Introduction: Health Hawke's Bay-Te Oranga Hawke's Bay (HHB) supports 29 general practices delivering to an enrolled population of 153,641; of this population 38,758 are Māori (indigenous people). Ischaemic heart disease for Māori is four times higher than non-Māori and the top cause of amenable mortality in Hawke's Bay[1]. Diabetes and breast cancer is a similar picture. The majority of the population, including Māori, access primary care services. Despite access and utilisation data being positively comparative there are still significant and abiding inequities. Approximately 25% of all Māori deaths occur before the age of 50 years compared to 5% of non- Māori. The HHB team has made a commitment to change this picture 'one whānau, at a time'. HHB acknowledged we were still not reaching Māori who most need services, but we were touching those who know those that most need services. What changed? Recognising that the make-up and cultural paradigm of Māori Whānau, Hapū (extended Whānau network) and Iwi (tribal affiliation) are different systems to those currently being used in our health system was the first step. This meant acknowledging there was a network in place based on whānau and whānaungatanga (system of relational connectedness), and to be prepared to ask questions rather than focus on fixing problems. By asking 'what we can do to help you do what you need to do?' our aim over time has been to work with the existing community strengths to influence and build whānau resilience, supporting the community to 'own' the activities so they are sustained beyond the support we provide to initiate and embed. The process remains iterative. We embarked on a journey together with Waimarama (name of a place) Marae(communal meeting place) in 2012. Waimarama is 30 kilometres from the closest urban area; the Māori community is built around a Marae and has genealogy connections to six other Marae in the area. Waimarama Marae was in the process of taking ownership and accountability of their health and wellbeing when we first engaged. The Marae aspirations were to have a nurse clinic, transport to access general practice particularly for the Kaumātua (older people) and more health support from the health clinic sited at the Marae. The Marae links to approximately 230 Māori living within the Waimarama area (up to 1,500 immediate whānau members connect directly to this group) these are our key stakeholders. Key Findings: We have supported the introduction of the Stanford University Chronic Disease Self-Management Programme (Better Choices, Better Health® Workshop)[2]. The Marae health champion and a community member have been trained to deliver this programme; this has had a positive impact, nine Marae whānau graduated the first programme with the potential to impact positive effects to a further 72 individuals, these nine are now equipped to manage their own health and wellbeing better and are actively engaging their whānau in discussions about health and wellbeing. A further 12 from connected Marae are requesting to be trained as lay trainers. Because the local community has been telling others about this programme, increased demand for training has also come from other providers and general practice. Highlights: A highlight from the Stanford programme is expressed in the following comment from a participant, Kaumātua Nanny Piki Ruahina Winitana. Before the Stanford programme she described being in the Kaumātua flats as 'This is where we go, you know, waiting to die,' now, she says 'not even! Stanford course is so interesting, we learn how to become healthy Kaumātua, eat healthy, think healthy, walk every day'. A key lesson was work with the natural rhythms of the community and to take time to know what the community aspiration is. The key for this community was being on their Tūrangawaewae (a place to stand and be listened to and heard) supported by people from the own community. Conclusion: If we had set out to address the problems of Ischaemic heart disease or diabetes by instigating standard programmes such as publicity campaigns, focused recalls, health promotion information about health eating and healthy activity, we may have affected individuals. By investing in and working closely with this community we increased the community resource and capability to manage more health achievement for themselves. The outcomes and benefits for this community may not be realised in 3, 6 or 12 months or longer. However, with knowledge invested into the community, the potential is there to change outcomes 'one whānau at a time'. [ABSTRACT FROM AUTHOR]