Issue 284 - 14 September 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 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)

Barriers to and Recommendations for Equitable Access to Healthcare for Migrants and Refugees in Aotearoa, New Zealand: An Integrative Review
The health system in Aotearoa New Zealand is predicated on equity in access to health services as a fundamental objective yet barriers to equitable access for migrant and refugees continue to exist. There is a paucity of studies that synthesise the experiences and realities of migrants, refugees and healthcare providers that hinder access to healthcare and provide recommendations to improve services. This review, published in the Journal of Immigrant and Minority Health, synthesised these barriers and recommendations, with an aim to improve equitable access to healthcare to migrants and refugees.

Racism, early psychosis, and institutional contact: A qualitative study of Indigenous experiences
There is evidence of Indigenous and ethnic minority inequities in the incidence and outcomes of early psychosis. Racism has been implicated as having an important role. The aim of this study, published in The International Journal of Social Psychiatry, was to use Indigenous experiences to develop a more detailed understanding of how racism operates to impact early psychosis outcomes.

Quality Improvement (New Zealand)

Frailty care guides Aotearoa New Zealand
As Aotearoa’s aged population increases, the recognition and treatment of frailty has become crucial to all health care environments. Frailty is a recognised clinical syndrome that requires specialised assessment and interventions. The Health Quality & Safety Commission has recently published the Frailty care guides. The 2023 edition includes mātauranga Māori (Māori knowledge) and cultural concepts relevant to caring for kaumātua (Māori elders) along with audio links for correct pronunciation of key te reo Māori kupu (words).

Paediatric early warning system (PEWS) preparation and implementation guide
The Health Quality & Safety Commission has developed a national paediatric early warning system (PEWS) to help clinicians identify hospitalised tamariki with the potential to become more unwell, so they can respond quickly.

Cancer Services (New Zealand)

Patients’ and clinicians’ views on shared decision making in cancer care: a qualitative study of Aotearoa New Zealand patients’ and clinicians’ perspectives
This study, published in the New Zealand Medical Journal, aimed to explore the perspectives of patients, clinicians and other cancer care stakeholders on shared decision making, and how and why shared decision making in cancer care can be viable and appropriate for patients and healthcare providers.

Teledermatology for Enhancing Skin Cancer Diagnosis and Management: Retrospective Chart Review
Skin cancer rates are at all-time highs, but the shortage of dermatologists compels patients to seek medical advice from general practitioners. A new referral pathway called the Suspected Skin Cancer (SSC) service was established to provide general practitioners in Waikato, New Zealand, with rapid diagnosis and treatment advice for lesions suspicious for skin cancer.  The aim of this study, published in JMIR Dermatology,  was to assess the quantity, quality, and characteristics of referrals to the SSC teledermatology service during its first 6 months.

Cardiovascular Disease and Diabetes (International)

A codesigned integrated kidney and diabetes model of care improves patient activation among patients from culturally and linguistically diverse backgrounds
Little is known about the relationship between patients' cultural and linguistic backgrounds and patient activation, especially in people with diabetes and chronic kidney disease (CKD). This study, published in Health Expectations, examined the association between culturally and linguistically diverse (CALD) background and patient activation and evaluated the impact of a codesigned integrated kidney and diabetes model of care on patient activation by CALD status in people with diabetes and CKD.

Primary Health Care (International)

Psychological therapies delivered remotely for the management of chronic pain (excluding headache) in adults
The objective of this Cochrane Review was to determine the benefits and harms of remotely‐delivered psychological therapies compared to active control, waiting list, or treatment as usual for the management of chronic pain in adults.

Examining nursing processes in primary care settings using the Chronic Care Model: an umbrella review
This systematic overview, published in BMC Primary Care, aims to provide a picture of the nursing processes and their characteristics in chronic disease management as reported in empirical studies, using the Chronic Care Model (CCM) conceptual approach.

Primary Mental Health (New Zealand)

Caregiver experiences of racism and child mental health outcomes: cross-sectional analysis from Aotearoa New Zealand
This study, published in the New Zealand Medical Journal, aimed to estimate the prevalence of vicarious racism experienced by children (0–14 years) in Aotearoa New Zealand and investigate the association between vicarious racism and diagnosed child mental health conditions.

Primary Mental Health (International)

Structured communication methods for mental health consultations in primary care: a scoping review
Majority of people with mental health problems attend primary care for support. Interventions that structure consultations have been found effective for physical health conditions and secondary mental health care. The aim of the review, published in BMC Primary Care, was to identify what tools or interventions exist to structure communication in primary care for appointments related to mental health problems and examine existing evidence for effectiveness for mental health and quality of life outcomes.

Increased Immunisation (International)

Behavioral interventions for vaccination uptake: A systematic review and meta-analysis
Human behaviour and more specifically behavioural insight-based approaches to vaccine uptake have often been overlooked. This systematic review, published in Health Policy, explored behavioural interventions to increase vaccine uptake.

Smoking Cessation (New Zealand)

Pacific Peoples’ Nicotine-Free Futures: Understanding Pacific Peoples’ perceptions and practices of vaping
Increased rates of smoking (nicotine use through tobacco) among the Pacific population have resulted in an urgent need to explore possible harm reduction techniques. This report, published by the Health Promotion Agency, uses Pacific research methodologies to present Pacific peoples’ attitudes towards vaping, in Aotearoa New Zealand. This report also intentionally draws attention to vaping as an Electronic Nicotine Delivery System (ENDS), as this reflects what vaping is in practice.

Smoking Cessation (International)

A systematic review of interventions to increase the use of smoking cessation services for women who smoke during pregnancy
Although many pregnant women accept referrals to stop‐smoking support, the uptake of appointments often remains low. The aim of this review, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, was to examine the success of interventions to increase the uptake of external stop‐smoking appointments following health professional referrals in pregnancy.

Oral Health (International)

Motivational interviewing for preventing oral morbidities in adults: Systematic review and meta‐analysis
This systematic review with meta‐analysis, published in Community Dentistry and Oral Epidemiology, was performed to assess whether motivational interviewing (MI) effectively prevents oral morbidities in adults.

Key Ministry of Health Publications

Weaving Insights – Summary report for the Rongoā Workstream
Weaving Insights is the summary report for engagement led by Manatū Hauora as part of the rongoā workstream which was progressed alongside the Therapeutic Products Bill.

Aotearoa New Zealand Strategic Framework for Managing COVID-19
The Aotearoa New Zealand Strategic Framework for Managing COVID-19 sets out the direction for the long-term management of COVID-19 for our country.

Health Sector Initiative

New vaccination van brings immunisation to Pacific communities
Making it easier for families to get their children immunised is one of the aims of a new vaccination van launched at Seugagogo Aoga Amata Preschool in Ōtāhuhu.

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.