Issue 279 - 6 July 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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Quality Improvement (New Zealand)

Healing, learning and improving from harm: National adverse events policy 2023 | Te whakaora, te ako me te whakapai ake i te kino: Te kaupapa here ā-motu mō ngā mahi tūkino 2023
This policy, published by the Health Quality and Safety Commission, provides a national framework for health and disability providers to continually improve the quality and safety of services for consumers, whānau and health care workers. It provides a consistent way to understand and improve through reporting, reviewing and learning from all types of harm. The policy will guide the process for reporting to the Commission and for using the information gathered from learning reviews, along with quality improvement approaches, to strengthen system safety.
 

Cancer Services (New Zealand)

Primary care experiences in the ‘Let’s test for HPV’ study: a qualitative analysis
The National Cervical Screening Programme (NCSP) will switch from cervical cytology to Human Papillomavirus (HPV) testing as the primary cervical screening modality in 2023. To prepare for rollout, an implementation study of HPV testing in primary care commenced in August 2022 in three different geographic regions in NZ. This study, published in the Journal of Primary Health Care, explores Primary Care Staff’s experience of using the HPV testing pathway in the ‘Let’s test for HPV’ study so that recommendations can be made to improve the testing process before nationwide roll-out. 
 

Cancer Services (International)

Systematic Review of Models of Effective Community Specialist Palliative Care Services for Evidence of Improved Patient-Related Outcomes, Equity, Integration, and Health Service Utilization
The benefits of palliative care programs are well documented. However, the effectiveness of specialist palliative care services is not well established. The previous lack of consensus on criteria for defining and characterizing models of care has restrained direct comparison between these models and limited the evidence base to inform policy makers. This rapid review, published in the Journal of Palliative Medicine, aims to find an effective model.
 

Emergency Department Services (International)

Nurse-led emergency department avoidance model of care for patients receiving cancer therapy in the ambulatory setting: a health service improvement initiative
The Symptom and Urgent Review Clinic was a service improvement initiative, which consisted of the implementation and evaluation of a nurse-led emergency department (ED) avoidance model of care. The clinic was developed for patients experiencing symptoms associated with systemic anti-cancer therapy in ambulatory cancer settings. This study, published in BMC Health Services Research, evaluated prospective data collected of the frequency and characteristics of patients who used the service, pre- and post-survey of patient reported experience, and a post-implementation survey of clinician engagement and experience.
 

Cardiovascular Disease and Diabetes (New Zealand)

Screening, diagnosing and management of Pacific peoples with prediabetes in New Zealand primary healthcare clinics with high concentrations of Pacific peoples: an online survey
Prediabetes is a condition of elevated blood sugar levels which can increase the risk of type 2 diabetes (T2D) if not managed effectively. Prediabetes is likely to affect about 24.6% of New Zealand (NZ) adults, with estimates of 29% of the Pacific population currently living with the condition. A prediabetes diagnosis is an opportunity for intervention from trusted primary care providers. This study, published in the Journal of Primary Healthcare, aims to describe primary healthcare clinician’s knowledge and practice regarding screening, diagnosing and management of prediabetes in Pacific patients. 
 

Cardiovascular Disease and Diabetes (International)

Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease
Globally, cardiovascular diseases (CVD, that is, coronary heart (CHD) and circulatory diseases combined) contribute to 31% of all deaths, more than any other cause. In line with guidance in the UK and globally, cardiac rehabilitation programmes are widely offered to people with heart disease, and include psychosocial, educational, health behaviour change, and risk management components. Social support and social network interventions have potential to improve outcomes of these programmes, but whether and how these interventions work is poorly understood. This Cochrane Review aims to assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease
 

Primary Health Care (New Zealand)

Influencing Factors to mHealth Uptake With Indigenous Populations: Qualitative Systematic Review
This systematic review, published in JMIR mHealth and uHealth, suggests that mHealth can meet the needs of both patients and service providers when the mHealth intervention is culturally relevant, accounts for digital and health literacy, incorporates interactive components, is supported by workplaces, fits into health provider workflows, and meets security and confidentiality standards.

Characteristics and gender affirming healthcare needs of transgender and non-binary students starting hormone therapy in a student health service in Aotearoa New Zealand
Traditionally, gender-affirming hormonal therapy (GAHT) is initiated in secondary care, but a primary care based approach has been developed to reduce access barriers. This study, published in the Journal of Primary Health Care, aims to describe the demographics, hormone choices, and additional referrals made for young people initiating GAHT in a primary care setting in Aotearoa New Zealand. 
 

Primary Mental Health (New Zealand)

Do patients with mental health and substance use conditions experience discrimination and diagnostic overshadowing in primary care in Aotearoa New Zealand? Results from a national online survey
Quality of health care contributes to poor physical health outcomes for people with mental health and substance use conditions (MHSUC). This study, published in the Journal of Primary Healthcare, investigated experiences of people with MHSUC who sought help for a physical health condition in primary healthcare services, examining quality of care attributes via an online survey of adults who were accessing services for MHSUC in 2022. 

