Issue 327 - 24 July 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

‘Let us enjoy the fruits of our own labour, we have our own solutions’ Creative co-design methods and narratives of Māori whānau with chronic pain
Chronic or persistent pain disproportionately affects Māori and their whānau (family and significant others). Our previous engagement with Māori living with persistent pain has identified significant barriers for Māori to accessing primary, secondary, and tertiary services. This paper, published in Kōtuitui, describes the insights obtained from Māori living with persistent pain by using a creative art-based data collection method as part of a co-design process to understand how they would like to be supported in their pain management journey.

Acceptability and exploratory efficacy of a Māori-led injury prevention and care model for older Māori in primary care in Aotearoa New Zealand: pilot study
In Aotearoa New Zealand (NZ), healthcare access inequities exist for unintentional injuries between older Māori and non-Māori. This study, published in the Journal of the Royal Society of New Zealand, investigated the acceptability and exploratory efficacy of a co-designed paeārahi (navigator)-led injury prevention and care model for koeke (older Māori) in a prospective, non-randomised, pilot study.

Health Equity (New Zealand)

The Māori Health Data Governance Model: A planning and protocol checklist
Māori health data (MHD) governance is a critical enabler of achieving health equity for Māori. The Māori Data Governance Model (the Model) provides a framework for all stages of Māori data handling but has yet to be meaningfully implemented within health settings. This study, published in First Nations Health and Wellbeing - The Lowitja Journal, aimed to meet the need for health-specific guidance by adapting the Model to create an MHD governance checklist.

Investigating the Landscape of General Surgical Care in Rural Aotearoa, New Zealand: A Scoping Review
This scoping review, published in ANZ Journal of Surgery, explores the provision of general surgical services in rural and regional Aotearoa, New Zealand (Aotearoa NZ). 

Health Equity (International)

Under what conditions do people accept health inequality? A cross-national regression analysis of OECD countries
This study, published in Health Policy, investigates the evolution of public attitudes towards health inequality in OECD countries and evaluates the interaction between institutional structures and societal norms over time.

Is the quest for efficiency harmful to health equity? An examination of the health efficiency-equity nexus in OECD countries over the past two decades
Has the quest for efficiency in OECD health systems impacted the social gradient of health? This article, published in Social Science & Medicine, examined the cross-dynamics of the health system equity-efficiency nexus among OECD countries in the past two decades.

Nutrition & Physical Activity (International)

Digital health, technology‐driven or technology‐assisted interventions for the management of obesity in children and adolescents
Childhood obesity is a worldwide public health problem that increases the risk of chronic diseases. The objective of this Cochrane Review was to assess the effects and safety of interventions using digital technology – that is, interventions applied to achieve health objectives implemented within any digital application, communication, or system – for the integrated management of obesity in children and adolescents.

Cancer Services (New Zealand)

From small steps to big impact: what we learnt from the National Bowel Screening Programme
Implementation of the National Bowel Screening Programme for Aotearoa New Zealand has been a 26-year journey with many challenges and obstacles. This paper, published in the Journal of the Royal Society of New Zealand, describes lessons learnt.

Cancer Services (International)

Interventions to Increase Colorectal Cancer Screening Uptake in Rural Settings: A Scoping Review
This scoping review, published in Preventing Chronic Disease, aimed to describe the types and effectiveness of interventions to increase Colorectal Cancer Screening in primarily rural settings.

Emergency Department Services (International)

Ambulance diversion and its use as an ED overcrowding mitigation strategy: Does it work? A scoping review
Emergency department (ED) overcrowding is a worldwide issue with significant negative consequences, including increased patient mortality. Ambulance diversion (AD) is sometimes used as an intervention to momentarily relieve overcrowded EDs, however, jury is still out about the negative consequences both for emergency medical services (EMS) who are required to divert to an alternative destination, and for patients whose care is delayed. Additionally, there is no operational guidance to best operationalize AD. The objective of this scoping review, published in the International Journal of Emergency Medicine, was to collate and organise the peer-reviewed published literature on the effects of both diversion and diversion aversion measures, on emergency medical services (EMS) and patient outcomes.

