Ministry of Health Library

Health Improvement and Innovation Digest

Issue 153 - 12 October 2017

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). The Digest has links to key evidence of interest, with access to new content arranged by topic.

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Have you heard about Grey Matter?

We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email library@moh.govt.nz

Article access

For articles that aren't open access, contact your DHB library, or organisational or local library for assistance in accessing the full text. If your organisation has a subscription, you may be able to use the icon under full text links in PubMed to access the full article.

Quality Improvement (International)

Patient family advisors’ perspectives on engagement in health-care quality improvement initiatives: Power and partnership
Engagement of the public in defining and shaping the organization and delivery of health care is increasingly viewed as integral to improving quality and promoting transparent decision making. Meaningful engagement of the public in health-care reform is predicated on shifting entrenched power imbalances between health-care systems and those it claims to serve. The objective of this study, published in Health Expectations, was to describe the expressions, forms and spaces of power from the perspectives of persons who participated as Patient/Family Advisors (PFAs) in Rapid Process Improvement Workshops (RPIWs) within Saskatchewan, Canada.

Shorter Waits for Cancer Treatment (New Zealand)

Cutaneous melanoma: an audit of management timeliness against New Zealand guidelines
The New Zealand Ministry of Health's "Faster Cancer Treatment" programme aims for timely care for patients with cancer, including melanoma. Melanoma care guidelines detail investigation and treatment timeliness standards. This audit, published in the New Zealand Medical Journal, assesses compliance with these.

Shorter Stays In Emergency Departments (New Zealand)

New Zealand’s emergency department target – did it reduce ED length of stay, and if so, how and when?
In 2009, the New Zealand government introduced a hospital emergency department (ED) target – 95% of patients seen, treated or discharged within 6 hours - in order to alleviate crowding in public hospital EDs. While these targets were largely met by 2012, research suggests that such targets can be met without corresponding overall reductions in ED length-of-stay (LOS). This study, published in BMC Health Services Research, explores whether the NZ ED time target actually reduced ED LOS, and if so, how and when.

Shorter Stays In Emergency Departments (International)

Primary care services co-located with Emergency Departments across a UK region: early views on their development
Co-location of primary care services with Emergency Departments (ED) is one initiative aiming to reduce the burden on EDs of patients attending with non-urgent problems. However, the extent to which these services are operating within or alongside EDs is not currently known. This study, published in the Emergency Medicine Journal, aimed to create a typology of co-located primary care services in operation across Yorkshire and Humber (Y&H) as well as identify early barriers and facilitators to their implementation and sustainability.

More Heart and Diabetes Checks (New Zealand)

How people from ethnic minorities describe their experiences of managing type-2 diabetes mellitus: A qualitative meta-synthesis
The increasing prevalence of diabetes is well-documented along with the findings that some ethnic minorities have a higher prevalence than non-minority individuals. Along with possible biological differences between ethnicities, access to economic, social, cultural and symbolic capital may impact on the success of managing type-2 diabetes. The objective of this study, published in the International Journal of Nursing Studies, was to examine how people from ethnic minorities in Western countries describe their experiences of managing type-2 diabetes mellitus.

Primary Health Care (New Zealand)

Family planning unmet need and access among iTaukei women in New Zealand and Fiji
The aim of this study, published in the New Zealand Medical Journal, was to identify unmet need and family planning access among indigenous Fijian or iTaukei women living in New Zealand and Fiji.

Primary Health Care (International)

Web-based self-management support for people with type 2 diabetes (HeLP-Diabetes): randomised controlled trial in English primary care
The objective of this study, published in BMJ Open, was to determine the effectiveness of a web-based self-management programme for people with type 2 diabetes in improving glycaemic control and reducing diabetes-related distress.

Developing a positive patient experience with nurses in general practice: an integrated model of patient satisfaction and enablement
The aim of this study, published in the Journal of Advanced Nursing, was to develop a conceptual model that provides a comprehensive understanding of the structures and processes underpinning patient enablement and satisfaction in general practice nurse consultations.

Primary Mental Health (New Zealand)

Green Space and Depression during Pregnancy: Results from the Growing Up in New Zealand Study
Antenatal depression is an important contributor to poor maternal health experienced by some women. This study, published in the International Journal of Environmental Research and Public Health, aimed to determine whether exposure to green space during pregnancy is associated with less depression, and whether this association is moderated by relevant factors, such as age, education, self-identified ethnicity, physical activity, residential rurality, and socioeconomic status.

