Issue 259 - 18 August 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)

Children’s perspectives on the wicked problem of child poverty in Aotearoa New Zealand: a wearable camera study
Child poverty is a wicked problem and a key determinant of health, but research on child poverty has relied largely on self-report methods and reports from parents or caregivers. This study, published in the New Zealand Medical Journal, aimed to assess aspects of child poverty using data collected by children using wearable cameras. 

Health Equity (International)

Inequity in Access and Delivery of Virtual Care Interventions: A Scoping Review
The objectives of this review, published in the International Journal of Environmental Research and Public Health, were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities.

Quality Improvement (International)

Fostering a just culture in healthcare organizations: experiences in practice
A just culture is regarded as vital for learning from errors and fostering patient safety. Key to a just culture after incidents is a focus on learning rather than blaming. Existing research on just culture is mostly theoretical in nature. This study, published in BMC Health Services Research, aims to explore requirements and challenges for fostering a just culture within healthcare organizations.

Hospital Productivity (New Zealand)

The role of communication in successful outpatient attendance in a New Zealand Hospital, a qualitative study
There are significant implications for both patients and providers when patients do not attend (DNA) outpatient specialist appointments. Non-attendance has an impact on the efficiency of health care, provider resources, and patient health outcomes. This qualitative study, published in Internal Medicine Journal, aimed to gather insights on how Dunedin Hospital notifies patients about their appointments, the implications for the hospital and for patients, and how the system could be improved.

Hospital Productivity (International)

Lean Design of the Pediatric Intensive Care Unit Patient Room for Efficient and Safe Care Delivery
The pediatric intensive care unit (PICU) is an environment where seriously ill children receive complex care, delivered mostly by specialty-trained nurses (registered nurses [RNs]) who must perform multiple high-level tasks. With stressors on healthcare systems at an all-time high, design that optimizes RN workflow has taken on a renewed imperative. The objective of this study, published in HERD was to employ a multimodal approach to identify environmental factors in the PICU patient room that contribute to caregiver workflow inefficiencies.

Cancer Services (International)

mHealth Interventions to Improve Cancer Screening and Early Detection: Scoping Review of Reviews
Cancer screening provision in resource-constrained settings tends to be opportunistic, and uptake tends to be low, leading to delayed presentation and treatment and poor survival. The aim of this study, published in the Journal of Medical Internet Research, was to identify, review, map, and summarize findings from different types of literature reviews on the use of mobile health (mHealth) technologies to improve the uptake of cancer screening.

Emergency Department Services (International)

Patient-centered care in the emergency department: a systematic review and meta-ethnographic synthesis
Patient-centered care (PCC) is an emerging priority in many healthcare settings but lacks clarity in the emergency department (ED). It is of interest to know what PCC practices are most important to patients to better their experience. The objective of this study, published in the International Journal of Emergency Medicine, was to conduct a mixed-methods systematic review of PCC in the ED.

Cardiovascular Disease and Diabetes (New Zealand)

Perspectives and experiences of Māori and Pasifika peoples living with cardiac inherited disease: a qualitative study
Cardiac inherited diseases can have considerable psychosocial effects, including lifestyle limitations, anxiety and depression. Most research to date on patient experiences of CID has been conducted with people from Western cultures, yet culture can shape patient views and experiences of health. The aim of this research, published in Psychology & Health, was to explore the experiences and perspectives of Māori and Pasifika living with a cardiac inherited disease.

Diabetes podiatry services for Māori in Aotearoa: a step in the right direction?
Māori with diabetes are at a 65% greater risk of amputation compared to non-Māori with diabetes. Despite evidence to support the role of podiatrists in reducing diabetes-related lower limb amputations. This study, published in the Journal of Foot and Ankle Research, looked at the effectiveness of diabetes podiatry services at the community and secondary level for Māori.

Cardiovascular Disease and Diabetes (International)

From clinic to community: A randomized controlled trial of a peer support model for adults with type 2 diabetes from specialty care settings in British Columbia
The objective of this randomized controlled trial, published in Diabetic Medicine, was to examine the impact of a 12-month peer-led diabetes self-management support intervention delivered via telephone among adults with type 2 diabetes (T2D) from specialty care settings in British Columbia.

Effectiveness of oral health promotion interventions for people with type 2 diabetes delivered by non-dental health care professionals: a systematic review
Oral health problems among people with diabetes mellitus are an emerging public health problem. Despite the rising concerns of oral health and diabetes mellitus comorbidity, there is a lack of dental health care professionals such as dentists, to address this problem, especially at the primary care level in low- and middle-income countries. This review, published in Global Health Action, systematically synthesizes the current evidence in terms of the involvement of non-dental health care professionals in promoting oral health among people with type 2 diabetes mellitus and assessed the effectiveness of such programs.

