Issue 300 - 16 May 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)

An integrative review of racism in nursing to inform anti-racist nursing praxis in Aotearoa New Zealand
The aim of this study, published in the Journal of Clinical Nursing, was to synthesise international literature to identify mechanisms that maintain racism in nursing and understand the factors that contribute to designing and implementing anti-racist praxis to inform nursing in Aotearoa New Zealand.

Health Equity (International)

The Landscape of Health Technology for Equity Deserving Groups in Rural Communities: A Systematic Review
Equity-deserving groups face well-known health disparities that are exacerbated by rural residence. Health technologies have shown promise in reducing disparities among these groups, but there has been no comprehensive evidence synthesis of outcomes. The purpose of this systematic review, published in the Community Health Equity Research & Policy, was to examine the patient, healthcare, and economic outcomes of health technology applications with rural living equity-deserving groups.

Nutrition & Physical Activity (New Zealand)

Comparison of ten policy options to equitably reduce children's exposure to unhealthy food marketing
Reducing children's exposure to unhealthy food marketing is crucial to combat childhood obesity. This study, published in Public Health Nutrition, aimed to estimate the reduction of children's exposure to food marketing under different policy scenarios and assess exposure differences by socioeconomic status.

Nutrition & Physical Activity (International)

A systematic review of culturally adapted physical activity interventions for culturally and linguistically diverse children and adolescents
Limited evidence shows culturally and linguistically diverse (CALD) children and adolescents are less active, compared to the general population. It is unclear, how physical activity interventions have been adapted for CALD children and adolescents to enhance engagement. This study, published in Preventive Medicine, aimed to review culturally adapted physical activity interventions targeting CALD children and adolescents.

Public Health (International)

Psychosocial and medication interventions to stop or reduce alcohol consumption during pregnancy
Despite the known harms, alcohol consumption is common in pregnancy. Rates vary between countries, and are estimated to be 10% globally, with up to 25% in Europe. The objective of this Cochrane Review was to assess the efficacy of psychosocial interventions and medications to reduce or stop alcohol consumption during pregnancy.

Respiratory syncytial virus vaccination during pregnancy for improving infant outcomes
Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections (LRTIs) in infants. Maternal RSV vaccination is a preventive strategy of great interest, as it could have a substantial impact on infant RSV disease burden. In recent years, the clinical development of maternal RSV vaccines has advanced rapidly. The objective of this Cochrane Review was to assess the efficacy and safety of maternal respiratory syncytial virus (RSV) vaccination for preventing RSV disease in infants.

Quality Improvement (International)

Overview of mental health and addiction adverse event review methods, types and approaches
The following overview, published by the Health Quality & Safety Commission, aims to help clinicians better understand the various adverse event review methodologies available.

Hospital Productivity (International)

Enhancing Hospital Pharmacy Operations Through Lean and Six Sigma Strategies: A Systematic Review
Hospital pharmacies are integral to the healthcare system, and evaluating the factors influencing their efficiency and service standards is imperative. This analysis, published in Cureus, offers global insights to assist in developing strategies for future enhancements. The objective is to identify the optimal Lean Six Sigma methodologies to improve workflow and quality of hospital pharmacy services.

Cancer Services (International)

Shared decision‐making for supporting women’s decisions about breast cancer screening
In breast cancer screening programmes, women may have discussions with a healthcare provider to help them decide whether or not they wish to join the breast cancer screening programme. This process is called shared decision‐making (SDM) and involves discussions and decisions based on the evidence and the person's values and preferences. SDM is becoming a recommended approach in clinical guidelines, extending beyond decision aids. However, the overall effect of SDM in women deciding to participate in breast cancer screening remains uncertain. The objective of this Cochrane Review was to assess the effect of SDM on women's satisfaction, confidence, and knowledge when deciding whether to participate in breast cancer screening.

