Ascending the Poutama: culturally responsive diabetes care for Māori communities

Rebekah Crosswell; Hinetu Nikora; Ryan Paul; Cathy Buntting; Tom Roa; Rawiri Keenan; Apo Aporosa; Capri Paekau; Glenda Raumati; Suzanne Moorhouse; Anna Tiatia Fa’atoese Latu

doi:10.1071/HC25066

RESEARCH ARTICLE (Open Access)

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Ascending the Poutama: culturally responsive diabetes care for Māori communities

Rebekah Crosswell

¹ ^* , Hinetu Nikora

¹ , Ryan Paul ¹ ² , Cathy Buntting ³ , Tom Roa

⁴ , Rawiri Keenan

¹ , Apo Aporosa

¹ , Capri Paekau ⁴ , Glenda Raumati ⁴ , Suzanne Moorhouse ⁵ ⁶ , Anna Tiatia Fa’atoese Latu

¹

+ Author Affiliations

- Author Affiliations

¹ Division of Health, School of Equity and Innovation, University of Waikato, Hamilton, New Zealand.

² Te Whatu Ora Waikato, Hamilton, New Zealand.

³ Te Kura Toi Tangata - School of Education & Wilf Malcom Institute of Educational Research (WMIER), University of Waikato, Kirkiriroa, New Zealand.

⁴ Te Pua Wānanga ki te Aō - School of Māori and Indigenous Studies, University of Waikato, Kirikiriroa, New Zealand.

⁵ Ngā Miro Community Health Centre, Waikato, New Zealand.

⁶ Te Puna Hauora Matua o Hauraki (Hauraki Primary Healthcare Organisation), New Zealand.

^* Correspondence to: rebekah.crosswell@waikato.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care https://doi.org/10.1071/HC25066

Submitted: 14 April 2025 Accepted: 7 July 2025 Published: 5 August 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

Type 2 diabetes (T2D) significantly impacts Māori populations in Aotearoa New Zealand (NZ) who experience health disparities including suboptimal disease management.

Aim

To explore culturally responsive approaches to supporting Māori living with T2D from the perspective of healthcare providers.

Methods

Nine semi-structured interviews were conducted with clinicians from various disciplines (general practitioner, podiatrist, exercise physiologist, three kaiāwhina, dietitian, two pharmacists); five clinicians identify as Māori, four as non-Māori. Kaupapa Māori inductive thematic analysis was used.

Results

Four key themes emerged: empowering patient-centred communication, whānau involvement, interprofessional collaboration, and culturally appropriate analogies.

Discussion

The findings underscore the need for holistic, culturally responsive T2D care that prioritises culturally appropriate communication to improve patient engagement, health outcomes and address Māori health disparities.

Keywords: culturally responsive, health communication, health equity, holistic disease management, indigenous health, Kaupapa Māori, patient-centred care, poutama, primary healthcare, type 2 diabetes mellitus.

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