contexts (McMeeking et al., 2020). These case studies show how bottom-up, grass-roots efforts can assist whānau communities reclaim a sense of self-determination. Mana motuhake has been identified as a fundamental element in New Zealand’s health system, with both the Māori Health Action Plan (Ministry of Health, 2020) and the newly constituted Māori Health Authority (Department of the Prime Minister and Cabinet, 2022) using the term as a crucial goal. The premise is that these reforms will enable Māori to build systems and health solutions that are beneficial to Māori. Historically, gov- ernment health and social services for Māori have been developed with an emphasis on individuals and sin- gle-issue concerns, rather than on whānau as a collective (McMeeking and Pierre, 2019). Additionally, kaupapa Māori services have been hindered by contractual agreements with the government that are prescriptive, fragmented and compliance driven (Durie et al. 2010; McMeeking et al., 2020). The current health reforms in Aotearoa New Zealand present an opportunity to reflect on past shortcomings and to commit to doing things differently going forward. These case studies illustrate that whānau have the abil- ity to effect positive change not only in their personal situations, but also in the development of their whānau and broader communities. This highlights the importance of funding contracts for Māori health services that align with the overarching focus on empowering whānau to take control of their own health and wellbeing, in a man- ner that enhances the mana motuhake of whanau. This supports the concept that service design and delivery should be centred on the requirements of whānau and the people who use them, rather than a top-down conventional approach in which health practitioners determine what those needs look like. While not all solutions will be the same, this approach recognizes that whānau and their circumstances differ, and that whānau must be fully engaged in creating goals and capitalizing on their strengths and resources in order to achieve their objectives. As a result, service development should aim to provide whānau with the assistance and resources needed to identify and define the thriving pathways that are unique to their individ- ual whānau and/or community. CONCLUSION This study highlights the diversity and ways in which whānau-centred initiatives increase whānau capac- ity, emphasizing the critical importance of whānau in enhancing Māori health and wellbeing. Consistent with an Indigenous approach to health promotion, this research indicates that interventions that take into account Māori worldviews and values, as well as those generated within Māori communities, will have a greater influence on Māori health outcomes than top-down, single-issue public health promotion pro- grammes. It adds to the global call for more expansive thinking and the integration of Indigenous viewpoints and practices into Westernized healthcare to improve Indigenous health outcomes. The Tū Kahikatea framework presented here can be used to foster the development of initiatives anchored in te ao Māori focussing on whānau strengths and self-determination rather than prevalent deficiency narratives. Rather than focussing on problems, these types of efforts will help whānau thrive. Whilst recognizing that the impact of colonization continues to have negative repercussions for whānau wellbeing, this perspective highlights enormous and collaborative capabilities that can be mobilized within whānau to address these challenges. With the evolving landscape of the health system in Aotearoa New Zealand, we have a unique opportunity to embrace and further enhance whānau ora practices that empower and uplift whānau. It is important