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HCN Services Co-ordinator’s National Forum Wellington 4 Nov 2010 Averil Herbert PhD Clinical and Research Associate, Wai PowerPoint Presentation
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HCN Services Co-ordinator’s National Forum Wellington 4 Nov 2010 Averil Herbert PhD Clinical and Research Associate, Wai

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HCN Services Co-ordinator’s National Forum Wellington 4 Nov 2010 Averil Herbert PhD Clinical and Research Associate, Wai
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  1. HCN Services Co-ordinator’sNational ForumWellington 4 Nov 2010Averil Herbert PhDClinical and Research Associate, Waikato University

  2. Planning and Outcome Measures for Māori Kaupapa for session: » Building contact with whānau and iwi » Understanding whakapapa » Measurable goals around identity

  3. Reflections . . » Best Practice Outcome report » HCN planning and practice GAS » Māori-centred research » Real-life situations . .

  4. Whānau WhakapakariA Māori Centred Approach to Child Rearing and Parent-Training ProgrammesEmphasising Client Strengths and Maori Values in ParentingHerbert, ( 2001)

  5. Whānau Whakapakari Research Outline ● Undertake applied research in the Māori community ● Explore Māori views in child rearing ● Develop a parenting model to incorporate these values into a Matuataunga Model (MM) ● Test a Standard Parenting Training Model (SPT) and the adapted Matuatanga Model with a range of measures ● Establish which measures were acceptable and effective

  6. Nga Mahi Rangahau Consents: - kaumatua - iwi/hapū/whānau - pan-tribal/urban agencies  Kaumatua interviews: (n=8) Focus groups: (n=6) - 3 Māori Service Providers - 3 Māori parent groups  Test a Standard Parenting Training Model (SPT) and the adapted Matuatanga Model with a range of measures  Parent Training Programmes (SPT, MM) with pre and post measures

  7. Interviews: Role of culture and Māori identity in child rearing > Tribal connections and the “kuia model” (importance of senior female relatives) > Māori values including whakapapa (genealogy), whanaungatanga (relationships), āwhinatanga (support) > Large families, absence of violence, shared caring and shared resources

  8. Whakapapa • “When a mokopuna was born, there was joy throughout the family. It strengthened the family and hapu. Every birth was a special occasion, and it reflected on the whanau and on the tribe.” (kuia 1) • “I, too, was brought up by my grandparents. It was a kuia model, because it was my kuia, especially my kuia, who grounded me.” (koroua 3)

  9. Whanaungatanga ➣ “I have one sister and herchildren are very close to me. I see them as my own children. My sister’s mokopuna are my mokopuna. The children of my first and second cousins are like my nieces and nephews. I am very close to them.” (kuia 1)

  10. Āwhinatanga • “That’s the quick method, putting them into counselling, or whatever.” • “Taking time. ‘Mā te wā’ - wait and see! • “Your instinct kicks in, in quite alot of cases. Don't rush it, because it might be quite different from what you feel? Nei ra? I suppose the wairua part of you comes into play with the wairua of that whānau you are working with. So it is waiting and coming to the right conclusion. You are sensing something that needs to be addressed, although they don't want to at that stage.”

  11. Focus Groups: Younger age groups and service providers ● Shared “kai” (food) and shared child care ●Importance of learning marae protocols (Tikanga) ●Identity Whakapapa ●Spirituality (Wairuatanga) ●Role of te reo (Māori language) ●Approval of standard child management strategies ●Importance of extended family (Whanaungatanga) ●Social and economic issues ●Loneliness(Āwhinatanga) ● Importance of Maori working with Maori

  12. Māori Households? ➣ Children may stay in different households. ➣ Aunties and Uncles are very important . Nans too. ➣ Instead of a cup of tea, you get a meal. ➣ Everyone holds on to the baby. You pick them up.

  13. Māori Values? ➣ We look after our own. ➣ We feel at home with our own. ➣ One’s grief is everybody’s grief. ➣ If you win lotto - look out!.

