Māori working with and for Māori in health research, and for better vision

The research was led by Dr Jason Turuwhenua, Senior Research Fellow at the Auckland Bioengineering Institute (ABI), who was trialing an innovative eye-testing device that he has developed.

Dr Turuwhenua, of Tuhoe descent, was keen to get local Māori involved, a community that is negatively overrepresented in health statistics and who, for various reasons, don’t tend to participate in health research.

Which is why he and Dr Joanna Black, a Senior Lecturer in the School of Optometry and Vision Science at the University approached Kia Aroha College in Otara, South Auckland, a school comprised mostly of Māori and Pacific Island students.

“It was about testing the usability of the device, but it was also a chance to build a model of engagement for researchers working with Māori and Pacific communities,” says Dr Turuwhenua.

Moreover, while the Ministry of Health funds free vision checks for children, Māori have low participation rates. “There’s very little data about the health of eyes in South Auckland,” he says.

He and Dr Black got some early and sage advice from Misty Edmonds, a registered nurse and Senior Lecturer, Māori, at the Manukau Institute of Technology.

Ms Edmonds has a long history of working with secondary schools across Counties Manukau, including whare kura (Māori high schools) and was aware that getting Māori and Pacific communities on board with health initiatives requires a specific approach, as well as time and patience.

“It requires more than sending home a form or letter,” she says.

Participation in this type of trial among this cohort of students would typically be around 20 percent, she says, but the more than 60 percent of pupils participated in completed research eye checks, which is unusually high.  

How did they do it? There were lengthy discussions between researchers and staff at the school/kura before the trial, about how to engage with students and parents, how to best explain what the consent process meant and how to highlight the benefits for tamariki and rangatahi participating.

“I think we spent more time engaging with staff and whānau than the actual time it took to do the eye tests,” says Ms Edmonds.

“The message was that this was an awesome opportunity for our kids, that this was free vision testing, that our kids can struggle to get access to these services, and it would contribute to University of Auckland research."

The eye-testing device Dr Turuwhenua and team developed involves a portable headset that tracks Optokinetic Nystagmus (OKN), the involuntary and natural eye movement our eyes make when tracking a moving object such as a passing train.

The device elicits the movement with patterns on a screen. “If your vision is good, your eyes will move in a certain way,” says Dr Turuwhenua. “If they don’t, you know something is wrong.”

Unlike standard eye tests, the test doesn’t require the person being tested to be able to recognise the letters of the alphabet, so it can used to test the vision of those too young to read.

This is important; as Dr Turuwhenua notes, early diagnosis can save people’s vision.

The high participation rate in the trial with Kia Aroha College has meant that nearly all students received a comprehensive eye examination.

Moreover, some of them will have better vision as a result. With the support of the charitable trust, Essilor Vision, free spectacles have been prescribed and provided for those found to need them - and at a crucial time in their education.

Importantly, it the trial has also opened the door for health researchers hoping to work with Māori and Pacific communities. “A community who don’t fare well in health statistics,” he says.

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