Issue 265 - 24 November 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

Indigenous Social Enterprises and Health and Wellbeing: A Scoping Review and Conceptual Framework
Indigenous people and communities are establishing social enterprises to address social disadvantage and overcome health inequities in their communities. This review, published in the International Journal of Environmental Research and Public Health, sought to characterise the spectrum of Indigenous social enterprises in Australia, New Zealand, Canada, and the United States to identify the operational models and cultural values that underpin them and their impact on Indigenous health and wellbeing.

Health Equity (New Zealand)

Re-orientating health and nursing care: a qualitative study on indigenous conceptualisations of wellbeing
Health systems often fail to address the wellbeing needs of older Indigenous populations; this is attributed to a lack of knowledge of Indigenous health systems arising from a privileging of dominant western biomedical epistemologies. In Aotearoa/New Zealand, there is a dearth of nursing knowledge relating to Māori, which negatively impacts on the provision of holistic nursing care. This research, published in BMC Nursing, explores insights and perspectives of older Māori adult's (pakeke) perceptions of wellbeing so nurses can provide culturally responsive care and support the wellbeing of Indigenous New Zealanders.

Refugee healthcare needs and barriers to accessing healthcare services in New Zealand: a qualitative phenomenological approach
Refuges and asylum seekers have specific healthcare needs; however there has been insufficient attention and effort to address these needs globally. Furthermore, effective communication between healthcare providers and refugees remains poor, further widening the imbalanced power dynamics. The aim of this research project, published in BMC Health Services Research, was to examine refugee healthcare needs and current barriers to accessing healthcare services in New Zealand, and to propose solutions by exploring the perceptions, attitudes, beliefs, and opinions of key stakeholders regarding refugee healthcare needs within the scaffold of health and social care systems.

Understanding the context of hospital transfers and away-from-home hospitalisations for Māori
In Aotearoa New Zealand, people regularly travel away from their home to receive hospital care. While the role of whānau support for patients in hospital is critical for Māori, there is little information about away-from-home hospitalisations. This paper, published in the New Zealand Medical Journal, describes the frequency and patterning of away-from-home hospitalisations and inter-hospital transfers for Māori.

Cancer Services (New Zealand)

Feasibility and acceptability of telehealth and contactless delivery of human papillomavirus (HPV) self-testing for cervical screening with Māori and Pacific women in a COVID-19 outbreak in Aotearoa New Zealand
The aim of this study, published in the New Zealand Medical Journal, was to determine the feasibility and acceptability of a telehealth offer and contactless delivery of human papillomavirus (HPV) cervical screening self-test during the 2021 COVID-19 Level 4 lockdown in Auckland, New Zealand.

Cancer Services (International)

Systematic review of randomised controlled trials on interventions aimed at promoting colorectal cancer screening amongst ethnic minorities
Significant disparities exist between different ethnic groups when it comes to participation in colorectal cancer (CRC) screening programmes. A variety of interventions have been proposed to improve participation rates of ethnic minorities for CRC screening. This systematic review, published in Ethnicity & Health, aims to appraise the evidence available from published randomised controlled trials (RCTs) and to identify effective interventions aimed at promoting CRC screening amongst underserved ethnic minorities.

Cardiovascular Disease and Diabetes (New Zealand)

Effective primary care management of type 2 diabetes for indigenous populations: A systematic review
Indigenous peoples in high income countries are disproportionately affected by Type 2 Diabetes. Socioeconomic disadvantages and inadequate access to appropriate healthcare are important contributors. This systematic review, published in PLOS One, investigates effective designs of primary care management of Type 2 Diabetes for Indigenous adults in Australia, Canada, New Zealand, and the United States.

Tino rangatiratanga – a rural Māori community’s response to stroke: ‘I’m an invalid but I’m not invalid’
This article, published in the Journal of the Royal Society of New Zealand, presents a community-led kaupapa Māori research project involving Whakatōhea and neighbouring rohe (areas). This project arose from a moemoeā (dream or vision) of Tawhai, a stroke survivor who wanted to help fellow stroke survivors. The ultimate aim was to facilitate Māori stroke survivors and whānau (family) to support recent stroke survivors, and find funding to allow sustainable employment of stroke survivors in this capacity.

Cardiovascular Disease and Diabetes (International)

Impact of gestational diabetes mellitus treatment on medium/long‐term outcomes after pregnancy: A systematic review and meta‐analysis
This review and meta-analysis, published in Diabetic Medicine, aimed to evaluate the effect of gestational diabetes mellitus (GDM) treatment on medium/long-term outcomes both the mother and offspring.

Primary Health Care (New Zealand)

A Scoping Literature Review of Rural Beliefs and Attitudes toward Telehealth Utilization
The purpose of this scoping literature review, published in the Western Journal of Nursing Research, was to understand what is known about how the rural profile influences beliefs regarding telehealth utilization.

Decision-making and related outcomes of patients with complex care needs in primary care settings: a systematic literature review with a case-based qualitative synthesis
In primary care, patients increasingly face difficult decisions related to complex care needs (multimorbidity, polypharmacy, mental health issues, social vulnerability and structural barriers). There is a need for a pragmatic conceptual model to understand decisional needs among patients with complex care needs and outcomes related to decision. This review, published in BMC Primary Care, aimed to identify types of decisional needs among patients with complex care needs, and decision-making configurations of conditions associated with decision outcomes.

