Evaluating a healthy eating, healthy action program in small M?ori communities in Aotearoa, New Zealand
Christine Mercer A D , Denise Riini A , Heather Hamerton B , Laurie Morrison C and Brighid McPherson AA Waiariki Institute of Technology, Te Puna Whai Ora, School of Nursing and Health Studies, Private Bag 3028, Rotorua 3046, New Zealand.
B Taiorangahau Pacific Coast Applied Research Centre, Bay of Plenty Polytechnic, Private Bag 12001, Tauranga 3143, New Zealand.
C Morrison Consultants Ltd, 1 Ariariterangi Street, Rotorua 3046, New Zealand.
D Corresponding author. Email: Christine.Mercer@boppoly.ac.nz
Australian Journal of Primary Health 19(1) 74-80 https://doi.org/10.1071/PY11096
Submitted: 15 August 2011 Accepted: 7 February 2012 Published: 29 March 2012
Abstract
Evidence from health surveys have identified that Māori, the indigenous people of Aotearoa New Zealand, experience a high incidence of obesity with physical and social implications. In 2000, the New Zealand Government introduced a strategy aimed, among other objectives, at improving nutrition, increasing physical activity and reducing obesity through a ‘Healthy Eating Health Action’ (HEHA) strategy. As part of the HEHA strategy, a Māori primary health organisation (PHO) in a regional centre of Aotearoa, New Zealand, developed a program aimed at improving the health of the local Māori communities. The program, called Project REPLACE, invited participants to gradually change their behaviour by replacing behaviours potentially detrimental to health with a healthier alternative. Between 2009 and 2010 a team of researchers evaluated the program, taking care to use Māori approaches when conducting the research. The findings from the evaluation were that each community was innovative in their approaches to implementing Project REPLACE, drawing on their culture to combine healthy eating with increased exercise activities as well as measurements of achievement. The relationship that each coordinator had with the community was pivotal to the success of the program. Project REPLACE highlighted the importance of Māori ownership and control of health initiatives.
References
Bay of Plenty District Health Board (2007) Request for delivery of a research and evaluation programme for Project REPLACE – Healthy Eating Healthy Action initiative in the Western Bay of Plenty 2008–2010. (Bay of Plenty District Health Board: Tauranga, NZ)Berry D, Savoye M, Melkus G, Grey M (2007) An intervention for multiethnic obese parents and overweight children. Applied Nursing Research 20, 63–71.
| An intervention for multiethnic obese parents and overweight children.Crossref | GoogleScholarGoogle Scholar | 17481469PubMed |
Bishop R (1996) Addressing issues of self-determination and legitimation in kaupapa Māori research. In ‘He paepae kōrero: research perspectives in Māori education’. (Ed. B Webber) pp. 143–160. (New Zealand Council for Educational Research: Wellington, NZ)
Bishop R, Glynn T (1999) ‘Culture counts: changing power relations in education.’ (Dunmore Press: Palmerston North, NZ)
Blakely T, Kawachi I, Atkinson J, Fawcett J (2004) Income and mortality: the shape of the association and confounding New Zealand Census-Mortality Study, 1981–1999. International Journal of Epidemiology 33, 874–883.
| Income and mortality: the shape of the association and confounding New Zealand Census-Mortality Study, 1981–1999.Crossref | GoogleScholarGoogle Scholar | 15155699PubMed |
Boynton-Jarrett R, Thomas TN, Peterson KE, Wiecha J, Sobol AM, Gortmaker SL (2003) Impact of television viewing patterns on fruit and vegetable consumption among adolescents. Pediatrics 112, 1321–1326.
| Impact of television viewing patterns on fruit and vegetable consumption among adolescents.Crossref | GoogleScholarGoogle Scholar | 14654604PubMed |
Burns R (2000) Introduction to research methods (4th edn) (Pearson Education Australia: Frenchs Forest NSW)
Caudwell P, Hopkins M, King NA, Stubbs RJ, Blundell JE (2009) Exercise alone is not enough: weight loss also needs a healthy (Mediterranean) diet? Public Health Nutrition 12, 1663–1666.
| Exercise alone is not enough: weight loss also needs a healthy (Mediterranean) diet?Crossref | GoogleScholarGoogle Scholar | 19689837PubMed |
Cram F (2001) Rangahau Māori: Tona tika, tona pono – the validity and integrity of Māori research. In ‘Research ethics in Aotearoa New Zealand’. (Ed. M Tolich) pp. 35–52. (Pearson Education New Zealand: Auckland, NZ)
Denscombe M (2003) ‘The good research guide (2nd edn).’ (Open University Press: Glasgow)
Durie M (2001) ‘Mauri ora: the dynamics of Māori health.’ (Oxford University Press: Auckland, NZ)
Ellis R (2004) ‘Enhancing Māori wellbeing through a critical engagement with social marketing: Tauranga Moana speaks out.’ (University of Waikato at Tauranga: Tauranga, NZ)
Hamerton H, McPherson B, Mercer C, Morrison L, Riini D (2010) Project REPLACE in the Western Bay of Plenty. Final evaluation report. Prepared for the Ministry of Health and Bay of Plenty District Health Board. Ref: 323315/00.
