A Strength-Based and Peer Education Approach to helping Maori elders work through greatest needs

• Register: ANZCTR
• Last refreshed on: 26 June 2023
• Main ID: ACTRN12620000316909
• Date of registration: 06/03/2020
• Prospective Registration: Yes
• Primary sponsor: University of Waikato
• Public title: A Strength-Based and Peer Education Approach to helping Maori elders work through greatest needs
• Scientific title: Enhancing kaumatua wellbeing through tuakana-teina/peer-education: Impacts on health and mana motuhake (self-actualisation)
• Date of first enrolment: 22/06/2020
• Target sample size: 144
• Recruitment status: Completed
• URL: https://anzctr.org.au/ACTRN12620000316909.aspx
• Study type: Interventional
• Study design: Purpose: Treatment; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Other;
• Phase: Not Applicable

Countries of recruitment

New Zealand

Contacts

• Name: Prof Brendan Hokowhitu

• Name: Prof John Oetzel

Key inclusion & exclusion criteria

Inclusion criteria: Maori aged 55 or above who are registered/receive services at one of the following five service providers in New Zealand:

Tui Ora, Inc
Te Roopu Tautoko ki te Tonga Inc
Te Korowai Hauora o Hauraki
Poutini Trust Maori Development Organisation
Ngaruahine Health
Exclusion criteria: Severe forms of dementia and related cognitive impairment; any other health condition that a health professional suggests they shouldn't participate

Age minimum: 55 Years
Age maximum: No limit
Gender: Both males and females

Health Condition(s) or Problem(s) studied

Health-related quality of life;
Health-related quality of life

Public Health - Health promotion/education

Intervention(s)

This project uses a tuakana-teina (older sibling/younger sibling)/peer education orientation programme for service utilisation for health and wellbeing needs.

Through a co-design process we worked with five service providers to identify the key health and social issues particular to their community. Once these were defined, a resource kit and orientation programme was created to guide four kaumatua to be tuakana (peer educators) with each service provider. The tuakana then serve as tuakana for six teina for a period of six months. Teina are the recipients of the peer education.

The resource kit include a variety of health and social services to refer the teina. The Tuakana Orientation Programme is a training programme consisting of four, three-hour sessions over a two-week period (i.e., 2 sessions per week) guiding the tuakana on peer education skills from a Maori perspective (e.g., effective listening, eliciting information, sharing stories and providing advice/referrals).

After completing the orientation programme, tuakana will talk with teina once a month for six months to understand their needs and empower them to gain access to needed health and social services. Each conversation will last between 30 and 60 minutes and be face-to-face. They will share the resource kit with the teina and link them to advocates withing their respective health providers.

The aim is to select teina participants randomly from a list of elders within each provider. They are assigned an intervention time based on location and assigned a tuakana based on matching characteristics (i.e., age and gender).

Primary Outcome(s)

Health-related quality of life; 7 items self-report adapted from Medical Outcomes Study; Wu A, Revicki D, Jacobsen D, Malitz F. Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV health survey (MOS-HIV). Qual Life Res. 1997; 6:481-93.[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up (primary timepoint for first group); post-second group intervention assessment of outcomes 12 months follow-up`(primary timepoint for second group)]

Received social support; 4 items self-report from Unger JB, McAvay G, Bruce ML, et al. Variation in the impact of social network characteristics on physical functioning in elderly persons: MacArthur Studies of Successful Aging. Journals of Gerontology Series B-Psychological Sciences & Social Sciences 1999;54(5):S245-51[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up (primary timepoint for first group); post-second group intervention assessment of outcomes 12 months follow-up`(primary timepoint for second group)]

Service utilisation and satisfaction with use; 3 items self-report created for this study[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up (primary timepoint for first group); post-second group intervention assessment of outcomes 12 months follow-up`(primary timepoint for second group)]

Secondary Outcome(s)

Sense of purpose; 3 item self-report scale: Windsor, T., Curtis, R., & Luszcz, M.A. (2015). Sense of purpose as a psychological resource for aging well. Developmental Psychology, 51, 975-986.[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up; post-second group intervention assessment of outcomes 12 months follow-up]

Cultural connection; 3 items from LiLAC NZ study; Dyall, L., Kepa, M., Teh, R., Mules, R., Moyes, S., Wham, C., et al. (2014). Cultural and social factors and quality of life of Maori in advanced age. Te puawaitanga o nga tapuwae kia ora tonu—Life and living in advanced age: a cohort study in New Zealand (LiLACS NZ). NZ Medical Journal, 127, 62-79[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up; post-second group intervention assessment of outcomes 12 months follow-up]

Elder abuse; adapted from Vulnerability to Abuse Screening Scale, coercion subscale; Schofield MJ, Reynolds R, Mishra GD, Powers JR, Dobson AJ. Screening for vulnerability to abuse among older women: Women’s Health Australia Study. J Appl Gerontol. 2002;21(1):23-4. [Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up; post-second group intervention assessment of outcomes 12 months follow-up]

Housing and financial issues; self-report with 4 items adapted from Te Kupenga (2 items) and created for this study (2 items)[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up; post-second group intervention assessment of outcomes 12 months follow-up]

Mana motuhake (identity, autonomy): 1 item self-report from Te Kupenga Maori Social Survey measuring perceived autonomy--http://www.stats.govt.nz/survey-participants/a-z-of-our-surveys/te-kupenga-2013-questionnaire.aspx[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up; post-second group intervention assessment of outcomes 12 months follow-up]

Mana motuhake: 1 item self-report from Cantril's ladder for life satisfaction; Cantril, H. (1965). The pattern of human concerns. New Brunswick, NJ: Rutgers University Press[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up; post-second group intervention assessment of outcomes 12 months follow-up]

Loneliness; Maori loneliness scale; .Waldegrave, C., Cunningham, C., Love, C. and Nguyen, G. (2019) Developing a Maori Loneliness Scale: Work in progress, in Older Maori Co-creating Research on Loneliness and Social Isolation: Challenging Western Perspectives. A presentation to the Ageing Well Together: Science, Policy and Translation Conference at Te Wharewaka, Wellington. Friday 15 November 2019. Wellington: Family Centre Social Policy Research Unit[Pre-intervention assessment of outcomes; post first group-intervention assessment of outcomes==6 months follow-up; post-second group intervention assessment of outcomes 12 months follow-up]

Secondary ID(s)

Nill

Source(s) of Monetary Support

Ministry of Business Innovation and Employment --Ageing Well National Science Challenge

Ethics review

Status: Approved
Approval date: 18/12/2019
Contact:

Human Research Ethics Committee, University of Waikato

Results

• Results available: Yes
• Date Posted: 17/09/2021
• Date Completed: 31/03/2022