Issue 294 - 22 February 2024

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.

Māori Innovation

An innovative Indigenous-led model for integrated COVID-19 case management in Auckland, New Zealand: lessons from implementation
In Aotearoa/New Zealand, the Indigenous Māori population have been more severely impacted than non-Māori throughout the COVID-19 pandemic, and less well served by NZ’s COVID-19 response. This case-study, published in the Frontiers in Public Health, describes an innovative Indigenous-led service delivery model, which was designed and implemented to improve the case and contact management of Māori with COVID-19 in Auckland.

Health Equity (International)

Assessing the effects of population-level political, economic and social exposures, interventions and policies on inclusive economy outcomes for health equity in high-income countries: a systematic review of reviews
A fairer economy is increasingly recognised as crucial for tackling widening social, economic and health inequalities within society. However, which actions have been evaluated for their impact on inclusive economy outcomes is yet unknown. The objective of this review, published in Systematic Reviews, was to identify the effects of political, economic and social exposures, interventions and policies on inclusive economy (IE) outcomes in high-income countries, by systematically reviewing the review-level evidence.

Quality Improvement (New Zealand)

Mental health and addiction quality improvement programme evaluation 2023
This report presents an evaluation of the mental health and addiction quality improvement programme. This programme was launched by the Health Quality and Safety Commission in July 2017.

Cancer Services (New Zealand)

Cancer Screening Services: What Do Indigenous Communities Want? A Systematic Review
Indigenous communities experience worse cancer outcomes compared with the general population partly because of lower cancer screening access. One-size-fits-all screening programs are unsuitable for reaching Indigenous communities. This review, published in JCO Global Oncology, summarised available evidence on the perspectives of these communities; with a view to informing the improvement of cancer screening services to achieve equitable access.

Emergency Department Services (International)

“Whatever journey you want to take, I’ll support you through”: a mixed methods evaluation of a peer worker program in the hospital emergency department
People who are unhoused, use substances (drugs and/or alcohol), and who have mental health conditions experience barriers to care access and are frequently confronted with discrimination and stigma in health care settings. The role of Peer Workers in addressing these gaps in a hospital-based context is not well characterized. The aim of this evaluation, published in BMC Health Services Research, was to outline the role of Peer Workers in the care of a marginalised populations in the emergency department; characterise the impact of Peer Workers on patient care, and to describe how being employed as a Peer Worker impacts the Peer.

Strategies to improve care for older adults who present to the emergency department: a systematic review
The aim of this systematic review, published in BMC Health Services Research, was to examine the relationship between strategies to improve care delivery for older adults in ED and evaluation measures of patient outcomes, patient experience, staff experience, and system performance.

Cardiovascular Disease and Diabetes (International)

Artificial intelligence in the risk prediction models of cardiovascular disease and development of an independent validation screening tool: a systematic review
A comprehensive overview of artificial intelligence (AI) for cardiovascular disease (CVD) prediction and a screening tool of AI models (AI-Ms) for independent external validation are lacking. This systematic review, published in BMC Medicine, aims to identify, describe, and appraise AI-Ms of CVD prediction in the general and special populations and develop a new independent validation score (IVS) for AI-Ms replicability evaluation.

Primary Health Care (New Zealand)

Evaluating the Feasibility of a Community Pharmacy-Delivered Behaviour Change Intervention to Reduce Reliever Reliance in Asthma
The aim of this study, published in Patient Preference and Adherence, was to evaluate the feasibility of a community pharmacy-delivered intervention to shift patients' beliefs about short-acting beta2 agonists (SABA) in asthma management. The study targeted individual beliefs about SABA and assessed actual SABA use, focusing on reducing SABA use as well as adherence to inhaled corticosteroids (ICS) as a preventive measure.

Enhancing Aotearoa, New Zealand's Free Healthline Service through Image Upload Technology
Healthline is one of the 39 free telehealth services that Whakarongorau Aotearoa/New Zealand Telehealth Services provides to New Zealanders. In early 2021, an image upload system for viewing service user-uploaded images was implemented into the Healthline service. The aim of this research, published in the International Journal of Telemedicine and Applications, was to understand the utilisation of Healthline's image upload system by clinicians and service users in New Zealand.

