Issue 255 - 23 June 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

Waka ama: An exemplar of indigenous health promotion in Aotearoa New Zealand
The use of old-style, top-down health education and awareness programmes in Aotearoa New Zealand, which adopt a single issue-based approach to health promotion, primarily ignores a broad approach to social determinants of health, as well as indigenous Māori understandings of well-being. This paper, published in the Health Promotion Journal of Australia, draws on the indigenous framework Te Pae Māhutonga as a guide for presenting narratives collated from members of a waka ama rōpū (group) who were interviewed about the social, cultural, and health benefits of waka ama.

Health Equity (New Zealand)

Improving cultural competence of healthcare workers in First Nations communities: a narrative review of implemented educational interventions in 2015-20
Cultural competency is often promoted as a strategy to address health inequities; however, there is little evidence linking cultural competency with improved patient outcomes. This article, published in the Australian Journal of Primary Health, describes the characteristics of recent educational interventions designed to improve cultural competency in healthcare workers for First Nations peoples of Australia, New Zealand, Canada and the USA.

Quality Improvement (New Zealand)

Zero seclusion: Safety and dignity for all – change package | Aukatia te noho punanga: Noho haumanu, tū rangatira mō te tokomaha – mōkī aroha
This Zero seclusion change package, published by the Health Quality & Safety Commission, uses a set of globally recognised, evidence-based interventions aimed at improving the care of tāngata whaiora while moving towards achieving zero seclusion in mental health inpatient units.

Hospital Productivity (International)

Impact of the Automation of Inpatient Bed Management to Reduce the Emergency Service Waiting Time
The patient waiting time to be transferred for hospitalisation is the time that the patient waits between the decision to hospitalise and the actual admission to an inpatient hospital bed. One of the difficulties encountered in qualifying waiting time for inpatient bed is the inability of hospital information systems to measure it. Hospitals in France have a specialised bed allocation team. This team must manage the bed allocation problem between different hospital departments using phone communication to assign patients to the adapted service. This kind of communication represents a lengthy additional workload in which effectiveness is uncertain. This paper, published in Studies in Health Technology and Informatics, presents a new approach to automate bed management in downstream service.

Cancer Services (International)

Oxycodone for cancer‐related pain
Many people with cancer experience moderate to severe pain that requires treatment with strong opioids, such as oxycodone and morphine. Strong opioids are, however, not effective for pain in all people, neither are they well tolerated by all people. The aim of this Cochrane Review was to assess whether oxycodone is associated with better pain relief and tolerability than other analgesic options for adults with cancer pain.

Emergency Department Services (International)

Development of the use of primary health care emergency departments after interventions aimed at decreasing overcrowding: a longitudinal follow-up study
This study, conducted in a Finnish city and published in BMC Emergency Medicine, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hours primary care would modify service usage for specific gender, age or diagnosis groups.

Cardiovascular Disease and Diabetes (New Zealand)

Barriers to optimal stroke service care and solutions: a qualitative study engaging people with stroke and their whānau
The aim of this study, published in the New Zealand Medical Journal, was to explore the perspectives of people with stroke and their whānau on barriers to accessing best practice care across Aotearoa, and to brainstorm potential solutions.

Cardiovascular Disease and Diabetes (International)

Promoting nurse‐led behaviour change interventions to prevent cardiovascular disease in disadvantaged communities: A scoping review
Cardiovascular diseases (CVD) are the leading cause of death worldwide and they disproportionately affect people living in disadvantaged communities. Nurse-led behaviour change interventions have shown great promise in preventing CVD. However, knowledge regarding the impact and nature of such interventions in disadvantaged communities is limited. This review, published in Health & Social Care in the Community, aimed to address this knowledge gap.

Primary Health Care (New Zealand)

The health coaching competency gap – Analysis of pharmacist competency frameworks from Australia, Canada, New Zealand the United Kingdom and the United States of America
The traditional competency frameworks for coaches, the International Coaching Federation (ICF) and the European Mentoring and Coaching Council (EMCC) disregard the differences in expertise required among the diverse professions that may provide coaching. A recent systematic review has identified competencies specific to health professionals who health coach. There are increasing workload pressures in primary care; pharmacists can potentially shift to the greater provision of health promotion services, such as health coaching. The provision of such services needs to be underpinned by competency frameworks, which support the role of pharmacists as health coaches. This analysis, published in Health & Social Care in the Community, identifies the competency gaps for pharmacists if they are to take on the role of health coaching.

Primary Health Care (International)

Digital interventions to improve adherence to maintenance medication in asthma
Asthma is the most common chronic lung condition worldwide, affecting 334 million adults and children globally. Despite the availability of effective treatment, such as inhaled corticosteroids (ICS), adherence to maintenance medication remains suboptimal. Poor ICS adherence leads to increased asthma symptoms, exacerbations, hospitalisations, and healthcare utilisation. Importantly, suboptimal use of asthma medication is a key contributor to asthma deaths. The impact of digital interventions on adherence and asthma outcomes is unknown. The objective of this Cochrane Review was to determine the effectiveness of digital interventions for improving adherence to maintenance treatments in asthma.

Stakeholders' Acceptability of Pharmacist-Led Screening in Community Pharmacies: A Systematic Review
Community pharmacists are among the most accessible healthcare providers. Community pharmacist-led screening may facilitate the early detection of illnesses/medical risk factors, optimizing health outcomes. However, it is important to assess the acceptability of screening services to ensure uptake by key stakeholders. The aim of this review, published in the American Journal of Preventive Medicine, was to explore the acceptability of community pharmacist-led screening by all stakeholders (i.e., patients, pharmacists, and other healthcare professionals).