that we continue to advocate for and pri- oritize practices that acknowledge and reinforce the inherent strengths, resilience and potential of whānau in order to achieve positive, sustainable change. In this way, we can foster a culture of resilience and self-de- termination within whānau, leading to increased mana motuhake and improved overall wellbeing. ACKNOWLEDGEMENTS The author acknowledges Sport Manawatū, Heretaunga Ararau o Ngāti Kahungunu Waka Ama Rōpu, members of the Reweti Whānau Hui and the whānau who shared their time and stories so generously. Tēnā koutou ki a koutou ki te tautoko te kaupapa nei. FUNDING This work was supported by a Massey University Research Fund grant. The author was further sup- ported through a Hauora Māori scholarship, Ngāpuhi D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 Understanding how whānau-centred initiatives can improve Māori health 11 education scholarship, Massey Vice Chancellor Doctoral scholarship and Te Rau Puawai bursary. CONFLICT OF INTEREST The author has no conflict of interest to declare. ETHICAL APPROVAL Ethics approval for the case studies were granted through Massey University Ethics Committee (SOB 16/12) and guided by a kaupapa whānau ethics framework devel- oped alongside whānau involved in the research. REFERENCES Barlow, C. (1991) Tikanga whakaaro: Key Concepts in Māori Culture. Oxford University Press, Victoria, Australia. Bryant, J., Bolt, R., Botfield, J. R., Martin, K., Doyle, M., Murphy, D. et al. (2021) Beyond deficit: ‘strengths-based approaches’ in Indigenous health research. Sociology of Health & Illness, 43, 1405–1421. Burke, W. D. (1974) Regeneration of podocarps on Mt Tarawera, Rotorua. Ecology, 12, 219–226. doi:10.1080/0 028825X.1974.10428863 Came, H. and O’Sullivan, D. (2021) New Māori health author- ity needs independence and accountability. Kai Tiakai Nursing New Zealand, 27, 16–17. Crowe, S., Cresswell, K., Robertson, A., Huby, G., Avery, A. and Sheikh, A. (2011) The case study approach. BMC Medical Research Methodology, 11, 100. doi:10.1186/1471-2288-11-100 Dawson, J., Lucas, R. and Sneddon, B. (2020) Field Guide to New Zealand’s Native Trees. Craig Potton, NZ. Department of the Prime Minister and Cabinet. (2022) About the health reforms/Mō ngā whakahounga hauora. Retrieved August 01, 2022 from https://www.futureofhealth.govt.nz/ about-the-reforms/ Doherty, W. (2012) Ranga framework—He raranga kau- papa. In Black, T., Bean, D., Collings, W. and Nuku, W. (eds), Conversations on mātauranga Māori. New Zealand Qualifications Authority, pp. 37–58. Retrieved June 01, 2022 from https://www.nzqa.govt.nz/assets/Maori/ ConversationsMMv6AW-web.pdf Durie, M. (2001) Mauri ora: The Dynamics of Māori Health. Oxford University Press, Auckland, NZ. Durie, M. (2004) An Indigenous model of health promotion. Health Promotion Journal of Australia, 15, 181–185. Durie, M. (2011) Ngā tini whetū: Navigating Māori Futures. Huia Publishing, Wellington, NZ. Durie, M. K. (2021) Mātauranga at the interface. In Ruru, J. and Nikora, L. W. (eds), Ngā kete mātauranga: Māori Scholars at the Research Interface. Otago University Press, Otago, NZ, pp. 22–35. Durie, M., Cooper, R., Grennell, D., Snively, S. and Tuaine, N. (2010) Whānau ora: report of the taskforce on whānau-cen- tred initiatives. Retrieved May 1, 2022 from https://www. msd.govt.nz/documents/about-msd-and-our-work/publi- cations-resources/planning-strategy/whanau-ora/whanau- ora-taskforce-report.pdf Eggleton, K., Anderson, A. and Harwood, M. (2021) The whitewashing of contracts: unpacking the discourse within Māori health provider contracts in Aotearoa/New Zealand. Health and Social Care in the Community, 30, 1–8. doi:10.1111/hsc.13691 Elder, H. (2017) Te waka kuaka and Te waka oranga. Working with whānau to improve outcomes. Australian and New Zealand Journal of Family Therapy, 38, 27–42. Fogarty, W., Lovell, M., Langenberg, J. and Heron, M.