Issue 301 - 30 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.

Māori Innovation

Cultural and co-designed principles for developing a Māori kaumātua housing village to address health and social wellbeing
This paper, published in BMC Public Health, is a case study of a Māori (Indigenous people of New Zealand) organisation and their developmental processes in creating a kaumātua (older people) housing village for health and social wellbeing. This study identifies how a set of established co-design and culturally-centred principles were enacted when creating and developing the village.

The Tihei Rangatahi Research Programme: tailoring a community-based youth empowerment programme for rangatahi Māori
Empowering Indigenous youth in their communities and within their own social-cultural contexts is an essential approach to developing their capacity as community advocators. The authors of this study, published in AlterNative, adapted an established youth empowerment programme for use among 51 Indigenous New Zealand youth.

Health Equity (New Zealand)

Equity scorecard
This equity scorecard was developed by the Health Quality & Safety Commission as a tool to support you in your learning and help identify areas that might need more work or reflection to enable you to deliver on equity and comply with the principles of Te Tiriti o Waitangi.

Nutrition & Physical Activity (New Zealand)

A very-low-calorie diet (VLCD) intervention for the management of prediabetes and early Type 2 diabetes mellitus in a multi-ethnic cohort in Aotearoa New Zealand: The PROGRESS NZ feasibility study
Very-low calorie diets (VLCD) achieve weight loss and remission of Type 2 diabetes (T2DM), but efficacy and acceptability in non-European populations is less clear. This feasibility study, published in the Asia Pacific Journal of Clinical Nutrition, examines the impact of 10% weight loss through VLCD on metabolic and body composition outcomes in a multi-ethnic cohort of Aotearoa New Zealand (AoNZ) men with prediabetes/early T2DM, and VLCD tolerability/cultural acceptability.

Nutrition & Physical Activity (International)

Interventions to prevent obesity in children aged 5 to 11 years old
Prevention of obesity in children is an international public health priority given the prevalence of the condition (and its significant impact on health, development and well‐being). Interventions that aim to prevent obesity involve behavioural change strategies that promote healthy eating or 'activity' levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. The objective of this Cochrane Review was to assess the effects of interventions that aim to prevent obesity in children by modifying dietary intake or ‘activity’ levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events.

Interventions to prevent obesity in children aged 12 to 18 years old
Prevention of obesity in adolescents is an international public health priority. The prevalence of overweight and obesity is over 25% in North and South America, Australia, most of Europe, and the Gulf region. Interventions that aim to prevent obesity involve strategies that promote healthy diets or ‘activity’ levels (physical activity, sedentary behaviour and/or sleep) or both, and work by reducing energy intake and/or increasing energy expenditure, respectively. The objective of this Cochrane Review was to assess the effects of interventions that aim to prevent obesity in adolescents by modifying dietary intake or ‘activity’ levels, or a combination of both, on changes in BMI, zBMI score and serious adverse events.

Quality Improvement (New Zealand)

Increasing access to cataract surgery in Counties Manukau by optimising the clinical pathway: a quality improvement report
The aim of this paper, published in The New Zealand Medical Journal, was to report on the streamlining of the the cataract surgery pathway to improve the time from first specialist assessment (FSA) to surgery, while reducing the clinical priority assessment criteria (CPAC) score from 55 to 50.

What do clinical practice guidelines say about deprescribing? A scoping review
Deprescribing (medication dose reduction or cessation) is an integral component of appropriate prescribing. The extent to which deprescribing recommendations are included in clinical practice guidelines is unclear. This scoping review, published in BMJ Quality & Safety, aimed to identify guidelines that contain deprescribing recommendations, qualitatively explore the content and format of deprescribing recommendations and estimate the proportion of guidelines that contain deprescribing recommendations.

Emergency Department Services (International)

Improving Indigenous health equity within the emergency department: a global review of interventions
Indigenous health equity interventions situated within emergency care settings remain underexplored, despite their potential to influence patient care satisfaction and empowerment. This study, published in CJEM, aimed to systematically review and identify Indigenous equity interventions and their outcomes within acute care settings, which can potentially be utilized to improve equity within Canadian healthcare for Indigenous patients.

Health mediation does not reduce the readmission rate of frequent users of emergency departments living in precarious conditions: what lessons can be learned from this randomised controlled trial?
Severe overcrowding of emergency departments (EDs) affects the quality of healthcare. One factor of overcrowding is precariousness, but it has rarely been considered a key factor in designing interventions to improve ED care. Health mediation aims to facilitate access to rights, prevention, and care for the most vulnerable persons and to raise awareness among healthcare providers about obstacles in accessing healthcare. The primary aim of this study, published in BMC Emergency Medicine, was to determine whether health mediation intervention for frequent users of EDs living in precarious conditions could reduce the readmission rate at 90 days.

Asking patients if they have any questions can help improve patient satisfaction with medical team communication in the emergency department
It is well known that patient satisfaction with medical communication in the emergency department (ED) improves patient experience. Investing in good communication practices is highly desirable in the emergency setting. In the literature, very few studies offer evidence of effective interventions to achieve this outcome. The aim of this study, published in BMC Emergency Medicine, was to evaluate whether encouraging emergency physicians to ask if patients have questions at the end of the visit would improve patient satisfaction with medical communication.