Primary Mental Health (New Zealand)

Indigenous community psychologies, decolonization, and radical imagination within ecologies of knowledges
This article, published in the American Journal of Community Psychology, explores the inalienable right to self-determination as the ethical foundation of Indigenous psychology. The task of decolonising psychology is not only about divesting from Eurocentric paradigms that have controlled and limited Indigenous wellbeing, but producing new paradigms founded on Indigenous knowledges. The Indigenous paradigm of social and emotional wellbeing is both a new therapeutic practice and theory of wellbeing.

Primary Mental Health (International)

Improving Suicide Prevention in Primary Care for Differing Levels of Behavioral Health Integration: A Review
Suicide prevention implementation in primary care is needed due to the increasing rate of suicide in the past few decades, particularly for young and marginalised people. Primary care is the most likely point of contact for suicidal patients in the healthcare system. This review, published in Frontiers in Medicine, explores the level of medical integration with behavioural health.

teen Mental Health First Aid: 12-month outcomes from a cluster crossover randomized controlled trial evaluation of a universal program to help adolescents better support peers with a mental health problem
teen Mental Health First Aid (tMHFA) is a universal mental health literacy, stigma reduction, help-seeking, and suicide prevention program designed for adolescents in Years 10-12 of secondary school (16-18 years). tMHFA is delivered by trained instructors, in a regular classroom setting, to increase the knowledge, attitudes and behaviours that adolescents' require to better support peers with mental health problems or mental health crises. The aim of this randomised controlled trial, published in BMC Public Health, was to explore the efficacy of tMHFA.

Do Integrated Hub Models of Care Improve Mental Health Outcomes for Children Experiencing Adversity? A Systematic Review
This review, published in the International Journal of Integrated Care, assesses the effectiveness of integrated primary health and social care hubs on mental health outcomes for children experiencing adversity and describes common integration dimensions of effective hubs.

Increased Immunisation (New Zealand)

He Pou Whirinaki (pillars of support). Elder indigenous New Zealand Māori narratives about influenza immunisation and the use of telehealth during the first COVID-19 lockdown
This paper, published in Kōtuitui, describes issues, strengths and challenges experienced by elderly Māori accessing influenza vaccination, during the first Level 4 COVID-19 lockdown in 2020.

Weight Management (New Zealand)

Culture of Healthy Eating and Food Environments, Policies, and Practices in Regional New Zealand Schools
The school food environment plays an important role in shaping students' dietary choices, which often influence future dietary behaviours. This study, published in the International Journal of Environmental Research and Public Health, surveyed primary and secondary schools in Hawke's Bay, to measure the comprehensiveness and strength of food policies, describe the culture of food provision, and identify barriers to improving school food environments.

Oral Health (International)

Factors influencing oral health behaviours, access and delivery of dental care for autistic children and adolescents: A mixed‐methods systematic review
Autistic children and young people experience oral health inequalities. They are at high risk of dental disease and show significant levels of unmet need in relation to oral health and access to dental care. This study, published in Health Expectations, aimed to gather evidence on the factors that influence oral health behaviours, access to and delivery of dental care for autistic children and young people.

Disability Services (International)

An overview of systematic reviews to determine the impact of socio‐environmental factors on health outcomes of people with disabilities
People with disabilities are often subject to intersecting layers of social and economic disadvantage and other barriers that drive health inequity. As a result, they frequently experience worse health than people without disabilities, beyond the direct effects of their health condition or impairment. The aim of this overview of systematic reviews, published in Health & Social Care in the Community, was to summarise the evidence on the impact of socio-environmental factors (i.e. social, physical or attitudinal) on the health outcomes of disabled people.

Key Ministry of Health Publications

The Cost of Long-Term Conditions in New Zealand
This publication provides an updated review of the evidence on cost of illness studies in New Zealand and internationally. It updates a 2009 report, incorporating more recent research in this space. The scope of the report was also increased to consider a larger number of long-term conditions and associated risk factors.

Long-acting Reversible Contraception: Health Practitioner Training Principles and Standards
The contraceptive guidance and LARC training standards provide guidance and tools to support best practice training and contraceptive care. The first standards document the Long-acting Reversible Contraception: Principles and Standards for Trainers document provides health practitioners with detailed descriptions of the competencies, numbers of observed LARC procedures and training that health practitioners need to train to competence. The second standards document defines the standards, training and competencies required to become a LARC trainer.

COVID-19 PCR Testing Backlog: Rapid Review
The Ministry of Health commissioned report into PCR testing backlog.

Delta Response Rapid Review
This rapid review provides a key stakeholder reflection on the Incident Management response by the Ministry of Health to the Delta outbreak, in the period up to December 2021.

Ministry of Health Consultations & Events

Cervical Screening & Primary Care Capacity
As COVID-19 and other pressures continue to impact our health sector, the National Cervical Screening Programme (NCSP) wants input to determine how cervical screening is being affected in primary care, specifically with regards to sector capacity. This consultation closes on the 30th June 2022.

District Health Board Initiative

RSE workers' programme "very important to us", Samoan prime minister tells Hastings leaders
The health and wellbeing of RSE workers was the topic of discussion during Samoan Prime Minister Fiamē Naomi Mata’afa’s visit to Hastings.

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.