School of Nursing

Permanent link for this collectionhttp://hdl.handle.net/10292/19640

The School of Nursing evolves with the latest research and needs of the healthcare sector. Our research focuses on advancing knowledge to improve patient outcomes and recovery.

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Tauiwi (Settler) Visioning an Antiracist Health System for Aotearoa Before the National-led Coalition Government
(University of Otago Library, 2025-08-15) Came, Heather; Kidd, Jacquie; Rae, Ngaire; Badu, Emmanuel; Rigby, Garrick; McCreanor, Tim
In Aotearoa, systemic ethnic inequities are longstanding and fuelled by the intergenerational impacts of colonisation and systemic racism. Our health system disadvantages Māori (the Indigenous peoples of Aotearoa) while Pākehā (white settlers) are advantaged. This paper addresses a literature gap by describing a Tauiwi (settler) vision of an antiracist health system. It is a companion piece to a Māori-led paper on the same topic. An exploratory qualitative design, informed by kaupapa Māori research, drew on three virtual wānanga (learning spaces) with twenty-eight Tauiwi health practitioners, activists and academics held in November 2021. A reflexive thematic analysis then generated four themes: i) honourable kāwanatanga and decolonisation; ii) building antiracism infrastructure; iii) understanding privilege and power; and iv) a shared commitment to transformation. Participants described a Tiriti o Waitangi-based health system as just, culturally safe, holistic, and well-being focused. Transforming the health system requires Indigenous leadership and the engaging of settler hearts, heads and hands in solidarity with those targeted by racism.
Performance of Large Language Models on Nursing Licensure Examinations: A Systematic Review and Meta-analysis
(Elsevier BV, 2026-05-12) Amankwaa, I; Odoom, A; Kasim, A; Kobiah, E; Diebieri, M; Boateng, EA; Gyamfi, S; Hales, C
Objectives: This systematic review and meta-analysis assessed the performance of large language models (LLMs) in nursing licensure examinations. Despite the increasing use of LLMs in healthcare education, their capabilities in nursing licensure examinations remain uncertain. This study provides evidence on the accuracy and limitations of LLMs to help guide their integration into nursing education and licensure. Design: The systematic review and meta-analysis adhered to PRISMA 2020 guidelines. Data sources: PubMed, CINAHL, PsycINFO, EMCARE, and ERIC were searched from April to June 2025. Eligibility criteria: Studies were eligible if they evaluated LLMs (e.g., GPT-4, ChatGPT, Qwen-2.5) using multiple-choice nursing licensure questions under exam-like conditions and reported quantitative accuracy. Open-ended items were excluded from the meta-analysis due to incompatible scoring methods, but were narratively synthesised. Review methods: Two reviewers independently screened, extracted data, and appraised the risk of bias. A random-effects meta-analysis estimated pooled accuracy; subgroup and meta-regression analyses explored heterogeneity. Results: Twelve studies assessed 13,870 MCQs across seven exam systems and ten LLMs. Pooled accuracy was 69.6% (95% CI: 65.6–73.6%) with substantial heterogeneity (I² = 98%). GPT-4 outperformed GPT-3.5 (77.2% vs. 60.4%); domain-customised and newer models reached 93.6%. LLMs excelled in general medicine and pharmacology but underperformed in ethics and psychosocial integrity. Accuracy did not differ significantly by exam system (p = 0.14), question difficulty (p = 0.90) or format (p = 0.96). In meta-regression, Custom GPT (p = 0.0006) and Qwen 2.5 (p = 0.026) were the only significant predictors of higher accuracy; no exam system, question format, or difficulty level reached significance. Methodological variability and underreporting of model parameters were common. Conclusions: LLMs show promise for low-stakes educational applications, such as formative assessments within hybrid teaching models; however, they are unsuitable for unmoderated, high-stakes licensure decisions due to inconsistent performance. Regulatory guidelines, equitable access, and nursing-specific model development are needed to ensure fairness and validity. Research must prioritise standardised frameworks, error analysis, and broader geographic representation to address these limitations.
