Ministry of Health Library

Health Improvement and Innovation Digest

Issue 125 - 25 August 2016

Welcome to the fortnightly Health Improvement and Innovation Digest (HIID). 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.  You can use this link to subscribe to Grey Matter.

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.

Hospital Productivity (New Zealand)

Health sector: Results of the 2014/15 audits
The performance of the health sector greatly affects New Zealand's overall social and economic performance, and thus the quality of life for all of us. Financial sustainability has been a challenge for district health boards (DHBs) for a long time. In general, DHBs are doing reasonably well at marshalling their resources for current operational needs. This analysis of DHBs, by the Controller and Auditor-General, financial statements for successive years suggests that their planning for the future and ability to deal with uncertainty or changing circumstances is limited.

Hospital Productivity (International)

Lean in healthcare: Engagement in development, job satisfaction or exhaustion?
Conclusions about implementing the management concept lean in healthcare are contradictory and longitudinal studies are scarce. In particular, little is known of how working conditions contribute to the sustainability of lean in healthcare. The aim of this article, published in the Journal of Hospital Administration, is to identify to what extent lean tools promote working conditions for employees and managers in healthcare organisations.

Shorter Stays In Emergency Departments (International)

Predictors of emergency department referral in patients using out-of-hours primary care services
Out of hours (OOH) doctors could manage many cases limiting the inappropriate accesses to ED. However the possible determinants of referral to ED by OOH doctors are poorly studied. The aim of this study, published in Health Policy, was to characterize patients referred from the OOH to ED service in order to explore the gate-keeping role of OOH service for hospital emergency care and to facilitate future research in improving its cost-effectiveness.

More Heart and Diabetes Checks (New Zealand)

To move or not to move? Exploring the relationship between residential mobility, risk of cardiovascular disease and ethnicity in New Zealand
Residential mobility can have negative impacts on health, with some studies finding that residential mobility can contribute to widening health gradients in the population. However, ethnically differentiated experiences of residential mobility and the relationship with health are neglected in the literature. This article, published in Social Science & Medicine, examined the relationship between residential mobility, risk of cardiovascular disease (CVD) and ethnicity.

More Heart and Diabetes Checks (International)

Factors influencing general practitioners’ decisions about cardiovascular disease risk reassessment: findings from experimental and interview studies
Guidelines on cardiovascular disease (CVD) risk reassessment intervals are unclear, potentially leading to detrimental practice variation: too frequent can result in overtreatment and greater strain on the healthcare system; too infrequent could result in the neglect of high risk patients who require medication. This study, published in BMC Family Practice, aimed to understand the different factors that general practitioners (GPs) consider when deciding on the reassessment interval for patients previously assessed for primary CVD risk.

Tailored implementation of cardiovascular risk management in general practice: a cluster randomized trial
Counselling on health-related lifestyles is key to the prevention and management of chronic diseases. After comprehensive study of determinants of its delivery in general practice and strategies to improve, we composed a tailored improvement program, which included communication skills training, online patient information, and a clinical protocol for managing depressive symptoms. The aim of this study, published in Implementation Science, was to assess the effectiveness of this program on professional performance and outcomes in cardiovascular patients.

Primary Health Care (New Zealand)

Triggering safer general practice care
This editoral, published in BMJ Quality & Safety, explores how general practice can minimise people's exposure to healthcare that harms them, while maximising their exposure to healthcare that helps. It explores a diverse array of strategies have developed that includes tools such as alarms and alerts built in to equipment, postmarketing medicines surveillance, incident reporting systems, check lists, fish plots, run charts and many other things.

Determining the Efficacy of the Chronic Disease Self-Management Programme and Readability of “Living a Healthy Life with Chronic Conditions” in a New Zealand Setting
Self-management programmes are an increasingly popular way of treating chronic diseases. This study, published in Internal Medicine Journal, aims to determine the efficacy of the Stanford Chronic Disease Self Management Programme (CDSMP) in a New Zealand context, by assessing course outcomes and readability of the accompanying reference guide, “Living a Healthy Life with Chronic Conditions, 4th Edition.”

