Lived experience perspectives on resilience, mental health, and wellbeing: a focus group study of individual, social, and systemic determinants in Aotearoa New Zealand

Lived experience perspectives on resilience, mental health, and wellbeing: a focus group study of individual, social, and systemic determinants in Aotearoa New Zealand | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Lived experience perspectives on resilience, mental health, and wellbeing: a focus group study of individual, social, and systemic determinants in Aotearoa New Zealand Stefan Heinz, Anthony O’Brien, Matthew Parsons, Cameron Walker, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8133475/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Jan, 2026 Read the published version in BMC Public Health → Version 1 posted 10 You are reading this latest preprint version Abstract Background: Resilience research increasingly recognises the influence of cultural context and community perspective on adaptive responses to adversity. However, many resilience indices embody theoretical underpinnings that are not necessarily congruent with lived experiences, especially in relation to culturally diverse groups. This study explores resilience factors through community narratives of diversity in Aotearoa New Zealand. Methods: We conducted nine focus groups (N=92) across urban and rural contexts with 48% of participants identifying as Māori or Pacific Islanders. The twelve resilience indicators were explored through the participant narratives promoted by vignettes and semi-structured discussions using a thematic analysis approach. Cultural protocols were embedded in all aspects including partnering with Māori, Pacific Islander and lived experience advisors. Findings: Five themes emerged: (1) Personal resilience factors; (2) health and wellbeing; (3) social capital and connection; (4) systemic and structural factors; and (5) cultural and environmental resources. Participants contested Western individualised models of resilience by demonstrating that agency emerges through complex assemblages of relationships across human, more-than-human, ancestral, and environmental domains, rather than from individual capacity alone. Conclusion: In this study, resilience did not emerge as an individual capacity, but as something grounded in relational networks situated within cultural, spiritual and ecological contexts. These findings suggest a need for transformational approaches to resilience assessment and intervention by policymakers and clinicians, which attend to structural determinants as well as individual coping capacity. Effective interventions are likely to be more acceptable and meaningful when they are community-grounded, culturally embedded and recognise resilience as a collective resource, rather than only individualised adaption to inequitable conditions. Resilience Mental health Wellbeing Māori Focus groups New Zealand Qualitative Indigenous Lived Experience Figures Figure 1 Introduction Our conceptual understanding of resilience, the ability to positively adapt in the face of adversity, has evolved significantly over the past few decades. From early notions of discrete individual traits, through multidisciplinary perspectives, resilience has developed as a dynamic, multisystemic process [ 1 ]. This paradigm shift aligns with increased acknowledgment that resilience emerges from complex interactions between individuals and their social-ecological contexts that are largely defined by cultural values, historical experiences and structural conditions [ 2 ]. However, even with increasing theoretical understanding, the development of resilience questionnaires and interventions are often conducted without meaningful engagement with the communities for whom they are intended to serve. This increases the risk of developing culturally inappropriate and ineffective resilience interventions [ 3 ]. The construction of resilience as an individual trait is a particular issue for Indigenous peoples and other cultural minorities, whose conceptions of wellbeing and resilience may differ from Western psychological perspectives. In the Aotearoa New Zealand context, Māori understanding of health, described in models such as the Meihana Model [ 4 ] provide a more holistic interpretation, illustrating wairua (spiritual wellbeing), hinengaro (mental and emotional wellbeing), tinana (physical health) and whānau (family and social wellbeing) as foundational components. The model also incorporates taiao (physical environment), iwi katoa (services and systems) and contextual factors including the impacts of colonisation, racism, migration and marginalisation. These holistic conceptualisations render resilience not as an individual trail, but rather the relational capacity between people and their families, communities, cultural backgrounds and natural environment. These relationships must be balanced to attain wellbeing [ 6 ]. Similar relational approaches can be seen in Pacific models of wellbeing. For example, Pacific models emphasise the interrelationship of collective harmony, spiritual unity and social reciprocal obligations to extended family [ 7 ]. Amid the shift towards greater recognition of social determinants and community connections even in Western models, there is an increasing acknowledgment that we cannot treat resilience as a strictly individual psychological trait. Grounding resilience research within community contexts is urgent, particularly given persistent health and social inequities in Aotearoa New Zealand. For example, Māori are estimated to live on average seven years less than non-Māori, with disparities across physical health, mental health and social and economic outcomes [ 8 ]. These inequities are manifestations of the ongoing effects of colonisation and dispossession of ancestral lands, disruption of cultural and spiritual practices and systematic discrimination by the health and social services [ 9 ]. Challenges associated with rural living are shared among Māori and non-Māori communities alike, such as limited access to numerous services, high levels of economic volatility and growing social isolation [ 10 ]. Understanding how people and communities maintain well-being, despite facing adversity - and what factors promote and undermine their resilience - requires approaches that can privilege lived experience and cultural knowledge. Recent developments in resilience science have urged researchers to adopt culturally responsive and participatory frameworks for understanding resilience. For example, Ungar’s social-ecological model [ 11 ] describes resilience as the capacity of individuals, families and communities to navigate their way to health-sustaining resources, including opportunities to experience feelings of; the resources and opportunities themselves; and the collective condition of the individual’s family, community and culture to provide, in culturally meaningful ways, these resources and opportunities. This understanding articulated the social and structural dimensions of resilience, while recognising that what are deemed protective factors vary by context. Relatedly, Indigenous resilience researchers argue that approaches to resilience should adopt decolonising approaches that identify Indigenous knowledge systems as legitimate ways of understanding (and fostering) wellbeing. Such an approach avoids conceptualising Indigenous knowledge systems as cultural variants to Western models [ 12 ] and aligns with recent scoping review findings highlighting that Western concepts of resilience are predominately individualised [ 3 ]. This is also evident in the European Commission’s individual-resilience index which focused on traits and individuals coping [ 13 ]. In this study, we drew on a research agenda that aimed to build a resilience index for Aotearoa New Zealand to inform policy and practice based on recognition of individual, relational, structural, and cultural determinants of resilience. Instead of imposing pre-determined constructs from existing resilience frameworks, we sought to understand how diverse communities experience and conceptualise resilience in their everyday lives. Our research focused on how proposed indicators of resilience commonly cited in the literature (e.g., optimism as an individual characteristic; locus of control as contingent on social support, access to services, etc.) emerged in participants’ narratives of overcoming adversity. While we considered including recommendations based on the literature in our focus group methods, we recognised the importance of adhering to culturally informed practices that aligned with participants’ perspectives of resilience. We sought to contribute not only to theoretical understandings of resilience, but also to the practical applications of resilience research. This ensures that future measures are grounded in lived experience and are culturally embedded. We responded to calls for “resilience research that makes a difference” [ 14 ] by recognising the importance of engaging with communities, cultural responsiveness and attending to structural factors that shape resilience contexts. We situated this work within a transformative research paradigm that seeks not only to document resilience processes but also to contribute to social change. To illustrate how qualitative inquiry generates meaningful contribution towards resilience science, we aimed to highlight how participants’ understandings of resilience demonstrated the cultural situatedness of human adaptation and the knowledge of communities that sustain it. Methods This study was informed by a combination of multisystem resilience theory [ 15 ], Kaupapa Māori research principles [16; 17], and Talanoa [ 18 ] methodology for Pacific participants. We viewed resilience as a dynamic process that emerges from interactions at multiple system levels (individual, family/whānau, community, societal and natural), enabling the recognition that these categorical distinctions from Western worldviews may not be aligned with Indigenous holistic worldviews. By embedding Kaupapa Māori principles within the research processes, Māori knowledge was respected, and Māori wellbeing prioritised, ensuring the research was responsive to Māori communities. Similarly, Talanoa principles ensured responsiveness to Pacific communities. This integrated approach, combining international resilience scholarship with Indigenous and Pacific methodologies, provided opportunities to draw on established theoretical frameworks while simultaneously honouring Indigenous and Pacific ways of knowing. Partnerships and Protocols Research partnerships were developed with kairangahau Māori (Māori researcher), Māori health providers, Pacific community groups and broader community providers across the study sites. An advisory group supported the project throughout its development, implementation and interpretation. This group included Māori kaumātua (elders), Pacific Islander cultural leaders, health practitioners and community representatives from all backgrounds. Cultural protocols, such as the Hui Process [ 19 ], were used in all focus groups: mihimihi (introductions where connections are acknowledged), whakawhānaungatanga (strengthening and maintaining connections), Kaupapa (establishing the purpose of the encounter) and poroporoaki (concluding the encounter). The focus groups were all conducted by a kairangahau Māori with lived experience. This approach aimed to enhance trust and upheld the guiding principles of Māori-led research practice. Participants and Recruitment Between February and April 2025, nine focus groups were conducted across diverse geographical regions of Aotearoa New Zealand. The sites were selected across large urban centres (4-sites) and rural/coastal communities (5-sites). This geographical diversity provided a snapshot of variability in resource availability, cultural mix and diversity of community features, including communities with a significant number of Māori, Pacific Islander, immigrants and New Zealand Europeans. Participants (N = 92) were recruited through purposive sampling in partnership with community organisations, health providers, marae (traditional Māori meeting places), churches and cultural networks. The participants were approximate equal proportions of Māori (48%) and non-Māori (52%) participants. The mixed focus groups included New Zealand European, Māori, Pacific Islanders and other ethnicities, reflecting cultural diversity within Aotearoa New Zealand. Participants ranged from early 20s to late 80s, with relatively even distribution across age groups. While the majority of participants identified as male or female, reflecting general population distributions, our sample also included non-binary participants. Gender identity was not a primary axis of analysis in this study, as our focus was on ethnic/cultural perspectives on resilience. To enable culturally safe (i.e., free from cultural judgment or misunderstanding) spaces, two of the nine focus groups were conducted as ethnicity-specific groups, one with only Māori participants and one with only Pacific Island participants. Urban mixed focus groups showed greater ethnic diversity with Māori representation of 35–50%, while rural/coastal groups had 55–70% Māori participation, reflecting regional demographics and community-based recruitment strategies. Data Collection Procedures Each focus group ran for 90 to 150 minutes and was held in culturally appropriate community locations to support the comfort and accessibility of participants. A semi-structured guide was developed that included two vignettes to stimulate open and organic qualitative discussion. The guide was structured around three broad research questions: (1) what factors contribute to mental health and wellbeing; (2) what role health and social services play in supporting or undermining wellbeing; and (3) how participants understood the relationship between mental health, wellbeing and resilience. Open-ended prompts invited discussion of individual resources, whānau and community supports, external factors such as financial stress, isolation, employment and environment, and what helps people “thrive” in their context, including cultural practices, places and spiritual resources where participants felt strong or held. The first vignette discussed ‘Mary’, a person who is navigating mental health issues through connection with their community, connection with nature, and engagement in activities that were meaningful to them. The second vignette included ‘John’, a person who is confronted by social isolation and stagnation against a background of mental health issues. With participants’ consent, sessions were audio-recorded and transcribed verbatim. The focus group guide, including vignettes and prompts, is provided in Supplementary File 1. Data Analysis Braun and Clarke’s [ 20 ] model of reflective thematic analysis was used to analyse the focus group data. Two researchers (one Māori; one Pākehā/European) independently coded the transcripts using NVivo 12, meeting regularly and discussing interpretations to reach consensus. Throughout the analysis, particular attention was paid to cultural conceptions and collective-oriented understandings of resilience. Regular hui (meetings) with Māori advisors were held throughout the process to ensure cultural understandings were accurately represented. Particular focus was directed to differences articulated between Māori and non-Māori, across rural and urban contexts and between generations. Ethical considerations This study was conducted in accordance with the ethical principles of the Declaration of Helsinki Ethics and ethics approval was obtained from the [University of Waikato] Human Research Ethics Committee (Reference: 2024/385). In addition to the requirements of the University of Waikato, we followed guidelines (Te Ara Tika: Guidelines for Māori Research Ethics and the Pacific Health Research Guidelines) that align with tikanga Māori to guide the research. This adheres to consideration for processes involved in establishing researcher-community relationships; protecting participant confidentiality particularly in small communities; ensuring that the research provided benefit back to communities. All participants provided written informed consent after the research process and consent form content were thoroughly explained in plain language. Consent covered participation in focus groups, audio recording of sessions, and use of anonymised transcripts for research and publication purposes. Koha (gift/contribution) were given to participating organisation, rather than individuals, reflecting culture values. Results Through the analysis of data from nine focus group interviews, five themes emerged as overarching concepts capturing the complexity of resilience as viewed and experienced by different communities across Aotearoa New Zealand (Table 1 ). Each theme represents interconnected aspects, not independent categories, with participants’ stories weaving together rich complexity between individual, social, cultural and structural factors that support or limit resilience. Table 1 Thematic Framework Theme Category Focused Codes Personal Resilience Factors Happiness & Life Satisfaction Collective happiness through whānau, place-based contentment, purpose-driven wellbeing, loss and recovery cycles, cultivating vs experiencing happiness, mokopuna [grandchildren] as source of joy, community garden participation, realistic hope vs blind optimism Hope & Optimism Intergenerational hope, breaking trauma cycles, hope through consistency, spiritual temporality, faith in future possibilities, poetry group healing Agency & Control Wanting help as agency, asking for help as control, control vs acceptance lists, collective agency, community-led solutions, self-determination, choosing battles wisely Health and Wellbeing Physical-Mental Health Integration Cancer survival gratitude, depression disclosure normalisation, COVID-19 mental health impacts, physical illness cascading effects, mind-body connection, whānau rallying during illness, mental health openness shift, recovery pathways Healthcare Access Rural access barriers, medication vs food choices, after-hours unavailability, emergency department wait times, transport costs for healthcare, cultural safety in healthcare, Māori health provider experiences, rongoā preference, healthcare affordability crisis Social Capital and Connection Family & Whānau Networks extended family networks, chosen family, post-natal whānau support, sibling intuitive support, toxic family distancing, whānau collective wellbeing, family as primary safety net Community Connections Small town visibility, church connections, sports club belonging, volunteer networks, neighbourhood erosion concerns, community centre rebuilding, earthquake response solidarity, peer support networks, interpersonal trust rebuilding, community mutual aid Trust Foundations Systemic trust erosion, institutional scepticism, trust through consistency, vulnerability for support, historical betrayals impact Systemic and Structural Factors Economic Security Near-homelessness experiences, cost of living pressures, housing unaffordability, survival mode stress, moving goalposts frustration, informal sharing economies, marae fundraising support, tool libraries, babysitting circles, community gardens Fairness & Justice Beach access restrictions, intergenerational inequality, system rigged perception, daily microaggressions, racism denial frustration, cultural destruction, economic disparity, council decision exclusion, poverty embodiment Cultural and Environmental Resources Nature Connection Beach wave rhythms, ocean perspective giving, parks for depression relief, seasonal change grounding, moana