Issue 274 - 13 April 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.

You can forward this newsletter to others who may be interested in receiving it. They can register and subscribe here. You can also access other recent issues of the digest here.

If you have any queries, please email us at library@health.govt.nz.

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.

Quality Improvement (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.

Quality Improvement (International)

Safer Care for Older Persons in (residential) Environments (SCOPE): a pragmatic controlled trial of a care aide-led quality improvement intervention
The increased complexity of residents and increased needs for care in long-term care (LTC) have not been met with increased staffing. There remains a need to improve the quality of care for residents. Care aides, providers of the bulk of direct care, are well placed to contribute to quality improvement efforts but are often excluded from so doing. This study, published in Implementation Science, examined the effect of a facilitation intervention enabling care aides to lead quality improvement efforts and improve the use of evidence-informed best practices.

Cancer Services (New Zealand)

Uptake, experiences and barriers to cervical screening for trans and non‐binary people in Aotearoa New Zealand
Little is known about experiences and barriers for trans and non-binary (TGNB) people eligible for cervical screening in Aotearoa New Zealand. The aim of this study, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, was to identify uptake, barriers and reasons for delaying cervical cancer screening among TGNB people in Aotearoa.

Palliative care and quality of life needs and outcomes for Māori with cancer: what do we know?
There are access, treatment and morbidity inequities for Māori (Indigenous people of New Zealand) with cancer in Aotearoa (New Zealand). This includes inequities in quality of life and experiences of the palliative care setting for Māori. This review, published in AlterNative, considers the context of palliative care and cancer quality of care for Māori, draws on evidence regarding access and challenges for Māori with cancer in the palliative setting and discuss how to achieve palliative care equity for Māori with cancer.

Emergency Department Services (International)

Effectiveness and implementation of interventions for health promotion in urgent and emergency care settings: an umbrella review
Urgent and emergency care (UEC) settings provide an opportunity to prevent ill-health and promote healthy lifestyles with potential to screen and deliver interventions to under-served, at-risk populations. The aim of this study, published in BMC Emergency Medicine, was to synthesise and summarise the evidence on the effectiveness and implementation of interventions for health promotion in UEC settings.

Cardiovascular Disease and Diabetes (New Zealand)

Exploring the Lived Experience of Self-Management Practices of Indigenous Men, Women, and Two Spirited Individuals Living with Type 2 Diabetes in Canada, the USA, Australia, and New Zealand: A Scoping Review
Indigenous men, women and two-spirted individuals have been significantly impacted by type 2 diabetes mellitus (T2DM) and its complications. It is believed that T2DM in Indigenous Peoples is a direct result of colonization and the introduction of changes to traditional Indigenous ways of knowing, being and living. The objective of this review, published in the Canadian Journal of Diabetes, was to explore what is currently known about the lived experience of self-managing diabetes in Indigenous men, women and 2S individuals living with T2DM in Canada, USA, Australia and New Zealand.

Cardiovascular Disease and Diabetes (International)

Interventions to Enhance Pre‐pregnancy Care for Women with Type 2 Diabetes: A Systematic Review of the Literature
The aim of this review, published in Diabetic Medicine, was to examine the content and impact of interventions that have been used to increase the uptake of pre-pregnancy care for women with type 2 diabetes, and their impact on maternal and fetal outcomes.

Primary Health Care (New Zealand)

Addressing rheumatic fever inequities in Aotearoa New Zealand: a scoping review of prevention interventions
Rheumatic fever is a preventable illness caused by untreated Group A Streptococcus (GAS) infection. Despite reductions in most high-income countries, rheumatic fever rates remain a concern in Aotearoa New Zealand. Pacific and Māori people are inequitably affected, with risk of initial hospitalisation due to rheumatic fever 12- and 24-fold more likely, respectively, compared to non-Māori and non-Pacific people. This scoping review, published in the Journal of Primary Health Care, aims to explore the range of interventions and initiatives in New Zealand seeking to prevent GAS and rheumatic fever, with a particular focus on Pacific and Māori.

Influence of a rural interprofessional education placement on the rural health workforce: working in primary care, rural settings, and with Māori
Pre-registration interprofessional rural immersion programmes provide students with first-hand insight into challenges faced in rural clinical practice and can influence future practice intentions. The impact of short rural and hauora Māori interdisciplinary placements on early healthcare careers is unknown. The aim of this study, published in the Journal of Primary Health Care, was to explore whether a 5-week rural interprofessional education programme influenced graduates’ choices to work in primary care, rurally, and with Māori patients.

