Enhancing Well-Being and Social Connectedness for Maori Elders Through a Peer Education (Tuakana-Teina) Programme: A Cross-Sectional Baseline Study.
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ABSTRACT:
SUBMITTER: Oetzel JG
PROVIDER: S-EPMC8692656 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundThe study offers baseline data for a strengths-based approach emphasizing intergenerational cultural knowledge exchange and physical activity developed through a partnership with kaumātua (Māori elders) and kaumātua service providers. The study aims to identify the baseline characteristics, along with correlates of five key outcomes.MethodsThe study design is a cross-sectional survey. A total of 75 kaumātua from six providers completed two physical functioning tests and a survey that included dependent variables based in a holistic model of health: health-related quality of life (HRQOL), self-rated health, spirituality, life satisfaction, and loneliness.ResultsThe findings indicate that there was good reliability and moderate scores on most variables. Specific correlates included the following: (a) HRQOL: emotional support (β = 0.31), and frequent interaction with a co-participant (β = 0.25); (b) self-rated health: frequency of moderate exercise (β = 0.32) and sense of purpose (β = 0.27); (c) spirituality: sense of purpose (β = 0.46), not needing additional help with daily tasks (β = 0.28), and level of confidence with cultural practices (β = 0.20); (d) life satisfaction: sense of purpose (β = 0.57), frequency of interaction with a co-participant (β = -0.30), emotional support (β = 0.25), and quality of relationship with a co-participant (β = 0.16); and (e) lower loneliness: emotional support (β = 0.27), enjoyment interacting with a co-participant (β = 0.25), sense of purpose (β = 0.24), not needing additional help with daily tasks (β = 0.28), and frequency of moderate exercise (β = 0.18).ConclusionThis study provides the baseline scores and correlates of important social and health outcomes for the He Huarahi Tautoko (Avenue of Support) programme, a strengths-based approach for enhancing cultural connection and physical activity.
| S-EPMC10749953 | biostudies-literature
Project description:BackgroundThe Aotearoa New Zealand population is ageing accompanied by health and social challenges including significant inequities that exist between Māori and non-Māori around poor ageing and health. Although historically kaumātua (elder Māori) faced a dominant society that failed to realise their full potential as they age, Māori culture has remained steadfast in upholding elders as cultural/community anchors. Yet, many of today's kaumātua have experienced 'cultural dissonance' as the result of a hegemonic dominant culture subjugating an Indigenous culture, leading to generations of Indigenous peoples compelled or forced to dissociate with their culture. The present research project, Kaumātua Mana Motuhake Pōī (KMMP) comprises two interrelated projects that foreground dimensions of wellbeing within a holistic Te Ao Māori (Māori epistemology) view of wellbeing. Project 1 involves a tuakana-teina/peer educator model approach focused on increasing service access and utilisation to support kaumātua with the greatest health and social needs. Project 2 focuses on physical activity and cultural knowledge exchange (including te reo Māori--Māori language) through intergenerational models of learning.MethodsBoth projects have a consistent research design and common set of methods that coalesce around the emphasis on kaupapa kaumatua; research projects led by kaumātua and kaumātua providers that advance better life outcomes for kaumātua and their communities. The research design for each project is a mixed-methods, pre-test and two post-test, staggered design with 2-3 providers receiving the approach first and then 2-3 receiving it on a delayed basis. A pre-test (baseline) of all participants will be completed. The approach will then be implemented with the first providers. There will then be a follow-up data collection for all participants (post-test 1). The second providers will then implement the approach, which will be followed by a final data collection for all participants (post-test 2).DiscussionTwo specific outcomes are anticipated from this research; firstly, it is hoped that the research methodology provides a framework for how government agencies, researchers and relevant sector stakeholders can work with Māori communities. Secondly, the two individual projects will each produce a tangible approach that, it is anticipated, will be cost effective in enhancing kaumātua hauora and mana motuhake.Trial registrationAustralia New Zealand Clinical Trial Registry ( ACTRN12620000316909 ). Registered 6 March 2020.
