Taurite Tū

Injuries sustained following falls can have major consequences for ageing Māori. And yet, these falls are preventable, for the most part.

This led a physiotherapist with almost 30 years of clinical experience, Katrina Pōtiki Bryant, to do the mahi to discover solutions designed by kaumātua to strengthen their bodies to prevent the impact of falls.

Taurite Tū: achieving equitable injury prevention outcomes for ageing Māori is a kaupapa Māori falls prevention and wellness programme for ageing whānau, encompassing mātauraka Māori and other evidence-based science, that aims to empower Māori to age stronger.

The origin of the research started in 2018 when Bryant and Te Rūnanga o Ōtākou (TRŌ) received funding from the Health Research Council (HRC) to develop and deliver a falls prevention programme to specifically engage Māori. Taurite Tū is the product of this kaupapa Māori research conducted by TRŌ in collaboration with expert falls prevention researchers at the University of Otago.

Results from the initial 3-month pilot study show statistically significant reductions in falls risks for Māori participants. Importantly, attendance and retention rates were over 85%, indicating that Taurite Tū was successful in engaging Māori. The participants also demonstrated other numerous wellness benefits of the program. They had improved health and literacy focus; increased awareness of body, posture, and falls; involvement in te ao Māori and use of te reo Māori; enhanced whakawhanaukataka (socialisation); and a feeling of connection with the Māori community and to other Taurite Tū participants.

Following on from the success of the pilot program, a larger study was funded by HRC, the Accident Compensation Commission (ACC), and Ageing Well in 2021.

The scope of the study was widened to incorporate a longitudinal assessment on the impact on falls risk, injury prevention, and delivery of current Taurite Tū programme delivery in Ōtākou takiwā over a further 18 months. But it also sought to assess the replicability of the Taurite Tū template within six other rohe outside of Ōtākou, including Awarua, Hokonui, Murihiku, Oamaru, Porirua and Tūranganui-a Kiwa.

Why is it important to prevent falls?

Falls are a major cause of injury in ageing populations and are most common cause of death by unintentional injury of those aged 65 years and over. Māori have higher rates of mortality compared to non-Māori, with twice the mortality risk and 1.5 times the risk of hospitalisation due to unintentional injuries including falls. Research has also found that Māori demonstrate earlier onset of health conditions such as diabetes complications, cerebrovascular disease, and cardiovascular problems which have been shown to increase a person’s risk of falling and/or sustaining a fall-related injury.

Research has already shown that preventing falls is important and achievable, with fall prevention classes having demonstrated to reduce the risk of falls in older people. While falls prevention programmes are already provided in the community, the uptake of these programmes by Māori is minimal.

It is hoped that the Taurite Tū approach could potentially bridge the equity gap in three ways: in injury prevention, improving access to ACC services, and improving the injury treatment and health outcomes for Māori.

By Māori, for Māori

This project is for Māori and led by Māori. It takes the best practice of falls prevention rehabilitation from western science, but prioritises mātauranga Māori. This project is led by a Rūnaka based research unit, Te Rūnanga o Ōtākou Taurite Tū Research team, who have a history of successfully running and disseminating research.

The results from this study have the potential to inform service delivery that will led to reducing the inequities Māori face in accessing to ACC services, thereby leading to a reduction in falls risk and falls recovery.

What makes Taurite Tū innovative and different from other falls prevention studies is that it is guided by tikaka/tikanga, of which a key principle is ‘Aroha ki te Takata’. Aroha, in this instance, infers a sense of deep caring and responsibility for people involved with the Taurite Tū Kaupapa. This has led to Taurite Tū developing into a wrap-around service providing follow up, connecting health care providers and social services, supporting transport, and more. One of the benefits of this approach, for instance, was evident in the Covid 19 lockdown. Taurite Tū staff were able to contact all Taurite Tū kaumātua throughout lock down, delivered care packages and communicated with whānau members.

The name, Taurite Tū, was suggested by the Rōpu Kaiārahi. ‘Taurite’ meaning the balance of everything, and ‘Tū’ to stand; refers to standing strong as the elements of wellbeing are balanced (inferring to a holistic approach), and of course, balanced standing. Experts in mātauraka Māori (kaumātua engagement, exercise, and movement) contributed to the development of Taurite Tū exercise classes.

Additional consultation with University of Otago falls prevention researchers and others ensured that evidence-based approaches and criteria for community falls prevention were incorporated into the design of Taurite Tū. As with the original Taurite Tū research, the study will be guided by evidence-based, physiotherapy research findings, mātauraka Māori, and will utilise Kaupapa Māori Research methodology.

The future

The Taurite Tū template provides an innovative, evidence-based approach to injury prevention for ageing Māori. This approach has shown to be engaging and responsive to Māori, demonstrating direct, improved health outcomes and a reduction in falls risk. No other evidence-based, falls prevention approach exists which is specifically designed for engaging ageing Māori.

Our hope is that Taurite Tū proves to be easily replicable for communities all over Aotearoa to reduce the number of falls before they happen and helping our kaumātua live stronger for longer. By mid-2024, we have already seen the success of this practical wellness programme grow to serve over 26 communities around the motu. We look forward to seeing it continue to grow and positively impact kaumātua.

In the final months of the Challenge, Ageing Well funded an additional project, Taurite Tū: Interactive Resources, to invest in interactive training resources to support the kaiwhakaako | facilitators of the Taurite Tū kaupapa and expand the uptake of the programme.

Taurite Tū: Interactive Resources