{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T10:58:09Z","timestamp":1777287489660,"version":"3.51.4"},"reference-count":24,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,9,28]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Type 2 diabetes mellitus (T2DM) and its complications are more common among M\u0101ori and Pacific people compared with other ethnic groups in New Zealand. Comprehensive and sustained approaches that address social determinants of health are required to address this condition, including culturally specific interventions. Currently, New Zealand has no comprehensive T2DM management programme for M\u0101ori or Pacific people.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>The Mana T\u016b programme was developed by a M\u0101ori-led collaborative of primary healthcare workers and researchers, and codesigned with wh\u0101nau (patients and their families) in order to address this gap. The programme is based in primary care and has three major components: a Network hub, Kai Manaaki (skilled case managers who work with wh\u0101nau with poorly controlled diabetes) and a cross-sector network of services to whom wh\u0101nau can be referred to address the wider determinants of health. The Network hub supports the delivery of the intervention through training of Kai Manaaki, referrals management, cross-sector network development and quality improvement of the programme. A two-arm cluster randomised controlled trial will be conducted to evaluate the effectiveness of the Mana T\u016b programme among M\u0101ori, Pacific people or those living in areas of high socioeconomic deprivation who also have poorly controlled diabetes (glycated haemoglobin, HbA1c, &gt;65\u2009mmol\/mol (8%)), compared with being on a wait list for the programme. A total of 400 participants will be included from 10 general practices (5 practices per group, 40 participants per practice). The primary outcome is HbA1c at 12 months. Secondary outcomes include blood pressure, lipid levels, body mass index and smoking status at 12 months. This protocol outlines the proposed study design and analysis methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Ethical approval for the trial has been obtained from the New Zealand Health and Disability Ethics Committee (17\/NTB\/249). Findings will be presented to practices and their patients at appropriate fora, and disseminated widely through peer-reviewed publications and conference presentations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ACTRN12617001276347; Pre-result.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019572","type":"journal-article","created":{"date-parts":[[2018,12,14]],"date-time":"2018-12-14T12:55:59Z","timestamp":1544792159000},"page":"e019572","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Indigenous health worker support for patients with poorly controlled type 2 diabetes: study protocol for a cluster randomised controlled trial of the Mana T\u016b programme"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9824-8674","authenticated-orcid":false,"given":"Vanessa","family":"Selak","sequence":"first","affiliation":[{"name":"Epidemiology & Biostatistics, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tereki","family":"Stewart","sequence":"additional","affiliation":[{"name":"Mana Tu, National Hauora Coalition, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Statistics, The University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Reid","sequence":"additional","affiliation":[{"name":"Te Kupenga Hauora M\u0101ori, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taria","family":"Tane","sequence":"additional","affiliation":[{"name":"Mana Tu, National Hauora Coalition, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Carswell","sequence":"additional","affiliation":[{"name":"Department of Health Systems, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matire","family":"Harwood","sequence":"additional","affiliation":[{"name":"Te Kupenga Hauora M\u0101ori, University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,14]]},"reference":[{"key":"2025101812530233000_8.12.e019572.1","unstructured":"Harwood M , Tipene-Leach D . Maori and diabetes. In: Robson B , Harris R , eds. Hauora: maori standards of health iv a study of the years 2000-2005. Wellington: Te Ropu Rangahau Hauora a Eru Pomare, 2007."},{"key":"2025101812530233000_8.12.e019572.2","unstructured":"Ministry of Health. \u00a0New Zealand health survey. annual data explorer. Wellington, 2017."},{"key":"2025101812530233000_8.12.e019572.3","unstructured":"Ministry of HealthMinistry of Health. Tatau Kahukura: m\u0101ori health chart book. 3rd edn. Wellington, 2015."},{"key":"2025101812530233000_8.12.e019572.4","unstructured":"Health Partners Consulting Group. Metro-Auckland Pacific population health profile. Auckland: Health Partners Consulting Group, 2012."},{"key":"2025101812530233000_8.12.e019572.5","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0298"},{"key":"2025101812530233000_8.12.e019572.6","unstructured":"Cram F . Improving Maori access to diabetes health care: literature review. 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Wellington: Department of Public Health, University of Otago, 2007."},{"key":"2025101812530233000_8.12.e019572.12","unstructured":"New Zealand Guidelines Group. Guidance on the management of type 2 diabetes 2011. Wellington: New Zealand Guidelines Group, 2011."},{"key":"2025101812530233000_8.12.e019572.13","unstructured":"Ministry of Health. Cardiovascular disease risk assessment. New Zealand Primary Care handbook 2012. Wellington: Ministry of Health, 2013."},{"key":"2025101812530233000_8.12.e019572.14","unstructured":"New Zealand Guidelines Group. New Zealand primary care handbook. 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