Issue 250 - 14 April 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

Mana motuhake, Indigenous biopolitics and health
The majority of Indigenous health models do not directly acknowledge that health is a contested political space. Providing a Foucauldian analysis, this article, published in AlterNative, suggests a function of biopower is to naturalise discourses such as the poor Māori health statistic to appear based on factual evidence and thus are apolitical.

Health Equity (New Zealand)

Practising impact assessment: a content analysis of 20 Cultural Impact Assessment reports in Aotearoa New Zealand
There is potential to strengthen impact assessment as a tool for Indigenous community use in environmental management. The present research, published in AlterNative, contributes to this discussion by examining the report product that has resulted from 20 recent Cultural Impact Assessments (CIA) in Aotearoa New Zealand.

Racism and Indigenous Adolescent Development: A Scoping Review
Previous studies on the impacts of racism on adolescent development have largely overlooked Indigenous youth. This scoping review of the empirical literature on racism against Indigenous adolescents, published in Journal of Research on Adolescence, aimed to determine the nature and scope of this research and to establish associations with developmental outcomes.

Reducing healthcare inequities for Māori using Telehealth during COVID-19
Māori experience barriers to accessing timely, quality healthcare. The March 2020 COVID-19 lockdown in New Zealand required provision of Telehealth consultation options in primary care. Telehealth consultations have the potential to improve access to healthcare for Māori, and thereby reduce health inequities. Conversely, Telehealth may present additional barriers that contribute to inequities overall. This scoping project, published in the New Zealand Medical Journal, investigated Māori experiences of Telehealth consultations during the March 2020 COVID-19 lockdown.

Understanding engagement with Brown Buttabean Motivation, an Auckland grassroots, Pacific-led holistic health programme: a qualitative study
The aim of this study, published in BMJ Open, was to understand how participants engage with Brown Buttabean Motivation (BBM) a grassroots, Pacific-led holistic health programme and the meaning it has in their lives. The objectives were to explore the impact BBM had on all aspects of their health and well-being, what attracted them, why they stayed, identify possible enablers and barriers to engagement, and understand impact of COVID-19 restrictions.

Quality Improvement (New Zealand)

Pressure injury prevention in Aotearoa New Zealand aged care facilities: A case study
High dependency levels and complex care needs increase pressure injury risk for older adults in aged residential care, with devastating consequences for their health and well-being. The prevention of pressure injuries requires comprehensive and skilled care mainly provided by registered nurses and health care assistants. Despite high prevalence of pressure injuries, there is a lack of evidence on their prevention in aged residential care settings in Aotearoa New Zealand. This single case study, published in Nursing Praxis, aimed to identify factors affecting pressure injury prevention in aged residential care.

Quality Improvement (International)

Effect of the surgical safety checklist on provider and patient outcomes: a systematic review
Despite being implemented for over a decade, literature describing how the surgical safety checklist (SSC) is completed by operating room (OR) teams and how this relates to its effectiveness is scarce. This systematic review, published in BMJ Quality & Safety, aimed to quantify how many studies reported SSC completion versus described how the SSC was completed; and evaluate the impact of the SSC on provider outcomes (Communication, case Understanding, Safety Culture, CUSC), patient outcomes (complications, mortality rates) and moderators of these relationships.

Emergency Department Services (International)

Interventions and strategies involving primary healthcare professionals to manage emergency department overcrowding: a scoping review
The objective of this study, published in BMJ Open, was to conduct a scoping review to identify and summarise the existing literature on interventions involving primary healthcare professionals to manage emergency department (ED) overcrowding.

Cardiovascular Disease and Diabetes (International)

A Meta-Analysis of the Effectiveness of Telemedicine in Glycemic Management among Patients with Type 2 Diabetes in Primary Care
Telemedicine interventions are gradually being used in primary health care to help patients with type 2 diabetes receive ongoing medical guidance. The purpose of this study, published in the International Journal of Environmental Research and Public Health, was to analyse the effectiveness of using telemedicine in primary health care for the management of patients with type 2 diabetes.

Primary Health Care (International)

Optimising GPs’ communication of advice to facilitate patients’ self-care and prompt follow-up when the diagnosis is uncertain: a realist review of ‘safety-netting’ in primary care
Safety-netting has become best practice when dealing with diagnostic uncertainty in primary care. Its use, however, is highly varied and a lack of evidence-based guidance on its communication could be harming its effectiveness and putting patient safety at risk. The objective of this study, published in BMJ Quality & Safety, was to use a realist review method to produce a programme theory of safety-netting, that is, advice and support provided to patients when diagnosis or prognosis is uncertain, in primary care.

Peer support for people with chronic conditions: a systematic review of reviews
Peer support is a socially driven intervention involving people with lived experience of a condition helping others to manage the same condition, potentially offering a sense of connectedness and purpose, and experiential knowledge to manage disease. However, it is unclear what outcomes are important to patients across the spectrum of chronic conditions, what works and for whom. The aims of this review, published in BMC Health Services Research, were to collate peer support intervention components, collate the outcome domains used to evaluate peer support, synthesise evidence of effectiveness, and identify the mechanisms of effect, for people with chronic conditions.

