Issue 239 - 19 August 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

Is a cultural and theoretical programme for at risk Māori rangatahi (youth) useful in the context of resilience and wellbeing? 
This article, published in the Journal of Indigenous Wellbeing, discusses findings of a two-year study that explored the impact of a Māori cultural leadership programme delivered into schools for Māori rangatahi (youth) to assist them with their wellbeing and resilience.

Au.E! The Rangatahi Programme
As the Indigenous nation of Aotearoa New Zealand, Māori have suffered greatly with the number of rangatahi (Māori youth) lost to suicide. As Māori, we strive to lead strategies and solutions to address the issue of suicide in our communities and to realise Māori potential. Under Te Rau Ora: National Centre of Māori Suicide Prevention we now have evidence and examples of implementation and operational context, with promising practice of what achievements are being made for Māori suicide prevention and postvention. There remains the emphasis for explicit Māori suicide prevention and postvention programmes and approaches that are connected to Te Ao Māori (the Māori world/culture), that value te reo (Māori language), tikanga (Māori customs) and tino rangatiratanga (autonomy). Imperative to this approach is culturally relevant rangatahi suicide prevention initiatives that specifically focus on building resilience among rangatahi to reduce emotional distress and the impact of suicide.) Au.E! the rangatahi programme acknowledges the vast work we must continue to counteract suicide for our future generations. This article, published in the Journal of Indigenous Wellbeing, will provide an insight into Au.E! a rangatahi led and focused programme.

Tiaki Whānau Tiaki Ora: 1000 Māori Homes: The whānau initiative to build wellbeing and resilience to prevent suicide
This article, published in the Journal of Indigenous Wellbeing, provides an overview of the first year of the Tiaki Whānau – Tiaki Ora: 1000 Māori Homes programme (Tiaki Whānau – Tiaki Ora) delivered by Te Rau Ora Centre of Māori Suicide Prevention. Tiaki Whānau – Tiaki Ora provides a unique approach to support whānau to support each other, to raise their knowledge and awareness about suicide prevention and to develop protective factors that foster wellbeing and resilience, with specific self-help tools, and activities.

He Tūhononga Whaiaro: A Kaupapa Māori Approach to Mate Wareware (Dementia) and Cognitive Assessment of Older Māori
The aim of this study, published in the Journal of Applied Gerontology, is to investigate Māori understandings of dementia (mate wareware) and develop a framework to inform assessment of cognitive impairment.

Health Equity (New Zealand)

Home modifications to prevent home fall injuries in houses with Māori occupants (MHIPI): a randomised controlled trial
As with many Indigenous populations internationally, Māori in New Zealand suffer health inequity. This study, published in The Lancet Public Health, aimed to assess the rate of fall injuries at home with and without home modifications in houses with Māori occupants.

Whenua ki te whenua – an advance care planning guide for whanau 
This publication is an advance care planning guide designed by the Health Quality & Safety Commission using kaupapa Māori processes.

Health Equity (International)

Co-Designing Health Service Evaluation Tools That Foreground First Nation Worldviews for Better Mental Health and Wellbeing Outcomes
It is critical that health service evaluation frameworks include Aboriginal people and their cultural worldviews from design to implementation. During a large participatory action research study, Elders, service leaders and Aboriginal and non-Aboriginal researchers co-designed evaluation tools to test the efficacy of a previously co-designed engagement framework. Through a series of co-design workshops, tools were built using innovative collaborative processes that foregrounded Aboriginal worldviews. The workshops resulted in the development of a three-way survey that records the service experiences related to cultural safety from the perspective of Aboriginal clients, their carer/s, and the service staff with whom they work. The surveys centralise the role of relationships in client-service interactions, which strongly reflect their design from an Aboriginal worldview. This paper, published in the International Journal of Environmental Research and Public Health, provides new insights into the reciprocal benefits of engaging community Elders and service leaders to work together to develop new and more meaningful ways of servicing Aboriginal families.

Hospital Productivity (International)

Use of a Novel Patient-Flow Model to Optimize Hospital Bed Capacity for Medical Patients
There is no known method for determining the minimum number of beds in hospital inpatient units (IPs) to achieve patient waiting-time targets. This study, published in The Joint Commission Journal on Quality and Patient Safety, aims to determine the relationship between patient waiting time–related performance measures and bed utilization, so as to optimize IP capacity decisions.

Cancer Services (New Zealand)

He Tapu Te Whare Tangata (sacred house of humanity): Under-screened Māori women talk about HPV self-testing cervical screening clinical pathways
The objective of this paper, published in the International Journal of Gynaecology and Obstetrics, was to develop an in-depth understanding of HPV self-testing cervical screening clinical pathways for never-/under-screened Māori women.

Emergency Department Services (International)

What is the impact of team triage as an intervention on waiting times in an adult emergency department? – A systematic review
The aim of this review, published in the International Emergency Nursing, was to examine the impact of team triage on waiting times in adult emergency departments.

