Issue 227 - 4 March 2021

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 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

Mahi aroha: Māori work in times of trouble and disaster as an expression of a love for the people
In 2010 and 2011 the Canterbury earthquakes prompted expressions of mahi aroha – work done by Māori out of a love for the people – in the emergency context of a natural disaster. Similarly, the Covid-19 level 4 lockdown that began in the last week of March 2020 showcased Māori caring for one another in the context of a pandemic. Whether people were paid or unpaid, out in their communities as essential workers or broadcasting via the internet from their living rooms and kitchens, Māori around the country engaged in mahi aroha. While celebrating the capacity of Māori to move swiftly and effectively to care for others, the past two decades have seen an overall decline in the time Māori have been able to devote to mahi aroha, particularly voluntary work. It is proposed here the decline in Māori home ownership and access to secure, affordable housing is a key challenge to Māori capacity for mahi aroha. This article, published in Kōtuitui, therefore considers Māori responsiveness during times of crisis and how access to housing might help ensure that this capacity continues into the future.

Health Equity (New Zealand)

Fit for What Purpose? Exploring Bicultural Frameworks for the Architectural Design of Acute Mental Health Facilities
Acute mental health care facilities have become the modern equivalent to the old asylum, designed to provide emergency and temporary care for the acutely mentally unwell. These facilities require a model of mental health care, whether very basic or highly advanced, and an appropriately designed building facility within which to operate. Drawing on interview data from our four-year research project to examine the architectural design and social milieu of adult acute mental health wards in Aotearoa New Zealand, official documents, philosophies and models of mental health care, this paper, published in the International Journal of Environmental Research and Public Health, asks what is the purpose of the adult inpatient mental health ward in a bicultural country and how can we determine the degree to which they are fit for purpose.

Kainga (families) experiences of a Tongan-Indigenous faith-based violence-prevention programme
Christianity is an embedded value system within Pacific cultures that is now being employed to inform efforts to address social issues such as family violence. This article, published in AlterNative, chronicles a Tongan woman’s cultural immersion with 49 Tongan church kainga (families) who participated in the Tongan faith-based Kainga Tu’umalie (Prosperous families) family violence programme.

Quality Improvement (New Zealand)

The 777 Planner: improving the resuscitation call experience at North Shore Hospital
This baseline quality improvement project, published in the New Zealand Medical Journal, was conducted at North Shore Hospital in Auckland, New Zealand. It included a 777 Planner meeting and template for members of the resuscitation team who were designated to respond to 777 resuscitation calls in the hospital after hours. The aim of this project was to ensure that staff at North Shore Hospital are competent and confident in the roles that they are performing during a 777 call, and to improve leadership and teamwork within the resuscitation team.

Cancer Services (New Zealand)

Multidisciplinary pigmented lesion clinic at Auckland District Health Board: impacts on melanoma diagnosis and treatment outcomes
The aim of this study, published in the New Zealand Medical Journal, was to investigate the outcomes and effect of a multidisciplinary ‘see and treat’ pigmented lesion clinic, run jointly by dermatology and general surgery, on the diagnosis and treatment of melanoma at Auckland District Health Board (DHB).

Emergency Department Services (New Zealand)

Have emergency department time-based targets influenced patient care? A systematic review of qualitative literature
Time-based targets for ED length of stay were introduced in England in 2000, followed by the rest of the UK, Canada, Ireland, New Zealand, and Australia after ED crowding was associated with poor quality of care and increased mortality. This systematic review, published in Emergency Medicine Australasia, evaluates qualitative literature to see if ED time-based targets have influenced patient care quality. 

Cardiovascular Disease and Diabetes (New Zealand)

Pasifika Prediabetes Youth Empowerment Programme: learnings from a youth-led community-based intervention study
This study, published in the New Zealand Medical Journal, describes exploratory findings of a community-based intervention to mobilise Pasifika communities into action, with the intent of reducing the risk factors of prediabetes.

Cardiovascular Disease and Diabetes (International)

Effects of self‐management programs on blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension: Meta‐analysis of randomized controlled trials
The aim of this meta-analysis, published in the International Journal of Nursing Practice, was to assess the effects of self‐management interventions on systolic blood pressure, diastolic blood pressure, self‐efficacy, medication adherence and body mass index in older adults with hypertension.

Vegan dietary pattern for the primary and secondary prevention of cardiovascular diseases
Diet plays a major role in the aetiology of cardiovascular disease (CVD) and as a modifiable risk factor is the focus of many prevention strategies. Recently vegan diets have gained popularity and there is a need to synthesise existing clinical trial evidence for their potential in CVD prevention. The objective of this Cochrane Review was to determine the effectiveness of following a vegan dietary pattern for the primary and secondary prevention of CVD.

Walking for hypertension
Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low‐cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings. The objective of this Cochrane Review was to determine the effect of walking as a physical activity intervention on blood pressure and heart rate.

Primary Health Care (New Zealand)

New Zealand COPD Guidelines: Quick Reference Guide
The purpose of the Asthma and Respiratory Foundation of New Zealand’s COPD Guidelines: Quick Reference Guide, published in the New Zealand Medical Journal, is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment, and management of chronic obstructive pulmonary disease (COPD) in clinical practice.