The accessibility of pharmacist prescribing and impacts on medicines access: A systematic review
Pharmacist prescribing has been introduced in several countries as a strategy to improve access to health care and medicines. However, the direct impacts of pharmacist prescribing on medicines access, and the overall accessibility of pharmacist prescribing services, are not well known. This systematic review, published in Research in Social & Administrative Pharmacy, aimed to assess the direct impacts of pharmacist prescribing on medicines access, and the accessibility of pharmacist prescribing services, in community and primary care settings.

Primary Health Care (International)

Integrating nurse practitioners into primary healthcare to advance health equity through a social justice lens: An integrative review
The aim of this review, published in the Journal of Advanced Nursing, was to develop a framework to guide the successful integration of nurse practitioners (NPs) into practice settings and, working from a social justice lens, deliver comprehensive primary healthcare which advances health equity.

Primary Mental Health (International)

Supporting Quality Integrated Care for Adolescent Depression in Primary Care: A Learning System Approach
Quality integrated care, which involves primary care and mental health clinicians working together, can help identify and treat adolescent depression early. This study, published in the International Journal of Integrated Care, explored systemic barriers to quality integrated care at the provincial level in Ontario, Canada using a learning system approach.

Impact of Primary Care-Mental Health Care Integration on Mental Health Care Engagement Across Racial and Ethnic Groups
Receiving mental health services as part of primary care in the Veterans Health Administration (VHA) might increase engagement in specialty mental health care. In this study, published in Psychiatric Services, the authors reexamined the association between primary care-mental health integration (PCMHI) and continued engagement in specialty mental health care for VHA patients and assessed differences by race and ethnicity.

Mental health integrated care models in primary care and factors that contribute to their effective implementation: a scoping review
In the state of Victoria, Australia, the 111-day lockdown due to the COVID-19 pandemic exacerbated the population's prevailing state of poor mental health. Of the 87% of Australians who visit their GP annually, 71% of health problems they discussed related to psychological issues. This review, published in the International Journal of Mental Health Systems, had two objectives to describe models of mental health integrated care within primary care settings that demonstrated improved mental health outcomes that were transferable to Australian settings, and to outline the factors that contributed to the effective implementation of these models into routine practice.

Increased Immunisation (New Zealand)

Vaccine decision making in New Zealand: a discrete choice experiment
Vaccine hesitancy is a significant threat to global health. A key part of addressing hesitancy is to ensure that public health messaging prioritises information that is considered important to the public. This study, published in BMC Public Health, aimed to examine how different vaccine characteristics affect public preferences for vaccines in New Zealand, what trade-offs they are willing to make between different vaccine characteristics, and how their preferences are affected by their vaccine-related conspiracy beliefs and COVID-19 vaccination status.

Weight Management (New Zealand)

Empowering Pacific Patients on the Weight Loss Surgery Pathway: A Co-designed Evaluation Study
Despite having the highest medical needs by population for weight loss treatment, Pacific patients in Aotearoa New Zealand face substantial levels of attrition in publicly funded weight loss surgery programs. The study, published in Obesity Surgery, evaluated a Pacific-led preoperative weight loss surgery program that was co-designed, delivered, and evaluated between 2020 and 2023.

Public Health (International)

Assessment of global antimicrobial resistance campaigns conducted to improve public awareness and antimicrobial use behaviours: a rapid systematic review
Public health campaigns with a well-defined outcome behaviour have been shown to successfully alter behaviour. However, the complex nature of antimicrobial resistance (AMR) creates challenges when evaluating campaigns aimed at raising awareness and changing behaviour. The aim of this systematic review, published in BMC Public Health, was to determine what campaigns have been conducted and which reported being effective at improving awareness of antimicrobial resistance and changing behaviour around antimicrobial use in members of the public.

Disability Services (International)

Strategies for addressing the needs of children with or at risk of developmental disabilities in early childhood by 2030: a systematic umbrella review
There are over 53million children worldwide under five with developmental disabilities who require effective interventions to support their health and well-being. However, challenges in delivering interventions persist due to various barriers, particularly in low-income and middle-income countries. This global systematic umbrella review, published in BMC Medicine, aims to assess the evidence on prevention, early detection and rehabilitation interventions for child functioning outcomes related to developmental disabilities in children under 5 years.

Health Sector Initiative

First Class Cardiology Training at Whangārei Hospital - Learning in the 'heart' of the North
Last year, Whangārei Hospital became a fully accredited advanced training site in cardiology. Dr Robert Michael is the first advanced trainee in cardiology at Whangārei Hospital.

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.