Primary Health Care (New Zealand)

“I teach them. I have no choice”: experiences of primary care among transgender people in Aotearoa New Zealand
This study, published in the New Zealand Medical Journal, aims to report primary care experiences among transgender people in Aotearoa New Zealand based on quantitative and qualitative data from a nationwide community-based survey of transgender people. 

Primary Health Care (International)

More than signposting: Findings from an evaluation of a social prescribing service
This paper, published in Health & Social Care in the Community, presents findings from an evaluation of a social prescribing service, undertaken between January 2019 and December 2020. 

Digital Health Technologies Enabling Partnerships in Chronic Care Management: Scoping Review
An increasing number of patients expect and want to play a greater role in their treatment and care decisions. This emphasizes the need to adopt collaborative health care practices, which implies collaboration among interprofessional health care teams and patients, their families, caregivers, and communities. In recent years, digital health technologies that support self-care and collaboration between the community and health care providers (ie, participatory health technologies) have received increasing attention. However, knowledge regarding the features of such technologies that support effective patient-professional partnerships is still limited. This study, published in the Journal of Medical Internet Research, aimed to map and assess published studies on participatory health technologies intended to support partnerships among patients, caregivers, and health care professionals in chronic care, focusing specifically on identifying the main features of these technologies.

Technology-Delivered Adaptations of Motivational Interviewing for the Prevention and Management of Chronic Diseases: Scoping Review
Motivational interviewing (MI) can increase health-promoting behaviors and decrease health-damaging behaviors. However, MI is often resource intensive, precluding its use with people with limited financial or time resources. Mobile health–based versions of MI interventions or technology-delivered adaptations of MI (TAMIs) might increase reach. This review, published in the Journal of Medical Internet Research, aimed to understand the characteristics of existing TAMIs.

Primary Mental Health (New Zealand)

‘Really there because they care’: The importance of service users’ interpretations of staff motivations at a crisis intervention service in New Zealand
Crisis intervention services for people experiencing psychological distress and suicidal ideation are frequently described by the people accessing them as failing to meet their needs. This paper, published in Health & Social Care in the Community, reports a prominent finding from a realist evaluation of Taranaki Retreat—a charitable, non-clinical organisation in New Zealand, which offers free respite for people experiencing acute distress.

Primary Mental Health (International)

Effectiveness of a lifestyle modification programme in the treatment of depression symptoms in primary care
Depression symptoms are prevalent in the general population, and their onset and continuation may be related to biological and psychosocial factors, many of which are related to lifestyle aspects. Health promotion and lifestyle modification programmes (LMPs) may be effective on reducing the symptoms. The objective of this study, published in Frontiers in Medicine, was to analyse the clinical effectiveness of a LMP and a LMP plus Information and Communication Technologies, when compared to Treatment as Usual (TAU) over 6 months.

Integrated self-management support provided by primary care nurses to persons with chronic diseases and common mental disorders: a scoping review
The aim of this review, published in BMC Nursing, was to map integrated and non-integrated self-management support interventions provided by primary care nurses to persons with chronic diseases and common mental disorders and describe their characteristics.

Weight Management (International)

Overview of systematic reviews of health interventions that aim to prevent and treat overweight and obesity among children
Childhood overweight and obesity is a global public health issue. Although there is evidence of a reduced prevalence in some countries, there is still much controversy about the efficacy of health interventions that aim to prevent and treat obesity in this specific population. The objective of this study, published in Systematic Reviews, is to develop an overview of systematic reviews (OSRs) that assesses the effects of school-based, family, and multi-component health interventions for the prevention and treatment of obesity, change in physical activity, dietary, and/or hydration behaviours, and change in metabolic risk factors in school-aged children.

Key Ministry of Health Publications

Standard for Abortion Counselling Aotearoa New Zealand
This publication sets the standard for abortion counselling in Aotearoa New Zealand. 

Repealing and Replacing the Mental Health Act: Analysis of Public Consultation Submissions
The Government has agreed to repeal and replace the Mental Health (Compulsory Assessment and Treatment) Act 1992 (the Mental Health Act). To begin a dialogue on what new mental health legislation should like in Aotearoa New Zealand, a public consultation between October 2021 and January 2022. This document analyses the submissions.

Draft National HIV Action Plan for New Zealand Aotearoa 2022–2032
The Ministry of Health has drafted a new HIV Action Plan with the support of community organisations representing people living with and affected by HIV and the health sector. This new HIV Action Plan strives to eliminate local transmission of HIV and ensure people living with HIV have healthy lives free from stigma and discrimination. 

Health Sector Initiative

Teaming up to save lives
Counties Manukau and Waitemata have joined forces to deliver a bowel screening education workshop for the Chinese community in Pakuranga which can save lives. With the uptake of the National Bowel Screening Programme within the Asian community found to be low, the two districts have come together under the Te Whatu Ora umbrella to host education sessions and better utilise resources.

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.