Cardiovascular Disease and Diabetes (New Zealand)

Health care delivery of kidney transplantation to indigenous Māori in Aotearoa New Zealand: A qualitative interview study with clinician stakeholders
Indigenous people experience higher rates of kidney failure than do non-Indigenous Peoples. However, compared to Indigenous patients, health care systems deliver kidney transplantation to non-Indigenous patients at a substantially higher rate and more frequently as the first treatment of kidney failure. Indigenous Māori patients in Aotearoa New Zealand report numerous barriers to kidney transplantation. This study, published in the Journal of Health Services Research & Policy, explores the perspectives of clinicians as stakeholders in the delivery of kidney transplantation.

Drivers of access to cardiovascular health care for rural Indigenous Peoples: a scoping review
Māori are disproportionately represented in cardiovascular disease (CVD) prevalence, morbidity and mortality rates, and are less likely to receive evidence-based CVD health care. Rural Māori experience additional barriers to treatment access, poorer health outcomes and a greater burden of CVD risk factors compared to Non-Māori and Māori living in urban areas. Importantly, these inequities are similarly experienced by Indigenous Peoples in other nations impacted by colonisation. Given the scarcity of available literature, a systematic scoping review, published in Rural and Remote Health, was conducted on literature exploring barriers and facilitators in accessing CVD health care for rural Māori and other Indigenous Peoples in nations impacted by colonisation.

Management of chronic kidney disease for Māori in Aotearoa New Zealand: a summary of clinical practice guidelines
Māori patients in New Zealand have long experienced poorer outcomes of kidney disease, including much higher rates of dialysis and lower rates of kidney transplantation. There is good science on how these statistics can be addressed by the medical system. This paper, published in The New Zealand Medical Journal, provides clear and concrete solutions to making the health system better and reducing the burden of kidney disease experienced in our communities.

Cardiovascular Disease and Diabetes (International)

The short and long-term efficacy of nurse-led interventions for improving blood pressure control in people with hypertension in primary care settings: a systematic review and meta-analysis
Previous systematic reviews suggest that nurse-led interventions improve short-term blood pressure (BP) control for people with hypertension. However, the long-term effects, adverse events, and appropriate target BP level are unclear. This study, published in BMC Primary Care, aimed to evaluate the long-term efficacy and safety of nurse-led interventions.

Primary Health Care (New Zealand)

Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA
Indigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review, published in BMC Health Services Research, identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements.

Primary Health Care (International)

Supporting best practice in the management of chronic diseases in primary health care settings: a scoping review of training programs for Indigenous Health Workers and Practitioners
To improve diabetes management in primary health care for the Aboriginal and Torres Strait Islander peoples population, training programs that are culturally and contextually relevant to the local context are required. Using a scoping review methodology, the aim of this review, published in the Australian Journal of Primary Health, was to describe the characteristics of chronic disease management training programs for Aboriginal Health Workers and Practitioners, their effectiveness on knowledge and skills, and client-related outcomes, and the enablers, barriers to delivery and participation.

Primary Mental Health (New Zealand)

Family-based Interventions of Preventing Substance Use Among Immigrant Youth: A Scoping Review
Immigrant youth face heightened risks of substance use due to the stress associated with immigration and acculturation. While parental intervention can have a preventative impact on substance use, parents need to be well-informed about substance use and effective interventions that can prevent substance use among immigrant youth. Such interventions ought to be culturally sensitive, family-based, and targeted at the specific substances that are prevalent in a given context. Identifying and curating interventions that can empower parents in addressing substance use can help mitigate the risks that immigrant youth may face. This scoping review, published in Substance Use: Research and Treatment, aimed to identify the types, characteristics, and effectiveness of family-based substance use intervention programs.

Mental health and aging in New Zealand: mixed-methods analysis of experiences of healthcare from a survey of older adults with mental health conditions
Little is known about the experiences of older people who seek mental healthcare in New Zealand. From a survey of 227 older people, this study, published in Kōtuitui, explored the use of mental healthcare services with quantitative and qualitative questions.

