Ministry of Health Library

Health Improvement and Innovation Digest

Issue 222 - 19 November 2020

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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Article access

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Māori Innovation

An Indigenous self-determination social movement response to COVID-19
For Māori in New Zealand, COVID-19 is remarkable in two particular ways. First, we bet the odds for the first time in contemporary history. Forecasts predicted that Māori would have double the infection and mortality rates of non-Māori. However, as at June 2020, Māori have a disproportionately lower infection rate than non-Māori. This is perhaps the only example in our contemporary history of the Māori community having better social outcomes than non-Māori. Second is that attribution is due, perhaps not exclusively, but materially to a self-determination social movement within our Indigenous communities that the pandemic response unveiled and accelerated. This article, published in AlterNative, comments on this self-determination social movement, with a particular focus on how that movement has manifested within the South Island of New Zealand.

Health Equity (New Zealand)

Same inequities or engaged Te Tiriti partnership?
This article, published in MAI Journal, discusses how as the government shifts its focus from COVID-19 elimination to addressing the longer-term social and economic repercussions of the pandemic, it is critical that Mäori are able to partner and lead in decision-making.

Quality Improvement (New Zealand)

Improving the quality of mortality review equity reporting: Development of an indigenous Māori responsiveness rubric
The objective of this study, published in the International Journal for Quality in Health Care, was to improve consistency in New Zealand’s Mortality Review Committees’ (MRCs) analysis, interpretation and recommendations, specifically related to equity and Māori (the Indigenous peoples of Aotearoa New Zealand) mortality.

Ethical frameworks for quality improvement activities: an analysis of international practice
The purpose of this paper, published in the International Journal for Quality in Health Care, was to examine international approaches (including New Zealand) to the ethical oversight and regulation of quality improvement and clinical audit in healthcare systems.

Cancer Services (New Zealand)

Patients' experiences of a mindfulness intervention for adults with advanced cancer: a qualitative analysis
People with advanced cancer often experience significant emotional turmoil that accompanies their diagnosis and cancer-related treatments. Therefore, psychological interventions become relevant to address these impacts; however, there is a lack of research into the psychological support needs of those with advanced cancer (those not yet in palliative or end-of-life stages). In this context, the authors developed a mindfulness-based intervention, Coping with Cancer Mindfully (CCM), to provide psychological and emotional support to adults with advanced cancer. This article, published in Supportive Care in Cancer, reports on qualitative interviews from a mixed method study of the CCM intervention exploring its utility and the extent it provides psychological support to this population in a pre-post-intervention design.

Cancer Services (International)

Health Literacy Interventions in Cancer: a Systematic Review
Those with limited health literacy often have difficultly navigating the health care environment, including navigating care across the cancer continuum (e.g., prevention, screening, diagnosis, treatment). Evidence-based interventions to assist adults with limited health literacy improve health outcomes; however, little is known about health literacy interventions in the context of cancer and their impact on cancer-specific health outcomes. The purpose of this review, published in the Journal of Cancer Education, was to identify and characterize the literature on health literacy interventions across the cancer care continuum.

Cardiovascular Disease and Diabetes (New Zealand)

Youth and non‐European ethnicity are associated with increased loss of publicly funded insulin pump access in New Zealand people with type 1 diabetes
Continuous subcutaneous insulin infusion (CSII) has been publicly funded in New Zealand for people living with type 1 diabetes since 2012. The aim of the current study, published in Diabetic Medicine, was to investigate loss of access, once obtained, to public funded CSII.

Primary Health Care (New Zealand)

Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice Experiment
Given increasing patient populations, general practitioner (GP) workforce constraints and increasing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services may need to increase to improve people’s access to medicines. In this study, published in Applied Health Economics and Health Policy, a discrete choice experiment (DCE) was utilised to determine community pharmacist preferences for prescribing services in primary care in NZ, and to understand how these factors could improve the provision of pharmacist prescribing services.

Primary Health Care (International)

Transitioning to Aboriginal community control of primary health care: the process and strategies of one community-controlled health organisation in Queensland
Aboriginal Community Controlled Health Services (ACCHSs) play a critical role in providing culturally appropriate, accessible primary healthcare (PHC) for Aboriginal and Torres Strait Islander peoples in Australia. The success of many ACCHSs has led to increased policy support for their growth and development, including the transition of state government administered PHC services to Aboriginal community control in select communities. However, there is minimal published literature available which evaluates such transitions. This paper, published in BMC Family Practice, reports on an evaluation of one ACCHS (Gurriny Yealamucka Health Service)‘s experience of transitioning local PHC services to community control in Yarrabah, Queensland, with a focus on the processes and strategies which were implemented to achieve successful transition.

