Issue 310 - 3 October 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)

Worldviews of hearing health for Pacific peoples in Aotearoa New Zealand: a mixed methods study
Pacific peoples experience inequity in accessing hearing health care and are disproportionately exposed to the underlying determinants impacting ear and hearing health in Aotearoa New Zealand. Understanding community members’ worldviews, including perspectives, beliefs and values, is essential in developing appropriate and responsive hearing healthcare services to meet the needs of Pacific peoples. The purpose of this paper, published in the Journal of Primary Health Care, is to understand the worldviews, knowledge and beliefs held by Pacific peoples regarding hearing health in Aotearoa New Zealand.

Rural hospital contributions to community health: community perspectives from a New Zealand rural hospital
Rural hospitals provide secondary care for much of the rural New Zealand population. Little is known about community perspectives of the health and social contribution. This descriptive qualitative study, published in the Journal of Primary Health Care, aimed to explore community views on the role of their rural hospital in a low socioeconomic rural district with a high Māori and Pacific population.

Early Years Programme Developmental Evaluation Report
The Early Years team have produced this independent developmental evaluation for Health New Zealand - Health Promotion around the community innovation fund, which supports locally led initiatives that support māmā, pēpi, and whānau in the first 1,000 days of a child’s life. This report describes insights and lessons to support ongoing development of early years health promotion.

Compulsory Community Treatment Orders and health outcomes for Ma-ori in New Zealand
This analysis, published in The Australian and New Zealand Journal of Psychiatry, considers community treatment-order outcomes according to ethnicity.

The perspectives of Māori on community treatment orders: A thematic analysis
The aim of this study, published in The Australian and New Zealand Journal of Psychiatry, was to understand the themes for Māori subjected to compulsory community treatment orders.

Public Health (International)

Long‐term antibiotic prophylaxis for prevention of rheumatic fever recurrence and progression to rheumatic heart disease
Rheumatic fever is a non‐suppurative, inflammatory sequela of group A Streptococcus pharyngitis that can occur at two to four weeks after infection. Following an episode of rheumatic fever, there is a risk of developing rheumatic heart disease (RHD) later in life that carries significant risk of morbidity and mortality. The objectives of this Cochrane Review was to assess the effects of long‐term antibiotics versus no antibiotics (control) for secondary prevention of rheumatic fever recurrence and associated sequelae in people with previous rheumatic fever or RHD; and to assess the effects of long‐term intramuscular penicillin versus long‐term oral antibiotics for secondary prevention of rheumatic fever recurrence and associated sequelae in people with previous rheumatic fever or RHD.

Nutrition & Physical Activity (International)

Interventions for increasing fruit and vegetable consumption in children aged five years and under
Insufficient consumption of fruits and vegetables in childhood increases the risk of future non‐communicable diseases, including cardiovascular disease. Testing the effects of interventions designed to increase children's consumption of fruit and vegetables, including those focused on specific child‐feeding strategies or broader multicomponent interventions targeting the home or childcare environment, is required to assess the potential to reduce this disease burden. The objective of this Cochrane Review was to assess the benefits and harms of interventions designed to increase the consumption of fruit, vegetables or both amongst children aged five years and under.

The impact of behavioral weight management interventions on eating behavior traits in children with overweight or obesity: Systematic review and meta-analysis
Behavioural weight management interventions (BWMIs) are an evidence-based strategy for addressing childhood obesity. Targeting eating behavior traits (EBTs; individual tendencies determining food intake/occasions) could play a pivotal role in improving the effectiveness of these behavioral interventions. The present study, published in Obesity Reviews, describes a systematic review and meta-analysis of the impact of BWMIs on eating behavior traits in children with overweight or obesity.

Quality Improvement (New Zealand)

A supported primary health pathway for mild traumatic brain injury quality improvement report
Best-practice guidelines recommend that patients are followed-up to check if they have recovered following a mild traumatic brain injury (mTBI) and to refer to concussion services, if needed. However, in New Zealand, rates of follow-up are low and access to concussion services can be delayed. This study, published in the Journal of Primary Health Care, aimed to improve rates of follow-up and access to concussion services for mTBI patients aged ≥8 years by the implementation of a supported health pathway and test its success.

