ISSN 1178-6191

Maori Health Review

Making Education Easy Issue 54 – 2015

Maori Health Review
Maori Health Review
Maori Health Review

Facilitating access to effective and appropriate care for youth with mild to moderate mental health concerns in New Zealand

Authors: Clark TC et al.

Summary: This group of researchers employed a quasi-experimental pre-/postintervention design to explore the impact of facilitated access to free counselling support amongst 581 culturally diverse youth aged 10–24 years. The research using the following outcome measures: Strengths and Difficulties Questionnaire (SDQ), Substance Abuse Choices Scale (SACS), Children’s Global Assessment Scale (C-GAS), as well as consumer feedback questionnaires. Those participants who completed the intervention reported significant improvements from baseline in global social and psychiatric functioning measured by C-GAS (p<0.001), a reduced risk of clinically significant mental health concerns measured by the SDQ (p<0.001), and reductions in the use and impact of drugs/alcohol as measured by SACS scores (p<0.001). Participants and their families/whānau perceived the interventions to be safe and appropriate, resulting in increased skill development around coping and communication.

Comment: Great to see the development, testing, and effectiveness of an intervention based on the findings from the Youth Health Survey.

Reference: J Child Adolesc Psychiatr Nurs. 2014;27(4):190-200


Using incentives to encourage smoking abstinence among pregnant indigenous women? A feasibility study

Authors: Glover M et al.

Summary: Outcomes are reported from a feasibility study that sought to determine the likely effectiveness of an incentives-based cessation trial among pregnant Māori women that smoked. The study recruited 24 pregnant smokers aged ≥16 years (mean age 25 years) who self-identified as Māori, were 2–30 weeks pregnant, and currently smoked. A total of 74 women were approached through health practitioners, print media, and radio adverts in Auckland, New Zealand; 50 declined involvement in the study. Participants were randomised to (1) usual cessation support, including information about different cessation products and services, and access to nicotine replacement therapy (n=8; controls), (2) usual cessation support plus a retail voucher to the value of NZ$25 for each ‘abstinent from smoking’ week for 8 weeks (n=8; voucher), or (3) usual cessation support plus product to the value of NZ$25 for each ‘abstinent from smoking’ week for 8 weeks (n=8; product). Outcomes measures included weekly self-reported and monthly biochemically verified smoking status, and acceptability. Overall, 5 women (21%) were abstinent from smoking for at least 6 weeks of the 8-week study period; 1 woman from the control group, 6 from the product group and 3 from the voucher group.

Comment: Further research exploring the high rate of ‘decline participation’ would also be useful.

Reference: Matern Child Health J. 2014 Nov 27. [Epub ahead of print]


A literature review: addressing indigenous parental substance use and child welfare in Aotearoa: a Whānau Ora framework

Authors: McLachlan A et al

Summary: These researchers systematically reviewed the international and Aotearoa literature concerning key considerations for Māori parents with substance use disorders (SUDs) who present to an Alcohol and Drug (AoD) specialist for assessment and treatment. This paper details the knowledge and skills that adult AoD services must possess in order to provide effective support to parents with SUDs. Comprehensive assessment and intervention plans must consider both individual and familial risk and protective factors. Possible child welfare issues have to be identified early to ensure prevention or intervention. The paper also notes that the AoD workforce must have the knowledge and skills to facilitate access to other relevant sectors, such as education, employment, and housing. An AoD workforce that is effective with Māori must not only have these abilities, but also have at least some basic knowledge and skills in Whānau Ora philosophy and Whānaucentered best practice. The paper describes a set of knowledge and skills that are essential for developing an appropriate AoD workforce and improve service delivery for Māori parents with SUDs. This skillset must be based on Māori foundations, understand intergenerational dynamics, and endorse a group capacity for self-determination. Moreover, the paper recommends that AoD services increase their knowledge and skills associated with the realities of lifestyles centered in low socioeconomic communities and co-occurring issues that contribute to poor health outcomes.

Comment: The authors have undertaken the challenging role of applying ‘evidence’ to Whānau Ora policy in order to ‘make it work’ for our whānau.

Reference: J Ethn Subst Abuse. 2014 Dec 23:1-14. [Epub ahead of print]