Issue 256 - 7 July 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

Exploring Indigenous Traditional Healing programs in Canada, Australia, and New Zealand: A scoping review
The objective of this review, published in Explore, was to explore and catalogue ways Indigenous Traditional Healing practices are supported within the mainstream healthcare system through policies and programs in Canada, Australia, and New Zealand.

Health Equity (New Zealand)

Barriers to older Pacific peoples’ participation in the health-care system in Aotearoa New Zealand
Participation in the health-care system is a key component of healthy ageing strategies. The number of Pacific people aged ≥65 years in Aotearoa New Zealand will increase significantly over the next decade. Addressing the considerable health inequities and unmet need for care Pacific Island people experience when compared to other ethnicities in Aotearoa New Zealand should be a priority. The aim of this study, published in the Journal of Primary Health Care, was to identify barriers to older Pacific people’s participation in the health-care system in Aotearoa New Zealand.

Quality Improvement (New Zealand)

Measures Library: Health Quality & Safety Commission
Health sectors rely on data to improve quality. The Health Quality & Safety Commission’s Measures Library provides technical documents and summaries, management and case documents, plus links to other resources like the Atlas of Healthcare Variation.

Antimicrobial Resistance in New Zealand-A One Health Perspective
Antimicrobial resistance (AMR) is an increasing global threat that affects human, animal and, often less acknowledged, environmental health. This complex issue requires a multisectoral One Health approach to address the interconnectedness of humans, animals and the natural environment. This study, published in Antibiotics, aimed to provide a summary of the current knowledge on AMR in NZ, addressing all three components of the One Health triad with a particular focus on environmental AMR.

Contextual antecedents of quality improvement: a comparative case study in rural, urban and Kaupapa Māori general practice
The impact of contextual factors on primary health-care quality improvement is significant. In-depth research is required to identify the key contextual factors that influence quality improvement initiatives to develop high-performing primary health-care systems. This research, published in the Journal of Primary Health Care, seeks to answer two questions; what are the contextual factors influencing primary care improvement initiatives; and how do contextual factors, the quality improvement initiative and the implementation process influence one another and the overall improvement outcomes.

Cardiovascular Disease and Diabetes (New Zealand)

Screening of diabetes in pregnancy in New Zealand: translation of national guidelines into practice
The aim of this study, published in the New Zealand Medical Journal, was to evaluate the proportion of pregnant women who completed screening for pre-existing diabetes and GDM, following publication of the Guideline.

Cardiovascular Disease and Diabetes (International)

Non-Pharmacological Integrated Interventions for Adults Targeting Type 2 Diabetes and Mental Health Comorbidity: A Mixed-Methods Systematic Review
Adults living with Type 2 diabetes (T2D) and severe mental illness (SMI) disproportionally experience premature mortality and health inequality. Despite this, there is a limited evidence-base and evaluation of non-pharmacological integrated interventions that may contribute to improved patient experience and outcomes. To improve our understanding of how to optimise integrated care for this group, this review, published in the International Journal of Integrated Care, evaluates the effectiveness, acceptability, and feasibility of non-pharmacological integrated interventions for adults with SMI and T2D.

Primary Health Care (New Zealand)

Māori Experiences and Beliefs about Antibiotics and Antimicrobial Resistance for Acute Upper Respiratory Tract Symptoms: A Qualitative Study
Antimicrobial resistance (AMR) is a threat to public health. Addressing unnecessary antibiotic use provides an opportunity to reduce antibiotic consumption and to slow AMR. Understanding people's beliefs is important for informing antimicrobial stewardship (AMS) initiatives. Within New Zealand, health inequities exist between Māori and non-Māori; however, no research has examined Māori beliefs about antibiotics and AMR. The aim of this study, published in Antibiotics, was to explore the experiences related to antibiotic use of Māori in New Zealand.

Health Care Home implementation in Otago and Southland: a qualitative evaluation
Health systems internationally have developed new models of primary care to address health-care challenges. One such model is the Health Care Home (HCH),which has been widely adopted across New Zealand. The aim of this study, published in the Journal of Primary Health Care, was to explore the facilitators and barriers to implementation of the HCH in the southern health district (Otago and Southland).

Primary Mental Health (New Zealand)

Barriers and drivers in mental health services in New Zealand: current status and future direction
In New Zealand, mental health issues have created a 'silent epidemic' with diverse consequences in mental health outcomes. Poor mental health state along with inequities to access services are persistent. Key areas of mental health promotion in New Zealand that require constant attention are appropriate policymaking, reaching out to all communities, interventions at the individual level, and the complexity of the mental health system. This commentary, published in Global Health Promotion, evaluates the inadequacies faced by the public in accessing mental health services and the directions to improve in the future. It also reviews the New Zealand government's 'Like Mind, Like Mine' program, aiming to provide socially inclusive services to people to live a life free from mental health-related stigma or discrimination.