Quality Improvement (International)

A systematic review investigating the effectiveness of interventions in preventing stage 1 and 2 pressure injury of hospitalized elderly patients
Pressure injuries are now the third most costly disease after cancer and cardiovascular disease. Around 60,000 deaths occur annually from the complications of pressure injuries. Pressure injuries are preventable but frequently result in adverse events or severe complications such as infection when developed. This study, published in the Journal of Nursing Education and Practice, aims to determine which interventions prevent hospitalised-acquired pressure injuries and are more effective in hospitalised elderly patients.

Quality improvement project aiming to reduce inappropriate use of abdominal x-rays in the ED
There is compelling evidence that AXRs have limited clinical value in the acute setting. Despite this, they are frequently used in many EDs. This quality improvement project (QIP), published in the Emergency Medicine Journal, aimed to reduce unnecessary AXR use in a single-centre ED.

Emergency Department Services (International)

How Super Is Supertrack? Expediting Care of Fast-track Patients through a Pediatric Emergency Department
Fast-track models decrease patient crowding in emergency departments (EDs) by redirecting low-acuity patients to an expedited care pathway. This study, published in Pediatric Quality & Safety, explores a how a pediatric ED created a fast-track pathway for patients evaluated in a rapid assessment triage area who needed further management in the primary ED.

Cardiovascular Disease and Diabetes (New Zealand)

Navigating the long journey of heart failure—experiences of Māori and Pacific peoples
Māori and Pacific peoples in Aotearoa New Zealand experience significant inequities in heart failure rates, treatment and outcomes compared to NZ Europeans. This study, published in The New Zealand Medical Journal, aimed to understand the experiences of Māori and Pacific people living with heart failure as they navigated care across primary and secondary settings.

Primary Health Care (New Zealand)

Māori and Pacific young people’s perspectives on testing for sexually transmitted infections via an online service: a qualitative study
International research suggests free online postal self-sampling for sexually transmitted infection (STI) testing is an acceptable alternative to clinic-based testing. A user-pays online STI testing service exists in Aotearoa New Zealand, but acceptability among priority populations is unknown. The aim of this study, published in the Journal of Primary Health Care, was to explore Māori and Pacific young people’s perspectives on online postal self-sampling for STI testing (as prospective service users).

Primary Health Care (International)

Ethical assessment of virtual consultation services: application of a practical ethical checklist to direct-to-consumer services in Aotearoa New Zealand 
Evaluating digital health services from an ethical perspective remains one of the more difficult challenges in telemedicine and health technology assessment. This project, published in the Journal of Primary Health Care, applies the previously developed practical ethical checklist to direct-to-consumer virtual primary care consultation services in Aotearoa New Zealand to conduct an ethical assessment.

Strategies to improve the implementation of preventive care in primary care: a systematic review and meta-analysis
Action on smoking, obesity, excess alcohol, and physical inactivity in primary care is effective and cost-effective, but implementation is low. The aim of this review, published in BMC Medicine, was to examine the effectiveness of strategies to increase the implementation of preventive healthcare in primary care.

Primary Mental Health (New Zealand)

The potential of a rights-based approach to refugee-focused mental health policy in Aotearoa New Zealand
In accordance with international human rights commitments, individuals with a refugee background have the right to mental health services that are available, accessible, acceptable, and of good quality. However, refugee-background individuals living in Aotearoa New Zealand experience a myriad of barriers at the individual, community, and policy level that impede access to appropriate mental health services. This commentary, published in Kōtuitui, puts forward the argument that the incorporation of a human rights-based approach to mental healthcare service at a policy level is essential for reducing barriers to care and increasing the accessibility of mental health services. The article provides key recommendations for reforming the current New Zealand Refugee Resettlement Strategy (NZRRS) to include rights-based indicators for children and youth, to monitor accessibility relative to geographic location, to disaggregate data, to extend the 12-month monitoring period and to extend monitoring beyond one mental health visit.

Hauora hinengaro o takatāpui: analysing the effectiveness of mental health policies in addressing the needs of Takatāpui in Aotearoa New Zealand
Many studies have documented the effect that colonisation has had on takatāpui, that is, Māori (the Indigenous peoples of New Zealand) with diverse gender identities, sex characteristics and sexualities. In this paper, published in Culture, Health & Sexuality, we explore whether current Aotearoa New Zealand (hereafter Aotearoa) mental health policies meet the needs of takatāpui.

