Abstract
The purpose of this thesis is to investigate, within an Aotearoa/New Zealand context, the need for, approach to and effectiveness of cultural competence training for health researchers. Although there have been programmes in cultural competence training for New Zealand health professionals, often with a focus on cultural competence when working with Māori, there has been less focus on cultural competence training for health researchers.
In recent times cultural competency has been implemented mainly in health settings and associated with provider-patient interaction. However, there is a growing appreciation that health researchers should also demonstrate cultural competency. In New Zealand particular emphasis is placed on responsiveness to Māori in research and cultural competence in relation to Māori is fore-grounded in this thesis.
This thesis has three aims:
(i) To review recognised cultural competency frameworks
(ii) Develop a cultural competence training intervention within a health research group setting
(iii) To implement a cultural competence training intervention for a health research group and evaluate the process and effectiveness of this cultural competence training intervention including determining key concepts and content required for researchers to become cultural competent.
Using an action research methodology and informed by theoretical frameworks in this field, an intervention was developed with the Cancer Society Social and Behavioural Research Unit, SBRU (University of Otago, Dunedin, New Zealand).
The intervention consisted of three wānaka, held at Te Kura Kaupapa Māori o Ōtepoti. Each wānaka focused on a particular element of cultural competency; (i) Cultural Awareness or Identity, (ii) Cultural Knowledge and (iii) Cultural Action. Prior to each wānaka participants attended three one hour workshops and were further supported by an electronic newsletter, supported readings, cultural teachings, group discussions and opportunities to practise mihi mihi (introduction) and waiata (songs).
Prior to the intervention, participants provided information about their experience working with Māori and other cultures, experience of different aspects of te ao Māori (e.g. pōwhiri, noho) and their expectations and desires about what could be included in the intervention. After the intervention participants completed a questionnaire (and a follow-up interview if desired) which inquired as to whether the intervention had improved their ability to further the SBRU strategic objectives in relation to Māori research and suggestions for future initiatives, included generalisability, barriers and key concepts.
There were eight participants in this study. Findings suggest that progress was made on each of three strategic goals identified by the SBRU, these included increased understanding of the Treaty of Waitangi and its relevance to research and society, practical experience in te reo Māori, pōwhiri and mihi and insights into meaningful Māori consultation, partnerships and relationships.
In conclusion, if research is to contribute to reducing health inequities there is a need for cultural competence to ensure research practices are responsive to Māori. This study shows that a tailored intervention can be successful in cultural competence among health researchers and identifies key elements which would be useful for future initiatives.