Validating a Parental Trauma Informed Approaches Scale in Low-Income Countries Using the Rasch Model
(Elsevier, 2025-10-16) Efstratopoulou, M; Opoku, MP; Tsingilis, N; Nur, S; Gyimah, EM; Moustafa, A
Low-income countries, such as Bangladesh, Egypt and Nepal, are experiencing enormous social problems, such as poverty, violence and extremism, which can expose children to trauma. However, the literature on parental awareness of trauma-informed approaches is very limited, possibly due to the lack of a reliable instrument for continuous data collection on parental knowledge regarding the onset of trauma and the best management strategies. The overarching aim of this study was to thoroughly validate the parental trauma identification and management scale (PTIMS), a newly developed tool for trauma-informed approaches, using data collected from parents in three low-income countries. A total of 750 parents from three low-income countries (Bangladesh, n = 300; Egypt, n = 205; Nepal, n = 245) shared experiences of poverty and social problems that could increase their children's vulnerability to trauma. The parents completed the PTIMS, which was translated into the first language of each of the studied countries and subjected to validation using item response theory. Multivariate analysis of variance was computed to understand the differences between participants. Rasch analysis yielded appropriate psychometric properties for the PTIMS. For example, the outfit mean square and infit mean square values of all 33 items ranged from 0.878 to 1.124 and from 0.910 to 1.096, respectively. The multivariate analysis of variance revealed differences between participants in some demographic variables, such as country, age, employment status and school type. The PTIMS is a valid instrument for gathering surveillance data on trauma awareness among parents, who are important stakeholders in efforts to create trauma-informed schools in low-income contexts.
ICIRAS: Research and Reconciliation With Indigenous Peoples in Rural Health Journals
(Wiley, 2022-07-20) Lock, MJ; McMillan, F; Warne, D; Bennett, B; Kidd, Jacquie; Williams, N; Martire, JL; Worley, P; Hutten-Czapski, P; Saurman, E; Matthews, V; Walke, E; Edwards, D; Owen, J; Browne, J; Roberts, R
Aim: We aim to promote discussion about an Indigenous Cultural Identity of Research Authors Standard (ICIRAS) for academic journal publications. Context: This is based on a gap in research publishing practice where Indigenous peoples' identity is not systematically and rigorously flagged in rural health research publications. There are widespread reforms, in different research areas, to counter the reputation of scientific research as a vehicle of racism and discrimination against the world's Indigenous peoples. Reflecting on these broader movements, the editorial teams of three rural health journals—the Australian Journal of Rural Health, the Canadian Journal of Rural Medicine, and Rural and Remote Health—recognised that Indigenous peoples' identity could be embedded in authorship details. Approach: An environmental scan (through a cultural safety lens where Indigenous cultural authority is respected, valued, and empowered) of literature was undertaken to detect the signs of inclusion of Indigenous peoples in research. This revealed many ways in which editorial boards of Journals could systematically improve their process so that there is ‘nothing about Indigenous people, without Indigenous people’ in rural health research publications. Conclusion: Improving the health and wellbeing of Indigenous peoples worldwide requires high quality research evidence. The philosophy of cultural safety supports the purposeful positioning of Indigenous peoples within the kaleidoscope of cultural knowledges as identified contributors and authors of research evidence. The ICIRAS is a call-to-action for research journals and institutions to rigorously improve publication governance that signals “Editing with IndigenUs and for IndigenUs”.
Organizational Innovation in Long Term Care Enabled by Collaboration Between Government Agencies: A Critical Realist Case Study
(SAGE Publishing, 2023-01-13) Shannon, Kay; Neville, Stephen
Long term care for older people is a highly regulated sector providing accommodation, health, and social care to vulnerable older adults. Older adults in New Zealand are among the highest users of long term care services globally. Traditionally those requiring specialist care for dementia are housed apart from other residents. In an example of organizational innovation, 1 provider relocated residents to a secure village where residents requiring specialist dementia care would be desegregated. We utilized a critical realist case study to explain the role of intersectoral collaboration among government agencies in supporting the transition while managing risk and ensuring regulatory compliance.
