McKelvie-Sebileau Pippa, Rees David, Swinburn Boyd, Gerritsen Sarah, D'Souza Erica, Tipene-Leach David
Research and Innovation Centre, Eastern Institute of Technology, Napier, New Zealand.
School of Population Health, University of Auckland, Auckland, New Zealand.
Health Promot J Austr. 2022 Jul;33(3):631-641. doi: 10.1002/hpja.549. Epub 2021 Oct 27.
Hawke's Bay has one of the highest rates of childhood obesity in New Zealand. While several initiatives exist aiming to decrease obesity through physical activity, there are few nutritional interventions. This study adopted a systems science and mātauranga Māori approach to identify and target underlying drivers of rising childhood obesity and engage the community to improve the food environment.
Cognitive mapping interviews (CM) with local stakeholders (school principals, Iwi and district health board representatives, education managers and local councillors) were conducted. The aim was to map participants' mental models of the causes of rising childhood obesity and to identify key principles for engaging with the local community in a meaningful, impactful and culturally appropriate way for future action.
Eleven interviews were conducted face-to-face and cognitive maps were constructed. Follow-up interviews were carried out online, due to COVID restrictions, to present the maps and for interviewees to make any adjustments. Four composite themes emerged through centrality and cluster analysis of the resulting cognitive maps: the importance of building in mātauranga Māori (Māori knowledge and ways of being), the "hauora" of children, working with the community and integrating existing initiatives. Two contextual factors are also considered: the growing need for food security in our communities and the opportunity to start interventions in the school setting.
Cognitive mapping can produce useful insights in the early stages of community engagement. The six "pou" (pillars) underscore the importance of incorporating indigenous knowledge when embarking on public health interventions, particularly around obesity and in regional communities. SO WHAT?: When designing a public health initiative with a community with a high indigenous population, indigenous knowledge should be promoted to focus on holistic health, working with the community and creating opportunities for cohesion. These founding principles will be used to structure future community actions to improve children's food environments in regional New Zealand.
霍克斯湾是新西兰儿童肥胖率最高的地区之一。虽然有多项旨在通过体育活动降低肥胖率的举措，但营养干预措施却很少。本研究采用系统科学和毛利文化方法来识别并针对儿童肥胖率上升的潜在驱动因素，并促使社区参与改善食物环境。
对当地利益相关者（学校校长、部落和地区卫生局代表、教育管理人员和地方议员）进行了认知映射访谈（CM）。目的是绘制参与者关于儿童肥胖率上升原因的心智模型，并确定以有意义、有影响力且符合文化习惯的方式与当地社区互动以采取未来行动的关键原则。
进行了11次面对面访谈并构建了认知地图。由于新冠疫情限制，后续访谈通过在线方式进行，以展示地图并让受访者进行任何调整。通过对生成的认知地图进行中心性和聚类分析，出现了四个综合主题：融入毛利文化知识（毛利人的知识和处世方式）的重要性、儿童的“健康”、与社区合作以及整合现有举措。还考虑了两个背景因素：我们社区对粮食安全的需求日益增加，以及在学校环境中开展干预措施的机会。
认知映射可在社区参与的早期阶段产生有用的见解。这六个“支柱”强调了在开展公共卫生干预措施时，特别是围绕肥胖问题和在地区社区中纳入本土知识的重要性。那又如何？：在与原住民人口众多的社区设计公共卫生倡议时，应推广本土知识，以关注整体健康、与社区合作并创造凝聚的机会。这些基本原则将用于构建未来的社区行动，以改善新西兰地区儿童的食物环境。
