The He Waka Eke Noa research project aims to: (a) investigate whānau and clinical ideas of how to increase Māori access to primary health care (PHC) in the cancer pre-diagnosis phase; (b) bring the perspectives of both whānau and clinicians together to agree on changes required in both systems (whānau and PHC) to ensure earlier diagnosis (and therefore treatment) of cancer for Māori; and (c) test the ability of whānau and primary care staff to transform health services, using Kaupapa Māori and Appreciative Inquiry approaches, in one PHC site.
As a research team, we are celebrating three major wins in the first year of our research project implementation.
The first of these wins is reflected in the cohesiveness, caring and diverse capabilities evident among the researchers brought together under this project.
He Waka Eke Noa is an authentic and active partnership between three distinct groups of interest; Whakauae researchers, whānau research participants and Gonville Health, a primary care practice in Whanganui. The opportunity for Whakauae to work closely with Gonville Health, in the design and implementation of the research, has been a major contributing factor in the successful implementation of Phase One of the project.
Gonville Health has, for example, facilitated the initial connection between whānau registered with the practice and Whakauae researchers as well as supporting both its clinical and non-clinical staff to participate in the research.
A second win evident has been the willingness of whānau to take part in the research and the trust that they have placed in us to treat their stories with integrity.
The kōrero between the researchers and whānau has been described as "rich and multi-layered". We have been surprised and feel very honoured that whānau have been prepared to share their cancer journeys with us in such a trusting and open manner.
The third and final win has been the learnings we have gained as we explore what Appreciative Inquiry methodology looks and feels like when implemented within a Kaupapa Māori research framework.
Using an Appreciative Inquiry process has enabled us all to focus on what is working well and the qualities and values that drive success or hauora, even in the most challenging of situations. This focus on the “best of what is” has in turn energised the research, sustaining our enthusiasm for the work.
In this first phase of the research, we have collected preliminary data and have shared the insights generated both among our research partners and with wider research networks. The feedback we have received has been very positive. Whānau are open to sharing their stories about their cancer journeys and appreciate the open-ended, conversational style of interviewing being employed, wherein whanaungatanga is prioritised and time is not hurried. Whānau also welcome the opportunity offered, both during and following on from interviews, to co-create a visual map of their journey using the Mauri o te Awa Tool designed by one of our research team members, Gill Potaka-Osborne.
In our first phase of the research project, we have placed an emphasis on sharing information about what we are doing with our wider clinical and research networks. That sharing has included the preparation and publication of an overview of the research in NZ Doctor online and hui with members of Te Aho o Te Kahu (National Cancer Control Agency) as well as other Māori researchers engaged in cancer research. These connections with colleagues working in the cancer research space are a valuable way of exchanging information, focusing the research on emerging evidence and needs and ultimately maximising opportunities to use results for systems change.
In mid-2023 we will move into the second phase of our He Waka Eke Noa research. This phase will involve all three research partners working together to identify the strengths that can be called upon within whānau to support earlier diagnosis of cancer. It will also involve determining what primary care health services need to do to be responsive and effective in facilitating the earlier diagnosis of cancer among Māori whānau.
If this project is of interest to you, or you have questions of us, please contact one of our two project leads; Academic Lead, Dr Heather Gifford (hylandgifford@gmail.com) or Clinical Lead, Dr John McMenamin (doctorjohnmcmenamin@gmail.com).
From left: He Waka Eke Noa team members Dr Pat Neuwelt, Gill Potaka-Osborne, Lynley Cvitanovic and Dr Heather Gifford with the Mauri o te Awa Tool.