Evaluating Adherence to COVID-19 Quarantine Protocols at Two International Ground Crossings in Savannakhet Province, Lao PDR
(BMC, 2026-02-20) Xaylovong, Khamsamay; Adjei-Gyamfi, Silas; Pongvongsa, Tiengkham; Moji, Kazuhiko; Aiga, Hirotsugu
BACKGROUND: Border surveillance measures, including health screening and mandatory quarantine for travelers, are critical components of global pandemic response strategies. In Lao PDR, however, no known study has assessed the performance of the quarantine system, which was designed to protect the health of both citizens and incoming travelers, particularly during the COVID-19 pandemic and in preparation for future outbreaks. This study therefore evaluates adherence to the national COVID-19 quarantine protocols at two ground crossings (Vietnam-Laos and Thailand-Laos) in Savannakhet Province during the COVID-19 pandemic. METHODS: A retrospective cross-sectional study was conducted among 380 registered adult incoming travelers who entered Lao PDR via Dansavanh-Lao Bao border or Second Thai-Lao Friendship Bridge between April 2020 and March 2021. Data were extracted from point-of-entry registers, provincial hospital records, and quarantine facility registers. Overall quarantine performance (OQP) was defined as completion of the Lao PDR national quarantine protocol. Binary logistic regression was employed to identify the factors associated with OQP completion. RESULTS: Of the 380 incoming travelers, 277 (72.9%; 95%CI 68.2-77.1) completed the full quarantine procedures. Body temperature screening was conducted for 348 individuals (91.6%), with 13 (3.7%) presenting with fever ≥ 37.5 °C and referred for further screening. Among 335 incoming travelers directed to quarantine facilities, 264 (78.8%) completed the 14-day quarantine. Multivariate analysis revealed that female incoming travelers were significantly more likely to complete quarantine procedure than males (aOR: 1.84; 95%CI 1.14-2.96; p = 0.013). Those who traveled into the provinces other than Savannakhet had higher odds of quarantine completion (aOR: 1.78; 95%CI 1.49-3.26; p = 0.042). CONCLUSION: Based on locally defined indicators, the quarantine system achieved OQP rate of 72.9% which reflects an acceptable level of compliance. Gender and destination province were significant predictors of adherence. Enhancing communication strategies and standardizing strict quarantine procedures could improve border surveillance and preparedness for future public health emergencies.
Establishing Standards of Care for Forensic Mental Health: An International Delphi Consensus-building Study
(Frontiers Media SA, 2026-04-16) Leclair, Marichelle; Imbeault, Arianne; McKenna, Brian; Nicholls, Tonia; Crocker, Anne; Thomson, Lindsay
OBJECTIVES: The present study aimed to establish a consensus on a definition of forensic mental health systems and services, and to identify principles and components of forensic mental health systems. METHODS: A Delphi consensus-building process was employed among 23 experts in forensic mental health, defined by lived experience of forensic mental health services, professional, clinical or management practice in forensic settings, or academic research in the field. Items were rated on a 9-point Likert scale, with consensus defined as ≥75% of panelists rating an item between 7 and 9. Across three Delphi rounds, items were revised, merged, or added based on participant feedback. Data were collected anonymously using LimeSurvey, with reminders sent to maximize participation, followed by a structured consensus meeting to resolve remaining areas of disagreement. RESULTS: The final consensus statement comprises three components: (1) a definition of forensic mental health services; (2) a general statement including 12 guiding principles; and (3) 43 core components organized across 10 thematic domains addressing models of care, pathways and processes, programs and activities, physical health, service user and peer involvement, evaluation and improvement, service integration, safe environments, restrictive practices, and other system-level considerations. While all items achieved consensus at the consensus meeting, areas of sustained discussion related to the integration of cultural expertise, the inclusion of a lived experience workforce, and the distinction between descriptive and aspirational elements of forensic mental health services. CONCLUSIONS: This international consensus statement provides a structured framework for understanding forensic mental health systems. By articulating shared principles and core components while allowing flexibility across jurisdictions, the framework offers a foundation to support service development and evaluation across diverse jurisdictions.
