Issue 322 - 15 May 2025

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 Health NZ district 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

Emergency managers’ perspectives on Maori response and recovery approaches: managing catastrophic hazard events in Aotearoa New Zealand
Iwi, hapū and Māori communities have consistently demonstrated an ability to effectively engage in readiness, response and recovery for catastrophic hazard events in Aotearoa New Zealand. These actions are operationalised, both independently and in collaboration with local Civil Defence and Emergency Management (CDEM) groups. There are increasing calls from the Aotearoa New Zealand Government and from iwi and hapū to formalise relationships and support available. Little work has been done to understand what the perspectives and experiences of Māori and non-Māori emergency managers have been in navigating past events and planning for future ones. This qualitative research, published in the Australian Journal of Emergency Management, included a series of interviews with emergency managers from across the country on barriers and opportunities for Māori participation in response and recovery.

Whaowhia te Kete Matauranga: Papakainga as a Hapu Resilience Framework
Environmental hazards and climate change disproportionately affect Indigenous peoples and raises important concerns for social equity, environmental justice and disaster risk reduction. The under-representation of Indigenous peoples in natural hazard policymaking also impacts on the acceptability and relevance of disaster risk reduction initiatives to First Nations peoples. Indigenous concepts, values and understandings of environmental justice are pertinent to climate change mitigation, transformative practice and sustainable futures. This research, published in the Australian Journal of Emergency Management, was a collaboration between Māori academics and Māori community members and explores local understandings of Indigenous peoples of disaster risk reduction and highlights the need to maintain harmony and balance among humans and in relation to the natural world.

Health Equity (New Zealand)

Health Disparities of Head and Neck Cancer in Māori and European in Mid Central New Zealand 2014-2020
Māori face notable survival disparities for head and neck cancer (HNC). New studies on HNC disparities with a rural lens are limited. This study, published in ANZ Journal of Surgery, aims to assess differences in HNC survival and treatment between Māori and Europeans in the Mid Central region of New Zealand (NZ), identify survival-correlating factors, and highlight areas for health system improvement.

"We're living in a world that wasn't built for us": A qualitative exploration of young New Zealander's perspectives on socio-ecological determinants of declining youth mental health
Globally, youth mental health has been in decline since the beginning of the 21st century. While much has been written about the reasons for this, we have little understanding of young people's perspectives. A rich understanding of the issues young people identify as impacting their mental health is essential for developing effective interventions. This study, published in BMC Public Health, aimed to explore what young people from Aotearoa, New Zealand believe impacts their mental health, both positively and negatively, with a focus on social determinants.

Equity, power and resources in primary health care reform: insights from Aotearoa New Zealand
New Zealand's District Health Board reform (2000-2022) was underpinned by the goal of reducing inequities in health outcomes between population groups and improving health overall. A key policy vehicle for achieving the goal was a system-wide shift to population health with increased strategic focus on and investment in primary health care. This research, published in the International Journal for Equity in Health, explored shifts in power and resource to understand how equity as a policy goal for primary health care fared over the District Health Board era, and examined how the distribution of power and resources in the health sector changed for PHC over the period 2000-2020.

Ethnic equity in Aotearoa New Zealand's COVID-19 response: A descriptive epidemiological study
Aotearoa New Zealand employed one of the most stringent public health pandemic responses internationally. This study, published in Public Health, investigated whether ethnic health equity was achieved in the response and outcomes, from COVID-19 elimination in June 2020 through to Omicron-response easing, including international border reopening, in 2022.

Health Equity (International)

Structural Racism in Cervical Cancer Care and Survival Outcomes: A Systematic Review of Inequities and Barriers
Despite cervical cancer (CC) being a cancer that can be eliminated, CC disparities persist such that minoritized populations shoulder a disproportionate mortality burden. This may reflect upstream, fundamental drivers of health that impede equitable access to prevention, screening, early detection, and treatment among some groups. This systematic review, published in Current Epidemiology Reports, summarises evidence on the relationships between structural racism and CC care across the continuum.

