Issue 295 - 7 March 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.

You can forward this newsletter to others who may be interested in receiving it. They can register and subscribe here. You can also access other recent issues of the digest here.

If you have any queries, please email us at library@health.govt.nz.

Have you heard about Grey Matter?

We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email library@health.govt.nz.

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

A partnership between Māori healing and psychiatry in Aotearoa New Zealand
This paper, published in BJPsych International, describes an example of Māori healing and psychiatry working together in an Indigenous mental health context in Aotearoa (New Zealand).

‘I was able to make a better decision about my health.’ Wāhine experiences of colposcopy at a marae‐based health clinic: A qualitative study
Equitable access to colposcopy services is required if we are to realise the benefit of the introduction of human papilloma virus (HPV) screening in Aotearoa New Zealand. This study, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, aimed to describe the experiences of wāhine (women) attending the marae‐based colposcopy clinic.

Health Equity (New Zealand)

Selective under-representation of Pacific peoples in population estimates for health indicator measurements in Aotearoa New Zealand misinforms policy making
The Census of Populations and Dwellings' is the five yearly population count of Aotearoa New Zealand. Best available populations (BAP) are subnational projections based on census data and demographic assumptions developed for healthcare planning and funding allocation but are also used as the denominator for health indicator monitoring. Pacific people are systematically undercounted, but the impact on health statistics is not well studied. For COVID-19 vaccination coverage, health service user (HSU) data were considered a more reliable denominator than BAP but introduced new biases. This study, published in BMC Public Health, aimed to understand how the choice of denominator population impacts estimates of population size and health system performance for Pacific people at a local level.

Experiences and Outcomes of Indigenous Patients Undergoing Bariatric Surgery: a Mixed-Method Scoping Review
Obesity and type 2 diabetes (T2D) are growing global health concerns. Evidence suggests that Indigenous peoples are at higher lifetime risk of obesity and its associated conditions. Obesity increases the risk of T2D, cardiovascular disease, and all-cause mortality. Bariatric surgery is the most sustained and effective intervention for treating obesity-associated medical problems. This review, published in Obesity Surgery, aims to explore the experiences and outcomes of Indigenous peoples undergoing bariatric surgery in Canada, the USA, Australia, and New Zealand (CANZUS).

Hauora Māori - Māori health: a right to equal outcomes in primary care –Health Equity
For more than a century, Māori have experienced poorer health than non-Māori. In 2019 an independent Tribunal found the Government had breached Te Tiriti o Waitangi by "failing to design and administer the current primary health care system to actively address persistent Māori health inequities". Many Māori (44%) have unmet needs for primary care. Seven models of primary care were identified by the funders and the research team, including Māori-owned practices. This study, published in the International Journal for Equity in Health, hypothesised patient health outcomes for Māori would differ between models of care.

What we do matters: Supporting anti-racism and decolonisation of public health teaching and practice through the development of Māori public health competencies
This research, published in the Australian and New Zealand Journal of Public Health, sought to expand on a set of core Māori hauora ā-iwi/public health competencies initially designed for teaching and to enable their use in workplaces.

Nutrition & Physical Activity (New Zealand)

A Multisource Process Evaluation of a Community-Based Healthy Lifestyle Programme for Child and Adolescent Obesity
Whānau Pakari is a healthy lifestyle assessment and intervention programme for children and adolescents with obesity in Taranaki (Aotearoa/New Zealand), which, in this region, replaced the nationally funded Green Prescription Active Families (GRxAF) programme. This study, published in Children, compared national referral rates from the GRxAF programme (age 5-15 years) and the B4 School Check (B4SC, a national preschool health and development assessment) with referral rates in Taranaki from Whānau Pakari.

Nutrition & Physical Activity (International)

Mobile health (m‐health) smartphone interventions for adolescents and adults with overweight or obesity
Obesity is considered to be a risk factor for various diseases, and its incidence has tripled worldwide since 1975. In addition to potentially being at risk for adverse health outcomes, people with overweight or obesity are often stigmatised. Behaviour change interventions are increasingly delivered as mobile health (m‐health) interventions, using smartphone apps and wearables. They are believed to support healthy behaviours at the individual level in a low‐threshold manner. The objective of this Cochrane Review was to assess the effects of integrated smartphone applications for adolescents and adults with overweight or obesity.

Early childhood (1-5 years) obesity prevention: A systematic review of family-based multicomponent behavioral interventions
Globally 38.9 million children under age 5 have overweight or obesity, leading to type 2 diabetes, cardiovascular complications, depression, and poor educational outcomes. Obesity is difficult to reverse and lifestyle behaviours (healthy or unhealthy) can persist from 1.5 years of age. Targeting caregivers to help address modifiable behaviours may offer a viable solution. The objective of this review, published in Preventive Medicine, was to evaluate the impact of multicomponent family interventions on weight-based outcomes in early childhood and explore related secondary behavior outcomes.

Profiles of Cultural Adaptation and Parenting Approach for Childhood Obesity in Lifestyle Interventions for Families With Young Children: A Systematic Review
Various interventions aim to reduce obesity and promote healthy lifestyles among different cultural groups. This systematic review, published in Family & Community Health, explored profiles of cultural adaptation and parenting approach of lifestyle interventions for families with young children (1-4 years).

