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Abstract：
BACKGROUND: Addressing health inequities that Māori (Indigenous peoples) communities face in New Zealand is a key aim of researchers and practitioners. However, there is limited understanding of the implementation processes and outcomes of health programmes for addressing these inequities. The aim of this study was twofold: (a) to identify correlates of implementation outcomes and (b) to identify facilitators and barriers to implementation effectiveness.
METHODS: The study involved a concurrent mixed method approach. Through an online survey, 79 participants with experience in implementing a health programme with a Māori community identified outcomes and processes of the programme. Additionally, nine Māori community providers shared their perceptions and experience of facilitators and barriers to implementation effectiveness through an in-depth interview. The quantitative and qualitative findings were integrated to address the aims of the study.
RESULTS: For the first aim, we identified two key outcomes: overall health impacts and sustainability. Three of the variables had significant and positive bivariate correlations with health impacts: cultural alignment, community engagement, and individual skills. The only significant correlate of sustainability was evidence-based. For the second aim, participants described four facilitators (leadership, whanaungatanga [relationships], sharing information, digestible information) and four barriers (system constraints, lack of funding, cultural constraints, lack of engagement) to effective implementation.
CONCLUSIONS: Overall, leadership, aligning culture, and building on whanaungatanga, while getting financial resources and systems support, are the core elements to supporting implementation efforts in Māori communities.
METHODS: The study involved a concurrent mixed method approach. Through an online survey, 79 participants with experience in implementing a health programme with a Māori community identified outcomes and processes of the programme. Additionally, nine Māori community providers shared their perceptions and experience of facilitators and barriers to implementation effectiveness through an in-depth interview. The quantitative and qualitative findings were integrated to address the aims of the study.
RESULTS: For the first aim, we identified two key outcomes: overall health impacts and sustainability. Three of the variables had significant and positive bivariate correlations with health impacts: cultural alignment, community engagement, and individual skills. The only significant correlate of sustainability was evidence-based. For the second aim, participants described four facilitators (leadership, whanaungatanga [relationships], sharing information, digestible information) and four barriers (system constraints, lack of funding, cultural constraints, lack of engagement) to effective implementation.
CONCLUSIONS: Overall, leadership, aligning culture, and building on whanaungatanga, while getting financial resources and systems support, are the core elements to supporting implementation efforts in Māori communities.
摘要：
背景：解决毛利人（土著人民）社区在新西兰面临的健康不平等现象是研究人员和从业人员的主要目标。然而,对解决这些不平等的卫生方案的实施过程和结果的理解有限。这项研究的目的是双重的：（a）确定执行结果的相关性；（b）确定促进者和执行有效性的障碍。
方法：本研究采用并行混合方法。通过在线调查，79名在与毛利人社区实施卫生方案方面有经验的参与者确定了该方案的成果和过程。此外,九名毛利人社区提供者通过深入访谈分享了他们对促进者的看法和经验以及实施有效性的障碍。整合了定量和定性结果，以实现研究的目标。
结果：对于第一个目标，我们确定了两个关键结果:总体健康影响和可持续性.其中三个变量与健康影响具有显著和正的双变量相关性：文化一致性，社区参与,和个人技能。可持续性的唯一重要关联是基于证据。对于第二个目标，参与者描述了四名主持人(领导力，whanaungatanga[关系]，分享信息,可消化的信息)和四个障碍(系统约束，缺乏资金,文化约束,缺乏参与)有效实施。
结论：总体而言，领导力,对齐文化，在whanaungatanga上建造，在获得财政资源和系统支持的同时，是支持毛利人社区执行工作的核心要素。
方法：本研究采用并行混合方法。通过在线调查，79名在与毛利人社区实施卫生方案方面有经验的参与者确定了该方案的成果和过程。此外,九名毛利人社区提供者通过深入访谈分享了他们对促进者的看法和经验以及实施有效性的障碍。整合了定量和定性结果，以实现研究的目标。
结果：对于第一个目标，我们确定了两个关键结果:总体健康影响和可持续性.其中三个变量与健康影响具有显著和正的双变量相关性：文化一致性，社区参与,和个人技能。可持续性的唯一重要关联是基于证据。对于第二个目标，参与者描述了四名主持人(领导力，whanaungatanga[关系]，分享信息,可消化的信息)和四个障碍(系统约束，缺乏资金,文化约束,缺乏参与)有效实施。
结论：总体而言，领导力,对齐文化，在whanaungatanga上建造，在获得财政资源和系统支持的同时，是支持毛利人社区执行工作的核心要素。
