Issue 287 - 26 October 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)

Engaging with whānau to improve coronial investigations into rangatahi suicide. 
This article, published in Kōtuitui, reports the findings of two studies of the Aotearoa coronial service that sought to understand how coronial processes engage with whānau who have lost a rangatahi to suicide. Current efforts to embed Te Tiriti o Waitangi in government policy provide an ideal opportunity to adopt a Tiriti-based approach to coronial investigations so that they align with the needs of whānau in ways that contribute to culturally appropriate suicide investigation, suicide prevention and postvention initiatives. 

Reflections on the Prospective Outcomes of Injury Study (POIS; 2006-2023): how population-based research can address Māori outcomes and governance. 
Injury is a leading cause of disability. Twenty years ago, we knew financial costs of injury were high but little was known about the short, medium and long-term outcomes after injury. In 2006, a Pilot Study and engagement with Māori across the country was undertaken to discuss the planned main study to understand how best to design a study that was meaningful and beneficial to Māori and policy-makers. This paper, published in Frontiers in Research Metrics and Analytics, focuses on the why, how and impacts of POIS, especially in relation to Māori design and approaches, capability and capacity building, and leadership. 
 

Health Equity (International)

A scoping review of equity-focused implementation theories, models and frameworks in healthcare and their application in addressing ethnicity-related health inequities.
Inequities in implementation contribute to the unequal benefit of health interventions between groups of people with differing levels of advantage in society. Implementation science theories, models and frameworks (TMFs) provide a theoretical basis for understanding the multi-level factors that influence implementation outcomes and are used to guide implementation processes. This study, published in Implementation Science, aimed to identify and analyse TMFs that have an equity focus or have been used to implement interventions in populations who experience ethnicity or ‘race’-related health inequities. 

Quality Improvement (New Zealand)

Patient representation in New Zealand general practice and rural health case-based teaching: a quality improvement exercise.
Healthcare inequity disproportionately affects minority populations in Aotearoa New Zealand. Healthcare providers may contribute to inequity due to their biases. The aim of this study, published in the Journal of Primary Health Care, was to review case-based teaching material to determine its representation of the New Zealand population, and whether there is potential to contribute to implicit bias. 

Enhancing effective healthcare communication in Australia and Aotearoa New Zealand: Considerations for research, teaching, policy, and practice.
This paper, published in PEC Innovation, presents a conceptual framework for enhancing effective healthcare communication in Australia and Aotearoa New Zealand.  This framework is designed to start conversations, to form the foundation of a dialogue about the priorities and key considerations for developing teaching curricula, professional development, and research programs related to healthcare communication, providing a set of values specifically for the unique contexts of Australia and Aotearoa New Zealand. It can also be used to guide interdisciplinary healthcare professionals in advancing research, teaching, policy, and practice related to healthcare communication.
 

Cardiovascular Disease and Diabetes (International)

Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight: A Systematic Review and Network Meta-Analysis.
Although benefits have been reported for most exercise modalities, the most effective exercise approaches for reducing insulin resistance in children and adolescents with excess weight and the optimal exercise dose remain unknown. This paper, published in JAMA Pediatrics, aims to compare exercise training modalities and their association with changes in insulin resistance markers among children and adolescents with excess weight and to establish the optimal exercise dose. 
 

Primary Health Care (International)

Interventions to improve the appropriate use of polypharmacy for older people.
Inappropriate polypharmacy is a particular concern in older people and is associated with negative health outcomes. Choosing the best interventions to improve appropriate polypharmacy is a priority, so that many medicines may be used to achieve better clinical outcomes for patients. This Cochrane Review assesses the effects of interventions, alone or in combination, in improving the appropriate use of polypharmacy and reducing medication‐related problems in older people.
 

Primary Mental Health (New Zealand)

Alcohol and masculinity within community sports clubs in Aotearoa New Zealand. 
Traditionally, males have been more involved in community sports, and they also consume alcohol at higher rates compared to other genders in Aotearoa NZ. The present study, published in Kōtuitui, drew on notions of gender and hegemonic masculinity to explore people's experiences of sports clubs, alcohol and masculinity. 
 

Primary Mental Health (International)

Effect of exercise intervention on depression in children and adolescents: A systematic review and network meta-analysis. 
This paper, published in the Journal of Affective Disorders, aimed to evaluate the effect of different exercise interventions on depressive symptoms in children and adolescents. It was concluded that exercise significantly improves depressive symptoms in children and adolescents, with aerobic exercise having the most significant effect. A 12-week, three-times-a-week, 40–50-min exercise intervention was found to be more effective in younger children and adolescents.

