Issue 273 - 30 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)

Te Ao Māori Framework
The Health Quality & Safety Commission has developed a Te Ao Māori Framework in partnership with Māori health providers, Whānau Ora providers and participating district health boards (now Te Whatu Ora districts) across Aotearoa New Zealand. The aim of the framework is to help services improve the quality of care given to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all.

“It’s Total Erasure”: Trans and Nonbinary Peoples’ Experiences of Cisnormativity Within Perinatal Care Services in Aotearoa New Zealand
Transgender and nonbinary (trans) people can face unique barriers to accessing gender-inclusive perinatal care. The present study, published in Women's Reproductive Health, explored trans people’s experiences of perinatal care in Aotearoa New Zealand.

Scoping review of telehealth use by Indigenous populations from Australia, Canada, New Zealand, and the United States
Telehealth has the potential to address health disparities experienced by Indigenous people, especially in remote areas. This scoping review, published in the Journal of Telemedicine and Telecare, aims to map and characterise the existing evidence on telehealth use by Indigenous people and explore the key concepts for effective use, cultural safety, and building therapeutic relationships.

Describing the health-related quality of life of Māori adults in Aotearoa me Te Waipounamu (New Zealand)
In Aotearoa me Te Waipounamu (New Zealand) there are considerable inequities in health status and outcomes for Māori. It is therefore important that the health status and preferences of Māori are specifically considered in healthcare policy and decision making. This paper, published in Quality of Life Research, describes the health-related quality of life of 390 Māori adults who took part in the NZ EQ-5D-5L valuation study.

Culturally Safe Neonatal Care: Talking With Health Practitioners Identified as Champions by Indigenous Families
The burden of health inequities borne by Indigenous peoples can be overwhelming, especially when mothers and newborns' lives are at stake and health services seem slow to invest in responsiveness. In Aotearoa (New Zealand), urgent action is required to eliminate persistent systemic inequities for Māori (Indigenous) whānau (family collectives that extend beyond the household). This Kaupapa Māori (by Māori, for Māori) qualitative study, published in Qualitative Health Research, aimed to explore the views of health practitioners identified as champions by whānau of preterm Māori infants.

Public Health (International)

Technology-based and digital interventions for intimate partner violence: A systematic review and meta-analysis
A growing body of research shows the promise and efficacy of technology-based or digital interventions in improving the health and well-being of survivors of intimate partner violence (IPV). This meta-analysis and systematic review, published in Campbell Systematic Reviews, provide critical insight from several randomized controlled trials (RCTs) on the overall short and long-term impact of technology-based interventions on the health and well-being of female IPV survivors.

Success of community-based system dynamics in prevention interventions: A systematic review of the literature
Systems thinking approaches are increasingly being used to help communities understand and develop responses to preventing complex health problems. Less is known about how success is characterized and what influences success in these approaches. This systematic review, published in Frontiers in Public Health, explores how concepts of success are understood and evaluated in the peer reviewed literature of studies using systems thinking in community prevention.

Quality Improvement (International)

Environmental interventions for preventing falls in older people living in the community
Falls and fall‐related injuries are common. A third of community‐dwelling people aged over 65 years fall each year. Falls can have serious consequences including restricting activity or institutionalisation. This Cochrane Review updates the previous evidence for environmental interventions in fall prevention. The objective was to assess the effects (benefits and harms) of environmental interventions (such as fall‐hazard reduction, assistive technology, home modifications, and education) for preventing falls in older people living in the community.

The use of Smart Environments and Robots for Infection Prevention Control: a systematic literature review
Infection prevention and control (IPC) is essential to prevent nosocomial infections. The implementation of automation technologies can aid outbreak response. This manuscript, published in the American Journal of Infection Control, aims at investigating the current use and role of robots and smart environments on IPC systems in nosocomial settings.

Cardiovascular Disease and Diabetes (International)

Unravelling the potential of social prescribing in individual-level type 2 diabetes prevention: a mixed-methods realist evaluation
Social prescribing (SP) usually involves linking patients in primary care with services provided by the voluntary and community sector. Preliminary evidence suggests that SP may offer a means of connecting patients with community-based health promotion activities, potentially contributing to the prevention of long-term conditions, such as type 2 diabetes (T2D). This study, published in BMC Medicine, explored the possible contribution of SP to individual-level prevention of T2D in a multi-ethnic, socio-economically deprived population in London, UK.

