Indigenous and immigrant populations’ use and experience of community pharmacies in New Zealand
Authors: Green JA et al
Summary: These researchers reviewed the literature on counselling in pharmacy and interaction length as an
indicator of counselling quality, focusing on what services indigenous (Māori) and immigrant populations use
pharmacies for, and length of interactions with pharmacy staff. 1,086 interactions were discretely observed in
36 pharmacies in 5 New Zealand cities. Māori or Pacific people, as well as men, were more likely to treat pharmacies
as prescription ‘depots’; they were less likely to buy over-the-counter or pharmacist-only medicines (ORs: 0.25 to
0.72). Demographic factors had scant influence upon interaction length (|B|s < 7.7 s). The study authors suggest
that the weak effect of ethnicity on interaction length indicates that pharmacies are providing advice of relatively
consistent quality to different population groups. They discuss possible barriers to use of pharmacies for primary
healthcare, including over-the-counter medicines in Māori and Pacific people.
Reference: J Immigr Minor Health. 2012 Jan 18. [Epub ahead of print]
Abstract
Results of a telehealth-enabled chronic care management service to support people with long-term conditions at home
Authors: Venter A et al
Summary: In this 12-month pilot investigation into the cultural acceptability of home-based remote telemonitoring
among patients with chronic health conditions, there were no clear differences in quality of life at the end of the
trial among those in the control group, whereas the telehealth group showed a consistent trend towards improved
quality of life on several instruments, including the SF-36, the St George Respiratory Questionnaire and the
K10 questionnaire; the improvement in the latter was significant. Hospitalisations were reduced in both the control
(–19%) and telehealth group (–25%). Patient interviews indicated that the technology was acceptable to most
patients and their families, including Māori.
Reference: J Telemed Telecare. 2012;18(3):172-5.
Abstract
Pilot of Te Tomokanga: a child and adolescent mental health service evaluation tool for an indigenous population
Authors: McClintock K et al
Summary: This paper reports outcomes of an evaluation into the self-administered Te Tomokanga survey, designed
to determine the cultural acceptability of Child and Adolescent Mental Health Services (CAMHS) for indigenous
populations. It incorporates questions that examine CAMHS delivery in light of the Whare Tapa Whā,1 a Māori
comprehensive model of health with a focus on whānau involvement and culturally responsive services. This mail or
telephone survey was completed by a cohort of 168 Māori whānau, whose children had been referred to one of the
three types of CAMHS, mainstream, bicultural, and kaupapa Māori,2 of the District Health Board in the Midland health
region, an area with a large Māori population with high levels of social deprivation. The Te Tomokanga instrument
was shown to have a similar factor structure to the North American questionnaire from which it had been derived.
It identified issues relevant to Māori whānau satisfaction with CAMHS. The work supports the concept that Māori
desire therapeutic methods consistent with the Whare Tapa Whā, such as whānau involvement and the importance
of recognising culture and spirituality. Participants were generally positive about the services they received from the
three different CAMHS types, which shows good acceptability of CAMHS for Māori. Satisfaction with CAMHS was
related to whānau involvement and culturally delivered services.
1. The Whare Tapa Whā framework relies on a Māori worldview of health, a holistic approach advocating a balance between the
four dimensions of the Taha Whānau (family), the Taha Tinana (physical), the Taha Hinengaro (cognitive or intellectual) and the Taha
Wairua (spiritual). It is believed if one aspect is in distress then it impacts on the others causing tension and increased risk of poor
health. Optimal health requires balance between all four dimensions.
2. Kaupapa Māori mental health services provide Māori dedicated clinical and cultural workforce for Māori service users.
Reference: Int Indigenous Policy J. 2012;3(1):5.
Abstract