Issue 261 - 15 September 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)

Te Aho o Te Kahu: weaving equity into national-level cancer control
The purpose of this manuscript, published in The Lancet – Oncology, was to consider how mainstream health organisations can develop structures, processes, and functions to address inequity, using the New Zealand Cancer Control Agency (Te Aho o Te Kahu) as an example.

Using Cultural Lens Theory to Investigate the Impact of a Nursing Education Practicum in Aged Healthcare: Aotearoa New Zealand's Bi-cultural Framework
The aim of this paper, published in the Journal of Cross-Cultural Gerontology, is to apply Cultural Lens Approach theory to data collected from third year nursing students related to an assignment undertaken during their month-long practicum placement in an aged residential care facility.

Health Equity (International)

EQUIP emergency: can interventions to reduce racism, discrimination and stigma in EDs improve outcomes?
Despite a publicly funded system, health care in Canada has been shown to be deeply inequitable, particularly toward Indigenous people. This study, published in BMC Health Services Research, is based on research identifying key dimensions of equity-oriented health care as being cultural safety, harm reduction and trauma- and violence-informed care, an intervention to promote equity at the organizational level was tested in primary health care, refined and adapted, and tested in Emergency Departments (EDs). care, an intervention to promote equity at the organizational level was tested in primary health care, refined and adapted, and tested in Emergency Departments (EDs).

Emergency Department Services (International)

Quality Improvement: Implementing Nurse Standard Work in Emergency Department Fast-Track Area to Reduce Patient Length of Stay
The average length of stay of a fast-track area of a large urban hospital was excessively long, which affected the patient experience and the rate at which patients left without being seen. This study, published in the Journal of Emergency Nursing, explored one approach to reducing average length of stay is to create nurse standard work. Nurse standard work was a defined set of process and procedures that reduce variability within a nurse's workflow.

Cardiovascular Disease and Diabetes (New Zealand)

The needs and experiences of women with gestational diabetes mellitus from minority ethnic backgrounds in high-income nations: A systematic integrative review
Gestational diabetes mellitus (GDM) represents a growing challenge worldwide, with significant risks to both the mother and baby that extend beyond the duration of the pregnancy and immediate post-partum period. Women from ethnic minority groups who access GDM care in high-income settings face particular challenges. The aim of this systematic integrative review, published in Women and Birth, is to explore the experiences and needs of women with GDM from select ethnic groups in high-income healthcare settings.

Illness perceptions and diabetes self-care behaviours in Māori and New Zealand Europeans with type 2 diabetes mellitus: a cross-sectional study
This study, published in The New Zealand Medical Journal, investigated differences in illness perceptions and self-care behaviours between Māori and New Zealand (NZ) Europeans with type 2 diabetes mellitus (T2DM), and how these perceptions were related to clinical outcomes.

Patient, carer and health worker perspectives of stroke care in New Zealand: a mixed methods survey
It is important to understand how consumers (person with stroke/family member/carer) and health workers perceive stroke care services. In this study, published in Disability and Rehabilitation, consumers and health workers from across New Zealand were surveyed on perceptions of stroke care, access barriers, and views on service centralisation.

Tighter or less tight glycaemic targets for women with gestational diabetes mellitus for reducing maternal and perinatal morbidity: A stepped-wedge, cluster-randomised trial
Treatment for gestational diabetes mellitus (GDM) aims to reduce maternal hyperglycaemia. The TARGET Trial, published in PLOS Medicine, assessed whether tighter compared with less tight glycaemic control reduced maternal and perinatal morbidity.

Primary Health Care (International)

Hurdles to developing and scaling remote patients’ health management tools and systems: a scoping review
Despite all the excitement and hype generated regarding the expected transformative impact of digital technology on the healthcare industry, traditional healthcare systems around the world have largely remained unchanged and resultant improvements in developed countries are slower than anticipated. One area which was expected to significantly improve the quality of and access to primary healthcare services in particular is remote patient monitoring and management. The aim of the study, published in Systematic Reviews, was to assess whether or not recent, relevant literature would support the development of in-community, design, deployment and implementation framework based on three factors thought to be important drivers and levers of remote patient management tools and systems’ adoption and scalability.