Towards Promoting Innovation in Inclusive Education: Behavioural Intention of Teachers Towards Adopting AI to Teach Students with Learning Disabilities in the UAE
(Springer Science and Business Media LLC, 2026-01-13) Zraydi, F; Opoku, MP; Guirguis, BM; Ndijuye, LG; Gyimah, EM
The integration of artificial intelligence (AI) in education offers significant potential for identifying and supporting all students, including those with learning difficulties. Although discussions on the potential of AI to advance the learning of students are ongoing, AI usage among teachers to leverage it in the teaching of students with learning disabilities in nonwestern contexts, such as the United Arab Emirates, is unresearched. The study was guided by a unified theory of acceptance and use of technology to examine teachers’ intentions toward adopting AI tools to enhance educational outcomes for students with learning disabilities in the UAE. Using a quantitative research approach, a structured survey was completed by 244 teachers from both public and private schools. The data were subjected to analyses, such as structural equation modelling, to test the structural validity of the unified theory of acceptance and use of technology. Moreover, confirmatory factor analysis, means, multivariate analysis of variance and path analysis were computed to explore the variables that impact the behavioural intentions of teachers. The findings provide support from instruments used to measure intentions towards AI. While social influence positively predicts intention, effort expectancy makes a negative but significant contribution to the variance in intention (social influence: β =.32; effort expectancy: β = −.26, R² = 0.14). The implications of the study for AI policy development and teacher development are discussed.
“I will advocate for rehabilitation specialists…”: A Secondary Analysis of In-Service Adolescents with Disabilities and Families’ Recommendations to Enhance Rehabilitation Access in Ghana
(Wiley, 2026-01-20) Gyimah, EM; Dassah, E; Nuri, RP; Okyere, FC; Opoku, MP
Background: Despite supportive national policies in respect of healthcare access, in-service adolescents with disabilities and their families in Ghana still face key barriers in accessing rehabilitation services. The aim of this study is to identify and understand recommended solutions from in-service adolescents with disabilities and their families to improve access to rehabilitation services in Ghana. Methods: The study is a secondary analysis of data set from a previous qualitative study with 45 participants (consisting of 25 adolescents with disabilities and 20 families of adolescents with disabilities). We collectively analyzed the data thematically in combination with elements of a grounded theory approach. Results: We identified four key recommended solutions from the analysis. These are (i) affordable rehabilitation services, (ii) availability of services, (iii) protection of human rights, and (iv) greater awareness of rehabilitation services. Overall, participants’ recommended solutions related to policies and practices that can potentially improve access to rehabilitation services for adolescents with disabilities in Ghana and similar contexts. Conclusion: Participants’ recommended solutions have important implications for rehabilitation service provision and policy decision-making. As such, there is an urgent need to involve in-service adolescents with disabilities and their families in the development and implementation of rehabilitation interventions to meet the specific and unique needs of adolescents with disabilities. This may advance Ghana’s efforts towards the achievement of the 2030 Agenda for Rehabilitation and, ultimately, the Sustainable Development Goal 3.
