Ministry of Health Library

Health Improvement and Innovation Digest

Issue 226 - 4 February 2021

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

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

Local-Indigenous Autonomy and Community Streetscape Enhancement: Learnings from Māori and Te Ara Mua—Future Streets Project
In settler countries, attention is now extending to the wellbeing benefits of recognising and promoting the Indigenous cultural identity of neighbourhoods as a contributing factor to more equitable and healthier communities. Re-indigenisation efforts to (re)implement cultural factors into urban design can be challenging and ineffective without the leadership and collaboration of local-Indigenous peoples. Undertaken in Aotearoa New Zealand, Te Ara Mua — Future Street project, demonstrated that co-design has critical potential in the reclamation of Indigenous autonomy, increased local-Indigenous presence and revitalisation of cultural identity. Employing a Kaupapa Māori (Māori-centred) research approach, this study, published in the International Journal of Environmental Research and Public Health, focused on the workings and perspectives of mana whenua (local-Indigenous peoples) and community stakeholder engagement in Te Ara Mua.

Health Equity (International)

Communications in the time of a pandemic: the readability of documents for public consumption
Government communications in a crisis can influence public health outcomes. This research, published in the Australian and New Zealand Journal of Public Health, aimed to investigate if written communications of the most commonly sought sources of COVID‐19 information available on the internet have readability levels commensurate with those of the general public.

Quality Improvement (International)

Hand hygiene for the prevention of infections in neonates
Annually, infections contribute to approximately 25% of the 2.8 million neonatal deaths worldwide. Over 95% of sepsis‐related neonatal deaths occur in low‐ and middle‐income countries. Hand hygiene is an inexpensive and cost‐effective method of preventing infection in neonates, making it an affordable and practicable intervention in low‐ and middle‐income settings. Therefore, hand hygiene practices may hold strong prospects for reducing the occurrence of infection and infection‐related neonatal death. The objective of this Cochrane Review was to determine the effectiveness of different hand hygiene agents for preventing neonatal infection in community and health facility settings.

Cancer Services (New Zealand)

Communicating prognostic information: what do oncologists think patients with incurable cancer should be told?
People with incurable cancer require information about their prognosis to make informed decisions about their future. The aim of this study, published in the Internal Medicine Journal, was to determine the frequency, form and documentation of prognostic discussions between oncologists and their patients with incurable cancer.

Radiological imaging of melanoma: a review to guide clinical practice in New Zealand
The aim of this review, published in the New Zealand Medical Journal, is to propose guidelines for initial radiological staging and the follow-up imaging regime for melanoma. This will provide consistency in the access and delivery of quality melanoma care.

Cardiovascular Disease and Diabetes (International)

Long‐term effects of weight‐reducing drugs in people with hypertension
The objective of this Cochrane Review was to assess the long‐term effects of pharmacologically‐induced reduction in body weight in adults with essential hypertension on all‐cause mortality, cardiovascular morbidity, and adverse events (including total serious adverse events, withdrawal due to adverse events, and total non‐serious adverse events).

Impact of Clinical Pharmacy Interventions on Health and Economic Outcomes in Type 2 Diabetes: A Systematic Review and Meta‐Analysis
The aim of this review, published in Diabetic Medicine, was to examine the effectiveness of clinical pharmacy interventions on health and economic outcomes of patients with type 2 diabetes in hospital settings.

Evidence generated from a realist synthesis of trials on educational weight loss interventions in type 2 diabetes mellitus
Obesity and diabetes are major public health problems. Current approaches to weight loss show varying success. Complex community‐based interventions work through several interconnected stages. An individual’s actions in response to an intervention depend on many known and unknown factors, which vary among individuals. The aim of this article, published in Diabetic Medicine, was to conduct a realist synthesis to identify in which context, for whom, in what circumstances, and how weight loss interventions work in obese or overweight individuals with type 2 diabetes.

Primary Mental Health (New Zealand)

Technology Matters: SPARX – computerised cognitive behavioural therapy for adolescent depression in a game format
Adolescent depression is common, and its prevalence is thought to be increasing in many high income nations. Addressing adolescent depression has proven challenging using traditional face‐to‐face psychotherapies, with major barriers including workforce shortages internationally and reluctance to seek help among some adolescents. There is substantial evidence to support the use of digital tools to treat mental health problems, with the National Institute for Health and Care Excellence (NICE) now recommending such tools as a first‐line treatment. This article, published in Child and Adolescent Mental Health, outlines the evidence base for SPARX, a digital tool named specifically in NICE guideline NG134, and discuss its use in clinical settings. We also consider implementation issues and future research directions.

