Issue 272 - 16 March 2023

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)

Indigenous Knowledge and the Microbiome-Bridging the Disconnect between Colonized Places, Peoples, and the Unseen Influences That Shape Our Health and Well-Being
Indigenous Peoples have a rich and long-standing connection with the environments that they descend from-a connection that has informed a deep and multifaceted understanding of the relationship between human well-being and the environment. Through cultural narratives and practices, much of this knowledge has endured despite the ongoing effects that colonization has had on many Indigenous peoples across the world. These narratives and practices, based on observation, experimentation, and practical application over many generations, have the potential to make compelling contributions to our understanding of the environmental microbiome and its relationship to health. Furthermore, the inclusion of Indigenous perspectives regarding the microbiome opens pathways to those who rarely engage with the field and its learnings. Within the scientific community, Indigenous perspectives have not always been acknowledged as valid contributions and are often seen as myth or lacking rigor. Thus, this paper, published in mSystems, aims to explore an Indigenous perspective of the microbiome as an unseen influence on health and well-being by framing the importance of the natural environment, Indigenous knowledge and leadership, and future research directions that can contribute to this domain.

Ethnic differences in stroke outcomes in Aotearoa New Zealand: A national linkage study
Ethnic differences in post-stroke outcomes have been largely attributed to biological and socioeconomic characteristics resulting in differential risk factor profiles and stroke sub-types, but evidence is mixed. This study, published in the International Journal of Stroke, assessed ethnic differences in stroke outcome and service access in New Zealand (NZ) and explored underlying causes in addition to traditional risk factors.

Public Health (New Zealand)

Association Between Women's Exposure to Intimate Partner Violence and Self-reported Health Outcomes in New Zealand
Intimate partner violence (IPV) is increasingly recognized as a contributing factor for long-term health problems; however, few studies have assessed these health outcomes using consistent and comprehensive IPV measures or representative population-based samples. The objective of this study, published in JAMA Network Open, was to examine associations between women's lifetime IPV exposure and self-reported health outcomes.

A "bottom up" Health in All Policies program: Supporting local government wellbeing approaches
A wellbeing economy requires multiple inputs to enable the wholistic vision of a sustainable healthy population and planet. A Health in All Policies (HiAP) approach is a useful way to support policy makers and planners to implement the activities required to support a wellbeing economy. Aotearoa New Zealand's Government has explicitly set a path towards a wellbeing economy. This article, published in the Health Promotion Journal of Australia, reports on the utility of a HiAP approach in Greater Christchurch to achieving the shared societal goals of a sustainable healthy population and environment.

Quality Improvement (International)

Preventing falls in older people: the evidence for environmental interventions and why history matters
Falls in older people are common, with 1 in 3 people over 65 years of age and half of those over 80 years of age likely to have at least one fall each year. This Cochrane Review Editorial explores the Cochrane Reviews in the falls prevention in older people space.

Hospital Productivity (International)

A systematic review to identify the challenges to achieving effective patient flow in public hospitals
This systematic review, published in The International Journal of Health Planning and Management, aims to uncover the challenges related to patient flow from a whole public hospital perspective and identify strategies to overcome these challenges.

Emergency Department Services (International)

Main Features and Control Strategies to Reduce Overcrowding in Emergency Departments: A Systematic Review of the Literature
Overcrowding is a problem that affects emergency departments (ED) all over the world; it occurs due to a disproportion between user demand and the physical, human and structural resources available. Essential prerequisites to assessing and managing the phenomenon are its accurate measurement and an understanding of its impact. The objective of this systematic review, published in Risk Management and Healthcare Policy, is to identify the characteristics of the problem, analysing the proposed strategies aimed at improving patient flow, delay in services provided and overcrowding of emergency departments.

Emergency department crowding: an overview of reviews describing measures causes, and harms
Crowding in Emergency Departments (EDs) has emerged as a global public health crisis. Current literature has identified causes and the potential harms of crowding in recent years. The way crowding is measured has also been the source of emerging literature and debate. This study, published in the Internal and Emergency Medicine, aimed to synthesise the current literature of the causes, harms, and measures of crowding in emergency departments around the world.

Cardiovascular Disease and Diabetes (International)

Cardiovascular risk reduction with integrated care: results of 8 years follow up
Care groups organize integrated cardiovascular risk management programs in primary care for high-risk patients. Results of long-term cardiovascular risk management are scarce. The aim, published in BMC Primary Care, was to describe changes in low density lipoprotein cholesterol, systolic blood pressure and smoking between 2011 and 2018 in patients participating in an integrated program for cardiovascular risk management organized by a care group in the Netherlands.