| S-EPMC7530863 | biostudies-literature
Project description:BackgroundHealth inequities experienced by kaumātua (older Māori) in Aotearoa, New Zealand, are well documented. Examples of translating and adapting research into practice that identifies ways to help address such inequities are less evident. The study used the He Pikinga Waiora (HPW) implementation framework and the Consolidated Framework for Implementation Research (CFIR) to explore promising co-design and implementation practices in translating an evidence-based peer-education programme for older Māori to new communities.MethodsThe study was grounded in an Indigenous methodology (Kaupapa Māori) and a participatory research approach. Data were collected from research documentation, community meeting and briefing notes, and interviews with community researchers.ResultsThe data analysis resulted in several key promising practices: Kaumātua mana motuhake (kaumātua independence and autonomy) where community researchers centred the needs of kaumātua in co-designing the programme with researchers; Whanaungatanga (relationships and connectedness) which illustrated how community researchers' existing and emerging relationships with kaumātua, research partners, and each other facilitated the implementation process; and Whakaoti Rapanga (problem-solving) which centred on the joint problem-solving undertaken by the community and university researchers, particularly around safety issues. These results illustrate content, process, and relationship issues associated with implementation effectiveness.ConclusionsThis study showed that relational factors are central to the co-design process and also offers an example of a braided river, or He Awa Whiria, approach to implementation. The study offers a valuable case study in how to translate, adapt, and implement a research-based health programme to Indigenous community settings through co-design processes.Trial registrationThe project was registered on 6 March 2020 with the Australia New Zealand Clinical Trial Registry: ACTRN12620000316909 . Prospectively registered.
| S-EPMC9694883 | biostudies-literature
Project description:BACKGROUND:The Aotearoa/New Zealand population is ageing and numerous studies demonstrate with this phenomenon comes increases in non-communicable diseases, injuries and healthcare costs among other issues. Further, significant inequities exist between M?ori (Indigenous peoples of Aotearoa/New Zealand) and non-M?ori around poor ageing and health. Most research addressing these issues is deficit oriented; however, the current research project takes a strengths-based approach that highlights the potential of kaum?tua (elders) by asserting mana motuhake (autonomy, identity and self-actualisation). We believe that the esteem of elders in M?ori culture signals transformative potential. Specifically, this project utilises a 'tuakana-teina' (older sibling/younger sibling) peer-educator model, where kaum?tua work with other kaum?tua in relation to health and wellbeing. The objectives of the project are (a) to develop the capacity of kaum?tua as peer educators, whilst having positive impacts on their sense of purpose, health and wellbeing; and (b) to enhance the social and health outcomes for kaum?tua receiving the intervention. METHODS:The research is grounded in principles of Kaupapa M?ori and community-based participatory research, and brings together an Indigenous community of kaum?tua, community health researchers, and academic researchers working with two advisory boards. The project intervention involves an orientation programme for tuakana peer educators for other kaum?tua (teina). The research design is a pre- and post-test, clustered staggered design. All participants will complete a baseline assessment of health and wellbeing consistent with M?ori worldviews (i.e., holistic model). The tuakana and teina participants will be divided into two groups with the first group completing the intervention during the first half of the project and the second group during the second half of the project. All participants will complete post-test assessments following both interventions allowing comparison of the two groups along with repeated measures over time. DISCUSSION:The findings will provide an evidence base for the importance and relevancy of kaum?tua knowledge to create contextually based and culturally safe age-friendly environments that facilitate engagement and participation by kaum?tua for kaum?tua. If the model is effective, we will seek to facilitate the dissemination and scalability of the intervention. TRIAL REGISTRATION:Australia New Zealand Clinical Trial Registry ( ACTRN12617001396314 ); Date Registered: 3 October 2017 (retrospectively registered).