Cardiovascular Disease and Diabetes (New Zealand)

Real time continuous glucose monitoring in high-risk people with insulin-requiring type 2 diabetes: A randomised controlled trial
The aim of this study, published in Diabetic Medicine, was to investigate the impact of real-time continuous glucose monitoring (rtCGM) on glycaemia in a predominantly indigenous (Māori) population of adults with insulin-requiring type 2 diabetes (T2D) in New Zealand.

Cardiovascular Disease and Diabetes (International)

Barriers and facilitators of self‐management of diabetes amongst people experiencing socioeconomic deprivation: A systematic review and qualitative synthesis
The number of people living with diabetes is rising worldwide and a higher prevalence of diabetes has been linked to those experiencing socioeconomic deprivation. Self‐management strategies are vital and known to reduce the risks of long‐term complications amongst people living with diabetes. Lack of knowledge about self‐care activity required to manage diabetes is a key barrier to successful self‐management. Self‐management interventions can be less effective in socioeconomically deprived populations which can increase the risk of exacerbating health inequalities. The purpose of this review, published in Health Expectations, is to identify and synthesise qualitative evidence on the barriers and facilitators of self‐management of diabetes amongst people who are socioeconomically disadvantaged.

Primary Health Care (New Zealand)

"Hurts less, lasts longer"; a qualitative study on experiences of young people receiving high-dose subcutaneous injections of benzathine penicillin G to prevent rheumatic heart disease in New Zealand
Four-weekly intramuscular (IM) benzathine penicillin G (BPG) injections to prevent acute rheumatic fever (ARF) progression have remained unchanged since 1955. A Phase-I trial in healthy volunteers demonstrated the safety and tolerability of high-dose subcutaneous infusions of BPG which resulted in a much longer effective penicillin exposure, and fewer injections. This article, published in PloS One, describe the experiences of young people living with ARF participating in a Phase-II trial of SubCutaneous Injections of BPG.

'Atawhai': a primary care provider-led response to family violence in Aotearoa New Zealand
As a key determinant of ill-health, family violence is inadequately responded to within Aotearoa New Zealand health policy and practice. Without adequate system support, health professionals can often be unsure of what to do, or how to help.  This paper, published in Archives of Public Health, reports on the development of 'Atawhai' which aims to make it easier for primary care professionals to respond to family violence.

Primary Mental Health (New Zealand)

From infancy to eight: How early maternal mental health, emotion reminiscing, and language shape children's mental health
This study, published in Development and Psychopathology, aimed to test the transmission of mental health difficulties from mother to child.

Smoking Cessation (New Zealand)

A Qualitative Analysis of How Underage Adolescents Access Nicotine Vaping Products in Aotearoa New Zealand
Despite policies setting a minimum legal sales age, youth continue to access electronic cigarettes (ECs). Evidence of rising youth vaping prevalence in many countries suggests existing measures have serious loopholes and raise important questions about how youth source vaping products. This study, published in Nicotine & Tobacco Research, explored how youth source ECs using in-depth interviews with 30 adolescents aged 16–17 who vaped at least once a month and lived in Aotearoa New Zealand.

Smoking Cessation (International)

Health Messaging Strategies for Vaping Prevention and Cessation Among Youth and Young Adults: A Systematic Review
This systematic review, published in Health Communication, evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults.

Oral Health (International)

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries
Dental caries, a common chronic disease of childhood, is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). The objective of this Cochrane Review was to assess the effects of interventions undertaken with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years).

Key Ministry of Health Publications

Rebalancing our food system
The report, by the Public Health Advisory Committee, examines the deficiencies of how we produce, distribute, and consume food in New Zealand and the approach needed to ensure our food system supports the health and wellbeing of all New Zealanders.

Life since the pandemic: How the COVID-19 pandemic experience has shaped public attitudes and beliefs on public health, infectious disease and vaccination
In June 2023, the Public Health Agency, within the Ministry of Health, commissioned research and evaluation agency Verian to undertake a series of research projects and population surveys into attitudes and behaviours related to public health measures following the COVID-19 pandemic. The purpose of this research was to examine the impact of COVID-19 on New Zealanders’ attitudes and behaviours towards public health measures and use this knowledge to better prepare the Ministry, and other decision makers, for future pandemics and other major health threats.

Interim Government Policy Statement Measures Snapshot Report 2022/23
The Ministry of Health – Manatū Hauora has developed a snapshot report to monitor the progress the health system is making on delivery against the Interim Government Policy Statement on Health 2022–2024 (iGPS). The iGPS set the Government’s priorities and expectations for the health system for 2022–2024 as well as the framework for the interim New Zealand Health Plan. The snapshot report contains national results for iGPS measures from the first year (2022/23) of the two-year interim period.

Ngā Paerewa Implementation Evaluation
The Ministry of Health commissioned Malatest International to conduct an independent evaluation of the implementation of Ngā paerewa Health and disability services standard NZS 8134:2021 (Ngā Paerewa). The implementation period ran from June 2021, when Ngā Paerewa was publicly available, to August 2023. The evaluation focused on the Ministry’s role in the implementation of Ngā Paerewa.

Health Sector Initiative

Workforce development hub to provide support to the mental health and addiction peer support workforce in Southern
A lived experience-led workforce development hub to support and mentor our growing consumer, peer support and lived experience (CPSLE) workforce across the Southern district has started.

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.