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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 212 - 2 July 2020

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.

After suspending newsletter publication during Levels 2-4 of the COVID-19 response, we're happy to be publishing bi-weekly once again.

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If you have any queries, please email us at library@health.govt.nz.

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@health.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.

Māori Innovation

Te Hā o Whānau: A culturally responsive framework of maternity care
This article, published in the New Zealand Medical Journal,  explores the healthcare framework - Te Hā o Whānau. This framework aims to make the maternal-infant healthcare system more accessible and culturally responsive for Māori following unexpected events that led to the harm or loss of their baby.

Seeing the unseen: evidence of kaupapa Māori health interventions.
Māori in Aotearoa have higher incidence, prevalence and mortality from chronic disease. The dominant narrative in Aotearoa about the reasons for Māori ill health neglects to acknowledge the history of colonisation and failures of the health system, alongside the holistic view of health taken by Māori focusing on collective, whānau-based outcomes. This article, published in AlterNative, reviews health interventions for chronic disease that have a kaupapa Māori philosophical basis.

Health Equity (New Zealand)

Experiences of Māori of Aotearoa New Zealand's public health system: a systematic review of two decades of published qualitative research
This paper, published in the Australian and New Zealand Journal of Public Health, aims to synthesise the broader perspectives of Māori patients and their whānau of their treatment within the public health system.

Health Equity (International)

Health Inequality as a Large-Scale Outcome of Complex Social Systems: Lessons for Action on the Sustainable Development Goals
Action on the Sustainable Development Goals (SDGs) needs to become real and impactful, taking a "whole systems" perspective on levers for systems change. This article, published in the International Journal of Environmental Research & Public Health, reviews what we have learned over the past century about the large-scale outcome of health inequality, and what we know about the behaviour of complex social systems.

Interventions to Reduce Healthcare Disparities in Cancer Screening Among Minority Adults: a Systematic Review
Racial minority populations face an increased burden relative to cancer interventions. Compared with Caucasians, the cancer screening rate is substantially lower among African American, Asian American, Latinx American, and American Indian/Alaska Native populations. Barriers such as low health literacy, lack of health insurance, and miscommunication between patients and providers have been identified as important factors that result in low screening rates among minority adults. This study, published in the Journal of Racial and Ethnic Health Disparities, was designed to identify interventions targeting racial minority adults 40 years of age or older that were effective in increasing cancer screening uptake rates.

Quality Improvement (New Zealand)

Primary care improvement case study: Childhood respiratory warrant of fitness: Unichem Russell Street, Hastings
The Health Quality and Safety Commission’s focus on primary care includes partnerships with primary care teams to work on small-scale improvement projects through its quality improvement programme, Whakakotahi. As part of a Whakakotahi improvement project, Unichem Russell Street, Hastings developed a quality improvement project to improve asthma management in a group of Māori and Pacific children.

Quality Improvement (International)

Quality improvement in healthcare: Six Sigma systematic review
Six Sigma has been widely used in the healthcare sector as a management tool to improve patient quality and safety. The objective of this study, published in Health Policy, was to identify opportunities for its implementation through literature analysis.

Cancer Services (International)

Telephone interventions for symptom management in adults with cancer
People with cancer experience a variety of symptoms as a result of their disease and the therapies involved in its management. Inadequate symptom management has implications for patient outcomes including functioning, psychological well‐being, and quality of life. The objectives of this Cochrane Review were to assess the effectiveness of telephone‐delivered interventions for reducing symptoms associated with cancer and its treatment. To determine which symptoms are most responsive to telephone interventions. To determine whether certain configurations (e.g. with/without additional support such as face‐to‐face, printed or electronic resources) and duration/frequency of intervention calls mediate observed cancer symptom outcome effects.

Shorter Stays In Emergency Departments (International)

Impact of triage liaison provider on emergency department throughput: A systematic review and meta-analysis
Emergency department (ED) overcrowding is linked to poor outcome and decreases patient satisfaction. The objective of this systematic review and meta-analysis, published in the American Journal of Emergency Medicine, was to investigate the impact of triage liaison providers (TLPs) on the ED throughput.

Cardiovascular Disease and Diabetes (New Zealand)

Falling into a deep dark hole: Tongan people’s perceptions of being at risk of developing type 2 diabetes
Prediabetes is a precursor for type 2 diabetes. Compared to the New Zealand/European and other population groups (24.6%), the prevalence of prediabetes is higher within Pacific groups (29.8%). The diagnosis of prediabetes presents a potential opportunity to intervene to prevent progression to type 2 diabetes. The objective of this study, published in Health Expectations, was to develop an understanding of how being ‘at risk’ of developing type 2 diabetes is perceived by Tongan people with prediabetes living in Auckland, New Zealand.

