Issue 282 - 17 August 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)

A window on the quality of Aotearoa New Zealand's health care 2019 – a view on Māori health equity
In the ongoing Window series from the Health Quality & Safety Commission, this report focuses on Māori health equity, but also draws on thinking and ideas from both the broader fields of health equity and Māori health advancement throughout. 

Te hauora karu o te iwi Māori: A comprehensive review of Māori eye health in Aotearoa/New Zealand
This article, published in Clinical & Experimental Ophthalmology, provides a summary of available data on Māori ocular health, highlighting significant disparities between Māori and non-Māori populations.

An ecological analysis of hope amongst Asian rainbow young people in Aotearoa New Zealand
Rainbow research tends to prioritise gender and sexuality experiences over the racialised experiences of Asian rainbow young people. Informed by an intersectional lens, this study, published in Culture, Health & Sexuality, employed a hope-based ecological framework to examine how multiple overlapping axes of oppression (e.g. cisgenderism, heterosexism and racism) shape the aspirations of these youth.

The role of sleep in health and health inequities in early childhood in Aotearoa New Zealand
This research, published in the Journal of the Royal Society of New Zealand, investigated associations between multiple aspects of sleep health and child health, and the role of sleep in ethnic health inequities in early childhood.

Deprivation trends in potentially avoidable medical hospitalisations of under-25-year-old Māori and non-Māori non-Pacific in Aotearoa New Zealand: a 20-year perspective
Unnecessary hospitalisations for preventable or treatable conditions provides an indication of the health of a country and its systems. This study, published in the Journal of the Royal Society of New Zealand, presents data on potentially avoidable hospitalisations of Māori and non-Māori non-Pacific (NMNP) under-25-year-olds for medical conditions during the period 2000–2019, with particular focus on the magnitude of inequity by area deprivation.

Quality Improvement (New Zealand)

Ngā Taero a Kupe: Whānau Māori experiences of in-hospital adverse events 
A report by the Health Quality & Safety Commission based on the information gathered during a research project of whānau Māori experiences of in-hospital adverse events.

Cancer Services (New Zealand)

Centralisation of specialist cancer surgery: an assessment of patient preferences for location of care in the upper South Island of New Zealand
A positive association between volume and outcome for certain operations has led to increasing centralization. The latter is associated with a greater travel burden for patients. This study, published in the ANZ Journal of Surgery, investigated patient preferences for location of care for cancer surgery.

Relationship between survivorship care plans and unmet information needs, quality of life, satisfaction with care, and propensity to engage with, and attend, follow-up care
The impact of survivorship care plans (SCPs) on the proximal and distal outcomes of adult and childhood cancer survivors, and parent proxies, is unclear. This study, published in Cancer, aimed to determine the relationship between SCP receipt and these outcomes.

Cardiovascular Disease and Diabetes (International)

Interventions for the uptake of evidence‐based recommendations in acute stroke settings
Receiving care in a stroke unit improves access to recommended evidence‐based therapies and patient outcomes. However, even in stroke units, evidence‐based recommendations are inconsistently delivered by healthcare workers to patients with stroke. Implementation interventions are strategies designed to improve the delivery of evidence‐based care. The objective of this Cochrane Review was to assess the effects of implementation interventions (compared to no intervention or another implementation intervention) on adherence to evidence‐based recommendations by health professionals working in acute stroke units.

Primary Health Care (International)

Patient-centered care frameworks, models and approaches: An environmental scan
Although the definition of patient-centered care (PCC) remains unclear, researchers and healthcare professionals describe the concept as treating the patient as a unique human being with consideration for their physical and psychosocial needs and emphasize the importance of shared-decision making between patients and healthcare professionals. Insight into the operationalisation of PCC at a practical level may be attained through exploring models and programs introduced by various governments. This article, published in Patient Experience Journal, is an environmental scan examining models, approaches, and programs of PCC implemented by the governments of nine developed countries at regional and national levels, aiming to understand better how PCC is operationalised.

Student-led pop-up health check clinics: innovative health prevention strategy for a low socioeconomic community
To improve preventative health screening in regional Victoria, Australia, a collaborative student-led health prevention strategy was initiated. The aim of this study, published in the Australian Journal of Primary Health, is to evaluate the impact of four health check clinics using a free ‘pop-up’ format within community settings.

Primary care engagement in health system change: a scoping review of common barriers and effective strategies
The complexity of health systems necessitates coordination between a multitude of stakeholders to enact meaningful change. Primary care physicians are a crucial partner to engage, as their investment and participation are critical to the success of any system-level initiative. The aim of this scoping review, published in BMC Primary Care, was to identify common barriers and effective strategies when engaging primary care physicians in designing and implementing health system change. 

