Issue 237 - 22 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

Ngāti Kahungunu Whānau Services - working through COVID-19
In this series of videos, published by the Health Quality & Safety Commission, staff from Ngāti Kahungunu Whānau Services discuss the unique kaupapa Māori approach they took to supporting whānau during COVID-19.

Health Equity (New Zealand)

The experiences of refugee Muslim women in the Aotearoa New Zealand healthcare system
This study, published in Kōtuitui, explores the experiences of refugee Muslim women as they accessed and navigated the healthcare system in Aotearoa New Zealand (NZ).

Culturally competent, safe and equitable clinical care for Māori with bipolar disorder in New Zealand: The expert critique of Māori patients and Whānau
Research designed to increase knowledge about Māori with bipolar disorder is required to understand how health services support wellbeing and respond to identified levels of community need. This paper, published in the Australian and New Zealand Journal of Psychiatry, synthesises the expert critique of Māori patients with bipolar disorder and their whānau regarding the nuances of cultural competence and safety in clinical encounters with the health system.

Quality Improvement (New Zealand)

Bula Sautu – A window on quality 2021: Pacific health in the year of COVID-19
The latest in the Health Quality & Safety Commission’s ongoing Window on Quality series focuses on health for Pacific peoples, from maternity to end of life, using a life-course approach, and includes expert perspectives on how the health system is performing for Pacific peoples.

Quality Improvement (International)

Co-produced capability framework for successful patient and staff partnerships in healthcare quality improvement: results of a scoping review
Internationally, patient and public involvement (PPI) is core policy for health service quality improvement (QI). However, authentic QI partnerships are not commonplace. A lack of patient and staff capability to deliver successful partnerships may be a barrier to meaningful QI collaboration. The research questions for this scoping review, published in BMJ Quality & Safety, were: What is known regarding the capabilities required for healthcare staff and patients to effectively partner in QI at the service level?; and What is known regarding the best practice learning and development strategies required to build and support those capabilities.

Hospital Productivity (International)

Lean Healthcare Tools for Processes Evaluation: An Integrative Review
Several health services have used lean healthcare to seek continuous improvement of their processes. This review, published in the International Journal of Environmental Research and Public Health, investigated the evidence available in the literature about the most used lean tools in the health area.

Cardiovascular Disease and Diabetes (International)

Same goals, different challenges: A systematic review of perspectives of people with diabetes and healthcare professionals on Type 2 diabetes care
The aim of this review, published in Diabetic Medicine, was to identify the views of people with Type 2 diabetes (PWD) and healthcare professionals (HCP) about diabetes care.

Effects of continuity of care on health outcomes among patients with diabetes mellitus and/or hypertension: a systematic review
The rising prevalence of non-communicable diseases (NCDs) such as diabetes mellitus (DM) and hypertension (HT) has placed a tremendous burden on healthcare systems around the world, resulting in a call for more effective service delivery models. Better continuity of care (CoC) has been associated with improved health outcomes. This review, published in BMC Family Practice, examines the association between CoC and health outcomes in patients with DM and/or HT. 

Altered dietary salt intake for people with chronic kidney disease
Evidence indicates that reducing dietary salt may reduce the incidence of heart disease and delay decline in kidney function in people with chronic kidney disease (CKD). The objective of this Cochrane Review was to evaluate the benefits and harms of altering dietary salt for adults with CKD.

Self-management of diabetes and associated comorbidities in rural and remote communities: a scoping review
Chronic health conditions are more prevalent in rural and remote areas than in metropolitan areas; living in rural and remote areas may present particular barriers to the self-management of chronic conditions like diabetes and comorbidities. The aims of this review, published in the Australian Journal of Primary Health, were to: synthesise evidence examining the self-management of diabetes and comorbidities among adults living in rural and remote communities; and describe barriers and enablers underpinning self-management reported in studies that met the inclusion criteria. 

Interventions involving own treatment choice for people living with coexisting severe mental illness and type 1 or 2 diabetes: A scoping review
The objective of this scoping review, published in Diabetic Medicine, was to summarise, understand and provide an overview of the empirical literature on interventions involving own treatment choice for people with coexisting diabetes (type 1 and 2) and severe mental illness (SMI).

Primary Health Care (New Zealand)

Empty waiting rooms: the New Zealand general practice experience with telehealth during the COVID-19 pandemic
The primary care response to the coronavirus disease 2019 (COVID-19) pandemic in early 2020 required significant changes to the delivery of healthcare by general practices. This study, published in the New Zealand Medical Journal, explores the experiences of New Zealand general practice teams in their use of telehealth during the early stages of the COVID-19 pandemic in New Zealand. 

Young peoples’ perspectives about care in a youth-friendly general practice
Youth health outcomes are poor in New Zealand and have a life-long impact on individuals, whānau (family) and society. Little is known about how young people view their experiences of general practice care despite it being the most common place to access health care. This study, published in the Journal of Primary Health Care, sought to explore young peoples’ experiences of care in a selected, youth-friendly general practice.

