Issue 240 - 21 October 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)

Te Ao Māori Framework
The Health Quality & Safety Commission has developed a Te Ao Māori Framework in partnership with Māori health providers, Whānau Ora providers and participating district health boards across Aotearoa New Zealand.

He Tamariki Kokoti Tau: Families of Indigenous Infants Talk about Their Experiences of Preterm Birth and Neonatal Intensive Care
Māori (Indigenous peoples of Aotearoa New Zealand) bear an unequal burden of poor perinatal health outcomes, including preterm birth. An infant arriving preterm disrupts the birth imaginary of whānau (family collectives) and situates them in a foreign health environment that may not be culturally safe and nurturing. This qualitative longitudinal study of preterm birth published in the International Journal of Environmental Research and Public Health identified themes from families experiences and the meanings they attributed to them.

Quality Improvement (International)

Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation
Health services have traditionally been developed to focus on specific diseases or medical specialties. Involving consumers as partners in planning, delivering and evaluating health services may lead to services that are person‐centred and so better able to meet the needs of and provide care for individuals. The objective of this Cochrane Review was to assess the effects of consumers and health providers working in partnership, as an intervention to promote person‐centred health services.

A meta-review of methods of measuring and monitoring safety in primary care 
A major barrier to safety improvement in primary care is a lack of safety data. The aims of this systematic meta-review, published in the International Journal for Quality in Health Care, were to identify systematic reviews of studies that examine methods of measuring and monitoring safety in primary care; classify the methods of measuring and monitoring safety in the included systematic reviews using the five safety domains of Vincent et al.’s framework and use this information to make recommendations for improving the measurement and monitoring of safety in primary care.

Cancer Services (New Zealand)

Acceptability of human papillomavirus (HPV) self-sampling among never- and under-screened Indigenous and other minority women: a randomised three-arm community trial in Aotearoa New Zealand
Internationally, self-sampling for human papillomavirus (HPV) has been shown to increase participation in cervical-cancer screening. In Aotearoa New Zealand, there are long-standing ethnic inequalities in cervical-cancer screening, incidence, and mortality, particularly for indigenous Māori women, as well as Pacific and Asian women. This study, published in The Lancet Regional Health - Western Pacific, aimed to assess whether two specific invitation methods for self-sampling improved screening participation over usual care among the least medically served populations.

Cancer Services (International)

Interventions targeted at women to encourage the uptake of cervical screening
Worldwide, cervical cancer is the fourth commonest cancer affecting women. High‐risk human papillomavirus (HPV) infection is causative in 99.7% of cases. Other risk factors include smoking, multiple sexual partners, the presence of other sexually transmitted diseases and immunosuppression. Primary prevention strategies for cervical cancer focus on reducing HPV infection via vaccination and data suggest that this has the potential to prevent nearly 90% of cases in those vaccinated prior to HPV exposure. The objective of this Cochrane Review was to assess the effectiveness of interventions aimed at women, to increase the uptake, including informed uptake, of cervical screening.

Cardiovascular Disease and Diabetes (International)

Efficacy of eHealth Interventions for Adults with Diabetes: A Systematic Review and Meta-Analysis
The aim of this review, published in the International Journal of Environmental Research and Public Health, is to provide meta-analytical evidence on eHealth interventions’ efficacy in supporting the psychosocial and physical well-being of adults with type 1 or type 2 Diabetes Mellitus (DM), and to investigate differences in interventions primarily targeted at providing glycemic control vs. psychosocial support.

Primary Health Care (New Zealand)

Why does continuity of care with family doctors matter? Review and qualitative synthesis of patient and physician perspectives
The objective of this review, published in Canadian Family Physician, was to summarize and synthesize qualitative studies that report patient and physician perspectives on continuity of care in family practice. This review included studies that were conducted in Canada, the United States, the United Kingdom, the European Union, New Zealand, or Australia.

Primary Mental Health (New Zealand)

Can We Build ‘Somewhere That You Want to Go’? Conducting Collaborative Mental Health Service Design with New Zealand’s Young People
Globally, young people are at high risk of mental health problems, but have poor engagement with services. Several international models have emerged seeking to address this gap by providing youth-specific care designed in collaboration with young people. In this study, published in the International Journal of Environmental Research and Public Health, 94 young people in New Zealand participated in collaborative workshops exploring their vision of an ideal mental health service.

The wellbeing and health needs of a cohort of transgender young people accessing specialist medical gender-affirming healthcare in Auckland
Increasing numbers of young people are seeking gender-affirming healthcare in Aotearoa New Zealand, and although international studies report health and wellbeing benefits of early medical intervention, we have no published reports on the impact of health services in this country. This study, published in the New Zealand Medical Journal, details results of a survey of transgender young people accessing a specialist service providing medical gender-affirming.

Primary Mental Health (International)

Mapping key components of community-oriented strategies to facilitate alcohol-related early identification and brief intervention in general practice: a scoping review
Hazardous alcohol use is one of the leading risk factors for morbidity and mortality in the world. Early identification and brief interventions (EIBIs) delivered in primary care is an effective but underutilized strategy to address this issue. Community-oriented strategies (COS) are suggested to facilitate EIBI delivery. COS are public health activities directed to the general population raising awareness and encouraging behaviour change. Unfortunately, it remains unclear what these COS should comprise and what their added value might be in EIBI delivery. This review, published in Family Practice, was to map the available information on COS aiming to facilitate alcohol-related EIBI delivery in general practice.

