Issue 232 - 13 May 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.

You can forward this newsletter to others who may be interested in receiving it. They can register and subscribe here. You can also access other recent issues of the digest here.

If you have any queries, please email us at 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

Chronic conditions in the community: Preventative principles and emerging practices among Māori health services providers
The pressing chronic conditions prevention needs of Māori are yet to be adequately addressed using mainstream approaches. This study, published in the Health Promotion Journal of Australia, investigated how Māori health service providers (MHSP) are positioning themselves to better meet the chronic conditions prevention needs of Māori. 

Hospital Productivity (New Zealand)

New Zealand’s Integration- Based Policy for Driving Local Health System Improvement – Which Conditions Underpin More Successful Implementation?
The System Level Framework (SLMF) is a policy introduced by New Zealand’s Ministry of Health in 2016 with the aim of improving health outcomes by stimulating inter-organisational integration at the local level. This article, published in the International Journal of Integrated Care, sought to understand which conditions that vary at the local level are most important in shaping successful implementation of this novel and internationally significant policy initiative relevant to integrated care. 

Cancer Services (New Zealand)

Difficulties in navigating the intersection of generalist and specialist palliative care services: A cross-sectional study of bereaved family's experiences of care at home in New Zealand
A generalist–specialist model of palliative care is well established as a framework for the provision of community care in resource-rich countries. This study, published in Health & Social Care in the Community, explores how this model is experienced by family carers and the extent to which access to both generalist and specialist palliative care is equitable. 

Emergency Department Services (International)

Triage Nurse-Ordered Testing in the Emergency Department Setting: A Review of the Literature for the Clinician
In an effort to decrease length of stay (LOS) and reduce overcrowding, many emergency departments (ED) have implemented triage nurse-ordered testing. The objective of this study, published in the Journal of Emergency Medicine, was to review the medical literature to determine the utility of triage nurse-ordered testing and to offer evidence-based recommendations to emergency physicians. 

A Comparison Between Computer-Assisted Self-Triage by Patients and Triage Performed by Nurses in the Emergency Department 
Emergency departments (EDs) often find the number of arriving patients exceeding their capacity and find it difficult to triage them in a timely manner. The potential risk to the safety of patients awaiting assessment by a triage professional has led some hospitals to consider implementing patient self-triage, such as using kiosks. Published studies about patient self-triage are scarce and information about patients' ability to accurately assess the acuity of their condition or predict their need to be hospitalised is limited. This study, published in Cureus, aimed to compare computer-assisted patient self-triage scores versus the scores assigned by the dedicated ED triage nurse (TN). 

Cardiovascular Disease and Diabetes (International)

Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review
Hyperglycemia in pregnancy occurs worldwide and is closely associated with health issues in women and their offspring, such as pregnancy and birth complications, respectively, as well as comorbidities, such as metabolic and cardiovascular diseases. To optimize the management of diabetic pregnancies, sustainable strategies are urgently needed. Investigation of constantly evolving technologies for diabetes that help to manage pregnancy and health is required.  This systematic review, published in the Journal of Medical Internet Research, aimed to assess the clinical effectiveness of technologies for diabetes in pregnancy.

Adopting and implementing an innovative model to organize diabetes care within First Nations communities: A qualitative assessment
Diabetes care remains suboptimal in First Nations populations. Innovative and culturally relevant approaches are needed to promote systematic and proactive organization of diabetes care for people living with diabetes on-reserve in Canada. The RADAR model is one strategy to improve care: an integrated disease registry paired with an electronic health record for local community healthcare providers with remote care coordination. This study, published in BMC Health Services Research, qualitatively assessed adoption and implementation of RADAR in First Nations communities in Alberta to inform its potential spread in the province. 

Primary Health Care (International)

General Practitioners and Community Pharmacists’ Collaboration in Primary Care: Small Steps for a Major Change
Healthcare authorities worldwide search for ways to develop integrated care and interprofessional collaboration. In Belgium, Medical-Pharmaceutical Concertation (MPC) was introduced as a format to promote constructive dialogues between GPs and community pharmacists (CPs) with a focus on pharmacotherapy. The objective of this study, published in the International Journal of Integrated Care, was to evaluate the implementation of MPC from the perspective of healthcare authorities and GPs/CPs. 

