Issue 248 - 17 March 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.

Health Equity (New Zealand)

A Critical Tiriti Analysis of the Pae Ora (Healthy Futures) Bill
The Pae Ora (Healthy Futures) Bill is the framework for a reformed health system intended to embed Te Tiriti o Waitangi and centre equity. The Bill is informed by the Wai 2575 Health Kaupapa Waitangi Tribunal Inquiry and the Health and Disability System Review, both of which established an urgent mandate to transform the health sector. This desktop review, published in the New Zealand Medical Journal, explores to what extent the proposed Bill is likely to uphold Te Tiriti.

(Not That) Essential: A Scoping Review of Migrant Workers’ Access to Health Services and Social Protection during the COVID-19 Pandemic in Australia, Canada, and New Zealand
Migrant workers have been disproportionately affected by the COVID-19 pandemic. This study, published in the International Journal of Environmental Research and Public Health, examines their access to health services and social protection during the pandemic.

Health Equity (International)

All Quality Improvement Is Health Equity Work: Designing Improvement to Reduce Disparities
Quality improvement (QI) can be a critical means by which to achieve equity in health and health care. QI efforts, however, often fail to be designed and implemented through the lens of health equity. In this article, published in Pediatrics, the authors discuss the current state of the intersection between QI and health equity, then lay out specific steps researchers and practitioners can take to ensure that their QI work reduces, rather than increases or maintains, existing disparities.

Quality Improvement (International)

Improving the Development and Implementation of Audit and Feedback Systems to Support Health Care Workers in Limiting Antimicrobial Resistance in the Hospital: Scoping Review
For eHealth technologies in general and audit and feedback (AF) systems specifically, integrating interdisciplinary theoretical underpinnings is essential, as it increases the likelihood of achieving desired outcomes by ensuring a fit among eHealth technology, stakeholders, and their context. In addition, reporting on the development and implementation process of AF systems, including substantiations of choices, enables the identification of best practices and accumulation of knowledge across studies but is often not elaborated on in publications. This scoping review, published in the Journal of Medical Internet Research, aims to provide insights into the development and implementation strategies for AF systems for a real-world problem that threatens modern health care—antimicrobial resistance—and provide an interdisciplinary conceptual framework that can serve as a checklist and guidance for making informed choices in the development and implementation of future AF systems.

Cancer Services (International)

De-implementing low-value care in cancer care delivery: a systematic review
Accumulating evidence suggests that interventions to de-implement low-value services are urgently needed. While medical societies and educational campaigns such as Choosing Wisely have developed several guidelines and recommendations pertaining to low-value care, little is known about interventions that exist to de-implement low-value care in oncology settings. This review, published in Implementation Science, summarised the literature on interventions to de-implement low-value care in oncology settings.

Cardiovascular Disease and Diabetes (New Zealand)

Māori Health Outcomes in Intensive Care Following Cardiac Surgery in Aotearoa New Zealand
Māori experience disproportionately worse outcomes in cardiovascular health compared to non-Māori. Waikato Hospital provides tertiary cardiothoracic services to the Midland region of NZ, and has instituted an official policy to eliminate ethnic inequity in health. This study, published in Heart, Lung & Circulation, aimed to audit the outcomes of our cardiothoracic intensive care unit (ICU) against this standard.

Are social isolation, lack of social support or loneliness risk factors for cardiovascular disease in Australia and New Zealand? A systematic review and meta-analysis
This systematic review and meta-analysis, published in Health Promotion Journal of Australia, investigates the association between social isolation, lack of social support and loneliness and cardiovascular disease (CVD) incidence among people living in Australia and New Zealand.

Primary Health Care (New Zealand)

Pregnancy planning and barriers to accessing postnatal contraception in New Zealand
This study, published in Contraception, estimates rates of pregnancy and contraceptive planning and identifies barriers and enablers to postnatal contraceptive use.

Primary Health Care (International)

Development and feasibility testing of a training programme for community pharmacists to deliver a culturally responsive medication review intervention
Cultural differences between health professionals and Indigenous peoples contribute to health inequalities, and effective cross-cultural communication and person-centred healthcare are critical remedial elements. Community pharmacists can play a significant role by reducing medication-related problems through medication reviews, yet barriers to access include cultural and linguistic challenges. The Indigenous Medication Review Service (IMeRSe) aimed to address these barriers via a culturally responsive intervention. The aim of this paper, published in Pilot and Feasibility Studies, is to present the cross-cultural training framework developed as a component of this intervention and the feasibility evaluation of the first stage of the training framework.

