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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 209 - 13 February 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.

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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.

Health Equity (New Zealand)

Beyond awareness: Towards a critically conscious health promotion for rheumatic fever in Aotearoa, New Zealand
This paper, published in Social Science & Medicine, discusses the Rheumatic Fever Prevention Programme in New Zealand. Since 2014, it has targeted communities in Aotearoa, New Zealand affected by high rates of rheumatic fever (RF): namely, Māori and Pacific families. Initiated with the aim of reducing ethnic health disparities, the Health Promotion Agency attempted to use culturally appropriate approaches by engaging in consultative processes with Māori and Pacific communities and health leaders in developing the intervention. However, these consultations largely focused on evaluating strategies for reaching “priority” audiences with the message to get sore throats checked and on changing health-seeking behaviours. There was little regard for what the structural roots of RF in Aotearoa might suggest about equitable interventions, nor for the potentially harmful effects of the messages and their presentation.

Improving health equity among the African ethnic minority through health system strengthening: a narrative review of the New Zealand healthcare system
In New Zealand, health equity is a pressing concern and reaching disadvantaged populations has become the goal to close the inequity gap. Building and strengthening health systems is one way to secure better outcomes. However, the discourse to date has predominately focussed on inequities in health outcomes for Māori. This study, published in the International Journal for Equity in Health, has interest in the African ethnic minority community in New Zealand. It undertakes a narrative review of the New Zealand health system which aims to identify literature around the attainment of health equity of African minority by providing a critical overview of the healthcare delivery system using World Health Organization’s six inter-related building blocks of health system strengthening; developing a summary and discussions of the research results and; identifying priorities and recommendations for future research.

Health Equity (International)

Factors Impacting on Development and Implementation of Training Programs for Health Professionals to Deliver Brief Interventions, with a Focus on Programs Developed for Indigenous Clients: A Literature Review
This paper, published in the International Journal of Environmental Research and Public Health, reviews the literature on evaluations of brief intervention training programs for health professionals which address one or more lifestyle factors of chronic disease to identify factors impacting on development and implementation of programs.

Quality Improvement (International)

Do quality management systems influence clinical safety culture and leadership? A study in 32 Australian hospitals
This study, published in the International Journal for Quality in Health Care, aimed to explore the associations between the organization-level quality arrangements, improvement and implementation and department-level safety culture and leadership measures across 32 large Australian hospitals.

Cancer Services (New Zealand)

Quality assessment of a large primary GP skin cancer service in Auckland, New Zealand
Waitemata District Health Board has implemented a new approach to the management of skin cancers by triaging lesions to specialist-trained general practitioners (GPSI) with the aim of reducing patient wait times and treatment costs. The primary outcome was to determine positive margin rates for the GP surgeons, with secondary outcome being infection rates. This study, published in the New Zealand Medical Journal, assessed this new service.

Cancer Services (International)

Self-management of patients with advanced cancer: A systematic review of experiences and attitudes
Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention. The aim of this study, published in Palliative Medicine, was to summarise studies describing self-management strategies of patients with advanced cancer and associated experiences and personal characteristics. Also, to summarise attitudes of relatives and healthcare professionals towards patient self-management.

The impact of tumor board on cancer care: evidence from an umbrella review
Tumor Boards (TBs) are Multidisciplinary Team (MDT) meetings in which different specialists work together closely sharing clinical decisions in cancer care. The composition is variable, depending on the type of tumor discussed. As an organizational tool, MDTs are thought to optimize patient outcomes and to improve care performance. The aim of the study, published in BMC Health Services Research, was to perform an umbrella review summarizing the available evidence on the impact of TBs on healthcare outcomes and processes.

Shorter Stays In Emergency Departments (International)

The relationships between quality management systems, safety culture and leadership and patient outcomes in Australian Emergency Departments
The aim of this study, published in the International Journal of Quality in Health Care, was to examine whether Emergency Department (ED) quality strategies, safety culture and leadership were associated with patient-level outcomes, after controlling for other organization-level factors, in 32 large Australian hospitals.

Cardiovascular Disease and Diabetes (International)

Utilising clinical settings to identify and respond to the social determinants of health of individuals with type 2 diabetes—A review of the literature
Type 2 diabetes (T2DM) is increasing in global prevalence. It is more common among people with poor social determinants of health (SDoH). Social determinants of health are typically considered at a population and community level; however, identifying and addressing the barriers related to SDoH at an individual and clinical level, could improve the self‐management of T2DM. This literature review, published in Health and Social Care in the Community, aimed to explore the methods and strategies used in clinical settings to identify and address the SDoH in individuals with T2DM.

