Ministry of Health Library

Health Improvement and Innovation Digest

Issue 201 - 10 October 2019

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). 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.  If you'd like to subscribe to Grey Matter, email library@health.govt.nz.

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.

Māori Innovation

Mate wareware: Understanding ‘dementia’ from a Māori perspective
This paper, published in the New Zealand Medical Journal, explains an understanding of mate wareware (dementia) as obtained from interviews with over 200 elderly Māori and whānau from across Aotearoa New Zealand.

Health Equity (New Zealand)

Multimorbidity in early childhood and socioeconomic disadvantage: findings from a large New Zealand child cohort
In contrast with multimorbidity during adulthood, the relationship of childhood multimorbidity with socioeconomic position is poorly understood. This study, published in Academic Pediatric, aimed to describe early childhood multimorbidity and investigate the relationship of this with socioeconomic position.

The Association Between Hearing Impairment and Problem Behaviors in 11-Year-Old Pacific Children Living in New Zealand
Hearing impairment in childhood is a serious disability that can impose a heavy social and economic burden on individuals and families. This study, published in Ear and Hearing, hypothesised that hearing loss or middle ear disease in 11-year-old Pacific children living in New Zealand would be associated with higher levels of engagement in delinquent behaviours, and clinical level internalizing and externalizing problem behaviours than Pacific children with no hearing loss or middle ear disease.

Health Equity (International)

Screening Children for Social Determinants of Health: A Systematic Review
Screening children for social determinants of health (SDOHs) has gained attention in recent years, but there is a deficit in understanding the present state of the science. The objective of this study, published in Pediatrics, was to systematically review SDOH screening tools used with children, examine their psychometric properties, and evaluate how they detect early indicators of risk and inform care.

Quality Improvement (International)

Use and reporting of experience-based codesign studies in the healthcare setting: a systematic review
Experience-based codesign (EBCD) is an approach to health service design that engages patients and healthcare staff in partnership to develop and improve health services or pathways of care. The aim of this systematic review, published in BMJ Quality & Safety, was to examine the use (structure, process and outcomes) and reporting of EBCD in health service improvement activities.

Cancer Services (New Zealand)

The impact of primary HPV screening on the incidence of cervical cancer in New Zealand
The objective of this study, published in the Journal of the American Society of Cytopathology, was to evaluate the impact on the incidence of cervical cancer in New Zealand of 5-yearly human papillomavirus (HPV) primary screening compared with 3-yearly cytology.

Shorter Stays In Emergency Departments (International)

Does the @home team reduce local Emergency Department attendances? The experience of one London service
Since 2014, the @home team has been offering patients acute care in their own homes using a multi-disciplinary team with the aim of preventing some Emergency Department (ED) attendances, facilitating early discharges, and preventing acute admissions. By preventing some ED attendances, the @home team aims to contribute to the performance of the two local EDs, both of which are currently failing to meet the ED 4-h operational target. The objective of this study, published in International Emergency Nursing, was to determine if the @home team reduces ED attendances locally, and if so, by how much, and whether this impacted on the 4-h operational target.

Emergency department and hospital crowding: causes, consequences, and cures
Overcrowding with associated delays in patient care is a problem faced by emergency departments (EDs) worldwide. ED overcrowding can be the result of poor ED department design and prolonged throughput due to staffing, ancillary service performance, and flow processes. As such, the problem may be addressed by process improvements within the ED. A broad body of literature demonstrates that ED overcrowding can be a function of hospital capacity rather than an ED specific issue. Lack of institutional capacity leads to boarding in the ED with resultant ED crowding. This is a problem not solvable by the ED and must be addressed as an institution-wide problem. This paper, published in Clinical and Experimental Emergency Medicine, discusses the causes of ED overcrowding, provides a brief overview of the drastic consequences, and discusses possible cures that have been successfully implemented.

Cardiovascular Disease and Diabetes (New Zealand)

Self-management action and motivation of Pacific adults in New Zealand with end-stage renal disease
The aim of this study, published in PLoS One, was to explore actions and motivations for self-management practices of Pacific adults following diagnosis of end stage renal disease (ESRD).

Primary Health Care (New Zealand)

Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis
Supine maternal position in the third trimester is associated with reduced uterine blood flow and increased risk of late stillbirth. As reduced uterine blood flow is also associated with fetal growth restriction, this study explored the association between the position in which pregnant women went to sleep and infant birth weight. The objective of this study, published in JAMA Network Open, was to examine the association between supine position when going to sleep in women after 28 weeks of pregnancy and lower birth weight and birth weight centiles.

