Issue 266 - 8 December 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

Hapū Wānanga: A Kaupapa Māori childbirth education class for Māori and non-Māori māmā hapū and whānau 
This article, published in Mai Journal, examines Hapū Wānanga, a by Māori, for Māori childbirth education programme based in the Waikato District Health Board region.

Health Equity (New Zealand)

Creating 'safe spaces': A qualitative study to explore enablers and barriers to culturally safe end-of-life care
Internationally, efforts are being made to promote equity in palliative and end-of-life care for Indigenous peoples. There is a need to better understand the experiences of Indigenous service users and staff. The aim of this paper, published in Palliative Medicine, is to explore the views of Māori health practitioners and whānau (family group) caregivers regarding barriers and enablers to culturally safe palliative and end-of-life care. 

Adaptation and implementation processes of a culture-centred community-based peer-education programme for older Māori
Health inequities experienced by kaumātua (older Māori) in Aotearoa, New Zealand, are well documented. Examples of translating and adapting research into practice that identifies ways to help address such inequities are less evident. This study, published in Implementation Science Communication, used the He Pikinga Waiora (HPW) implementation framework and the Consolidated Framework for Implementation Research (CFIR) to explore promising co-design and implementation practices in translating an evidence-based peer-education programme for older Māori to new communities. 

Health effects of Indigenous language use and revitalization: a realist review
Indigenous populations across the world are more likely to suffer from poor health outcomes when compared to other racial and ethnic groups. Although these disparities have many sources, one protective factor that has become increasingly apparent is the continued use and/or revitalization of traditional Indigenous lifeways: Indigenous language in particular. This realist review, published in the International Journal for Equity in Health, is aimed at bringing together the literature that addresses effects of language use and revitalization on mental and physical health.
 

Health Equity (International)

Representations of clinical practice guidelines and health equity in healthcare literature: An integrative review
This paper, published in the Journal of Nursing Scholarship, reports an integrative review of international health literature that discusses health equity in relation to clinical practice guidelines (CPGs).

Quality Improvement (International)

Patient safety measurement tools used in nursing homes: a systematic literature review
An increase in the number of older adults has highlighted the important issue of the safety of residents in nursing homes. This review, published in the BMC Health Services Research, aimed to review previous studies on patient safety of older adults living in nursing homes, analyse the tools used to measure it, and identify factors affecting patient safety of older adult residents in nursing homes.

Cancer Services (New Zealand)

Survival Outcomes and Care Equity among Patients with Advanced Breast Cancer in Auckland, New Zealand
The Auckland Advanced Breast Cancer Review (AABC) was a review of patients diagnosed with advanced inoperable/metastatic breast cancer (ABC) within the Auckland region of New Zealand, commissioned in response to a Breast Cancer Registry report (BCFNZR) that showed poor and inequitable survival outcomes. The review, published in the Journal of Cancer Epidemiology, was aimed at assessing equity of care and identifying healthcare delivery gaps for patients with ABC in the Auckland region.

Cardiovascular Disease and Diabetes (New Zealand)

Transition from paediatric to adult care in young people with diabetes; A structured program from a regional diabetes service, Auckland, New Zealand
This paper, published in Diabetic Medicine, aims to assess participation with a structured transition programme for adolescents with diabetes.

Cardiovascular Disease and Diabetes (International)

Implementation of non-pharmacological interventions for the treatment of hypertension in primary care: a narrative review of effectiveness, cost-effectiveness, barriers, and facilitators
The current guidelines for the prevention, detection, evaluation, and management of hypertension recommend six types of non-pharmacological interventions: alcohol reduction, salt intake reduction, increased potassium intake, physical activity, weight loss, and heart-healthy diets. However, the non-pharmacological interventions are still not widely used in primary care. This paper, published in BMC Primary Care, reviewed and summarised the evidence on the effectiveness, cost-effectiveness, barriers, and facilitators of non-pharmacological interventions for the treatment of hypertension in primary care. 

Primary Mental Health (New Zealand)

The first consultation with a depressed patient: A qualitative study of GPs' approaches to diagnosis
The first consultation with a depressed patient is important because many patients do not return for subsequent visits. Therefore, the first consultation provides a unique opportunity for diagnosis (if required) and treatment, but there are risks of both under and over-diagnosis. This paper, published in the Journal of Family Medicine and Primary Care, aims to understand how general practitioners utilise diagnosis when patients present with a new episode of depression.

Connecting the health of country with the health of people: Application of "caring for country" in improving the social and emotional well-being of Indigenous people in Australia and New Zealand
Emerging evidence from the western literature suggests an increasing focus on applying nature-based interventions for mental health improvements. However, in Indigenous communities, caring for country has always been central to the Indigenous way of life. Knowing that nature-based interventions effectively improve mental health outcomes, this review, published in The Lancet Regional Health, collated evidence on the application of caring for country in improving social and emotional well-being (SEWB) of Indigenous peoples in Australia and New Zealand.

