Issue 345 - 25 June 2026

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

Family rituals, sleep, and well-being in Moemoeā: A Māori-led intervention
While sleep inequities exist worldwide, interventions to improve sleep and well-being have rarely been developed through an indigenous lens. This article, published in Sleep Health, outlines the development of a Māori-led intervention aiming to improve sleep in families with pēpi (infants) aged 2-12 months and thus well-being in the wider whānau (family).

Health Equity (New Zealand)

Advance Care Planning in Indigenous Populations: A Scoping Review
Advance care planning has proven to be beneficial to medical care as it elicits patient preferences at the end of life, yet Indigenous populations have low rates of participation. This gap map scoping review, published in the Journal of Palliative Medicine, serves to assess the current literature regarding the prevalence of advance care planning and palliative care characteristics in Indigenous populations of North America and Oceania.

Quality Improvement (New Zealand)

New Zealand Health and Disability System Safety Strategy
The New Zealand Health and Disability System Safety Strategy (the strategy), published by the Health Quality & Safety Commission, sets a system wide direction for strengthening quality and safety as a foundation for people centred care in New Zealand.

Quality Improvement (International)

Audit and feedback: effects on professional practice
Audit and feedback (A&F) is a widely used strategy to improve professional practice. The objective of this Cochrane Review was to assess the effects of A&F on the practice of healthcare professionals and to examine factors that may explain variation in the effectiveness of A&F.

Hospital Productivity (International)

Augmenting healthcare systems for pandemic preparedness: a Lean Six Sigma perspective
Past global healthcare crises have exposed vulnerabilities in healthcare systems, including inefficiencies in hospital operations, delayed response times, and overburdened infrastructure. Traditional hospital systems built for routine care were sometimes not resilient or adaptable in the face of such crises, resulting in global failures. This narrative review, published in the International Journal for Quality in Health Care, examines how Lean Six Sigma (LSS) principles can be incorporated into conventional hospital operations to enhance pandemic preparedness by building the resilience of hospital infrastructure, streamlining processes during time-sensitive situations, and improving waste reduction, all while being adaptable and sustainable.

Emergency Department Services (International)

Community-Based Crisis Care Beyond the Emergency Department: A Scoping Review
Suicide and mental ill-health remain a major global concern, reflected by rising emergency department presentations, however there is growing recognition that these settings often do not meet the needs of individuals in crisis. These settings are often experienced as crowded, traumatic, and poorly equipped for psychological distress, underscoring the need for accessible, community-based alternatives that offer safer, more supportive responses during crisis. This scoping review, published in the Community Mental Health Journal, examines the needs, motivations, and experiences of people using community-based alternatives to emergency departments and explores how peer support and lived experience are embedded in these models.

Cardiovascular Disease and Diabetes (New Zealand)

Weaving Maatauranga: The Ko Tuna Anahe Framework for Culturally Responsive Type 2 Diabetes Education for Maaori Communities
The significant burden of type 2 diabetes (T2D) for Maaori populations highlights the crucial need for culturally responsive health education. This study, published in MAI Journal, used Kaupapa Maaori participatory action research methodology in collaboration with a semi-rural Waikato community to develop tailored T2D educational resources.

Cardiovascular Disease and Diabetes (International)

Impact of Advanced Practice Nurses on the Outcomes of Individuals With Chronic Kidney Disease: A Systematic Review
The aim of this study, published in the International Nursing Review, to examine the association between advanced practice nursing roles and outcomes among individuals with chronic kidney disease.

Primary Health Care (New Zealand)

Models of Antenatal Care for Rural Indigenous Women: A Systematic Review
This review, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, sought to ascertain which features of antenatal models promote better outcomes among Indigenous pregnant women living in rural areas.

Primary Mental Health (New Zealand)

Towards Destigmatising Gambling Harms in Aotearoa New Zealand
This narrative review, published in MAI Journal, examines the intersection of gambling harms and stigma among Māori, Pacific peoples, Asian communities and youth in Aotearoa New Zealand.

Do natural and built environments influence mental health of Pacific young people in Aotearoa New Zealand? a nationwide geospatial study
The importance of the physical environments where Pacific Peoples live is embedded in their diverse histories, traditions, and world views, influencing indigenous models of health and wellbeing. Pacific young people of Aotearoa New Zealand are known to experience higher rates of mental and addiction problems than other young people. This paper, published in Pacific Health Dialog, investigates how environments where Pacific young people (10–24 years) live are associated with mental health outcomes.

Increased Immunisation (International)

Perceptions and attitudes towards human papillomavirus vaccination among Samoan girls Aged 10 –17 years and their caregivers in rural communities
Since introducing the human papillomavirus vaccine (HPV) in 2022, Samoa has achieved coverage rates of 80% or higher in consecutive years. However, coverage rates varied significantly by area during these years. This qualitative study, published in Pacific Health Dialog, interviewed unvaccinated eligible girls aged 10–17 years, their parents and caregivers, and health workers to understand vaccine perceptions and social factors affecting provision of consent.

Behavioural and social drivers of HPV vaccine uptake in Tonga: a mixed-methods study using the WHO BeSD framework and Talanoa in a Pacific Island setting
Small Pacific Island nations sustain a disproportionate cervical cancer burden. Despite an excellent routine immunisation program, HPV vaccine coverage in Tonga remains consistently low after a decade of programming. This study, published in Vaccine, used the WHO Behavioural and Social Drivers (BeSD) framework to identify drivers of HPV vaccine uptake among caregivers and to examine the underlying contextual mechanisms shaping vaccination decisions in this Pacific Island setting.

Disability Services (New Zealand)

The benefits of kapa haka for adults with intellectual disabilities in Aotearoa New Zealand
This study, published in the Journal of Intellectual & Developmental Disability, aimed to gain an in-depth understanding of how adults with intellectual disabilities experience kapa haka and explore the benefits and challenges they experience, in comparison with the general population.

Key Ministry of Health Publications

Research Agenda: Rheumatic Fever and Rheumatic Heart Disease
This Research Agenda sets out the key priorities for future rheumatic fever research in New Zealand, across prevention, clinical care, and long-term outcomes. It aims to better connect research with policy, and health services.

Health Sector Initiative

Rural medical programme expands to Taupō in 2027
The University of Auckland’s Rural Medical Immersion Programme (RMIP) will expand to Taupō in 2027, creating new opportunities for medical students to train in rural healthcare settings and strengthening connections with communities across Aotearoa New Zealand. The year-long programme places fifth-year medical students in rural locations, where they work alongside general practitioners, rural hospital doctors and multidisciplinary teams.

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.