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BMC Geriatrics
Published in: BMC Geriatrics 1/2020

Open Access 01-12-2020 | Research article

Kaumātua Mana Motuhake: peer education intervention to help Māori elders during later-stage life transitions

Authors: John G. Oetzel, Michael P. Cameron, Mary L. Simpson, Rangimahora Reddy, Sophie Nock, Hineitimoana Greensill, Pare Meha, Kirsten Johnston, Truely Harding, Pita Shelford, Linda Tuhiwai Smith, Brendan Hokowhitu

Published in: BMC Geriatrics | Issue 1/2020

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Abstract

Background

Aotearoa/New Zealand has a population that is ageing and there are challenges to health and social outcomes related to related to key life transitions (e.g., retirement, change in health conditions, loss of spouse). Further, there are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. The purpose of this study was to test the impacts and cost effectiveness of a tuakana/teina (peer education) intervention on kaumātua (elders) receiving the intervention. This study was framed by a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation).

Methods

This study was grounded in principles of Kaupapa Māori and community-based participatory research to bring together a diverse group of stakeholders to co-develop and co-evaluate the intervention. The intervention had tuakana (peer educators) having conversations with up to six teina (recipients) and providing information related to health and social services. The research design was a pre- and post-test, clustered staggered design. Participants completed a baseline assessment of health and mana motuhake measures consistent with Māori worldviews along with two follow-up assessments (one after the first intervention group completed its activities and a second after the second intervention group completed its activities). Additionally, five focus groups and open-ended questions on the assessments were used to provide qualitative evaluation.

Findings

A total of 180 kaumātua were recruited to the intervention with 121 completing it. The analysis revealed improvements over time in the expected direction on most of the variables. However, only three of the variables had statistically significant intervention effects: received support, tribal identity, and trouble paying bills. Qualitative results supported impacts of the intervention on mana motuhake, social connectedness, and tangible/information support related to services. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times gross domestic product per capita.

Conclusions

The findings support the relevancy and importance of kaumātua knowledge to create a strengths-based approach to improve health and social outcomes. This study demonstrates that a contextually based and culturally safe age-friendly environments can facilitate engagement and participation by kaumātua for kaumātua.

Trial registry

Australia New Zealand Clinical Trial Registry (ACTRN12617001396314); Date Registered: 3 October 2017 (retrospectively registered); https://​www.​anzctr.​org.​au/​Trial/​Registration/​TrialReview.​aspx?​id=​373733&​isClinicalTrial=​​False
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Metadata
Title
Kaumātua Mana Motuhake: peer education intervention to help Māori elders during later-stage life transitions
Authors
John G. Oetzel
Michael P. Cameron
Mary L. Simpson
Rangimahora Reddy
Sophie Nock
Hineitimoana Greensill
Pare Meha
Kirsten Johnston
Truely Harding
Pita Shelford
Linda Tuhiwai Smith
Brendan Hokowhitu
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01590-z

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