Issue 306 - 9 August 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)

Adolescent understanding of concepts related to the developmental origins of health and disease: a Pacific perspective
The Developmental Origins of Health and Disease (DOHaD) framework has highlighted the link between an adverse early life environment and later disease risk. There is an increasing focus on adolescents as the next generation of parents as DOHaD agents of change to break the disease cycle. However, DOHaD awareness in adolescents is key to enabling knowledge uptake and behavioural change, particularly in Pacific adolescents who have a higher non-communicable disease (NCD) burden. The present study, published in the Journal of the Royal Society of New Zealand, investigated understanding of DOHaD-related concepts among Pacific, Māori and other ethnic groups in New Zealand.

Midwifery experiences in rural Southern Aotearoa New Zealand: insights into pre-eclampsia management
This study, published in The New Zealand Medical Journal, investigated the experiences of rural midwives in the Southern region of Aotearoa New Zealand, focussing on practices and challenges in caring for pregnant individuals displaying signs of pre-eclampsia.

Nutrition & Physical Activity (New Zealand)

Initiatives and exposures associated with food security in remote and isolated communities: a scoping review
Chronic household food insecurity (HFI) and lack of food availability and accessibility in isolated communities are longstanding public health crises. This review, published in Rural and Remote Health, aims to paint a more fulsome picture of food security initiatives in remote and isolated communities by examining programs across circumpolar countries, Australia, and Aotearoa New Zealand.

Quality Improvement (New Zealand)

Rehabilitation collaborative review: 1 year on 
This document published on the Health Quality & Safety Commission is a summary of the state of the rehabilitation collaborative: 1 year on from completion of the projects.

Quality Improvement (International)

Implementation Strategies for Quality Improvement in Palliative Care: A Scoping Review
Quality improvement (QI) programs based on person‐centred outcome measures (PCOMs) play an important role in promoting optimal palliative care. However, routine use of PCOMs has been slow and difficult to implement, including within QI programs. This study, published in Health Expectations, aimed to identify implementation strategies that support the implementation of PCOMs as routine practice in hospital‐based palliative care, as well as the implementation theories, models and frameworks (TMFs) guiding the design of these implementation strategies.

Cancer Services (New Zealand)

Utilisation of endocrine therapy for cancer in Indigenous peoples: a systematic review and meta-analysis
Indigenous peoples worldwide experience inequitable cancer outcomes, and it is unclear if this is underpinned by differences in or inadequate use of endocrine treatment (ET), often used in conjunction with other cancer treatments. Previous studies examining ET use in Indigenous peoples have predominately focused on the sub-national level, often resulting in small sample sizes with limited statistical power. This systematic review, published in BMC Cancer, aimed to collate the findings of articles on ET utilisation for Indigenous cancer patients and describe relevant factors that may influence ET use.

Improving cervical screening rates among sexual minorities: Insights from Aotearoa New Zealand
Sexual minority women (SMW) experience inequities in health outcomes. The extant literature consistently suggests that SMW are much less likely than their heterosexual peers to engage in cervical screening. Using participant's voices, the focus of this study, published in Health Promotion Journal of Australia, was to explore the ways in which cervical screening rates for SMW might be improved.

Emergency Department Services (New Zealand)

Interventions to improve equity in emergency departments for Indigenous people: A scoping review
Disparities in health outcomes, including increased chronic disease prevalence and decreased life expectancy for Indigenous people, have been shown across settings affected by white settler colonialism including Canada, the United States, Australia, and New Zealand. Emergency departments (EDs) represent a unique setting in which urgent patient need and provider strain interact to amplify inequities within society. The aim of this scoping review, published in Academic Emergency Medicine, was to map the ED-based interventions aimed at improving equity in care for Indigenous patients in EDs.

Cardiovascular Disease and Diabetes (New Zealand)

Provision of care for diabetic retinopathy in New Zealand: are there ethnic disparities?
Ethnic disparities have been observed in treatment at first specialist appointments across various specialties within New Zealand. This study, published in The New Zealand Medical Journal, aimed to examine documentation and treatment decisions for diabetic retinopathy by ethnicity.