Cardiovascular Disease and Diabetes (International)

The Effects of Dietary Education Interventions on Individuals with Type 2 Diabetes: A Systematic Review and Meta-Analysis
As the incidence and prevalence of diabetes increases, intervention through dietary education is becoming more important for diabetes control. This systematic review, published in the International Journal of Environmental Research and Public Health, examines the evidence for the efficacy of dietary education interventions on diabetes control.

Primary Health Care (International)

Optimizing the diagnosis and management of dementia within primary care: a systematic review of systematic reviews
This systematic review, published in BMC Family Practice, examined the evidence related to diagnosing and managing dementia within primary care.

The Building Blocks of Implementation Frameworks and Models in Primary Care: A Narrative Review
The aim of this review, published in Frontiers in Public Health, was to identify the core building blocks of existing implementation frameworks and models, which can be used as a basis to further develop a framework for the implementation of complex interventions within primary care practices.

Primary Mental Health (New Zealand)

Critical elements for successful implementation of community based suicide prevention initiatives for Pacific Island people in Aotearoa New Zealand
This exploratory study, published in the Journal of Indigenous Wellbeing, set out to identify the critical elements to successfully implement community-based suicide prevention initiatives, within Pacific Island communities in Aotearoa New Zealand.

Strengthening community based suicide prevention initiatives for Pacific Islands people in Aotearoa New Zealand
This paper, published in the Journal of Indigenous Wellbeing, describes 17 community-based suicide prevention initiatives for Pacific Islands people living in Aotearoa New Zealand, and a brief summary of their extensive reach and results.

Increased Immunisation (New Zealand)

COVID-19 Vaccine Hesitancy and Acceptance in a Cohort of Diverse New Zealanders
New Zealand's Immunisation Programme is an important pillar in the war against COVID-19, making high vaccine uptake essential. This study, published in The Lancet Regional Health – Western Pacific sought to identify potential vaccine uptake rates among New Zealanders prior to programme rollout; understand reasons for unlikelihood/likelihood of vaccine uptake; and, explore sociodemographic differences in risk of and reasons for vaccine hesitancy.

Weight Management (New Zealand)

Five-year follow-up of a family-based multidisciplinary program for children with obesity
This study, published in Obesity, aimed to determine 5-year outcomes from a 12-month, family-based, multidisciplinary lifestyle intervention program for children.

Weight Management (International)

Twelve-Month Outcomes of the First 1000 Days Program on Infant Weight Status
The objective of this study, published in Pediatrics, was to examine the effects of the First 1000 Days intervention on the prevalence of infant overweight and maternal postpartum weight retention and care.

Oral Health (International)

Inequalities in utilization and provision of dental services: a scoping review
There are many determinants that can affect inequality in oral and dental health. This study, published in Systematic Reviews, aimed to explore the main determinants of inequality in both utilization and provision of dental services in Organization for Economic Co-operation and Development (OECD) countries. 

Key Ministry of Health Publications

Smokefree Environments and Regulated Product Act 1990 Proposals for regulations: Summary of submissions 2021
This report summarises the submissions the Ministry received as part of the public consultation process on the proposals for the Smokefree Environments and Regulated Products Regulations 2021.

Ministry of Health Consultations & Events

Breast Reconstruction – National Guidelines for Best Practice
The Ministry of Health has been working with a Breast Reconstruction Expert Advisory Group (EAG) to develop a set of national best practice guidelines for breast reconstruction. The final draft guidelines have now been approved by the EAG and we are seeking wider consultation with the sector prior to publication. The closing date for submissions is the 10th September 2021.

Feedback Survey Ngā Paerewa Health and Disability Services Standard Implementation Progress
The Ngā paerewa Health and disability services standard (NZS 8134:2021) (the 2021 standard) is now updated to better reflect the current models of care and support. The 2021 standard reflects the shift towards more person- and whānau-centred health and disability services, where people are empowered to make decisions about their own care and support in order to achieve their goals, with a stronger focus on outcomes for people receiving support. The updated standard comes into effect on 28 February 2022. HealthCERT is leading work to support the sector's implementation of the 2021 Standard, including providing resources, guidance, and running workshops for service providers, health professionals, and the people and whānau who use these services. The survey closes 27 August 2021.

Analysing access to interRAI (NASC) assessment
This consultation seeks information from Needs Assessment Service Coordination (NASC) settings regarding referrals for interRAI/NASC assessment for older people (>65). This will assist the Ministry of Health in responding to the interRAI Service Design recommendations.  This consultation will assist in quantifying current equity of access and assist in establishing metrics to track progress with the broader work of the interRAI Service Design. The survey consists of 9 questions relating to FTE and other aspects of referrals to NASC and closes on the 27th August 2021.
 

District Health Board Initiative

New housing project aims to keep kids out of hospital
Public Health South, Aukaha and Habitat for Humanity Dunedin have recently launched a new joint initiative to reduce the number of children being admitted to hospital with housing-related respiratory illnesses, by supporting families to make their homes warmer and drier.

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.