Primary Mental Health (New Zealand)

Trauma informed approaches
Knowledge of trauma and trauma informed approaches is important in mental health and addiction services given the high proportion of people who have experienced trauma. The acknowledgement of people’s experiences throughout their lives and their whānau is important for effective responses. This short resource developed by Te Rau Ora, Le Va, Werry Workforce Whāraurau and Te Pou aims to raise awareness of what trauma is, the effects of trauma, and how to develop trauma informed approaches within our workforce and organisations.

Primary Mental Health (International)

Evaluation of The Practitioner Online Referral and Treatment Service (PORTS): the first 18 months of a state-wide digital service for adults with anxiety, depression, or substance use problems
This study, published in Cognitive Behaviour Therapy, evaluated The Practitioner Online Referral and Treatment Service (PORTS). This is a new digital mental health service (DMHS) providing assessment, treatment, and consultation across Western Australia, for adults with anxiety, depression, or substance use problems, and experiencing financial hardship or geographical disadvantage.

Impact of a primary care training program on the prevention and management of unhealthy alcohol use: A quasi-experimental study
The objective of this study, published in Patient Education and Counselling, was to assess the impact of a training program targeted at Primary Care professionals on the acquisition of communication skills, attitudes, and knowledge about the prevention and management of unhealthy alcohol use.

Better Help for smokers to Quit (International)

Smoking reduction interventions for smoking cessation
The standard way most people are advised to stop smoking is by quitting abruptly on a designated quit day. However, many people who smoke have tried to quit many times and may like to try an alternative method. Reducing smoking behaviour before quitting could be an alternative approach to cessation. However, before this method can be recommended it is important to ensure that abrupt quitting is not more effective than reducing to quit, and to determine whether there are ways to optimise reduction methods to increase the chances of cessation. The objective of this Cochrane Review was to assess the effect of reduction‐to‐quit interventions on long‐term smoking cessation.

Situation, Impacts, and Future Challenges of Tobacco Control Policies for Youth: An Explorative Systematic Policy Review
Tobacco use in youths is a major public health challenge globally, and approaches to the challenge have not been sufficiently addressed. The existing policies for tobacco control are not well specified by age. This study, published in Frontiers in Pharmacology, aims to systematically investigate existing tobacco control policies, potential impacts, and national and international challenges to control tobacco use targeting the youth.

Weight Management (International)

Impact of service‐wide initiatives to support healthy pregnancy weight gain on weight-related documentation
Excess gestational weight gain is associated with adverse pregnancy outcomes. Addressing barriers to the provision of best practice care that supports healthy pregnancy weight gain could assist staff in clinical care; however, little is known about changes to staff practices after ameliorating barriers. The aim of this study, published in the Australian & New Zealand Journal of Obstetrics & Gynaecology, was to evaluate if service initiatives to promote healthy pregnancy weight gain improve weight‐related documentation by antenatal staff throughout pregnancy care.

Childhood Obesity (New Zealand)

Decomposing ethnic differences in body mass index and obesity rates among New Zealand pre-schoolers
The aim of this study, published in the International Journal of Obesity, was to determine the extent to which ethnic differences in BMI Z-scores and obesity rates could be explained by the differential distribution of demographic (e.g. age), familial (e.g. family income), area (e.g. area deprivation), parental (e.g. immigration status), and birth (e.g. gestational age) characteristics across ethnic groups.

Childhood Obesity (International)

Predicting Early Emergence of Childhood Obesity in Underserved Preschoolers
The objective of this study, published in the Journal of Pediatrics, was to determine the magnitude of risk of factors that contribute to the emergence of childhood obesity among low-income minority children.

Key Ministry of Health Publications

National Healthy Food and Drink Policy
The National Healthy Food and Drink Policy supports health sector leadership in promoting and ‘normalising’ healthy food environments in work and public places, as well as demonstrating a commitment to the health and wellbeing of staff, visitors and the general public.

Historical mortality
The Historical mortality web tool presents mortality data (numbers and age-standardised rates) by sex for certain causes of death from 1948 to 2016. Mortality data by sex, age group and ethnicity (Māori and non-Māori) is presented from 1996 to 2016. The web tool enables you to explore trends over time using interactive graphs and tables. Filtered results and the full data set can be downloaded from within the web tool.

District Health Board Initiative

Successful first year for new primary care mental health model
Counties Manukau Health’s new primary care mental health model, Wellness Support, is proving successful reaching in excess of 4,300 people and providing more than 10,000 consultations in its first year.

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.