Jahnke H, Taiapa J (2003) Māori research. In ‘Social science research in New Zealand: many paths to understanding’. (Eds C Davidson, M Tolich) pp. 39–50. (Pearson Education: Auckland, NZ)
Kline S (2004) ‘Sedentary lifestyle or fast food culture? Lessons from the battle of the bulge. Umashankar Shastri in fast food industry – issues and implications.’ [Executive Reference Books, Institute of Chartered Financial Analysts of India (ICFAI University): India]
Laverack G, Labonté R (2000) A planning framework for community empowerment goals within health promotion. Health Policy and Planning 15, 255–262.
| A planning framework for community empowerment goals within health promotion.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M%2FnslyhsA%3D%3D&md5=d24a5a73288aaafeba40f0677bbd46e5CAS | 11012399PubMed |
Lincoln Y, Guba E (1985) ‘Naturalistic inquiry.’ (Sage: Beverly Hills, CA)
Maclellan DL, Gottschall-Pass K, Larsen R (2004) Fruit and vegetable consumption: benefits and barriers. Canadian Journal of Dietetic Practice and Research 65, 101–105.
| Fruit and vegetable consumption: benefits and barriers.Crossref | GoogleScholarGoogle Scholar | 15363114PubMed |
Marín-Guerrero AC, Gutiérrez-Fisac JL, Guallar-Castillón P, Banegas JR, Rodríguez-Artalejo F (2008) Eating behaviours and obesity in the adult population of Spain. The British Journal of Nutrition 100, 1142–1148.
| Eating behaviours and obesity in the adult population of Spain.Crossref | GoogleScholarGoogle Scholar | 18377684PubMed |
Ministry of Health (2000) ‘New Zealand Health Strategy.’ (Ministry of Health: Wellington, NZ)
Ministry of Health (2003) ‘Healthy eating – healthy action: a strategic framework.’ (Ministry of Health: Wellington, NZ)
Ministry of Health (2006) ‘Embodying social rank: how body fat varies with social status, gender and ethnicity in New Zealand. Public health intelligence: occasional bulletin No. 34.’ (Ministry of Health: Wellington, NZ)
Ministry of Health (2007) ‘Diabetes surveillance: population-based estimates and projections for New Zealand, 2001–2011. Public health intelligence occasional bulletin No. 46.’ (Ministry of Health: Wellington, NZ)
Ministry of Health (2008) ‘A portrait of health: key resulted of the 2006/07 New Zealand health survey.’ (Ministry of Health: Wellington, NZ)
Ministry of Social Development (2001) ‘New Zealand Disability Strategy.’ (Ministry of Social Development: Wellington, NZ)
Ministry of Social Development (2010) ‘The Social Report.’ (Ministry of Social Development: Wellington, NZ)
Paradis A, Godin G, Pérusse L, Vohl M (2008) Dietary intakes and family history of obesity. Canadian Journal of Dietetic Practice and Research 69, 97–100.
| Dietary intakes and family history of obesity.Crossref | GoogleScholarGoogle Scholar | 18538063PubMed |
Powick K (2002) Māori research ethics: a literature review of the ethical issues and implications of kaupapa Māori research and research involving Māori for researchers, supervisors and ethics committees. (Wilf Malcolm Institute of Educational Research, School of Education, University of Waikato: Hamilton, NZ)
Robson B, Purdie G (2007) Mortality. In ‘Hauora: Māori standards of health IV. A study of the years 2000–2005’. (Eds B Robson, R Harris) pp. 33–61. (Te RopūRangahau Hauora a Eru Pōmare: Wellington, NZ)
Semmler C, Ashcroft J, van Jaarsveld CH, Carnell S, Wardle J (2009) Development of overweight in children in relation to parental weight and socioeconomic status. Obesity 17, 814–820.
| Development of overweight in children in relation to parental weight and socioeconomic status.Crossref | GoogleScholarGoogle Scholar | 19165162PubMed |
Simmons D, Voyle J (2003) Reaching hard-to-reach, high-risk populations: piloting a health promotion and diabetes disease prevention programme on an urban marae in New Zealand. Health Promotion International 18, 41–50.
| Reaching hard-to-reach, high-risk populations: piloting a health promotion and diabetes disease prevention programme on an urban marae in New Zealand.Crossref | GoogleScholarGoogle Scholar | 12571091PubMed |
Smith LT (1999) ‘Decolonizing methodologies: research and indigenous peoples.’ (Zed Books: London)
Stokes E (1985) ‘Māori research and development: discussion paper.’ (Social Sciences Committee of the National Research Advisory Council: Wellington, NZ)
Thomas D (2006) Case study as a method of research. In ‘Encyclopedia of nursing research (2nd edn)’. (Eds J Fitzpatrick, M Wallace) pp. 61–63. (Springer Publishing Company: New York, NY)
Tucker CM, Butler AM, Loyuk IS, Desmond FF, Surrency SL (2009) Predictors of a health-promoting lifestyle and behaviors among low-income African American mothers and white mothers of chronically ill children. Journal of the National Medical Association 101, 103–110.
Walton M, Signal L, Thomson G (2009) Household economic resources as a determinant of childhood nutrition: policy responses for New Zealand. Social Policy Journal of New Zealand 36, 194–207.
Yin R (2003) ‘Case study research (3rd edn).’ (Sage Publications: Thousand Oaks, CA)