7 th Health Services & Policy Research Conference Adelaide 5-7 th December 2011 Hilton Hotel

1. Tu Toa Tu Maia: Implementing an indigenous gambling harm minimisation model in community-based health services 7th Health Services & Policy Research Conference Adelaide 5-7th December 2011 Hilton Hotel Dr. Laurie Morrison – Auckland University of Technology Layla Lyndon-Tonga – Nga Manga Puriri Dr. AmohiaBoulton – Whakauae Research Centre

2. Background – Development of the Tool in Te Arawa • Gambling misuse amongst Māori is a critical public health issue • Little investment has been made in indigenous interventions • Mainstream initiatives imposed on Maori • Maori consulted post initiatives • This does not reflect partnership!

3. Context Relevance • Providing appropriate cultural context • Traditional knowledge is validated • Learning is a holistic process • Hinengaro (emotional effect) • Wairua (reflective) • Tinana (listening and doing) • Titiro (watching and monitoring)

4. Community Responsibility • Localising Resources • Linking providers’ needs and abilities with community aspirations • Promoting specialized training • Sharing, adapting and iwi (tribal) specific knowledge

5. Hei Tiki: Commitment to culture • Tiki symbolizes good luck • Tikitiki – Pokie machine • Provides a rationale for continuing to gamble • Helps to keep you connected to culture • Misuse of gambling icons has the potential to mislead

7. Powhiri Tool: Safe Gambling Checklist Activity Application Preparation Connections Protection Gambling behaviour Losing sight of reality Attractions Loss of mana Over compensating Identifying conflict • Te Waharoa • Karanga • Marae atea • Whaikorero • Waiata • Koha • Hariru • Hakari • Te Take o Marae

8. Lessons Learnt • Culturally congruent resources • Relevant , Acceptable, Meaningful • Appropriate education and training resource • Informed indigenous and non-indigenous community based health workers

9. Application of the resource

10. Lessons Learnt – Tai Tokerau • Lack of Maori Problem Gambling Models • Tailored the resource to suit local context • Integrating the resource across existing services • Age specificity ie, not acceptable with youth

11. Implications • Intervention and resource development needs to consider • community vision and long-term goals • self-empowerment & ownership • Community, Rangatahi, Kaumatua participation in every aspect of resource development • local context • role of decision makers to support intervention (e.g. government /iwi mandated advisory committees)

12. Implications • Necessary to create an environment of respect • Respect and inclusion of Maori knowledge • Respect for community • Inclusiveness i.e. kaumatua, pakeke and rangatahi • Legitimacy of Maori epistemology • Understanding of ecological relationships

13. Summary • Communities have a responsibility to transmit Maori knowledge and culture HOWEVER... • Responsibility must be shared • Communities must be supported to participate in the development of appropriate and relevant health service initiatives

14. Acknowledgements • Health Research Council • Taupua Waiora Maori Health Research • Nga Manga Puriri • Whakaue Research Centre • Nga Pae o Te Maramatanga

15. Contact Details Dr Laurie Morrison Mob: +64 0272595665 Em: laurie.morrison@aut.ac.nz