Perinatal cumulative risk scores for depression symptoms in young people from the Growing Up in New Zealand longitudinal study
Adolescent depression has increased markedly over the last decade and often persists into adulthood with a range of adverse outcomes. Identifying the perinatal risk factors contributing to adolescent depression is crucial to advise early interventions. The study, published in the Journal of Affective Disorders, included 4563 young people from the Growing Up in New Zealand (GUiNZ) longitudinal study who completed a questionnaire on depression symptoms at age 12 years.

Primary Mental Health (International)

Improving the Capacity of Non-Physician Primary Care Providers to Address Child and Youth Mental Health Through Mental Health Literacy Approaches
Canadians rely on their primary care providers to address their mental health needs, but there are longstanding system gaps that must be addressed to enhance their ability to deliver mental health care. The present study, published in the Journal of Primary Care & Community Health, addressed the gap in pediatric mental health care through the development, delivery, and evaluation of a mental health literacy training among non-physician primary care providers.

Key Ministry of Health Publications

Guidelines on Protected Quality Assurance Activities under the Health Practitioners Competence Assurance Act 2003
An explanation for health practitioners on what a quality assurance activity is, what the benefits are of having a quality assurance activity protected, and how to obtain that protection.

Evidence Brief: Invasive group A streptococcus and skin infections
Group A streptococcus (GAS) bacteria is a pervasive pathogen, spread through airborne droplets and skin-to-skin contact, that may lead to invasive group A streptococcus (iGAS), post-streptococcal glomerulonephritis (PSGN), acute rheumatic fever (ARF) or rheumatic heart disease (RHD). This brief reports on a systematic review of the prevalence of GAS skin infections in cases of iGAS, ARF, RHD and PSGN. It also reports on a scoping review of the evidence on risk factors and prevention of GAS skin infections and provides an analysis of knowledge gaps within the current evidence to inform future research priorities.

Ministry of Health Consultations & Events

Developing the Hauora Māori Strategy 2025
The Ministry, as chief steward of the health system, is responsible for the development and delivery of a new Hauora Māori Strategy under the Pae Ora (Healthy Futures) Act 2022. Manatū Hauora is therefore undertaking engagement to test and refine proposals for the Hauora Māori Strategy 2025. Developing a new Hauora Māori Strategy is about charting the direction of travel for the health system over the next 5 to 10 years. Consultation closes at midnight on Monday 14 October.

Draft Suicide Prevention Action Plan for 2025 – 2029 Public consultation document
The first Suicide Prevention Action Plan, covering 2019–2024, will expire at the end of this year. The Ministry of Health has led the drafting of a new action plan which is strongly aligned with the Government’s Mental Health portfolio priorities, which in this context are to: improve access to suicide prevention and postvention support grow a workforce that is able to support those at risk of or impacted by suicide strengthen our focus on prevention and early intervention across the range of factors that can influence suicide improve the effectiveness of suicide prevention and postvention supports by improving research and data collection. The draft action plan draws from the insights that communities, families, and people with lived experience have shared around what they need from government to prevent suicide, as well as the key evidence and research. The draft action plan focuses on a range of initiatives and actions that health agencies and government agencies have committed to that will support suicide prevention. Submissions close Friday, 1 November 2024 5:00pm.

Health Sector Initiative

Health New Zealand shows commitment to protecting our Pacific seasonal workforce partners
Health New Zealand has been vaccinating Recognised Seasonal Employer (RSE) workers to protect them from catching measles. The risk of a measles outbreak in New Zealand is considered high currently, due to low immunisation rates nationally and internationally. In Hawke’s Bay, our Pacific Public Health led RSE outreach clinic on 3-4 August saw 335 seasonal workers from Fiji, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu receive the Health New Zealand funded protection as part of our whanaungatanga commitment to our Pacific neighbour partners. The RSE workers were immunised with the Measles, Mumps and Rubella (MMR) vaccine to prevent an outbreak and spread of measles among these vulnerable migrant groups, and potentially from taking it back to their Pacific home countries.

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.