Issue 242 - 18 November 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.

Quality Improvement (International)

Dissemination interventions to improve healthcare workers’ adherence with infection prevention and control guidelines: a systematic review and meta-analysis
The COVID-19 pandemic has challenged health systems worldwide since 2020. At the frontline of the pandemic, healthcare workers are at high risk of exposure. Compliance with infection prevention and control (IPC) should be encouraged at the frontline. This systematic review, published in Implementation Science, aimed to assess the effects of dissemination interventions to improve healthcare workers’ adherence with IPC guidelines for respiratory infectious diseases in the workplace.

Hospital Productivity (International)

The role of patient navigators in ambulatory care: overview of systematic reviews
Patient navigators have been introduced across various countries to enable timely access to healthcare services and to ensure completion of diagnosis and follow-up of care. There is an increasing evidence on the role of patient navigation for patients and healthcare systems. The aim of this study, published in BMC Health Services Research, was to analyse the evidence on patient navigation interventions in ambulatory care and to evaluate their effects on individuals and health system outcomes.

Cancer Services (International)

Family communication and coping among racial-ethnic minority cancer patients: A systematic review
The ability to actively cope with cancer has been extensively associated with better patient-reported outcomes (PROs). This systematic review, published in Health & Social Care in the Community, aims to synthesise the available literature assessing the experience of cancer patients from racial-ethnic minoritised groups.

Emergency Department Services (New Zealand)

Examining emergency department inequities in Aotearoa New Zealand: Findings from a national retrospective observational study examining Indigenous emergency care outcomes
There is increasing evidence that EDs may not operate equitably for all patients, with Indigenous and minoritised ethnicity patients experiencing longer wait times for assessment, differential pain management and less evaluation and treatment of acute conditions. This retrospective observational study, published in Emergency Medicine Australasia, used a Kaupapa Māori framework to investigate ED admissions into 18/20 District Health Boards in Aotearoa New Zealand (2006-2012).

Cardiovascular Disease and Diabetes (New Zealand)

Cardiovascular disease and its management among Pacific people: a systematic review by ethnicity and place of birth
Pacific people experience a disproportionate burden of cardiovascular disease (CVD), whether they remain in their country of origin or migrate to higher-income countries, such as Australia, Aotearoa New Zealand or the United States of America. This review, published in BMC Cardiovascular Disorders, sought to determine whether the CVD health needs of Pacific people vary according to their ethnicity or place of birth.

Cardiovascular Disease and Diabetes (International)

Systematic Review of Self-Measured Blood Pressure Monitoring With Support: Intervention Effectiveness and Cost
Self-measured blood pressure monitoring with support is an evidence-based intervention that helps patients control their blood pressure. This systematic economic review, published in the American Journal of Preventive Medicine, describes how certain intervention aspects contribute to effectiveness, intervention cost, and intervention cost per unit of the effectiveness of self-measured blood pressure monitoring with support.

An Enhanced SMS Text Message–Based Support and Reminder Program for Young Adults With Type 2 Diabetes (TEXT2U): Randomized Controlled Trial
Clinic attendance, metabolic control, engagement in self-management, and psychological health are suboptimal in young-onset type 2 diabetes. This study, published in Journal of Medical Internet Research, examined the effectiveness of an enhanced SMS text message–based support and reminder program in improving clinic attendance, metabolic control, engagement in self-management, and psychological health in young-onset type 2 diabetes.

Primary Health Care (New Zealand)

A national survey of pharmacists and interns in Aotearoa New Zealand: provision and views of extended services in community pharmacies
Changes in pharmacy models of care, services and funding have been occurring internationally, moving away from the traditional dispensing role to more extended patient-facing roles utilising pharmacists’ clinical skills. This study, published in BMC Health Services Research, aimed to identify the extended services offered by community pharmacy in Aotearoa New Zealand and the barriers and facilitators to extended services provision. The study is unique in that it includes intern (pre-registration) pharmacists.

Primary Health Care (International)

Decision coaching for people making healthcare decisions
Decision coaching is non‐directive support delivered by a healthcare provider to help patients prepare to actively participate in making a health decision. ‘Healthcare providers’ are considered to be all people who are engaged in actions whose primary intent is to protect and improve health (e.g. nurses, doctors, pharmacists, social workers, health support workers such as peer health workers). Little is known about the effectiveness of decision coaching. The objective of this Cochrane Review was to determine the effects of decision coaching for people facing healthcare decisions for themselves or a family member compared to usual care or evidence‐based intervention only, on outcomes related to preparation for decision making, decisional needs and potential adverse effects.

