Introduction:Community-engaged research/community-based participatory research/patient-engaged research (CEnR/CBPR/PEnR) are increasingly recognized as important approaches for addressing health equity. However, there is limited support for CEnR/CBPR/PEnR within Academic Health Centers (AHCs). It is important for AHCs to measure and monitor the context, process, and policies in support for CEnR/CBPR/PEnR. The Engage for Equity (E2) team developed the first Institutional Multi-Sector Survey (IMSS) instrument to assess and explore CEnR/CBPR/PEnR-related practices at three AHCs. Methods:Working with "champion teams" consisting of academic leaders, researchers, and patient/community partners at each AHC, we developed the IMSS to assess the following domains: institutional mission, vision, and values; CEnR/CBPR/PEnR policies/practices; community processes/structures; function of formal community advisory boards; climate/culture for CEnR/CBPR; perceptions of institutional leadership for CEnR/CBPR/PEnR. The survey was piloted to a convenience sample of CEnR/CBPR/PEnR participants at each AHC site. Results:A sample aggregated across all sites consisting of community (n = 49) and academic (n = 50) participants perceived high levels of advocacy for CEnR/CBPR/PEnR among their AHC research teams. Participants indicated that institutional leadership supported CEnR/CBPR/PEnR in principle, but resources to build CEnR/CBPR/PEnR capacity at their respective institutions were lacking. Differences in responses from community and academic partners are summarized. Conclusions:While limited by survey length and question adaptation, the findings contribute to identification of institutional barriers and facilitators to CEnR/CBPR/PEnR in AHCs. These findings are critically important to support and improve CEnR/CBPR/PEnR practice in academic institutions and to elevate community partner voices and needs for advancing community and patient partners' research.

Introduction:Community-based participatory research (CBPR) and patient/ community engaged research (P/CEnR) are shown to be effective approaches that improve health inequities, particularly among disadvantaged populations. While the science of CBPR demonstrates promising partnering practices that lead to effective interventions, there are institutional and structural barriers to creating and sustaining patient/community research within academic health centers (AHCs). As the field matures, there is a growing need to enhance patient/community leadership so that communities can set their own research agendas and priorities. Methods:Engage for Equity PLUS sought to address these challenges by implementing an engagement intervention aimed at transforming AHCs through supporting champion teams of academic, community, and patient partners to strengthen research infrastructures for P/CEnR. This paper uses a qualitative, case study analysis to describe how E2PLUS enabled champion teams at Stanford School of Medicine, Fred Hutchinson/University of Washington Cancer Consortium, and Morehouse School of Medicine to pursue institutional change strategies through coaching, workshops, contextual data analysis, and a community of practice. Results:This paper describes key themes of how E2Plus helped identify targets of change by a) using institutional data collection as core to generating critical consciousness of contextual conditions; b) implementing feasible E2PLUS strategies to leverage conditions for catalyzing a champion team for advocacy and achievable actions; c) identifying the critical role of patients/community members in stimulating change; and d) the role of continual collective reflection. Conclusion:We discuss the overall implications for E2 PLUS for other AHCs working toward sustainable community/patient engaged research policies and practices.

Housing inequities are a growing global crisis. In Aotearoa New Zealand (Aotearoa), M & amacr;ori (Indigenous population) are severely impacted by this crisis due to contradictory ontologies and ideologies within the housing sector relating to Indigenous and Western viewpoints. Therefore, the purpose of this study was to investigate barriers and navigators for stakeholders involved in urban papak & amacr;inga (modern M & amacr;ori housing, sustainable city-based intergenerational ecosystem). Twenty in-depth, semi-structured interviews were conducted with urban papak & amacr;inga leaders. The barriers identified included the funding application process and procedure. Navigators included six ontological principles: whakakitenga (holistic visioning), whakawhanaungatanga (gathering and weaving alliances), honongatanga (solidifying professional partnerships), tohungatanga (forming specialist papak & amacr;inga management), whakaponotanga (creating harmony through trust, truth, and honesty), and kotahitanga (establishing unity through kinship and oneness). The significance of investigating barriers and navigators from the perspective of Indigenous housing leadership is to identify strategies that support development of sustainable and culturally-sound urban environments. Theoretical implications include housing developments for Aotearoa, other First Nation and Indigenous communities.

