Issue 245 - 3 February 2022

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

The voices of kaumātua during the COVID-19 pandemic 
Giving voice to kaumātua perspectives and experiences, and those of older people in general, during the COVID-19 pandemic has been rare because older people are more often spoken about than provided with opportunities to speak for themselves. When they have been spoken about, the focus has been on their vulnerability. While such vulnerabilities are a critical concern, this focus ignored their active participation in and contributions to their communities. In this study, published in Mai Journal, two video recordings were made, in which five Ngāti Whakaue kaumātua talked about their understanding and experience of the pandemic and the first nationwide lockdown. They also spoke about the activities in their community—Ohinemutu in Rotorua and their roles and those of others from the village, especially in relation to a project during the lockdown called, “Feed the Pā”.

Whakapiki Wairua: Co-designing and implementing a Māori mindfulness mental health intervention in a wharekura
This paper, published in Mai Journal, explores the process of co-designing a mātauranga-Māori-informed mindfulness intervention with rangatahi in a wharekura and examines the effects on wellbeing. 

Health Equity (New Zealand)

The Choosing Wisely campaign and shared decision-making with Māori
Choosing Wisely seeks to prevent harm by reducing the number of unnecessary tests, treatments and procedures, and by promoting shared decision-making. This article, published in the New Zealand Medical Journal, scopes perspectives of Māori patients/consumers and Māori health practitioners around Choosing Wisely and explores shared decision-making between Māori and their medical practitioners.

The whitewashing of contracts: Unpacking the discourse within Māori health provider contracts in Aotearoa/New Zealand
Māori health providers emerged in Aotearoa/New Zealand in the 1980s as a mechanism to achieve self-determination for Māori communities. However, the contracts funding Māori health providers limit expressions of self-determination and fail to reflect Te Tiriti O Waitangi, the founding treaty of Aotearoa/New Zealand. Significant health reforms are proposed in Aotearoa/New Zealand, including the creation of a Māori Health Authority that will commission services from Māori health providers. This paper, published in Health & Social Care in the Community, aims to critique the government contracts provided to Māori health providers in the light of the health reforms.

The needs of Pacific families affected by age-related cognitive impairment in New Zealand: interviews with providers from health-care organisations
Pacific populations in New Zealand are aging, but little is known in the health-care environment about their experiences with cognitive impairment. The aim of this study, published in the Journal of Primary Health Care, was to explore the needs of Pacific peoples affected by age-related cognitive decline from the perspectives of health-care providers.

Strengthening public health contracting: findings of a follow-up nationwide survey from Aotearoa
In 2010 and 2015 nationwide surveys monitored government management of public health providers. These surveys found evidence of inconsistent management which disadvantaged Māori providers, consistent with institutional racism. In Dec 2019 to March 2020 a follow-up nationwide telephone survey was completed. Public health units, primary health organisations, Māori health providers and non-governmental organisations with public health contracts responded. This paper, published in Kōtuitui, focuses on the findings about contracts, and relationships.

"We Need a System that's Not Designed to Fail Māori": Experiences of Racism Related to Kidney Transplantation in Aotearoa New Zealand
Reported experiences of racism in Aotearoa New Zealand are consistently associated with negative measures of health, self-rated health, life satisfaction, and reduced access to high-quality healthcare with subsequent poor health outcomes. In this paper, published in the Journal of Racial and Ethnic Health Disparities, the authors report on perceptions and experiences of prejudice and racism by Indigenous Māori with kidney disease and their family members and donors who took part in a wider study about experiences of kidney transplantation.

'It absolutely needs to move out of that structure': Māori with bipolar disorder identify structural barriers and propose solutions to reform the New Zealand mental health system
This paper, published in Ethnicity & Health, synthesises critique from Māori patients with Bipolar Disorder and their whānau to identify barriers and propose changes to improve the structure and function of the New Zealand mental health system.
 

