{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:05:28Z","timestamp":1790816728460,"version":"4.1.0"},"reference-count":22,"publisher":"CSIRO Publishing","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["21\/716"],"award-info":[{"award-number":["21\/716"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>M\u0101ori experience later cancer diagnosis and poorer cancer outcomes than non-M\u0101ori. Although consultation-level cultural safety frameworks exist, less is known about embedding cultural safety across general practice to improve outcomes, guided by wh\u0101nau (family) voices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to identify what culturally safe primary care looks like for wh\u0101nau M\u0101ori with cancer, and to describe development of a wh\u0101nau-led systems-change model within a single general practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative Kaupapa M\u0101ori (M\u0101ori approach) and Appreciative Inquiry study design was used. M\u0101ori patients with cancer, their wh\u0101nau (family), and general practice staff participated in iterative phases of interviews and group hui. Reflexive thematic analysis and mahi \u0101 r\u014dp\u016b (group work) informed theme development. A companion methods paper details methodology, data collection, and analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Wh\u0101nau and staff described culturally safe care grounded in relationships, continuity, and environments that signal belonging. Through the research process, participants co-created a shared set of values and formed a wh\u0101nau\u2013staff working group that initiated practical changes in the clinic environment, access pathways, communication processes, and team culture. The project generated an actionable systems change model, demonstrating how cultural safety can potentially be embedded over time through sustained wh\u0101nau involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case study offers a pathway for general practices seeking to embed cultural safety at the service level. Practical considerations \u2013 leadership, commitment, wh\u0101nau partnership, and willingness to address system constraints \u2013 are highlighted, and transferable pointers for other primary care services are outlined.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/hc26154","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:37:01Z","timestamp":1790815021000},"source":"Crossref","is-referenced-by-count":0,"title":["Co-creating culturally safe primary care for wh\u0101nau M\u0101ori with cancer: a qualitative case study of systems change in general practice"],"prefix":"10.1071","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0123-0513","authenticated-orcid":true,"given":"Gillian","family":"Potaka-Osborne","sequence":"first","affiliation":[{"name":"Whakauae Research Services Ltd A , , .","place":["Whanganui, New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Gifford","sequence":"additional","affiliation":[{"name":"Pirere Consulting B , , .","place":["Whanganui, New Zealand"]},{"name":"Health and Research Collaborative C , , .","place":["Whanganui, New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynley","family":"Cvitanovic","sequence":"additional","affiliation":[{"name":"Whakauae Research Services Ltd A , , .","place":["Whanganui, New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McMenamin","sequence":"additional","affiliation":[{"name":"Health and Research Collaborative C , , .","place":["Whanganui, New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pat M.","family":"Neuwelt","sequence":"additional","affiliation":[{"name":"Independent Contractor D , , .","place":["Ontario, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"2026093020365783400_R1"},{"issue":"1","key":"2026093020365783400_R2","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-02071-6","article-title":"Hauora M\u0101ori \u2013 M\u0101ori health: a right to equal outcomes in primary care.","volume":"23","author":"Sheridan","year":"2024","journal-title":"Int J Equity Health"},{"issue":"1347","key":"2026093020365783400_R3","first-page":"72","article-title":"The Hui process: a framework to enhance doctor-patient relationship with M\u0101ori.","author":"Lacey","year":"2011","journal-title":"NZ Med J"},{"issue":"1393","key":"2026093020365783400_R4","first-page":"107","article-title":"Improving Maori health through clinical assessment: Waikare o te Waka o Meihana.","volume":"127","author":"Pitama","year":"2014","journal-title":"N Z Med J"},{"issue":"1","key":"2026093020365783400_R5","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-019-1082-3","article-title":"Why cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition.","volume":"18","author":"Curtis","year":"2019","journal-title":"Int J Equity Health"},{"issue":"3","key":"2026093020365783400_R6","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1111\/1753-6405.12971","article-title":"Experiences of M\u0101ori of Aotearoa New Zealand\u2019s public health system: a systematic review of two decades of published qualitative research.","volume":"44","author":"Graham","year":"2020","journal-title":"Aust N Z J Public Health"},{"issue":"1","key":"2026093020365783400_R7","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1071\/HC24111","article-title":"Rural M\u0101ori experiences of accessing heart health care: a Kaupapa M\u0101ori qualitative analysis.","volume":"17","author":"Tane","year":"2025","journal-title":"J Prim Health Care"},{"issue":"4","key":"2026093020365783400_R8","doi-asserted-by":"publisher","first-page":"396","DOI":"10.20507\/AlterNative.2016.12.4.5","article-title":"Indigenous positioning in health research.","volume":"12","author":"Curtis","year":"2016","journal-title":"AlterNative: An International Journal of Indigenous Peoples"},{"issue":"24","key":"2026093020365783400_R9","first-page":"1","article-title":"Kaupapa M\u0101ori theory is critical and anti-colonial.","volume":"2","author":"Mahuika","year":"2008","journal-title":"MAI Review"},{"issue":"2","key":"2026093020365783400_R10","first-page":"10","article-title":"Kaupapa M\u0101ori: the dangers of domestication. 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