Taunakitanga Takitini, Reframing Self-Management Support for All in Aotearoa New Zealand: Protocol for a Participatory Case Study Program of Research.

backgroundIncreasingly, people are living with multimorbidity and long-term conditions or permanent impairments, which contribute substantially to health loss and additional health inequity. Critical to managing this health crisis is the appropriate support provided by health and social services. International research has informed the implementation of supported self-management knowledge into Aotearoa New Zealand. Meagre attention has been given to how New Zealand health care organizations can appropriately support people to self-manage their lifelong conditions within their own life contexts and cultures. Currently in New Zealand, those experiencing the greatest health inequities are Māori and Pacific peoples-Tāngata Whaikaha Māori (Māori living with disability) and people with learning (intellectual) disability who live with long-term health conditions or permanent impairments. This research aims to challenge and reframe supported self-management in New Zealand to enable our underserved populations and their whānau (families) to receive appropriate support to live well.

objectiveWe aim to reconceptualize supported self-management in New Zealand as a holistic approach to the provision of support and care within the complexities of the lived human and whānau experience. In total, three objectives will be considered across 3 key populations of people with long-term conditions or permanent impairments (Māori, Pacific Peoples, and those with learning disability) to (1) understand our community partners' and their communities' aspirations for living well and how best to support these desires, (2) develop innovative models of support by working alongside communities to enable supported self-management within their own context, and (3) implement models and evaluate outcomes.

methodsEmbracing social construction of reality, this participatory case study program uses mixed methods and implementation evaluation design and is underpinned by Whānau Tuatahi (Māori) and Fonua (Tongan) research models and the Transformative Paradigm. Moreover, 3 case studies, 1 for each population group, will apply the same program objectives. Objectives 1 and 2 will be addressed with qualitative methodologies underpinned by relevant participatory designs. Objective 3 will use appropriate implementation frameworks.

resultsFunded in October 2023, we have completed 2 years of this 5-year program grant. These first 2 years were focused on relationship building, ethical applications, research capability, and capacity building. Substantial, progressive consultation with the respective communities of each case study was undertaken.

conclusionsNew knowledge generated across our program has the potential to inform New Zealand policy and practice about service delivery acceptable to the people to whom it matters (particularly Māori, Pacific Peoples, and people with a learning disability) and places emphasis on well-being promotion. This approach focuses on the inherent strengths and abilities of people, rather than the deficits or problems, acknowledging the wealth of expertise and experience people living with long-term conditions or permanent impairments bring, and builds relationships and partnerships between people and health care partners. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/89658.