Issue 304 - 11 July 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)

Eye care following pre‐school vision screening: Data from the Growing Up in New Zealand study
This study, published in the Journal of Paediatrics and Child Health, aimed to determine adherence with follow‐up from the New Zealand pre‐school vision screening programme. The study also examined associations between pre‐school vision screening outcomes and cognitive measures assessed at the 54‐month follow‐up in the Growing Up in New Zealand study cohort.

Racism and Health Among Aotearoa New Zealand Young People Aged 15-24 years: Analysis of Multiple National Surveys
This Aotearoa New Zealand-based study, published in The Journal of Adolescent Health, addresses a gap in literature focusing on individual experiences of racism among adolescents and young adults and its links to health.

Quality Improvement (New Zealand)

A window on quality 2024: Turbulence, quality and the future
This report, published by the Health Quality & Safety Commission, highlights issues affecting the quality and safety of Aotearoa New Zealand’s health care system. In four parts, the report explores the impacts of the global COVID-19 pandemic and transformation of the health care system, changes in patient safety over 20 years, how the system has evolved since the pandemic and draws conclusions about priority areas of focus.

Sixteenth Annual Report of the Perinatal and Maternal Mortality Review Committee
The Sixteenth Annual Report of the Perinatal and Maternal Mortality Review Committee, published by the Health Quality & Safety Commission, aims to provide epidemiological analysis of perinatal mortality from 2007 to 2021, maternal mortality from 2006 to 2021, neonatal encephalopathy from 2010 to 2021 and COVID-19 impact on perinatal mortality; monitor and track trends and disparities to identify areas for improvement; and stimulate discussion around appropriate areas for further research.

Quality Improvement (International)

Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement
Falls are the leading cause of injury-related morbidity and mortality among older adults in the US. In 2018, 27.5% of community-dwelling adults 65 years or older reported at least 1 fall in the past year and 10.2% reported a fall-related injury. In 2021, an estimated 38 742 deaths resulted from fall-related injuries. This US Preventive Services Task Force (USPSTF) Recommendation Statement, published in JAMA, is based on a systematic review to evaluate the effectiveness and harms of primary care–relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling adults 65 years or older.

Cancer Services (New Zealand)

Ethnic differences in time to surgery for women with early stage breast cancer in Aotearoa/New Zealand: a population-based study
This study, published in The Lancet Regional Health: Western Pacific, evaluates whether there are ethnic differences in time to surgery in women with early-stage (1-3a) breast cancer in four NZ urban regions between 2000 and 2020 pre- and post- Faster Cancer Treatment (FCT) implementation, which was introduced to address inequities in cancer outcomes.

Cancer Services (International)

Cancer health awareness through screening and education: A community approach to healthy equity
This study, published in Cancer Medicine, examines the Cancer Health Awareness through screeNinG and Education (CHANGE) initiative delivers cancer awareness education with an emphasis on modifiable risk factors and navigation to screening for prostate, breast, and colorectal cancers to residents of public housing communities who experience significant negative social determinants of health.

Emergency Department Services (New Zealand)

How is enrolment with a general practice associated with subsequent use of the emergency department in Aotearoa New Zealand? A cohort study
This study, published in the Journal of Primary Health Care, aimed to explore the utilisation of general practice by enrolment status and subsequent use of an emergency department.

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. This systematic scoping review, published in Rural and Remote Health, examined literature exploring barriers and facilitators in accessing CVD health care for rural Māori and other Indigenous Peoples in nations impacted by colonisation.

Cultural safety in paramedic practice: experiences of Māori and their whānau who have received acute pre-hospital care for cardiac symptoms from paramedics
Cardiovascular disease is a major health issue for Māori that requires timely and effective first-response care. Māori report culturally unsafe experiences in health care, resulting in poor health outcomes. Research in the pre-hospital context is lacking. This study, published in the Journal of Primary Health Care, aimed to explore experiences of cultural (un)safety for Māori and their whānau who received acute pre-hospital cardiovascular care from paramedics.

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.

Emergent inequity of glycaemic metrics for Māori children with type 1 diabetes is negated by early use of continuous glucose monitoring
This study, published in The New Zealand Medical Journal, investigated if continuous glucose monitoring (CGM) in children with type 1 diabetes (T1D) within 12 months of being diagnosed modifies the development of glycaemic outcome inequity on the basis of either ethnicity or socio-economic status (SES).

Primary Health Care (New Zealand)

Unmet need for primary health care and subsequent inpatient hospitalisation in Aotearoa New Zealand. A cohort study
The inability to afford a consultation with a general practitioner may lead to delays in accessing care pathways. This study, published in the Journal of Primary Health Care, aimed to explore the characteristics of people by their unmet need for a general practitioner consultation because of cost, and the characteristics of subsequent inpatient hospitalisations.

