The effect of a 12-week exercise and lifestyle management programme on cardiac risk reduction: A pilot using a kaupapa Māori philosophy

Abstract

Introduction: Cardiovascular disease remains the leading cause of premature death and disability for all New Zealanders. Māori, the Indigenous people of New Zealand, are disproportionately affected. The New Zealand Māori Health Strategy recognises that "health and wellbeing are influenced and affected by the 'collective' … and the importance of working with people in their social contexts, not just with their physical symptoms" (Ministry of Health, 2002, p. 1). In a Māori worldview, a holistic approach to health is innate. Objectives: This project piloted a kaupapa Māori approach within an existing 12-week clinical exercise and lifestyle management programme. The aims of the study were to determine the effectiveness of a kaupapa Māori 12-week exercise and lifestyle management programme on parameters of cardiac risk and quality of life. Methods: 12 Māori participants attended, 3 times per week over a 12-week period, for monitored, supervised, and individualised exercise. Participants performed a progressive aerobic-only programme for 6 weeks and then a combined aerobic and resistance training programme from weeks 7 through 12. Education sessions were chosen by participants. Results: There was a statistically significant improvement in waist circumference (-3.7 cm; p = .05), hip circumference (-4.6 cm; p = .03), systolic blood pressure (-22 mm Hg; p = .01), and HDL cholesterol (0.22 mmol/L; p = .01). In addition, physical (p = .05) and overall (p = .03) quality of life improved. Conclusion: A kaupapa Māori approach within a structured lifestyle management programme modifies cardiac risk parameters in Māori.

What makes community‐based physical activity programs for culturally and linguistically diverse older adults effective? A systematic review

“…20 Designing a culturally meaningful milieu is evident in numerous intervention studies with CALD or indigenous populations that did not meet all of the inclusion criteria for this integrative review. 10,[21][22][23][24][25][26] The included articles reported bespoke intervention programs 13,14,18 and modified versions of existing community programs 5,16,17,19 as culturally suitable for enrolling CALD older adults. Similarly, examples of robust bespoke 10 and modified mainstream 27 physical activity programs for indigenous populations have been reported in the literature.…”

“…Examples of programs that used culture‐specific design principles include a cardiorespiratory fitness study involving Pacific adults 9 that focused on engagement with Pacific church leaders and communities. Further, Rolleston, Doughty and Poppe 10 implemented a co‐designed Kaupapa Māori clinical exercise and lifestyle management program using a culture‐specific approach. Despite the availability of global and country‐specific physical activity guidelines and frameworks, physical inactivity in older adults contributes to the worldwide health burden.…”

COVID-19 Vaccine Hesitancy and Acceptance in a Cohort of Diverse New Zealanders

“…28 The broader literature has demonstrated that equitable health care delivery for Māori (and Pacific), such as with the immunisation programme, will require Māori governance and leadership, culturally-responsive health care delivery, resourcing of trusted community providers, and supports for access. [29][30][31][32] It is known that the current primary health care system in New Zealand fails to deliver on these points, and fails to meet legal obligations to Māori. 33 Ongoing attention needs to be paid to the critical combination of heightened risk of mortality and morbidity from COVID-19 disease for Māori (and Pacific) populations 13 and the systemic racism within New Zealand's health system that will result in inability to translate rates of vaccination intention into vaccine access and uptake.…”

Pounamu: Integration of kaupapa Mãori concepts in health research: a way forward for Mãori cardiovascular health?

“…Exemplar: The effect of a 12-week exercise and lifestyle management programme on cardiac risk reduction: A Pilot using a kaupapa Māori philosophy 12 We use as an exemplar the kaupapa Māori approach used in the above project, outlining how Māori ideals were applied within a western medical care setting. The project used a Māori methodological approach and consultation began before any formal proposal or ethics process.…”

“…Individualised exercise, nutrition and stress management programmes are prescribed based on an enrolment assessment and clinical measures have been fully described elsewhere. 12 The UC programme's framework was explained to participants and how to ground the programme in Māori beliefs and values was discussed with them. Within the interface space the 'new' programme was created and underpinned by Māori values while maintaining important clinical aspects including exercise prescription (frequency, intensity, modality), exercise supervision, education, and clinical measurements (e.g.…”