Issue 236 - 8 July 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

Utilising te Tiriti o Waitangi to approach health intervention development and research: pharmacist-facilitated medicines review interventions for Māori older adults
This research, published in the Journal of Primary Health Care, aimed to use te Tiriti o Waitangi to structure the development of a culturally safe health intervention, using as an exemplar pharmacist-facilitated medicines review for Māori older adults.

Health Equity (New Zealand)

Ethnic Identity Buffers the Effect of Discrimination on Family, Life, and Health Satisfaction for Pacific Peoples in New Zealand
The effect of discrimination on health and wellbeing varies. Mixed findings show that greater ethnic identity can make one more susceptible to the harmful effects of discrimination, or that ethnic identity can protect one against discrimination. This study, published in Pacific Health Dialog, tests how ethnic identity moderates the relationship between ethnic discrimination and a range of wellbeing measures for Pacific peoples in Aotearoa New Zealand.

Examining the State of Health Research on Pacific Rainbow Communities in New Zealand – Literature Review
Pacific Rainbow/Queer Communities (PRCs) in New Zealand (NZ) have had scant attention paid to the specificities of their health and wellbeing needs in research. Recently, the Health Research Council of NZ funded its first Pacific-specific PRC project (The Manalagi Project) executed through the University of Auckland’s Centre for Pacific Studies. This paper, published in Pacific Health Dialog, reports a literature review conducted to ascertain the current state of health research on PRCs, Rainbow/Queer and Pacific communities’ health in NZ.

Quality Improvement (International)

Foam surfaces for preventing pressure ulcers
The aim of this Cochrane Review was to assess the effects of foam beds, mattresses or overlays compared with any support surface on the incidence of pressure ulcers in any population in any setting.

Alternative reactive support surfaces (non‐foam and non‐air‐filled) for preventing pressure ulcers
The aim of this Cochrane Review was to assess the effects of non‐foam and non‐air‐filled reactive beds, mattresses or overlays compared with any other support surface on the incidence of pressure ulcers in any population in any setting.

Reactive air surfaces for preventing pressure ulcers
The aim of this Cochrane Review was to assess the effects of reactive air beds, mattresses or overlays compared with any support surface on the incidence of pressure ulcers in any population in any setting.

Beds, overlays and mattresses for treating pressure ulcers
The aim of this Cochrane Review was to assess the effects of beds, overlays and mattresses on pressure ulcer healing in people with pressure ulcers of any stage, in any setting.

Alternating pressure (active) air surfaces for preventing pressure ulcers
The aim of this Cochrane Review was to assess the effects of alternating pressure (active) air surfaces (beds, mattresses or overlays) compared with any support surface on the incidence of pressure ulcers in any population in any setting.

Hospital Productivity (New Zealand)

Reducing the MRI outpatient waiting list through a capacity and demand time series improvement programme
The study, published in the New Zealand Medical Journal, examined a capacity and demand improvement initiative. This initiative commenced in January 2019 with the goal of reducing the growing outpatient waiting list for magnetic resonance imaging (MRI) at Counties Manukau District Health Board (CMDHB).

Cancer Services (International)

Psychological interventions for enhancing resilience in parents of children with cancer: a systematic review and meta-analysis
Caring for children with cancer is considerably stressful for parents and may negatively affect their physical and psychological well-being. Resilience plays a pivotal role in maintaining psychological well-being in the face of stress and adversity. The aim of this systematic review, published in Supportive Care in Cancer, was to evaluate the effectiveness of psychological interventions in promoting resilience among parents of children with cancer. 

Telephone follow-up of oncology patients: the contribution of the nurse specialist for a Service-Dominant Logic in hospital
This article published in BMC Health Services Research describes how the French healthcare system is characterised by a shift towards outpatient care and the desire to develop telemedicine affirmed in the collective commitment “Ma santé 2022” presented by President Macron in 2018. In France, remote patient follow up has recently been developed in the active phase of cancer treatment inspired by the patient navigation approach used in other countries. According to Service-Dominant Logic (S-D L), patients become more active. Their role in co-production of services is strengthened and their behaviours changed. Telephone follow-ups can contribute to modifying the relationship between the patient and the nurse navigators in charge of it, moving logically from a passive attitude from the patient to a more active one. 

Cardiovascular Disease and Diabetes (International)

Precision Health Care Elements, Definitions, and Strategies for Patients with Diabetes: A Literature Review
Diabetes is a prevalent disease with a high risk of complications. The number of people with diabetes worldwide was reported to increase every year. However, new integrated individualized health care related to diabetes is insufficiently developed. The objective of this study, published in the International Journal of Environmental Research and Public Health, was to conduct a literature review and discover precision health care elements, definitions, and strategies.

Primary Health Care (International)

Current developments in delivering customized care: a scoping review
In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study, published in BMC Health Services Research, undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care.

Primary Mental Health (New Zealand)

Is parent education protective of mental wellbeing in Pacific young people? A cohort study of mental health and census data in Aotearoa/New Zealand’s integrated data infrastructure
The aims of this paper, published in Pacific Health Dialog, are to quantify the impact of parental education on the five-year incidence of mental health conditions (MHC) in Pacific young people and to investigate the influence of other factors.

Primary Mental Health (International)

Pasifika preferences for mental health support in Australia: focus group study
Mental wellbeing is a growing health issue for Pacific Islands communities (Pasifika), particularly amongst people who have resettled in a different country. This article, published in Pacific Health Dialog, explored whether Pasifika people living in Australia think mental health services meet their needs.