Primary Health Care (International)

Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders
The adverse effects of prenatal alcohol exposure constitute a continuum of disabilities (fetal alcohol spectrum disorders [FASD]). In 1996, the Institute of Medicine established diagnostic categories delineating the spectrum but not specifying clinical criteria by which diagnoses could be assigned. In 2005, the authors published practical guidelines operationalizing the Institute of Medicine categories, allowing for standardization of FASD diagnoses in clinical settings. The purpose of the current report, published in Pediatrics, is to present updated diagnostic guidelines based on a thorough review of the literature and the authors’ combined expertise based on the evaluation of more than ten thousand children for potential FASD.

Enhancing Access to Diabetes Self-management Education in Primary Care
The purpose of this continuous quality improvement project, published in The Diabetes Educator, was to improve access to diabetes self-management education (DSME) and to evaluate the impact on glycemic and weight control by translating an academic medical center's DSME program, accredited per the Education Recognition Program (ERP) of the American Diabetes Association, into a program offered at primary care clinics (PCCs).

Primary Mental Health (New Zealand)

Systematic review of interventions for Indigenous adults with mental and substance use disorders in Australia, Canada, New Zealand and the United States
The aim of this study, published in the Australian and New Zealand Journal of Psychiatry, was to systematically review the evidence-base for the effectiveness of culturally unadapted, culturally adapted and culture-based interventions for Indigenous adults with mental or substance use disorders.

The role of neighborhood disadvantage, physical disorder, and collective efficacy in adolescent alcohol use: a multilevel path analysis
Research into the salient exposures which explain neighborhood variation in adolescent alcohol use remains inconclusive. The Social Disorganization Theory suggests that neighborhood-level disadvantage may reduce collective efficacy to control adolescent risky behavior. This study, published in Health & Place, drew on data from a nationally-representative survey of urban high school students in New Zealand, multilevel path analysis was used to estimate the direct and mediating effects of neighborhood disadvantage, physical disorder, and collective efficacy on current drinking, frequency of binge drinking, and typical quantity of alcohol consumed.

Primary Mental Health (International)

Cognitive behavioural therapy (CBT), third-wave CBT and interpersonal therapy (IPT) based interventions for preventing depression in children and adolescents
Depression is common in young people. It has a marked negative impact and is associated with self-harm and suicide. Preventing its onset would be an important advance in public health. This Cochrane Review aimed to determine whether evidence-based psychological interventions are effective in preventing the onset of depressive disorder in children and adolescents.

Does screening for and intervening with multiple health compromising behaviours and mental health disorders amongst young people attending primary care improve health outcomes? A systematic review
Adolescence and young adulthood are important developmental periods. Screening for health compromising behaviours and mental health disorders during routine primary care visits has the potential to assist clinicians to identify areas of concern and provide appropriate interventions. The objective of this systematic review, published in BMC Family Practice, is to investigate whether screening and subsequent interventions for multiple health compromising behaviours and mental health disorders in primary care settings improves the health outcomes of young people.

Utilizing clinical pharmacists to improve delivery of evidence-based care for depression and anxiety in primary care
Access to mental health providers has become an increasingly common challenge for many patients with depression and anxiety disorders. Primary care providers often manage this gap in care and currently provide solo care without the assistance of other team members. In order to provide quality care that aligns with best practice, the authors developed a depression and anxiety disorder treatment pathway utilizing a multidisciplinary team based on each members' individual skill set, or skill-task alignment. This program wa trialed and the results are explored in this study, published in BMJ Quality Improvement Reports.

