He Pikinga Waiora Framework

This section of the website provides a poster that visually displays each of the elements of the framework. We also provide a description of high, medium, low, and negatives levels of each of the elements.

HPW Poster FINAL.png
HPW Poster FINAL1.png

Applying the Framework

When developing the HPW Framework, we undertook a systematic review of 13 studies of diabetes prevention in Indigenous communities. We drew upon the work of Gibson and Segal (2015) as an initial guide and found strong evidence that key elements predicted diabetes outcomes and blood pressure outcomes. The front page of the poster provides a summary of the HPW framework key principles. Full descriptions can be found on the Main Principles page

The coding scheme on the second page of the poster, describes levels of each of the principles in the framework from high to medium to low and negative. The presence of ‘high, medium and low’ variations  demonstrate there is a range of possible engagement levels. Based on our research, we suggest that higher “scores” are more likely to result in better implementation outcomes. Negative values note that there are times when researchers cause harm such as when they suggest they want co-design and yet do it superficially or through victim blaming.  We think this framework can be used as a visioning/planning tool and as a result has value for all parties to determine authentic co-design.

The full details of our studies and the evidence supporting the framework can be found here.


Gibson OR, Segal L. Limited evidence to assess the impact of primary health care system or service level attributes on health outcomes of Indigenous people with type 2 diabetes: a systematic review. BMC Health Serv Res. 2015; 15:154.

Oetzel JG, Scott N, Hudson M, Masters-Awatere B, Rarere M, Foote J, et al., Implementation framework for chronic disease intervention effectiveness in Maori and other Indigenous communities, Global Health 13 (2017) 69. 

You can download the poster and print for your reference. The poster summarises the key principles of the HPW framework and provides a description, or coding scheme, of various levels of the principles.