Implementation Science Perspectives on Implementing Telemedicine Interventions for Hypertension or Diabetes Management: Scoping Review
Hypertension and diabetes are becoming increasingly prevalent worldwide. Telemedicine is an accessible and cost-effective means of supporting hypertension and diabetes management, especially as the COVID-19 pandemic has accelerated the adoption of technological solutions for care. However, to date, no review has examined the contextual factors that influence the implementation of telemedicine interventions for hypertension or diabetes worldwide. This scoping review, published in the Journal of Medical Internet Research, adopted a comprehensive implementation research perspective to synthesise the barriers to and facilitators of implementing telemedicine interventions for the management of hypertension, diabetes, or both.

Screening for Prediabetes and Diabetes: Clinical Performance and Implications for Health Equity
In 2021, the U.S. Preventive Services Task Force recommended prediabetes and diabetes screening for asymptomatic adults aged 35–70 years with overweight/obesity, lowering the age from 40 years in its 2015 recommendation. The U.S. Preventive Services Task Force suggested considering earlier screening in racial and ethnic groups with high diabetes risk at younger ages or lower BMI. This study, published in American Journal of Preventive Medicine, examined the clinical performance of these U.S. Preventive Services Task Force screening recommendations as well as alternative age and BMI cutoffs in the U.S. adult population overall, and separately by race and ethnicity.

Structural Racism as an Upstream Social Determinant of Diabetes Outcomes: A Scoping Review
The objective of this study, published in Diabetes Care, was to evaluate the evidence on the role of structural racism as an upstream factor impacting diabetes outcomes, identify current gaps, and recommend areas for future work.

Primary Health Care (New Zealand)

"It was a very awkward consultation because I didn't know"-general practice staff experiences and challenges in providing healthcare to gender and sexual minority youth in Aotearoa New Zealand
Rainbow young people (RYP; people of diverse genders, sexualities, and variations in sex characteristics) face barriers accessing primary care, often report negative experiences and the need to educate clinicians on rainbow-specific issues. This study, published in Family Practice, explores general practice staff views and experiences of providing care to RYP.

Primary Health Care (International)

A rapid review of interventions to improve medicine self‐management for older people living at home
As people age, they are more likely to develop multiple long-term conditions that require complicated medicine regimens. Safely self-managing multiple medicines at home is challenging and how older people can be better supported to do so has not been fully explored. This study, published in Health Expectations, aimed to identify interventions to improve medicine self-management for older people living at home and the aspects of medicine self-management that they address.

Increasing the chance of dying at home: roles, tasks and approaches of general practitioners enabling palliative care: a systematic review of qualitative literature
Many elderly people wish to die at home but end up dying at the hospital. If the patient wishes to die at home, palliative care provided by General Practitioners (GPs) may increase the chance of dying at home, however, there is a lack of knowledge on how GPs should provide palliative care. This study, published in BMC Primary Care, aimed to identify roles, tasks and approaches of GPs enabling palliative care, by exploring the experiences of GPs, other healthcare professionals, patients, and relatives through a systematic review of the qualitative literature.

Primary Mental Health (New Zealand)

'An accident waiting to happen' - experiences of police officers, paramedics, and mental health clinicians involved in 911-mental health crises: a cross-sectional survey
First responders are increasingly called to assist people experiencing mental health crises but little research exists canvassing multi-agency perspectives of such work. The aim of this study, published in the Journal of Psychiatric and Mental Health Nursing, was to understand the views of police officers, ambulance and mental health staff attending mental health or suicide-related crises in Aotearoa New Zealand and to discover how they experience current models of cross-agency collaboration.

Weight Management (International)

Effects of nutritional intervention strategies in the primary prevention of overweight and obesity in school settings: systematic review and network meta-analysis
The objective of this review, published in BMJ Medicine, was to examine the effects of different nutritional intervention strategies in the school setting on anthropometric and quality of diet outcomes by comparing and ranking outcomes in a network meta-analysis.

Key Ministry of Health Publications

2021 COVID-19 Māori Health Protection Plan: December 2022 Monitoring Report
The December 2022 Māori COVID-19 Monitoring Report provides an overview of progress made against the 2021 COVID-19 Māori Health Protection Plan (the Māori Protection Plan) between May and November 2022.The Monitoring report is a supplementary to the 2021 COVID-19 Māori Health Protection Plan (the Protection Plan).

Health Sector Initiative

New Medical Bariatric Service for Counties Manukau
Te Whatu Ora Counties Manukau is setting up a new specialist weight management service to support healthy living and combat obesity in the South Auckland community. Te Mana Ki Tua, which is scheduled to start in mid-2023, includes wrap-around services to promote holistic well-being, low energy diets, health coaching, psychosocial support and healthy lifestyles. The co-designed programme will be available to support people and whaanau preparing for bariatric surgery, and as an alternative pathway for those not considering surgery.

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.