Increased Immunisation (International)

A systematic review of serious video games used for vaccination
Vaccination is an effective and proven method of preventing infectious diseases. However, uptake has not been optimal with available vaccines partly due to vaccination hesitancy. Various public health approaches have adressed vaccination hesitancy. Serious video games involving vaccination may represent an innovative public health approach. The aim of this study, published in Vaccine, was to identify, describe, and review existing serious video games on vaccination.

Better Help for smokers to Quit (New Zealand)

Stages of physical dependence in New Zealand smokers: Prevalence and correlates
Physically dependent smokers experience symptoms of wanting, craving or needing to smoke when too much time has passed since the last cigarette. There is interest in whether wanting, craving and needing represent variations in the intensity of a single physiological parameter or whether multiple physiological processes may be involved in the developmental progression of physical dependence. The aim of this study, published in Addictive Behaviors, was to determine how a population of cigarette smokers is distributed across the wanting, craving and needing stages of physical dependence.

Smoking prevalence in New Zealand from 1996–2015: a critical review of national data sources to inform progress toward the Smokefree 2025 goal
The New Zealand Government has committed to a goal of becoming a smokefree nation by 2025. This study, published in the New Zealand Medical Journal, analysed recent smoking trends using three national data sets to: assess progress towards the smokefree goal; and critically evaluate New Zealand’s main national-level data sources on smoking prevalence for measuring progress towards the Smokefree 2025 goal.

Smoking in cars: knowledge, behaviours and support for smokefree cars legislation among New Zealand smokers and recent quitters
Exposure to second-hand smoke (SHS) poses serious health consequences to non-smokers, and normalises smoking. Currently, there is no legislation restricting smoking in private cars in New Zealand. This paper, published in the New Zealand Medical Journal, supplements previous New Zealand studies on exposure to SHS in cars by examining smokers and recent quitters’ knowledge and behaviours towards smoking in cars, and their support for two possible smokefree cars policy options.

Better Help for smokers to Quit (International)

Is vaping a gateway to smoking: a review of the longitudinal studies
The use of e-cigarettes (ECs) is rising globally. There is concern that e-cigarette may actually lead to smoking, especially amongst adolescents. The objective of this study, published in the International Journal of Adolescent Medicine and Health, was to perform a comprehensive review of literature reporting the longitudinal effects of e-cigarette use on onset of smoking among adolescents and young adults.

Weight Management (New Zealand)

Nutrition and health claims on healthy and less-healthy packaged food products in New Zealand
Nutrition and health claims are displayed to influence consumers' food choices. This study, published in the British Journal of Nutrition, assessed the extent and nature of nutrition and health claims on the front-of-pack of 'healthy' and 'less-healthy' packaged foods in New Zealand.

Pregnant women lack accurate knowledge of their BMI and recommended gestational weight gain
The aim of this study, published in the New Zealand Medical Journal, was to investigate pregnant women’s knowledge of their body mass index (BMI) and their knowledge of gestational weight gain guidelines.

Childhood Obesity (International)

Environmental components of childhood obesity prevention interventions: an overview of systematic reviews
Childhood obesity has a complex multi-factorial aetiology grounded in environmental and individual level factors that affect behaviour and outcomes. An ecological, systems-based approach to addressing childhood obesity is increasingly being advocated. The primary aim of this review, published in Obesity Reviews, is to summarize the evidence reported in systematic reviews on the effectiveness of population-level childhood obesity prevention interventions that have an environmental component.

Key Ministry of Health Publications

Taking Action on Fetal Alcohol Spectrum Disorder: 2016–2019: An action plan
Fetal alcohol spectrum disorder (FASD) is the umbrella term used to describe the range of effects that can occur when a fetus is exposed to alcohol during pregnancy. This action plan aims to create a more effective, equitable and collaborative approach to FASD. It is a cross-agency commitment designed to build on the work that is already under way by providing coordinated support to those on the frontline of this issue.

Health Loss in New Zealand 1990–2013
This report analyses health loss and health expectancy in New Zealand from 1990 to 2013.