-J. (2018) Deficit Discourse and Strengths-Based Approaches: Changing the Narrative of Aboriginal and Torres Strait Islander Health and Wellbeing. The Lowitja Institute. Retrieved February 01, 2022 from https://www.lowitja.org. au/content/Document/Lowitja-Publishing/deficit-discourse- strengths-based.pdf Henare, M. (2001) Tapu, mana, mauri, hau, wairua: a Māori philosophy of vitalism and cosmos. In Grim, J. (eds), Indigenous Traditions and Ecology: The Interbeing of Cosmology and Community. Harvard University Press, Cambridge, pp. 197–221. Houkamau, C. A. and Sibley, C. G. (2015) The revised multidi- mensional model of Māori identity and cultural engagement (MMM-ICE2). Social Indicators Research, 122, 279–296. International Union for Health Promotion and Education (IUHPE). (2019) IUHPE’s 2019 legacy documents. Retrieved August 01, 2022 from https://www.iuhpe.org/ images/CONFERENCES/world/2019/Indigenous_People_ statement_final.pdf Jones, R., Kidd, B., Wild, K. and Woodward, A. (2020) Cycling amongst Māori: patterns, influences and opportunities. New Zealand Geographer, 76, 182–193. Kidd, J., Blundell, R., Egan, R., Broughton, J., Black, S., Lawrenson, R. et al. (2020) Oranga Tū: A Healthy Stand. A Kaupapa Māori Prostate Cancer Project. Movember Foundation. Retrieved February 01, 2022 from https:// www.nzdoctor.co.nz/document/view/oranga_t_wh_nau_ report_final.pdf Kingsley, J., Townsend, M., Phillips, R. and Aldous, D. (2009) “If the land is healthy…it makes the people healthy”: the relationships between caring for country and health for the Yorta Yorta Nation, Boonwurrung and Bangerang Tribes. Health & Place, 15, 291–299. Koia, M. (2019) He pita ora: exploring the role of Māori cancer navigators. Doctoral dissertation. Massey University, Semantic Scholar. Retrieved February 01, 2022 from https://mro.massey.ac.nz/bitstream/han- dle/10179/15258/KoiaPhDThesis.pdf?sequence=1&is Allowed=y Lawson-Te Aho, K. (2010) Definitions of whānau: A Review of Selected Literature. Families Commission. Retrieved August 01, 2021 from https://thehub.swa.govt.nz/resources/ definitions-of-whānau-a-review-of-selected-literature/ Marsden, M. and Royal, T. A. C. (2003) The Woven Universe: Selected Writings of Rev. Māori Marsden. Estate of Rev. Māori Marsden, Otaki, NZ. Masters-Awatere, B. and Graham, R. (2019) Whānau Māori explain how the Harti hauora tool assists with better access to health services. Australian Journal of Primary Health, 25, 471–477. McMeeking, S., Leahy, H. and Savage, C. (2020) An Indigenous self-determination social movement response to COVID- 19. AlterNative, 16, 395–398. D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 https://doi.org/10.1080/0028825X.1974.10428863 https://doi.org/10.1080/0028825X.1974.10428863 https://doi.org/10.1186/1471-2288-11-100 https://www.futureofhealth.govt.nz/about-the-reforms/ https://www.futureofhealth.govt.nz/about-the-reforms/ https://www.nzqa.govt.nz/assets/Maori/ConversationsMMv6AW-web.pdf https://www.nzqa.govt.nz/assets/Maori/ConversationsMMv6AW-web.pdf https://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/planning-strategy/whanau-ora/whanau-ora-taskforce-report.pdf https://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/planning-strategy/whanau-ora/whanau-ora-taskforce-report.pdf https://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/planning-strategy/whanau-ora/whanau-ora-taskforce-report.pdf https://www.msd.govt.nz/documents/about-msd-and-our-work/publications-resources/planning-strategy/whanau-ora/whanau-ora-taskforce-report.pdf https://doi.org/10.1111/hsc.13691 