Primary Mental Health (International)

A scoping review of the use of co‐design methods with culturally and linguistically diverse communities to improve or adapt mental health services
Mental health services are increasingly encouraged to use co‐design methodologies to engage individuals and families affected by mental health problems in service design and improvement. This scoping review, published in Health and Social Care in the Community, aimed to identify research that used co‐design methods with Culturally and Linguistically Diverse (CALD) communities in mental health services, and to identify methodological considerations for working with this population.

It Is Time to REACT: Opportunities for Digital Mental Health Apps to Reduce Mental Health Disparities in Racially and Ethnically Minoritized Groups
The behavioral health toll of the COVID-19 pandemic and systemic racism has directed increased attention to the potential of digital health as a way of improving access to and quality of behavioral health care. However, as the pandemic continues to widen health disparities in racially and ethnically minoritized groups, concerns arise around an increased reliance on digital health technologies exacerbating the digital divide and reinforcing rather than mitigating systemic health inequities in communities of color. This article, published in JMIR Mental Health, offers five key recommendations on how the field can “REACT” to ensure the development of approaches that increase health equity by increasing real-world evidence, educating consumers and providers, utilizing adaptive interventions to optimize care, creating for diverse populations, and building trust.

Increased Immunisation (New Zealand)

Influenza vaccination strategies for 2020-21 in the context of COVID-19
Influenza vaccination prevents people from influenza-related diseases and thereby mitigates the burden on national health systems when COVID-19 circulates and public health measures controlling respiratory viral infections are relaxed. However, it is challenging to maintain influenza vaccine services as the COVID-19 pandemic has the potential to disrupt vaccination programmes in many countries during the 2020/21 winter. This article, published in the Journal of Global Health, summarises available recommendations and strategies on influenza vaccination, specifically the changes in the context of the COVID-19 pandemic.

Better Help for smokers to Quit (International)

Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons US Preventive Services Task Force Recommendation Statement
The objective of this statement, published in JAMA, was to update the 2015 recommendation. The USPSTF commissioned a review to evaluate the benefits and harms of primary care interventions on tobacco use cessation in adults, including pregnant persons.

Childhood Obesity (International)

Obesity Prevention within the Early Childhood Education and Care Setting: A Systematic Review of Dietary Behavior and Physical Activity Policies and Guidelines in High Income Countries
As a strategy for early childhood obesity prevention, a variety of dietary behavior and physical activity policies and guidelines published by leading health agencies and early childhood education and care (ECEC) licensing and accreditation bodies exist. This narrative review, published in the International Journal of Environmental Research and Public Health, sought to synthesise, appraise and describe the various policies and guidelines made by organizational and professional bodies to highlight consistent recommendations and identify opportunities to strengthen such policies.

Comparative effectiveness of school‐based interventions targeting physical activity, physical fitness or sedentary behaviour on obesity prevention in 6‐ to 12‐year‐old children: A systematic review and meta‐analysis
This review, published in Obesity Reviews, aimed to compare the effects of interventions that targeted sedentary behaviours or physical activity (PA) or physical fitness on primary prevention of obesity in 6‐ to 12‐year‐old children.

Key Ministry of Health Publications

Smokefree Environments and Regulated Products Act 1990 - Proposals for regulations
The Ministry of Health is seeking views on a number of regulatory proposals that will provide the operational detail to help achieve the intent of the new provisions of Smokefree Environments and Regulated Products Act 1990. The closing date for submissions is 5.00 pm, Monday 15 March 2021.

Interim Evaluation Report 2020: Healthy Families NZ
In 2015 the Ministry of Health contracted Massey University to undertake the evaluation of Healthy Families NZ. A previously published Summative Evaluation Report updated the findings of the national evaluation of Healthy Families NZ following the first three years of implementation of the initiative (from late 2014 to end of 2017). This Interim Evaluation Report, prepared by Victoria University of Wellington, outlines the methods and tools that will be used for the second phase of implementation (2019-2022).

District Health Board Initiative

Emergency Department recognised for equity work
A staff-led equity group is making change on the ground in Wellington Regional Hospital’s Emergency Department (ED), resulting in a more culturally safe environment for Māori patients.

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.