Despite significant changes in the social landscape over the past two decades, much ethnographic research suggests that young women's negotiations of (hetero)sexuality remain dominated by the sexual double standard. Within the sexual double standard, an active, desiring sexuality is positively regarded in men, but denigrated and regulated by negative labelling in women. This article analyses young women's talk on the subject of negotiating (hetero)sexual relationships, drawn from focus-group interviews with six groups of young women aged 16-18 years. A feminist, post-structuralist form of discourse analysis is used to analyse the material, the aim being to examine young women's talk about (hetero)sexuality from the standpoints of agency and resistance. Analyses identified various ways in which the sexual double standard was disrupted, including challenging the language of the sexual double standard, articulating sexual desire, and positioning of self and (hetero)sex within alternative discourses. The findings also suggest, however, that voices of resistance to the sexual double standard may be muted and individual rather than collective, and that, accordingly, every effort should be made by those working with young women to recognize and support attempts to disrupt the sexual double standard.

Background: Human papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Māori women who suffer a greater burden of cervical disease than New Zealand European women. Aims:This study aimed to explore the potential acceptability of HPV self-testing for never/under-screened (self-reported no cervical screen in 4+ years, aged 25+) Māori women by Kaupapa Māori (by, with and for Māori) mixed methods, involving hui (focus groups/interviews) and survey. Materials and Methods:Community-based researchers ran hui with women in four regions (N = 106) and supported hui participants to collect survey data (N = 397). Healthcare providers (HCPs) were also interviewed (N = 17). Hui data were thematically analysed. Survey data were analysed by age group, rural/urban, primary health organisation (PHO) enrolment, and time since last cervical screen.Results: Most survey participants were PHO-enrolled (87.15%) and attended regularly (71.79%), but did not attend regular cervical screening. A desire for bodily autonomy, including whakamā (embarrassment/shyness/reticence), was the most frequently cited barrier. Three in four women reported being likely/very likely to do an HPV self-test. Nine in ten women reported being likely/very likely to attend follow up if they receive a positive HPV test result. Women and HCPs in the hui emphasised the importance of health literacy, cultural competence and empathetic support. Conclusion:The findings indicate that with a culturally competent introduction of HPV self-testing, many currently never/under-screened Māori women would be willing to be screened and followed up if necessary. HPV self-testing has the potential to save lives. K E Y W O R D Scervical screening, HPV self-sampling, HPV self-testing, Indigenous health, Kaupapa Māori

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BackgroundThe prevalence of asthma for Indigenous New Zealand Māori is amongst the highest in the world. Recent evidence shows ethnic differences in asthma symptom prevalence in New Zealand have widened, with asthma symptoms and hospitalisation rates consistently higher for Māori across all age-groups, especially children and adolescents. This paper: outlines our qualitative, longitudinal research exploring the practical issues Māori children and their families face trying to achieve optimum asthma outcomes; details the research methods used within this study; and discusses the process evaluation findings of the features that made this approach successful in engaging and retaining participants in the study.MethodsThirty-two Māori families were recruited using a Kaupapa Māori (Māori way) Research approach. Each participated in a series of four in-depth interviews that were carried out at seasonal intervals over the course of one year. Families also took part in an interviewer-administered questionnaire and participated in a Photovoice exercise. All interviews were digitally recorded, transcribed verbatim and independently coded by two researchers. The research team then conducted the analysis and theme development. The questionnaires were analysed separately, with explanations for findings explored within the qualitative data.ResultsThe methodology produced a 100 percent retention rate of the participating families over the course of the follow-up. This was attributed to the research collaboration, the respectful research relationships established with families, and the families’ judgement that the methods used enabled them to tell their stories. The acceptability of the methodology will add to the validity and trustworthiness of the findings.ConclusionGiven the extent and persistence of ethnic disparities in childhood asthma management, it is imperative that an indigenous approach be taken to understanding the core issues facing Māori families. By conducting community-partnership research underpinned by an indigenous methodology, and employing a range of appropriate methods, we have successfully recruited and retained a cohort of Māori families with experiences of childhood asthma. We aim to make their voices heard in order to develop a series of culturally relevant interventions aimed at remediating these disparities.