Primary Health Care (International)

The development of Future Health Today: piloting a new platform for identification and management of chronic disease in general practice
Chronic disease identification and management is a significant issue in Australia, with general practice being the primary contact point for those at risk of, or living with, chronic disease. However, there is a well-described gap between guideline recommendations for chronic disease management and translation in the general practice setting. In 2018, a group of researchers, clinicians and software developers collaborated to develop a tool to support the identification and management of chronic disease in general practice, with the aim to create a platform that met the needs of general practice. This paper, published in the Australian Journal of Primary Health, provides a report on the key features and functionalities of the tool that participants identified and implemented in practice.

Interactive Remote Patient Monitoring Devices for Managing Chronic Health Conditions: Systematic Review and Meta-analysis
Telemedicine is an expanding and feasible approach to improve medical care for patients with long-term conditions. However, there is a poor understanding of patients’ acceptability of this technology and their rate of uptake. The aim of this study, published in the Journal of Medical Internet Research, was to systematically review the current evidence on telemonitoring in the management of patients with long-term conditions and evaluate the patients’ uptake and acceptability of this technology.

Scaling-up a pharmacist-led information technology intervention (PINCER) to reduce hazardous prescribing in general practices: Multiple interrupted time series study
This study, published in PLOS Medicine, investigated whether pharmacist-led information technology intervention (PINCER) was effective in reducing hazardous prescribing when rolled out at scale in UK general practices.

Primary Mental Health (New Zealand)

A Chatbot to Support Young People During the COVID-19 Pandemic in New Zealand: Evaluation of the Real-World Rollout of an Open Trial
The number of young people in New Zealand (Aotearoa) who experience mental health challenges is increasing. As those in Aotearoa went into the initial COVID-19 lockdown, an ongoing digital mental health project was adapted and underwent rapid content authoring to create the Aroha chatbot. This dynamic digital support was designed with and for young people to help manage pandemic-related worry. Aroha chatbot is explored in this study, published in the Journal of Medical Internet Research.

Using Fa'afaletui to explore Samoan consumers' experience and interpretation of mental health person-centred care in Aotearoa, New Zealand
This study, published in the International Journal of Mental Health Nursing, applied a fa'afaletui cultural lens to an exploratory qualitative study examining Samoan families' experiences and engagement with a person-centred care model employed in specific mental health services in Aotearoa.

Primary Mental Health (International)

Shared decision-making interventions for people with mental health conditions
One person in every four will suffer from a diagnosable mental health condition during their life. Such conditions can have a devastating impact on the lives of the individual and their family, as well as society. International healthcare policy makers have increasingly advocated and enshrined partnership models of mental health care. Shared decision‐making (SDM) is one such partnership approach. Shared decision‐making is a form of service user‐provider communication where both parties are acknowledged to bring expertise to the process and work in partnership to make a decision. This Cochrane Review assesses whether SDM interventions improve a range of outcomes.

Determination of Markers of Successful Implementation of Mental Health Apps for Young People: Systematic Review
Smartphone apps have the potential to address some of the current issues facing service provision for young people’s mental health by improving the scalability of evidence-based mental health interventions. However, very few apps have been successfully implemented, and consensus on implementation measurement is lacking. This review, published in the Journal of Medical Internet Research, aims to determine the proportion of evidence-based mental health and well-being apps that have been successfully adopted and sustained in real-world settings.

Evaluating the role and effectiveness of co‐produced community‐based mental health interventions that aim to reduce suicide among adults: A systematic review
Suicide is a major public health risk requiring targeted suicide prevention interventions. The principles of co-production are compatible with tailoring suicide prevention interventions to meet an individual's needs. This review, published in Health Expectations, aimed to evaluate the role and effectiveness of co-produced community-based suicide prevention interventions among adults.

Oral Health (International)

Oral care measures for preventing nursing home‐acquired pneumonia
Pneumonia in residents of nursing homes can be termed nursing home‐acquired pneumonia (NHAP). NHAP is one of the most common infections identified in nursing home residents and has the highest mortality of any infection in this population. NHAP is associated with poor oral hygiene and may be caused by aspiration of oropharyngeal flora into the lung. Oral care measures to remove or disrupt oral plaque might reduce the risk of NHAP. The objective of this Cochrane Review was to assess effects of oral care measures for preventing nursing home‐acquired pneumonia in residents of nursing homes and other long‐term care facilities.

Key Ministry of Health Publications

Cancer: Historical summary 1948–2020
These tables contain cancer registration and death data for selected cancers by sex, from 1948–2020.

Annual Update of Key Results 2021/22: New Zealand Health Survey
The Annual Data Explorer presents results from the 2021/22 New Zealand Health Survey, with comparisons to earlier surveys where possible.

Pharmaceutical Data web tool
The Pharmaceutical Data web tool displays summary data on pharmaceuticals that were dispensed in the community and funded by the New Zealand Government.

Ministry of Health Consultations & Events

Quarterly Feedback Survey Ngā Paerewa Health and Disability Services Standard Implementation
Ngā Paerewa Health and disability services standard (NZS 8134:2021) came into effect on 28 February 2022. HealthCERT is leading work to support the sector's implementation of the Ngā Paerewa, including providing resources, guidance, and running workshops for service providers, health professionals, and the people and whānau who use these services. HealthCERT is running a regular survey throughout the implementation and transition period to gather your feedback. The survey is aimed at learning more about your current level of understanding of Ngā Paerewa, and identifying which key areas of change you’d like HealthCERT to focus training on. It closes 6th December 2022.

Health Sector Initiative

'Protect Your Breath' youth vaping harm campaign starts 
A new campaign designed to get Aotearoa’s youth thinking about their vaping has started. Protect your Breath has been co-designed with the Hā Collective, a group of young people, schools and experts to explore ways to reduce the harms of youth vaping.

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.