Background: About 40% of all health burden in New Zealand is due to cancer, cardiovascular disease, and type 2 diabetes/obesity. Outcomes for Māori (indigenous people) are significantly worse than non-Maori; these inequities mirror those found in indigenous communities elsewhere. Evidence-based interventions with established efficacy may not be effective in indigenous communities without addressing specific implementation challenges. We present an implementation framework for interventions to prevent and treat chronic conditions for Māori and other indigenous communities. Theoretical framework: The He Pikinga Waiora Implementation Framework has indigenous self-determination at its core and consists of four elements: cultural-centeredness, community engagement, systems thinking, and integrated knowledge translation. All elements have conceptual fit with Kaupapa Māori aspirations (i.e., indigenous knowledge creation, theorizing, and methodology) and all have demonstrated evidence of positive implementation outcomes.

Objective: This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was 'What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?'Methods: A systematic search using PRISMA protocols and reflexive typology organised around the categories of Māori, public healthcare and qualitative research identified 14 papers that covered all three categories. We undertook a qualitative metasynthesis on these papers using a critical community psychology approach.Results: Māori patients and whānau from the included papers mention both barriers and facilitators to health. We categorised barriers as organisational structures, staff interactions and practical considerations. Facilitators were categorised as the provision of whānau support in the form of practical assistance, emotional care and health system navigation.Conclusions: For many Māori, the existing public health system is experienced as hostile and alienating. Whānau members provide support to mitigate this, but it comes as a cost to whānau. Implications for public health:Public health providers must find ways to ensure that Māori consistently experience positive, high-quality healthcare interactions that support Māori ways of being.

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Death is a universal event. It will happen to all of us, yet how we respond to death is particular and influenced by our cultural worlds. This study offers an investigation of the idiographic, of how one woman responded to, and made arrangements to, mourn and bury her mother. Specifically, we explore how she and her whanau (family) under pressure of time and grief and in the absence of clear final wishes met to consider issues and make decisions about the situation they were confronted with. This case forms part of a much larger programme of research into Maori death rituals, change and adaption. Informing a scholarly audience unfamiliar with the Maori world requires a significant amount of contextual information. The case study is a powerful strategy to achieve this and one that draws readers into deep understanding (Willig, 2008). This case provides insight into the struggles of an indigenous fourth‐world people living within the heterogeneity of Aotearoa/New Zealand society; it demonstrates how values change across generations as people live their lives increasingly away from their ancestral homelands and how traditionally defined roles and responsibilities within the whanau (family) are challenged by members living away from each other. Copyright © 2012 John Wiley & Sons, Ltd.

Aims To examine the incidence of type 2 diabetes in people with newly diagnosed prediabetes and the factors that protect against this progression. Methods The study population was 14,043 adults with pre-diabetes enrolled in a primary health organization in the upper North Island of New Zealand. Glycated hemoglobin (HbA1c) and body mass index (BMI) were linked to government health, census and social datasets in the Statistics New Zealand Integrated Data Infrastructure. Adults with a first diagnosis of pre-diabetes between 2009 and 2017 (HbA1c in range 5.9-6.6% [41-49 mmol/mol]) were followed-up for type 2 diabetes incidence. Cox regression was used to examine protective factors and adjust for potential confounding. Results Cumulative diabetes incidence was 5.0% after three years. Progression was greater in younger adults, men, people with higher HbA1c, greater BMI and a more recent diagnosis. Progression was lower in people treated with metformin, and Indigenous language speakers. Higher progression rates for Māori (Indigenous population) and Pacific peoples (migrants to New Zealand) were related to higher baseline HbA1c. Conclusions This is the first study to identify Indigenous language as a protective factor against diabetes, and results confirm obesity as a key target for population prevention. People with identified risk factors should be prioritized for pre-diabetes interventions.