Primary Mental Health (International)

Adolescent suicide assessment and management in primary care
The objective of this study, published in BMC Pediatrics, was to understand how suicide management occurs within the primary care setting in terms of follow-up assessments and referral practices.

Increased Immunisation (New Zealand)

Understanding barriers to immunisation against vaccine-preventable diseases in Pacific people in New Zealand, Aotearoa: an integrative review
Pacific people have an increased risk of hospitalisation if barriers to immunisation against vaccine-preventable diseases are not reduced. This research, published in the Journal of Primary Health Care, sought to determine what is known about the barriers to immunisations in Pacific people living in New Zealand and identify ways to reduce these barriers and inform health care.

Smoking Cessation (International)

The effectiveness of smoking cessation interventions in rural and remote populations: Systematic review and meta-analyses
Rural and remote residents are more likely to smoke tobacco than those in major cities. However, they may experience unique systemic, provider, and individual barriers to accessing smoking cessation treatments, including distance and limited resources. The aim of this systematic review and meta-analysis, published in The International Journal on Drug Policy, is to explore the effectiveness of smoking cessation interventions in this population is important due to higher smoking-related disease burden and death compared to those in major cities.

STOP— a training intervention to optimise treatment for smoking cessation in community pharmacies: cluster randomised controlled trial
Community pharmacies serve people with high levels of tobacco-related illness, but throughput in NHS Stop Smoking Services in pharmacies remains relatively low. This study, published in BMC Medicine, investigated the effectiveness of a complex intervention to increase service uptake and retention.

Oral Health (International)

Anti-racist approaches to increase access to general and oral health care during a pandemic in the Pacific Islander community
Limited data exists on Pacific Islander (PI) health, but a growing body of literature reports the existence of racial discrimination and inequities and mistrust of the healthcare system, leading to poor health outcomes. When COVID-19 restricted health services, such inequities and mistrust due to historical trauma were magnified. This report, published in the Journal of Public Health Dentistry, describes one federally qualified health centre’s dental department's response utilizing culture-based approaches, community relationships, and the social determinants of health (SDOH) to dispel the stigma of COVID and restrictions on in-person care in order to lower barriers to accessing care.

Key Ministry of Health Publications

Interim Government Policy Statement on Health 2022-2024
The interim Government Policy Statement on Health 2022-2024 (or interim GPS) is the public statement of what Government expects the health system to deliver and achieve over the next two years, and how success will be measured, monitored and reported.

Pasifika Youth Online Gaming and Gambling Research: Are online video games a gateway to problem gambling among Pasifika youth?
This research aimed to understand the experiences of Pasifika youth (age 16-30) gamers and whether there is a relationship between gaming and gambling.

Literature Review of the provision and effectiveness of residential programmes for gambling harm treatment
This literature review provides a systematic review of information about the provision and effectiveness of residential programmes for gambling harm treatment in New Zealand and overseas.

Strategy to Prevent and Minimise Gambling Harm 2022/23 to 2024/25
This document sets out the Ministry’s approach to and budget for funding and coordinating services to prevent and minimise gambling harm for the three year period starting 1 July 2022.

Guidance for the Acute Phase of Rehabilitation of People with or Recovering from COVID 19 in Aotearoa New Zealand
The purpose of this document is to highlight the complexity and potential long-term needs of people recovering from COVID-19 and to demonstrate the importance of the allied, scientific and technical workforce in reducing the short- and long-term health and wellbeing implications of COVID-19 infection.

Designated Auditing Agency Handbook
This handbook gives the Ministry of Health's requirements of designated auditing agencies (DAAs) for auditing and audit reporting for the certification of health care services under the Health and Disability Services (Safety) Act 2001. The handbook also gives providers of health care services a guide to specific requirements for various types of audits.

Funding to Māori Health Providers 2016/17 to 2020/21
This publication summarises funding to Māori health providers by the Ministry of Health and District Health Boards from 2016/17 to 2020/21.

Health Sector Initiative

Northland quality improvement project brings better support for tangata whaiora and whānau
A Northland District Health Board (DHB) project to improve the transition between services for mental health and addiction (MHA) tangata whaiora (consumers) is improving support for tangata whaiora and whānau, as well as providing a forum for secondary services, non-governmental organisation (NGO) services, tangata whaiora and general practice to work together on quality improvement projects.

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.