Primary Mental Health (New Zealand)

What stops Korean immigrants from accessing child and adolescent mental health services?
Access to child and adolescent mental health services by ethnic minorities has been poorly studied. Despite rapid growth of the immigrant Korean population, evidence indicates that few Korean families utilise these services in New Zealand. Those that do tend to present late and with significant morbidity. This study, published in Child and Adolescent Psychiatry and Mental Health, sought to understand barriers to service access from Korean parents' perspectives.

Supportive interactions with primary care doctors are associated with better mental health among transgender people: results of a nationwide survey in Aotearoa/New Zealand
Past research has established that transgender people experience significant disparities in mental health outcomes and healthcare dissatisfaction compared with cisgender people, but more research is needed on how supportive healthcare interactions relate to the mental health of transgender people. The main aims of this study, published in Family Practice, were to establish the most common negative experiences in healthcare and the most common supportive experiences specifically with primary care doctors for transgender people; and to examine the association of supportive experiences with mental health variables after controlling for demographic factors.

Primary Mental Health (International)

How Can We Actually Change Help-Seeking Behaviour for Mental Health Problems among the General Public? Development of the ‘PLACES’ Model
Good treatment uptake is essential for clinically effective interventions to be fully utilised. Numerous studies have examined barriers to help-seeking for mental health treatment and to a lesser extent, facilitators. However, much of the current research focuses on changing help-seeking attitudes, which often do not lead to changes in behaviour. There is a clear gap in the literature for interventions that successfully change help-seeking behaviour among the general public. This gap is particularly relevant for early intervention. This study, published in the International Journal of Environmental Research and Public Health, describes the development of a new model which combines facilitators to treatment and an engaging, acceptable intervention for the general public.

Nature-Based Interventions for Psychological Wellbeing in Long-Term Conditions: A Systematic Review
With the global burden of disease increasing, particularly in relation to often preventable chronic diseases, researchers and clinicians are keen to identify interventions that can mitigate ill health and enhance the psychological wellbeing of people living with long-term conditions (LTCs). It is long established that engagement with nature can support human health and wellbeing, and in recent years, nature-based interventions (NBIs) have been advanced as of potential benefit. This review, published in the International Journal of Environmental Research and Public Health, sought to systematically appraise published evidence of the application of NBIs to address psychological wellbeing for those living with LTCs.

Implementation of Cognitive Behavioral Therapy in e–Mental Health Apps: Literature Review
To address the matter of limited resources for treating individuals with mental disorders, e–mental health has gained interest in recent years. More specifically, mobile health (mHealth) apps have been suggested as electronic mental health interventions accompanied by cognitive behavioral therapy (CBT). This study, published in the Journal of Medical Internet Research, aims to identify the therapeutic aspects of CBT that have been implemented in existing mHealth apps and the technologies used.

Smoking Cessation (International)

Effectiveness of smoking cessation interventions for smokers with chronic diseases: A systematic review
This review, published in the Journal of Advanced Nursing, aimed to systematically summarise seminal studies on the design and effectiveness of smoking cessation interventions targeted at patients with chronic diseases through a critical appraisal of the literature.

Weight Management (International)

Effect of screen time intervention on obesity among children and adolescent: A meta-analysis of randomized controlled studies
Several studies have investigated the effect of screen time interventions on obesity in children and adolescents, but the existing results were controversial. This study, published in Preventive Medicine, aimed to analyse the effect of screen time intervention on obesity in children and adolescents.

Key Ministry of Health Publications

Health Workforce Advisory Board 2021 Annual Report to the Minister of Health
This is the 2021 Annual Report to the Minister of Health by the Health Workforce Advisory Board, established under section 11 of the New Zealand Public Health and Disability Act 2000.

District Health Board Initiative

Te Amo Huia - Bridging the gap and leading the way
What started as a ‘passion’ to achieve equity for Māori has evolved into a clinic providing better outcomes for Māori patients and whānau in the Emergency Department (ED). Te Amo Huia, meaning ‘Sanctuary of Care’, is the first clinic of its kind in the Northern region, and the brainchild of Carly Brown, a then nurse in our Emergency Department. Carly saw gaps in acute care for Māori and was passionate about bringing change.

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.