spiritual connection, karakia by water, river pollution grief, lost gathering places, environmental health trade-offs Cultural & Spiritual Identity Cultural reconnection healing, whakapapa understanding, Te reo revitalisation, Kapa haka multilayered benefits, marae as rehabilitation, tūpuna connection strength, faith-based coping, tikanga transmission, collective survival knowledge, prayer and meditation practices Note: Analytical Process: Line-by-line coding of nine focus groups (N = 92) generated 487 initial codes. Through iterative refinement and consensus between coders (κ = 0.78), these were condensed to 92 focused codes, grouped into 12 categories, and synthesised into 5 overarching themes representing multidimensional resilience across diverse communities in Aotearoa New Zealand. Theme 1: Personal Resilience Factors Personal resilience factors encompassed interrelated psychological and emotional resources that participants noted as critical factors. This theme encompassed three interconnected sub-themes: happiness and life satisfaction as an outcome and motivator of resilience; optimism and hope as an emotional fuel to get over the line; and locus of control as a sense of personal agency in one’s world. Happiness and Life Satisfaction Participants discussed happiness as not being in a constant happy state but instead as a general sense of overall satisfaction and capability to experience happiness in the midst of adversity. Individuals expressed complex understandings of happiness as a capacity to be cultivated rather than a state to be passively experienced. A young father noted the relationship between his environment and emotional wellbeing: “When I drive home, I feel like I’m a happy person. [It’s a beach town], it’s pretty cool. Just being here, knowing this is my place, it puts something in me every-single-day”. Stories of loss and recovery illustrated the frailty and resilience of happiness. A participant who had found happiness in rock climbing shared how easily wellbeing could collapse: “Climbing was the thing that was making me happy, giving me purpose really and then I had this work placement, and it was just horrific - long hours, awful culture. When I came out of that I lost all the things that give me those benefits. Suddenly I couldn’t even remember why I used to be happy”. Stories of loss and recovery were mirrored in some participants by the recognition that, in fact, happiness was not an attribute they naturally held, but rather something that required effort and either good fortune and/or conditioning to sustain. Māori participants framed happiness collectively, rather than singularly. Whānau ora (family wellbeing) could be heard and felt throughout. One kaumātua shared, “For us, you can’t separate individual happiness and whānau happiness. If my mokopuna [grandchildren] are doing well, I am happy, if my sister is having hard times, it weighs on me. We’re just connected like that”. This relational understanding of happiness counters Western notions of happiness as an individual state of being and suggests that resilience interventions conducted in contexts which focus on individual happiness as the singular object of intervention may miss important relational pieces. Happiness and purpose emerged consistently as a correlation. Participants who had sustained wellbeing through very challenging times attributed this largely to having a purpose, or meaningful role or valued contribution. A participant reflected on her journey through grieving: “My husband died and I was really lonely, probably as bad as John [vignette two] at one point. But I got into volunteering at the community garden. Having those plants that needed my focus and seeing families come in and get fresh vegetables—it gave me a reason to get up. Now I feel like there is a layer of joy that is sitting in me, even when I still miss him every day”. Optimism and Faith in Future Possibilities Hope was arguably the most potent psychological resource described by participants as the emotional drive that carries people through challenging situations. Participants made a distinction between blind optimism and realistic hope. A participant explained, “I don’t tell people ‘Cheer up, it’ll be fine’. That can seem dismissive when someone is really struggling, so we say, ‘It’s tough and it can get better’. That is true of each of these phrases. You have to recognise the dark to believe in the light”. Losing and then regaining or restoring hope, in particular, came to the foreground in recovery narratives. A middle-aged participant shared a deep story of how disappointment had stripped him of hope: “I know what it is to be without hope because I lived like that for 20, 30 years, however long. Every time I reached out for help there was no one there, or if there was, they let me down. After a while, you stop hoping. Hope is painful when it lets you down over and over again”. The focus group sat in attention as he continued, “Only recently and through a poetry group, I am starting to let myself trust in hope. These people keep showing up every week. The consistency, the reliability, it is teaching me that maybe good things can last”. Combining this with intergenerational hope surfaced as a strong source of motivation for some, especially amongst the Māori participants. An older participant shared their views confidently and clearly about how they understand the process of navigating intergenerational trauma: “If we comprehend [inter]generational trauma and I mean really get it, then there comes a time when it dies with me; I look at my mokopuna [grandchildren] and say, ‘It dies with me, they are going to be better’. My hope for my grandchildren is what gets me up and out of bed, when I consider throwing in the towel”. The hope for future generations was more than this participant’s hope for her mokopuna. It also reflects resilience towards significant systemic barriers and contexts of hopelessness. Relationality to culture, specifically time and hope also created rich, narrative connections. For example, a participant spoke about a deep sense of spirituality around how they see time and relationally to the past, present and future, in the following manner: “Our world view is that, before we entered this realm, our babies chose us to be their parents. So yes, we bear witness to the trauma experienced by our ancestors and the trauma we have experienced ourselves—it is our responsibility, as the chosen people, to actually heal those traumas—even for our ancestors. Yes, it is heavy responsibility, but it is also a heavy hope”. Locus of Control & Personal Agency The movement towards the experience of some sense of control over their circumstances manifested as another critical difference that divided those participants who had resilience from those who felt ‘stuck or trapped’. The participants were not using academic language, but they were simultaneously articulating the difference between the feeling of agency, versus feeling of being a victim. For example, one participant was succinct: “You gotta want help. You gotta want to get out of this. No one can help you until you want help to get out of your problem or issues. No one can push you into that change; you have to want something for yourself to change”. The nuance of the relationship between personal agency and accepting help revealed how resilience operates in complex ways. For example, resilient participants did not view self-agency and asking for help as oppositional; in fact, for these participants asking for help is viewed as an example of personal agency. A young participant, explained that for him; “Yes, I have to still help myself, but that does not mean by myself; sometimes the most powerful thing to do, is to pick up the phone and say, ‘I need help’. That is taking control, not giving it away”. The experience of taking self-control in relation to help, emerged as the most important, when the participant was stating their experience of learning how to know what they could and could not control, as a measure of resilience. In this example, a participant referenced a practice, they were introduced to in therapy, that was life changing; “My counsellor had me write two lists—things I can control and things I can’t control. Then she [counsellor] said, ‘Think about the first list, let the second one go’. It sounds simple but it changed everything for me. I just stopped using brain energy raging about the government or the economy and would focus on what I could do—budget better, retrain, look after my health”. Collective agency might be dismissed as a simple variation of individual locus of control. Yet participants engaged with notions of being together and often described belonging to a group, as identities to increase their locus of control. For example, a participant commented that, “When we were on our own, we could do nothing about the big things in the world like poverty or mental health services. But together, from the outside, we made our own solutions—peer support, community gardens, homework clubs; we took control rather than waiting for someone to come and rescue us”. Theme 2: Health and Wellbeing Health was identified as a core aspect of resilience, with participants conveying intricate connections among physical health and mental wellbeing and considering access to healthcare services. This theme also demonstrated how health challenges can put resilience to the test but also contribute to the development of resilience, while barriers wrought by the healthcare system can destroy resilience. Interrelated Physical and Mental Health Participants repeatedly discussed physical and mental health as not distinct but interrelated, with direct implications for one another. The narratives related to health challenges illustrated the extent to which an illness or injury could start a domino effect across all domains of life. A participant described how she responded with resilience to her health adversity, sharing her journey with cancer: “Three years ago, I found out I had [a type of cancer]. I thought that was it for me. But here’s the thing—I went through treatment, saw how my whānau rallied around me, met other survivors—it changed everything. Now I am [70s] and I love it. Every day that I wake up I am grateful”. Mental health was a dominant theme in every focus group, participants spoke openly and honestly about struggles with depression, anxiety and trauma. There was clear evidence that the COVID-19 pandemic exacerbated pre-existing mental health challenges and there was also evidence that this pandemic had reduced stigma related to openly discussing mental health challenges. One participant described their experience with depression in a way that resonated across the focus groups, they shared, “Last year I battled really bad depression for a whole year. I couldn’t get out of bed for weeks, like literally. I ended up losing my job and that was worse - It reached a point where I had to reach out otherwise, I wouldn’t have made it”. The group’s reactions to disclosing these experiences were extremely accommodating, sharing their own experiences and how they were dealing with recovery. The collective expression of mental health challenges was conveyed in a manner that portrayed them as universal as opposed to shameful, which was perceived as a cultural shift participants appreciated. An older participant reflected on this: “Twenty years ago you didn’t hear people talk about their depression. Now my grandson lets me know when he’s having a bad mental health day. That openness, that’s progress”. Healthcare Access as a Marker of Resilience Accessibility of healthcare services, with a particular emphasis on general practitioner and mental health services were a major structural factor impacting resilience. Participants from rural areas faced these barriers on a minimum of three fronts: proximity, availability and cost. A kaumatua [elder] from a rural area elaborated the interrelatedness of barriers: “If I have to see a doctor, my niece has to take a day off work and take me to town. That’s her losing a day’s pay, plus the petrol, plus the doctor’s fee. So, I wait until I am really sick. When I finally go it will be worse then and cost more. It’s a vicious cycle”. Even in urban areas, the challenge of accessing healthcare was illustrated through a participant recalling a frightening experience: “My boy had an asthma attack at night. The after-hours clinic was closed; the ED had a five-hour wait. I’m sitting there watching him wheeze and wondering if I should wait, or should I call an ambulance that I can’t afford? No parent should have to make that kind of calculation”. Despite the health system being publicly funded, price continued to be a significant barrier, as recounted by a participant: “I had medications that I’m meant to be on for my heart, but when it was, pay $ 30 for the script or buy kai [food] for the kids, you know what I bought. I am not proud of this, but that’s the reality of a lot of us”. These types of decisions, to forego health in favour of basic necessities, highlight the compounding issues of poverty. Poverty deepens health vulnerabilities and undermines resilience at all levels. Another major issue determined through these conversations, was the cultural accessibility of healthcare. Māori and Pacific participants frequently articulated experiences of mainstream health services as alienating or culturally unsafe. A young Māori participant spoke about his own experiences with General Practice: “They just rush you through, give you a bunch of pills, but they didn’t listen to anything else. They have no understanding of where I’m coming from and what healing means in my world. I would rather talk to my kaumātua [elder] or try rongoā [traditional Māori medicine] first”. However, counter-examples demonstrated how culturally responsive healthcare transformed participants’ experiences. A participant reflected positively of their experience with a Māori health provider: “At the clinic, that operated by our people, they go through the proper process of greeting you and asking about your whānau, they bring nurses in, and they know and understand that health is more than just physical. They’re treating with the person, not just the symptom. That is what makes the difference between people coming back for a follow-up”. Theme 3: Social Capital and Connection Social support was perhaps the most consistently highlighted factor in all focus groups. Participants spoke about layered connections from family to community. This theme highlighted social capital as both a shield against adversity as well as an active resource to help them bounce back. Whānau and Family as the Primary Circle of Support Māori, in particular, understood whānau to mean extended family networks, but also close friends who were “family-like”. This indicator of family extended beyond a nuclear family understanding that is more common in the West. An older participant provided a thoughtful worldview: “For us, wellbeing is whānau wellbeing. If my brother’s struggling, I’m not okay. If my mokopuna [grandchildren] are flourishing, I’m rich regardless of what’s in my bank account. We rise and fall together”. There were multiple examples from participants to demonstrate the protective nature of whānau support. A young participant explained how their extended family nearly moved in with them to stave off post-natal depression and support her transition to motherhood. “After baby was born, my aunties basically moved in. They did the cooking, cleaning, washing—everything except breastfeeding. I could just focus on bonding with baby and healing. Without them, I know I would have gotten really dark. That’s what whānau does—they hold you up when you can’t stand.”. Non-Māori participants spoke about family support, but often in a more nuclear family way. One participant described their relationship with their siblings and their support as they became parents: “My brother is my rock. He somehow knows when I’m struggling before I even tell him. He’ll just show up with a coffee and say, ‘Let’s go for a walk.’ That intuitive support—it’s kept me from going under more times than I can count.” The complexity of family relationships also came into play, with some participants saying family had added stress, rather than support. A participant, noted: Everyone talks about family support, but what if your family is the problem? I had to distance myself from toxic family members to protect my mental health. Finding chosen family—friends who became my real support—that was my resilience journey. Community Networks and Social Cohesion In addition to family, participants also identified communities as a source of supportive connection through their neighbourhoods, workplaces, churches, sports clubs and cultural organisations. Broader communities provided practical support, social identity and belonging, which contributed to their resilience capacity. Rural communities placed a unique emphasis on the double-edged sword of social networks in small towns. A participant noted, “In a small place like this, everyone knows everyone. If you’re struggling, you can’t hide; someone will notice and check in. That can feel intrusive, but it’s also a safety net. We have caught people before they fell too far.” Each participant group had a universal concern about the diminishing traditional community connections today. An older participant mentioned: “When I was young, neighbourhoods were communities. Kids played together, adults watched over each other. Now everyone is busy, on their phones, isolated in their houses. We’ve lost something precious—that natural, everyday connection that kept people resilient.” Nevertheless, participants also provided examples of individuals and communities that were actively reconstructing social cohesion. A community centre in an urban area on the South Island was one example: “We’ve got over 100 volunteers running everything from exercise classes to grief support groups. It’s by the community, for the community. People come for one thing and stay because they find connection. That's rebuilding the village we’ve lost.” Trust as the Foundation of Social Capital Trust emerged as an essential mechanism that allowed social support to operate effectively. Trust was discussed by participants at several levels, interpersonal trust was explained as trust between individuals; community trust was trust that existed between people and institutions in the community and systemic trust was described as trust in government and public infrastructures. Each of these layers affected resilience in multiple ways. Interpersonal trust established the vulnerability necessary for genuine support to be offered. A participant described her experience with trauma: “After being hurt, I built walls. But walls that keep pain out also keep help out. Learning to trust again—letting one or two people past those walls—that’s what allowed me to heal. But it took years to rebuild that capacity to trust.” Community trust was articulated as a collective resource that enabled mutual aid and cooperation in communities. High trust communities organised themselves quickly when needed, shared resources readily when needed and created a social order without reliance on outside intervention. One participant reflected on the disaster response: During the earthquakes, our neighbourhood just clicked into action. Everyone checking on everyone, sharing water, food, generators. You didn’t even have to ask…people just showed up for each other. That experience-built trust that’s lasted years. Nonetheless, systemic trust is significantly eroded, principally among Māori and marginalised peoples. A Māori participant stated bluntly: “Our people don’t trust any of