Primary Mental Health (International)

mHealth Interventions for Self-Harm: Scoping Review
Self-harm is a growing issue with increasing prevalence rates; however, individuals who self-harm do not often receive treatment. Mobile health (mHealth) interventions are a possible solution to some of the barriers that individuals face when seeking support, and they have also been found to be effective in improving mental health. This scoping review, published in the Journal of Medical Internet Research, aims to identify mHealth interventions for self-harm within the literature, understand the types and features of interventions that have been developed and evaluated, highlight research findings around mHealth interventions for self-harm, and determine what outcomes are typically used to assess the efficacy of interventions. 

Approaches for discontinuation versus continuation of long‐term antidepressant use for depressive and anxiety disorders in adults
The objective of this Cochrane Review was to assess the effectiveness and safety of approaches for discontinuation versus continuation of long‐term antidepressant use for depressive and anxiety disorders in adults. 

Increased Immunisation (International)

Strategies to Address COVID-19 Vaccine Hesitancy and Mitigate Health Disparities in Minority Populations
Beyond the complex logistical task of prioritizing, distributing and safely storing millions of doses of COVID-19 vaccines, state and local governments must simultaneously devise and carry out transparent plans that centre equity and overcome the barriers to vaccination facing minority communities. This study, published in Frontiers in Public Health, uses insights gleaned from four focus groups conducted with health care and social service professionals serving minority communities in New York State as well as from existing research on vaccination. The results emphasize that vaccine hesitancy and access barriers – particularly within minority communities – pose significant hurdles to achieving widespread uptake of COVID-19 vaccines. 

Smoking Cessation (International)

Effectiveness of smoking cessation interventions for smokers with chronic diseases: A systematic review
The aim of this review, published in the Journal of Advanced Nursing, was to systematically summarise seminal studies on the design and effectiveness of smoking cessation interventions targeted at patients with chronic diseases through a critical appraisal of the literature.

Weight Management (New Zealand)

Effectiveness of programs aimed at obesity prevention among Indigenous children: A systematic review
Given the significant health burden of childhood obesity, it is imperative that effective programs be better understood. When evaluating obesity prevention efforts, one must recognize the contextual factors which drive the disproportionate risk of obesity between populations. This systematic review, published in Preventive Medicine Reports, sought to understand if programs aimed at obesity prevention and/or the promotion of healthy lifestyle behaviours for Indigenous children are effective

Weight Management (International)

Long-term Effectiveness of mHealth Physical Activity Interventions: Systematic Review and Meta-analysis of Randomized Controlled Trials
Mobile health (mHealth) interventions can increase physical activity (PA); however, their long-term impact is not well understood. The primary aim of this study, published in the Journal of Medical Internet Research, is to understand the immediate and long-term effects of mHealth interventions on PA.

A Health-Literacy Intervention for Early Childhood Obesity Prevention: A Cluster-Randomized Controlled Trial
Children who become overweight by age 2 have greater risk of long-term obesity and health problems. The aim of this study, published in Pediatrics, was to assess the effectiveness of a primary care–based intervention on the prevalence of overweight at age 24 months. 

Efficacy of Clinic-Based Telehealth vs. Face-to-Face Interventions for Obesity Treatment in Children and Adolescents in the United States and Canada: A Systematic Review
This systematic review, published in Childhood Obesity aims to examine the literature regarding the effectiveness of clinic-based telehealth vs. face-to-face modalities to reduce obesity among school-aged children. 

Key Ministry of Health Publications

More Than Just a Jab: Evaluation of the Māori Influenza Vaccination Programme as part of the COVID-19 Māori Health Response
In 2020, the Ministry of Health launched the Māori Influenza Vaccination Programme (MIVP) to increase access to the influenza vaccine for vulnerable Māori groups, particularly kaumatua, and to address persistent health equity gaps for Māori. The More Than Just a Jab MIVP evaluation was prepared for the Ministry of Health by Research Evaluation Consultancy Ltd to understand the impact of the MIVP on Māori influenza rates and equity. 

District Health Board Initiative

Health minister salutes new service for at-risk mothers
He Puna Ora is an initiative to help vulnerable mothers, babies and their whānau. A partnership between Whanganui District Health Board and local iwi health services, the programme was launched in March and aims to help 100 at-risk families each 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.