https://www.lowitja.org.au/content/Document/Lowitja-Publishing/deficit-discourse-strengths-based.pdf https://www.lowitja.org.au/content/Document/Lowitja-Publishing/deficit-discourse-strengths-based.pdf https://www.lowitja.org.au/content/Document/Lowitja-Publishing/deficit-discourse-strengths-based.pdf https://www.iuhpe.org/images/CONFERENCES/world/2019/Indigenous_People_statement_final.pdf https://www.iuhpe.org/images/CONFERENCES/world/2019/Indigenous_People_statement_final.pdf https://www.iuhpe.org/images/CONFERENCES/world/2019/Indigenous_People_statement_final.pdf https://www.nzdoctor.co.nz/document/view/oranga_t_wh_nau_report_final.pdf https://www.nzdoctor.co.nz/document/view/oranga_t_wh_nau_report_final.pdf https://www.nzdoctor.co.nz/document/view/oranga_t_wh_nau_report_final.pdf https://mro.massey.ac.nz/bitstream/handle/10179/15258/KoiaPhDThesis.pdf?sequence=1&isAllowed=y https://mro.massey.ac.nz/bitstream/handle/10179/15258/KoiaPhDThesis.pdf?sequence=1&isAllowed=y https://mro.massey.ac.nz/bitstream/handle/10179/15258/KoiaPhDThesis.pdf?sequence=1&isAllowed=y https://thehub.swa.govt.nz/resources/definitions-of-whānau-a-review-of-selected-literature/ https://thehub.swa.govt.nz/resources/definitions-of-whānau-a-review-of-selected-literature/ 12 A. Reweti McMeeking, S. and Pierre, S. (2019) Whānau ora: building Māori self-determination in Aotearoa/New Zealand. In Nikolakis, W., Cornell, S. and Nelson, H. (eds), Reclaiming Indigenous Governance: Reflections and Insights from Australia, Canada, New Zealand, and the United States. University of Arizona Press, pp. 155–171. Retrieved December 01, 2021 from http://www.jstor.org/stable/j. ctvqc6jwv.11 Mead, H. M. (2003) Tikanga Māori: Living by Māori Values. Huia Publishers, Wellington, NZ. Mead, H. M. (2012) Understanding mātauranga Māori. In Black, T., Beans, D., Collings, W. and Nuku, W. (eds), Conversations on mātauranga Māori. New Zealand Qualifications Authority, pp. 9–14. Retrieved June 01, 2022 from https://www.nzqa.govt.nz/assets/Maori/ ConversationsMMv6AW-web.pdf Ministry of Health. (2020) Whakamaua: Maori health action plan 2020–2025. Retrieved June 01, 2021 from https://www.health.govt.nz/publication/ whakamaua-maori-health-action-plan-2020-2025 Moorfield, J. C. (n.d. a) Hau. Te Aka Māori Dictionary. https:// maoridictionary.co.nz/search?idiom=&phrase=&prover- b=&loan=&histLoanWords=&keywords=hau (last accessed 20 April 2023). Moorfield, J. C. (n.d. b) Ora. Te Aka Māori Dictionary. https:// maoridictionary.co.nz/search?idiom=&phrase=&prover- b=&loan=&histLoanWords=&keywords=ora (last accessed 20 April 2023). Murphy, M. (2014) Self-determination and indigenous health: is there a connection? In Woods, M. (eds), Restoring Indigenous Self-determination: Theoretical and Practical Approaches. E-International Relations Publishing, Bristol, UK, pp. 34–40. Mutu, M. (2020) Mana Māori Motuhake: Māori concepts and practices of sovereignty. In Hokowhitu, B., Moreton- Robinson, A., Tuhiwai-Smith, L., Andersen, C. and Larkin, S. (eds), Routledge Handbook of Critical Indigenous Studies. Routledge, London, UK, pp. 269–282. Oetzel, J. G., Cameron, M. P., Simpson, M. L., Reddy, R., Nock, S., Greensill, H. et al. (2020) Kaumātua Mana Motuhake: peer education intervention to help Māori elders during lat- er-stage life transitions. BMC Geriatrics, 20. doi:10.1186/ s12877-020-01590-z Palmer, S. C., Gray, H., Huria, T., Lacey, C., Beckert, L. and Pitama, S. (2019) Reported Māori consumer experiences of health systems and programs in qualitative research: a systematic review with meta-synthesis. International Journal for Equity in Health, 18, 163. doi:10.1186/ s12939-019-1057-4 Panelli, R. and Tipa, G. (2007) Placing wellbeing: a Māori case study of cultural and environmental specificity. EcoHealth, 4, 