Artificial Intelligence Solutions to Improve Emergency Department Wait Times: Living Systematic Review
Overcrowding and long wait times in emergency departments (EDs) remain global challenges that negatively affect patient outcomes and staff satisfaction. As an emerging technology, artificial intelligence (AI) offers the potential to optimize ED operations and reduce wait times. The objective of this review, published in The Journal of Emergency Medicine, was to establish a strategy to evaluate AI modeling as it relates to utilizing AI based strategies for ED flow.

Primary Health Care (International)

The implementation challenge of computerised clinical decision support systems for the detection of disease in primary care: systematic review and recommendations
Early detection of diseases in primary care is crucial for timely treatment and better outcomes. Complex care demands and limited resources can make early detection challenging. Clinical decision support systems (CDSS) aim to improve the diagnostic process. However, barriers to implementation have so far prevented their effective use. This systematic review, published in Implementation Science, aimed to identify barriers for the implementation of CDSS for disease detection in primary care and use this to develop recommendations for implementation.

Primary Mental Health (New Zealand)

Pacific peoples’ conceptualisations of depression in Aotearoa New Zealand: Findings from a cross-sectional survey
The aim of the present study, published in the Journal of the Royal Society of New Zealand, is to provide a snapshot of how depression is understood and addressed by Pacific peoples in Aotearoa New Zealand.

Primary Mental Health (International)

Mental health discussions among rural residents: a social network approach
Mental health in rural areas can be affected by a lack of available services, which highlights the need for alternative support. Social relationships are known to bolster mental health, yet discussions of mental health in rural areas may be hindered by concerns over stigma and anonymity. This study, published in Rural and Remote Health, applies a novel social network design to identify characteristics of mental health discussion networks among rural residents in Scotland.

Key Ministry of Health Publications

New Zealand Clinical Principles Framework for Attention Deficit Hyperactivity Disorder
The New Zealand Clinical Principles Framework for Attention Deficit Hyperactivity Disorder (the framework) describes the expected clinical standards for quality assessment, diagnosis and treatment of ADHD in New Zealand based on existing international clinical guidelines. The framework also includes further considerations that may represent clinical best practice or areas that have limited evidence. The framework has been developed in partnership with a Clinical Reference Group, with members including people with lived experience of ADHD, family and whānau of individuals with ADHD, and New Zealand clinicians with expertise and experience in assessing and treating ADHD.

Public Health Guidance for Hairdressers and Barbers
This publication outlines practical actions that hairdressers and barbers can take to reduce the spread of infection. It covers hygiene, equipment handling, and cleaning and is designed to help hairdressers and barbers across New Zealand keep their clients safe.

Registrar (assisted dying) Annual Report – June 2025
The End of Life Choice Act 2019 (the Act) came into force on the 7 November 2021. This established the Assisted Dying – Ngā Ratonga Mate Whakaahuru service in New Zealand Aotearoa. The Ministry of Health is responsible for the administration of the Act. The Act requires the Registrar (assisted dying) to report to the Minister of Health about the operation of the service by 30 June each year. This Registrar (assisted dying) Annual Report covers the period from 1 April 2024 to 31 March 2025. In addition to information required by the Act, this report summarises information relating to the Ministry’s regulation and monitoring of the service, service usage, workforce and feedback about the service.

Tupu Ola Moui: Pacific Health Chart Book 2025 series
The Tupu Ola Moui series serves as a foundational reference point for understanding the current state of Pacific health. Volume 3-5 have just been published.

Health Sector Initiative

Enhancing Sleep Care at Hawke’s Bay Hospital
Patients with severe sleep apnea can now access treatment faster thanks to a new approach by the Sleep Service at Hawke’s Bay Hospital. The hospital’s sleep service is now offering group sessions for patients needing Continuous Positive Airway Pressure (CPAP) therapy, where up to 10 patients can be seen at once.

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.