Diabetes: Waikato University researcher determined to change health outcomes for Māori

Research officer and kaiāwhina at the University of Waikato's Medical Research Centre, Rebekah Crosswell. Photo / University of Waikato

Māori are disproportionately affected by Type 2 diabetes, with significantly poorer outcomes and higher mortality rates, but University of Waikato research officer Rebekah Crosswell (Whakatōhea) is determined to help even the odds for Māori patients.

Crosswell has been awarded a Health Research Council of New Zealand career development grant of $107,120, which will fund the research project Matauranga o Mate Huka - Creation of Type 2 Diabetes Resources, which looks into more culturally relevant educational resources.

Crosswell says self-management is critical for patients with Type 2 diabetes, but its effectiveness relies on patients understanding what is needed.

“Educational materials are an incredibly important way of helping patients understand a disease and how to manage it, but in Aotearoa, Type 2 diabetes resources are often lacking, outdated and culturally inappropriate for those who need them most.”

“The grant will fund research into what more effective healthcare education and resources would look like,” Crosswell said.

“I want to use te ao Māori principles and tikanga, including whakawhanaungatanga, tino rangatiratanga and Te Whare Tapa Wha, to analyse the existing materials and to understand what opportunities exist for improvement.”

At the heart of the research project is the need to address long-standing inequities in healthcare for Māori.

Crosswell says one of the biggest barriers to developing effective education tools is health literacy: the capacity to find, understand and use information to make effective decisions for one’s wellbeing.

“It has been identified that many Māori have reduced health literacy. This shows there is a greater need for health education that is focused on working with Māori populations,” Crosswell said.

That’s why Crosswell wants to ensure the study is designed by Māori, for Māori, so she is planning a multi-phased approach with patient interviews and a collaborative survey with Hauraki Primary Health Organisation.

“I want to ensure whānau gain real benefit from this study, that it is conducted in a culturally safe and sensitive way, and that whānau have an active role to play in their ongoing hauora journey.”

With the data from the survey and interviews, Crosswell will determine new directions for tailoring culturally relevant resources that are taking a more visual approach.

“We know that internationally, indigenous populations have shown success with health education when using visual approaches like pictures and video – and particularly those that reference foods and locations that are familiar to them.”

For the research project, Crosswell is being mentored by several University of Waikato researchers, including Associate Professor of Health Dr Lynne Chepulis and Professor of Population Health, Dr Ross Lawrenson.