Issue 289 - 23 November 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 (International)

Interventions for improving health literacy in migrants
Health literacy (HL) is a determinant of health and important for autonomous decision‐making. Migrants are at high risk for limited HL. Improving HL is important for equitable promotion of migrants' health. The objective of this Cochrane Review was to assess the effectiveness of interventions for improving HL in migrants.

Health equity for persons with disabilities: a global scoping review on barriers and interventions in healthcare services
Persons with disabilities experience health inequities in terms of increased mortality, morbidity, and limitations in functioning when compared to the rest of the population. Many of the poor health outcomes experienced by persons with disabilities cannot be explained by the underlying health condition or impairment, but are health inequities driven by unfair societal and health system factors. This scoping review, published in the International Journal for Equity in Health, is a synthesis of the global evidence to identify the factors that hinder equitable access to healthcare services for persons with disabilities, and the interventions to remove these barriers and promote disability inclusion.

Quality Improvement (New Zealand)

Code of expectations for health entities’ engagement with consumers and whānau
The code of expectations for health entities’ engagement with consumers and whānau, published by the Health Quality & Safety Commission, sets the expectations for how health entities must work with consumers, whānau and communities in the planning, design, delivery and evaluation of health services.

Cancer Services (New Zealand)

Inequities in colonoscopy access: a retrospective audit of accepted referrals in Te Whatu Ora Counties Manukau
Māori are more likely to have colorectal cancer (CRC) diagnosed in the emergency setting. CRC patients diagnosed in the emergency setting have a higher stage, increased surgical complications and worse survival than those diagnosed elsewhere. Access to colonoscopy is crucial to diagnosing CRC prior to an emergency presentation. This study, published in The New Zealand Medical Journal, aims to assess inequities in access to symptomatic and surveillance colonoscopies.

Cardiovascular Disease and Diabetes (International)

Lifestyle Interventions to Prevent Type 2 Diabetes in Women with a History of Gestational Diabetes: A Systematic Review and Meta-Analysis through the Lens of Health Equity
Type 2 diabetes mellites is one of the health problems disproportionally affecting people with low socioeconomic statuses. Gestational diabetes mellites increases the risk of type 2 diabetes by up to ten-fold for women. Lifestyle interventions prevent type 2 diabetes in women with prior gestational diabetes. However, it is unknown if similar effectiveness can be expected for all population subgroups. This study, published in Nutrients, aims to assess the prevention of type 2 diabetes in women with prior gestational diabetes using population characteristics.

Uses of Social Determinants of Health Data to Address Cardiovascular Disease and Health Equity: A Scoping Review
Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Prior research suggests that social determinants of health have a compounding effect on health and are associated with cardiovascular disease. This scoping review, published in the Journal of the American Heart Association, explores what and how social determinants of health data are being used to address cardiovascular disease and improve health equity.

Primary Health Care (New Zealand)

Co-design of youth appropriate services for young people with rheumatic fever/rheumatic heart disease in Counties Manukau District
The aim of this study, published in the New Zealand Medical Journal, was to co-design a rheumatic fever service model which enables young people with acute rheumatic fever/rheumatic heart disease and their families to access the health and wellbeing services they need.

Transgender-related stigma and gender minority stress-related health disparities in Aotearoa New Zealand: hypercholesterolemia, hypertension, myocardial infarction, stroke, diabetes, and general health
Research has found that transgender-related enacted stigma-including discrimination, harassment, violence, cyberbullying, community rejection, and conversion efforts-is associated with negative mental health among transgender people. Transgender people also experience physical health disparities that could be due to chronic gender minority stress caused by stigma and prejudice. This study, published in The Lancet Regional Health - Western Pacific, compared a large New Zealand national survey of transgender participants with the New Zealand Health Survey (NZHS) with age and ethnicity weightings on stress-related health conditions and indicators.

Primary Health Care (International)

Supporting family carers in general practice: a scoping review of clinical guidelines and recommendations
Increasing numbers of family carers are providing informal care in community settings. This creates several challenges because family carers are at risk of poor physical and psychological health outcomes, with consequences both for themselves and those for whom they provide care. General Practitioners (GPs), who play a central role in community-based care, are ideally positioned to identify, assess, and signpost carers to supports. However, there is a significant gap in the literature in respect of appropriate guidance and resources to support them in this role. A scoping review, published in BMC Primary Care, was undertaken to examine clinical guidelines and recommendations for GPs to support them in their role with family carers.

Improving Equity of Services For Sexually Transmitted Infections Through Community Pharmacies: A Scoping Review
Pharmacists have the potential to improve care for marginalised populations. Stigmatised and racialised groups may not find traditional health services accessible in other settings. Research focused on healthcare access for these populations is fundamental in understanding how to improve health equity. The objective of this scoping review, published in Journal of the American Pharmacists Association, is to determine how health equity is addressed within services offered through community pharmacies for sexually transmitted infections.

Interventions for preventing or controlling healthcare-associated infection amongst healthcare workers or patients within primary care facilities: a scoping review
This review, published in the American Journal of Infection Control, aimed to synthesise the evidence on infection prevention and control (IPC) interventions for the prevention of healthcare-associated infection (HAI) amongst healthcare workers (HCW) or patients within primary care facilities.

People-centred primary health care: a scoping review
Integrated people-centred health services (IPCHS) are vital for ensuring comprehensive care towards achieving universal health coverage (UHC). The World Health Organisation (WHO) envisions IPCHS in delivery and access to health services. This scoping review, published in BMC Primary Care aimed to synthesise available evidence on people-centred primary health care (PHC) and primary care.

Primary Mental Health (New Zealand)

Dealing With Discrimination in Physical Health Care Services: Strategies of People With Mental Health and Substance Use Conditions
Discrimination against people with mental health and substance use conditions (MHSUC) by health professionals contributes to the poor physical health outcomes this group experiences. This article, published in Journal of Patient Experience, reported on a survey of people with MHSUC in Aotearoa New Zealand to explore how they experienced and responded to discrimination from physical health services.

Primary Mental Health (International)

Structural Racism and Lessons Not Heard: A Rapid Review of the Telepsychiatry Literature During the COVID-19 Public Health Emergency
The objective of this review, published in the Primary Care Companion for CNS disorders, was to assess the extent to which articles examining telepsychiatry after the start of the COVID-19 pandemic provided racial and sociodemographic characteristics for people receiving audiovisual (video) versus audio-only telepsychiatry.

Smoking Cessation (International)

Interventions to prevent or cease electronic cigarette use in children and adolescents
The prevalence of e‐cigarette use has increased globally amongst children and adolescents in recent years. In response to the increasing prevalence and emerging evidence about the potential harms of e‐cigarettes in children and adolescents, leading public health organisations have called for approaches to address increasing e‐cigarette use. The co‐primary objectives of this Cochrane Review was to evaluate the effectiveness of interventions to prevent e‐cigarette use in children and adolescents (aged 19 years and younger) with no prior use; and evaluate the effectiveness of interventions to cease e‐cigarette use in children and adolescents (aged 19 years and younger).

Oral Health (International)

Screening and Preventive Interventions for Oral Health in Adults: US Preventive Services Task Force Recommendation Statement
Oral health is fundamental to health and well-being across the life span. Dental caries (cavities) and periodontal disease (gum disease) are common and often untreated oral health conditions that affect eating, speaking, learning, smiling, and employment potential. Untreated oral health conditions can lead to tooth loss, irreversible tooth damage, and other serious adverse health outcomes. This statement published in JAMA, presents the US Preventive Services Task Force (USPSTF) recommendations of screening and preventive interventions for oral health in adults.

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.