the systems because they’ve never served us well. Health, education, justice…they’ve all failed us repeatedly. So, when they come with new programs or initiatives, there’s deep scepticism. Why should this time be different?” Theme 4: Systemic and Structural Factors Systemic factors such as economic conditions, institutional structures, and social fairness were found to profoundly shape resilience capacity. This theme demonstrated how individual and community resilience cannot be disentangled from wider structures that enable, or restrict, adaptive capacity. Financial Security and Economic Stress Financial security was found to be a fundamental protective factor, and economic stress was articulated as one of the features able to counteract resilience and wellbeing across all residents. Respondents described financial insecurity as an ongoing stressor that risks draining the psychological and emotional resources needed to enable adaptive coping with the multiple demands of other stressors. One participant described their near-homelessness experience: When I lost my job, we had no savings buffer. Within a month we were behind on rent, choosing between food and power bills. The stress destroyed us. We were fighting constantly, couldn’t sleep, couldn’t think straight. How can you be resilient when you’re in survival mode every day? The rising cost of living was universally mentioned as a growing threat to wellbeing. A participant shared their frustrations regarding the economic climate: “Once upon a time, $ 100,000 was a great household income. Now it’s nothing. You still struggle to buy a house, still worry about bills. The goalposts keep moving. How are our kids supposed to have hope when working full-time doesn’t even guarantee basic security?” Communities demonstrated remarkable creativity in developing collective economic strategies. Informal economies that rely on reciprocal sharing provided some insurance against individual financial vulnerabilities. A participant shared the strength of their community: “We’ve got community gardens, tool libraries, babysitting circles…all these ways we share resources instead of everyone buying everything. If I have extra eggs or vegetables, I give them out knowing someone will help me when I need it. That’s how we survive on not much money.” Māori particularly exhibited economic collective practice that relied on their cultural values. A participant from a coastal town stated: “If someone’s struggling, the marae organises a fundraiser. Everyone gives what they can…even if it’s just a few dollars. We won’t let whānau go hungry or homeless. That collective responsibility is our economic resilience.” Perceptions of Fairness and Justice Fairness as a perception emerged as a strong factor of resilience, as systemic unfairness has potential to deny hope and trust to the community, while reported fairness reinforces social cohesion and collective efficacies. Participants often articulated frustration addressing a variety of forms of inequality and discrimination that fit together under the heading of wellbeing. An exemplary issue itself of fairness to beach access in a rural area where the Regional Council resolutions have restricted traditional access, was particularly contentious. A participant of this community mentioned, “Our people have gathered kai moana [seafood] from these beaches for generations. Now the council—people who don’t even live here—decide we can’t drive down to the beach anymore. For elderly or disabled folks, that means no access at all. It’s not just inconvenient; it’s cultural destruction.” Economic inequality was also an issue discussed at length and conveyed perceptions of fairness within these shared stories. Many participants described differences between rich and poor communities. A few stated they were feeling like the system was “rigged” against the everyday person. One young participant stated: “They tell us the economy’s doing great, but we’re going backwards. My parents bought a house on one income; I can’t afford rent on two [incomes]. That’s not progress. The system feels designed to keep us struggling while a few get richer.” Discrimination emerged as another aspect of unfairness. “My Pākehā [non-Māori] colleague had never experienced racism…couldn’t even imagine it. Meanwhile, I face microaggressions daily. That constant extra burden of navigating bias. It wears you down, makes everything harder. The unfairness isn’t just the discrimination itself, but that half of society doesn’t even believe it exists.” Theme 5: Cultural and Environmental Resources The last theme highlighted resources which emerged from cultural identity, spirituality and connection to natural places. These resources provided unique forms of resilience, which were not limited to the individual but made connections to wellbeing at the ecological and cosmological levels. Nature as Healing Landscape Green and blue spaces were considered an important resilience resource, with participants referring to nature using terms such as restorative , perspective and spiritual connection . Therapeutic benefits from nature were stated in every focus group but were most prevalent in the coastal and rural groups, as expressed by one participant: “When I’m overwhelmed, I go to the beach. Something about the rhythm of the waves, the vastness of the ocean…it puts my problems in perspective. The sea doesn’t care about my mortgage or my work stress. It just is. That groundedness [feeling centred and anchored], that’s what I find in nature.” Urban participants valued natural spaces too, however, had more difficulty in accessing green or blue spaces. One mother described how parks help her mental health, “After the baby, I was drowning in postnatal depression. The only thing that helped was pushing the pram to the park every day. Just seeing trees, hearing birds, watching the seasons change—it reminded me life goes on, things grow and change. That park saved my sanity.” For Māori, the natural environment also has cultural and spiritual value. A kaumatua elaborated on the relativeness of all aspects of connection: “When I feel pauri [heavy-hearted], I go sit by the moana [ocean]. I karakia [pray] to Tangaroa [God of the sea], talk to my tūpuna [ancestors]. The water carries away my worries. This isn’t just about pretty scenery…it’s about whakapapa [genealogy], connection to everything that came before and everything that will come after.” Environmental decline was described as directly reducing resilience by cutting off these resources. Participants spoke with true sorrow regarding contaminated rivers, developed coastlines and sites of gathering lost. One participant explained: The river where I learned to swim, where we caught eels as kids…it’s too polluted now. My children will never have those experiences. We’ve traded environmental health for economic growth, but what’s the real cost to our wellbeing? Cultural Identity and Spiritual Resources Cultural identity was presented as a significant resilience resource, each Māori participant described the connection to culture as a source of strength, a source of meaning and even practical support based when dealing with adversity. Cultural revitalisation was understood as directly promoting individual and collective resilience. One young Māori participant who had re-established their connection to culture shared: I grew up disconnected from my Māoritanga. When I hit rock bottom…depression, addiction…someone brought me to the marae. Learning my whakapapa, my reo [language], understanding where I fit in the larger story … it gave me identity and purpose. Culture became my rehabilitation. Cultural participation provided multiple layers of resilience benefits. A participant discussed kapa haka (Māori performing arts): “Kapa isn’t just singing and dancing. It’s physical exercise, mental discipline, social connection, cultural pride and spiritual practice all in one. When I’m on stage with my group, I’m connected to my tūpuna, my iwi, my identity. That strength carries over into everything else.” Spiritual beliefs and practices, either in the context of Indigenous beliefs or any introduced religions provided a way of making meaning in adversity. Participants described relying on faith in times of crises, finding peace in prayer or meditation and support in their faith-based communities. Spirituality was described in various terms - some explained Christian faith, some shared Māori cosmology references and some practiced secular mindfulness. The passing on of cultural knowledge across generations was described as both resilience and responsibility. Elders spoke about sharing their culture, stories and values taught to them, which had sustained their people despite colonisation, an ongoing effect of marginalisation. A kaumātua reflected: “Our resilience isn’t just individual … it’s centuries of survival knowledge passed down. When I teach the young ones our stories, our tikanga [customs], I’m giving them tools their tūpuna used to survive. That’s why cultural revival is so important. It’s collective resilience building. Discussion This study found that resilience was not merely positioned at the individual trait level, but rather at (1) relational networks of whānau and community, (2) the indivisibility of physical and mental health, (3) the role of systemic and economic conditions and (4) cultural–spiritual–ecological connections. These findings reframe resilience as collective, relational and situated-structurally. Embodiment, Biology and Social Inequality Our findings compellingly illustrate what Krieger [ 21 ] theorises as “embodiment”—how we literally, biologically, incorporate our material and social world. When one participant described choosing between their heart medication or feeding their children, he did not just narrate how difficult life was, he illustrated how social inequities get biologically embodied through what Krieger calls “pathways of embodiment.” Krieger’s ecosocial theory [ 21 ] offers ways of thinking about how the “vicious cycles” our participants discussed, poverty to bad health, bad health to unemployment, worsening poverty, happened at the same time across multiple levels and timescales. As one participant says, “poverty gets into your bones,” articulating what epigenetics research has recently demonstrated: chronic stress with discrimination and deprivation change gene expression and hastens cellular aging and impacts allostatic load [ 22 ]. The biological embedding of social position disrupts psychological definitions of resilience which do not incorporate how we materially embody histories of oppression. The five-hour wait in the emergency department, the polluted rivers, the decision between medication and food—these are not social determinants of health but rather described as “structural determinants” [ 21 ], the economic and political mechanisms which create social stratification. These experiences can also be called “slow death”—the wearing down of populations through systemic neglect [ 23 ]. Krieger’s ecosocial theory [ 21 ] resonates deeply with Māori participants’ ‘embodied histories’, whereby historical trauma and ongoing colonisation remain embodied in present-day experiences. Instead of framing health inequities in the context of cultural deficits, this framing acknowledges that structural violence produces ongoing inequities [ 24 ]. Complexity Theory and Resilience as Emergent Property In this research resilience can be seen as a complex phenomenon operating at multiple levels of organisation, from the individual level to the macrolevel of structural determinants. This complexity helps to explain concerns that individually focused resilience interventions may have limited or short-lived impact, particularly when they do not address the structural conditions that shape people’s lives [3, 25, 26]. The science of complex systems can help illuminate multifaceted phenomena such as resilience. Complex adaptive systems have emergent properties that are the result of dynamic interactions across multiple factors, rather than arising from components [ 27 ]. The perspective of resilience as a system highlights how individual outcomes arise from the complex relationship of multiple contextual factors. This helps to explain what we observed in participants’ experiences. The participants’ experiential accounts from which we derived themes of personal factors, health, social capital, structural conditions and cultural resources do not describe independent variables, but systems that interact and show nonlinear dynamics. The accounts show complex adaptive systems of feedback loops and emergent properties. The participant who lost their job because of depression and whose depression consequently got worse, exemplifies what complexity theorists describe as “positive feedback loops”, where initial conditions are made worse by cumulative effects. The participant whose community “clicked into action”, during and after the earthquakes provides a specific example of system resilience, with the resilience being present in redundancy, diversity and adaptive capacity, attributes of a resilient complex adaptive system [ 28 ]. Recent work in “syndemic theory”, presents a health model of co-occurring health and social conditions interacting in a synergistic way [ 29 ]. Our study illustrate that resilience can be understood through a syndemic lens. The confluence of poverty, mental health challenges, ecological destruction and systemic racism appeared, in participants’ accounts, to generate an effect that was not merely additive but multiplicative. This syndemic characterisation highlights why participants emphasised solutions that address multiple issues simultaneously: community gardens as solutions for food security, social isolation and cultural disconnection. Our data showed that participants did not experience trauma recovery as a linear process. The participant who “lived without hope for 20, or 30 years” before recovering a sense of self through poetry shows that resilience presents in ways we never thought possible, outside of clinical time. Epigenetic research supports both cycles of intergenerational trauma and the possibilities for resilience to spread across generations [ 30 ]. Participants validated this double-edged sword in their discussions; they described wanting to stop the cycle of trauma, stating ‘it dies with me,’ yet at the same time, wanted to pass on resilience. Indigenous Ontologies and Relational Resilience Indigenous participants expressed that “you can’t separate the happiness of the individual from the happiness of a whānau”. This illustrates what Indigenous scholars describe as ontologically different, ways of being, that stand in contrast to the Western model of individualism [31; 32]. These conceptions of different ways of being are not cultural differences but “ontological politics,” to borrow the term from De la Cadena and Blaser [ 33 ]: different worlds, not different perspectives on one world. A relational understanding of existence that spans time and generations is also evident in participants’ talk of babies “choosing” their parents, ancestors as current guides and restoring “for our ancestors.” The discussions characterise what Rifkin [ 34 ] defines as “Indigenous temporalities,” where past-future-present are not linear but reflect simultaneity. Such a concept of time presents a challenge to models of resilience that imply sequenced stages of recovery. The recent Indigenous literature on resilience identifies that resilience is not about “bouncing back” but connection to land-person-culture-relationship in the face of ongoing colonisation [35; 36]. Kaumātua describe Tangaroa and tūpuna in the moana as living relatives with their own purpose, highlighting relationships of respect and care rather than viewing them as resources. This relational ontology aligns with emerging new materialist critiques of human exceptionalism [ 37 ]. Environmental scarification is understood as more than the loss of ecosystem services, but the disruption of kinship relations necessary to create colonised Indigenous identity, leading Nixon [ 38 ] to describe “slow violence” against histories and lands. The dismantling of trust among Māori is what Simpson [ 39 ] refers to as “refusal” which is not a scarce need of attention, but a declaration of sovereignty through refusal to engage on colonial terms. Refusal is resilience, holding on to one’s cultural beliefs even though systems call for one to assimilate. Implications for Research and Practice Research Implications Our findings raise questions about some of the essential principles of resilience research. First, they point to the value of shifting our primary unit of analysis from individuals to assemblages, complex relationships that include human, more-than-human, ancestral and environmental relationships. Mixed-methods approaches could combine ethnographic observation, participatory mapping of who is in a participant’s support networks and tracking resilience assemblages longitudinally over time. Second, temporal frameworks may need reconceptualising. An assumption of linear recovery pathways could be replaced with research designs that allow for the circular, spiral and discontinuous realities of recovery, resilience and growth. This could include narrative methods that document how people story-map their resilience over time, or innovative visual methodologies that depict non-linear recovery pathways. Third, methodologies need to move beyond tokenistic consultation towards more genuine partnership. Indigenous communities can be supported to lead the design of research, own the data and decide how widely and to whom to disseminate findings. Our research partnership with Māori researchers was an ethical necessity for us and, in our view, also produced more useful and therefore more valid findings. Practice Implications For mental health services: Our findings highlight tensions between individualistic therapeutic models and collective wellbeing. The participant who pointed out that “you can’t pull individual happiness and whānau happiness apart” illustrates some limits of Western therapeutic models. Mental health services may benefit from avoiding overly rigid structures so as to allow for extended whānau participation, integration of cultural health practices and recognition that recovery is often experienced as arising through relationships based not only in the therapy room but also in nature. For community health: The value of community gardens, tool libraries and peer support networks in participants’ narratives suggests that we should be investing more in community-led initiatives alongside professionally led initiatives. Each initiative is addressing multiple needs at the same time including food security, social connection, cultural practice, and mental health, and simply operates more efficiently than siloed services. For clinical training: In addition to culturally competent training, practitioners need the ability to recognise how social conditions manifest as clinical symptoms. This includes teaching clinicians to see a patient choosing between taking medication or feeding their family not as ‘non-compliant’, but as working within impossible structural constraints, and to recognise that advocacy, as well as adjusting the prescription, may be an appropriate and necessary response. Policy Implications Housing and economic policy: The participant trying to make rent with two incomes while their parents were able to buy homes with one income illustrates how economic policy is health policy. Participants’ accounts are consistent with arguments that universal basic income, living wages and affordable housing are not just health interventions that will help, but may be