445–460. Penehira, M., Smith, L. T., Green, A. and Aspin, C. (2011) Mouri matters: contextualizing mouri in Māori health dis- course. AlterNative, 7, 177–187. Pihama, L., Tipene, J. and Skipper, H. (2014) Ngā hua a Tāne rore: The Benefits of kapa haka. Scoping report for Te Kotahi Research Institute, University of Waikato. Ministry for Culture and Heritage, Manatū Taonga. Retrieved June 01, 2022 from http://www.mch.govt.nz/sites/default/ files/Nga%20Hua%20A%20Tane%20 Rore%20%20 The%20benefits%20of%20kapa%20haka%20%28D– 0570327%29.PDF Pohatu, L. (2015) Iron Māori: a kaupapa Māori driver hauora initiative. Masters thesis. Otago University, Semantic  Scholar. Retrieved April 01, 2021 from https:// ourarchive.otago.ac.nz/bitstream/handle/10523/5811/ PohatuLisa2015MPH.pdf?sequence=1&isAllowed=y Pulla, V. (2012) What are strengths based practices all about? In Pulla, V., Chenoweth, L., Francis, A. and Bakaj, S. (eds), Papers in Strength Based Practice. Allied Publishers Pvt. Ltd., New Delhi, India, pp. 1–18. Ratima, M., Martin, D., Castleden, H. and Delormier, T. (2019) Indigenous voices and knowledge systems: promoting plan- etary health, health equity, and sustainable development now and for future generations. Global Health Promotion, 26(3 Suppl), 3–5. Redvers, N., Schultz, C., Prince, M. V., Cunningham, M., Jones, R. and Blondin, B. (2020) Indigenous perspectives on edu- cation for sustainable healthcare. Medical Teacher, 42, 1085–1090. Reid, P., Cormack, D. and Paine, S. J. (2019) Colonial histories, racism and health: the experience of Māori and indigenous peoples. Public Health, 172, 119–124. Reweti, A. (2019) Tū Kahikatea: Whanaungatanga as a cata- lyst for whānau wellbeing. Te Kura Nui o Waipareira, 3, 21–34. https://wairesearch.waipareira.com/wp-content/ uploads/2019/11/Waipareira-Journal_Kotahitanga-Issue-3- 2019-WEB.pdf Reweti, A. (2022a) Securing cultural identity for whānau well-be- ing: a qualitative study of a whānau-led initiative. AlterNative, 18, 375–382. doi:10.1177/11771801221118623 Reweti, A. (2022b) Developing a kaupapa whānau frame- work to explore social, cultural and health benefits of a whānau-inspired initiative. MAI Journal, 11, 129–139. doi: 10.20507/MAIJournal.2022.11.2.4 Reweti, A. and Severinsen, C. (2022) Waka ama: an exemplar of indigenous health promotion in Aotearoa New Zealand. Health Promotion Journal of Australia, 33(Suppl 1), 246–254. Reweti, A., Ware, F. and Moriarty, H. (2022) A tangata whenua (people of the land) approach to conceptualising Māori health and wellbeing. Global Health Promotion (Online). doi:10.1177/17579759221130948 Royal, T. A. C. (2009) Mātauranga Māori: An Introduction. Mauriora-ki-te-Ao/Living Universe, NZ. Royal, T. A. C. (2011) Wānanga: The Creative Potential of mātauranga Māori. Mauriora-ki-te-Ao/Living Universe Ltd, NZ. Savage, C., Dallas-Katoa, W., Leonard, J. and Goldsmith, L. (2018) Evaluation of Waves 4 & 5 Commissioning for Te Pūtahitanga o Te Waipounamu. Ihi Research Social Change & Innovation, Christchurch, NZ. Savage, C., Goldsmith, L., Te Hēmi, H. and Dallas-Katoa, W. (2020) Evaluation of Wave Eight Initiatives for Te Pūtahitanga o Te Waipounamu. Ihi Research Social Change & Innovation, Christchurch, NZ. Savage, C., Goldsmith, L., Tikao, K., Leonard, J., Te Hēmi, H., and Hynds, A. (2021) Evaluation of wave 10 initiatives for Te Pūtahitanga o Te Waipounamu. Ihi Research Social Change & Innovation, Christchurch, NZ. Savage, C., Hynds, A., Leonard, L., Goldsmith, L. and Te Hemi, H. (2019) Whānau wānanga: PS Haitana whānau D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 http://www.jstor.org/stable/j.ctvqc6jwv.11 http://www.jstor.org/stable/j.ctvqc6jwv.11 https://www.nzqa.govt.nz/assets/Maori/ConversationsMMv6AW-web.pdf