Exploring the Attitudes Toward Climate Change and Pro-Climate-Change Behavior Among People With Sensory Disabilities in the Middle East and North Africa
(Informa UK Limited, 2026-04-07) Opoku, MP; Gyimah, EM; Alnuaimi, A; Frimpomaa, L; Sallam, A; Mansour, K; Mustafa, A
Global ecosystems, including those of the Middle East and North Africa (MENA) region, are severely threatened by the climate crisis. However, there are limited studies on climate change awareness among people with sensory disabilities, especially as climate change affects them as they navigate their daily activities. Guided by Ajzen’s theory of planned behavior, 542 participants with sensory impairments in the MENA region completed the Awareness of Climate Change and Pro-Environmental Behavior Willingness Questionnaire. We performed confirmatory factor analysis and multivariate analysis of variance to understand the influence of demographics on awareness and behavior. The instrument demonstrated robust validity and reliability, with appropriate fit indices and mean scores indicating participants’ ambivalence toward awareness and pro-climate-change behaviors, as well as notable demographic variations. The findings underscore the need for targeted education and climate change activism, as prescribed by the Sustainable Development Goals (SDGs).
How Does Pre-Registration Child Specific Education Prepare Newly Qualified Nurses’ to Care for Children, Young People, and Their Families? An Empty Narrative Review
(Informa UK Limited, 2026-04-23) Carey, Matthew; Edge, Danielle; Blamires, Julie; Foster, Mandie; Neill, Sarah
This narrative review investigates the influence of child-specific content within pre-registration nursing programs on newly qualified nurses’ perceptions of preparedness to care for children, young people, and their families. Despite international recognition of the specialised competencies required for pediatric nursing, the proportion and quality of child-focused education across Higher Education Institutions is not clear. The Population, Exposure, Outcome framework provided a comprehensive search strategy applied across eight databases to identify relevant studies that met the inclusion and exclusion criteria. Of 663 records identified, 451 were screened and 25 full texts were assessed for eligibility by two reviewers. No studies met the eligibility criteria, resulting in an empty review. Although no empirical evidence could be synthesized, the absence of eligible studies is itself a notable finding. Empty reviews are becoming increasingly recognized within structured review methodology as scientifically meaningful contributions. An empty review can highlight areas where assumptions are made without evidence and where systematic research is urgently needed. In our review, the lack of studies reveals a critical and previously uncharted gap in the literature. Although authors acknowledge that a strict inclusion criteria may narrow the field for capturing relevant studies. Rather than representing a failure of the review process, the empty review demonstrates that the research question has not been empirically investigated despite longstanding concerns about adequacy of children’s nursing education. Empty reviews aid researchers to identify gaps in the evidence base and to identify where research is needed. They can ensure that policy or curriculum reform is not based upon untested beliefs. Empty reviews offer guidance for researchers, educators and healthcare providers on future research. By confirming through a robust and comprehensive search strategy that no eligible evidence exists, this empty review strengthens the case for dedicated studies exploring the relationship between curriculum content and preparedness outcomes. It highlights the need for empirical work before evidence‑based recommendations on child‑specific content can be made. In this sense, the empty review is not a negative result but an important and constructive contribution, drawing attention to a neglected but vital area of nursing education research.
Who Cares for the Carers? A Holistic Approach to Teacher Wellbeing in a Tribal Head Start Context
(Teachers College Press, 2026-02-27) Gourneau, Hilary; Brockie, Teresa N.; Wilson, Deborah H
Introduction: Often, our focus when investigating the stress and well-being of teachers is on how it affects the students they teach. It’s true that a teacher’s levels of stress, depression, and well-being affects the socio-emotional and academic development of the children, not to mention students often come to school with physical, mental, social, learning difficulties, or trauma, that teachers can be ill-supported in handling. However far less time and resources have been spent on valuing teachers as individuals who themselves need psychological support and resources to optimize their own health and well-being. Methods: Through a research-practice partnership between the Fort Peck Native American Reservation, Fort Peck Head Start and Johns Hopkins University, USA we implemented a culturally informed intervention focused solely on the teachers, to support their well-being and find ways to help them manage and decrease stress and depression. Results: By focusing on re-connection to culture, healing historical and contemporary traumas perpetrated by colonizing practices and normalizing traditional cultural practices we supported a process of healing. Discussion: This presentation discusses what has followed on from the research study. We describe the process of building morale, improving partnerships between Tribal Head Start administration and staff as we navigate reconnection to our Native American culture, put supports in place to mitigate the harmful effects of colonization such as addiction, suicide, poverty and poor physical health. Conclusion: Focusing on our Sovereignty, rich cultural heritage, connection to land, relatives and the Creator is enabling a flourishing and healing in our teachers.