Primary Health Care (International)

Effectiveness of Community‐Based Multidisciplinary Integrated Care for Older Adults with General Practitioner Involvement: A Systematic Review and Meta‐Analysis
Changing demographics has led to healthcare systems reorientating healthcare delivery towards the community setting and implementing integrated models of care worldwide. This systematic review, published in Health & Social Care in the Community, examines the effectiveness of community‐based multidisciplinary integrated care strategies with general practitioner (GP) participation for community‐dwelling older adults and describes the level of care integration in each study.

Cultivating a psychological health and safety culture for interprofessional primary care teams through a co-created evidence-informed toolkit
The psychological health and safety of healthcare workers workplaces and learning environments impacts the quality of healthcare services. To facilitate the psychological health and safety of interprofessional primary care teams, the authors of this paper, published in Healthcare Management Forum, curated a bilingual toolkit of 122 psychological health and safety resources comprising a multi-level categorization addressing individual, team, organization, and system-level interventions.

The cultural safety of research reports on primary healthcare use by Indigenous Peoples: a systematic review
Community-driven research in primary healthcare (PHC) may reduce the chronic disease burden in Indigenous peoples. This systematic review, published in BMC Health Services Research, assessed the cultural safety of reports of research on PHC use by Indigenous peoples from four countries with similar colonial histories.

Primary Mental Health (International)

Prenatal determinants of anxiety symptoms in middle childhood. Evidence from Growing Up in New Zealand
Early life environments can have long-lasting impacts on future health and wellbeing. This study, published in the Journal of Affective Disorders, explored data from Growing Up in New Zealand on how maternal health during pregnancy, including experiencing stress or mood disorders, has been associated with psychopathology in later life.

Multilevel perspectives on the implementation of the collaborative care model for depression and anxiety in primary care
The Collaborative Care Model (CoCM) is an evidence-based mental health treatment in primary care. A greater understanding of the determinants of successful CoCM implementation, particularly the characteristics of multi-level implementers, is needed. This study, published in BMC Psychiatry, was a process evaluation of the Collaborative Behavioral Health Program (CBHP) study in which CoCM was implemented in 11 primary care practices.

Interventions targeting patients with co-occuring severe mental illness and substance use (dual diagnosis) in general practice settings - a scoping review of the literature
People with dual diagnosis die prematurely compared to the general population, and general practice might serve as a setting in the healthcare system to mend this gap in health inequity. However, little is known about which interventions that have been tested in this setting. The aim of this review, published in BMC Primary Care, was to scope the literature on interventions targeting patients with dual diagnosis in a general practice setting, the outcomes used, and the findings.

Key Ministry of Health Publications

Aotearoa New Zealand Rare Disorders Strategy
The Aotearoa New Zealand Rare Disorders Strategy sets out the direction for the health system to better support people and their whānau living with rare disorders. It provides a framework and long-term priorities that will guide health entities in improving health and wellbeing outcomes for people and their whānau with rare disorders over the decade 2024 to 2034.

Ministry of Health Consultations & Events

Public consultation for the review of the End of Life Choice Act (2019)
The End of Life Choice Act 2019 (the Act) is the law that makes assisted dying legal in New Zealand. It came into force on 7 November 2021. The Act is administered by the Ministry of Health | Manatū Hauora, and the Assisted Dying Service is delivered by Health New Zealand | Te Whatu Ora.  The Act sets out the legal framework for assisted dying, including eligibility criteria, processes, safeguards to protect patients and practitioners, and the establishment of administrative bodies to oversee and monitor the provision of assisted dying. This consultation is open until 26 September 2024.

Health Sector Initiative

Success for Pacific professionals upskilling through micro-credential - The University of Auckland
Micro-credentials have become an increasingly popular way to formally recognise a person's knowledge of a set of skills, or their experience. Tara Apa, a community health navigator for the F’INE Pasifika Aotearoa Trust, was part of the first cohort to undertake the Waipapa Taumata Rau, University of Auckland health science micro-credential course, 'Improving well-being outcomes for Pacific families'.

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.