Urban papakāinga is a modern form of housing that involves sustainable, city-based intergenerational habitation that adheres to tikanga (cultural practices) of integrating people, spirituality, and nature for Māori (Indigenous people of Aotearoa New Zealand). The aim of this study was to identify how urban papakāinga leaders and managers integrate spirituality and balance with nature during housing development processes as a management ontology. This aim was achieved through application of an Indigenous methodological framework during an investigation of urban papakāinga stakeholders (N=25). Thematic analysis recognised a key ontologic principle consistent with traditional tikanga which facilitates urban papakāinga enterprise: tauwhirotanga (spirit, or wairua-based, empathy infused, strategic management approach). It is comprised of three parts: empathetic concern and regard, empathetic autonomy and expression, and holism within organisation and design throughout development and post completion. Tauwhirotanga guides the process for developing Māori housing ecosystems within the constraints of mainstream ideology.

Adverse childhood experiences (ACEs) can contribute to housing instability and risk of homelessness, featuring disproportionately in the life histories of many people experiencing homelessness. However, little is known about the prevalence and lifelong impact of ACEs among people experiencing homelessness in New Zealand, a country experiencing increasing homelessness levels amid a housing affordability crisis. Drawing on data from 100 questionnaire surveys and 11 interviews with participants registered with The People's Project, a Housing First homeless service in Hamilton, we explore the prevalence and role of ACEs in homeless journeys, identifying a common pathway to homelessness among participants. Some varying factors contributing additionally for M & amacr;ori (indigenous people) were identified. Our findings showed ACEs were commonly reported by participants, often preceding a series of disruptive events across participants' lives. Accumulations of adverse events, coupled with structural and other constraints, contributed to housing insecurity across lifespans. Results highlight the importance of trauma-informed homelessness initiatives, such as Housing First, as well as measures aimed at reducing upstream drivers of homelessness such as poverty, structural racism, and the ongoing impacts of colonisation in New Zealand.

As the interest in sustainable development increases, businesses can benefit from aligning their orientation with the Sustainable Development Goals (SDGs). It remains unclear, however, how focusing on a broader or narrower set of SDGs affects enterprises' economic performance. This study examines the impact of a communicated SDG orientation on the economic performance of social enterprises and traditional commercial businesses. Using natural language processing (NLP) techniques to analyse textual content from 661 enterprises' websites, we found a positive relationship between the communication of a narrow set of SDGs and enterprises' economic performance. The extent of this effect is similar between social and traditional commercial enterprises. Therefore, stakeholders may value an enterprise's SDG orientation strategy that focuses on a narrow set of SDGs in distinct purpose-driven institutional contexts.

Background Addressing health inequities that Māori (Indigenous peoples) communities face in New Zealand is a key aim of researchers and practitioners. However, there is limited understanding of the implementation processes and outcomes of health programmes for addressing these inequities. The aim of this study was twofold: (a) to identify correlates of implementation outcomes and (b) to identify facilitators and barriers to implementation effectiveness. Methods The study involved a concurrent mixed method approach. Through an online survey, 79 participants with experience in implementing a health programme with a Māori community identified outcomes and processes of the programme. Additionally, nine Māori community providers shared their perceptions and experience of facilitators and barriers to implementation effectiveness through an in-depth interview. The quantitative and qualitative findings were integrated to address the aims of the study. Results For the first aim, we identified two key outcomes: overall health impacts and sustainability. Three of the variables had significant and positive bivariate correlations with health impacts: cultural alignment, community engagement, and individual skills. The only significant correlate of sustainability was evidence-based. For the second aim, participants described four facilitators (leadership, whanaungatanga [relationships], sharing information, digestible information) and four barriers (system constraints, lack of funding, cultural constraints, lack of engagement) to effective implementation. Conclusion Overall, leadership, aligning culture, and building on whanaungatanga, while getting financial resources and systems support, are the core elements to supporting implementation efforts in Māori communities.