Paramedics’ understandings and perceptions of cultural safety and the provision of culturally safe care
Aboriginal and Torres Strait Islander peoples experience persistent disadvantage and health inequity in today’s society. It is widely accepted that this is resultant of Australia’s colonial history. Current literature suggests that an increase in culturally safe care may assist in bettering the health outcomes of Aboriginal and Torres Strait Islander recipients of care. Research in nursing has suggested that cultural safety is largely misunderstood. This study, published in BMC Health Services Research, explored paramedics understanding of cultural safety and the provision of culturally safe care

Nutrition & Physical Activity (International)

Effectiveness of virtual reality interventions in promoting healthy eating and physical activity among children: A systematic review
Childhood obesity significantly impacts health, making the promotion of healthy behavior (HB) among children crucial to address this issue. Virtual reality (VR) has emerged as a promising tool for encouraging HB in children. This systematic review, published in Digital Health, aims to evaluate the literature on the application of VR in promoting healthy dietary habits and physical activity (PA) among children.

Cancer Services (International)

Cancer Partnerships Hub (CPH) Model: Implementing an Organizational Innovation to Enhance Engagement of Patient-Partner in Cancer Care Services
Patient partnership is rapidly becoming a cornerstone of effective care, with healthcare professionals recognizing the immense value of collaboration. This case study, published in the Patient Experience Journal, delves into the innovative Cancer Partnership Hub (CPH) model implemented at the Integrated University Health and Social Services Center of East Montreal Island (CIUSSS-EMTL) in Quebec, Canada.

The effect of community-based palliative supportive care integrated with primary health care (PHC) on the outcomes of terminally ill cancer patients
Cancer is increasing worldwide. Palliative care can help reduce the suffering of patients with cancer. Providing palliative care with a primary health care (PHC) approach can lead to greater patient access to palliative services. Given the lack of studies in this area, the present study, published in BMC Primary Care, aimed to determine the impact of community-based palliative care integrated with PHC on outcomes of terminally ill cancer patients.

Emergency Department Services (New Zealand)

Evaluation of a virtual emergency care service to avoid unnecessary emergency department presentations and provide specialist-led definitive care
This evaluation, published in Emergency Medicine Australasia, explored the impact of a peer-to-peer telehealth service called Specialist Telehealth Aotearoa (STAR) on transfers to the ED.

Cardiovascular Disease and Diabetes (International)

Policy models for preventative interventions in cardiometabolic diseases: a systematic review
Cardiometabolic diseases (CMDs), including cardiovascular disease (CVD) and type 2 diabetes (T2DM), are major contributors to morbidity, mortality, and rising healthcare costs. Effective disease prevention programs rely on robust mathematical models to generate long-term evidence regarding the effectiveness, cost-effectiveness, and policy implications of interventions in the population. Population-level interventions, such as dietary policies, are recognised as essential prevention strategies, yet there is limited synthesis of policy models assessing their impact. This study, published in BMC Health Services Research, systematically reviews existing CMD policy models to provide a comprehensive overview of current models, and a critical appraisal of their application, particularly in the context of primordial prevention programmes.

Pre‐Pregnancy Diet and/or Physical Activity Interventions for the Prevention of Gestational Diabetes Mellitus: A Systematic Review and Meta‐Analysis
Gestational diabetes mellitus (GDM) is associated with short‐ and long‐term adverse health outcomes for women and their infants. Antenatal diet and/or physical activity interventions have not been effective at preventing GDM, and currently, it is not clear whether intervening similarly prior to pregnancy is beneficial. This review, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, aims to evaluate the impact of pre‐pregnancy diet and/or physical activity interventions on rates of GDM and other maternal and infant health outcomes.

Primary Health Care (International)

Primary Care Behavioral Counseling Interventions to Support Breastfeeding
The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the evidence on the benefits and harms of primary care behavioral counseling interventions to support breastfeeding and published this in JAMA.

Smoking Cessation (New Zealand)

Vape shops on the way to school: Geographical analysis of the proximity of specialist vape retailers to New Zealand schools
This study, published in the Australian and New Zealand Journal of Public Health, aimed to investigate the proximity of existing specialist vape retailers to schools in New Zealand.

Oral Health (International)

Oral Health Promotion Interventions in Residential Aged Care Facilities - A Systematic Review of Behaviour Change Techniques Used in Interventions
The oral health status of older people living in residential aged care facilities (RACFs) is found to be very poor. Many oral health promotion interventions have been tested in RACF settings around the world with varying degrees of success. The aim of this systematic review, published in Community Dentistry and Oral Epidemiology, was to analyse the health promotion strategies used in oral health promotion interventions in RACF settings.

Health Sector Initiative

Police and Health NZ continue to implement mental health response changes
Phase Two of the Police Mental Health Response Change Programme is set to be extended with a second group of districts implementing Phase Two from 19 May. The tranche two districts have been jointly assessed for their readiness and the multi-agency Mental Health Response Change Programme Governance Group has endorsed their implementation.

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.