Issue 264 - 10 November 2022

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

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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)

Aspects of Wellbeing for Indigenous Youth in CANZUS Countries: A Systematic Review
This review, published in the International Journal of Environmental Research and Public Health, aims to identify components contributing to wellbeing for Indigenous youth in CANZUS nations.

Systems Mapping of the New Zealand Free and Healthy School Lunch Programme: Perspectives from Lunch Providers
As part of the COVID-19 economic recovery package, the Aotearoa New Zealand Government rolled out a universal free and healthy lunch programme to the 25% least advantaged schools nationwide. This study, published in Nutrients, explored experiences of school lunch providers in the Hawke's Bay region.

Estimating the economic costs of Indigenous health inequities in New Zealand: a retrospective cohort analysis
Despite significant international interest in the economic impacts of health inequities, few studies have quantified the costs associated with unfair and preventable ethnic/racial health inequities. This Indigenous-led study, published in the BMJ Open, is the first to investigate health inequities between Māori and non-Māori adults in New Zealand (NZ) and estimate the economic costs associated with these differences.

Health Equity (International)

The commercial determinants of Indigenous health and well-being: a systematic scoping review
Despite emerging literature on the commercial determinants of health, the health and well-being impacts of commercial activities for Indigenous populations is not well understood. This study, published in the BMJ Global Health, aimed to identify, map and synthesise the available evidence on the commercial determinants of Indigenous health and well-being.

Quality Improvement (New Zealand)

Driving quality improvement through better data: The story of New Zealand's radiation oncology collection
Aotearoa/New Zealand is one of the first nations in the world to develop a comprehensive, high-quality collection of radiation therapy data (the Radiation Oncology Collection, ROC) that is able to report on treatment delivery by health region, patient demographics and service provider. This has been guided by radiation therapy leaders, who have been instrumental in overseeing the establishment of clear and robust data definitions, a centralised database and outputs delivered via an online tool. This paper, published in the Journal of Medical Imaging and Radiation Oncology, details the development of the ROC, provide examples of variation in practice identified from the ROC and how these changed over time, then consider the ramifications of the ROC in the wider context of cancer care quality improvement.

Cancer Services (New Zealand)

Improving early detection of colorectal cancer in Aotearoa New Zealand; how do the direct access criteria perform?​​​​​​​
Colorectal cancer (CRC) is a common malignancy in New Zealand, and there is increasing pressure on investigative resources for diagnosis. The national direct access referral guidelines from the Ministry of Health (MoH) guide who should be referred for investigation, but their performance in detecting CRC and other significant diseases has not been reported previously. This paper, published in The New Zealand Medical Journal, describes the yield, by direct access criterion, of all referrals through the direct access pathway to the Canterbury District Health Board (CDHB) during 2018.

Cardiovascular Disease and Diabetes (International)

The effectiveness of patient-centered care vs. usual care in type 2 diabetes self-management: A systematic review and meta-analysis
Patient-centred care in diabetes self-management might be a significant factor in improving health outcomes of adults with type 2 diabetes, yet the supporting evidence is inadequate. This review, published in Frontiers in Public Health, assessed the effectiveness of patient-centred self-management care interventions on glycaemic control (HbA1c) and self-care behaviours compared with usual care

Effectiveness and Cost-Effectiveness of Case Management in Advanced Heart Failure Patients Attended in Primary Care: A Systematic Review and Meta-Analysis
Nurse-led case management (CM) may improve quality of life (QoL) for advanced heart failure (HF) patients. This paper, published in the International Journal of Environmental Research and Public Health aimed to evaluate the effect of such programs in primary care settings.

Primary Health Care (New Zealand)

Lessons learnt from the implementation of new models of care delivery through alliance governance in the Southern health region of New Zealand: a qualitative study​​​​​​​
The objective of this paper, published in the BMJ Open, is to explore the process of implementation of the primary and community care strategy through alliance governance in the Southern health region of New Zealand (NZ). With alliances, partnerships and networks increasingly held up as models for integration, this evaluation identifies important lessons for policy makers, managers and services providers both in NZ and internationally.

Primary Mental Health (International)

Therapeutic Community Gardening as a Green Social Prescription for Mental Ill-Health: Impact, Barriers, and Facilitators from the Perspective of Multiple Stakeholders
This study, published in the International Journal of Environmental Research and Public Health, identified mechanisms by which therapeutic community gardening impacted mental health.

Increased Immunisation (New Zealand)

Vaccine hesitancy and its determinants among refugee parents resettled in Aotearoa New Zealand​​​​​​​
Vaccine hesitancy is an important factor underpinning suboptimal vaccine uptake and evidence on marginalized subgroups, such as refugees, is limited. This cross-sectional survey, published in Human Vaccines and Immunotheraputics, was conducted with former refugee parents who resettled in Aotearoa New Zealand (NZ). The prevalence of parental vaccine hesitancy was explored and the association between vaccine hesitancy and sociodemographic factors was examined.

