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Racism is a key modifiable determinant of health that contributes to health inequities in Aotearoa and elsewhere. Experiences of racism occur within the health sector for workers, patients and their whānau (extended family) every day. This paper uses stories of racism from nurses – reworked into vignettes – to examine the dynamics of racism to generate possible micro, meso and macro anti‐racism interventions. A critical qualitative design was utilised, informed by kaupapa Māori approaches. The five vignettes in this paper were sourced from a pair of caucused focus groups with nine senior Māori (Indigenous peoples of Aotearoa) and Tauiwi (non‐Māori) nurses held in Auckland Aotearoa in 2019. The vignettes were lightly edited and then critically analysed by both authors to identify sites of racism and generate ideas for anti‐racism interventions. The vignettes illustrate five key themes in relation to racism. These include (i) mono‐cultural practice, (ii) everyday micro‐aggressions; (iii) complexity and the costs of racism, (iv) Pākehā (white settler) privilege and (v) employment discrimination. From analysing these themes, a range of evidence‐based micro, meso and macro‐level anti‐racism interventions were derived. These ranged from engaging in reflective practice, education initiatives, monitoring, through to collective advocacy. Vignettes are a novel way to reveal sites of racism to create teachable moments and spark reflective practice and more active engagement in anti‐racism interventions. When systematically analysed vignettes can be utilised to inform and refine anti‐racist interventions. Being able to identify racism is essential to being able to effectively counter racism. [ABSTRACT FROM AUTHOR]

Māori health providers emerged in Aotearoa/New Zealand in the 1980s as a mechanism to achieve self‐determination for Māori communities. However, the contracts funding Māori health providers limit expressions of self‐determination and fail to reflect Te Tiriti O Waitangi, the founding treaty of Aotearoa/New Zealand. Significant health reforms are proposed in Aotearoa/New Zealand, including the creation of a Māori Health Authority that will commission services from Māori health providers. This paper aims to critique the government contracts provided to Māori health providers in the light of the health reforms. A discourse analysis was undertaken on contracts held by a Māori health provider. The study was informed by a Kaupapa Māori congruent methodology that centralised Māori knowledge. The contractural language utilised a variety of discursive techniques that ultimately limit the power of Māori health providers. These discursive techniques included the redefinition of Māori concepts of self‐determination, the use of rhetoric that was not matched by action, reshaping Māori health priorities to reflect the funders' priorities and the application of a deficit lens to Māori health issues. The discursive techniques present in these contracts is consistent with previous work demonstrating a failure of funders to centralise Māori knowledge and ways of being. Success of the proposed health reforms and the Māori Health Authority should require dismantling of non‐Māori ways of commissioning and contracting, otherwise there is the continued risk of discriminatory contracting practices limiting the expression of self‐determination for Māori health providers. [ABSTRACT FROM AUTHOR]

There is widespread and growing support and requirement for researchers and larger organisations to collaborate with communities. This ensures that social, educational, or health programmes are relevant and acceptable and address the needs of groups that experience inequity. There is limited research about the processes and approaches that impact successful collaboration. The aim of this study was to identify the best‐practice processes used to develop and sustain collaborative partnerships between community members and formal organisations in Aotearoa New Zealand. Using a qualitative case study methodology and guidance from our community advisory group, we selected three effective collaborations with groups that experienced inequity in Aotearoa New Zealand. We examined these by reviewing their publicly available documents and conducting focus group discussions and interviews with key stakeholders. We coded and analysed transcriptions thematically to develop case study summaries of findings and then conducted cross‐case analysis to identify themes inherent in the data. Seven themes emerged from the data: (1) work together under Te Tiriti to ensure that collaborations are built on the articles of this founding document of Aotearoa New Zealand; (2) start before the beginning by forming strong relationships with diverse and representative community members; (3) walk the talk by using critically reflexive processes built on shared values and equal power relations; (4) use pencils not pens to implement ensuring an iterative project process; (5) recognise all contributions and especially the value of lived experience and local knowledge; (6) journey at a pace that allows all to participate; and (7) listen twice, talk once to give priority to hearing quieter voices. These seven practices can be utilised by other collaborative initiatives to increase genuine and power‐shared participation. These participatory processes can make sure that collaborative projects respect local knowledge, indigenous culture, and respond iteratively to community needs. [ABSTRACT FROM AUTHOR]

Internationally, the COVID-19 pandemic resulted in changes to services as governments funneled health-related funding and resources into stopping the spread of COVID-19. At the same time, older people were singled out as an "at-risk" group, which prompted caution from both older people and governments to limit their exposure to COVID-19. It remains unclear what the impact this has had on older people's routine health and social care access, and how older people themselves viewed these changes. This analysis investigates older people's understanding and experiences of using health and social care services under the COVID-19 lockdown restrictions in 2020. This analysis draws from a wider, letter-writing study that received 748 letters from 854 participants aged 70 years and older who were living in New Zealand during the COVID-19 lockdowns. Just over half of letter writers described access to health and social care services. Informed by Penchansky and Thomas' 5 A's of the access framework, we conducted a thematic analysis of this subsample of letters (n = 404). This analysis identified four broad categories relating to access to health and social care services under COVID-19 lockdown restrictions: (a) the system-wide strangeness of physically accessing services, (b) accommodation of services, (c) availability of resources and personnel, and (d) enhanced quality of those included by services. Rather than passively accepting changes, older people adapted to restrictions by drawing on their available materials and social resources. We conclude this analysis with suggestions for improving future interventions and policies to better older people's access to health and social care during times of crisis. [ABSTRACT FROM AUTHOR]