Primary Mental Health (International)

Personalised digital interventions for reducing hazardous and harmful alcohol consumption in community-dwelling populations
Excessive alcohol use contributes significantly to physical and psychological illness, injury and death, and a wide array of social harm in all age groups. A proven strategy for reducing excessive alcohol consumption levels is to offer a brief conversation-based intervention in primary care settings, but more recent technological innovations have enabled people to interact directly via computer, mobile device or smartphone with digital interventions designed to address problem alcohol consumption. The objective of this Cochrane Review was to assess the effectiveness and cost-effectiveness of digital interventions for reducing hazardous and harmful alcohol consumption, alcohol-related problems, or both, in people living in the community.

Transdiagnostic versus disorder-specific internet-delivered cognitive behaviour therapy for anxiety and depression in primary care
This study, published in the Journal of Anxiety Disorders, compared disorder-specific and transdiagnostic internet cognitive behaviour therapy (iCBT) programs for anxiety and depression effectiveness in primary care.

Increased Immunisation (New Zealand)

Personality and demographic correlates of New Zealanders' confidence in the safety of childhood vaccinations
Despite extensive scientific evidence on the safety of standard vaccinations, some parents express skeptical attitudes towards the safety of childhood immunisations. This paper, published in Vaccine, explores the distribution, and demographic and personality correlates of New Zealanders' attitudes towards the safety of childhood vaccinations.

Better Help for smokers to Quit (New Zealand)

What wāhine Māori think about smoking and about trying to quit: Findings of Rotorua focus group discussions
This presentation, published by the Health Promotion Agency, shows the findings of Rotorua focus group discussions around smoking and trying to quit.

Weight Management (New Zealand)

Barriers to and facilitators and perceptions of nut consumption among the general population in New Zealand
Despite considerable evidence supporting the health benefits of regular nut consumption, nut intakes remain lower than recommended among many populations. This study, published in Public Health Nutrition, explores how the general population perceives nuts, and could inform strategies to promote regular nut consumption and increase intakes among the general public.

Weight Management (International)

A systematic review and meta-analysis of the effectiveness of nudging to increase fruit and vegetable choice
Nudging refers to interventions that organize the choice architecture in order to alter people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives. As a strategy to encourage healthy behaviour, nudging can serve as a complement to health education. However, the empirical evidence regarding the effectiveness of nudging as a way to influence food choice remains contradictory. This systematic review and meta-analysis, published in the European Journal of Public Health, was conducted to test the effects of nudging to encourage people to select more fruit and vegetables.

Childhood Obesity (New Zealand)

Implementing a Health and Wellbeing Programme for Children in Early Childhood: A Preliminary Study
In New Zealand, there is a high prevalence of childhood poverty and food insecurity, which can impact a family's ability to provide high quality, nutrient dense foods for their children. In an attempt to increase the quality of the food consumed by children attending a decile two (low socio-economic) kindergarten and to address food insecurity issues, an educational health and wellness initiative, in conjunction with a free lunch programme, was introduced. The impact of the lunches and the effectiveness of the programme were evaluated and the results published in Nutrients.

Childhood Obesity (International)

Interventions for increasing eating of fruit and vegetables in children aged five years and under
Consuming not enough fruit and vegetables is a considerable health burden in developed countries. Eating fruit and vegetables is associated with a reduced risk of future chronic disease. Early childhood represents a critical period for the establishment of dietary habits. Interventions to increase consumption of fruit and vegetables in early childhood may therefore be an effective strategy in reducing this disease burden. The objective of this Cochrane Review was to assess the impact of interventions designed to increase eating of fruit or vegetables or both among children aged five years and under.

Early food for future health: a randomized controlled trial evaluating the effect of an eHealth intervention aiming to promote healthy food habits from early childhood
Childhood overweight and obesity is a global public health challenge. Primary prevention initiatives targeting parents have been called for to encourage a positive feeding environment and healthy eating habits that may lay a good foundation for future health. At the same time, there is a need for interventions which combine accessibility and scalability with cost effectiveness. Today's parents are extensive Internet-users, but only a few randomized controlled trials have investigated the use of Internet to promote healthy eating habits in early childhood. This study, published in BMC Public Health, has developed and evaluated an Internet-based tool for parents of children between 6 and 12 months, aiming to increase knowledge about infant nutrition and foster protective feeding behaviour.

Oral Health (International)

Barriers and facilitators in the integration of oral health into primary care: a scoping review
This scoping study, published in BMJ Open, has been conducted to map the literature and provide a descriptive synthesis on the barriers and facilitators of the integration of oral health into primary care.

The information available on or through this newsletter does not represent Ministry of Health policy. It is intended to provide general information to the health sector and the public, and is not intended to address specific circumstances of any particular individual or entity.