| S-EPMC6367813 | biostudies-other
Project description:IntroductionPatients with severe mental illness (SMI) have higher rates of cardiovascular disease (CVD) morbidity and mortality than the general population. In the UK, data were limited regarding the known prevalence of physical health screening of SMI patients.AimsA total of 966 patients with SMI from seven geographically varied regions in the UK agreed to participate in a 2-year nurse-led intervention (Well-being Support Programme), designed to improve their overall physical health by providing basic physical health checks, health promotion advice, weight management and physical activity groups in secondary care.ResultsAt baseline, only 31% of participants had undergone a recent physical health check. There were high rates of obesity (BMI > 30 in 49%), glucose abnormalities (12.4%), hypertension/prehypertension (50%), hyperlipidaemia (71%), poor diet (32%), low exercise levels (37.4%) and smoking (50%).ConclusionsPatients with SMI where healthcare professionals have concerns regarding their physical health, have potentially modifiable risk factors for CVD, which remain undiagnosed. Programmes designed to address the physical health problems in SMI need to be implemented and evaluated in this already marginalised group of people.
| S-EPMC2779991 | biostudies-literature
Project description:BackgroundInterprofessional Education (IPE) is an educational approach that brings together students from different healthcare professions to foster collaborative learning and teamwork. Before integrating IPE into the curriculum of health preprofessional students, it is necessary to increase their readiness for IPE. Dentistry increasingly values interprofessional collaboration and teamwork for enhanced patient care and healthcare team competencies, an emphasis also echoed by recent dental education authorities. The aim of this quasi-experimental research was to assess the influence of Scenario Based Learning Peer Learning (SBPL) programme, which involved scenarios necessitating interprofessional communication, on the readiness for IPE among a cohort of undergraduate dental students studying within the framework of the European Higher Education Area (EHEA).MethodsThis study investigates undergraduate dental students' readiness for IPE and the influence of SBPL programme on their readiness. Participants (n = 25) from 18 EHEA countries completed the Readiness for Interprofessional Learning Scale (RIPLS) before and after SBPL programme, held at the 70th European Dental Students' Association (EDSA) meeting. Data were analyzed using the Wilcoxon Signed Rank Test (p = 0.05).ResultsAfter the SBPT programme, there was a statistically significant increase (p < 0.05) in the mean of the total scale, teamwork and collaboration, roles and responsibilities and professional identity subscale. In general, SBPL programme showed a constructive effect on interprofessional readiness. Although there was no statistically significant increase only in items 9,12,18 of the 19 items of the RIPLS, there was an increase in the averages in all except item 12.ConclusionOur research emphasizes the importance of diverse perspectives and IPE in the realm of dental education. Within the limits of this study, it showcases the efficacy of a brief half-day SBPL programme with interprofessional scenarios in enhancing participants' readiness. The programme notably enhanced dental students' readiness in grasping crucial aspects of IPE: teamwork and collaboration, professional identity, and roles and responsibilities. However, this study does not delve into the potential impact of a comprehensive, long-term curriculum integrating IPE principles. This gap underscores the need for further exploration into the sustained influence of IPE on the interprofessional skills of dental school graduates.
| S-EPMC10801947 | biostudies-literature
Project description:Policymakers and business leaders often use peer comparison information-showing people how their behavior compares to that of their peers-to motivate a range of behaviors. Despite their widespread use, the potential impact of peer comparison interventions on recipients' well-being is largely unknown. We conducted a 5-mo field experiment involving 199 primary care physicians and 46,631 patients to examine the impact of a peer comparison intervention on physicians' job performance, job satisfaction, and burnout. We varied whether physicians received information about their preventive care performance compared to that of other physicians in the same health system. Our analyses reveal that our implementation of peer comparison did not significantly improve physicians' preventive care performance, but it did significantly decrease job satisfaction and increase burnout, with the effect on job satisfaction persisting for at least 4 mo after the intervention had been discontinued. Quantitative and qualitative evidence on the mechanisms underlying these unanticipated negative effects suggest that the intervention inadvertently signaled a lack of support from leadership. Consistent with this account, providing leaders with training on how to support physicians mitigated the negative effects on well-being. Our research uncovers a critical potential downside of peer comparison interventions, highlights the importance of evaluating the psychological costs of behavioral interventions, and points to how a complementary intervention-leadership support training-can mitigate these costs.