What are the Clinical and Social Outcomes of Integrated Care for Older People? A Qualitative Systematic Review
Older people with multiple chronic conditions have most to gain from successful integrated care models. This review, published in the International Journal of Integrated Care, explored the current evidence of outcomes for older people.

Patient perspectives on primary care for multimorbidity: An integrative review
Improving healthcare for people with multiple chronic or ongoing conditions is receiving increased attention, particularly due to the growing number of people experiencing multimorbidity (MM) and concerns about the sustainability of the healthcare system. Primary care has been promoted as an important resource for supporting people with MM to live well with their conditions and to prevent unnecessary use of health care services. However, traditional primary care has been criticized for not centring the needs and preferences of people with MM themselves. The aim of this paper, published in Health Expectations, was to conduct a review that centred on the perspective of people with MM in multiple ways, including having patient partners co-lead the design, conduct and reporting of findings, and focusing on literature that reported the perspective of people with MM, irrespective of it being experimental or nonexperimental.

Primary Mental Health (International)

Effectiveness of Collaborative Care for Depression and HbA1c in Patients with Depression and Diabetes: A Systematic Review and Meta-Analysis
The collaborative care is emerging as an effective method in treating patients with multimorbidity, but evidence whether this model is effective for people with comorbid depression and diabetes is unclear. This study, published in International Journal of Integrated Care, aimed to investigate whether collaborative care could improve depression outcomes and HbA1c in patients with depressive symptoms and diabetes, and assess its effects on Quality of Life (QoL).

Smoking Cessation (New Zealand)

An evaluation of a New Zealand "vape to quit smoking" programme
The aim of this study, published in The New Zealand Medical Journal, was to compare the use of smoking cessation aids across different ethnic groups and age groups within a large New Zealand cohort and to assess the uptake and effectiveness of e-cigarettes for smoking cessation via a "vape to quit" initiative.

Weight Management (International)

Surgery for the treatment of obesity in children and adolescents
Child and adolescent overweight and obesity have increased globally and are associated with significant short‐ and long‐term health consequences. The objective of this Cochrane Review was to assess the effects of surgery for treating obesity in childhood and adolescence.

Domains of Capacity Building in Whole-Systems Approaches to Prevent Obesity—A “Systematized” Review
Despite increased awareness of its risks, for the most part, contemporary efforts for obesity prevention have been patchy at best. As such, the burgeoning interest in whole-systems approaches (WSAs) that acknowledge the complex, dynamic nature of overweight and obesity and operate across multiple levels of society is particularly timely. Many components of “community capacity building” (CB), an essential but often neglected aspect of obesity prevention, overlap with “best practice principles” in effective/optimal community-based obesity-prevention initiatives. Rhetoric urging WSAs and community CB in public health abounds although operative and efficacious contemporary examples of these approaches to reducing obesity levels are scarce. The aim of this investigation, published in the International Journal of Environmental Research and Public Health, was to undertake a systematized review of the level of capacity building incorporated in published literature on WSAs targeting obesity to better understand how domains of CB have been incorporated.

Interventions for Health Promotion and Obesity Prevention for Children and Adolescents with Developmental Disabilities: a Systematic Review
This systematic review, published in the Review Journal of Autism and Developmental Disorders, evaluated interventions and relevant outcomes for health promotion and obesity prevention among children and adolescents with developmental disabilities.

Face-to-face physical activity incorporated into dietary intervention for overweight/obesity in children and adolescents: a Bayesian network meta-analysis
Adolescent obesity has been reported to have deleterious consequences but is considered a promising modifiable risk factor. This study, published in BMC Medicine, aimed to investigate the optimal intervention for obese and overweight children and adolescents.

Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition
People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to individuals with severe mental illness (SMI), with a focus of impact on weight. This review, published in Systematic Reviews, assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet.

Key Ministry of Health Publications

Mortality web tool
The Mortality web tool presents mortality and demographic data for selected causes of deaths registered in New Zealand from 1948–2019. Information about all deaths by ICD Chapter, ICD Subgroup, ICD three-character codes and demographics is available from 2010–2019.

Whakamaua Quantitative Dashboard: Year two
This publication is an interactive web tool showing a statistical overview of the 13 initial quantitative measures for Whakamaua: the Māori Health Action Plan 2020–2025.

Health Sector Initiative

School students try hands-on healthcare
At Tauranga Hospital, high school students took part in a programme to encourage young people into medicine.

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.