Quality Improvement (New Zealand)

Healing, learning and improving from harm: National adverse events policy 2023 
The national adverse events policy 2023 was updated in February 2024. This update is informed by the Health Quality & Safety Commission framework of ‘he toki ngao matariki’ (resilient health care), which seeks to adopt a relational approach to health care focused on meeting the needs of the people within the system.

Raise the Flag II: sepsis mortality before and after the introduction of a whole-of-system quality improvement programme at a tertiary hospital in New Zealand
The objective of this article, published in The New Zealand Medical Journal, was to study in-patient mortality before and after the introduction of a whole-of-system sepsis quality improvement programme at a tertiary hospital in New Zealand.

Hospital Productivity (International)

Streamlining patient flow and enhancing operational efficiency through case management implementation
Improving patient flow in hospitals represents a worldwide healthcare challenge. The objective of this project, published in BMJ Open Quality, was to depict the effectiveness of case management in improving patient flow in a tertiary hospital setting.

Cancer Services (New Zealand)

Equity of travel to access surgery and radiation therapy for lung cancer in New Zealand – move health equity
Centralisation of lung cancer treatment can improve outcomes, but may result in differential access to care for those who do not reside within treatment centres. This study, published in Supportive Care in Cancer, used national-level cancer registration and health care access data and used Geographic Information Systems (GIS) methods to determine the distance and time to access first relevant surgery and first radiation therapy among all New Zealanders diagnosed with lung cancer, and compared these outcomes between ethnic groups.

Perceived barriers to self-collected HPV testing for cervical cancer screening, and knowledge of HPV: a survey of primary healthcare smear-takers across Aotearoa New Zealand
Cervical cancer remains a burden within Aotearoa New Zealand, with 2022 screening rates sitting 12.7% below target. The National Cervical Screening Programme has changed to primary human papillomavirus (HPV) testing for all screen-eligible people, with the aim for home self-testing. Little is known about the readiness of primary care for the change to self-testing and its associated challenges. A pilot HPV cervical cancer screening programme is being conducted in 17 practice centres. The aim of this study, published in The New Zealand Medical Journal, is to explore smear-taker knowledge at these centres about the use of primary HPV testing for cervical cancer screening.

Cancer Services (International)

"Somebody That can Meet you on Your Level:" Cancer Survivors' Perspectives on the Role of Indigenous Patient Navigators in Cancer Care
Cancer incidence has increased for First Nations and Métis Peoples in Canada over recent years. Despite a growing cancer burden, there remain challenges to accessing culturally appropriate and quality care in Saskatchewan. This study, published in The Canadian Journal of Nursing Research, aimed to explore, from cancer survivors' perspectives, the potential of Indigenous patient navigators to enhance the healthcare experiences of First Nations and Métis cancer survivors in Saskatchewan.

Emergency Department Services (International)

Geriatric Population Triage: The Risk of Real-Life Over- and Under-Triage in an Overcrowded ED: 4- and 5-Level Triage Systems Compared: The CREONTE (Crowding and R E Organization National TriagE) Study
Elderly patients, when they present to the emergency department (ED) or are admitted to the hospital, are at higher risk of adverse outcomes such as higher mortality and longer hospital stays. This is mainly due to their age and their increased fragility. In order to minimise this already increased risk, adequate triage is of foremost importance for fragile geriatric (>75 years old) patients who present to the ED. The admissions of elderly patients from 1 January 2014 to 31 December 2020 were examined, taking into consideration the presence of two different triage systems, a 4-level (4LT) and a 5-level (5LT) triage system. This study, published in the Journal of Personalized Medicine, analyses the difference in wait times and under- (UT) and over-triage (OT) in geriatric and general populations with two different triage models.

Cardiovascular Disease and Diabetes (International)

The effectiveness of chronic disease management planning on self-management among patients with diabetes at general practice settings in Australia: a scoping review
Medicare provides significant funding to improve, encourage and coordinate better practices in primary care. Medicare-rebated Chronic Disease Management (CDM) plans are a structured approach to managing chronic diseases in Australia. These chronic disease care plans are intended to be a vehicle to deliver guideline-based / evidence-based care. However, recommended care is not always provided, and health outcomes are often not achieved. This scoping review, published in BMC Primary Care, aimed to identify the specific components of CDM plans that are most effective in promoting self-management, as well as the factors that may hinder or facilitate the implementation of these plans in general practice settings in Australia.

Primary Mental Health (International)

The effectiveness, implementation, and experiences of peer support approaches for mental health: a systematic umbrella review
Peer support for mental health is recommended across international policy guidance and provision. This systematic umbrella review, published in BMC Medicine, summarises evidence on the effectiveness, implementation, and experiences of paid peer support approaches for mental health.

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.

Health Sector Initiative

Revolutionary iwi-partnership aims to elevate dementia care for Māori
The University of Auckland has partnered with Ngāpuhi to develop support strategies for carers and whānau of kaumātua with mate wareware (dementia).

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.