The journey so far... Midland Cancer Research & Audit Component Sharing Day July 19th 2011 By Wayne Johnstone

Oranga Tāne Māori 3 year research project funded by the Health Research Council and the Foundation for Research, Science and Technology Waikato Region Rural / Urban

Oranga Tāne Māori Project started in March 2009 The project is lead by Te Puna Oranga (Waikato DHB Māori Health Service) Waikato Clinical School, University of Auckland Māori Health Providers, Health organisations/groups

Oranga Tāne Māori Explores the Whānau Ora Journey of Māori men from a number of stakeholders including: - Māori men, 40 years > who have a chronic illness or cancer (Total 62 interviews, with 47 Māori men and 15 support persons) - Service providers - Māori community health workers (MCHWs) Clinicians Qualitative Interviews

OUTCOMES Identified and address barriers and enablers to enhance services for Māori men with a: Chronic disease Cancer Provide an evaluation of the Whānau ora contracts Detailing Whānau ora as a feature of health and health journey Addressing health inequalities for Māori men

Cancer 19 interviews with Māori males with cancer Includes co-morbidities Prostate 4 Bowel 7 Lung 7 Throat 1 Average age = 64 years Age range = 49-79 (years)

Cancer Informal interviews with participants Prompt questions included: How did you first come to know that you had cancer What prompted you to seek medical advice/ attention with this illness What challenges/ support have you encountered What does the term Whanau Ora mean to you

Cancer Interviews were transcribed and coded accordingly to Te Korowai model, developed by the research team as an evaluation tool. Kaupapa Māori basis Engagement with and by Māori Model developed with consultation by Māori elders Korowai (Māori cloak) worn on special occasions, weaving of parts comprise the finished korowai Symbolic to concept of Whānau Ora

Cancer Te Korowai Tuapapa Vision & foundation whanaungatanga relationships Uara Tu Guiding values, tikanga Huarahi Pathway of the person Oranga & Hauora Health & well being Mana tangata Empowerment, responsibility Rangatiratanga/ whakaruruhau Self determination

Huarahi (pathway) “I went to hospital for a scan on my shoulder (hurt at work) and scan picked up cancer [growth] on my lung” Mana Tāngata (responsibility/Barriers) “I went on ACC then moved onto invalids benefit..no money.. Having to make [hospital] appointments, not when needed, but when having money to get transport there…” Uara Tu (guiding values) “Holistic models of health are important for Māori..”

Whanaungatanga (relationships) “Whānau ora means to me family… if you can get [their] help that’s good…” Rangatiratanga (self determination) “I’m independent… I hate asking for help… its always the way I’ve been…” (63, Lung cancer)

Oranga and Hauora “It’s a horrific sensation to have this happen to you an you don’t know what’s going to happen to you…your hinengaro, your wairua, and your tinana all work together.” (71, Bowel cancer) Huarahi “I didn’t like it because he actually told me over the phone…I had no one at home to talk to…” (52, Lung cancer)

Whanaungatanga “I don’t want to become a burden to them (family/whānau)…I’d rather not be here than be a burden. My family is everything to me. (49, Prostate Cancer)

Questions