key priorities for strengthening population resilience. Environmental policy: Participant distress at river pollution and lost places to gather, underline that environmental degradation is experienced as a threat to resilience. Climate action, restoration of waterways and protecting sources of traditional food from pollution can be understood as ecological interventions to protect mental health and resiliency, especially for Indigenous peoples where their connectedness to the environment affects their wellbeing. Health system reform: Encountering five-hour wait times in an emergency setting, or having to choose between medications and food, was experienced by participants as evidence of health system failure. Rather than focusing primarily on training people to be more ‘resilient’ within inadequate services, these accounts point to the importance of guaranteeing access to culturally safe health care services. This includes funding Indigenous health services, where, as echoed by participants, clinicians were described as “treating the person and not the symptom.” Strengths and Limitations Strengths This study’s greatest strength was the method, which chose to partner with Māori researchers and Māori communities from inception to dissemination. This partnership model ensures cultural validity, which is otherwise often absent in resilience research, particularly where instruments have been developed and validated predominantly in Western populations [ 40 , 41 ]. Utilising tikanga Māori protocols (e.g. mihimihi, whanaungatanga and shared kai) allowed for safe spaces for deep sharing. Rural participants were more reliant on place-based connections while urban participants created substitute social systems, yet they all centred on relationships. Our analysis, a careful interplay of Indigenous and Western frameworks, generated insights that neither approach could have achieved alone. This enabled “two eyed seeing” [ 42 ], where Western concepts of resilience were reframed though an Indigenous lens; social support became whanaungatanga and coping became resisting and recovering. Limitations Since this study was qualitative and utilised purposive, community-based recruitment, our participants do not represent a statistically significant sample of the entire population in Aotearoa New Zealand. Thus, the findings cannot be used to determine prevalence rates. Our intention in this co-design phase was not strict statistical representativeness, but to ensure that groups whose perspectives on resilience are often missing or under-represented in large-scale surveys and health datasets were at least as visible as those from the general population [ 43 – 45 ]. We therefore used purposive recruitment to achieve approximate gender balance and roughly equal numbers of Māori/Pacific Island and non-Māori/non-Pacific Island participants, and to include a wide range of lived experiences of mental health challenges, so that both dominant and marginalised perspectives could inform the co-design of the resilience framework and index. At the same time, because recruitment occurred primarily through community organisations, marae, churches and services, people who are highly socially isolated, homeless, imprisoned, or otherwise disconnected from such networks may still be under-represented, and their experiences of resilience and adversity may differ from those described here. National mental health surveys in high-income countries commonly exclude or under-sample precisely these groups (e.g. homeless people, those in hospitals or correctional facilities). In addition, the participation of recent migrants, refugees, LGBTQ + and underrepresented Asian communities was very low. Since the resilience of these populations is based on unique risks of accessing not only a new system but doing so while facing cultural marginalisation and systemic racism, their ways of knowing would contribute to a far deeper understanding. These omissions mirror well-documented patterns in national mental health surveys, where such populations are frequently excluded or under-sampled, leading to an underestimation of need [ 44 , 45 ]. The cross-sectional design allows only a snapshot of resilience at one point in time and does not show resilience fluctuating over periods of time. For example, one participant stated they lived “without hope for 20–30 years,” and this idea of resilience as time/long-term is something we cannot capture in our snapshot. While we worked alongside a kairangahau Māori, there is no doubt that the main authors’ – Pākehā /European - position will have an impact on how this data is interpreted. Despite engaging in reflexive practice with cultural supervision, the principal investigator took on the role of main author and with Western academic frameworks, there is a constrained space for Indigenous ways of knowing to be revealed in this framework. The focus group method, while it can be a rich way to facilitate discussions, it may not capture the voices of those most marginalised, such as homeless individuals, individuals in crisis and individuals with no community ties. These voices, who are often most vulnerable, remain silenced. Future Directions The following section outlines six interrelated domains that represent key areas for advancing resilience research (Fig. 1 ). Longitudinal and Life-Course Research Future research should longitudinally map individuals and communities, capturing how resilience assemblages form, dissolve and reform. It will also be particularly relevant to understand how, at critical points of transition, for example, loss of a job, death of a loved one, diagnosis of a serious illness, existing forms of resilience may break down or be altered. Research that adopts a life-course framework that attends to childhood adversity, adult resources and context over time may also find points to intervene and disrupt intergenerational cycles. Climate Change and Resilience Emerging from the consideration of the wellbeing of individuals and communities is recognition that environmental degradation, disconnect from place, and climate change profoundly threaten wellbeing. Research should attend to the concept of resilience when studying the climate crisis. In what way do communities articulate, retain and maintain wellbeing when the landscape they are used to changes? What new practices of resilience are created when old lifestyle practices are no longer viable? Climate grief, eco-anxiety, and cultural loss require urgent attention. Digital Resilience Assemblages Our participants, like the literature, emphasised the importance of face-to-face connections, but digital communities are increasingly becoming important sources of resilience for many people. Research needs to investigate how virtual communities provide a sense of community or support, we need to consider how algorithmic systems create and/or obstruct opportunities, we need to consider how digital divides impact community resilience. The COVID-19 pandemic’s enforced digital transition offers a valuable research opportunity to examine these questions, comparing communities that maintained connection through digital means with those unable to access such technologies and exploring what was gained and lost in the shift from physical to virtual support networks. Intervention Development and Testing Our research suggests that community designed and implemented interventions are needed that addresses multiple needs at once. Participatory action research rather than top-down research might develop and test community-led initiatives that build on existing collective strengths. Given our findings that resilience is an emergent property of complex adaptive systems, traditional experimental designs that isolate single variables may be inadequate. Research approaches should instead focus on understanding how interventions shift system dynamics—examining changes in feedback loops, community connections, resource flows, and adaptive capacity. System dynamics modelling, network analysis, and developmental evaluation offer methodologies better suited to capturing the complexity of interventions targeting structural determinants of health. Economic Evaluation It is essential to show the economics of transformative approaches to facilitate policy change. Cost-utility analyses can demonstrate the value of upstream interventions (living wages, secure housing) by comparing them to downstream costs (health services, emergency services, hospitalisation). When we include a spectrum of social returns on investment of potentially reduced incarceration rates, increased individual employment, intergenerational returns, the real bottom line could be evaluated. Indigenous-Led Research Programs Future research should be Indigenous-designed, Indigenous-led, Indigenous-governed. It is not just about having Indigenous researchers involved. It is recognising that the research systems used, including funding systems, ethics systems, publication systems, need to acknowledge Indigenous knowledge is just as valuable as Western science. International collaboration among Indigenous peoples may assist in identifying resilience strategies and practices that emerge from shared experiences of colonisation, while remaining attentive to distinct cultural contexts. Declarations Ethics approval and Consent to Participate This study was conducted in accordance with the ethical principles of the Declaration of Helsinki Ethics and was approved by the University of Waikato Human Research Ethics Committee, reference number [HREC(Health)2024#37]. All participants provided informed consent online prior to participating. Consent for publication Not Applicable Availability & Data materials Full focus-group transcripts/audio cannot be shared. De-identified materials (codebook, framework, selected quotations) are available on reasonable request, subject to HREC approval (HREC(Health)2024#37) and Māori advisory-group permission. Competing interests The authors declare no conflict of interest regarding this study Funding This research was funded by the Health Research Council of New Zealand (24/981) and the University of Waikato. Author Contribution Stefan Heinz: conceptualisation, methodology, investigation, data curation, formal analysis, writing—original draft, visualisation.Anthony O’Brien: methodology, formal analysis, validation, writing—review and editing, supervision.Matthew Parsons: project administration, conceptualisation, writing—review and editing, supervision.Cameron Walker: conceptualisation, review and editing, supervision.Michael O’Sullivan: conceptualisation, review and editing, supervision.Paul Rouse: conceptualisation, review and editing, supervision.Jesse Whitehead: methodology, writing—review and editing.Lara Wall: writing—review and editing.Michael Edmonds: data collection, writing—review and editing. Acknowledgement We thank all participants who shared their experiences and perspectives with us. We are grateful to our cultural advisors and lived experience advisors for their guidance and wisdom. Thanks also to our colleagues in the Division of Health at the University of Waikato for their contributions through feedback and the many conversations, formal and informal, that shaped this project. Open access publishing facilitated by the University of Waikato. Open access publishing facilitated by the University of Waikato. Data Availability Full focus-group transcripts/audio cannot be shared. De-identified materials (codebook, framework, selected quotations) are available on reasonable request, subject to HREC approval (HREC(Health)2024#37) and Māori advisory-group permission. References Stainton A, Chisholm K, Kaiser N, Rosen M, Upthegrove R, Ruhrmann S, Wood SJ. Resilience as a multimodal dynamic process. Early Interv Psychiatry. 2019;13(4):725–32. 10.1111/eip.12726 . 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Harris R, Paine S-J, Atkinson J, Robson B, King P, Cormack D, et al. We still don’t count: the under-counting and under-representation of Māori in health and disability sector data. N Z Med J. 2022;135(1567):54–63. Wright E, Pagliaro C, Page IS, Diminic S. A review of excluded groups and non-response in population-based mental health surveys from high-income countries. Soc Psychiatry Psychiatr Epidemiol. 2023;58(9):1265–92. 10.1007/s00127-023-02488-y . Oakley Browne MA, Wells JE, Scott KM. Te Rau Hinengaro: The New Zealand Mental Health Survey. Wellington: Ministry of Health; 2006. Additional Declarations No competing interests reported. Supplementary Files 251125FocusGroupguideResiliencestudy.docx Cite Share Download PDF Status: Published Journal Publication published 16 Jan, 2026 Read the published version in BMC Public Health → Version 1 posted Editorial decision: Revision requested 23 Dec, 2025 Reviews received at journal 21 Dec, 2025 Reviews received at journal 16 Dec, 2025 Reviewers agreed at journal 12 Dec, 2025 Reviewers agreed at journal 08 Dec, 2025 Reviewers invited by journal 08 Dec, 2025 Editor assigned by journal 08 Dec, 2025 Editor invited by journal 25 Nov, 2025 Submission checks completed at journal 24 Nov, 2025 First submitted to journal 24 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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10:52:07","extension":"html","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":162451,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8133475/v1/4e421cfa2c9e2aea7650c331.html"},{"id":97874445,"identity":"0b2fa9e0-d202-4b68-9827-e1d4d0096dc6","added_by":"auto","created_at":"2025-12-10 10:52:07","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":269507,"visible":true,"origin":"","legend":"\u003cp\u003eFuture Research Directions in Resilience Studies\u003c/p\u003e\n\u003cp\u003eNote: ROI = Return on Investment; SDM = System Dynamics Modelling; DE = Developmental Evaluation.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8133475/v1/206102e31b85f3374141e817.png"},{"id":100615825,"identity":"59c2b198-561d-46ce-aebc-46eca791ecdd","added_by":"auto","created_at":"2026-01-19 17:37:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":853716,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8133475/v1/33edd558-746d-4c6c-bcd3-a69d516ca0e6.pdf"},{"id":97899612,"identity":"6457ee8e-7d7c-4c34-b8f4-21a3e837eb17","added_by":"auto","created_at":"2025-12-10 15:44:45","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":32111,"visible":true,"origin":"","legend":"","description":"","filename":"251125FocusGroupguideResiliencestudy.docx","url":"https://assets-eu.researchsquare.com/files/rs-8133475/v1/3ca8a5f5ab1e21229946e423.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Lived experience perspectives on resilience, mental health, and wellbeing: a focus group study of individual, social, and systemic determinants in Aotearoa New Zealand","fulltext":[{"header":"Introduction","content":"\u003cp\u003eOur conceptual understanding of resilience, the ability to positively adapt in the face of adversity, has evolved significantly over the past few decades. From early notions of discrete individual traits, through multidisciplinary perspectives, resilience has developed as a dynamic, multisystemic process [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This paradigm shift aligns with increased acknowledgment that resilience emerges from complex interactions between individuals and their social-ecological contexts that are largely defined by cultural values, historical experiences and structural conditions [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, even with increasing theoretical understanding, the development of resilience questionnaires and interventions are often conducted without meaningful engagement with the communities for whom they are intended to serve. This increases the risk of developing culturally inappropriate and ineffective resilience interventions [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe construction of resilience as an individual trait is a particular issue for Indigenous peoples and other cultural minorities, whose conceptions of wellbeing and resilience may differ from Western psychological perspectives. In the Aotearoa New Zealand context, Māori understanding of health, described in models such as the Meihana Model [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] provide a more holistic interpretation, illustrating wairua (spiritual wellbeing), hinengaro (mental and emotional wellbeing), tinana (physical health) and whānau (family and social wellbeing) as foundational components. The model also incorporates taiao (physical environment), iwi katoa (services and systems) and contextual factors including the impacts of colonisation, racism, migration and marginalisation. These holistic conceptualisations render resilience not as an individual trail, but rather the relational capacity between people and their families, communities, cultural backgrounds and natural environment. These relationships must be balanced to attain wellbeing [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Similar relational approaches can be seen in Pacific models of wellbeing. For example, Pacific models emphasise the interrelationship of collective harmony, spiritual unity and social reciprocal obligations to extended family [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Amid the shift towards greater recognition of social determinants and community connections even in Western models, there is an increasing acknowledgment that we cannot treat resilience as a strictly individual psychological trait.\u003c/p\u003e\u003cp\u003eGrounding resilience research within community contexts is urgent, particularly given persistent health and social inequities in Aotearoa New Zealand. For example, Māori are estimated to live on average seven years less than non-Māori, with disparities across physical health, mental health and social and economic outcomes [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. These inequities are manifestations of the ongoing effects of colonisation and dispossession of ancestral lands, disruption of cultural and spiritual practices and systematic discrimination by the health and social services [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Challenges associated with rural living are shared among Māori and non-Māori communities alike, such as limited access to numerous services, high levels of economic volatility and growing social isolation [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Understanding how people and communities maintain well-being, despite facing adversity - and what factors promote and undermine their resilience - requires approaches that can privilege lived experience and cultural knowledge.