Barriers and Enablers in Implementing Electronic Consultations in Primary Care: Scoping Review
Often promoted as a way to address increasing demands, improve patient accessibility, and improve overall efficiency, electronic consultations are becoming increasingly common in primary care, particularly in light of the current COVID-19 pandemic. However, despite their increasing use, a theoretically informed understanding of the factors that support and inhibit their effective implementation is severely limited. The objective of this scoping review, published in the Journal of Medical Internet Research, was to identify the factors that support and inhibit the implementation of electronic consultations in primary care.

Avoiding unnecessary hospitalisation for patients with chronic conditions: a systematic review of implementation determinants for hospital avoidance programmes
Studies of clinical effectiveness have demonstrated the many benefits of programmes that avoid unnecessary hospitalisations. Therefore, it is imperative to examine the factors influencing implementation of these programmes to ensure these benefits are realised across different healthcare contexts and settings. Numerous factors may act as determinants of implementation success or failure (facilitators and barriers), by either obstructing or enabling changes in healthcare delivery. Understanding the relationships between these determinants is needed to design and tailor strategies that integrate effective programmes into routine practice. The aims of this study, published in Implementation Science, were to describe the implementation determinants for hospital avoidance programmes for people with chronic conditions and the relationships between these determinants.

Primary Mental Health (International)

24-Month Outcomes of Primary Care Web-Based Depression Prevention Intervention in Adolescents: Randomized Clinical Trial
Adolescent depression carries a high burden of disease worldwide, but access to care for this population is limited. Prevention is one solution to curtail the negative consequences of adolescent depression. Internet interventions to prevent adolescent depression can overcome barriers to access, but few studies examine long-term outcomes. This study, published in the Journal of Medical Internet Research, compares CATCH-IT (Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training), an internet-based intervention, to a general health education active control for depression onset at 12 and 24 months in adolescents presenting to primary care settings.

Increased Immunisation (International)

Web-Based Tailored Messaging to Increase Vaccination: A Randomized Clinical Trial
To increase vaccine acceptance, the authors of this study, published in Pediatrics, created a Web-based the “Vaccines and Your Baby” intervention (VAYB) that provided new parents with vaccine information messages tailored to vaccine beliefs and values. This study evaluated the effectiveness of the VAYB by comparing timely uptake of infant vaccines to an untailored version of the intervention (UT) or usual care intervention (UC) only.

Weight Management (New Zealand)

Challenges of making healthy lifestyle changes for families in Aotearoa/New Zealand
The objective of the current study, published in Public Health Nutrition, was to identify challenges of making and sustaining healthy lifestyle changes for families with children/adolescents affected by obesity, who were referred to a multicomponent healthy lifestyle assessment and intervention programme in Aotearoa/New Zealand (NZ).

Health and Wellness Impacts of Traditional Physical Activity Experiences on Indigenous Youth: A Systematic Review
Traditional physical activities have numerous physiological and psychosocial benefits for Indigenous youth around the world. Little is known about the positive health and wellness impacts of traditional physical activity experiences on Indigenous youths. The aim of this systematic review, published in the International Journal of Environmental Research and Public Health, is to explore the holistic health and wellness impacts of traditional physical activities on Indigenous youth from certain North American and Oceania geographic areas.

Weight Management (International)

Usability and utility of eHealth for physical activity counselling in primary health care: a scoping review
Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping review, published in BMC Family Practice, aimed to identify usability and utility of eHealth for tailored PA counselling introduced in PHC settings.

Childhood Obesity (New Zealand)

Healthier Together: Co-design of a culturally-tailored childhood obesity community prevention program for Māori & Pacific Islander children and families
Children of Māori & Pacific Islander descent living in Australia have a greater prevalence of overweight/obesity and an increased risk of adverse health outcomes. This study, published in the Health Promotion Journal of Australia, aimed to co-design Healthier Together, a community-based, childhood overweight/obesity prevention program tailored to the Māori & Pacific Islander cultures.

Childhood Obesity (International)

Motivational Interviewing for Overweight Children: A Systematic Review
Motivational interviewing (MI) is a communication method to help facilitate adherence to health behaviors through a series of person-centered strategies. MI’s evidence base supports its use as a potential intervention strategy at the parental decision-maker level to impact young children’s lifestyle behaviors to address childhood obesity; however, clarity is needed on the literature. The purpose of this systematic review, published in Pediatrics, was to synthesize the literature examining the use of MI at the parental level to impact young children’s weight status.

Disability Services (International)

Transitional Care Interventions for Youth With Disabilities: A Systematic Review
Transition from the pediatric to the adult health care system is a complex process that should include medical, psychosocial, educational, recreational, and vocational considerations. This systematic review, published in Pediatrics, aims to synthesize the evidence on transitional care interventions (TCIs) to improve the quality of life (QoL) for adolescents and young adults with childhood-onset disabilities, including neurodevelopmental disorders.

District Health Board Initiative

Counties Manukau Health develops ground-breaking primary and community services system of care
Counties Manukau Health (CM Health) is developing a system of care for primary and community services to support people and whaanau living with long-term conditions (LTCs) that is the first of its kind.

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.