Browsing by Author "Tupara H"

Now showing 1 - 3 of 3
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    He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing
    (Taylor and Francis, on behalf of Te Aparangi, The Royal Society of New Zealand, 2023-02-06) Howden-Chapman P; Crane J; Keall M; Pierse N; Baker MG; Cunningham C; Amore K; Aspinall C; Bennett J; Bierre S; Boulic M; Chapman R; Chisholm E; Davies C; Fougere G; Fraser B; Fyfe C; Grant L; Grimes A; Halley C; Logan-Riley A; Nathan K; Olin C; Ombler J; O’Sullivan K; Pehi T; Penny G; Phipps R; Plagman M; Randal E; Riggs L; Robson B; Ruru J; Shaw C; Schrader B; Teariki MA; Telfar Barnard L; Tiatia R; Toy-Cronin B; Tupara H; Viggers H; Wall T; Wilkie M; Woodward A; Zhang W
    This paper reflects on the influences and outcomes of He Kāinga Oranga/Housing and Health Research Programme over 25 years, and their impact on housing and health policy in Aotearoa and internationally. Working in partnership particularly with Māori and Pasifika communities, we have conducted randomised control trials which have shown the health and broad co-benefits of retrofitted insulation, heating and remediation of home hazards, which have underpinned government policy in the Warm Up NZ-Heat Smart programme and the Healthy Homes Standards for rental housing. These trials have been included as evidence in the WHO Housing and Health Guidelines and led to our designation as a WHO Collaborating Centre on Housing and Wellbeing. We are increasingly explicitly weaving Māori frameworks, values and processes with traditional Western science.
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    Home modifications to prevent home fall injuries in houses with Māori occupants (MHIPI): a randomised controlled trial
    (Elsevier Ltd, 2021-09) Keall MD; Tupara H; Pierse N; Wilkie M; Baker MG; Howden-Chapman P; Cunningham C
    BACKGROUND: As with many Indigenous populations internationally, Māori in New Zealand suffer health inequity. We aimed to assess the rate of fall injuries at home with and without home modifications in houses with Māori occupants. METHODS: We did a single-blind randomised controlled trial in the Wellington and Taranaki regions of New Zealand and enrolled owner-occupied households with at least one Māori occupant. Only households who stated they intended to live at that address for the subsequent 3 years were eligible for participation. We randomly assigned (1:1) households to either the intervention group, who received home modifications (handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, repairs to window catches, high-visibility and slip-resistant edging for outside steps, fixing of lifted edges of carpets and mats, non-slip bath mats, and slip-resistant surfacing for outside areas such as decks) immediately, or the control group, who received the modifications 3 years later. Data on home injuries were obtained from the Accident Compensation Corporation and coded by study team members, who were masked to study group allocation. The primary outcome was the rate of medically treated fall injuries at home per household per year, analysed according to intention to treat. This Māori Home Injury Prevention Intervention (MHIPI) trial is now completed, and is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12613000148774. FINDINGS: Between Sept 3, 2013, and Oct 1, 2014, 824 households were assessed for eligibility and 254 were enrolled, of which 126 (50%) were assigned to the intervention group and 128 (50%) were assigned to the control group. After adjustment for previous falls and geographical region, there was an estimated 31% reduction in the rate of fall injuries at home per year exposed to the intervention compared with households in the control group (adjusted relative rate 0·69 [95% CI 0·47-1·00]). INTERPRETATION: Low-cost home modifications and repairs can be an effective means to reduce injury disparities. The high prevalence of modifiable safety issues in Māori homes merits considerable policy and community effort. FUNDING: Health Research Council of New Zealand.
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    Sleep health in later life: Interviews exploring experiences, attitudes and behaviours of older people
    (Cambridge University Press, 21/04/2022) Crestani F; Williams G; Breheny M; Tupara H; Cunningham C; Gander P; Gibson R
    Sleep is vital for health and wellbeing across the lifecourse. Ethnic differences have been observed with regards to the prevalence and predictors of self-reported sleep problems. An understanding of sleep experiences with ageing and across ethnicities is required to better support older people. Open-ended interviews were conducted with 23 people living in Aotearoa/New Zealand aged 61-92 years (12 MAori and 11 non-MAori) concerning current sleep status, changes over their lifecourse and personal strategies for supporting good sleep. Participants typically expressed satisfaction with current sleep (usually pertaining to duration) or feelings that sleep was compromised (usually pertaining to waking function). Comparisons to a socially perceived 'ideal' sleep were common, with sleep transitions presented as a gradual and accepted part of ageing. Participants resisted medicalising sleep disruptions in older age. While participants were aware of ways to enhance their sleep, many acknowledged engaging in practices that undermined it. Unique insights from some MA ori participants indicated that sleep disruptions were not so readily pathologised compared to Western views and that sleeplessness could provide opportunity for cultural or spiritual connection. Common narratives underpinning the themes were: 'You don't need as much sleep when you're older', 'Sleep just fits in' and 'Having the time of my life'. Findings provide personal experiences and cultural interpretations relating to sleep and ageing. This provides the foundation for future participatory research to co-design sleep health messages which are meaningful for ageing well across ethnicities.