Primary Health Care (International)

An Overview of Reviews on Interprofessional Collaboration in Primary Care: Effectiveness
Interprofessional collaboration (IPC) is increasingly used but diversely implemented in primary care. This study, published in the International Journal of Integrated Care, aimed to assess the effectiveness of IPC in primary care settings.

Primary Mental Health (International)

New Evidence in the Booming Field of Online Mindfulness: An Updated Meta-analysis of Randomized Controlled Trials
There is a need to regularly update the evidence base on the effectiveness of online mindfulness-based interventions (MBIs), especially considering how fast this field is growing and developing. This study, published in JMIR Mental Health, presents an updated meta-analysis of randomized controlled trials assessing the effects of online MBIs on mental health and the potential moderators of these effects.

Current state of scientific evidence on Internet-based interventions for the treatment of depression, anxiety, eating disorders and substance abuse: an overview of systematic reviews and meta-analyses
This article, published in the European Journal of Public Health, provides an overview of the evidence of effectiveness for Internet-based treatment for four common mental health disorders.

Increased Immunisation (International)

Developing an Evidence-Based Tool for Planning and Evaluating Vaccination Strategies Aimed at Improving Coverage in Elderly and At-Risk Adult Population
Vaccination coverages need to be constantly maintained and improved with the implementation of vaccination strategies. This paper, published in Frontiers in Public Health, describes the development of an evidence-based tool to guide their planning and evaluation.

Weight Management (New Zealand)

The Impact of Land-Based Physical Activity Interventions on Self-Reported Health and Well-Being of Indigenous Adults: A Systematic Review
For many Indigenous communities, decreased participation in traditional land-based activities has led to higher rates of chronic disease and a decrease in well-being. This systematic review, published in the International Journal of Environmental Research and Public Health, explores how traditional land-based activities impact self-reported health and well-being of Indigenous adults, using Indigenous and Western perspectives.

Weight Management (International)

Interventions for reducing sedentary behaviour in community‐dwelling older adults
Older adults are the most sedentary segment of society, often spending in excess of 8.5 hours a day sitting. Large amounts of time spent sedentary, defined as time spend sitting or in a reclining posture without spending energy, has been linked to an increased risk of chronic diseases, frailty, loss of function, disablement, social isolation, and premature death. The objective of this Cochrane Review was to evaluate the effectiveness of interventions aimed at reducing sedentary behaviour amongst older adults living independently in the community compared to control conditions involving either no intervention or interventions that do not target sedentary behaviour. 

Methods of connecting primary care patients with community-based physical activity opportunities: A realist scoping review
Deemed a global public health problem by the World Health Organization, physical inactivity is estimated to be responsible for one in six deaths in the United Kingdom (UK) and to cost the nation's economy £7.4 billion per year. A response to the problem receiving increasing attention is connecting primary care patients with community-based physical activity opportunities. This article, published in Health & Social Care in the Community, aimed to explore what is known about the effectiveness of different methods of connecting primary care patients with community-based physical activity opportunities in the United Kingdom by answering three research questions: 1) What methods of connection from primary care to community-based physical activity opportunities have been evaluated?; 2) What processes of physical activity promotion incorporating such methods of connection are (or are not) effective or acceptable, for whom, to what extent and under what circumstances; 3) How and why are (or are not) those processes effective or acceptable?

Tracking implementation within a community-led whole of system approach to address childhood overweight and obesity in south west Sydney, Australia
Obesity is a chronic disease that contributes to additional comorbidities including diabetes, kidney disease and several cancers. Change4Campbelltown implemented a ‘whole of system’ approach to address childhood overweight and obesity. This article, published in BMC Public Health, discusses methods to track implementation and stakeholder engagement in Change4Campbelltown.

Key Ministry of Health Publications

Well Child Tamariki Ora Review Report
Well Child Tamariki Ora (WCTO) is New Zealand’s key programme for supporting the health, development and wellbeing of tamariki from birth to five years. In 2019, the Ministry began a process to review the Well Child Tamariki Ora programme to ensure it was delivering the best possible outcomes it could for all tamariki and their whānau. The review was commissioned as part of the health and disability sector’s response to the Government’s 2019 Child and Youth Wellbeing Strategy and sought to analyse the programme’s sustainability and equity.

District Health Board Initiative

Wairarapa Pasifika vaccinations set a fun, colourful and welcoming tone for the community
Recognised Seasonal Employer (RSE) workers from Vanuatu currently employed by Te Muna Viticulture, and Solomon RSE workers from JR’s Orchards Ltd had their covid-19 vaccinations. "It was fantastic to see our Pasifika community coming in with their families and friends and joining together as a community to support one another to get vaccinated," said Eseta Manesa, the Pacific Health Navigator who engineered the clinic.

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.