\u003c/p\u003e\u003cp\u003eRecent developments in resilience science have urged researchers to adopt culturally responsive and participatory frameworks for understanding resilience. For example, Ungar’s social-ecological model [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e11\u003c/span\u003e] describes resilience as the capacity of individuals, families and communities to navigate their way to health-sustaining resources, including opportunities to experience feelings of; the resources and opportunities themselves; and the collective condition of the individual’s family, community and culture to provide, in culturally meaningful ways, these resources and opportunities. This understanding articulated the social and structural dimensions of resilience, while recognising that what are deemed protective factors vary by context. Relatedly, Indigenous resilience researchers argue that approaches to resilience should adopt decolonising approaches that identify Indigenous knowledge systems as legitimate ways of understanding (and fostering) wellbeing. Such an approach avoids conceptualising Indigenous knowledge systems as cultural variants to Western models [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e12\u003c/span\u003e] and aligns with recent scoping review findings highlighting that Western concepts of resilience are predominately individualised [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This is also evident in the European Commission’s individual-resilience index which focused on traits and individuals coping [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e13\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn this study, we drew on a research agenda that aimed to build a resilience index for Aotearoa New Zealand to inform policy and practice based on recognition of individual, relational, structural, and cultural determinants of resilience. Instead of imposing pre-determined constructs from existing resilience frameworks, we sought to understand how diverse communities experience and conceptualise resilience in their everyday lives. Our research focused on how proposed indicators of resilience commonly cited in the literature (e.g., optimism as an individual characteristic; locus of control as contingent on social support, access to services, etc.) emerged in participants’ narratives of overcoming adversity. While we considered including recommendations based on the literature in our focus group methods, we recognised the importance of adhering to culturally informed practices that aligned with participants’ perspectives of resilience. We sought to contribute not only to theoretical understandings of resilience, but also to the practical applications of resilience research. This ensures that future measures are grounded in lived experience and are culturally embedded.\u003c/p\u003e\u003cp\u003eWe responded to calls for “resilience research that makes a difference” [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e14\u003c/span\u003e] by recognising the importance of engaging with communities, cultural responsiveness and attending to structural factors that shape resilience contexts. We situated this work within a transformative research paradigm that seeks not only to document resilience processes but also to contribute to social change. To illustrate how qualitative inquiry generates meaningful contribution towards resilience science, we aimed to highlight how participants’ understandings of resilience demonstrated the cultural situatedness of human adaptation and the knowledge of communities that sustain it.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis study was informed by a combination of multisystem resilience theory [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e15\u003c/span\u003e], Kaupapa Māori research principles [16; 17], and Talanoa [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e18\u003c/span\u003e] methodology for Pacific participants. We viewed resilience as a dynamic process that emerges from interactions at multiple system levels (individual, family/whānau, community, societal and natural), enabling the recognition that these categorical distinctions from Western worldviews may not be aligned with Indigenous holistic worldviews. By embedding Kaupapa Māori principles within the research processes, Māori knowledge was respected, and Māori wellbeing prioritised, ensuring the research was responsive to Māori communities. Similarly, Talanoa principles ensured responsiveness to Pacific communities. This integrated approach, combining international resilience scholarship with Indigenous and Pacific methodologies, provided opportunities to draw on established theoretical frameworks while simultaneously honouring Indigenous and Pacific ways of knowing.\u003c/p\u003e\u003cp\u003ePartnerships and Protocols\u003c/p\u003e\u003cp\u003eResearch partnerships were developed with kairangahau Māori (Māori researcher), Māori health providers, Pacific community groups and broader community providers across the study sites. An advisory group supported the project throughout its development, implementation and interpretation. This group included Māori kaumātua (elders), Pacific Islander cultural leaders, health practitioners and community representatives from all backgrounds. Cultural protocols, such as the Hui Process [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e19\u003c/span\u003e], were used in all focus groups: mihimihi (introductions where connections are acknowledged), whakawhānaungatanga (strengthening and maintaining connections), Kaupapa (establishing the purpose of the encounter) and poroporoaki (concluding the encounter). The focus groups were all conducted by a kairangahau Māori with lived experience. This approach aimed to enhance trust and upheld the guiding principles of Māori-led research practice.\u003c/p\u003e\u003cp\u003eParticipants and Recruitment\u003c/p\u003e\u003cp\u003eBetween February and April 2025, nine focus groups were conducted across diverse geographical regions of Aotearoa New Zealand. The sites were selected across large urban centres (4-sites) and rural/coastal communities (5-sites). This geographical diversity provided a snapshot of variability in resource availability, cultural mix and diversity of community features, including communities with a significant number of Māori, Pacific Islander, immigrants and New Zealand Europeans.\u003c/p\u003e\u003cp\u003e Participants (N = 92) were recruited through purposive sampling in partnership with community organisations, health providers, marae (traditional Māori meeting places), churches and cultural networks. The participants were approximate equal proportions of Māori (48%) and non-Māori (52%) participants. The mixed focus groups included New Zealand European, Māori, Pacific Islanders and other ethnicities, reflecting cultural diversity within Aotearoa New Zealand. Participants ranged from early 20s to late 80s, with relatively even distribution across age groups. While the majority of participants identified as male or female, reflecting general population distributions, our sample also included non-binary participants. Gender identity was not a primary axis of analysis in this study, as our focus was on ethnic/cultural perspectives on resilience. To enable culturally safe (i.e., free from cultural judgment or misunderstanding) spaces, two of the nine focus groups were conducted as ethnicity-specific groups, one with only Māori participants and one with only Pacific Island participants. Urban mixed focus groups showed greater ethnic diversity with Māori representation of 35–50%, while rural/coastal groups had 55–70% Māori participation, reflecting regional demographics and community-based recruitment strategies.\u003c/p\u003e\u003cp\u003eData Collection Procedures\u003c/p\u003e\u003cp\u003eEach focus group ran for 90 to 150 minutes and was held in culturally appropriate community locations to support the comfort and accessibility of participants. A semi-structured guide was developed that included two vignettes to stimulate open and organic qualitative discussion. The guide was structured around three broad research questions: (1) what factors contribute to mental health and wellbeing; (2) what role health and social services play in supporting or undermining wellbeing; and (3) how participants understood the relationship between mental health, wellbeing and resilience. Open-ended prompts invited discussion of individual resources, whānau and community supports, external factors such as financial stress, isolation, employment and environment, and what helps people “thrive” in their context, including cultural practices, places and spiritual resources where participants felt strong or held. The first vignette discussed ‘Mary’, a person who is navigating mental health issues through connection with their community, connection with nature, and engagement in activities that were meaningful to them. The second vignette included ‘John’, a person who is confronted by social isolation and stagnation against a background of mental health issues. With participants’ consent, sessions were audio-recorded and transcribed verbatim. The focus group guide, including vignettes and prompts, is provided in Supplementary File 1.\u003c/p\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eBraun and Clarke’s [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e20\u003c/span\u003e] model of reflective thematic analysis was used to analyse the focus group data. Two researchers (one Māori; one Pākehā/European) independently coded the transcripts using NVivo 12, meeting regularly and discussing interpretations to reach consensus. Throughout the analysis, particular attention was paid to cultural conceptions and collective-oriented understandings of resilience. Regular hui (meetings) with Māori advisors were held throughout the process to ensure cultural understandings were accurately represented. Particular focus was directed to differences articulated between Māori and non-Māori, across rural and urban contexts and between generations.\u003c/p\u003e\u003cp\u003eEthical considerations\u003c/p\u003e\u003cp\u003e This study was conducted in accordance with the ethical principles of the Declaration of Helsinki Ethics and ethics approval was obtained from the [University of Waikato] Human Research Ethics Committee (Reference: 2024/385). In addition to the requirements of the University of Waikato, we followed guidelines (Te Ara Tika: Guidelines for Māori Research Ethics and the Pacific Health Research Guidelines) that align with tikanga Māori to guide the research. This adheres to consideration for processes involved in establishing researcher-community relationships; protecting participant confidentiality particularly in small communities; ensuring that the research provided benefit back to communities. All participants provided written informed consent after the research process and consent form content were thoroughly explained in plain language. Consent covered participation in focus groups, audio recording of sessions, and use of anonymised transcripts for research and publication purposes. Koha (gift/contribution) were given to participating organisation, rather than individuals, reflecting culture values.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThrough the analysis of data from nine focus group interviews, five themes emerged as overarching concepts capturing the complexity of resilience as viewed and experienced by different communities across Aotearoa New Zealand (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Each theme represents interconnected aspects, not independent categories, with participants\u0026rsquo; stories weaving together rich complexity between individual, social, cultural and structural factors that support or limit resilience.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThematic Framework\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTheme\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFocused Codes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePersonal Resilience Factors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHappiness \u0026amp; Life Satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCollective happiness through whānau, place-based contentment, purpose-driven wellbeing, loss and recovery cycles, cultivating vs experiencing happiness, mokopuna [grandchildren] as source of joy, community garden participation, realistic hope vs blind optimism\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHope \u0026amp; Optimism\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIntergenerational hope, breaking trauma cycles, hope through consistency, spiritual temporality, faith in future possibilities, poetry group healing\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAgency \u0026amp; Control\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWanting help as agency, asking for help as control, control vs acceptance lists, collective agency, community-led solutions, self-determination, choosing battles wisely\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHealth and Wellbeing\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhysical-Mental Health Integration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCancer survival gratitude, depression disclosure normalisation, COVID-19 mental health impacts, physical illness cascading effects, mind-body connection, whānau rallying during illness, mental health openness shift, recovery pathways\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHealthcare Access\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRural access barriers, medication vs food choices, after-hours unavailability, emergency department wait times, transport costs for healthcare, cultural safety in healthcare, Māori health provider experiences, rongoā preference, healthcare affordability crisis\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSocial Capital and Connection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFamily \u0026amp; Whānau Networks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eextended family networks, chosen family, post-natal whānau support, sibling intuitive support, toxic family distancing, whānau collective wellbeing, family as primary safety net\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCommunity Connections\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSmall town visibility, church connections, sports club belonging, volunteer networks, neighbourhood erosion concerns, community centre rebuilding, earthquake response solidarity, peer support networks, interpersonal trust rebuilding, community mutual aid\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTrust Foundations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSystemic trust erosion, institutional scepticism, trust through consistency, vulnerability for support, historical betrayals impact\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSystemic and Structural Factors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEconomic Security\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNear-homelessness experiences, cost of living pressures, housing unaffordability, survival mode stress, moving goalposts frustration, informal sharing economies, marae fundraising support, tool libraries, babysitting circles, community gardens\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFairness \u0026amp; Justice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBeach access restrictions, intergenerational inequality, system rigged perception, daily microaggressions, racism denial frustration, cultural destruction, economic disparity, council decision exclusion, poverty embodiment\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCultural and Environmental Resources\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNature Connection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eBeach wave rhythms, ocean perspective giving, parks for depression relief, seasonal change grounding, moana spiritual connection, karakia by water, river pollution grief, lost gathering places, environmental health trade-offs\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCultural \u0026amp; Spiritual Identity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCultural reconnection healing, whakapapa understanding, Te reo revitalisation, Kapa haka multilayered benefits, marae as rehabilitation, tūpuna connection strength, faith-based coping, tikanga transmission, collective survival knowledge, prayer and meditation practices\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eNote: Analytical Process: Line-by-line coding of nine focus groups (N\u0026thinsp;=\u0026thinsp;92) generated 487 initial codes. Through iterative refinement and consensus between coders (κ\u0026thinsp;=\u0026thinsp;0.78), these were condensed to 92 focused codes, grouped into 12 categories, and synthesised into 5 overarching themes representing multidimensional resilience across diverse communities in Aotearoa New Zealand.\u003c/p\u003e\u003cp\u003eTheme 1: Personal Resilience Factors\u003c/p\u003e\u003cp\u003ePersonal resilience factors encompassed interrelated psychological and emotional resources that participants noted as critical factors. This theme encompassed three interconnected sub-themes: happiness and life satisfaction as an outcome and motivator of resilience; optimism and hope as an emotional fuel to get over the line; and locus of control as a sense of personal agency in one\u0026rsquo;s world.\u003c/p\u003e\u003cp\u003eHappiness and Life Satisfaction\u003c/p\u003e\u003cp\u003eParticipants discussed happiness as not being in a constant happy state but instead as a general sense of overall satisfaction and capability to experience happiness in the midst of adversity. Individuals expressed complex understandings of happiness as a capacity to be cultivated rather than a state to be passively experienced. A young father noted the relationship between his environment and emotional wellbeing: \u0026ldquo;When I drive home, I feel like I\u0026rsquo;m a happy person. [It\u0026rsquo;s a beach town], it\u0026rsquo;s pretty cool. Just being here, knowing this is my place, it puts something in me every-single-day\u0026rdquo;.\u003c/p\u003e\u003cp\u003eStories of loss and recovery illustrated the frailty and resilience of happiness. A participant who had found happiness in rock climbing shared how easily wellbeing could collapse: \u0026ldquo;Climbing was the thing that was making me happy, giving me purpose really and then I had this work placement, and it was just horrific - long hours, awful culture. When I came out of that I lost all the things that give me those benefits. Suddenly I couldn\u0026rsquo;t even remember why I used to be happy\u0026rdquo;. Stories of loss and recovery were mirrored in some participants by the recognition that, in fact, happiness was not an attribute they naturally held, but rather something that required effort and either good fortune and/or conditioning to sustain.\u003c/p\u003e\u003cp\u003eMāori participants framed happiness collectively, rather than singularly. Whānau ora (family wellbeing) could be heard and felt throughout. One kaumātua shared, \u0026ldquo;For us, you can\u0026rsquo;t separate individual happiness and whānau happiness. If my mokopuna [grandchildren] are doing well, I am happy, if my sister is having hard times, it weighs on me. We\u0026rsquo;re just connected like that\u0026rdquo;. This relational understanding of happiness counters Western notions of happiness as an individual state of being and suggests that resilience interventions conducted in contexts which focus on individual happiness as the singular object of intervention may miss important relational pieces. Happiness and purpose emerged consistently as a correlation. Participants who had sustained wellbeing through very challenging times attributed this largely to having a purpose, or meaningful role or valued contribution. A participant reflected on her journey through grieving: \u0026ldquo;My husband died and I was really lonely, probably as bad as John [vignette two] at one point. But I got into volunteering at the community garden. Having those plants that needed my focus and seeing families come in and get fresh vegetables\u0026mdash;it gave me a reason to get up. Now I feel like there is a layer of joy that is sitting in me, even when I still miss him every day\u0026rdquo;.