Increased Immunisation (New Zealand)

Maternal intentions for human papillomavirus vaccination of girls and boys in New Zealand
This research project, published by the Ministry of Social Development, uses data from over 4000 children who participated in the Growing Up in New Zealand (GUiNZ) cohort study, to explore maternal intentions to vaccinate their child against HPV, assessed at the eight-year data collection wave.

Smoking Cessation (New Zealand)

A Qualitative Analysis of the Experiences of People Who Resumed Smoking Following Exclusive Electronic Nicotine Delivery Systems Use
For electronic nicotine delivery systems (ENDS) to reduce harms caused by smoking, people who smoke must be able to switch to exclusive ENDS use without subsequently returning to smoking. Identifying factors prompting a return to smoking among former exclusive ENDS users is crucial, yet few qualitative studies have probed experiences of this process. This study, published in Nicotine and Tobacco, describes the in-depth, semi-structured interviews conducted with 20 people (seven indigenous Māori and 13 non-Māori) who smoked tobacco at least weekly, had smoked at least 100 cigarettes in their lifetime, and reported using ENDS to stop smoking cigarettes for at least 30 days (ideally, within the preceding 6 months). The study explores their experiences of ENDS use, probes critical return-to-smoking settings and triggers, and analyses strategies that could promote sustained smoking abstinence.

Smoking Cessation (International)

Smoking cessation interventions for smokers diagnosed with cancer: a systematic review
Smoking continuation or uptake after a diagnosis of cancer is associated with decreased treatment efficacy, health deterioration, and worse survival outcomes; nonetheless, many patients with cancer continue smoking after their diagnosis. The extent and effectiveness of smoking cessation services in this cohort is poorly understood, but engagement with smoking cessation services is known to be scarce. The aim of this systematic review, published in The Lancet, was to identify interventions for smokers diagnosed with cancer, as part of a larger study to develop a quit pathway.

Proactive referral to behavioural smoking cessation programs by healthcare staff: a systematic review
Behavioural smoking cessation programs are an effective tool for quitting smoking, yet remain underused by smokers. Proactive referral may be a promising strategy for healthcare staff to connect smokers to such programs. The aim of this study, published in Nicotine and Tobacco Research, was to gain insight into the effectiveness and implementability of proactive referral of smokers to behavioural smoking cessation programs by healthcare staff. 

Oral Health (New Zealand)

Health professionals delivering oral health interventions in early childhood: a scoping review of Australian and New Zealand literature
Dental caries is highly prevalent in very young Australian and New Zealand children. Health professionals other than registered dental professionals can help prevent early childhood caries, promoting oral health to assist families establish preventative oral health habits at a child's early age. This review, published in the Health Promotion Journal of Australia, identifies oral health promotion delivered by non-dental health professionals in Australia and New Zealand involving very young children.

Key Ministry of Health Publications

Health and Independence Report 2021
This publication provides an overview of the state of public health in Aotearoa New Zealand for the 2021 calendar year.

He Kaupapa Waka
He Kaupapa Waka has an overarching message of investment in people and their communities to build healthy environments that facilitate, support, and meet their identified needs. The report includes statements and recommendations on what needs to change to strengthen the health and disability sector’s response to family violence / sexual violence.

Ministry of Health Consultations & Events

Research involving human gametes and embryos
This consultation document presents, for public feedback, ACART’s thoughts about the matters that will, or might, need to be addressed in updated guidelines for human reproductive research. The current guidelines for human reproductive research, titled Guidelines for Research on Gametes and Non-viable Embryos, were published in 2005. Based on the outcome of this consultation, ACART will develop draft guidelines which will later be the subject of a second round of consultation. This consultation closes 31 March 2023.

Precision health: Exploring opportunities and challenges to predict, prevent, diagnose, and treat disease more precisely in Aotearoa New Zealand
Manatū Hauora is seeking feedback on our proposed topic for our first Long-term Insights Briefing (LTIB). The topic proposed is Precision health: Exploring opportunities and challenges to predict, prevent, diagnose, and treat disease more precisely in Aotearoa New Zealand. Examples of precision health include screening at birth to identify genetic variants indicating any diseases you are at higher risk of developing later in life and regular wastewater surveillance to identify outbreaks – such as COVID-19. The Ministry wants to hear about the opportunities and challenges that exist now and into the future and what areas might be suitable for case studies within the topic of precision health. Consultation closes at 5pm on Friday 27th January 2023.

Health Sector Initiative

New healthcare van to bring diagnostic services closer to home
A new mobile diagnostic service is ready to accelerate into Northland. Te Whatu Ora Te Tai Tokerau’s new van, named Te Pahi O Ngā Iwi (The People’s Bus), was officially launched today by Minister of Health Andrew Little in Whangārei, before hitting the road to the region’s mid and far north to provide a range of diagnostic, assessment and treatment services for people, closer to their homes and without them needing to visit a hospital.

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.