Asian migrants navigating New Zealand primary care: a qualitative study
Information on the responsiveness of the New Zealand (NZ) health system to Asians to enable navigation of healthcare services is currently lacking. Barriers experienced by Asian patients to enable optimal navigation of, and engagement with, healthcare services are also sparse. This research, published in the Journal of Primary Health Care, aimed to document and analyse resources available on the websites of general practices that aid in optimal health care navigation for NZ Asians; and explore the barriers perceived by Asian migrants to navigating the NZ Health System, particularly primary care.

Understanding virtual primary healthcare with Indigenous populations: a rapid evidence review
Virtual care has become an increasingly useful tool for the virtual delivery of care across the globe. With the unexpected emergence of COVID-19 and ongoing public health restrictions, it has become evident that the delivery of high-quality telemedicine is critical to ensuring the health and wellbeing of Indigenous peoples, especially those living in rural and remote communities. The authors of this study, published in BMC Health Services Research, conducted a rapid evidence review from August to December 2021 to understand how high quality Indigenous primary healthcare is defined in virtual modalities.

Primary Mental Health (New Zealand)

Consumer, peer support, and lived experience guide for Aotearoa New Zealand
This guide, published by Te Pou, has been written for anyone involved with the consumer, peer support, and lived experience (CPSLE) workforce in mental health and addiction services in Aotearoa New Zealand.

Indigenous approaches to perinatal mental health: a systematic review with critical interpretive synthesis
Indigenous mothers and birthing parents experience significant inequities during the perinatal period, with mental health distress causing adverse outcomes for mothers/birthing parents and their infants. Limited literature is available to inform our understanding of solutions to these issues, with research primarily focusing on inequities. The aim of this systematic review, published in the Archives of Women's Mental Health, was to explore Indigenous approaches to treatment of perinatal mental health illness.

Primary Mental Health (International)

Alcohol, the overlooked drug: clinical pharmacist perspectives on addressing alcohol in primary care
This study, published in Addiction Science & Clinical Practice, explores clinical pharmacists' experiences of discussing alcohol with patients in their new role in UK primary care. It investigates their confidence with the subject of alcohol in routine practice and explores views on a new approach, integrating alcohol into the medication review as another drug directly linked to the patient's health conditions and medicines, rather than a separated 'healthy living' issue.

Non-pharmaceutical primary care interventions to improve mental health in deprived populations: a systematic review
Common mental health disorders are especially prevalent among people from socioeconomically disadvantaged backgrounds. Non-pharmaceutical primary care interventions, such as social prescribing and collaborative care, provide alternatives to pharmaceutical treatments for common mental health disorders, but little is known about the impact of these interventions for patients who are socioeconomically disadvantaged. The aim of this study, published in The British Journal of General Practice, was to synthesise evidence for the effects of non-pharmaceutical primary care interventions on common mental health disorders and associated socioeconomic inequalities.

Nudging General Practitioners to explore suicidal thoughts among depressed patients
While frank discussion of suicidal thoughts in patients with depression is important for the prevention of suicide, suicide exploration of General Practitioners (GPs) is suboptimal. This study, published in BMC Primary Care, aimed to assess whether an intervention that prompts pop-up screens nudges GPs to more frequently explore suicidal thoughts over the course of two years.

Weight Management (International)

Effectiveness of eHealth weight management interventions in overweight and obese adults from low socioeconomic groups: a systematic review
Low socioeconomic status (SES) is associated with increased rates of overweight and obesity. Proponents of electronic health (eHealth) hypothesise that its inclusion in weight management interventions can improve efficacy by mitigating typical barriers associated with low SES. The objective of this review, published in Systematic Reviews, was to establish the scope of eHealth weight management interventions for people with overweight and obesity from a low SES. Secondary objectives were to determine the efficacy of eHealth interventions in facilitating weight loss, physical activity and fitness improvements.

Disability Services (International)

Listening to people with severe or profound intellectual disabilities: a literature review
This article, published in Learning Disability Practice, presents a literature review that explores communication partners’ experiences of listening or attending to people with severe or profound intellectual disabilities during interactions.

Ministry of Health Consultations & Events

Quarterly Feedback Survey Ngā Paerewa Health and Disability Services Standard Implementation March 2023
HealthCERT continues to support the implementation of Ngā Paerewa Health and disability services standard (NZS 8134:2021). As part of the implementation and transition period, HealthCERT is running a regular survey to gather feedback from all stakeholders, including service providers, auditing agencies, health professionals, people and whānau who use these services. This survey closes on the 1st of May 2023.

Third HealthCERT team Implementation survey
This survey is to get an understanding from the HealthCERT team where additional training or support is required. This survey closes on the 1st of May 2023.

Health Sector Initiative

New surgery service at Hutt Hospital will help improve patient wait times – Te Whatu Ora - Health New Zealand
A new procedure suite in Hutt Valley Hospital has been opened. The multi-specialty, five-room procedure suite will enable care for patients in a more clinically-appropriate environment, without the need to go into the main operating theatre.

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.