Increased Immunisation (New Zealand)

Enablers and barriers to COVID-19 vaccine uptake: An international study of perceptions and intentions
The development of COVID-19 vaccines is occurring at unprecedented speeds, but require high coverage rates to be successful. This research, published in Vaccine, examines individuals’ psychological beliefs that may act as enablers and barriers to vaccination intentions.

Increased Immunisation (International)

Patient Portal Reminders for Pediatric Influenza Vaccinations: A Randomized Clinical Trial
This study, published in Pediatrics, evaluated the effectiveness of electronic health record patient portal reminders in increasing pediatric influenza vaccination rates.

Smoking Cessation (International)

Electronic cigarettes for smoking cessation
Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol formed by heating an e‐liquid. Some people who smoke use ECs to stop or reduce smoking, but some organizations, advocacy groups and policymakers have discouraged this, citing lack of evidence of efficacy and safety. People who smoke, healthcare providers and regulators want to know if ECs can help people quit and if they are safe to use for this purpose. The objective of this Cochrane Review was to examine the effectiveness, tolerability, and safety of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long‐term smoking abstinence.

Strategies to improve smoking cessation rates in primary care
Primary care is an important setting in which to treat tobacco addiction. However, the rates at which providers address smoking cessation and the success of that support vary. Strategies can be implemented to improve and increase the delivery of smoking cessation support (e.g. through provider training), and to increase the amount and breadth of support given to people who smoke (e.g. through additional counseling or tailored printed materials). The objective of this Cochrane Review was to assess the effectiveness of strategies intended to increase the success of smoking cessation interventions in primary care settings. To assess whether any effect that these interventions have on smoking cessation may be due to increased implementation by healthcare providers.

Weight Management (New Zealand)

Outcomes of a culturally informed weight-loss competition for New Zealand Indigenous and Pacific peoples: a quasi-experimental trial
Reducing obesity prevalence among marginalised subgroups with disproportionately high obesity rates is challenging. This study, published in BMC nutrition, trialled a culturally tailored, team-based weight-loss competition with New Zealand Māori (Indigenous) and Pacific Island people.

Weight Management (International)

Weight Loss Interventions for Adolescents With Intellectual Disabilities: An RCT
In this randomized trial, published in Pediatrics, the authors compared the effectiveness of 2 diets (enhanced stop light diet versus conventional meal plan diet) and 2 delivery strategies (face–to–face versus remote delivery) on weight loss across 6 months in adolescents with intellectual and developmental disabilities who were overweight or obese.

Key Ministry of Health Publications

The New Zealand Guidelines for Helping People to Stop Smoking Update
This guideline provides health care workers with advice they can use when dealing with people who smoke.

Kia Manawanui Aotearoa – Long-term pathway to mental wellbeing
This publication is the Government’s high-level plan for transformation over the long-term. It outlines the next steps for further implementation of the changes required to support the mental wellbeing of New Zealanders.

Media Guidelines for Reporting on Suicide
It is important that there are guidelines for media to follow when reporting on suicide, in order to minimise the chances of contagion, and increase the chances of contributing to suicide prevention efforts.

New Zealand Aotearoa Abortion Clinical Guideline
This guideline provides best practice clinical guidance for health professionals on abortion care in the Aotearoa New Zealand context.

Assisted Dying Section 88 Notice User Guide
This user guide provides information for health practitioners on funding for assisted dying services as defined under the Assisted Dying Section 88 Notice (the s88 notice).

Healthy Eating Guidelines for New Zealand Babies and Toddlers (0-2 years old)
This publication provides the Ministry’s evidence base for advice about babies and toddlers food and nutrition needs. The document is written for health practitioners and others who provide advice on nutrition for babies and toddlers.

Health Consultations & Events

HISO 10094:2021 Māori Descent and Iwi Affiliation Data Protocols
The protocols describe procedures for the standardised collection, recording and output of Māori descent and iwi affiliation data for the New Zealand health and disability system. This document is consistent with the Iwi Statistical Standard and Classification published by Stats NZ (statistical standard) and outlines a new set of minimum standards that apply across the health and disability system to all organisations that collect, record and use iwi affiliation data. Integration of the protocols into the health and disability system will assist in the ongoing process of improving the quality, accuracy and consistency of iwi affiliation data. This document is a draft. This consultation seeks any and all comments on the suitability and fit-for-purpose nature of the draft. The consultation closes 22 November 2021.

Proposed warning and advisory statements relating to the harm of long-term use and overuse of stimulant laxatives
This Medsafe consultation proposes warning and advisory statements for stimulant laxatives. Stimulant laxatives are either general sale or pharmacy-only medicines. This means these medicines can sometimes be purchased without advice from a healthcare professional. It also means there is no requirement for these medicines to have a data sheet or consumer medicine information leaflet. Consumers may therefore be unaware of the harm associated with long-term use or overuse of stimulant laxatives when purchasing these medicines. Medsafe is seeking comments on: whether the package labelling for stimulant laxatives should include warning and advisory statements relating to the harm of long-term use and overuse; the proposed wording of the statements; and whether there are any other statements relating to the harm of long-term use and overuse of stimulant laxatives that should be included on the package labelling. This consultation closes 8th November 2021.

Draft code of expectations – welcoming feedback
The Health Quality & Safety Commission is developing a code of expectations (the code) which will set how health and disability service providers and organisations will involve and work effectively in partnership with consumers and whanau and are seeking feedback.

District Health Board Initiative

Pain psychology trial yields promising results for patient treatment times
A New Zealand-first trial, looking at the psychology of pain, has shown promising results in helping reduce patient treatment times. The trial of a Health Psychologist working in a ‘non-mental health’ setting at the Bay of Plenty District Health Board (BOPDHB) has been described as a great success.

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.