Issue 302 - 13 June 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

Introducing 'Ngaruroro', a New Model for Understanding Māori Wellbeing
Indigenous peoples around the world are revitalising their ancestral beliefs, practices, and languages, including traditional understandings of health and wellbeing. In the Aotearoa (New Zealand) context, several ground-breaking Māori health- and wellbeing-related models have emerged, each with their own scope and applications. This article, published in the International Journal of Environmental Research and Public Health, sought to explore and identify several key sources of wellbeing for Māori individuals.

Health Equity (New Zealand)

Long-term health conditions among household families in Aotearoa New Zealand: cross-sectional analysis of integrated Census and administrative data
Little is known about the extent to which families in Aotearoa New Zealand are affected by long-term health conditions (HCs). This study, published in the New Zealand Medical Journal, aimed to explore the rates of nine selected HCs among New Zealand family members within the same household.

Quality Improvement (International)

Rapid response systems, antibiotic stewardship and medication reconciliation: a scoping review on implementation factors, activities and outcomes
Many patient safety practices are only partly established in routine clinical care, despite extensive quality improvement efforts. Implementation science can offer insights into how patient safety practices can be successfully adopted. The objective of this study, published in BMJ Quality & Safety, was to examine the literature on implementation of three internationally used safety practices: medication reconciliation, antibiotic stewardship programmes and rapid response systems.

Cancer Services (New Zealand)

Preliminary assessment of using mobile point-of-care human papillomavirus (HPV) testing with the option of immediate colposcopy in a rural area in a high-income country: a case study
Cervical cancer is now preventable with human papillomavirus (HPV) vaccination and HPV screening. However, structural health system barriers in rural areas can inhibit screening access. Inequitable access for rural Māori is exacerbated by social determinants and racism. Pro-equity tools, such as self-taken swabs point-of-care (POC) testing, now exist. This study, published in the New Zealand Medical Journal, aimed to investigate whether POC HPV testing and immediate offer of colposcopy by a mobile colposcopy service is possible at a rural community event.

Colorectal cancer screening participation in First Nations populations worldwide: a systematic review and data synthesis
have poorer colorectal cancer (CRC) survival compared to non-First Nations populations. Whilst First Nations populations across the world are distinct, shared experiences of discrimination and oppression contribute to persistent health inequities. CRC screening improves survival, however screening rates in First Nations populations are poorly described. This study, published in EClinicalMedicine, seeks to define participation rates in CRC screening in First Nations populations worldwide, including New Zealand.

Cardiovascular Disease and Diabetes (New Zealand)

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, explored barriers and facilitators in accessing CVD health care for rural Māori and other Indigenous Peoples in nations impacted by colonisation.

Māori and Pacific families' experiences and perspectives of cardiovascular care; A qualitative study
This study, published in the Australian and New Zealand Journal of Public Health, aimed to understand the reasons behind evidence-practice gaps and inequities in cardiovascular care for Māori and Pacific people, as evidenced by the experiences and perspectives of patients and their families.

Cardiovascular Disease and Diabetes (International)

A systematic review of the mechanisms influencing engagement in diabetes prevention programmes for people with pre‐diabetes
The aim of this study, published in Diabetic Medicine, was to identify barriers and enablers that influence engagement in and acceptability of diabetes prevention programmes for people with pre‐diabetes.

Primary Health Care (International)

Physician perspectives of the community paramedicine at clinic (CP@clinic) and my care plan app (myCP app) for older adults
Community Paramedicine (CP) is an emerging model of care addressing health problems through non-emergency services. Little evidence exists examining the integration of an app for improved patient, CP, and family physician (FP) communication. This study, published in BMC Primary Care, investigated FP perspectives on the impact of the Community Paramedicine at Clinic (CP@clinic) program on providing patient care and the feasibility and value of a novel “My Care Plan App” (myCP app).

Primary Mental Health (New Zealand)

Le Va for Youth survey gives insights into Pasifika youth mental wellbeing
During Polyfest 2024, Le Va carried out a survey that captured the voices of more than 1,150 young people aged 16-24. With a focus on mental health and wellbeing, the survey explored factors that impact mental health, where our youth seek support and possible solutions.

