{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:20:52Z","timestamp":1784557252131,"version":"3.55.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Royal Melbourne Institute of Technology"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J. Racial and Ethnic Health Disparities"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>M\u0101ori experience a disproportionate burden of Type 2 diabetes mellitus (T2DM), with ongoing inequities in access, continuity, and outcomes of care. While culturally responsive approaches are recognised as important, limited qualitative research centers kaum\u0101tua (M\u0101ori elders aged 50 years and over) voices in evaluating current diabetes care and informing service redesign.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore kaum\u0101tua and M\u0101ori health providers\u2019 perspectives on the cultural responsiveness, strengths, and limitations of current T2DM management in New Zealand, and to examine perceived opportunities for community-embedded and mobile models of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study informed by Kaupapa M\u0101ori principles was conducted using a w\u0101nanga-based (collective forum for discussion and knowledge-sharing) approach. Kaum\u0101tua living with T2DM were purposively recruited through a M\u0101ori community organisation. Collective k\u014drero (conversation\/discussion) were audio-recorded and analysed using reflexive thematic analysis, interpreted through a Kaupapa M\u0101ori analytic lens. Reporting followed the Consolidated Criteria for Strengthening Reporting of Health Research Involving Indigenous Peoples (CONSIDER).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seven kaum\u0101tua and M\u0101ori health providers participated. Current diabetes care was described as fragmented and insufficiently responsive to cultural and contextual needs. Effective care was grounded in whanaungatanga (relationships and connectedness), manaakitanga (care, respect, and dignity), wh\u0101nau engagement, culturally safe spaces, and accessibility. Structural barriers, including transport challenges, financial pressures, and fragmented information systems, constrained continuity of care. Participants strongly endorsed a mobile, community-embedded diabetes service as a culturally appropriate approach to improving access, continuity, and equity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Kaum\u0101tua perspectives highlight the need for relational, culturally grounded, and accessible diabetes care. Mobile, community-embedded models offer a promising pathway to address structural barriers while upholding mana, dignity, and wh\u0101nau-centred care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40615-026-03069-w","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:55:19Z","timestamp":1784555719000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018Not very Responsive for Kaum\u0101tua\u2019: A W\u0101nanga-Based Qualitative Study (Single-Group Design) of M\u0101ori Kaum\u0101tua and M\u0101ori Health Provider Experiences of Type 2 Diabetes Care"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9908-3659","authenticated-orcid":false,"given":"Kesava","family":"Kovanur Sampath","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marrin","family":"Haggie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timi","family":"Tapara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Brownie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"3069_CR1","doi-asserted-by":"crossref","unstructured":"Harris R, Tobias M, Jeffreys M, Waldegrave K, Karlsen S, Nazroo J. 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No financial, professional, or personal relationships have influenced the work reported in this manuscript.","order":1,"name":"Ethics","label":"Competing Interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}