Smoking Cessation (New Zealand)

How do New Zealand youth perceive the smoke-free generation policy? A qualitative analysis​​​​​​​​​​​​​​
Aotearoa New Zealand (NZ) plans to introduce a smoke-free generation (SFG) policy, alongside denicotinisation and reducing the availability of tobacco products. The SFG has a clear rationale, yet little is known about how young people perceive it. To inform policy design, communication and implementation, this paper (published in Tobacco Control) explored how NZ youth perceived the SFG.

Weight Management (New Zealand)

Sometimes choices are not made, because we have 'a' choice, they're made because they are 'the' choice": Barriers to weight management for clients in rural general practice
People living in rural communities experience health inequities and have a high-risk of becoming obese. The aim of this study, published in BMC Primary Care, was to explore and identify barriers to effective weight management in rural Waikato general practice.

The Impact of a Family-Based Assessment and Intervention Healthy Lifestyle Programme on Health Knowledge and Beliefs of Children with Obesity and Their Families​​​​​​​​​​​​​​​​​​​​​
The objective of this study, published in Nutrients, was to determine the impact of a family-based assessment-and-intervention healthy lifestyle programme on health knowledge and beliefs of children and families affected by obesity. The study also compared the health knowledge of the programme cohort to those of a national cohort in Aotearoa/New Zealand.  

Weight Management (International)

Interventions to prevent obesity in school-aged children 6-18 years: An update of a Cochrane systematic review and meta-analysis including studies from 2015-2021
Childhood obesity remains a global public health priority due to the enormous burden it generates. Recent surveillance data suggests there has been a sharp increase in the prevalence of childhood obesity during the COVID-19 pandemic. The Cochrane review of childhood obesity prevention interventions (0-18 years), published in EClinical Medicine, updated to 2015 is the most rigorous and comprehensive review of randomised controlled trials (RCTs) on this topic.

Oral Health (New Zealand)

Oral health of children in Aotearoa New Zealand–time for change​​​​​​​​​​​​​​
This review, published in the Journal of the Royal Society of New Zealand, looks at children’s oral health in NZ and make recommendations for change among oral health professionals, all health professionals, health services and society.

Disability Services (New Zealand)

The Multidimensional Impacts of Inequities for Tāngata Whaikaha Māori (Indigenous Māori with Lived Experience of Disability) in Aotearoa, New Zealand​​​​​​​​​​​​​​​​​​​​​
People with lived experience of disability have poorer health and socioeconomic outcomes than people without it. However, within this population, certain social groups are more likely to experience poorer outcomes due to the impacts of multiple intersecting forms of oppression including colonisation, coloniality and racism. This paper, published in the International Journal of Environmental Research and Public Health, describes the multidimensional impacts of inequities for Indigenous tāngata whaikaha Māori (Māori with lived experience of disability).

Public Health (International)

The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels​​​​​​​​​​​​​​​​​​​​​
The 2022 report of the Lancet Countdown is published as the world confronts profound and concurrent systemic shocks. Countries and health systems continue to contend with the health, social, and economic impacts of the COVID-19 pandemic, while Russia's invasion of Ukraine and a persistent fossil fuel overdependence has pushed the world into global energy and cost-of-living crises. As these crises unfold, climate change escalates unabated. Its worsening impacts are increasingly affecting the foundations of human health and wellbeing, exacerbating the vulnerability of the world's populations to concurrent health threats.

Key Ministry of Health Publications

Ministry of Health Annual Report for the year ended 30 June 2022
The 2021/22 Annual Report summarises the Ministry’s major work programmes and achievements, and demonstrates our progress towards our strategic intentions 2021–25, and the strategic objectives set out in Ta Tatou Rautaki | Our Strategy and Pae Ora | Healthy Futures.

Abortion Services Aotearoa New Zealand: Annual Report 2022
This report provides an of overview of Manatū Hauora’s abortion services work between October 2021 and September 2022. Key areas of focus include meeting Te Tiriti o Waitangi obligations and improving equity and access.

Suicide web tool
The Suicide web tool presents data on confirmed suicides reported by Te Whatu Ora, as well as data on suspected intentionally self-inflicted deaths reported by the Chief Coroner. Numbers and rates of suicide deaths are presented by year, ethnicity, sex, age group and district health board of residence of the deceased. Confirmed suicide data are reported from 2009 to 2018, while suspected intentionally self-inflicted death data are reported from 2009 to the 2021/22 financial year.

Health Sector Initiative

Te Pae Tata Interim New Zealand Health Plan 2022
Te Pae Tata interim New Zealand Health Plan 2022 outlines the first steps to becoming a health service delivery system that better serves all New Zealand’s people and communities. This plan covers a period of reset while the foundations of the health system change. Te Pae Tata replaces 20 different district annual plans.

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.