| S-EPMC9303988 | biostudies-literature
Project description:We study whether grandparenthood is associated with older people's subjective well-being (SWB), considering the association with life satisfaction of having grandchildren per se, their number, and of the provision of grandchild care. Older people's education may not only be an important confounder to control for, but also a moderator in the relation between grandparenthood-related variables and SWB. We investigate these issues by adopting a cross-country comparative perspective and using data from the Survey of Health, Ageing and Retirement in Europe covering 20 countries. Our results show that grandparenthood has a stronger positive association with SWB in countries where intensive grandparental childcare is not common and less socially expected. Yet, this result is driven by a negative association between grandparenthood without grandparental childcare and SWB that we only found in countries where intensive grandparental childcare is widespread. Therefore, in accordance with the structural ambivalence theory, we argue that in countries where it is socially expected for grandparents to have a role as providers of childcare, not taking on such a role may negatively influence SWB. However, our results show that grandparental childcare (either intensive or not) is generally associated with higher SWB. Overall, we do not find support for a moderating effect of education. We also do not find striking differences by gender in the association between grandparenthood and SWB. The only noteworthy discrepancy refers to grandmothers being often more satisfied when they provide grandchild care.
| S-EPMC6156724 | biostudies-literature
Project description:ImportanceLiterature on peer-to-peer (P2P) programs suggests they improve health and well-being of older adults. Analysis from a previous study showed P2P to be associated with higher rates of hospitalization and no significant differences in rates of emergency department or urgent care visits; however, it is not known whether measures of health and well-being varied by group over time.ObjectiveTo compare the association between receiving P2P support and secondary outcomes (ie, health status, quality of life, and depressive and anxiety symptoms) with receiving standard community services (SCS) over time.Design, setting, and participantsThis cohort study was conducted among a volunteer sample of older adults (≥65 years) who were new to P2P or were already receiving P2P and a corresponding control group. Participants were matched between groups on age, sex, and race/ethnicity. The study was conducted from March 2015 to December 2017 at 3 community-based organizations that delivered P2P in California, Florida, and New York. Data analysis was performed from October 2018 through May 2020.ExposuresP2P support, provided by trained older adult volunteers.Main outcomes and measuresMental and physical components of the health status and quality of life measure and depressive and anxiety symptoms were collected over 12 months. The hypothesis was that older adults receiving P2P support would maintain higher health status and quality of life than the SCS group.ResultsA total of 503 participants were screened, 456 participants were enrolled and had baseline data, and 8 participants only had baseline information with no follow-up data, leaving 448 participants (231 [52%] in the SCS group; 217 [48%] in the P2P group; 363 [81%] women; mean [SD] age, 80 [9] years). The P2P group had improvements in mental health (change at 12 months, 1.1 points; 95% CI, -0.8 to 3.0 points) and physical health (change at 12 months, 1.0 points; 95% CI, -0.7 to 2.8 points). However, the difference of differences between the 2 groups did not differ significantly from baseline to 12 months (mental health: 0.2 points; 95% CI -2.3 to 2.7 points; physical health: 1.7 points; 95% CI, -0.6 to 3.9 points). The P2P and SCS groups had a statistically significant difference of differences in anxiety symptoms of 0.36 points (95% CI, 0.04 to 0.61 points). There were no significant differences in depressive symptoms or mental and physical components of the health status and quality of life.Conclusions and relevanceThese findings suggest that receiving P2P support did not slow the decline of health and well-being in older adults compared with those who received SCS. Baseline imbalance in key characteristics, even after adjusting for the imbalance using the propensity score method, may explain the results. Randomized trials are needed.
| S-EPMC8207241 | biostudies-literature
Project description:Intervention 1: Intervention group: The intervention group is subjected to peer support interventions for one month, at least twice a week by phone, and at least weekly by the Internet (virtual network) at least once a week. Intervention 2: The control group receives the same routine care and there is no intervention in it.
Primary outcome(s): Subjective well-being Score, in the Warwick Edinburgh Questionnaire. Timepoint: Before the intervention and one month after the end of the intervention. Method of measurement: Warwick Edinburgh subjective well-being Questionnaire.
Study Design: Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Supportive, Randomization description: Patients are randomly assigned to two groups of intervention and control (using the random numbers table at www.randomization.com), Blinding description: The analyst will be unaware of the intervention and control groups and the data collected and which group it relates to.
| 2498403 | ecrin-mdr-crc