Primary Mental Health (International)

Interventions promoting recovery from depression for patients transitioning from outpatient mental health services to primary care: A scoping review
Major Depressive Disorder (MDD) is one of the most prevalent mental disorders worldwide with significant personal and public health consequences. After an episode of MDD, the likelihood of relapse is high. Therefore, there is a need for interventions that prevent relapse of depression when outpatient mental health care treatment has ended. This scoping review, published in PLOS One, aimed to systematically map the evidence and identify knowledge gaps in interventions that aimed to promote recovery from MDD for patients transitioning from outpatient mental health services to primary care.

Collaborative care approaches for people with severe mental illness
Collaborative care for severe mental illness (SMI) is a community‐based intervention that promotes interdisciplinary working across primary and secondary care. Collaborative care interventions aim to improve the physical and/or mental health care of individuals with SMI. The objective of this Cochrane Review was to assess the effectiveness of collaborative care approaches in comparison with standard care (or other non‐collaborative care interventions) for people with diagnoses of SMI who are living in the community.

Healthcare utilization patterns of individuals with depression after national policy to increase the mental health workforce in primary care: a data linkage study
The deployment of the mental health nurse, an additional healthcare provider for individuals in need of mental healthcare in Dutch general practices, was expected to substitute treatments from general practitioners and providers in basic and specialized mental healthcare (psychologists, psychotherapists, psychiatrists, etc.). The goal of this study, published in BMC Primary Care, was to investigate the extent to which the degree of mental health nurse deployment in general practices is associated with healthcare utilisation patterns of individuals with depression.

Smoking Cessation (International)

Effectiveness of Very Brief Advice on Tobacco Cessation: A Systematic Review and Meta-Analysis
Very brief advice (VBA; ≤ 3 min) on quitting is practical and scalable during brief medical interactions with patients who smoke. This study, published in the Journal of General Internal Medicine, aims to synthesise the effectiveness of VBA for smoking cessation and summarise the implementation strategies.

Oral Health (New Zealand)

The oral health status and treatment needs of adults with intellectual disabilities in Auckland
Adults with intellectual disabilities (ID) are known to have poor oral health and complex dental needs requiring treatment under general anesthesia (GA). This retrospective chart review, published in Special Care in Dentistry, aimed to provide information on the oral health status and treatment needs of adults with ID in Auckland.

Ministry of Health Consultations & Events

Proposed addition of diabetes medicines to the specified prescription medicines list for designated registered nurse prescribers in primary health and specialty teams
The Ministry of Health invites submissions on the addition of two classes of diabetes medicines to the list of specified prescription medicines for designated registered nurse prescribers. The Nursing Council of New Zealand (the Council) has recommended two classes of prescription-only diabetes medicines it considers appropriate for designated registered nurse prescribers in primary health and specialty teams. Manatū Hauora, on behalf of the Director-General of Health, must consult with those people or organisations that may be affected by a change to the specified prescription medicines before making a legal change by Gazette notice. This consultation closes on the 31st of May 2024.

Revised Code of Practice for Industrial Radiography: ORS C7
The Radiation Safety Act 2016 (the Act) is administered by the Ministry of Health. Section 86(1) of the Act allows the Director for Radiation Safety (the Director) to issue codes of practice. This is for the purpose of specifying technical requirements. The Code of Practice for Industrial Radiography: ORS C7 (C7) was first issued by the Director on 7 June 2019. Section 90(a) of the Act requires the Director to review a code of practice at least once every five years. Section 89(2) of the Act requires that the Director consult with any person who the Director reasonably considers is likely to be affected by a proposed amendment or revocation to a code of practice. The Director has produced a revised C7 for public consultation to meet the Directors’ duties under section 89(2) of the Act. This document sets out the revised C7. This consultation closes on the 5th June 2024. 

Health Sector Initiative

Taking a church-based approach to health and wellbeing
The Pasefika Family Health Group, the EFKS Puaseisei Church Magele and Otago University (Community Engagement) have partnered to create a new church-based community health initiative in South Auckland. The Puaseisei Health Centre, a parish satellite centre, is based at the EFKS Puaseisei Church Magele in Mangere East, and will provide the surrounding Pacific community with accessible healthcare and advice in familiar and safe surroundings.

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.