Hoki ki te Rito - Oranga Whānau: A parenting support approach for Māori parents

Abstract

Background: The legacy of colonisation has contributed to disproportionately poor outcomes for Māori in health, mental health, and education. Much of this rooted in poverty, and poor family functioning. Parenting programmes could provide support for whānau, to address historical and current needs, and Mellow Parenting aligns with Kaupapa Māori principles. There were promising results from preliminary studies, supporting the need for further research, and highlighting the need to include fathers. This thesis summarises the cultural adaptation and testing of Mellow Parenting for Māori. Aim: To build upon previous studies of Mellow Parenting to determine whether the Hoki ki te Rito- Oranga Whānau (HKTR-OW) intensive parenting programme is feasible and acceptable to Māori parents, and improves parental wellbeing, parenting, and child behaviour and development, at the conclusion of the programme. Methods: A mixed-methods stepped-wedge design with a waitlist control, was used. Quantitative measures included analyses of pre- and post-programme, 3-month and 12-month follow-up data from GHQ-30, PDH Scale, SDQ, ASQ-SE questionnaires; and pre- and post programme home videos of parents and children interacting during naturalistic mealtimes coded blind using the Mellow Parenting Observation System (MPOS). Focus group interviews, carried out at the end of the programme, used a phenomenological approach and were thematically analysed, using a Kaupapa Māori framework. Results: The retention rate was 91% for fathers and 98% for mothers which indicates feasibility and acceptability for this population. For fathers, there were improvements in mental health (n=33) pre-post intervention GHQ-30 (Mean difference 4.27; CI 1.78–6.76, p <0.0001), and parenting (n=32) PDH frequency (Mean difference 4.44; CI 1.80–7.08; p<0.002); PDH intensity (Mean difference 11.34; CI 6.82–15.87; p<0.001) PDH challenging behaviour (Mean difference 5.09; CI 3.51–6.68; p<0.001); PDH parenting tasks (Mean difference 3.50; CI -1.46– 5.54; p<0.001) and changes persisted to 12 month follow up. Results for mothers were similarly positive. Videos showed an increase in positive interactions for fathers, n=22, (MPOS Mean difference 59.90; CI 4.36–115.44); p=0.036) and mothers, n=29, (MPOS Mean difference 51.74; CI 8.82– 94.66; p=0.02). Negative responses were reduced. Children showed improved social and emotional development and behaviour. Conclusions: This results from this study indicate that Hoki ki te Rito-Oranga Whānau shows promise as an acceptable and effective intervention for Māori parents experiencing significant parenting challenges.