https://www.nzqa.govt.nz/assets/Maori/ConversationsMMv6AW-web.pdf https://www.health.govt.nz/publication/whakamaua-maori-health-action-plan-2020-2025 https://www.health.govt.nz/publication/whakamaua-maori-health-action-plan-2020-2025 https://maoridictionary.co.nz/search?idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=hau https://maoridictionary.co.nz/search?idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=hau https://maoridictionary.co.nz/search?idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=hau https://maoridictionary.co.nz/search?idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=ora https://maoridictionary.co.nz/search?idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=ora https://maoridictionary.co.nz/search?idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=ora https://doi.org/10.1186/s12877-020-01590-z https://doi.org/10.1186/s12877-020-01590-z https://doi.org/10.1186/s12939-019-1057-4 https://doi.org/10.1186/s12939-019-1057-4 http://www.mch.govt.nz/sites/default/files/Nga%20Hua%20A%20Tane%20 Rore%20%20The%20benefits%20of%20kapa%20haka%20%28D– 0570327%29.PDF http://www.mch.govt.nz/sites/default/files/Nga%20Hua%20A%20Tane%20 Rore%20%20The%20benefits%20of%20kapa%20haka%20%28D– 0570327%29.PDF http://www.mch.govt.nz/sites/default/files/Nga%20Hua%20A%20Tane%20 Rore%20%20The%20benefits%20of%20kapa%20haka%20%28D– 0570327%29.PDF http://www.mch.govt.nz/sites/default/files/Nga%20Hua%20A%20Tane%20 Rore%20%20The%20benefits%20of%20kapa%20haka%20%28D– 0570327%29.PDF https://ourarchive.otago.ac.nz/bitstream/handle/10523/5811/PohatuLisa2015MPH.pdf?sequence=1&isAllowed=y https://ourarchive.otago.ac.nz/bitstream/handle/10523/5811/PohatuLisa2015MPH.pdf?sequence=1&isAllowed=y https://ourarchive.otago.ac.nz/bitstream/handle/10523/5811/PohatuLisa2015MPH.pdf?sequence=1&isAllowed=y https://wairesearch.waipareira.com/wp-content/uploads/2019/11/Waipareira-Journal_Kotahitanga-Issue-3-2019-WEB.pdf https://wairesearch.waipareira.com/wp-content/uploads/2019/11/Waipareira-Journal_Kotahitanga-Issue-3-2019-WEB.pdf https://wairesearch.waipareira.com/wp-content/uploads/2019/11/Waipareira-Journal_Kotahitanga-Issue-3-2019-WEB.pdf https://doi.org/10.1177/11771801221118623 https://doi.org/10.20507/MAIJournal.2022.11.2.4 https://doi.org/10.1177/17579759221130948 Understanding how whānau-centred initiatives can improve Māori health 13 Trust: Impact Report for Wave 7: Whānau Commissioning Initiative for Te Pūtahitanga o te Waipounamu. Ihi Research Social Change & Innovation, Christchurch, NZ. Severinsen, C. and Reweti, A. (2020) Promoting health through waka ama. Global Journal of Community Psychology Practice, 11. https://www.gjcpp.org/en/photovid. php?issue=34&photovid=69 Severinsen, C. and Reweti, A. (2021) Waiora: connecting peo- ple, well-being, and environment through waka ama in Aotearoa New Zealand. Health Promotion Practice, 22, 524–530. Sport Manawatū. (2019) Sport Manawatū annual report 2018/2019. Retrieved June 01, 2022 from https://www. sportmanawatu.org.nz/about/reports/ Te Aka Whai Ora. (2023) Leading and Monitoring Transformational Change for the hauora Health and Wellbeing Needs of whānau Māori. https://www.teaka- whaiora.nz/ Te Pae Herenga o Tāmaki. (2017) Kokiritia i roto i te kota- hitanga: Tāmaki regions kaiārahi outcomes snapshot. Retrieved August  01, 2022 from https://www.waipareira. com/wp-content/uploads/2018/09/TWW177021-Te-Pae- Herenga-o-Tamaki-Whānau-Direct-Outcomes-Report- PAGES-....pdf Thompson, C., Kerr, R., Carpenter, L. and Kobayashi, K. (2017) Māori philosophies and the social value of community sports clubs: a case study from kapa haka. New Zealand Sociology, 32, 29–53. Tu’itahi, S. and Lima, I. (2015) Pacific health promotion. In Signal, L.and Ratima, M. (eds), Promoting Health in