\u003c/p\u003e\u003cp\u003eOptimism and Faith in Future Possibilities\u003c/p\u003e\u003cp\u003eHope was arguably the most potent psychological resource described by participants as the emotional drive that carries people through challenging situations. Participants made a distinction between blind optimism and realistic hope. A participant explained, \u0026ldquo;I don\u0026rsquo;t tell people \u0026lsquo;Cheer up, it\u0026rsquo;ll be fine\u0026rsquo;. That can seem dismissive when someone is really struggling, so we say, \u0026lsquo;It\u0026rsquo;s tough and it can get better\u0026rsquo;. That is true of each of these phrases. You have to recognise the dark to believe in the light\u0026rdquo;.\u003c/p\u003e\u003cp\u003eLosing and then regaining or restoring hope, in particular, came to the foreground in recovery narratives. A middle-aged participant shared a deep story of how disappointment had stripped him of hope: \u0026ldquo;I know what it is to be without hope because I lived like that for 20, 30 years, however long. Every time I reached out for help there was no one there, or if there was, they let me down. After a while, you stop hoping. Hope is painful when it lets you down over and over again\u0026rdquo;. The focus group sat in attention as he continued, \u0026ldquo;Only recently and through a poetry group, I am starting to let myself trust in hope. These people keep showing up every week. The consistency, the reliability, it is teaching me that maybe good things can last\u0026rdquo;.\u003c/p\u003e\u003cp\u003eCombining this with intergenerational hope surfaced as a strong source of motivation for some, especially amongst the Māori participants. An older participant shared their views confidently and clearly about how they understand the process of navigating intergenerational trauma:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;If we comprehend [inter]generational trauma and I mean really get it, then there comes a time when it dies with me; I look at my mokopuna [grandchildren] and say, \u0026lsquo;It dies with me, they are going to be better\u0026rsquo;. My hope for my grandchildren is what gets me up and out of bed, when I consider throwing in the towel\u0026rdquo;.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe hope for future generations was more than this participant\u0026rsquo;s hope for her mokopuna. It also reflects resilience towards significant systemic barriers and contexts of hopelessness. Relationality to culture, specifically time and hope also created rich, narrative connections. For example, a participant spoke about a deep sense of spirituality around how they see time and relationally to the past, present and future, in the following manner:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e \u0026ldquo;Our world view is that, before we entered this realm, our babies chose us to be their parents. So yes, we bear witness to the trauma experienced by our ancestors and the trauma we have experienced ourselves\u0026mdash;it is our responsibility, as the chosen people, to actually heal those traumas\u0026mdash;even for our ancestors. Yes, it is heavy responsibility, but it is also a heavy hope\u0026rdquo;.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eLocus of Control \u0026amp; Personal Agency\u003c/p\u003e\u003cp\u003eThe movement towards the experience of some sense of control over their circumstances manifested as another critical difference that divided those participants who had resilience from those who felt \u0026lsquo;stuck or trapped\u0026rsquo;. The participants were not using academic language, but they were simultaneously articulating the difference between the feeling of agency, versus feeling of being a victim. For example, one participant was succinct: \u0026ldquo;You gotta want help. You gotta want to get out of this. No one can help you until you want help to get out of your problem or issues. No one can push you into that change; you have to want something for yourself to change\u0026rdquo;. The nuance of the relationship between personal agency and accepting help revealed how resilience operates in complex ways. For example, resilient participants did not view self-agency and asking for help as oppositional; in fact, for these participants asking for help is viewed as an example of personal agency.\u003c/p\u003e\u003cp\u003eA young participant, explained that for him; \u0026ldquo;Yes, I have to still help myself, but that does not mean by myself; sometimes the most powerful thing to do, is to pick up the phone and say, \u0026lsquo;I need help\u0026rsquo;. That is taking control, not giving it away\u0026rdquo;. The experience of taking self-control in relation to help, emerged as the most important, when the participant was stating their experience of learning how to know what they could and could not control, as a measure of resilience. In this example, a participant referenced a practice, they were introduced to in therapy, that was life changing; \u0026ldquo;My counsellor had me write two lists\u0026mdash;things I can control and things I can\u0026rsquo;t control. Then she [counsellor] said, \u0026lsquo;Think about the first list, let the second one go\u0026rsquo;. It sounds simple but it changed everything for me. I just stopped using brain energy raging about the government or the economy and would focus on what I could do\u0026mdash;budget better, retrain, look after my health\u0026rdquo;.\u003c/p\u003e\u003cp\u003eCollective agency might be dismissed as a simple variation of individual locus of control. Yet participants engaged with notions of being together and often described belonging to a group, as identities to increase their locus of control. For example, a participant commented that, \u0026ldquo;When we were on our own, we could do nothing about the big things in the world like poverty or mental health services. But together, from the outside, we made our own solutions\u0026mdash;peer support, community gardens, homework clubs; we took control rather than waiting for someone to come and rescue us\u0026rdquo;.\u003c/p\u003e\u003cp\u003eTheme 2: Health and Wellbeing\u003c/p\u003e\u003cp\u003eHealth was identified as a core aspect of resilience, with participants conveying intricate connections among physical health and mental wellbeing and considering access to healthcare services. This theme also demonstrated how health challenges can put resilience to the test but also contribute to the development of resilience, while barriers wrought by the healthcare system can destroy resilience.\u003c/p\u003e\u003cp\u003eInterrelated Physical and Mental Health\u003c/p\u003e\u003cp\u003e Participants repeatedly discussed physical and mental health as not distinct but interrelated, with direct implications for one another. The narratives related to health challenges illustrated the extent to which an illness or injury could start a domino effect across all domains of life. A participant described how she responded with resilience to her health adversity, sharing her journey with cancer: \u0026ldquo;Three years ago, I found out I had [a type of cancer]. I thought that was it for me. But here\u0026rsquo;s the thing\u0026mdash;I went through treatment, saw how my whānau rallied around me, met other survivors\u0026mdash;it changed everything. Now I am [70s] and I love it. Every day that I wake up I am grateful\u0026rdquo;. Mental health was a dominant theme in every focus group, participants spoke openly and honestly about struggles with depression, anxiety and trauma. There was clear evidence that the COVID-19 pandemic exacerbated pre-existing mental health challenges and there was also evidence that this pandemic had reduced stigma related to openly discussing mental health challenges. One participant described their experience with depression in a way that resonated across the focus groups, they shared, \u0026ldquo;Last year I battled really bad depression for a whole year. I couldn\u0026rsquo;t get out of bed for weeks, like literally. I ended up losing my job and that was worse - It reached a point where I had to reach out otherwise, I wouldn\u0026rsquo;t have made it\u0026rdquo;. The group\u0026rsquo;s reactions to disclosing these experiences were extremely accommodating, sharing their own experiences and how they were dealing with recovery. The collective expression of mental health challenges was conveyed in a manner that portrayed them as universal as opposed to shameful, which was perceived as a cultural shift participants appreciated. An older participant reflected on this: \u0026ldquo;Twenty years ago you didn\u0026rsquo;t hear people talk about their depression. Now my grandson lets me know when he\u0026rsquo;s having a bad mental health day. That openness, that\u0026rsquo;s progress\u0026rdquo;.\u003c/p\u003e\u003cp\u003eHealthcare Access as a Marker of Resilience\u003c/p\u003e\u003cp\u003eAccessibility of healthcare services, with a particular emphasis on general practitioner and mental health services were a major structural factor impacting resilience. Participants from rural areas faced these barriers on a minimum of three fronts: proximity, availability and cost. A kaumatua [elder] from a rural area elaborated the interrelatedness of barriers: \u0026ldquo;If I have to see a doctor, my niece has to take a day off work and take me to town. That\u0026rsquo;s her losing a day\u0026rsquo;s pay, plus the petrol, plus the doctor\u0026rsquo;s fee. So, I wait until I am really sick. When I finally go it will be worse then and cost more. It\u0026rsquo;s a vicious cycle\u0026rdquo;. Even in urban areas, the challenge of accessing healthcare was illustrated through a participant recalling a frightening experience: \u0026ldquo;My boy had an asthma attack at night. The after-hours clinic was closed; the ED had a five-hour wait. I\u0026rsquo;m sitting there watching him wheeze and wondering if I should wait, or should I call an ambulance that I can\u0026rsquo;t afford? No parent should have to make that kind of calculation\u0026rdquo;.\u003c/p\u003e\u003cp\u003eDespite the health system being publicly funded, price continued to be a significant barrier, as recounted by a participant: \u0026ldquo;I had medications that I\u0026rsquo;m meant to be on for my heart, but when it was, pay \u003cspan\u003e$\u003c/span\u003e30 for the script or buy kai [food] for the kids, you know what I bought. I am not proud of this, but that\u0026rsquo;s the reality of a lot of us\u0026rdquo;. These types of decisions, to forego health in favour of basic necessities, highlight the compounding issues of poverty. Poverty deepens health vulnerabilities and undermines resilience at all levels. Another major issue determined through these conversations, was the cultural accessibility of healthcare. Māori and Pacific participants frequently articulated experiences of mainstream health services as alienating or culturally unsafe. A young Māori participant spoke about his own experiences with General Practice: \u0026ldquo;They just rush you through, give you a bunch of pills, but they didn\u0026rsquo;t listen to anything else. They have no understanding of where I\u0026rsquo;m coming from and what healing means in my world. I would rather talk to my kaumātua [elder] or try rongoā [traditional Māori medicine] first\u0026rdquo;. However, counter-examples demonstrated how culturally responsive healthcare transformed participants\u0026rsquo; experiences. A participant reflected positively of their experience with a Māori health provider: \u0026ldquo;At the clinic, that operated by our people, they go through the proper process of greeting you and asking about your whānau, they bring nurses in, and they know and understand that health is more than just physical. They\u0026rsquo;re treating with the person, not just the symptom. That is what makes the difference between people coming back for a follow-up\u0026rdquo;.\u003c/p\u003e\u003cp\u003eTheme 3: Social Capital and Connection\u003c/p\u003e\u003cp\u003eSocial support was perhaps the most consistently highlighted factor in all focus groups. Participants spoke about layered connections from family to community. This theme highlighted social capital as both a shield against adversity as well as an active resource to help them bounce back.\u003c/p\u003e\u003cp\u003eWhānau and Family as the Primary Circle of Support\u003c/p\u003e\u003cp\u003eMāori, in particular, understood whānau to mean extended family networks, but also close friends who were \u0026ldquo;family-like\u0026rdquo;. This indicator of family extended beyond a nuclear family understanding that is more common in the West. An older participant provided a thoughtful worldview:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;For us, wellbeing is whānau wellbeing. If my brother\u0026rsquo;s struggling, I\u0026rsquo;m not okay. If my mokopuna [grandchildren] are flourishing, I\u0026rsquo;m rich regardless of what\u0026rsquo;s in my bank account. We rise and fall together\u0026rdquo;.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThere were multiple examples from participants to demonstrate the protective nature of whānau support. A young participant explained how their extended family nearly moved in with them to stave off post-natal depression and support her transition to motherhood. \u0026ldquo;After baby was born, my aunties basically moved in. They did the cooking, cleaning, washing\u0026mdash;everything except breastfeeding. I could just focus on bonding with baby and healing. Without them, I know I would have gotten really dark. That\u0026rsquo;s what whānau does\u0026mdash;they hold you up when you can\u0026rsquo;t stand.\u0026rdquo;.\u003c/p\u003e\u003cp\u003e Non-Māori participants spoke about family support, but often in a more nuclear family way. One participant described their relationship with their siblings and their support as they became parents: \u0026ldquo;My brother is my rock. He somehow knows when I\u0026rsquo;m struggling before I even tell him. He\u0026rsquo;ll just show up with a coffee and say, \u0026lsquo;Let\u0026rsquo;s go for a walk.\u0026rsquo; That intuitive support\u0026mdash;it\u0026rsquo;s kept me from going under more times than I can count.\u0026rdquo; The complexity of family relationships also came into play, with some participants saying family had added stress, rather than support. A participant, noted:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eEveryone talks about family support, but what if your family is the problem? I had to distance myself from toxic family members to protect my mental health. Finding chosen family\u0026mdash;friends who became my real support\u0026mdash;that was my resilience journey.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eCommunity Networks and Social Cohesion\u003c/p\u003e\u003cp\u003eIn addition to family, participants also identified communities as a source of supportive connection through their neighbourhoods, workplaces, churches, sports clubs and cultural organisations. Broader communities provided practical support, social identity and belonging, which contributed to their resilience capacity. Rural communities placed a unique emphasis on the double-edged sword of social networks in small towns. A participant noted, \u0026ldquo;In a small place like this, everyone knows everyone. If you\u0026rsquo;re struggling, you can\u0026rsquo;t hide; someone will notice and check in. That can feel intrusive, but it\u0026rsquo;s also a safety net. We have caught people before they fell too far.\u0026rdquo; Each participant group had a universal concern about the diminishing traditional community connections today. An older participant mentioned: \u0026ldquo;When I was young, neighbourhoods were communities. Kids played together, adults watched over each other. Now everyone is busy, on their phones, isolated in their houses. We\u0026rsquo;ve lost something precious\u0026mdash;that natural, everyday connection that kept people resilient.\u0026rdquo; Nevertheless, participants also provided examples of individuals and communities that were actively reconstructing social cohesion. A community centre in an urban area on the South Island was one example: \u0026ldquo;We\u0026rsquo;ve got over 100 volunteers running everything from exercise classes to grief support groups. It\u0026rsquo;s by the community, for the community. People come for one thing and stay because they find connection. That's rebuilding the village we\u0026rsquo;ve lost.\u0026rdquo;\u003c/p\u003e\u003cp\u003eTrust as the Foundation of Social Capital\u003c/p\u003e\u003cp\u003eTrust emerged as an essential mechanism that allowed social support to operate effectively. Trust was discussed by participants at several levels, interpersonal trust was explained as trust between individuals; community trust was trust that existed between people and institutions in the community and systemic trust was described as trust in government and public infrastructures. Each of these layers affected resilience in multiple ways. Interpersonal trust established the vulnerability necessary for genuine support to be offered. A participant described her experience with trauma: \u0026ldquo;After being hurt, I built walls. But walls that keep pain out also keep help out. Learning to trust again\u0026mdash;letting one or two people past those walls\u0026mdash;that\u0026rsquo;s what allowed me to heal. But it took years to rebuild that capacity to trust.\u0026rdquo;\u003c/p\u003e\u003cp\u003eCommunity trust was articulated as a collective resource that enabled mutual aid and cooperation in communities. High trust communities organised themselves quickly when needed, shared resources readily when needed and created a social order without reliance on outside intervention. One participant reflected on the disaster response:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eDuring the earthquakes, our neighbourhood just clicked into action. Everyone checking on everyone, sharing water, food, generators. You didn\u0026rsquo;t even have to ask\u0026hellip;people just showed up for each other. That experience-built trust that\u0026rsquo;s lasted years.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eNonetheless, systemic trust is significantly eroded, principally among Māori and marginalised peoples. A Māori participant stated bluntly: \u0026ldquo;Our people don\u0026rsquo;t trust any of the systems because they\u0026rsquo;ve never served us well. Health, education, justice\u0026hellip;they\u0026rsquo;ve all failed us repeatedly. So, when they come with new programs or initiatives, there\u0026rsquo;s deep scepticism. Why should this time be different?\u0026rdquo;\u003c/p\u003e\u003cp\u003eTheme 4: Systemic and Structural Factors\u003c/p\u003e\u003cp\u003eSystemic factors such as economic conditions, institutional structures, and social fairness were found to profoundly shape resilience capacity. This theme demonstrated how individual and community resilience cannot be disentangled from wider structures that enable, or restrict, adaptive capacity.\u003c/p\u003e\u003cp\u003eFinancial Security and Economic Stress\u003c/p\u003e\u003cp\u003eFinancial security was found to be a fundamental protective factor, and economic stress was articulated as one of the features able to counteract resilience and wellbeing across all residents. Respondents described financial insecurity as an ongoing stressor that risks draining the psychological and emotional resources needed to enable adaptive coping with the multiple demands of other stressors. One participant described their near-homelessness experience:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eWhen I lost my job, we had no savings buffer. Within a month we were behind on rent, choosing between food and power bills. The stress destroyed us. We were fighting constantly, couldn\u0026rsquo;t sleep, couldn\u0026rsquo;t think straight. How can you be resilient when you\u0026rsquo;re in survival mode every day?