Risk factors for respiratory syncytial virus-associated acute lower respiratory infection in children under five years: An updated systematic review and meta-analysis
Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection (ALRI) in young children. This article, published in the International Journal of Infectious Diseases, aimed to conduct an updated systematic review of risk factors for RSV-ALRI in children under five years.

Primary Health Care (International)

BETTER LIFE- guidelines for chronic disease preventive care for people aged 18–39 years: a literature review
The original ‘BETTER’ (Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care) approach consisted of a prevention-focused visit between participants aged 40–65 years and a “Prevention Practitioner” (PP), who empowered the participant to set achievable prevention and screening goals for cancers and chronic diseases. BETTER was successfully adapted for economically deprived communities (BETTER HEALTH) in Canada. The objective of this article, published in BMC Primary Care, was to conduct a review of guidelines in preparation for adapting the ‘BETTER HEALTH’ approach for younger adults aged 18–39 years living with lower income, a group known to have earlier mortality due to a higher prevalence of preventable chronic diseases than their peers with higher income.

Behavior Change Techniques Involved in Physical Activity Interventions for Children With Chronic Conditions: A Systematic Review
Behaviour change techniques (BCTs) have been extensively used in physical activity interventions for children, however, no systematic reviews have synthesised their effects. The present review, published in Annals of Behavioral Medicine, aimed to identify the most promising BCTs used in physical activity interventions.

Tailoring communication practices to support effective delivery of telehealth in general practice
The unprecedented increase in telehealth use due to COVID-19 has changed general practitioners’ (GP) and patients’ engagement in healthcare. There is limited specific advice for effective communication when using telehealth. Examining telehealth use in practice in conjunction with perspectives on telehealth as they relate to communication allows opportunities to produce evidence-based guidance for optimal use of telehealth, while also offering practitioners the opportunity to reflect on elements of their communicative practice common to both styles of consultation. The objective of this research, published in BMC Primary Care, was to develop evidence-based resources to support effective, person-centred communication when GPs and patients use telehealth.

Primary Mental Health (New Zealand)

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. This study, published in Kōtuitui, explored the use of mental healthcare services with quantitative and qualitative questions.

A community of practice intervention to increase education-focused mental health promotion actions among interdisciplinary professionals: a qualitative study
Through a unique, inter-sectoral and interprofessional initiative, practitioners from education, health and social service sectors were invited to participate in communities of practice, facilitated online. The focus was on building workforce capacity to address the mental health needs of children and youth. This paper, published in the Journal of Primary Health Care, explores interprofessional workforce development by translating knowledge from a mental health promotion initiative developed overseas into the Aotearoa New Zealand context.

Increased Immunisation (International)

Categorising interventions to enhance vaccine uptake or reduce vaccine hesitancy in the United Kingdom: A systematic review and meta-analysis
Vaccination is one of the most important public health interventions to combat infectious disease. However, vaccine hesitancy prevents us reaching the global target of vaccine uptake. This review, published in Vaccine, summarises all interventions designed to reduce vaccine hesitancy and increase vaccine uptake for all types of vaccines offered to adults (≥18 years) since 2000, in the United Kingdom.

Key Ministry of Health Publications

Government Policy Statement on Health 2024–2027
The Government Policy Statement on Health 2024-27 is the public statement of what Government expects the health system to deliver and achieve, and how success will be measured, monitored, and reported. The GPS sets the direction for the health system as a whole and incorporates the Government’s priorities. It sets the expectations for health entities to make sure they are working towards common goals that matter for New Zealanders.

HIV Monitoring Plan: Measuring progress against the National HIV Action Plan for Aotearoa New Zealand 2023-2030
The HIV Monitoring Plan sets out 52 indicators that that will be used to monitor New Zealand’s progress towards achieving the goals, targets, and overarching vision of the National HIV Action Plan for Aotearoa New Zealand 2023-2030.

Hauora Haumi Allied Health Report 2024
The Hauora Haumi Allied Health Report is intended to be a living document which serves as a point of reference to inform stakeholders about the breadth and depth of knowledge and skill contained within hauora haumi | allied health professions. It serves as a starting point and will be iteratively updated to include more hauora haumi | allied health professions over time.

Health Sector Initiative

Innovative dual health qualification addresses workforce issues
Auckland University of Technology (AUT) has launched a new pathway for paramedicine students to earn a second degree within a continuous four-year course of study. Created in conjunction with Health New Zealand, newly graduated students will be able to move straight into studying to become a Perioperative Practitioner (anaesthetic technician) for the first time. The programme commences in July this year, with the first students graduating next year with a degree in Perioperative Practice alongside their existing qualification.

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.