Cardiovascular Disease and Diabetes (International)

What psychosocial interventions work to reduce hospital admissions in people with diabetes and elevated HbA1c: a systematic review of the evidence
Diabetes is a chronic condition that can lead to devastating complications if not managed effectively. Individuals with elevated HbA1c are at higher risk of developing complications resulting in diabetes-related hospital admissions, an additional pressure and expense for healthcare systems. The aim of this article, published in Diabetic Medicine, was systematically review evidence of the effectiveness of psychosocial interventions among individuals with elevated HbA1c, as indicated by hospital admissions.

Screening for type 2 diabetes mellitus
Diabetes mellitus, a metabolic disorder characterised by hyperglycaemia and associated with a heavy burden of microvascular and macrovascular complications, frequently remains undiagnosed. Screening of apparently healthy individuals may lead to early detection and treatment of type 2 diabetes mellitus and may prevent or delay the development of related complications. The objective of this Cochrane Review was to assess the effects of screening for type 2 diabetes mellitus.

Screening strategies for hypertension
Hypertension is a major public health challenge affecting more than one billion people worldwide. The increasing prevalence of hypertension is associated with population growth, ageing, genetic factors, and behavioural risk factors, such as excessive salt and fat consumption, physical inactivity, being overweight and obese, harmful alcohol consumption, and poor management of stress. Over the long term, hypertension leads to risk for cardiovascular events, such as heart disease, stroke, kidney failure, disability, and premature mortality. The objective of this Cochrane Review was to assess the effectiveness of different screening strategies for hypertension (mass, targeted, or opportunistic) to reduce morbidity and mortality associated with hypertension.

Primary Health Care (New Zealand)

Clinical pharmacist facilitators in primary care: a descriptive study of their roles and services provided in general practices of southern New Zealand
Internationally, the inclusion of pharmacists into general practice as clinical pharmacy facilitators has improved patient outcomes. However, clinical pharmacists are relatively new to southern New Zealand general practices and their range of services has not been studied. The aim of this study, published in the Journal of Primary Health Care, was to describe the implementation of clinical pharmacist services in general practices in the Southern region; to examine the tasks conducted by clinical pharmacy facilitators; and to determine the characteristics of patients who access this service.

Health literacy of Samoan mothers and their experiences with health professionals
Patient and health professional engagement is a crucial factor for the effectiveness of service delivery and the management of care. Low health literacy amongst Pacific peoples is likely to affect their engagement with health professionals. The aim of this study, published in Journal of Primary Health Care, was to explore the health literacy of Samoan mothers and their experiences with health professionals in primary care.

Primary Health Care (International)

Efficacy and safety of rapid tests to guide antibiotic prescriptions for sore throat
Sore throat is a common condition caused by viruses or bacteria, and is a leading cause of antibiotic prescription in primary care. The objective of this Cochrane Review was to assess the efficacy and safety of strategies based on rapid tests to guide antibiotic prescriptions for sore throat in primary care settings.

Interventions for improving medication‐taking ability and adherence in older adults prescribed multiple medications
Older people taking multiple medications represent a large and growing proportion of the population. Managing multiple medications can be challenging, and this is especially the case for older people, who have higher rates of comorbidity and physical and cognitive impairment than younger adults. Good medication‐taking ability and medication adherence are necessary to ensure safe and effective use of medications. The objective of this Cochrane Review was to evaluate the effectiveness of interventions designed to improve medication‐taking ability and/or medication adherence in older community‐dwelling adults prescribed multiple long‐term medications.

Health workers’ perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis
Mobile health (mHealth), refers to healthcare practices supported by mobile devices, such as mobile phones and tablets. Within primary care, health workers often use mobile devices to register clients, track their health, and make decisions about care, as well as to communicate with clients and other health workers. An understanding of how health workers relate to, and experience mHealth, can help in its implementation. The objective of this Cochrane Review was to synthesise qualitative research evidence on health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services, and to develop hypotheses about why some technologies are more effective than others.

Primary Mental Health (New Zealand)

Providing support by phone or video call
Te Pou o te Whakaaro Nui has created a resource offering practical guidance for NGO support workers providing support by phone or video to people they are already supporting.

Use and uptake of web-based therapeutic interventions amongst Indigenous populations in Australia, New Zealand, the United States of America and Canada: a scoping review
Barriers to receiving optimal healthcare exist for Indigenous populations globally for a range of reasons. To overcome such barriers and enable greater access to basic and specialist care, developments in information and communication technologies are being applied. The focus of this scoping review, published in Systematic Reviews, is on web-based therapeutic interventions (WBTI) that aim to provide guidance, support and treatment for health problems.

Primary Mental Health (International)

Key Components of Effective Pediatric Integrated Mental Health Care Models: A Systematic Review
Emerging evidence suggests that integrated care models are associated with improved mental health care access and outcomes for youths served in pediatric primary care settings. However, the key components of these complex models remain unexamined. The objective of this review, published in JAMA Pediatrics, was to identify and describe the key components of effective pediatric integrated mental health care models.