Primary Health Care (International)

Systematic review of pragmatic randomised control trials assessing the effectiveness of professional pharmacy services in community pharmacies
Implementation of Professional Pharmacy Services (PPSs) requires a demonstration of the service’s impact (efficacy) and its effectiveness. Several systematic reviews and randomised controlled trials (RCT) have shown the efficacy of PPSs in patient’s outcomes in community pharmacy. There is, however, a need to determine the level of evidence on the effectiveness of PPSs in daily practice by means of pragmatic trials. The aim of this systematic review, published in BMC Health Services Research, was to identify and analyse pragmatic RCTs that measure the effectiveness of PPSs in clinical, economic and humanistic outcomes in the community pharmacy setting.

Primary Mental Health (International)

Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review
The authors of this systematic review, published in the American Journal of Psychiatry, sought to identify scalable evidence-based suicide prevention strategies.

Increased Immunisation (International)

Pre‐ and post‐intervention study examining immunisation rates, documentation, catch‐up delivery and the impact of a dedicated immunisation service at a tertiary paediatric hospital
The aim of this study, published in the Journal of Paediatrics and Child Health, was to explore immunisation rates and catch‐up delivery to children admitted to hospital before and after an immunisation service was commenced.

Smoking Cessation (International)

Supporting smoking cessation and preventing relapse following a stay in a smokefree setting: A meta-analysis and investigation of effective behaviour change techniques
Admission to a smokefree setting presents a unique opportunity to encourage smokers to quit. However, risk of relapse post-discharge is high, and little is known about effective strategies to support smoking cessation following discharge. This meta-analysis, published in Addiction, aimed to identify interventions that maintain abstinence following a smokefree stay and determine their effectiveness, as well as the likely effectiveness of Behaviour Change Techniques (BCTs) used in these interventions.

Interventions for tobacco cessation delivered by dental professionals
Dental professionals are well placed to help their patients stop using tobacco products. Large proportions of the population visit the dentist regularly. In addition, the adverse effects of tobacco use on oral health provide a context that dental professionals can use to motivate a quit attempt. The objective of this Cochrane Review was to assess the effectiveness, adverse events and oral health effects of tobacco cessation interventions offered by dental professionals.

Weight Management (New Zealand)

Modifiable Early Childhood Risk Factors for Obesity at Age Four Years
Childhood obesity is associated with an increased risk of adult obesity and related chronic disease. The aim of this study, published in Childhood Obesity, was to identify modifiable exposures that are independently associated with obesity in the preschool age group.

Weight Management (International)

Impact of Lifestyle Intervention Programs for Children and Adolescents with Overweight or Obesity on Body Weight and Selected Cardiometabolic Factors—A Systematic Review
Excessive body mass is a health problem among children and adolescents that contributes to the occurrence of lipid disorders and abnormal blood pressure. Effective treatment of excessive body mass in children is essential for the health of population in the future. The aim of the study, published in the International Journal of Environmental Research and Public Health, was to identify universal components of lifestyle interventions in children and adolescents with overweight or obesity leading to weight loss and improvement of selected cardiometabolic parameters.

Maternal stress in the first 1000 days and risk of childhood obesity: a systematic review
Maternal stress is associated with adverse child outcomes. Conception to 2-years postpartum (the first 1000 days) is a developmentally sensitive period for stress exposure. The role of maternal stress in the first 1000 days on child obesity risk is unclear. This review, published in the Journal of Reproductive and Infant Psychology, systematically examines the relationship between maternal stress across the first 1000 days and child obesity risk.

Harnessing technological solutions for childhood obesity prevention and treatment: a systematic review and meta-analysis of current applications
Technology holds promise for delivery of accessible, individualized, and destigmatized obesity prevention and treatment to youth. This review, published in International Journal of Obesity, examined the efficacy of recent technology-based interventions on weight outcomes.

Effects of eHealth-Based Multiple Health Behavior Change Interventions on Physical Activity, Healthy Diet, and Weight in People With Noncommunicable Diseases: Systematic Review and Meta-analysis
Noncommunicable diseases (NCDs) are associated with the burden of premature deaths and huge medical costs globally. There is an increasing number of studies combining a multiple health behavior change (MHBC) intervention paradigm with eHealth approaches to jointly promote weight-related health behaviors among people with NCD; yet, a comprehensive summary of these studies is lacking. This review, published in the Journal of Medical Internet Research, aims to meta-analyze the effectiveness and systematically summarize the characteristics of the relevant intervention studies for improving the outcomes of physical activity, healthy diet, and weight among people with NCD.

Key Ministry of Health Publications

Health Workforce Advisory Board 2020 Annual Report to the Minister of Health
This is the first Annual Report to the Minister of Health by the Health Workforce Advisory Board, which was established in 2019 under section 11 of the New Zealand Public Health and Disability Act 2000. The Board works with the Ministry of Health, in particular alongside the Health Workforce Directorate, to provide strategic oversight and sector leadership for New Zealand’s health workforce.

District Health Board Initiative

Changing the lives of Pacific youth
Waitematā DHB’s community alcohol and drug service (CADS) is leading the way with a specialised programme for pacific youth who experience alcohol and/or drug issues.

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.