Primary Mental Health (New Zealand)

Integrated competencies for co-existing issues: Holistic support for people accessing mental health and addiction services
A wide range of competencies (including values, attitudes, knowledge and skills) are required to work in an integrated way to effectively support people with co-existing issues accessing services. This document, published by Te Pou, summarises the required competencies and compares them to existing competency frameworks like Let’s get real and Te Whare o Tiki. It also summaries what integrated support is in the context of co-existing issues, enablers and barriers for integrated support, and steps for organisations to implement integrated support.

Systematic review of Indigenous involvement and content in mental health interventions and their effectiveness for Indigenous populations
The objective of this review, published in The Australian and New Zealand Journal of Psychiatry, was to assess the effects of psychological, psychosocial, educational and alternative interventions on mental health outcomes of Indigenous adult populations in Australia, Canada, New Zealand and the United States and the Indigenous involvement and content in each study.

Primary Mental Health (International)

Control interventions in randomised trials among people with mental health disorders
Control interventions in randomised trials provide a frame of reference for the experimental interventions and enable estimations of causality. In the case of randomised trials assessing patients with mental health disorders, many different control interventions are used, and the choice of control intervention may have considerable impact on the estimated effects of the treatments being evaluated. The objective of this Cochrane Review was to assess the benefits and harms of typical control interventions in randomised trials with patients with mental health disorders.

Effect of mental health collaborative care models on primary care provider outcomes: an integrative review
Collaborative care models (CCMs) have robust research evidence in improving mental health outcomes for diverse patient populations with complex health care needs. However, the impact of CCMs on primary care provider (PCP) outcomes are not well described. This integrative review, published in Family Practice, synthesises the evidence regarding the effect of mental health CCMs on PCP outcomes.

Increased Immunisation (International)

Healthcare professional’s promotional strategies in improving Human papillomavirus (HPV) vaccination uptake in adolescents: A systematic review
Human papillomavirus (HPV) vaccination coverage remains suboptimal with a global vaccination rate ranging from 12 to 90%. This review, published in Vaccine, examined the approaches used by healthcare professionals in improving the uptake of HPV vaccine and reducing vaccine misconceptions among adolescents.

Weight Management (New Zealand)

Examining the sustainability of effects of early childhood obesity prevention interventions: Follow-up of the EPOCH individual participant data prospective meta-analysis
Although early childhood obesity prevention has become an important issue internationally, little evidence exists regarding longer term effects (i.e., sustainability) of early interventions. The objective of this study, published in Pediatric Obesity, was to determine whether intervention benefits at 2 years of age were sustained at 3.5 and 5 years.

Weight Management (International)

Effect of obesity treatment interventions in preschool children aged 2-6 years: a systematic review and meta-analysis
The objective of this article, published in BMJ Open, was to summarise the literature on the impact of paediatric weight management interventions on health outcomes in preschool age children with overweight or obesity and to evaluate the completeness of intervention description and real-world applicability using validated tools.

Effectiveness of Mobile Apps in Promoting Healthy Behavior Changes and Preventing Obesity in Children: Systematic Review
Mobile apps have been increasingly incorporated into healthy behavior promotion interventions targeting childhood obesity. However, their effectiveness remains unclear. This paper, published in JMIR Pediatrics and Parenting, aims to conduct a systematic review examining the effectiveness of mobile apps aimed at preventing childhood obesity by promoting health behavior changes in diet, physical activity, or sedentary behavior in children aged 8 to 12 years.

What makes interventions aimed at improving dietary behaviours successful in the secondary school environment? A systematic review of systematic reviews
The objective of this review, published in Public Health Nutrition, was to systematically review evidence from systematic reviews of interventions to improve dietary behaviours and reduce food wastage in secondary school pupils.

Key Ministry of Health Publications

Research on social licence for health data re-use
The re-use of health data has the potential to improve evidence-based decision-making across the health and disability sector. However, it is important to ensure health data is managed in an appropriate way. This research paper presents the results of a survey which explored the views of the Aotearoa New Zealand public on when and how their health data should be re-used. A number of use cases are investigated, ranging from scenarios where the re-use of health data supports decisions on a person’s own care, through to the re-use of health data to improve wider health services and population health planning.

Annual Report on Drinking-water Quality 2020–2021
This report summarises drinking-water compliance for the 485 registered networked drinking-water supplies that served populations of more than 100 people in the period from 1 July 2020 to 30 June 2021.

National Consensus Guideline for Treatment of Postpartum Haemorrhage and Treating Postpartum Haemorrhage
This consensus guideline has been updated to include the latest evidence-based research and clinical practice. This will ensure consistency of care for all birthing women/people across Aotearoa New Zealand.

District Health Board Initiative

A ‘life changing’ programme helping chronic respiratory patients
The Better Breathing program run by Counties Manukau Health is pulmonary rehabilitation programme is designed to help patients with chronic respiratory conditions like chronic obstructive pulmonary disease (COPD), bronchiectasis, and cystic fibrosis.

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.