Ministry of Health Library

Health Improvement and Innovation Digest

Issue 226 - 18 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

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Health Equity (New Zealand)

Ethnic differences in the use and experience of child healthcare services in NZ: An empirical examination
This research, published by the New Zealand Work Research Institute, uses Growing Up in New Zealand (GUiNZ) data to provide insights regarding life-course differences in the use and experience of child healthcare services in NZ and focuses on decisions to immunise, seek dental care, and visit the doctor.

Hospital Productivity (International)

Using governance and patient flow strategies to improve healthcare service efficiency
The aim of this case study, published in the Australian Health Review, was to share lessons learned regarding strategies likely to increase healthcare service efficiency.

Cancer Services (New Zealand)

Hā Ora: secondary care barriers and enablers to early diagnosis of lung cancer for Māori communities
Lung Cancer is the leading cause of cancer deaths in Aotearoa New Zealand. Māori communities in particular have higher incidence and mortality rates from Lung Cancer. Diagnosis of lung cancer at an early stage can allow for curative treatment. This project, published in BMC Cancer, aimed to document the barriers to early diagnosis and treatment of lung cancer in secondary care for Māori communities.

Cardiovascular Disease and Diabetes (New Zealand)

Pasifika prediabetes youth empowerment programme: evaluating a co-designed community-based intervention from a participants’ perspective
This paper, published in Kōtuitui, provides insights from a community-centre intervention study that was co-designed by youth, health providers and researchers. The aims of the paper were to highlight the effectiveness of a co-designed community centred diabetes prevention intervention, and to determine whether a culturally tailored approach was successful.

Primary care improvement case study: Taumarunui Community Kokiri Trust: He Mate Huka Oranga – a project to keep well with diabetes
Taumarunui Community Kokiri Trust (TCKT) is a kaupapa Māori health and social services provider, which delivers holistic care following a whānau ora approach, underpinned by kaupapa Māori values. In this case study, published by HQSC, you can read about how TCKT's disease state management (DSM) nursing service identified that many of the community’s whānau who weren’t engaged with any health services also had type 2 diabetes.

Cardiovascular Disease and Diabetes (International)

Psychological interventions for treating foot ulcers, and preventing their recurrence, in people with diabetes
Diabetic foot ulceration (DFU) can be defined as a full‐thickness wound below the ankle and is a major complication of diabetes mellitus. Despite best practice, many wounds fail to heal, and when they do, the risk of recurrence of DFU remains high. Beliefs about personal control, or influence, on ulceration are associated with better engagement with self‐care in DFU. Psychological interventions aim to reduce levels of psychological distress and empower people to engage in self‐care, and there is some evidence to suggest that they can impact positively on the rate of wound healing. The objective of this Cochrane Review was to evaluate the effects of psychological interventions on healing and recurrence of DFU.

Intermittent fasting for the prevention of cardiovascular disease
Cardiovascular disease (CVD) is the leading cause of death worldwide. Lifestyle changes are at the forefront of preventing the disease. This includes advice such as increasing physical activity and having a healthy balanced diet to reduce risk factors. Intermittent fasting (IF) is a popular dietary plan involving restricting caloric intake to certain days in the week such as alternate day fasting and periodic fasting, and restricting intake to a number of hours in a given day, otherwise known as time‐restricted feeding. IF is being researched for its benefits and many randomised controlled trials have looked at its benefits in preventing CVD. The objective of this Cochrane Review was to determine the role of IF in preventing and reducing the risk of CVD in people with or without prior documented CVD.

Primary Health Care (New Zealand)

Primary care improvement case study: Tongan Health Society: Improving medicine access in primary care for Pacific peoples
This case study, published by HQSC and the Tongan Health Society, details an innovative approach to underpin best practice models for patients with diabetes who are on maximum oral hypoglycaemic medication to start insulin therapy when they are hesitant to do so.

Primary Health Care (International)

Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review
In Ireland, as in many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of chronic disease. Integrated care is an approach to healthcare systems delivery that aims to minimise fragmentation of patient services and improve care continuity. To this end, how best to integrate primary and secondary care is a challenge. This paper, published in the International Journal of Integrated Care, aims to undertake a scoping review of empirical work on the integration of primary and secondary care in relation to chronic disease management.