Improving primary health care quality for refugees and asylum seekers: A systematic review of interventional approaches
It has been widely acknowledged that refugees are at risk of poorer health outcomes, spanning mental health and general well-being. A common point of access to health care for the migrant population is via the primary health care network in the country of resettlement. This review, published in Health Expectations, aims to synthesise the evidence of primary health care interventions to improve the quality of health care provided to refugees and asylum seekers. 

Interventions for improving outcomes in patients with multimorbidity in primary care and community setting: a systematic review
Multimorbidity, defined as the co-existence of two or more chronic conditions, presents significant challenges to patients, healthcare providers and health systems. Despite this, there is ongoing uncertainty about the most effective ways to manage patients with multimorbidity. This review, published in Systematic Reviews, updated and narrowed the focus of a previous Cochrane review and aimed to determine the effectiveness of interventions designed to improve outcomes in people with multimorbidity in primary care and community settings, compared to usual care.

Primary Mental Health (New Zealand)

Mindfulness‐based interventions for substance use disorders
Substance use disorders (SUDs) are highly prevalent and associated with a substantial public health burden. Although evidence‐based interventions exist for treating SUDs, many individuals remain symptomatic despite treatment, and relapse is common. Mindfulness‐based interventions (MBIs) have been examined for the treatment of SUDs, but available evidence is mixed. The objective of this Cochrane Review was to determine the effects of MBIs for SUDs in terms of substance use outcomes, craving and adverse events compared to standard care, further psychotherapeutic, psychosocial or pharmacological interventions, or instructions, waiting list and no treatment.

Increased Immunisation (International)

Persuasive messaging to increase COVID-19 vaccine uptake intentions
Widespread vaccination remains the best option for controlling the spread of COVID-19 and ending the pandemic. Despite the considerable disruption the virus has caused to people’s lives, many people are still hesitant to receive a vaccine. Without high rates of uptake, however, the pandemic is likely to be prolonged. The authors of this study, published in Vaccine, explore two survey experiments to study how persuasive messaging affects COVID-19 vaccine uptake intentions.

Weight Management (New Zealand)

Combining Cognitive Mapping and indigenous knowledge to improve food environments in regional New Zealand
Hawke's Bay has one of the highest rates of childhood obesity in New Zealand. While several initiatives exist aiming to decrease obesity through physical activity, there are few nutritional interventions. This study, published in Health Promotion Journal of Australia, adopted a systems science and mātauranga Māori approach to identify and target underlying drivers of rising childhood obesity and engage the community to improve the food environment.

Weight Management (International)

Identifying effective intervention strategies to reduce children's screen time: a systematic review and meta-analysis
Excessive screen time is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviours, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviours. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis, published in The International Journal of Behavioral Nutrition and Physical Activity, was to identify the behaviour change techniques and study characteristics associated with effectiveness in behavioural interventions to reduce children's (0-18 years) screen time.

Effectiveness of interventions to optimise dietary intakes in the first 1000 d of life in Indigenous children: a systematic review
Indigenous infants are disproportionately more likely to have negative outcomes compared to non-Indigenous infants with suboptimal nutrition in the first 1000 d playing a major role. This review, published in Public Health Nutrition, aimed to systematically assess the effectiveness of interventions designed to optimise dietary intake and/or nutrition-related behaviours among Indigenous infants globally and to identify whether Indigenous populations were involved in the co-design of the intervention.

Key Ministry of Health Publications

Regional Results 2017–2020: New Zealand Health Survey
The Regional Data Explorer presents the 2017–2020 regional results from the New Zealand Health Survey, for adults and children, at all District Health Board (DHB), Public Health Unit (PHU) and Regional Council levels. It includes more than 150 indicators on health behaviours, health status and access to health care.

Consultation on amendments to the schedules of specified prescription medicines for designated pharmacist prescribers: Analysis of submissions
This publication provides the analysis of submissions on the proposed amendments to the schedule of the Medicines (Designated Pharmacist Prescribers) Regulations 2013 and Schedule 1B of the Misuse of Drugs Regulations 1977 consultation.

Ministry of Health Consultations & Events

Public Health Workforce survey
This survey is a joint collaboration between the Public Health Association and the Ministry of Health, aimed at those who work or volunteer in Public Health in Aotearoa. It aims to gather data on the Public Health workforce for use in workforce planning. This survey closes 21st December 2021.

District Health Board Initiative

Positive progress on 2DHB Maternal and Neonatal System Strategy
Capital and Coast DHB are pleased to provide an update on the development of the 2DHB Maternal and Neonatal System Strategy and action plan for our region, ahead of Board review in December and its rollout from 2022. This strategy seeks to deliver a whole-of-system approach to improving maternal and neonatal care for all families in our region, with a pro-equity focus on actions to improve outcomes for Māori and Pacific whānau & families, and disabled women and babies with impairments.

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.