Primary Health Care (New Zealand)

What is important for high quality rural health care? A qualitative study of rural community and provider views in Aotearoa New Zealand
While the general principles of healthcare quality are well articulated internationally, less has been written about applying these principles to rural contexts. Research exploring patient and provider views of healthcare quality in rural communities is limited. This study, published in Rural and Remote Health, investigated what was important in healthcare quality particularly for hospital-level care for rural communities in Aotearoa New Zealand.

Primary Mental Health (New Zealand)

The development and implementation of an enhanced digital alcohol screening algorithm and training package for primary health care settings
The aim of this project, published by the Health Promotion Agency, was to explore whether an improved alcohol screening tool for older adults could be integrated within primary health care settings.

Primary Mental Health (International)

Identifying patients with psychosocial problems in general practice: A scoping review
This scoping review, published in Frontiers in Medicine, aimed to comprehensively investigate what tools or methods have been examined in general practice research that capture a wide range of psychosocial problems (PSPs) and serve to identify patients and highlight their characteristics.

A Collaborative-Care Telephone-Based Intervention for Depression, Anxiety, and at-Risk Drinking in Primary Care: The PARTNERs Randomized Clinical Trial
Collaborative care (CC) could improve outcomes in primary care patients with common mental conditions. This article, published in Canadian Journal of Psychiatry, assessed the effectiveness of a transdiagnostic model of telephone-based CC (tCC) delivered by lay providers to primary care patients with depression, anxiety, or at-risk drinking.

A multicomponent digital intervention to promote help-seeking for mental health problems and suicide in sexual and gender diverse young adults: A randomized controlled trial
LGBTQ+ community’s higher susceptibility to worse mental health outcomes and more help-seeking barriers compared to the cis-heterosexual population. Despite the LGBTQ+ population facing higher mental health risks, there has been a dearth of research focusing on developing tailored interventions targeting them. This study, published in PLOS Medicine, aimed to assess the effectiveness of a digital multicomponent intervention in promoting help-seeking for mental health issues in LGBTQ+ young adults.

Weight Management (International)

Environmental determinants of childhood obesity: a meta-analysis
The increasing prevalence of childhood obesity has contributed to the growing global burden of chronic diseases over the life course, which has been largely attributed to obesogenic environments. This giant-scale review, published in The Lancet - Global Health, was done to translate existing obesogenic environmental studies into evidence-based governance for fighting childhood obesity and promoting life-course health.

Why do preconception and pregnancy lifestyle interventions show little evidence of success in preventing overweight and obesity in children? A scoping review
Adverse lifestyle factors in the periconception and early life period, including high maternal pre-pregnancy BMI and excessive gestational weight gain, are important risk factors for childhood obesity. Early prevention is key, but results from systematic reviews of preconception and pregnancy lifestyle interventions have shown mixed success in improving children's weight outcomes and adiposity. This review, published in The Lancet - Global Health, aimed to investigate the complexity of these early interventions and process evaluation components and authors' statements to improve understanding regarding their limited success.

Key Ministry of Health Publications

Best Practice Approaches to Addressing Racism – Lessons for the Aotearoa New Zealand Health System (Stage Two Literature Review)
This is the second literature review for phase one of Ao Mai te Rā: the Anti-Racism Kaupapa. This review explores best practice approaches to addressing racism in all its forms.

Anti-Racism Maturity Models – Lessons for the Aotearoa New Zealand Health System (Stage Three Literature Review)
This is the third and final literature review for phase one of Ao Mai te Rā: the Anti-Racism Kaupapa. This review examines the key features and characteristics of an anti-racism maturity model approach.

Whiria te Muka Tangata: Anti-Racism Systems Change
This publication outlines a preliminary systems change model that provides an organisational and system-level blueprint for anti-racism action in health.

COVID-19 Risk Among Disabled People
This report is a recent analysis undertaken by the Public Health Agency, Manatū Hauora regarding burden of COVID-19 disease in the disabled population who receive Disability Support Services (DSS).

Aotearoa New Zealand Sexually Transmitted and Blood Borne Infection Strategy 2023-2030
The Sexually Transmitted and Blood Borne Infection (STBBI) strategy provides a framework to achieve a reduction in infection rates, better outcomes for people living with sexually transmitted and blood borne infections, and elimination of hepatitis C, congenital syphilis and HIV transmission.

National HIV Action Plan for Aotearoa New Zealand 2023-2030
This plan outlines the path we need to take to eliminate human immunodeficiency virus (HIV) transmission and ensure that people living with HIV have healthy lives free from stigma and discrimination. The plan aims to reduce the morbidity and mortality of HIV and achieve equitable outcomes across all population groups.

Health Sector Initiative

South Canterbury DHB - Timaru Hospital’s first maxillofacial surgeries prove successful
The two maxillofacial surgeries – undertaken in early February, are the first ever to be completed in Timaru and were carried out by a Christchurch-based surgeon, supported by the Timaru Hospital team, and were a part of the Te Waipounamu’s work to reduce long waits across the region.

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.