\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe rising cost of living was universally mentioned as a growing threat to wellbeing. A participant shared their frustrations regarding the economic climate: \u0026ldquo;Once upon a time, \u003cspan\u003e$\u003c/span\u003e100,000 was a great household income. Now it\u0026rsquo;s nothing. You still struggle to buy a house, still worry about bills. The goalposts keep moving. How are our kids supposed to have hope when working full-time doesn\u0026rsquo;t even guarantee basic security?\u0026rdquo; Communities demonstrated remarkable creativity in developing collective economic strategies. Informal economies that rely on reciprocal sharing provided some insurance against individual financial vulnerabilities. A participant shared the strength of their community: \u0026ldquo;We\u0026rsquo;ve got community gardens, tool libraries, babysitting circles\u0026hellip;all these ways we share resources instead of everyone buying everything. If I have extra eggs or vegetables, I give them out knowing someone will help me when I need it. That\u0026rsquo;s how we survive on not much money.\u0026rdquo;\u003c/p\u003e\u003cp\u003eMāori particularly exhibited economic collective practice that relied on their cultural values. A participant from a coastal town stated: \u0026ldquo;If someone\u0026rsquo;s struggling, the marae organises a fundraiser. Everyone gives what they can\u0026hellip;even if it\u0026rsquo;s just a few dollars. We won\u0026rsquo;t let whānau go hungry or homeless. That collective responsibility is our economic resilience.\u0026rdquo;\u003c/p\u003e\u003cp\u003ePerceptions of Fairness and Justice\u003c/p\u003e\u003cp\u003eFairness as a perception emerged as a strong factor of resilience, as systemic unfairness has potential to deny hope and trust to the community, while reported fairness reinforces social cohesion and collective efficacies. Participants often articulated frustration addressing a variety of forms of inequality and discrimination that fit together under the heading of wellbeing. An exemplary issue itself of fairness to beach access in a rural area where the Regional Council resolutions have restricted traditional access, was particularly contentious. A participant of this community mentioned, \u0026ldquo;Our people have gathered kai moana [seafood] from these beaches for generations. Now the council\u0026mdash;people who don\u0026rsquo;t even live here\u0026mdash;decide we can\u0026rsquo;t drive down to the beach anymore. For elderly or disabled folks, that means no access at all. It\u0026rsquo;s not just inconvenient; it\u0026rsquo;s cultural destruction.\u0026rdquo;\u003c/p\u003e\u003cp\u003eEconomic inequality was also an issue discussed at length and conveyed perceptions of fairness within these shared stories. Many participants described differences between rich and poor communities. A few stated they were feeling like the system was \u0026ldquo;rigged\u0026rdquo; against the everyday person. One young participant stated: \u0026ldquo;They tell us the economy\u0026rsquo;s doing great, but we\u0026rsquo;re going backwards. My parents bought a house on one income; I can\u0026rsquo;t afford rent on two [incomes]. That\u0026rsquo;s not progress. The system feels designed to keep us struggling while a few get richer.\u0026rdquo; Discrimination emerged as another aspect of unfairness. \u0026ldquo;My Pākehā [non-Māori] colleague had never experienced racism\u0026hellip;couldn\u0026rsquo;t even imagine it. Meanwhile, I face microaggressions daily. That constant extra burden of navigating bias. It wears you down, makes everything harder. The unfairness isn\u0026rsquo;t just the discrimination itself, but that half of society doesn\u0026rsquo;t even believe it exists.\u0026rdquo;\u003c/p\u003e\u003cp\u003eTheme 5: Cultural and Environmental Resources\u003c/p\u003e\u003cp\u003eThe last theme highlighted resources which emerged from cultural identity, spirituality and connection to natural places. These resources provided unique forms of resilience, which were not limited to the individual but made connections to wellbeing at the ecological and cosmological levels.\u003c/p\u003e\u003cp\u003eNature as Healing Landscape\u003c/p\u003e\u003cp\u003eGreen and blue spaces were considered an important resilience resource, with participants referring to nature using terms such as \u003cem\u003erestorative\u003c/em\u003e, \u003cem\u003eperspective\u003c/em\u003e and \u003cem\u003espiritual connection\u003c/em\u003e. Therapeutic benefits from nature were stated in every focus group but were most prevalent in the coastal and rural groups, as expressed by one participant: \u0026ldquo;When I\u0026rsquo;m overwhelmed, I go to the beach. Something about the rhythm of the waves, the vastness of the ocean\u0026hellip;it puts my problems in perspective. The sea doesn\u0026rsquo;t care about my mortgage or my work stress. It just is. That groundedness [feeling centred and anchored], that\u0026rsquo;s what I find in nature.\u0026rdquo; Urban participants valued natural spaces too, however, had more difficulty in accessing green or blue spaces. One mother described how parks help her mental health, \u0026ldquo;After the baby, I was drowning in postnatal depression. The only thing that helped was pushing the pram to the park every day. Just seeing trees, hearing birds, watching the seasons change\u0026mdash;it reminded me life goes on, things grow and change. That park saved my sanity.\u0026rdquo;\u003c/p\u003e\u003cp\u003eFor Māori, the natural environment also has cultural and spiritual value. A kaumatua elaborated on the relativeness of all aspects of connection: \u0026ldquo;When I feel pauri [heavy-hearted], I go sit by the moana [ocean]. I karakia [pray] to Tangaroa [God of the sea], talk to my tūpuna [ancestors]. The water carries away my worries. This isn\u0026rsquo;t just about pretty scenery\u0026hellip;it\u0026rsquo;s about whakapapa [genealogy], connection to everything that came before and everything that will come after.\u0026rdquo; Environmental decline was described as directly reducing resilience by cutting off these resources. Participants spoke with true sorrow regarding contaminated rivers, developed coastlines and sites of gathering lost. One participant explained:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eThe river where I learned to swim, where we caught eels as kids\u0026hellip;it\u0026rsquo;s too polluted now. My children will never have those experiences. We\u0026rsquo;ve traded environmental health for economic growth, but what\u0026rsquo;s the real cost to our wellbeing?\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eCultural Identity and Spiritual Resources\u003c/p\u003e\u003cp\u003eCultural identity was presented as a significant resilience resource, each Māori participant described the connection to culture as a source of strength, a source of meaning and even practical support based when dealing with adversity. Cultural revitalisation was understood as directly promoting individual and collective resilience. One young Māori participant who had re-established their connection to culture shared:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003eI grew up disconnected from my Māoritanga. When I hit rock bottom\u0026hellip;depression, addiction\u0026hellip;someone brought me to the marae. Learning my whakapapa, my reo [language], understanding where I fit in the larger story \u0026hellip; it gave me identity and purpose. Culture became my rehabilitation.\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eCultural participation provided multiple layers of resilience benefits. A participant discussed kapa haka (Māori performing arts): \u0026ldquo;Kapa isn\u0026rsquo;t just singing and dancing. It\u0026rsquo;s physical exercise, mental discipline, social connection, cultural pride and spiritual practice all in one. When I\u0026rsquo;m on stage with my group, I\u0026rsquo;m connected to my tūpuna, my iwi, my identity. That strength carries over into everything else.\u0026rdquo;\u003c/p\u003e\u003cp\u003eSpiritual beliefs and practices, either in the context of Indigenous beliefs or any introduced religions provided a way of making meaning in adversity. Participants described relying on faith in times of crises, finding peace in prayer or meditation and support in their faith-based communities. Spirituality was described in various terms - some explained Christian faith, some shared Māori cosmology references and some practiced secular mindfulness. The passing on of cultural knowledge across generations was described as both resilience and responsibility. Elders spoke about sharing their culture, stories and values taught to them, which had sustained their people despite colonisation, an ongoing effect of marginalisation. A kaumātua reflected: \u0026ldquo;Our resilience isn\u0026rsquo;t just individual \u0026hellip; it\u0026rsquo;s centuries of survival knowledge passed down. When I teach the young ones our stories, our tikanga [customs], I\u0026rsquo;m giving them tools their tūpuna used to survive. That\u0026rsquo;s why cultural revival is so important. It\u0026rsquo;s collective resilience building.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study found that resilience was not merely positioned at the individual trait level, but rather at (1) relational networks of whānau and community, (2) the indivisibility of physical and mental health, (3) the role of systemic and economic conditions and (4) cultural\u0026ndash;spiritual\u0026ndash;ecological connections. These findings reframe resilience as collective, relational and situated-structurally.\u003c/p\u003e\u003cp\u003eEmbodiment, Biology and Social Inequality\u003c/p\u003e\u003cp\u003eOur findings compellingly illustrate what Krieger [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e21\u003c/span\u003e] theorises as \u0026ldquo;embodiment\u0026rdquo;\u0026mdash;how we literally, biologically, incorporate our material and social world. When one participant described choosing between their heart medication or feeding their children, he did not just narrate how difficult life was, he illustrated how social inequities get biologically embodied through what Krieger calls \u0026ldquo;pathways of embodiment.\u0026rdquo;\u003c/p\u003e\u003cp\u003eKrieger\u0026rsquo;s ecosocial theory [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e21\u003c/span\u003e] offers ways of thinking about how the \u0026ldquo;vicious cycles\u0026rdquo; our participants discussed, poverty to bad health, bad health to unemployment, worsening poverty, happened at the same time across multiple levels and timescales. As one participant says, \u0026ldquo;poverty gets into your bones,\u0026rdquo; articulating what epigenetics research has recently demonstrated: chronic stress with discrimination and deprivation change gene expression and hastens cellular aging and impacts allostatic load [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The biological embedding of social position disrupts psychological definitions of resilience which do not incorporate how we materially embody histories of oppression.\u003c/p\u003e\u003cp\u003eThe five-hour wait in the emergency department, the polluted rivers, the decision between medication and food\u0026mdash;these are not social determinants of health but rather described as \u0026ldquo;structural determinants\u0026rdquo; [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e21\u003c/span\u003e], the economic and political mechanisms which create social stratification. These experiences can also be called \u0026ldquo;slow death\u0026rdquo;\u0026mdash;the wearing down of populations through systemic neglect [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Krieger\u0026rsquo;s ecosocial theory [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e21\u003c/span\u003e] resonates deeply with Māori participants\u0026rsquo; \u0026lsquo;embodied histories\u0026rsquo;, whereby historical trauma and ongoing colonisation remain embodied in present-day experiences. Instead of framing health inequities in the context of cultural deficits, this framing acknowledges that structural violence produces ongoing inequities [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eComplexity Theory and Resilience as Emergent Property\u003c/p\u003e\u003cp\u003eIn this research resilience can be seen as a complex phenomenon operating at multiple levels of organisation, from the individual level to the macrolevel of structural determinants. This complexity helps to explain concerns that individually focused resilience interventions may have limited or short-lived impact, particularly when they do not address the structural conditions that shape people\u0026rsquo;s lives [3, 25, 26]. The science of complex systems can help illuminate multifaceted phenomena such as resilience. Complex adaptive systems have emergent properties that are the result of dynamic interactions across multiple factors, rather than arising from components [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. The perspective of resilience as a system highlights how individual outcomes arise from the complex relationship of multiple contextual factors. This helps to explain what we observed in participants\u0026rsquo; experiences. The participants\u0026rsquo; experiential accounts from which we derived themes of personal factors, health, social capital, structural conditions and cultural resources do not describe independent variables, but systems that interact and show nonlinear dynamics. The accounts show complex adaptive systems of feedback loops and emergent properties. The participant who lost their job because of depression and whose depression consequently got worse, exemplifies what complexity theorists describe as \u0026ldquo;positive feedback loops\u0026rdquo;, where initial conditions are made worse by cumulative effects. The participant whose community \u0026ldquo;clicked into action\u0026rdquo;, during and after the earthquakes provides a specific example of system resilience, with the resilience being present in redundancy, diversity and adaptive capacity, attributes of a resilient complex adaptive system [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eRecent work in \u0026ldquo;syndemic theory\u0026rdquo;, presents a health model of co-occurring health and social conditions interacting in a synergistic way [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Our study illustrate that resilience can be understood through a syndemic lens. The confluence of poverty, mental health challenges, ecological destruction and systemic racism appeared, in participants\u0026rsquo; accounts, to generate an effect that was not merely additive but multiplicative. This syndemic characterisation highlights why participants emphasised solutions that address multiple issues simultaneously: community gardens as solutions for food security, social isolation and cultural disconnection. Our data showed that participants did not experience trauma recovery as a linear process. The participant who \u0026ldquo;lived without hope for 20, or 30 years\u0026rdquo; before recovering a sense of self through poetry shows that resilience presents in ways we never thought possible, outside of clinical time. Epigenetic research supports both cycles of intergenerational trauma and the possibilities for resilience to spread across generations [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Participants validated this double-edged sword in their discussions; they described wanting to stop the cycle of trauma, stating \u0026lsquo;it dies with me,\u0026rsquo; yet at the same time, wanted to pass on resilience.\u003c/p\u003e\u003cp\u003eIndigenous Ontologies and Relational Resilience\u003c/p\u003e\u003cp\u003eIndigenous participants expressed that \u0026ldquo;you can\u0026rsquo;t separate the happiness of the individual from the happiness of a whānau\u0026rdquo;. This illustrates what Indigenous scholars describe as ontologically different, ways of being, that stand in contrast to the Western model of individualism [31; 32]. These conceptions of different ways of being are not cultural differences but \u0026ldquo;ontological politics,\u0026rdquo; to borrow the term from De la Cadena and Blaser [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e33\u003c/span\u003e]: different worlds, not different perspectives on one world. A relational understanding of existence that spans time and generations is also evident in participants\u0026rsquo; talk of babies \u0026ldquo;choosing\u0026rdquo; their parents, ancestors as current guides and restoring \u0026ldquo;for our ancestors.\u0026rdquo; The discussions characterise what Rifkin [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e34\u003c/span\u003e] defines as \u0026ldquo;Indigenous temporalities,\u0026rdquo; where past-future-present are not linear but reflect simultaneity. Such a concept of time presents a challenge to models of resilience that imply sequenced stages of recovery.\u003c/p\u003e\u003cp\u003eThe recent Indigenous literature on resilience identifies that resilience is not about \u0026ldquo;bouncing back\u0026rdquo; but connection to land-person-culture-relationship in the face of ongoing colonisation [35; 36]. Kaumātua describe Tangaroa and tūpuna in the moana as living relatives with their own purpose, highlighting relationships of respect and care rather than viewing them as resources. This relational ontology aligns with emerging new materialist critiques of human exceptionalism [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Environmental scarification is understood as more than the loss of ecosystem services, but the disruption of kinship relations necessary to create colonised Indigenous identity, leading Nixon [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e38\u003c/span\u003e] to describe \u0026ldquo;slow violence\u0026rdquo; against histories and lands. The dismantling of trust among Māori is what Simpson [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e39\u003c/span\u003e] refers to as \u0026ldquo;refusal\u0026rdquo; which is not a scarce need of attention, but a declaration of sovereignty through refusal to engage on colonial terms. Refusal is resilience, holding on to one\u0026rsquo;s cultural beliefs even though systems call for one to assimilate.\u003c/p\u003e\u003cp\u003eImplications for Research and Practice\u003c/p\u003e\n\u003ch3\u003eResearch Implications\u003c/h3\u003e\n\u003cp\u003eOur findings raise questions about some of the essential principles of resilience research. First, they point to the value of shifting our primary unit of analysis from individuals to assemblages, complex relationships that include human, more-than-human, ancestral and environmental relationships. Mixed-methods approaches could combine ethnographic observation, participatory mapping of who is in a participant\u0026rsquo;s support networks and tracking resilience assemblages longitudinally over time. Second, temporal frameworks may need reconceptualising. An assumption of linear recovery pathways could be replaced with research designs that allow for the circular, spiral and discontinuous realities of recovery, resilience and growth. This could include narrative methods that document how people story-map their resilience over time, or innovative visual methodologies that depict non-linear recovery pathways. Third, methodologies need to move beyond tokenistic consultation towards more genuine partnership. Indigenous communities can be supported to lead the design of research, own the data and decide how widely and to whom to disseminate findings. Our research partnership with Māori researchers was an ethical necessity for us and, in our view, also produced more useful and therefore more valid findings.