Envisioning Auckland 2050: Insights from Emerging Scholars for a Thriving Future
(AUT Graduate Research School, and Te Mātāpuna: AUT Library, 2026-03-24) Nagalingam, Jayanthi
Kia ora and welcome to the latest edition of Rangahau Aranga. This edition marks the journal’s first issue dedicated to the theme “Auckland 2050”. As a fellow doctoral student, I am delighted to contribute to the editorial for the first issue of 2026, highlighting the work of postgraduate researchers whose scholarship explores how Auckland and Aotearoa New Zealand might evolve and flourish in the decades ahead. Together, these contributions offer diverse perspectives on the opportunities and challenges shaping our shared urban future. To begin with, a brief context, the Auckland Plan 2050, developed by the Auckland Council, is the region’s long-term spatial plan designed to guide growth in ways that respond to future opportunities and pressures. The plan outlines Auckland’s current state, identifies major challenges, and sets a strategic direction to ensure the city remains a place where people want to live, work, and visit (Auckland Council, 2018). This issue builds on that vision by presenting research that engages with themes such as urban design and architecture, social geography and demographics, cultural identity in urban spaces, environmental sustainability, wellbeing, and artificial intelligence (AI). Submissions for this edition were received as research summaries and one research overview, with three projects adopting participatory or co-design approaches. Yang Guo examines how AI is reshaping journalism and newsroom ethics. Focusing on Channel 33, a television station serving Auckland’s Chinese community, the study uses ethnographic methods to explore how AI tools influence reporting practices, editorial decision-making, and public discourse. The research raises critical questions about whether AI will ultimately supplement or replace journalistic expertise and highlights the ethical dilemmas that arise as newsrooms integrate automated systems into their workflows. Khulani Dube draws on experiences from the DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) programme in Zimbabwe. Coordinated by Zimbabwe Health Interventions (ZHI), the DREAMS initiative aims to reduce HIV infections among adolescent girls and young women through various prevention and support services. Using a reflective, practice-based approach, Khulani discusses the practicalities of implementing Community-Led Monitoring (CLM), emphasising the importance of stakeholder engagement, simplifying monitoring tools, and involving communities in co-designing data collection mechanisms. The findings underscore the value of empowering communities to collect, analyse, and interpret their own data, strengthening advocacy and accountability. The research also acknowledges the structural and operational challenges of CLM. Importantly, the lessons from DREAMS offer insights that could be adapted to the New Zealand context, particularly in addressing health inequities, improving mental health and wellbeing among vulnerable populations, and designing inclusive, community-owned service delivery systems. Sarah Bodmer and Cath Conn present research of vital importance to the future healthy cities agenda by creating a collaborative space for university students to envision sustainable urban futures. Conducted as a summer project, the research involved a co-design workshop with four university students and a student researcher. The study highlights the potential of serious games, especially world-building games, to foster creative, interdisciplinary thinking about complex urban challenges such as climate change, overpopulation, and social disconnection. Participants imagined solutions including eco-bubbles, arcologies, improved transport systems, and free community-based services. Their ideas reflected values such as Kaitiakitanga (Māori environmental guardianship), demonstrating how Indigenous perspectives can enrich future city design. The authors argue that youth-led co-design and serious games should be embedded in policy development processes to ensure young people’s voices shape long-term sustainability and health strategies for cities like Auckland. Cassie Wang, Cath Conn, and Julie Trafford address how Auckland’s emerging smart-city systems can support healthy ageing among Asian communities. Using a co-design methodology that blends creative participation with policy analysis (Berg & Gulden, 2012; Sanders & Stappers, 2014), the researchers developed an adapted World Café method called the “World Teahouse”. This culturally resonant format brings together older Asian adults (aged 55+), policymakers, service providers, and technology actors to share stories, ideas, and aspirations in both English and heritage languages (Brown & Isaacs, 2005). By foregrounding the experiences of Asian older adults' voices, which are often absent from ageing and digital health discussions, the study positions healthy ageing as a shared act of design. The authors envision a 2050 Auckland that is not only smart but wise: a city where ageing means becoming more connected, and where every generation sees its future reflected with dignity and hope. Collectively, the research presented in this edition demonstrates the depth, creativity, and commitment of postgraduate scholarship focused on shaping a thriving, inclusive Auckland. Each contribution offers unique insights into the opportunities and challenges ahead, enriching our understanding of what it means to design a city for all. Thank you to everyone (contributors, reviewers, editors and the entire team of Rangahau Aranga) who have made this issue possible. I hope this issue inspires continued dialogue and collaboration as we work toward a vibrant Auckland of the future.