Priority actions for improving population youth mental health: An equity framework for Aotearoa New Zealand
Symptoms of depression and anxiety have increased dramatically among Aotearoa New Zealand (Aotearoa) youth over the last decade, with widening inequities for Māori (Indigenous population). Increased access to quality timely treatment is essential, but not sufficient to reduce population rates of mental distress. Social determinants and other risk factors which increase the chances of mental health problems are cumulative, interact and are unequally distributed. Most of these risk factors are preventable. This paper, published in Mental Health & Prevention, presents a framework for improving youth mental health in Aotearoa building on global evidence, ‘Te Mauri’ (an Aotearoa prevention model) and young people's perspectives.

Healing and wellbeing outcomes of services for Aboriginal people based on cultural therapeutic ways: A systematic scoping review
Aboriginal Australians experience disproportionately high rates of mental health problems as the result of European colonisation, and Western evidence-based treatment has been strikingly ineffective in improving the situation. Cultural Therapeutic Ways is a culturally specific healing and wellbeing practice framework developed by the Victorian Aboriginal Child and Community Agency that focuses on culturally based practices, trauma awareness, and self-determination. Despite wide recognition of the importance of these elements in Indigenous healing and wellbeing programs, its measurable empirical impact is currently unclear. This paper, published in the American Journal of Community Psychology, summarises findings from a systematic scoping review to ascertain the published knowledge base for Cultural Therapeutic Ways and the gaps in knowledge that can inform future evaluation. Forty-two studies of programs that applied Cultural Therapeutic Ways with Indigenous participants from Australia, Canada, New Zealand, and the United States of America were identified from the literature search.

Understanding the impact of digital therapeutic engagement in promoting mental wellbeing for Pacific youth in Aotearoa New Zealand: an exploration of the literature
The Pacific population in Aotearoa New Zealand is youthful, with the majority (55%) being under the age of 25. This review, published in the International Journal of Mental Health Systems, aims to examine the therapeutic approaches, specifically in the digital space, that are proven effective when promoting wellness for Pacific youth.

Primary Mental Health (International)

Comorbidity of Depression and Diabetes: A Literature Review on Systemic Flaws in Healthcare and the Benefits of Collaborative Diagnosis and Treatment in Primary Care Settings
The increasing specialisation and dispersion of healthcare systems have led to a shortage of resources to address comorbidities. Patients with coexisting mental and physical conditions are disadvantaged, as medical providers often only focus on the patient's mental illness while neglecting their physical needs, resulting in poorer health outcomes. This study, published in Current Diabetes Reviews, aimed to shed light on the systemic flaws in healthcare systems that contribute to suboptimal health outcomes in individuals with comorbid diseases, including depression and diabetes. This paper also discusses the clinical and economic benefits of collaborative methods for diagnosing and treating depressive disorders in primary care settings.

Recognising and Responding to Suicide-Risk Factors in Primary Care: A Scoping Review
Most people who die by suicide have seen a primary care practitioner (PCP) in the year prior to death. PCPs could aim to intervene before suicidal behaviours arise by addressing suicide-risk factors noted in primary care consultations, thereby preventing suicide and promoting health and wellbeing. This study, published in the Journal of Prevention, aimed to conduct a rapid, systematic scoping review to explore how PCPs can effectively recognise and respond to suicide-risk factors.

Towards understanding and improving medication safety for patients with mental illness in primary care: A multimethod study
Medication safety incidents have been identified as an important target to improve patient safety in mental healthcare. This study, published in Health Expectations, explores the causes of preventable medication safety incidents affecting patients with mental illness.

Increased Immunisation (International)

Going (Anti)Viral: Improving HIV and HCV Screening and HPV Vaccination in Primary Care
Human immunodeficiency virus (HIV) and hepatitis C (HCV) screening and human papillomavirus (HPV) vaccine uptake remain suboptimal. To improve HIV and HCV screening and HPV vaccination, the authors of this study, published in the Joint Commission Journal on Quality and Patient Safety, implemented a quality improvement project in three southwestern Pennsylvania family medicine residency practices.

Key Ministry of Health Publications

Mental Health and Problematic Substance Use
The New Zealand Health Survey (NZHS) included a module on mental health and problematic substance use (including tobacco, alcohol and illicit substance use) in 2016/17, 2021/22 and 2022/23. This report presents information and key results from the mental health and problematic substance use module.

Health Sector Initiative

A new mental health design approach wins international award
Two new mental health facilities in Ōtautahi Christchurch won the title of Project of the Year - New Build International at the Design in Mental Health Awards ceremony in the United Kingdom.

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.