Maternal mental health plays a vital role in the overall wellbeing of mothers, children, families, whānau (core support network) and communities. However, many mothers face mental health challenges during the transition to parenthood. In this study, we used an online story-sharing platform to collect the experiences of mothers who have faced unmet needs while using the Well Child Tamariki Ora (WCTO) service in Aotearoa New Zealand. From the 420 submitted stories, 125 stories related to mental health need while using the WCTO service. Using thematic analysis, we identified three main themes that highlighted the experiences of mothers with the service. This includes (1) making it seem that I'm coping: Mothers' fear of being judged; (2) i wish I had connected with my WCTO nurse: Fostering meaningful relationships to facilitate personal information sharing; and (3) beyond the baby: Mothers desire for recognition and support during WCTO visits. These findings point to several missed opportunities for WCTO providers to inquire about mental health and offer support needed by mothers. To address this, a relational approach to care would prioritise families and whānau as the focus of care rather than just monitoring the development of babies. [ABSTRACT FROM AUTHOR]

Young people are known to face challenges when accessing healthcare and generally have low rates of health service utilisation. Use of telehealth might be one way to improve access, but evidence is needed from young people as to how acceptable it is. This online survey of 15‐ to 25‐year olds in the greater Wellington region of New Zealand sought young people's views on telehealth (phone and videocalls) as a means of accessing primary care. The survey included both forced‐choice questions and free‐text options. We report here on the free‐text data from open‐ended questions that were qualitatively analysed using template analysis. A total of 346 participants took part between August 6 and September 21, 2021, of whom 60% were female, 12% Māori (indigenous) ethnicity, and 38% had used telehealth methods of consulting previously. Analysis was undertaken of the free‐text comments that were provided by 132 participants (38%). Although those contributing comments described both benefits and drawbacks to using telehealth, more drawbacks were cited, with specific examples given to illustrate a range of concerns and potential limitations of telehealth including privacy, communication difficulties and compromised quality of care. Participants thought telehealth could be used successfully in specific situations, for example by people concerned about leaving the house due to anxiety, illness or being immunocompromised and for simple consultations or when the person knows exactly what they need. Respondents expressed a strong desire to be offered the choice between in‐person and telehealth consultations. Providing young people with a choice of consultation mode together with clear information about all aspects of a telehealth consultation is important if clinicians want young people to engage with this method of primary care service delivery. [ABSTRACT FROM AUTHOR]

A growing body of research indicates both positive and negative effects of grandparent childcare; effects that are largely dependent upon the context and intensity of the care are required. Here, we suggest that context to be inclusive of cultural background. Drawing on the indigenous methodological framework, talanoa, the views of 13 Pacific Island grandparents in relation to themes of grandparent childminding are explored, as well its proximity to perceptions of elder abuse. A cultural analysis reveals that traditions specific to the Pacific way of life may lead to increased risk of prolonged childcare. The participants in this study felt that prolonged childminding deprived them of time which could be used to benefit them and their community in the long run. It was viewed as a form of disrespect, as older people are revered and held in high regard in decision making activities from the Pacific worldview. The participants embraced their roles as the knowledge holders of cultural treasures; responsible for teaching children and grandchildren their genealogy and language, and for upholding the protocols of their cultural heritage. However, they felt their contributions were not reciprocated nor valued, but instead exploited. [ABSTRACT FROM AUTHOR]

Volunteering is a way for people to develop meaningful relationships within a social group and can lead to the building of social capital, from which both individuals and the wider group can benefit in the form of enhanced well‐being. This study aimed to explore and describe the impact of volunteering on the volunteer coordinators and volunteers themselves in the eastern suburbs of Christchurch, New Zealand, an area particularly impacted by the devastating earthquakes in the period 2010/2011. Data were collected via semi‐structured interviews with volunteer coordinators and volunteers (n = 35; 16 men, 19 women) from November 2018 to mid‐January 2019. Thematic analysis of data highlighted a key theme of Creating and strengthening valued community connections, with subthemes of Personal growth, Community connections and Role of coordination. The key theme illustrated how formal volunteering created effort and opportunities towards the strengthening of personal and community connectedness. Our study demonstrates the importance of social connection for both individual and community well‐being, emphasises the important role of "champions" in facilitating the building of bridging and bonding relationships between individuals and communities, and suggests a role for healthcare professionals to prescribe volunteering as a way to improve individual health and well‐being outcomes. [ABSTRACT FROM AUTHOR]