Telerehabilitation services for stroke
Telerehabilitation offers an alternate way of delivering rehabilitation services. Information and communication technologies are used to facilitate communication between the healthcare professional and the patient in a remote location. The use of telerehabilitation is becoming more viable as the speed and sophistication of communication technologies improve. However, it is currently unclear how effective this model of delivery is relative to rehabilitation delivered face‐to‐face or when added to usual care. The objective of this Cochrane Review was to determine whether the use of telerehabilitation leads to improved ability to perform activities of daily living amongst stroke survivors when compared with in‐person rehabilitation (when the clinician and the patient are at the same physical location and rehabilitation is provided face‐to‐face); or no rehabilitation or usual care.

Primary Health Care (New Zealand)

Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand.
Cannabidiol (CBD) is the non-euphoriant component of cannabis. In 2017, the New Zealand Misuse of Drugs Regulations (1977) were amended, allowing doctors to prescribe CBD. Therapeutic benefit and tolerability of CBD remains unclear. The aim of this study, published in BJGP Open, was to review the changes in self-reported quality of life measurements, drug tolerability, and dose-dependent relationships in patients prescribed CBD oil for various conditions at a single institution.

Primary Mental Health (New Zealand)

Pacific models of mental health service delivery in New Zealand: Part I: What do we know about Pacific mental health in New Zealand? A narrative review
The objective of this study, published in Australasian Psychiatry, was to update measures of mental disorders and service use in Pacific people living in New Zealand.

Part II: using an integrated case model for delivering mental health services in general practice for Pacific people.
The objective of this study, published in Australasian Psychiatry, was to discuss an alternative model for delivering mental health services to Pacific people in general practice.

Primary Mental Health (International)

Strategies for engaging patients and families in collaborative care programs for depression and anxiety disorders: A systematic review
Patients and families are often referred to as important partners in collaborative mental health care (CMHC). However, how to meaningfully engage them as partners remains unclear. This study, published in the Journal of Affective Disorders, aimed to identify strategies for engaging patients and families in CMHC programs for depression and anxiety disorders.

Increased Immunisation (International)

Improving vaccination uptake among adolescents
Adolescent vaccination has received increased attention since the Global Vaccine Action Plan's call to extend the benefits of immunisation more equitably beyond childhood. In recent years, many programmes have been launched to increase the uptake of different vaccines in adolescent populations; however, vaccination coverage among adolescents remains suboptimal. Therefore, understanding and evaluating the various interventions that can be used to improve adolescent vaccination is crucial. The objective of this Cochrane Review was to evaluate the effects of interventions to improve vaccine uptake among adolescents.

Childhood Obesity (International)

Interventions commenced by early infancy to prevent childhood obesity—The EPOCH Collaboration: An individual participant data prospective meta‐analysis of four randomized controlled trials
Childhood obesity is a significant global problem. This study, published in Pediatric Obesity, examined whether childhood obesity prevention interventions may be more effective when started very early in life before metabolic and behavioural patterns are established.

Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services
Despite the existence of effective interventions and best‐practice guideline recommendations for childcare services to implement evidence‐based policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. The primary aim of this Cochrane Review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention.

Oral Health (International)

Learning programmes and teaching techniques to enhance oral health literacy or patient-centred communication for healthcare providers: A systematic review
The objective of this review, published in European Journal of Dental Education, was to investigate the learning programmes and teaching techniques used in interventions to enhance oral health literacy (OHL) or patient-centred communication (PCC) for healthcare providers.

Key Ministry of Health Publications

New Zealand Cancer Action Plan 2019–2029
Cancer is the leading cause of death in New Zealand. Each year, around 23,000 people are diagnosed with cancer and 10,000 die from cancer. The New Zealand Cancer Action Plan 2019-2029 (the plan) provides a pathway to improve cancer outcomes for all New Zealanders. On 1 December 2019, the Government launched the Cancer Control Agency to lead the implementation of this plan.

District Health Board Initiative

Tooth-conscious mokopuna 'E Whakahāmana…Te Wero Oranga-ā-Waha' to win oral health challenge
The mokopuna and whānau of Te Kiriwera Hana Kōhanga Reo based in Te Teko have triumphed in an Eastern Bay of Plenty oral health challenge. Kōhanga Reo from across the Eastern Bay were invited to enter the annual challenge, run by the Bay of Plenty District Health Board's (BOPDHB) Oral Health Promotion team, which looks at initiatives employed by Kōhanga Reo to inspire tamariki and their whānau towards greater oral health awareness and practice.

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
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Wellington, 6011
New Zealand

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