Video calls for reducing social isolation and loneliness in older people: a rapid review
The current COVID‐19 pandemic has been identified as a possible trigger for increases in loneliness and social isolation among older people due to the restrictions on movement that many countries have put in place. Loneliness and social isolation are consistently identified as risk factors for poor mental and physical health in older people. Video calls may help older people stay connected during the current crisis by widening the participant’s social circle or by increasing the frequency of contact with existing acquaintances. The primary objective of this Cochrane Rapid Review was to assess the effectiveness of video calls for reducing social isolation and loneliness in older adults. The review also sought to address the effectiveness of video calls on reducing symptoms of depression and improving quality of life.

Childhood Obesity (International)

Interventions for increasing fruit and vegetable consumption in children aged five years and under
Insufficient consumption of fruits and vegetables in childhood increases the risk of future non‐communicable diseases, including cardiovascular disease. Testing the effects of interventions to increase consumption of fruit and vegetables, including those focused on specific child‐feeding strategies or broader multicomponent interventions targeting the home or childcare environment is required to assess the potential to reduce this disease burden. The objective of this Cochrane Review was to assess the effectiveness, cost effectiveness and associated adverse events of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under.

Oral Health (New Zealand)

The Dunedin Multidisciplinary Health and Development Study: Oral health findings and their implications
Longitudinal research is needed to better understand the natural history of oral conditions and long-term health and social outcomes. Oral health data has been collected periodically in the Dunedin Multidisciplinary Health and Development Study for over 40 years. To date, 70+ peer-review articles on the Study's oral health-related findings have been published, providing insight into the natural history of oral conditions, risk factors, impacts on quality of life, and disparities in oral health. Some of these report new findings, while others build upon the existing body of evidence. This paper, published in the Journal of the Royal Society of New Zealand, provides an overview of these findings and reflects on their public health implications and policy utility in New Zealand.

Oral and dental health and health care for Maori with type 2 diabetes: A qualitative study
Type 2 diabetes mellitus (T2DM) and periodontal disease are two highly prevalent, directly and independently associated long-term conditions that disproportionately impact Indigenous Maori in New Zealand (NZ). Although poorly understood, a number of social and biological mechanisms connect these conditions. This qualitative study, published in Community Dentistry & Oral Epidemiology, explored experiences of T2DM and oral and dental (hereafter oral/dental) health; access to oral/dental health care; whether participants' experiences supported or challenged existing evidence; and sought suggestions for improving oral/dental health in a high-deprivation rural area of Northland, NZ.

Disability Improvement (New Zealand)

The role of key workers in supporting people with intellectual disability in the self-management of their diabetes: a qualitative New Zealand study
The incidence of diabetes in people with an intellectual disability, although unknown, is indicated to be higher than the general population. Given the challenges individuals with intellectual disability may face, this population is often dependent upon key workers to manage their health and well-being. The aim of this study, published in Health & Social Care in the Community, was to explore how key workers supported the self-management of diabetes by people with intellectual disability.

Key Ministry of Health Publications

Health and Independence Report 2018
The 2018 Health and Independence report outlines that overall New Zealanders have maintained a good level of health, but inequities in access to services and health outcomes continue to exist. Māori, Pacific peoples, people living in low socioeconomic areas and disabled people have comparably poorer health outcomes. The 2018 report focuses on the fact that poor social conditions and the determinants of health (such as housing) underlie unequal health outcomes among New Zealanders.

Ola Manuia: Pacific Health and Wellbeing Action Plan 2020–2025
Although many Pacific communities are thriving, overall, Pacific peoples in New Zealand experience significant and long-standing health inequities compared with many other groups. A fresh approach is needed to improve Pacific health outcomes. The Ministry has developed Ola Manuia: Pacific Health and Wellbeing Action Plan 2020–2025 with input from Pacific communities, the health sector, and relevant government agencies, to provide a new direction for Pacific health and improve Pacific health and wellbeing. 

COVID-19 Psychosocial and Mental Wellbeing Recovery Plan
The Kia Kaha, Kia Māia, Kia Ora Aotearoa: COVID-19 Psychosocial and Mental Wellbeing Recovery Plan provides a national approach to supporting the mental and social wellbeing of New Zealanders in the COVID-19 recovery period.

District Health Board Initiative

Northland DHB rolls out intra-hospital eReferrals
Northland District Health Board has partnered with Clanwilliam Health to build an integration into Whangarei Hospital's clinical platform to enable electronic referrals to be sent between hospital departments and out to private specialists and community providers.

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.

Ministry of Health - Manatū Hauora
133 Molesworth Street
Wellington, 6011
New Zealand

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