Issue 297 - 4 April 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 Health NZ district 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)

Facilitators and barriers for implementation of health programmes with Māori communities
Addressing health inequities that Māori (Indigenous peoples) communities face in New Zealand is a key aim of researchers and practitioners. However, there is limited understanding of the implementation processes and outcomes of health programmes for addressing these inequities. The aim of this study, published in Implementation Science Communications, was to identify correlates of implementation outcomes and to identify facilitators and barriers to implementation effectiveness.

'Every strategy needs to be contributing to erasing the stigma': Māori and Pacific young people talk about overcoming barriers to testing for sexually transmitted infections
Māori and Pacific young people are disproportionately impacted by sexually transmitted infections (STIs). Access to STI screening is important to reduce transmission and reproductive health complications. The authors of this study, published in Sexual Health, held four wānanga (workshops) with Māori and Pacific participants (15-24years old) to find out what barriers they encounter to STI testing, and hear their ideas about how to overcome these.

'E koekoe te Tūī, e ketekete te Kākā, e kuku te Kererū, The Tūī chatters, the Kākā cackles, and the Kererū coos': Insights into explanatory factors, treatment experiences and recovery for Māori with eating disorders - A qualitative study
Eating disorders are as common in Māori, the Indigenous people of Aotearoa-New Zealand, as they are in non-Māori; however, research has focused on the experiences of non-Māori. This paper, published in The Australian and New Zealand Journal of Psychiatry, will describe explanatory factors, treatment experiences and what helps with recovery for Māori.

Quality Improvement (New Zealand)

Maternal morbidity review toolkit for maternity services 
This document forms the Health Quality & Safety Commission's maternal morbidity review toolkit.

Hospital Productivity (New Zealand)

Improving access to dermatology specialist care: review of a dermatologist- and general practitioner-integrated clinic model
This study, published in the Journal of Primary Health Care, presents an innovative model of integrated dermatology service delivery.

Cancer Services (New Zealand)

Ethnic inequities in use of breast conserving surgery and radiation therapy in Aotearoa/New Zealand: which factors contribute?
Aotearoa/New Zealand (NZ) faces ethnic inequities with respect to breast cancer survival and treatment. This study, published in Breast Cancer Research and Treatment, establishes if there are ethnic differences in the type of surgery and the receipt of radiotherapy (RT) following breast conserving surgery (BCS), among women with early-stage breast cancer in NZ.

Emergency Department Services (New Zealand)

A mapping review of interventions to address patients who frequently seek care in the emergency department
The high utilisation of acute care services, particularly emergency departments (ED), continues to be a significant concern for healthcare providers. Numerous approaches have been studied to meet the care needs of patients who frequently seek care in the ED; however, there is no comprehensive review of the current literature base. As such, a current understanding of the interventions initiated within the ED to address the needs of frequent users is required. This mapping review, published in BMC Emergency Medicine, had three objectives: identify the characteristics associated with the need to frequently seek care in the ED; identify interventions implemented to address the needs of this population; and identify gaps in the current evidence base.

Cardiovascular Disease and Diabetes (New Zealand)

Upholding te mana o te wā: Māori patients and their families' experiences of accessing care following an out-of-hospital cardiac event
The purpose of this study, published in the American Heart Journal Plus: Cardiology Research and Practice, was to explore the experiences of Māori patients and their families accessing care for an acute out-of-hospital cardiac event and to identify any barriers or enablers of timely access to care.

The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review
The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middle-income countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. This rapid review, published in the Journal of Primary Health Care, was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds.

Patient perceptions of barriers to attending annual diabetes review and foot assessment in general practice: a qualitative study
Regular diabetic foot checks, at least annually, are important for early identification of risk factors and prevention of ulceration and amputation. To ensure this, most general practices in Aotearoa New Zealand (NZ) offer free annual diabetes reviews (ADRs) which include a comprehensive foot evaluation. However, attendance rates at these ADRs are low. The aim of this study, published in the Journal of Primary Health Care, was to explore patients’ perspectives on the barriers to attending ADRs and foot checks.

Cardiovascular Disease and Diabetes (International)

The effectiveness of pharmacological and lifestyle interventions to reduce the risk of diabetes and hyperglycaemia following gestational diabetes: A systematic review and meta‐analysis
The aim of this review, published in Diabetic Medicine, was to synthesise the available evidence to better understand the effectiveness of interventions to prevent or delay hyperglycaemia and Type 2 diabetes mellitus (T2DM) postnatally in women with current or previous gestational diabetes mellitus (GDM).

Primary Health Care (New Zealand)

'I think we just do it once and leave it …' The collection and utility of family health history in general practice in Aotearoa New Zealand: a qualitative study
The value of family health history as a means to understanding health risk has been long known. Its value in a precision medicine context is also now becoming apparent. General practitioners (GPs) are considered to play a key role in the collection, and investigation, of family health history, but it remains widely reported as being both poorly and infrequently undertaken. Little is known about this practice in Aotearoa New Zealand (NZ). This study, published in the Journal of Primary Health Care, aimed to explore current practices in relation to the ascertainment of family health history, with a view towards precision medicine.

Nursing practices to optimise rheumatic fever prevention in a high-risk country: An integrative review
New Zealand is one of the last high-income countries in the world experiencing significant rates of rheumatic fever. Nurses play a crucial role in rheumatic fever prevention; however, little is understood as to how nurses can best achieve this. The aim of this study, published in the Journal of Clinical Nursing, was to explore nursing practices that optimise rheumatic fever prevention.

Primary Mental Health (International)

Are psychological therapies effective in reducing depression in older adults living in long-term care?
Depression is common amongst older people residing in long‐term care (LTC) facilities. Currently, most residents treated for depression are prescribed antidepressant medications, despite the potential availability of psychological therapies that are suitable for older people and a preference amongst many older people for non‐pharmacological treatment approaches. The objective of this Cochrane Review was to assess the effect of psychological therapies for depression in older people living in LTC settings, in comparison with treatment as usual, waiting list control, and non‐specific attentional control; and to compare the effectiveness of different types of psychological therapies in this setting.

Disability Services (New Zealand)

Working Together to Support Self-Determination for Tāngata Kāpō (Blind and Low Vision) Māori: An Exemplar
This paper, published in the International Journal of Environmental Research and Public Health, addresses the marginalisation of tāngata kāpō Māori (blind and low-vision Indigenous New Zealanders) in health- and vision-related research, despite New Zealand's commitments to international conventions. Utilising a pūrākau-based approach, it challenges existing colonial narratives and emphasises the importance of Māori perspectives.

Ministry of Health Consultations & Events

HCSS Feedback Survey Ngā Paerewa Health and Disability Services Standard Implementation March 2024
HealthCERT is conducting a regular survey to gather insightful opinions regarding the implementation of the Ngā paerewa Health and disability services standard NZS 8134:2021 (Ngā Paerewa) within the health sector. This survey closes on the 29th April 2024.

Health Sector Initiative

Strengthening Te Tai Tokerau’s Oral Health Workforce
A collaboration between AUT and Health New Zealand - Te Tai Tokerau is addressing the oral health workforce shortage by supporting oral health bachelor students to work remotely and close to home.

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.