  14. PRE- AND POST-MEASURES • Parent Support Networks • Parent Opinion Questionaire (Azar) • Self Efficacy (Pearlin) • Parent Effectiveness (McPhee) • Critical Incident Scenarios (Pridham et al) • Final programme evaluation • Clinical observations • Followup data

  15. PROGRAMMES AND OUTCOME MEASURES PART I PART II SPT SPT+MRM SPT SPT+MVM (Programme 1 & 4) (Programme 2 & 3) (Programme 5) (Programme 6) ___________________________________________________________________ Support Networks  POQ  Self Efficacy  Critical Incident  Self-Rating Scale  Programme Evaluations Demographic Information __________________________________________________________________

  16. Programme Participants • Diverse group • Early experiences range from secure to abusive • Generally low educational achievement • Current circumstances mainly under-resourced, single parenting, beneficiaries • Transport, other agency involvement, family crises barriers to attendance • Range of motivation and commitment • Supportive of each other

  17. PART I(SPT AND MRM): OUTCOME MEASURES POQ: Both SPT and MRM showed significant post training improvements and medium effect size but no difference between SPT and MRM. The MRM group did show a more consistent improvement across the subscale scores Self Efficacy: No difference post training. Small but non-significant difference in programme type Self Rating: Similar trends as the POQ ie both programmes showed an improvement with a medium effect size. No significant difference between the programmes Programme Evaluation: SPT rated more highly on the specific skills questions. MRM participants reported higher overall enjoyment.

  18. PART II (SPT AND MVM): OUTCOME MEASURES POQ: SPT and MRM no significant post training improvements but a medium effect size. No difference between SPT and MRM but a medium effect size Critical Incident Scenarios: Coded on types of responses SPT Assistive: no change post training Neutral: small change Co-oercive: reduction MVM Assistive: small change post training large effect size Neutral: small change medium effect size Co-oercive: big reduction large effect size Self Rating: Similar trends as the POQ ie SPT and MRM no significant post training improvements but a medium effect size. No difference between SPT and MRM but a medium effect size Programme Evaluation: (Page 161) SPT rated more highly on the specific skills questions. MVM participants reported higher overall enjoyment.

  19. Research Outcomes • No statistically significant differences between SPT and SPT + MM on the measures. • Parent Opinion Questionnaire provided a description of parental expectations. • Critical Incident Scenarios provided the best analysis of differences

  20. Clinical Outcomes • Clarification of values and parental expectations in Maori parenting • Increased understanding of Maori participation in parenting programmes • Evaluate effects of parenting programmes on a target population

  21. Considerations for SC and SP Levels of information/support » Community: Rohe/iwi/marae » Household: Mana kainga » Individual: Thoughts/feelings/behaviours

  22. Building contact with whānau and iwi » Brief history of area and Treaty claims » Current iwi agencies » Marae and pan tribal agencies MWWL etc. Kaumatua. » Hui and introductions Shared responsibilities: SC & SP » »

  23. Outcomes . . . » Shared knowledge base » Up-to-date deskfile and contacts » Discussion about key people/ Māori youth programmes/ school based supports/kaumatua » Pro-active emphasis Shared responsibilities: SC & SP

  24. “to understand a person you need to understand the world they live in.” Miki Roderick

  25. Understanding whakapapa » Household – Mana Kainga » Own or other tribal area and affiliations with marae locally or other areas » Family and whānau connections – 21st 80th birthdays, tangihanga, unveilings » Kaumatua in family SP – household approach

  26. Outcomes . . . » Strategies and contingencies to include safe supports beyond household » Connection with marae via kaumatua » Shared safe household approach SP – household approach

  27. Measurable goals around identity » Engagement in whakapapa activities - see slide above » Engagement and responsibilities in household » Readiness to change – meetings with kaumatua or the identified resilience supports – see following slide » Understanding change/decision making processes

  28. SC/SP/Community Relationship Goals • Relationships between service co-ordinators and service providers • Relationships between service providers and community/iwi • Relationships within households • Relationships between households and iwi/community » »

  29. Individual Resilience & Pathway Goals • Individual characteristics • Relationships with someone in extended whānau • Relationship with someone in the community – sport/church/school (Werner, 1982)