Primary Mental Health (New Zealand)

"She Actually Sounds Like a Real Person" - Exploring Young Adults' Views About Aroha, a Chatbot for Stress Associated with the COVID-19 Pandemic
In March 2020, New Zealand was plunged into its first nationwide lockdown to halt the spread of COVID-19. The team behind this study rapidly adapted our existing chatbot platform to create Aroha - a wellbeing chatbot intended to address the stress experienced by young people aged 13-24 in the early phase of the pandemic. Aroha was made available nationally within two weeks of the lockdown and continued to be available throughout 2020. The objective of this study, published in JMIR Formative Research, was to evaluate the acceptability and relevance of the chatbot format and Aroha's content in young adults and to identify areas for improvement.

Understanding suicidality in Pacific adolescents in New Zealand using network analysis
Pacific adolescents in New Zealand (NZ) are three to four times more likely than NZ European adolescents to report suicide attempts and have higher rates of suicidal plans. This study, published in Suicide & Life-Threatening Behavior, used cross-sectional network analysis to model the relationships between suicidality, self-harm, and individual depression symptoms, whilst conditioning on a multi-dimensional set of variables relevant to suicidality.

Primary Mental Health (International)

Effectiveness of primary care interventions in conjointly treating comorbid chronic pain and depression: a systematic review and meta-analysis
Chronic pain and depression are highly comorbid, but the lack of consensus on the best treatment strategies puts patients at high risk of suboptimal care-coordination as well as health and social complications. This study, published in Family Practice, aims to quantitatively assesses how effective different primary care interventions have been in treating the comorbid state of chronic pain and depression. In particular, this study evaluates both short-term outcomes-based specifically on measures of chronic pain and depression during an intervention itself-and long-term outcomes or measures of pain and depression in the months after conclusion of the formal study intervention. 

Self‐directed self‐management interventions to prevent or address distress in young people with long‐term physical conditions: a rapid review
Comorbid distress in adolescents and young adults with physical long‐term conditions (LTCs) is common but can be difficult to identify and manage. Self‐directed self‐management interventions to reduce distress and improve wellbeing may be beneficial. It is unknown, however, which intervention characteristics are successful in supporting young people. This rapid review, published in Health Expectations, aimed to identify characteristics of self‐directed self‐management interventions that aimed, in whole or part, to address distress, wellbeing or self‐efficacy in this population.

Increased Immunisation (New Zealand)

Childhood vaccination uptake among children born in Aotearoa New Zealand based on parental nationality
Migrants and refugees generally experience immunization inequities compared to their host populations. Childhood vaccination coverage rates are influenced by a complex set of interrelated factors, including child and parental nativity. This study, published in Human Vaccines & Immunotherapeutics, examined coverage rates for MMR, pertussis, and HPV vaccines were compared among children born in Aotearoa New Zealand (NZ) of overseas-born parents or NZ-born parents.

Increased Immunisation (International)

Interventions for increasing the uptake of immunisations in healthcare workers: A systematic review
This systemic review, published in Vaccine, aimed to evaluate the effectiveness of interventions for increasing the uptake of immunisation in healthcare workers compared to no or alternative interventions.

Weight Management (New Zealand)

Change in the food environment and measured adiposity in adulthood in the Christchurch Health and development birth cohort, Aotearoa, New Zealand: A birth cohort study
This study, published in Health & Place, investigated associations between change in the food environment and change in measured body mass index (BMI) and waist circumference (WC) in the Christchurch Health and Development Study (CHDS) birth cohort.

'They're all individuals, none of them are on the same boat': barriers to weight management in general practice from the rural nurse perspective
The aim of this study, published in Primary Health Care Research & Development, was to explore nurses' experiences with, and barriers to, obesity healthcare in rural general practice.

Weight Management (International)

Interventions targeting children and young people's physical activity behavior at home: A systematic review
Increased time at home during the COVID-19 pandemic significantly decreased children's physical activity. This systematic review, published in PloS One, aimed to evaluate the effectiveness of children's home-based physical activity interventions, and identify 'active ingredients' underpinning these.

Key Ministry of Health Publications

Precision health: exploring opportunities and challenges to predict, prevent, diagnose, and treat health needs more precisely in Aotearoa New Zealand
This publication is the inaugural Manatū Hauora Long-term Insights Briefing on the topic of precision health. 

Ministry of Health Consultations & Events

Clozapine Survey 2023
The aim of this survey is to gain important insights into experiences of people who take clozapine and from healthcare professionals who support people who take clozapine in New Zealand. Survey closes 6th of October.

Health Sector Initiative

Patients benefitting from prescriber pathway for nurses
Faster access to medications for patients and extra support for senior clinicians are just some of the benefits Te Whatu Ora South Canterbury’s newest nurse prescribers are seeing as a result of their decision to upskill.

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.