Primary Mental Health (International)

Antidepressant treatment for postnatal depression
Depression is one of the most common morbidities of the postnatal period. It has been associated with adverse outcomes for women, children, the wider family and society as a whole. Treatment is with psychosocial interventions or antidepressant medication, or both. The aim of this Cochrane Review was to evaluate the effectiveness of different antidepressants and to compare their effectiveness with placebo, treatment as usual or other forms of treatment.

Identification of Behavior Change Techniques From Successful Web-Based Interventions Targeting Alcohol Consumption, Binge Eating, and Gambling: Systematic Review
Web-based interventions are thought to overcome barriers to treatment, such as accessibility and geographical location, which can undermine the effectiveness of traditional face-to-face interventions. Owing to these features, researchers are increasingly testing the efficacy of web-based interventions as ways to reduce alcohol misuse, binge eating, and gambling. However, many web-based interventions have poorly defined mechanisms of action; therefore, it is often uncertain how they propose to bring about behavior change. This systematic review, published in the Journal of Medical Internet Research, aims to identify effective behavior change techniques (BCTs) present in web-based interventions aimed at reducing alcohol consumption, binge eating, or gambling.

Childhood Obesity (International)

Effect of interventions based on regular physical activity on weight management in adolescents: a systematic review and a meta-analysis
Physical inactivity is one of the major risk factors for non-communicable diseases. This systematic review and meta-analysis, published in Systematic Reviews, aimed to assess the effects of educational interventions on promoting regular physical activity in adolescent weight management programs.

A secondary analysis of the childhood obesity prevention Cochrane Review through a wider determinants of health lens: implications for research funders, researchers, policymakers and practitioners
Randomised controlled trials (RCTs) are often regarded as the gold standard of evidence, and subsequently go on to inform policymaking. Cochrane Reviews synthesise this type of evidence to create recommendations for practice, policy, and future research. This article, published in the International Journal of Behavioral Nutrition and Physical Activity, critically appraises the RCTs included in the childhood obesity prevention Cochrane Review to understand the focus of these interventions when examined through a wider determinants of health (WDoH) lens.

Oral Health (International)

Motivational interviewing for preventing early childhood caries: A systematic review and meta‐analysis
This systematic review with meta‐analysis, published in Community Dentistry and Oral Epidemiology, was performed to assess whether motivational interviewing (MI) is effective in the prevention of early childhood caries (ECC) and to examine potential sources of heterogeneity.

Disability Services (International)

Telemedicine Treatment and Care for Patients with Intellectual Disability
In recent years, telemedicine has been developing very dynamically. The development of new technologies allows their use in the treatment of dermatological, cardiological, endocrine and other diseases. However, there are few reports on the use of digital technologies in the mental health care of people with intellectual disabilities. Intellectual disability is a disease that affects a large number of people. Patients suffering from intellectual disability encounter barriers that make it difficult for them to fully use telemedicine, however, these barriers can be overcome with appropriate support and adaptation. This paper, published in the International Journal of Environmental Research and Public Health, provides a review of the literature on telemedicine solutions in the care of people with intellectual disabilities.

Key Ministry of Health Publications

Stroke Clot Retrieval: A National Service Improvement Programme Action Plan
Stroke is reported to be the second most common cause of death worldwide, causing 6.24 million deaths globally in 2015. Those who survive stroke are often left with major long-term disability. An acute ischemic stroke (AIS) is caused by a sudden blockage of a major brain artery, usually from a clot from the heart or neck moving into the brain. Stroke Clot Retrieval (SCR) is the removal of the clot from the artery by an endovascular technique. The SCR Action Plan aims to: improve access to SCR; reduce inequity of access to SCR; provide patient-centred, culturally appropriate care; improve health outcomes; and improve equity in outcomes. This will be achieved through the provision of a nationally consistent, sustainable, 24/7 SCR service supported by an appropriately skilled and resourced workforce, to improve the health outcomes of New Zealanders with AIS stroke.

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.