\u003c/p\u003e\n\u003ch3\u003ePractice Implications\u003c/h3\u003e\n\u003cp\u003eFor mental health services: Our findings highlight tensions between individualistic therapeutic models and collective wellbeing. The participant who pointed out that \u0026ldquo;you can\u0026rsquo;t pull individual happiness and whānau happiness apart\u0026rdquo; illustrates some limits of Western therapeutic models. Mental health services may benefit from avoiding overly rigid structures so as to allow for extended whānau participation, integration of cultural health practices and recognition that recovery is often experienced as arising through relationships based not only in the therapy room but also in nature.\u003c/p\u003e\u003cp\u003eFor community health: The value of community gardens, tool libraries and peer support networks in participants\u0026rsquo; narratives suggests that we should be investing more in community-led initiatives alongside professionally led initiatives. Each initiative is addressing multiple needs at the same time including food security, social connection, cultural practice, and mental health, and simply operates more efficiently than siloed services.\u003c/p\u003e\u003cp\u003eFor clinical training: In addition to culturally competent training, practitioners need the ability to recognise how social conditions manifest as clinical symptoms. This includes teaching clinicians to see a patient choosing between taking medication or feeding their family not as \u0026lsquo;non-compliant\u0026rsquo;, but as working within impossible structural constraints, and to recognise that advocacy, as well as adjusting the prescription, may be an appropriate and necessary response.\u003c/p\u003e\n\u003ch3\u003ePolicy Implications\u003c/h3\u003e\n\u003cp\u003eHousing and economic policy: The participant trying to make rent with two incomes while their parents were able to buy homes with one income illustrates how economic policy is health policy. Participants\u0026rsquo; accounts are consistent with arguments that universal basic income, living wages and affordable housing are not just health interventions that will help, but may be key priorities for strengthening population resilience.\u003c/p\u003e\u003cp\u003eEnvironmental policy: Participant distress at river pollution and lost places to gather, underline that environmental degradation is experienced as a threat to resilience. Climate action, restoration of waterways and protecting sources of traditional food from pollution can be understood as ecological interventions to protect mental health and resiliency, especially for Indigenous peoples where their connectedness to the environment affects their wellbeing.\u003c/p\u003e\u003cp\u003eHealth system reform: Encountering five-hour wait times in an emergency setting, or having to choose between medications and food, was experienced by participants as evidence of health system failure. Rather than focusing primarily on training people to be more \u0026lsquo;resilient\u0026rsquo; within inadequate services, these accounts point to the importance of guaranteeing access to culturally safe health care services. This includes funding Indigenous health services, where, as echoed by participants, clinicians were described as \u0026ldquo;treating the person and not the symptom.\u0026rdquo;\u003c/p\u003e\u003cp\u003eStrengths and Limitations\u003c/p\u003e\u003cp\u003eStrengths\u003c/p\u003e\u003cp\u003eThis study\u0026rsquo;s greatest strength was the method, which chose to partner with Māori researchers and Māori communities from inception to dissemination. This partnership model ensures cultural validity, which is otherwise often absent in resilience research, particularly where instruments have been developed and validated predominantly in Western populations [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Utilising tikanga Māori protocols (e.g. mihimihi, whanaungatanga and shared kai) allowed for safe spaces for deep sharing. Rural participants were more reliant on place-based connections while urban participants created substitute social systems, yet they all centred on relationships. Our analysis, a careful interplay of Indigenous and Western frameworks, generated insights that neither approach could have achieved alone. This enabled \u0026ldquo;two eyed seeing\u0026rdquo; [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e42\u003c/span\u003e], where Western concepts of resilience were reframed though an Indigenous lens; social support became whanaungatanga and coping became resisting and recovering.\u003c/p\u003e\u003cp\u003eLimitations\u003c/p\u003e\u003cp\u003eSince this study was qualitative and utilised purposive, community-based recruitment, our participants do not represent a statistically significant sample of the entire population in Aotearoa New Zealand. Thus, the findings cannot be used to determine prevalence rates. Our intention in this co-design phase was not strict statistical representativeness, but to ensure that groups whose perspectives on resilience are often missing or under-represented in large-scale surveys and health datasets were at least as visible as those from the general population [\u003cspan additionalcitationids=\"CR44\" citationid=\"CR40\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. We therefore used purposive recruitment to achieve approximate gender balance and roughly equal numbers of Māori/Pacific Island and non-Māori/non-Pacific Island participants, and to include a wide range of lived experiences of mental health challenges, so that both dominant and marginalised perspectives could inform the co-design of the resilience framework and index.\u003c/p\u003e\u003cp\u003eAt the same time, because recruitment occurred primarily through community organisations, marae, churches and services, people who are highly socially isolated, homeless, imprisoned, or otherwise disconnected from such networks may still be under-represented, and their experiences of resilience and adversity may differ from those described here. National mental health surveys in high-income countries commonly exclude or under-sample precisely these groups (e.g. homeless people, those in hospitals or correctional facilities). In addition, the participation of recent migrants, refugees, LGBTQ\u0026thinsp;+\u0026thinsp;and underrepresented Asian communities was very low. Since the resilience of these populations is based on unique risks of accessing not only a new system but doing so while facing cultural marginalisation and systemic racism, their ways of knowing would contribute to a far deeper understanding. These omissions mirror well-documented patterns in national mental health surveys, where such populations are frequently excluded or under-sampled, leading to an underestimation of need [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e45\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe cross-sectional design allows only a snapshot of resilience at one point in time and does not show resilience fluctuating over periods of time. For example, one participant stated they lived \u0026ldquo;without hope for 20\u0026ndash;30 years,\u0026rdquo; and this idea of resilience as time/long-term is something we cannot capture in our snapshot. While we worked alongside a kairangahau Māori, there is no doubt that the main authors\u0026rsquo; \u0026ndash; Pākehā /European - position will have an impact on how this data is interpreted. Despite engaging in reflexive practice with cultural supervision, the principal investigator took on the role of main author and with Western academic frameworks, there is a constrained space for Indigenous ways of knowing to be revealed in this framework. The focus group method, while it can be a rich way to facilitate discussions, it may not capture the voices of those most marginalised, such as homeless individuals, individuals in crisis and individuals with no community ties. These voices, who are often most vulnerable, remain silenced.\u003c/p\u003e\u003cp\u003eFuture Directions\u003c/p\u003e\u003cp\u003eThe following section outlines six interrelated domains that represent key areas for advancing resilience research (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLongitudinal and Life-Course Research\u003c/p\u003e\u003cp\u003eFuture research should longitudinally map individuals and communities, capturing how resilience assemblages form, dissolve and reform. It will also be particularly relevant to understand how, at critical points of transition, for example, loss of a job, death of a loved one, diagnosis of a serious illness, existing forms of resilience may break down or be altered. Research that adopts a life-course framework that attends to childhood adversity, adult resources and context over time may also find points to intervene and disrupt intergenerational cycles.\u003c/p\u003e\u003cp\u003eClimate Change and Resilience\u003c/p\u003e\u003cp\u003eEmerging from the consideration of the wellbeing of individuals and communities is recognition that environmental degradation, disconnect from place, and climate change profoundly threaten wellbeing. Research should attend to the concept of resilience when studying the climate crisis. In what way do communities articulate, retain and maintain wellbeing when the landscape they are used to changes? What new practices of resilience are created when old lifestyle practices are no longer viable? Climate grief, eco-anxiety, and cultural loss require urgent attention.\u003c/p\u003e\u003cp\u003eDigital Resilience Assemblages\u003c/p\u003e\u003cp\u003eOur participants, like the literature, emphasised the importance of face-to-face connections, but digital communities are increasingly becoming important sources of resilience for many people. Research needs to investigate how virtual communities provide a sense of community or support, we need to consider how algorithmic systems create and/or obstruct opportunities, we need to consider how digital divides impact community resilience. The COVID-19 pandemic\u0026rsquo;s enforced digital transition offers a valuable research opportunity to examine these questions, comparing communities that maintained connection through digital means with those unable to access such technologies and exploring what was gained and lost in the shift from physical to virtual support networks.\u003c/p\u003e\u003cp\u003eIntervention Development and Testing\u003c/p\u003e\u003cp\u003eOur research suggests that community designed and implemented interventions are needed that addresses multiple needs at once. Participatory action research rather than top-down research might develop and test community-led initiatives that build on existing collective strengths. Given our findings that resilience is an emergent property of complex adaptive systems, traditional experimental designs that isolate single variables may be inadequate. Research approaches should instead focus on understanding how interventions shift system dynamics\u0026mdash;examining changes in feedback loops, community connections, resource flows, and adaptive capacity. System dynamics modelling, network analysis, and developmental evaluation offer methodologies better suited to capturing the complexity of interventions targeting structural determinants of health.\u003c/p\u003e\u003cp\u003eEconomic Evaluation\u003c/p\u003e\u003cp\u003eIt is essential to show the economics of transformative approaches to facilitate policy change. Cost-utility analyses can demonstrate the value of upstream interventions (living wages, secure housing) by comparing them to downstream costs (health services, emergency services, hospitalisation). When we include a spectrum of social returns on investment of potentially reduced incarceration rates, increased individual employment, intergenerational returns, the real bottom line could be evaluated.\u003c/p\u003e\u003cp\u003eIndigenous-Led Research Programs\u003c/p\u003e\u003cp\u003eFuture research should be Indigenous-designed, Indigenous-led, Indigenous-governed. It is not just about having Indigenous researchers involved. It is recognising that the research systems used, including funding systems, ethics systems, publication systems, need to acknowledge Indigenous knowledge is just as valuable as Western science. International collaboration among Indigenous peoples may assist in identifying resilience strategies and practices that emerge from shared experiences of colonisation, while remaining attentive to distinct cultural contexts.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and Consent to Participate\u003c/strong\u003e\u003cp\u003e This study was conducted in accordance with the ethical principles of the Declaration of Helsinki Ethics and was approved by the University of Waikato Human Research Ethics Committee, reference number [HREC(Health)2024#37]. All participants provided informed consent online prior to participating.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003eNot Applicable\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eAvailability \u0026amp; Data materials\u003c/h2\u003e\u003cp\u003eFull focus-group transcripts/audio cannot be shared. De-identified materials (codebook, framework, selected quotations) are available on reasonable request, subject to HREC approval (HREC(Health)2024#37) and Māori advisory-group permission.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors declare no conflict of interest regarding this study\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThis research was funded by the Health Research Council of New Zealand (24/981) and the University of Waikato.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eStefan Heinz: conceptualisation, methodology, investigation, data curation, formal analysis, writing\u0026mdash;original draft, visualisation.Anthony O\u0026rsquo;Brien: methodology, formal analysis, validation, writing\u0026mdash;review and editing, supervision.Matthew Parsons: project administration, conceptualisation, writing\u0026mdash;review and editing, supervision.Cameron Walker: conceptualisation, review and editing, supervision.Michael O\u0026rsquo;Sullivan: conceptualisation, review and editing, supervision.Paul Rouse: conceptualisation, review and editing, supervision.Jesse Whitehead: methodology, writing\u0026mdash;review and editing.Lara Wall: writing\u0026mdash;review and editing.Michael Edmonds: data collection, writing\u0026mdash;review and editing.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe thank all participants who shared their experiences and perspectives with us. We are grateful to our cultural advisors and lived experience advisors for their guidance and wisdom. Thanks also to our colleagues in the Division of Health at the University of Waikato for their contributions through feedback and the many conversations, formal and informal, that shaped this project. Open access publishing facilitated by the University of Waikato. Open access publishing facilitated by the University of Waikato.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eFull focus-group transcripts/audio cannot be shared. De-identified materials (codebook, framework, selected quotations) are available on reasonable request, subject to HREC approval (HREC(Health)2024#37) and Māori advisory-group permission.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eStainton A, Chisholm K, Kaiser N, Rosen M, Upthegrove R, Ruhrmann S, Wood SJ. Resilience as a multimodal dynamic process. 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Wellington: Ministry of Health; 2006.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Resilience, Mental health, Wellbeing, Māori, Focus groups, New Zealand, Qualitative, Indigenous, Lived Experience","lastPublishedDoi":"10.21203/rs.3.rs-8133475/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8133475/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Resilience research increasingly recognises the influence of cultural context and community perspective on adaptive responses to adversity. However, many resilience indices embody theoretical underpinnings that are not necessarily congruent with lived experiences, especially in relation to culturally diverse groups. This study explores resilience factors through community narratives of diversity in Aotearoa New Zealand.\u003c/p\u003e\n\u003cp\u003eMethods: We conducted nine focus groups (N=92) across urban and rural contexts with 48% of participants identifying as Māori or Pacific Islanders. The twelve resilience indicators were explored through the participant narratives promoted by vignettes and semi-structured discussions using a thematic analysis approach. Cultural protocols were embedded in all aspects including partnering with Māori, Pacific Islander and lived experience advisors.\u003c/p\u003e\n\u003cp\u003eFindings: Five themes emerged: (1) Personal resilience factors; (2) health and wellbeing; (3) social capital and connection; (4) systemic and structural factors; and (5) cultural and environmental resources. Participants contested Western individualised models of resilience by demonstrating that agency emerges through complex assemblages of relationships across human, more-than-human, ancestral, and environmental domains, rather than from individual capacity alone.\u003c/p\u003e\n\u003cp\u003eConclusion: In this study, resilience did not emerge as an individual capacity, but as something grounded in relational networks situated within cultural, spiritual and ecological contexts. These findings suggest a need for transformational approaches to resilience assessment and intervention by policymakers and clinicians, which attend to structural determinants as well as individual coping capacity. Effective interventions are likely to be more acceptable and meaningful when they are community-grounded, culturally embedded and recognise resilience as a collective resource, rather than only individualised adaption to inequitable conditions.\u003c/p\u003e","manuscriptTitle":"Lived experience perspectives on resilience, mental health, and wellbeing: a focus group study of individual, social, and systemic determinants in Aotearoa New Zealand","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-10 10:51:58","doi":"10.21203/rs.3.rs-8133475/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-23T15:50:42+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-21T10:57:09+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-17T01:59:11+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"146675261738736768002007196265127348565","date":"2025-12-12T11:06:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"235339857734640686387593017979994076150","date":"2025-12-09T00:49:47+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-08T10:08:55+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-08T09:55:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-25T06:40:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-24T21:49:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-11-24T21:46:03+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3cf6c4c9-c825-4824-acfd-b27c22755a0d","owner":[],"postedDate":"December 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-01-19T17:03:09+00:00","versionOfRecord":{"articleIdentity":"rs-8133475","link":"https://doi.org/10.1186/s12889-026-26255-1","journal":{"identity":"bmc-public-health","isVorOnly":false,"title":"BMC Public Health"},"publishedOn":"2026-01-16 16:28:52","publishedOnDateReadable":"January 16th, 2026"},"versionCreatedAt":"2025-12-10 10:51:58","video":"","vorDoi":"10.1186/s12889-026-26255-1","vorDoiUrl":"https://doi.org/10.1186/s12889-026-26255-1","workflowStages":[]},"version":"v1","identity":"rs-8133475","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8133475","identity":"rs-8133475","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}