Quality Improvement (New Zealand)

A window on quality 2021: COVID-19 and impacts on our broader health system – Part 1 | He tirohanga kounga 2021: me ngā pānga ki te pūnaha hauora whānui – Wāhanga 1
This report by Health Quality & Safety Commission is the latest in their window report series exploring the secondary impacts of the COVID 19 response on selected aspects of the functioning of our health system so we can learn from that experience and shape resilient system responses in the future.

Cardiovascular Disease and Diabetes (New Zealand)

What is the experience of registered nurses in assessing people with severe mental illness for metabolic syndrome?
Metabolic Syndrome is a prevalent condition in New Zealand and worldwide, affecting adult populations, especially those who are in long-term antipsychotic medications for severe mental illness. Registered nurses play a crucial role in improving the health of this population. In this study, published in Pacific Health Dialog, five registered nurses with at least two years of working experience in the mental health settings participated in this qualitative, exploratory study, underpinned by the Kakala Research Framework.

Primary Health Care (International)

Remote Monitoring Systems for Patients With Chronic Diseases in Primary Health Care: Systematic Review
The digital age, with digital sensors, the Internet of Things (IoT), and big data tools, has opened new opportunities for improving the delivery of health care services, with remote monitoring systems playing a crucial role and improving access to patients. The versatility of these systems has been demonstrated during the current COVID-19 pandemic. Health remote monitoring systems (HRMS) present various advantages such as the reduction in patient load at hospitals and health centers. Patients that would most benefit from HRMS are those with chronic diseases, older adults, and patients that experience less severe symptoms recovering from SARS-CoV-2 viral infection. This paper, published in JMIR mHealth and uHealth, aimed to perform a systematic review of the literature of HRMS in primary health care (PHC) settings, identifying the current status of the digitalization of health processes, remote data acquisition, and interactions between health care personnel and patients.

Primary Mental Health (International)

Farmer Mental Health Interventions: A Systematic Review
The prevalence of mental health disorders and suicide amongst agricultural producers is a global problem. Community leaders, researchers, policymakers, and clinicians have mobilized to develop programs to address this issue. This study, published in the International Journal of Environmental Research and Public Health, reviewed a wide range of mental health interventions targeting farmer mental health spanning over 50 years and examined their reported effectiveness and constraints.

Increased Immunisation (New Zealand)

Māori Māmā views and experiences of vaccinating their pēpi and tamariki: A qualitative Kaupapa Māori study
This report, published by the Health Promotion Agency, explores the complex social and cultural reasons that Māori may be less likely to engage with childhood vaccination services.

Increased Immunisation (International)

Personalized Reminders for Immunization Using Short Messaging Systems to Improve Human Papillomavirus Vaccination Series Completion: Parallel-Group Randomized Trial
Completion rates among adolescents who initiate the human papillomavirus (HPV) vaccine 3-dose series are low. SMS text message vaccine reminders are effective, but less is known about the best types for HPV series completion or the ability to assess and target vaccine decision-making stage. The aim of this study, published in the JMIR mHealth and uHealth, is to compare the effectiveness of HPV vaccine series completion in minority adolescents who received precision and educational versus conventional SMS text message reminders.

Smoking Cessation (New Zealand)

Fefine Tonga moe ifi tapaka: A qualitative study to explore Tongan female tobacco smoking & cessation in the Auckland region
Tongan female smokers’ smoking experiences have manifested within a realm of socioeconomic and cultural conditions in New Zealand with cessation service engagement relatively low. Due to the projected tobacco burden attributed to Pacific women, pertinent research proves vital to bettering understandings of smoking and cessation within this group. This study, published in Pacific Health Dialog, explored the knowledge and experiences of smoking and smoking cessation services among Tongan women aged 16 years and over, living in the Auckland region.

Weight Management (New Zealand)

The relationship between diet and sleep in 2-y-old children: Results from Growing Up in New Zealand
This study, published in Nutrition, aimed to examine the relationship between dietary practices and sleep in young children.

