Issue 233 - 27 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.

Health Equity (New Zealand)

Will access to COVID-19 vaccine in Aotearoa be equitable for priority populations?
This research, published in the New Zealand Medical Journal, examines the equity implications of the geographic distribution of COVID-19 vaccine delivery locations in Aotearoa New Zealand under five potential scenarios: stadium mega-clinics; Community Based Assessment Centres; GP clinics; community pharmacies; and schools.

Te Tiriti o Waitangi compliance in regulated health practitioner competency documents in Aotearoa
Within Aotearoa (New Zealand) there are systemic health inequities between Māori (the Indigenous people of Aotearoa) and other New Zealanders. These inequities are enabled in part by the failure of the health providers, policy and practitioners to fulfil treaty obligations to Māori as outlined in our foundational document, te Tiriti o Waitangi (te Tiriti). Regulated health professionals have the potential to play a central role in upholding te Tiriti and addressing inequities. Competency documents define health professionals’ scope of practice and inform curriculum in health faculties. This novel study, published in New Zealand Medical Journal, critically examines 18 regulated health practitioners’ competency documents, which were sourced from the websites of their respective professional bodies. 

Cancer Services (International)

Screening for Colorectal Cancer
The objective of this article, published in JAMA, was to update its 2016 recommendation for Screening in Colorectal Cancer. The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the benefits and harms of screening for colorectal cancer in adults 40 years or older. The review also examined whether these findings varied by age, sex, or race/ethnicity. In addition, as in 2016, the USPSTF commissioned a report from the Cancer Intervention and Surveillance Modeling Network Colorectal Cancer Working Group to provide information from comparative modeling on how estimated life-years gained, colorectal cancer cases averted, and colorectal cancer deaths averted vary by different starting and stopping ages for various screening strategies. 

Cardiovascular Disease and Diabetes (International)

Shared decision making and patient-centeredness for patients with poorly controlled type 2 diabetes mellitus in primary care—results of the cluster-randomised controlled DEBATE trial
This study, published in BMC Family Practice, investigates whether an educational intervention of GPs increases patient-centeredness and perceived shared decision making in the treatment of patients with poorly controlled type 2 diabetes mellitus.

Primary Health Care (New Zealand)

It’s about who they are and what they can do: Māori perspectives on frailty in later life
This study, published in the New Zealand Medical Journal, aimed to explore Māori (the indigenous people of Aotearoa New Zealand) understandings of frailty.

A critical analysis of te Tiriti o Waitangi application in primary health organisations in Aotearoa New Zealand: Findings from a nationwide survey
Primary health is at the forefront of efforts to address health inequities. Effective primary health care keeps people well and improves longevity and quality of life. The persistence of health inequities, particularly between Indigenous peoples and non-Indigenous peoples globally, suggests that there is a need to strengthen policy and practise. Unique to Aotearoa (New Zealand) is te Tiriti o Waitangi, a treaty negotiated in 1840 between the British Crown and hapū (Māori [Indigenous] subtribes). This treaty is foundational to public policy in Aotearoa and requires the Crown (New Zealand government) to uphold a set of responsibilities around protecting and promoting Māori health. This paper, published in Health & Social Care in the Community, examines to what extent Primary Health Organisations are upholding te Tiriti o Waitangi. 
 

Primary Health Care (International)

Health coaching provided by registered nurses described: a systematic review and narrative synthesis
The aim of this systematic review and narrative synthesis, published in BMC Nursing, was to identify how and why health coaching is delivered by Registered Nurses. 

Using community-led development to build health communication about rheumatic heart disease in Aboriginal children: a developmental evaluation
A high prevalence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) among Aboriginal children in northern Australia is coupled with low understanding among families. This has negative impacts on children's health, limits opportunities for prevention and suggests that better health communication is needed. This study, published in Australian and New Zealand Journal of Public Health, assessed a community-led development program to build communication about rheumatic heart disease.

Primary Mental Health (International)

Person-centred experiential therapy versus cognitive behavioural therapy delivered in the English Improving Access to Psychological Therapies service for the treatment of moderate or severe depression (PRaCTICED): a pragmatic, randomised, non-inferiority trial
The UK Government's implementation in 2008 of the Improving Access to Psychological Therapies (IAPT) initiative in England has hugely increased the availability of cognitive behavioural therapy (CBT) for the treatment of depression and anxiety in primary care. Counselling for depression—a form of person-centred experiential therapy (PCET)—has since been included as an IAPT-approved therapy, but there is no evidence of its efficacy from randomised controlled trials (RCTs), as required for recommendations by the National Institute for Health and Care Excellence. Therefore, this study, published in The Lancet Psychiatry, aimed to examine whether PCET is cost effective and non-inferior to CBT in the treatment of moderate and severe depression within the IAPT service.

A systematic scoping review of community‐based interventions for the prevention of mental ill‐health and the promotion of mental health in older adults in the UK
Mental health concerns in older adults are common, with increasing age-related risks to physical health, mobility and social isolation. Community-based approaches are a key focus of public health strategy in the UK, and may reduce the impact of these risks, protecting mental health and promoting wellbeing. This review of UK community-based interventions, published in Health & Social Care in the Community, aimed to understand the types of intervention studied and mental health/wellbeing impacts reported.

Contemporary treatment of anxiety in primary care: a systematic review and meta-analysis of outcomes in countries with universal healthcare
Anxiety disorders are highly prevalent mental health conditions and are managed predominantly in primary care. This systematic review and meta-analysis, published in BMC Family Practice, explored psychological and pharmacological treatments in countries with universal healthcare, and investigated the influence of treatment provider on the efficacy of psychological treatment. 

Internet‐based cognitive and behavioural therapies for post‐traumatic stress disorder (PTSD) in adults
Therapist‐delivered trauma‐focused psychological therapies are effective for post‐traumatic stress disorder (PTSD) and have become the accepted first‐line treatments. Despite the established evidence‐base for these therapies, they are not always widely available or accessible. Many barriers limit treatment uptake, such as the number of qualified therapists available to deliver the interventions; cost; and compliance issues, such as time off work, childcare, and transportation, associated with the need to attend weekly appointments. Delivering Internet‐based cognitive and behavioural therapy (I‐C/BT) is an effective and acceptable alternative to therapist‐delivered treatments for anxiety and depression. The objective of this Cochrane Review was to assess the effects of I‐C/BT for PTSD in adults. 

Increased Immunisation (International)

Easing Human Papillomavirus Vaccine Hesitancy: A Communication Experiment With U.S. Parents
The Announcement Approach using presumptive announcements increases human papillomavirus vaccine uptake. This study, published in the American Journal of Preventive Medicine, seeks to understand the impact of the final Announcement Approach steps—easing parents' vaccine concerns and then encouraging them to get human papillomavirus vaccine for their children—on parents' human papillomavirus vaccine hesitancy and confidence in the vaccine's benefits.

District Health Board Initiative

A welcome boost to Māori-led lung cancer screening programme
The GACD grant will fund the first trial of lung cancer screening in Aotearoa and will focus on Māori, whose mortality rates from the disease are up to four times higher than other ethnic groups.

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.