In addition to developing the rōpū and conducting the literature review, we made progress on the full health delivery research project grant application. We submitted the first application in 2022 and advanced to the second round but were unsuccessful. However, our application for 2023 was successful.

We would like to acknowledge the 2022 team who were part of the grant application (HRC ID #22/688), as they all had input into the work. This included an 18-strong codesign rōpū (the Nis), which includes four Māori members, including Kaumātua Hata Temo. There are also 12 researchers across various fields, including general practice, hauora Māori psychology, economics, palliative care, public health, religious studies, sociology, and theology. We have Pacific, Islamic, humanist, nurses, and consumer advocate members and members representing the two NZ healthcare chaplaincy organisations.

The named investigators were: A.Prof Richard Egan, who co-leads a Unit that has a 27-year research relationship with the Cancer Society (CS). In 2019, Egan helped lead (as a director) a newly established Cancer Society Research Collaboration that secured a five-year programme grant. Egan has also been a Co-PI on a three-year kaupapa Māori prostate cancer project (Oranga Tu). The Oranga Tu project produced a film output shown on TV1 and Māori TV, and it also produced resources for HCPs. Egan's expertise is in spiritual care research, qualitative methods, supportive care in cancer, and health promotion. His PhD research, supervised by rōpū member Professor Rod MacLeod, led to Hospice NZ's Spiritual Care Fundamentals workshops, which are still taught today. Egan is considered one of the leading researchers in the field of spirituality in health, both in the country and internationally. His research has impacted CS resources and policy, and his euthanasia/assisted dying research has impacted policy as well.

A.Prof Natasha Tassell-Matamua (Te Ātiawa, Ngāti Makea kei Rarotonga, Pākehā) is a founding Director of the Centre for Indigenous Psychologies, an inclusive intellectual and physical space that focuses on elevating Indigenous perspectives, including those related to spirituality, in the research and teaching of psychology in Aotearoa. She has been teaching Indigenous Psychologies since 2008 and coordinates the only course in Indigenous Psychologies in the country. Along with this experience and expertise, she has led a range of research projects grounded in Kaupapa Māori approaches. Tassell-Matamua is perhaps best-known for her work on spiritual experiences, particularly near-death and end-of-life experiences. She has gained an internationally recognised reputation for her work and has authored numerous journal articles and book chapters on the practical implications of spiritual experiences for everyday life. She is regularly invited to speak on the topic at national and international events.

Prof Chrystal Jaye is a medical anthropologist and the Director of the UoO Research Theme CARE (Collaboration for Ageing Research Excellence) situated in the Department of General Practice and Rural Health, Dunedin School of Medicine. Her expertise lies in clinical education, primary healthcare, rural health and wellbeing, ageing, illness experiences, and qualitative methodology. She has collaborated with Age Concern Otago to conduct research evaluating several initiatives to improve the wellbeing and social support of older adults in the region. Her strength lies in the generation of research outputs for various audiences from each research project, with differing emphases on theory building, policy development, and clinical implications.

Māori expertise was led by Natasha Tassell-Matamua and supported by Hata Temo (Kaumātua, UoO & Te Whatu Ora/Health New Zealand Southern), an experienced Kaumātua and Tohunga (wairua).

Dr Hukarere Valentine (Nō Ngati Kahungunu ahau. He uri ahau hoki no Ngai Tahu, Ngati Awa, Te Ati Awa, Tuwharetoa ki Kawerau) is a senior practicing clinical psychologist at Massey University in Palmerston North with expertise in forensics, mental health, chronic health conditions, and psycho-oncology. Valentine works predominantly from a Te Ao Māori perspective, blending together clinical and cultural psychology. She has a passion for wairua and Māori wellbeing, which was the topic of her doctoral thesis.

Mata Cherrington (Ngāti Hine, Te Kapotai, Ngāpuhi, Ngāi Pakeha, Te Whatu Ora/Health NZ Southern Chief Māori Health Strategy and Improvement Officer) brings a wealth of MoH, organisational, and governance expertise. She has recently served as the Kaihautū/CEO of an Iwi hauora provider in Murihiku.

Our academic strength lies in both expertise and breadth.