Aotearoa New Zealand. Otago University Press,  Otago, NZ, pp. 64–81. Waitangi Tribunal. (2019) Hauora: Report on Stage One of the Health Services and Outcomes kaupapa Inquiry: WAI 2575. Legislation Direct. Retrieved June 01, 2022 from https://forms.justice.govt.nz/search/Documents/WT/wt_ DOC_152801817/Hauora%20W.pdf Waiti, J. and Kingi, T. K. (2014) Whakaoranga whānau: Whānau resilience. MAI Journal, 3, 126–127. http://www.journal. mai.ac.nz/sites/default/files/MAI_Jrnl_V3_iss2_Waiti.pdf Walters, K. L., Johnson-Jennings, M., Stroud, S., Rasmus, S., Charles, B., John, S. et al. (2020) Growing from our roots: strategies for developing culturally grounded health promo- tion interventions in American Indian, Alaska Native, and Native Hawaiian communities. Prevention Science, 21, 54–64. Warbrick, I., Wilson, D. and Boulton, A. (2016) Provider, father, and bro—sedentary Māori men and their thoughts on phys- ical activity. International Journal for Equity in Health, 15, 22. doi:10.1186/s12939-016-0313-0 Watego, C., Whop, L., Singh, D., Mukandi, B., Macoun, A., Newhouse, G. et al. (2021) Black to the future: making the case for indigenist health humanities. International Journal of Environmental Research and Public Health, 18, 8704. doi:10.3390/ijerph18168704 Wilson, D., Boulton, A. and Warbrick, I. (2019) Physical wellbeing of Māori. In Fleming, C. and Manning, M. (eds), Routledge Handbook of Indigenous Wellbeing. Routledge, New York, NY, pp. 71–85. Wilson, B., Bright, F., Cummins, C., Elder, H. and Kayes, N. (2021a) ‘The wairua first brings you together’: Māori expe- riences of meaningful connection in neurorehabilitation. Brain Impairment, 23, 1–15. doi:10.1017/BrImp.2021.29 Wilson, D., Mikahere-Hall, A. and Sherwood, J. (2021b) Using indigenous kaupapa Māori research methodology with constructivist grounded theory: generating a theoretical explanation of indigenous womens realities. International Journal of Social Research Methodology, 1–16. doi:10.108 0/13645579.2021.1897756 Wilson, D., Moloney, E., Parr, J. M., Aspinall, C. and Slark, J. (2021c) Creating an Indigenous Māori-centred model of relational health: a literature review of Māori models of health. Journal of Clinical Nursing, 1, 1–17. Yin, R. K. (2014) Case Study Research: Design and Methods, 5th edn. Sage, Thousand Oaks, CA. D ow nloaded from https://academ ic.oup.com /heapro/article/38/4/daad070/7231222 by M assey U niversity user on 12 June 2024 https://www.gjcpp.org/en/photovid.php?issue=34&photovid=69 https://www.gjcpp.org/en/photovid.php?issue=34&photovid=69 https://www.sportmanawatu.org.nz/about/reports/ https://www.sportmanawatu.org.nz/about/reports/ https://www.teakawhaiora.nz/ https://www.teakawhaiora.nz/ https://www.waipareira.com/wp-content/uploads/2018/09/TWW177021-Te-Pae-Herenga-o-Tamaki-Whānau-Direct-Outcomes-Report-PAGES-....pdf https://www.waipareira.com/wp-content/uploads/2018/09/TWW177021-Te-Pae-Herenga-o-Tamaki-Whānau-Direct-Outcomes-Report-PAGES-....pdf https://www.waipareira.com/wp-content/uploads/2018/09/TWW177021-Te-Pae-Herenga-o-Tamaki-Whānau-Direct-Outcomes-Report-PAGES-....pdf https://www.waipareira.com/wp-content/uploads/2018/09/TWW177021-Te-Pae-Herenga-o-Tamaki-Whānau-Direct-Outcomes-Report-PAGES-....pdf https://forms.justice.govt.nz/search/Documents/WT/wt_DOC_152801817/Hauora%20W.pdf https://forms.justice.govt.nz/search/Documents/WT/wt_DOC_152801817/Hauora%20W.pdf http://www.journal.mai.ac.nz/sites/default/files/MAI_Jrnl_V3_iss2_Waiti.pdf http://www.journal.mai.ac.nz/sites/default/files/MAI_Jrnl_V3_iss2_Waiti.pdf https://doi.org/10.1186/s12939-016-0313-0 https://doi.org/10.3390/ijerph18168704 https://doi.org/10.1017/BrImp.2021.29 https://doi.org/10.1080/13645579.2021.1897756 https://doi.org/10.1080/13645579.2021.1897756