Background There are significant inequities between Māori (Indigenous people) and non-Māori in ageing outcomes. This study used a strengths-based approach based on the key cultural concept of mana motuhake (autonomy and self-actualisation) to develop a tuakana-teina (literally older sibling-younger sibling) peer education programme to assist kaumātua (elders) in addressing health and social needs. The purpose of this study was to test the impact on those receiving the programme. Three aims identify the impact on outcomes, resources received and the cost effectiveness of the programme. Methods Five Kaupapa Māori (research and services guided by Māori worldviews) iwi (tribe) and community providers implemented the project using a partnership approach. Tuakana (peer educators) had up to six conversations each with up to six teina (peer learners) and shared information related to social and health services. A pre- and post-test, clustered staggered design was the research design. Participants completed a baseline and post-programme assessment of health and mana motuhake measures consistent with Māori worldviews. Open-ended questions on the assessments, five focus groups, and four individual interviews were used for qualitative evaluation. Findings A total of 113 kaumātua were recruited, and 86 completed the programme. The analysis revealed improvements in health-related quality of life, needing more help with daily tasks, life satisfaction, paying bills and housing problems. Qualitative results supported impacts of the programme on mana motuhake and hauora (holistic health) through providing intangible and tangible resources. Cost-effectiveness analysis showed that the intervention is cost effective, with a cost per QALY of less than the conventional threshold of three times GDP per capita. Conclusions A culturally-resonant, strengths-based programme developed through a participatory approach can significantly improve health and social outcomes in a cost-effective way. Trial Registry Clinical trial registry : Trial registration: (ACTRN12620000316909). Prospectively registered 06/03/2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379302&isClinicalTrial=False .

Abstract Background The current study is a case study of a Māori (Indigenous people of New Zealand) organisation and their developmental processes in creating a kaumātua (older people) housing village for health and social wellbeing. This study identifies how a set of established co-design and culturally-centred principles were enacted when creating and developing the village. Method A mixed-method concurrent design was used in creating the case with interviews (n = 4), focus groups (N = 4 with 16 total participants) and survey questionnaires (n = 56) involving kaumātua and organisation members. Results Survey results illustrate that suitable and affordable housing are associated with self-rated health, loneliness, and life satisfaction. The primary purpose of the housing village was to enable kaumātua to be connected to the marae (community meeting house) as part of a larger vision of developing intergenerational housing around the marae to enhance wellbeing. Further, key themes around visioning, collaborative team and funding, leadership, fit-for-purpose design, and tenancy management were grounded in cultural elements using te ao Māori (Māori worldview). Conclusion This case study illustrates several co-design and culturally-centred principles from a previously developed toolkit that supported the project. This case study demonstrates how one community enacted these principles to provide the ground for developing a housing project that meets the health and social wellbeing of kaumātua.

Cultural targeting and tailoring are different, yet they remain intertwined in the literature inhibiting theory development and limiting the possibility of determining their effects. This preregistered systematic literature review describes these constructs and provides a framework for cultural tailoring with evidence from a review of 63 studies, published from 2010 to 2020, to characterize the processes, elements, and theories used in the existing literature. The results show that 86% of studies self-defined as cultural tailoring, but coding revealed relatively few tailoring studies (25%) with 31% including both tailoring and targeting elements. Most studies used outreach and consultation as processes for tailoring or targeting with participatory approaches used in a fifth of the studies. Surface-level features of message content were commonly used to tailor or target with deep-cultural-values found in only a quarter of the studies. We argue from theories of communication accommodation and persuasion that cultural tailoring or targeting may provide gains in attention, recall, or source evaluation.