Background Indigenous women in the high‐income countries of Canada, Australia, New Zealand and USA, have a higher incidence and mortality from cervical cancer than non‐Indigenous women. Increasing cervical screening coverage could ultimately decrease cervical cancer disparities. Aims To increase cervical screening for under‐screened/never‐screened Māori women. Materials and Methods This study was a cluster randomised controlled trial. Inclusion criteria were women aged 25–69, last screened ≥4 years ago, in Northland, New Zealand. The intervention arm was the offer of a human papilloma virus (HPV) self‐test and the control arm was the usual offer of standard care – a cervical smear. The primary outcome was rate of cervical screening in the intervention group compared to control in Māori, the Indigenous peoples of New Zealand. Six primary care clinics were randomly allocated to intervention or control. Results Of 500 eligible Māori women in the intervention arm, 295 (59.0%) were screened. Of 431 eligible Māori women in the control arm, 94 (21.8%) were screened. Adjusting for age, time since last screen, deprivation index, Māori women in the intervention arm were 2.8 times more likely to be screened than women in the control arm (95% CI: 2.4–3.1, P‐value <0.0001). Conclusions Offer of HPV self‐testing could potentially halve the number of under‐screened/never‐screened Māori women and decrease cervical morbidity and mortality. These results may be generalisable to benefit Indigenous peoples facing similar barriers in other high‐income countries.

Young Māori mothers in Aotearoa/New Zealand are disproportionately vulnerable to intimate partner violence (IPV) due to multiple intersecting factors, such as relationship dynamics during youth, pregnancy, and racialized Māori (Indigenous) identity. An enduring legacy of settler colonialism has resulted in Māori being overrepresented as victims and perpetrators of violence. IPV, in particular, leads to adverse social, mental, and health outcomes over time, including those specific to mothers (e.g., postpartum depression, miscarriage). This study analyzed six narrative interviews with young Māori mothers aged 14 to 19 from the E Hine longitudinal maternal health care study. Kaupapa Māori (by Māori, for Māori) was the primary research framework, which allowed for the use of Māori modes of engagement and the centering of Māori women’s voices in the research process. Using a thematic and interpretive phenomenological analysis (IPA), we aimed to understand the lived realities of young Māori mothers who have experienced IPV and to examine the extent to which service responsiveness has been culturally safe. Our findings illustrated how IPV manifests in the relationships of these six women. Their stories showed the various ways in which young Māori women resist violence, reclaim their Māori identities, and experience personal transformation during their motherhood journeys despite abuse. We find that whānau (extended family) is both a violence-perpetuating and immensely protective factor. Moreover, there are structural and institutional barriers to culturally safe service responsiveness for young Māori women. These come in the form of racism at the frontlines of government agencies, pervasive victim-blaming, and a lack of earnest decolonial structural change at the institutional level. We conclude that social services must be multisectoral, culturally safe, and specialized for Māori youth and families to support Māori mothers experiencing IPV.

Child welfare data collected for administrative purposes are often used as a source of information for understanding the population impact of child abuse and neglect (CA/N). This study used administrative data linked at the individual level for a cohort of Aotearoa New Zealand (NZ) children to follow and extend a model developed by Drake et al. In this investigation, we aimed to build an understanding of the high representation of indigenous NZ children in administratively sourced measures of CA/N. Variation in rate ratios (RRs) within infant mortality and birth outcomes considered as possible proxies for actual CA/N RRs leaves open a range of interpretations. Our findings indicate that a more nuanced interpretation of the overrepresentation of indigenous children in administratively recorded maltreatment statistics is required. Rather than considering risk and bias as competing explanations, we suggest an acknowledgment of the impact of colonization and the existence of systemic bias generating increased risk as key drivers. As linked administrative data are increasingly used for research and evaluation, and considered for use in supporting decision making, there is a need for a deeper understanding of the drivers of administratively recorded CA/N in order to effectively address the needs of indigenous populations.

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