Hospital Audit Finds Siblings of Children with Serious Conditions Are Overlooked, Lack Support
(The Conversation, 2026-03-24) Blamires, Julie
Predatory Journals and Authors in the Age of AI: An Emerging Threat to Pediatric Research [Editorial]
(Elsevier BV, 2026-01-27) Al-Motlaq, M; Foster, M
The Relationship Between Indigenous Health and Relevant Sector Standards in Aotearoa New Zealand, Australia and Canada: A Scoping Review
(Oxford University Press (OUP), 2026-03-07) Cowles, Dean; Dewar, Jan; Cook, Catherine
Background Health sector Standards in Aotearoa New Zealand, Australia and Canada increasingly acknowledge the importance of culturally appropriate care for Indigenous populations. Despite this, inequities persist. This review explores how national health Standards intersect with Indigenous health, focusing on Cultural Safety, Indigenous-led governance, Indigenous knowledge, and anti-racism. Methods A scoping review methodology was employed to map the breadth of literature across Aotearoa New Zealand, Australia and Canada. Guided by a six-stage framework and the PRISMA-ScR protocol, the review used the qualitative variant—Population/Problem, Interest, Context (PICo) approach–to structure inclusion criteria and search strategies. Literature was sourced from five major databases and supplemented by grey literature. Data from 36 records were charted, synthesised, and analysed through narrative synthesis and stakeholder engagement. Results Cultural Safety was consistently identified as more impactful than cultural competency alone, yet most Standards fall short of indicating how Cultural Safety will be measured. Across records, 75% highlighted the need to address social determinants of health, and 67% advocated anti-racism and structural reform. Indigenous-led governance and self-determination were linked to improved health outcomes in 50% of the records, though practical implementation was uneven. Integration of Indigenous knowledge and holistic approaches was supported in 47% of records, but limited by weak policy infrastructure. Racism, both systemic and interpersonal, was identified in all studies as a persistent barrier to equity. National Standards often lack the enforcement mechanisms to address these issues meaningfully. Conclusion This review identified significant gaps between the intent and implementation of health sector Standards across Aotearoa New Zealand, Australia, and Canada in relation to Indigenous health. Despite formal commitments to culturally appropriate care, systemic barriers, rooted in colonisation and policy-practice disconnects, continue to undermine equitable outcomes. The findings highlight the need for Indigenous-led evaluation, stronger accountability, and the embedding of Cultural Safety, Indigenous leadership, and holistic health approaches to drive meaningful and lasting change.
