Acceptability and exploratory efficacy of a Māori-led injury prevention and care model for older Māori in primary care in Aotearoa New Zealand: pilot study.

Abstract

In Aotearoa New Zealand (NZ), healthcare access inequities exist for unintentional injuries between older Māori and non-Māori. We investigated the acceptability and exploratory efficacy of a co-designed paeārahi (navigator)-led injury prevention and care model for koeke (older Māori) in a prospective, non-randomised, pilot study. We enrolled 192 community-dwelling older Māori participants (≥ 55 years) from three primary healthcare clinics. The primary outcome was intervention acceptability, using an acceptability framework and kaupapa Māori theory to analyse focus group and interview data. Exploratory efficacy outcomes included changes in mobility, fall rates, koeke confidence in injury care, and healthcare utilisation. 132 koeke (mean ± SD age: 68.3 ± 8.5 years) completed the study, and 25 people participated in acceptability data collection (focus groups/interviews). The care model was acceptable to koeke, whānau (family), paeārahi and other health providers, and perceived as having a positive impact across multiple wellbeing domains and improving koeke and whānau control over healthcare. Paeārahi working within healthcare teams contributed to acceptability by assisting with referrals and healthcare access. Participants' confidence in preventing injury and accessing support increased (p = 0.004 and p = 0.009, respectively). Although assessment points need streamlining, these findings support further evaluation of this model among koeke in more community settings.