Technology-Facilitated Depression Self-Management Linked with Lay Supporters and Primary Care Clinics: Randomized Controlled Trial in a Low-Income Sample
The purpose of this study, published in Telemedicine Journal and E-Health, is to test whether technology-facilitated self-management support improves depression in primary care settings.

Improving Access to Psychological Therapies (IAPT) has potential but is not sufficient: How can it better meet the range of primary care mental health needs?
The Improving Access to Psychological Therapies (IAPT) programme has been impactful in increasing access to psychological therapies at primary care level. However, it remains unclear whether IAPT's widely disseminated achievements include the reduction in service users' transition to secondary care services and whether IAPT services are providing interventions that match the level of complexity of presenting problems of those who are referred. This review, published in The British Journal of Clinical Psychology, sets out to clarify the clinical characteristics of IAPT cohorts, whether the interventions provided target these characteristics, and whether outcomes are related to the use of the stepped-care model advocated in the operationalization of IAPT services.

A community-led design for an Indigenous Model of Mental Health Care for Indigenous people with depressive disorders
The objective of this study, published in the Australian and New Zealand Journal of Public Health, was to generate outcomes for the development of a culturally appropriate mental health treatment model for Indigenous Australians with depression.

Increased Immunisation (International)

Health inequities related to vaccination: An evidence map of potentially influential factors and systematic review of interventions
The National Advisory Committee on Immunization (NACI) makes recommendations for vaccines in Canada. To inform considerations for equity when making recommendations, the NACI Secretariat developed a matrix of factors that may influence vaccine equity. To inform the matrix, this review, published in Vaccine, mapped the evidence for P2ROGRESS and other factors potentially associated with unequal levels of illness or death from vaccine-preventable diseases (VPDs) and systematically reviewed the evidence for interventions aimed at reducing inequities.

School-based HPV vaccination positively impacts parents’ attitudes toward adolescent vaccination
This qualitative study, published in Vaccine, aimed to explore parental attitudes, knowledge and decision-making about HPV vaccination for adolescents in the context of a gender-neutral school-based Australian National Immunisation Program.

Weight Management (International)

Effects of Maternal Exercise During Pregnancy on Perinatal Growth and Childhood Obesity Outcomes: A Meta-analysis and Meta-regression
Perinatal growth abnormalities program susceptibility to childhood obesity, which is further exaggerated by maternal overweight and obesity (MO) during pregnancy. Exercise is highly accessible, but reports about the benefits of maternal exercise on fetal growth and childhood obesity outcomes are inconsistent, reducing the incentives for pregnant women to participate in exercise to improve children's perinatal growth. This systematic review and meta-analysis, published in Sports Medicine, aims to establish evidence-based efficacy of exercise in mothers with normal weight (MNW) and MO during pregnancy in reducing the risks of perinatal growth abnormalities and childhood obesity. In addition, the impacts of exercise volume are also assessed.

Rethinking sustainability in childhood obesity prevention interventions: learning from South Australia's Obesity Prevention and Lifestyle (OPAL) Programme
Increases in childhood obesity have occurred across a relatively short time-period, yet childhood obesity prevention is a longer-term game. Programmes have only identified population-level changes after 12 years of on-the-ground activity. Community stakeholders can impact the success of public health interventions and they have been identified as a critical success factor for programme sustainability. This qualitative research with stakeholders, published in Health Promotion International, provides their insights and understandings of the sustainability of OPAL, a South Australian childhood obesity prevention programme.

The effectiveness of nurse-led interventions to prevent childhood and adolescent overweight and obesity: A systematic review of randomised trials
Obesity among children and adolescents continues to rise worldwide. Despite the efforts of the healthcare workforce, limited high-quality evidence has been put forward demonstrating effective childhood obesity interventions. The role of nurses as primary actors in childhood obesity prevention has also been underresearched given the size of the workforce and their growing involvement in chronic disease prevention. The aim of this systematic review, published in the Journal of Advanced Nursing, was to examine the effectiveness of nurse-led interventions to prevent childhood and adolescent overweight and obesity.

Key Ministry of Health Publications

Mortality web tool
The Mortality web tool presents mortality and demographic data for selected causes of deaths registered in New Zealand from 1948–2018. Information about all deaths by ICD Chapter, ICD Subgroup, ICD three-character codes and demographics is available from 2014–2018. The web tool enables you to explore trends over time using interactive graphs and tables. Filtered results, data dictionaries and full data sets can be downloaded from within the web tool.

Ngā Paerewa Health and Disability Services Standard

The updated Ngā Paerewa Health and Disability Services Standard has been approved for use by the Minister for Health.

The Standard outlines steps health and disability service providers must take to ensure they are providing safe, quality services. Over 650 different providers across the health and disability system must demonstrate compliance with the Standard, including DHBs, aged care, and hospices. It sets out what people can expect from the services they receive, and is one of the tools we use to continuously improve those services in Aotearoa.

The updated Standard comes into effect on 28 February 2022. Over the next few months, the Ministry of Health will work with health and disability service providers to bring them up to speed on the changes, and what it means for them.

The Ministry will be hosting a Zoom hui from 12pm-1pm 14 July 2021 to introduce the 2021 standard, discuss high-level changes, and give an overview of our implementation plan. Please contact certification@health.govt.nz to register your attendance and receive the Zoom link.

Ngā Paerewa has been developed by the sector, for the sector – it’s the result of significant review where more than 300 people and organisations shared their knowledge, experiences and expertise. More information can be found on the Ministry of Health website.

District Health Board Initiative

Southland’s ‘super team’ supports new nurse-led respiratory clinic
‘Southland’s Super Team’ -   a dedicated group of respiratory doctors and nurses, is supporting a new nurse-led clinic that is already making a difference for 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.