Safe, secure, suitable housing is often an unattainable reality for kaumatua (older Maori aged 55 years and over in this study) in Aotearoa New Zealand. Kaumatua, unfortunately, are at the forefront of the housing crisis, and struggle to find housing which meets their most basic needs. Therefore, many organisations are considering the development of urban papakainga to meet their needs. The purpose of this study is to assess the needs of kaumatua currently in temporary, emergency or state housing situations to understand their perspectives about what factors enable successful urban papakainga. The research design and methodology in this article apply a multi-method observational approach, guided by the He Pikinga Waiora (HPW) Implementation Framework. The main findings in this study include five cultural characteristics necessary within urban papakainga developments; whanaungatanga (connections); kaitiakitanga (environmental care/ guardianship); manaakitanga (care for others); rangatiratanga (leadership, autonomy, or control); and haumarutanga (safety/security). In addition, key correlates of wellbeing indicators included housing suitability, community connection and a safe neighbourhood. These key needs and perspectives have important theoretical and practical implications for kaumatua wellbeing, and successful housing developments for Maori.Glossary of Kupu Maori words: Aotearoa: Maori name of New Zealand; haumarutanga: security, safety, or peace of mind; kaitiakitanga: environmental care, guardianship, or stewardship; kaumatua: older Maori aged 55 years and over; kaupapa Maori: Maori approach; koroua: older male; kuia: older female; manaakitanga: generosity, cherish, respect, care and hospitality; Maori: Indigenous people of Aotearoa-NZ; papakainga: traditional Maori housing/community complex; Papatuanuku: Earth Mother; rangatiratanga: leadership, self-determination, autonomy, or control; Te Puawaitanga o Nga Waka: The Blossoming of Aspirations for All; tikanga: correct custom, procedure, or protocol; turangawaewae: a place of strength, belonging, connection, a place to stand; urban papakainga: modern Maori housing/urban intergenerational village; wairuatanga: spirituality; whakapapa: decent, lineage, ancestor, or genealogy; whanau: family or closely connected kin group; whanaungatanga: connectedness, kinship, or relationships

A common strategy characterises the various methods independently defined to identify almost unambiguously different types of RNA molecules in DNA fragments. So far, the good quality of detection of RNA motif has been the prior motivation and effectively delayed the optimisation of programs. As an illustration of possible improvements, a modified version oftRNAscanis described. The previous algorithm was altered to run 500 times faster and to lower both rates of false positives and false negatives. The newly sequenced genome ofSaccharomyces cerevisiaeis scanned both ways in less than three minutes and results match annotations found in databanks with three exceptions, two of which being arguably not real tRNAs.

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.

Tuhinga whakarāpopoto (Abstract) Poor, unaffordable and overcrowded housing among Māori in Aotearoa New Zealand is one of the converging societal trends to impact significantly on older Māori ageing in place and in age-friendly environments. Some kaupapa Māori (Māori approach) organisations have sought to develop kaumātua (elders) villages to address these challenges. From the study of one such village, a toolkit of successful practices was developed. The purpose of this article is to describe the research design and methods for a project that will use this toolkit to develop community determined villages in three additional communities. The research approach involves process evaluation using photovoice, interviews, wānanga (consultation meetings) seminars and meeting’s notes, along with summative evaluation using surveys. The research process is grounded in a culture-centred and co-design approach with a vision underpinned by tikanga Māori (Māori custom) and te ao Māori (Māori world) that will be shared with others through a revised toolkit.

COPYRIGHT © 2023 Eder, D’Alonzo, Yonas and Oetzel. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Editorial: Examining community-engaged and participatory research programs and projects

Background: There is growing interest in palliative care within Indigenous communities, and within Aotearoa New Zealand, of the significant role that Māori (Indigenous people) families play in caring for older relatives. This study explored the centrality of culture in how Māori extended families ( whānau) in Aotearoa New Zealand interpret and enact family-based care roles within the Māori world ( Te Ao Māori). Methods: Applying Māori-centered and community-based participatory research principles, we examined 17 interviews with older Māori who shared experiences of palliative care for a partner or family member. The thematic analysis used a cultural-discursive framework incorporating Māori principles of wellbeing and values expressed within the care relationship. Results: The findings centered on three whānau roles in palliative care: whānau as (1) Holders and protectors of Māori knowledge; (2) Weavers of spiritual connection; and (3) Navigators in different worlds. Conclusion: The study problematizes the notion of a single ‘primary caregiver’, privileges whānau as an inter-woven relational, dynamic care network, and encourages health professionals to recognize the cultural embeddedness of dominant approaches to palliative care.