Professor Nathan Berg (UoO, Economics) specializes in survey design and rigorous econometric measurement of willingness-to-pay. He brings expertise in behavioural economics and focuses on highperforming organisations and institutions that are well-suited for diverse human minds.

Professor David Tombs (UoO, Theology) is the Director of the Centre for Theology and Public Issues at the University of Otago. His work draws on contextual and liberation theologies to provide insights on public issues. He has previously worked in multi-faith contexts in the United Kingdom. His expertise includes research on the role of religion in social and cultural identity, and he has recently contributed to a World Council of Churches project on health and healing.

Associate Professor John Shaver (UoO, Religious Studies, now at Baylor University Waco, TX) is a biocultural anthropologist primarily interested in understanding the relationships between social inequality, cooperation, and conflict. His recent research focuses on how religion affects maternal fertility, as well as maternal and child health, and how these dynamics influence population change and global health.

Professor Rod MacLeod (UoO, Medical School, Palliative Care physician) has over 45 years of experience as a physician, with more than 30 years in specialist palliative care. He has extensive experience as a researcher in various aspects of palliative care, having published over 130 peer-reviewed articles in international journals, thirteen of which examine aspects of spirituality in healthcare.

Professor Patrick Vakaoti (UoO, Sociology, Gender Studies, and Criminology) is an Indigenous Fijian academic with a background in Sociology and Social Work. He is a leading Pacific academic utilizing these insights to understand the lives and experiences of Pacific children and young people. He brings expertise and relationships in working with Pacific Peoples. Patrick is now Dean ofTeTemuTe Tumu School of Maori, Pacific & Indigenous Studies.

Dr. Usman Afzali (University of Canterbury, Doctor/Psychologist) holds a PhD in psychology with a focus on cognitive psychology and forensic neuroscience. Afzali has a background in quantitative social science research and Islamic education, and he possesses a strong national network of Muslims in Aotearoa. He is a practicing Muslim with profound knowledge of spirituality and related concepts in Islam.

Dr. Graham Redding (UoO, Theology) teaches chaplaincy studies and has over 30 years of experience providing pastoral and spiritual care in various church and organisational settings. As a former Moderator (national leader) of the Presbyterian Church of Aotearoa New Zealand and Principal of the Knox Centre for Ministry and Leadership, he has deep connections with church, ministry, and chaplaincy networks. The co-design rōpū has strong connections to the health sector and spiritual care providers.

Among our community co-investigators is Jacqueline Tuffnell (NZ Healthcare Chaplains' Association/Nurse), a registered nurse with over 30 years of experience in primary and secondary care and clinical governance. Jacqueline currently works part-time as a Nurse Consultant for Presbyterian Support Central. She is also a consumer representative on the MOH Surgical Mesh Round Table and a PhD student at UoO, researching the role of healthcare chaplains as advocates and agents of change. Jacqueline represents the NZ Healthcare Chaplain's Association, which oversees the registration and accreditation of healthcare chaplains in NZ. Colin Woodhouse, a nurse and member of Humanist NZ Council and Te Whatu Ora / Health NZ Waitaha Canterbury, is currently working on a master's thesis focused on providing spiritual support in public hospitals, particularly considering the growing secular population.

Sande Ramage, a spiritual care practitioner from Te Whatu Ora MidCentral, is one of two active spiritual care professionals in our group. Since 2011, Sande has been offering support to patients, whānau (family), and staff in a regional hospital, helping them explore spirituality during times of illness and distress.

Rev Julian Perkins, an ecumenical chaplain and the Dean of Waikato Cathedral in Hamilton, serves as one of the Anglican representatives on the board of the Interchurch Council for Hospital Chaplaincy (ICHC). He is also a parish priest in the Diocese of Waikato and Taranaki. With ten years of experience as a healthcare chaplain, Perkins is currently conducting research on the recruitment and development of healthcare chaplains. He has also conducted a literature survey on spirituality and spinal cord injury.

David Hough, the Interim CEO of the ICHC National Office in Wellington, represents the organisation responsible for managing most hospital chaplains in Aotearoa. With his background in Christian ministry, project management, quality assurance, health and safety, health promotion, fitness, and sport, David currently serves as the National Operations Manager for the ICHC.

In addition, we have a range of advisors who are still involved in the funded project.