Weight Management (International)

Are ‘Behaviour Change’ Approaches to Obesity and Health Effective? A case Study from Samoa
‘Behaviour Change’ approaches in public health strategies have been used in Pacific Island countries to address the problem of dietary and lifestyle changes that are believed to be the cause of rising rates of obesity and associated NCDS. This case study, published in Pacific Health Dialog, considers the limitations of this approach in the context of Samoa’s socioeconomic situation and public health policy and proposes that an ‘obesogenic’ environment and structural factors are causational and require policy measures that go beyond the scope of responsibilities of the Samoa Ministry of Health.

Disability Services (New Zealand)

The health care experience of disabled people during COVID-19: Summary of findings from the COVID-19 patient experience survey
This report published by the Health Quality & Safety Commission discusses findings relating to disabled people following the COVID-19 patient experience survey.

Disability Services (International)

Peer support interventions for parents and carers of children with complex needs
Parents and family carers of children with complex needs experience a high level of pressure to meet children's needs while maintaining family functioning and, as a consequence, often experience reduced well‐being and elevated psychological distress. Peer support interventions are intended to improve parent and carer well‐being by enhancing the social support available to them. Support may be delivered via peer mentoring or through support groups (peer or facilitator led). Peer support interventions are widely available, but the potential benefits and risks of such interventions are not well established. The objective of this Cochrane Review was to assess the effects of peer support interventions (compared to usual care or alternate interventions) on psychological and psychosocial outcomes, including adverse outcomes, for parents and other family carers of children with complex needs in any setting.

Key Ministry of Health Publications

COVID-19 Māori Health Protection Plan
This plan provides an updated framework that is informed by Te Tiriti o Waitangi to protect whānau, hapū, iwi and hapori Māori from the impacts of COVID-19. It will help guide health and disability system actions for Māori through the next 3 to 12 months of the COVID-19 response. 

Strategy to Prevent and Minimise Gambling Harm proposal document
On 29 August 2021 the Ministry of Health released its draft Strategy to Prevent and Minimise Gambling Harm for 2022/23-2024/25 consultation document and invited submissions, which closed on 8 October 2021. During the consultation period, 10 online meetings were held including one each for Māori, Pacific, Asian and young people/rangatahi viewpoints, one for the gambling industry and one for people with lived experience of gambling harm. Meetings were held online to keep people safe during the COVID-19 alert level restrictions. By the close of the consultation period, the Ministry had received a total of 64 written submissions representing a range of groups and individuals. An external contractor, Allen + Clarke, analysed the submissions and notes of the hui and has produced a “Draft Strategy to Prevent and Minimise Gambling Harm 2022/23 to 2024/25: Submissions Analysis “report for the Ministry of Health. This report and the submissions informed the Ministry’s revised proposals.

Models of Care in Forensic Mental Health Services: A Review of the International and National Literature
This publication provides an evidence-based literature review on best practices pertaining to models of care in the four areas, which broadly represent the main sectors of Forensic Mental Health Service delivery (inpatient, community, prisons, and courts).

Consultation on Proposals for a Smokefree Aotearoa 2025 Action Plan: Analysis of submissions
The Summary of Submissions for the Consultation on Proposals for a Smokefree Aotearoa 2025 Action Plan describes the key themes which emerged during the consultation process. These submissions were used to inform policy decisions and complete the Smokefree Aotearoa 2025 Action Plan.

District Health Board Initiative

Reconnecting Pacific communities with the health sector
The Pacific 2DHB COVID-19 Vaccination Campaign team are joint winners of Hutt Valley and Capital & Coast DHBs’ Celebrating Success Champion of Collaboration and Integration award. The team is made up of staff across Hutt Valley and Capital & Coast DHBs and key Pacific leaders from various Pacific health organisations and community groups such as the Pacific Health Service Hutt Valley, Pacific Health Plus, Te Vaka Atafaga, Taeaomaninio Trust, church leaders, and media professionals such as Catalyst Pacific, who all have the shared goal of protecting Pacific people from COVID-19.

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.