Mental health treatment programs for children and young people in secure settings: A systematic review. 
While there are mental health treatment programs for children and young people in secure settings (i.e., secure treatment programs) in many countries, there is a lack of transparency and consistency across these that causes confusion for stakeholders and challenges for the design and delivery of high-quality, evidence-based programs. This systematic review, published in the International Journal of Mental Health Systems, addresses two questions: What do mental health treatment programs for children and young people in secure community settings look like across jurisdictions? What is the evidence underlying the various components of these programs? 
 

Public Health (New Zealand)

Transdisciplinary stakeholder understandings of antimicrobial resistance: An integrative approach in Aotearoa New Zealand.
Antimicrobial resistance (AMR) is a complex public health issue, with a range of influences across human, animal, and environmental health. Given the complexity of the problem, the diversity of stakeholders, and the failure of current policies to curb AMR worldwide, integrative approaches are needed to identify effective actions. Underpinned by systems thinking and One Health principles, this qualitative study (published in the Australian and New Zealand Journal of Public Health) explored how diverse AMR experts in Aotearoa New Zealand perceive the main drivers and effects of AMR.
 

Public Health (International)

Exploring the factors that contribute to the successful implementation of antimicrobial resistance interventions: a comparison of high-income and low-middle-income countries.
Antimicrobial resistance (AMR) is a challenge to modern medicine. Interventions have been applied worldwide to tackle AMR, but these actions are often not reported to peers or published, leading to important knowledge gaps about what actions are being taken. Understanding factors that influence the implementation of AMR interventions and what factors are relevant in low-middle-income countries (LMICs) and high-income countries (HICs) were the key objectives of this exploratory study, published in Frontiers in Public Health, with the aim to identifying which priorities these contexts need. 
 

Oral Health (International)

Unfavourable beliefs about oral health and safety of dental care during pregnancy: a systematic review.
Oral conditions such as gingivitis and periodontitis are correlated with adverse pregnancy outcomes such as preeclampsia, preterm birth and low birth weight. Oral health-related unfavourable beliefs can have negative influences on oral health behaviours including hesitation in accessing preventative dental treatments and dental service utilization. The objective of this systematic review, published in BMC Oral Health, was to examine unfavourable beliefs that expectant or new mothers frequently hold about oral health and the safety of dental care during pregnancy. 
 

Disability Services (New Zealand)

Disabled People or Their Support Persons’ Perceptions of a Community Based Multi-Sensory Environment (MSE): A Mixed-Method Study. 
Multi-sensory environments (MSEs) are specialised spaces purposely designed to stimulate the senses, whilst providing a calming and relaxing environment for leisure and enjoyment, predominantly intended for disabled people. Most MSEs are in institutions, hospitals, or educational settings, with a few in community-based settings. This study, published in the International Journal of Environmental Research and Public Health, explored disabled users’ experiences of a community based MSE in a large metropolitan area in New Zealand, with a view to expanding access to MSE-type environments within the area. 
 

Key Ministry of Health Publications

National Polio Outbreak Preparedness and Response Framework for Aotearoa New Zealand.
The National Poliomyelitis Response Framework provides a toolkit for how Aotearoa would respond to various scenarios in which there was detection of polio, including a polio outbreak, in New Zealand.

Research, Evaluation and Monitoring of Illicit Tobacco in New Zealand: Baseline report 2022. 
This publication is the first in a series of reports designed to provide an independent baseline of illicit trade in tobacco in Aotearoa.

Ministry of Health Consultations & Events

Quarterly Feedback Survey Ngā Paerewa Health and Disability Services Standard Implementation September 2023
HealthCERT continues to support the implementation of Ngā Paerewa Health and disability services standard NZS 8134:2021 (Ngā Paerewa). As part of the implementation and transition period, HealthCERT is running a regular survey to gather feedback from all stakeholders, including service providers, health professionals, people and whānau who use these services. This survey aims to check in on how the transition is going so we can identify the most useful guidance and training to offer. This survey closes on the 31st October.
 

Health Sector Initiative

Parenting tool developed in South Canterbury
A tool to help parents guide their teens through the minefield of living in the 21st century has been specifically adapted for South Canterbury use. The Whānau Book covers practical advice on parent– teen relationships, communication, role modelling, boundaries, nutrition and aiding teenagers and young people to navigate such issues as social media, addiction, the pandemic, alcohol and drugs.

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.