Internet-based cognitive behavioural therapy in the real world: Naturalistic use and effectiveness of an evidence-based platform in New Zealand
Internet-based cognitive behavioural therapy (iCBT) is an efficacious, scalable intervention that could help meet the significant demand for psychological treatment. Yet, there is limited real-world evidence for its effectiveness. This study, published in The Australian and New Zealand Journal of Psychiatry, investigated the use and effectiveness of a free iCBT programme ('Just a Thought') in New Zealand. 

An emerging framework for digital mental health design with Indigenous young people: a scoping review of the involvement of Indigenous young people in the design and evaluation of digital mental health interventions
Indigenous young people worldwide possess unique protective factors that support wellbeing. However, they experience mental illness at higher rates than their non-indigenous counterparts. Digital mental health (dMH) resources can increase access to structured, timely, and culturally tailored mental health interventions by reducing structural and attitudinal barriers to accessing treatment. The involvement of Indigenous young people in dMH resource development is recommended, however, no guidelines exist on how this can best be facilitated. This scoping review, published in Systematic Reviews, identified recommendations for undertaking participatory design with Indigenous young people and evaluated the current literature against these criteria and presents an emergent framework informed by the findings.
 

Primary Mental Health (International)

The effectiveness of nurse practitioner care for patients with mental health conditions in primary care settings: A systematic review
The nurse practitioner (NP) workforce is key to meeting the demand for mental health services in primary care settings. The purpose of this study, published in Nursing Outlook, is to synthesize the evidence focused on the effectiveness of NP care for patients with mental health conditions in primary care settings, particularly focused on primary care NPs and psychiatric mental health NPs and patients with anxiety, depression, and substance use disorders. 
 

Smoking Cessation (International)

Different doses, durations and modes of delivery of nicotine replacement therapy for smoking cessation
Nicotine replacement therapy (NRT) aims to replace nicotine from cigarettes. This helps to reduce cravings and withdrawal symptoms, and ease the transition from cigarette smoking to complete abstinence. Although there is high‐certainty evidence that NRT is effective for achieving long‐term smoking abstinence, it is unclear whether different forms, doses, durations of treatment or timing of use impacts its effects. This Cochrane Review aims to determine the effectiveness and safety of different forms, deliveries, doses, durations and schedules of NRT, for achieving long‐term smoking cessation. 

Smoking cessation interventions and abstinence outcomes for people living in rural, regional, and remote areas of three high-income countries: A systematic review
Tobacco smoking rates in high-income countries are greater in rural, regional, and remote (RRR) areas compared to cities. Yet, there is limited knowledge about interventions targeted to RRR smokers. This review, published in Nicotine and Tobacco Research, describes the effectiveness of smoking cessation interventions for RRR smokers in supporting smoking abstinence. 
 

Weight Management (International)

A rapid review of the scalability of interventions targeting obesity prevention in infants
Obesity in children is one of the most significant public health issues globally. Given the high prevalence of overweight and obesity in children, there is a need to identify effective obesity prevention efforts that can be delivered at scale to improve child health. This study, published in the Health Promotion Journal of Australia, aimed to identify obesity prevention interventions targeted at children aged 0-2 that have been scaled-up, their relative efficacy compared to their pre-scale trial, describe adaptations made, and the extent to which factors related to scalability have been reported. 
 

Disability Services (International)

What is the efficacy and effectiveness of telemedicine intervention for deaf signing populations in comparison to face-to-face interventions? A systematic review
Deaf signing populations face inequality in both access to health services and health outcomes. Telemedicine intervention might offer a potential solution to address these inequalities in mental health and health related services, therefore a systematic review was carried out. This systematic review, published in BMC Health Services Research, investigated the efficacy and effectiveness of telemedicine intervention for Deaf signing populations in comparison to face-to-face interventions. 
 

Key Ministry of Health Publications

Whakamaua Quantitative Dashboard: Year Three
This publication is an interactive web tool showing a statistical overview of the 13 quantitative measures for Whakamaua: the Māori Health Action Plan 2020:2025 

Racial Discrimination 2011/12, 2016/17 and 2020/21: New Zealand Health Survey
This report presents information on adults’ experiences of racial discrimination in the past 12 months and over their lifetime. This includes the experience of ethnically motivated personal attack (physical or verbal), and experience of unfair treatment in healthcare, employment or housing. Data was collected from the racial discrimination module included in the 2011/12, 2016/17 and 2020/21 New Zealand Health Survey. 
 

Ministry of Health Consultations & Events

New Zealand Health Survey Feedback - New Zealand Ministry of Health - Citizen Space
The purpose of this questionnaire is to gather information about how New Zealand Health Survey results are shared, uncover which New Zealand Health Survey data products people find most useful, and identify ways to improve them. They are interested in hearing from people who use, or may potentially use, New Zealand Health Survey data. Feedback closes 27 July 2023.
 

Health Sector Initiative

Kurawaka Waipapa tells unique stories through its design and finishes
Kurawaka Waipapa, Canterbury’s new central city birthing unit, will boast a unique and purposeful interior design that reflects the values of our community. The interior design of Kurawaka is inspired by natural birthing practices, cultural awareness, whānau/family experience, and inclusiveness. The themes also include New Zealand flora and fauna, regional landmarks, and sustainability. 
 

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.