From Positive Screen to Engagement in Treatment: A Preliminary Study of the Impact of a New Model of Care for Prisoners With Serious Mental Illness
(BioMed Central Ltd., 2016-01-15) Pillai, K; Rouse, P; McKenna, B; Skipworth, J; Cavney, J; Tapsell, R; Simpson, A; Madell, D
Background: The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental health services. Many prisoners with SMI do not receive care. Screening tools have been developed but better detection has not translated to higher rates of treatment. In New Zealand a Prison Model of Care (PMOC) was developed by forensic mental health and correctional services to address this challenge. The PMOC broadened triggers for referrals to mental health teams. Referrals were triaged by mental health nurses leading to multidisciplinary team assessment within specified timeframes. This pathway for screening, referral and assessment was introduced within existing resources. Method: The PMOC was implemented across four prisons. An AB research design was used to explore the extent to which mentally ill prisoners were referred to and accepted by prison in-reach mental health teams and to determine the proportion of prison population receiving specialist mental health care. Results: The number of prisoners in the study in the year before the PMOC (n = 19,349) was similar to the year after (n = 19,421). 24.6 % of prisoners were screened as per the PMOC in the post period. Referrals increased from 491 to 734 in the post period (Z = -7.23, p < 0.0001). A greater number of triage assessments occurred after the introduction of the PMOC (pre = 458; post = 613, Z = 4.74, p < 0.0001) leading to a significant increase in the numbers accepted onto in-reach caseloads (pre = 338; post = 426, Z = 3.16, p < 0.01). Numbers of triage assessments completed within specified time frames showed no statistically significant difference before or after implementation. The proportion of prison population on in-reach caseloads increased from 5.6 % in the pre period to 7.0 % in the year post implementation while diagnostic patterns did not change, indicating more prisoners with SMI were identified and engaged in treatment. Conclusions: The PMOC led to increased prisoner numbers across screening, referral, treatment and engagement. Gains were achieved without extra resources by consistent processes and improved clarity of professional roles and tasks. The PMOC described a more effective pathway to specialist care for people with SMI entering prison.
Āhurutanga - A Mātauranga Māori Response to Racism
(Hei Āhuru Mōwai | Māori Cancer Leadership Aotearoa, 2024-09-09) Goza, Moahuia; Blundell, Rawiri; Arnet, Hayley; Kidd, Jacquie; Rachelle, Love; Ronald, Maxine; Scott, Nina
Tō Mātou Haerenga: The Journey of a Fractured-Connected Taiamai Whānau: Reflections From a Hapū Wānanga
(Auckland University of Technology (AUT) Library, 2024-09-09) Kidd, Jacquie; Murphy, Tracy; Putnam, Caitlin; Kidd, Andrew; Robertson, Ellie
For some whānau Māori, colonisation has resulted in the disconnection from their home marae, whenua, hapū and iwi. This paper takes a collective authoethnograhical approach to describing and exploring a recent journey of reconnection and discovery embarked on by one whānau. The journey is framed by the construction of a waka hourua, a double hulled canoe, to represent the two parts of the hapū; those who retained their home base connection and those who were disconnected through generations of colonisation, racism and geographical distance.
Hauora Māori: Aspirations of Māori Health Practitioners for a Culturally Relevant Health System
(Auckland University of Technology (AUT) Library, 2025-05-11) Kidd, Jacquie; Tipa, Zoe; Arnet, Hayley; Rēnata, Haidee
Health care in Aotearoa New Zealand privileges the Western worldview. Consequently, institutional racism is a health system attribute demonstrated by prolonged health inequities, including life expectancy, between Māori and non-Māori. The Crown has breached Te Tiriti o Waitangi, an enduring agreement between Māori and the Crown, by failing to design and deliver health services adequately for Māori, and failing to provide opportunities for Māori sovereignty. Māori experts have articulated the need to surpass equity and achieve Māori aspirations. This qualitative kaupapa Māori research explored Indigenous aspirations for health system transformation, specifically in an environment free of racism. Three online wānanga with Māori health practitioners highlighted the difficulty of describing aspirations when mamae (hurt) continues to be felt in the existing system. By capturing these experiences, we mapped differences between the current system and Māori aspirations for Hauora Māori - a construct where whānau health care and support for wellbeing is indistinguishable from everyday life. The biggest barriers identified in moving towards this approach are Crown resistance to prioritising Māori aspirations for hauora, and the expectation that aspirations should fit within current structures. To achieve hauora Māori, we need changes to funding allocations, prioritising hapū-based commissioning, and improved monitoring and accountability.

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