Background: There is growing interest in palliative care within Indigenous communities, and within Aotearoa New Zealand, of the significant role that Māori (Indigenous people) families play in caring for older relatives. This study explored the centrality of culture in how Māori extended families ( whānau ) in Aotearoa New Zealand interpret and enact family-based care roles within the Māori world ( Te Ao Māori ). Methods: Applying Māori-centered and community-based participatory research principles, we examined 17 interviews with older Māori who shared experiences of palliative care for a partner or family member. The thematic analysis used a cultural-discursive framework incorporating Māori principles of wellbeing and values expressed within the care relationship. Results: The findings centered on three whānau roles in palliative care: whānau as (1) Holders and protectors of Māori knowledge; (2) Weavers of spiritual connection; and (3) Navigators in different worlds. Conclusion: The study problematizes the notion of a single ‘primary caregiver’, privileges whānau as an inter-woven relational, dynamic care network, and encourages health professionals to recognize the cultural embeddedness of dominant approaches to palliative care. Keywords care roles , culture-centered approach , family care , Indigenous , ,

Background Community-Based Participatory Research (CBPR) is often used to address health inequities due to structural racism. However, much of the existing literature emphasizes relationships and synergy rather than structural components of CBPR. This study introduces and tests new theoretical mechanisms of the CBPR Conceptual Model to address this limitation. Methods Three-stage online cross-sectional survey administered from 2016 to 2018 with 165 community-engaged research projects identified through federal databases or training grants. Participants ( N = 453) were principal investigators and project team members (both academic and community partners) who provided project-level details and perceived contexts, processes, and outcomes. Data were analyzed through structural equation modeling and fuzzy-set qualitative comparison analysis. Results Commitment to Collective Empowerment was a key mediating variable between context and intervention activities. Synergy and Community Engagement in Research Actions were mediating variables between context/partnership process and outcomes. Collective Empowerment was most strongly aligned with Synergy, while higher levels of Structural Governance and lower levels of Relationships were most consistent with higher Community Engagement in Research Actions. Conclusions The CBPR Conceptual Model identifies key theoretical mechanisms for explaining health equity and health outcomes in community-academic partnerships. The scholarly literature’s preoccupation with synergy and relationships overlooks two promising practices—Structural Governance and Collective Empowerment—that interact from contexts through mechanisms to influence outcomes. These results also expand expectations beyond a “one size fits all” for reliably producing positive outcomes.

Background Despite incremental gains in the Aotearoa New Zealand health sector, Māori and Pacific peoples still experience poorer health outcomes than non-Māori and non-Pacific. Access to the latest research and innovation is critical to improving and addressing health outcomes and health inequities in particular. However, there are numerous challenges to translating research into practice including that there is currently no known a specific infrastructure in Aotearoa New Zealand to facilitate this process. The aim of the project is to develop a network of community providers, researchers and health systems representatives that can help facilitate the implementation of novel and innovative programmes and products that help to meet the health needs of Māori and Pacific communities. Methods This project has three stages, one of which has been completed. In Stage 1, we engaged with key leaders of organisations from various components in the health system through a co-design process to identify parameters and infrastructure of the network. In Stage 2, we propose to construct the network involving approximately 20–30 community providers (and other affiliated researchers and health system representatives) and refine its parameters through an additional co-design process. Additionally, we will use a mixed methods research design using survey and interviews to identify perceived implementation needs, facilitators and barriers to help inform the work in the third stage. In Stage 3, we will support the active implementation of evidence-based programmes with a smaller number of providers (approximately four to eight community providers depending on the complexity of the implementation). Mixed methods research will be conducted to understand facilitators and barriers to implementation processes and outcomes. Discussion The proposed network infrastructure is an equity-oriented strategy focused on building capacity through a strength-based approach that can help address inequities over time. Our “proof-of-concept” study will not be able to change inequities in that time period given its relatively small scale and time period, but it should set the foundation for continued equity-oriented work.

Health 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. The 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. The 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. This 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. The project was registered on 6 March 2020 with the Australia New Zealand Clinical Trial Registry: ACTRN12620000316909 . Prospectively registered.