Issue 311 - 17 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.

Māori Innovation

Development of a culturally informed tool to assess chronic pain for Māori: the Pictorial Representation of Illness and Self Measure-Aotearoa (PRISM-A)
Chronic pain is one of the most common long-term conditions in Aotearoa (New Zealand), and there is a higher prevalence and greater impact of pain for Māori (Indigenous People of New Zealand). Māori tend to have a more holistic interpretation of pain compared with western views; therefore, current assessments may not capture the full meaning and impact of pain for Māori. This study, published in AlterNative, developed a holistic assessment tool for chronic pain in collaboration with Māori clinicians and Māori with chronic pain.

Health Equity (New Zealand)

Fostering collaboration: an exploration of knowledge exchange between Rongoā Māori practitioners and surgical clinicians
This research, published in ANZ Journal of Surgery, investigates the potential for collaboration of Rongoā Māori, the Indigenous healing practices of Māori, with New Zealand's contemporary healthcare system. It aims to bridge the gap between Rongoā Māori and Western medicine by exploring the perspectives of practitioners from both fields, identifying barriers to integration, and highlighting potential areas for collaboration.

Provision and outcomes of publicly funded bariatric surgery in a metropolitan versus a provincial population of New Zealand
Obesity is an important health problem worldwide. The prevalence of obesity in New Zealand (NZ) is the third highest amongst OECD countries. Previous studies have demonstrated inequity in the provision of bariatric and metabolic surgery (BMS) across NZ, but detailed data regarding patients and surgical outcomes is lacking. The aim of this study, published in the ANZ Journal of Surgery, is to examine the rates and outcomes of BMS between patients domiciled in a metropolitan versus provincial area in NZ.

Communicating health information to children: is a child-rights-based approach being adopted by nurses? An integrative review
Childhood is a time when health behaviours are established and the foundations for health literacy are cemented. In Aotearoa New Zealand nurses are responsible for communicating health messages to children at key stages in children's lives. This review, published in Contemporary Nurse, explores the ways in which nurses communicate health messages to children and adolescents in Aotearoa New Zealand. It evaluates whether current approaches to health communication are in-line with a child's rights-based approach.

Health Equity (International)

Racism and health and wellbeing among children and youth-An updated systematic review and meta-analysis
Evidence of racism's health harms among children and youth is rapidly increasing, though attention to impacts on physical health and biomarker outcomes is more emergent. This systematic review, published in Social Science & Medicine, examined the association between racism and health among children and youth, with a meta-analysis of the specific relationships between racism and physical health and biomarkers.

Nutrition & Physical Activity (New Zealand)

Using co-design to identify intervention components to address unhealthy dietary and activity behaviours in New Zealand South Asians
There is an urgent need to develop sustainable and impactful interventions to mitigate the high risk of diet-related non-communicable diseases (diet-NCDs) in South Asians living in high-income countries. The current study, published in the Journal of Nutritional Science, using a co-design methodology aimed to identify community-led intervention components (solutions) to address barriers and enablers of disease-promoting dietary and physical activity behaviours in New Zealand South Asians.

Slow and steady—small, but insufficient, changes in food and drink availability after four years of implementing a healthy food policy in New Zealand hospitals
A voluntary National Healthy Food and Drink Policy (the Policy) was introduced in public hospitals in New Zealand in 2016. This study, published in BMC Medicine, assessed the changes in implementation of the Policy and its impact on providing healthier food and drinks for staff and visitors in four district health boards between 1 and 5 years after the initial Policy introduction.

Nutrition & Physical Activity (International)

The impact of food aid interventions on food insecurity, diet quality and mental health in households with children in high-income countries: a systematic review
Households with children accessing food aid in high-income countries are often food insecure. This paper, published in Public Health Nutrition, aimed to review the evidence on food aid interventions in households with children and impact on food insecurity, diet quality and mental health.

Public Health (New Zealand)

Economic Abuse by An Intimate Partner and Its Associations with Women's Socioeconomic Status and Mental Health
This study, published in the Journal of Interpersonal Violence, used a population-based and representative sample of 1,431 ever-partnered New Zealand women to explore associations between their experience of economic abuse and a range of mental health and financial outcomes.

Cancer Services (New Zealand)

The impact of non-structured PSA testing on prostate cancer-specific mortality on New Zealand Māori men
The objective of this study, published in the World Journal of Urology, was to assess the impact of differences in Prostate-Specific Antigen (PSA) testing rates on prostate cancer (PCa) diagnosis and PCa-specific mortality among Māori men in a New Zealand (NZ) population.

Emergency Department Services (International)

Effectiveness of Direct Admission Compared to Admission Through the Emergency Department: A Stepped-Wedge Cluster-Randomized Trial
Direct admission (DA) to hospital can reduce emergency department (ED) utilisation by bypassing the ED during the admission process. This study, published in Pediatrics, discusses the implementation of a DA program across 3 health systems and compared timeliness of care, family experience of care, and post-admission clinical deterioration among children admitted via DA versus the ED after their clinic was randomized to begin the DA program.

Emergency department physiotherapists: consideration of perceived barriers and facilitators to help optimise their role in the Australian emergency department
This paper, published in the International Journal of Emergency Medicine, explored the following questions: What are the current barriers and facilitators to the role of ED physiotherapists? How do ED physiotherapists believe their role may be optimised within the context of the ED?

Cardiovascular Disease and Diabetes (New Zealand)

Gestational Diabetes Mellitus and Risk Factors in a Multi-Ethnic National Case-Control Study
Gestational diabetes mellitus (GDM) continues to increase particularly for non-European women. This study, published in Endocrinology, Diabetes & Metabolism, aimed to identify and quantify risk factors for women diagnosed with gestational diabetes in New Zealand to identify women at higher risk.

Primary Health Care (New Zealand)

Efficacy of the Otago-Exercise-Programme to reduce falls in community-dwelling adults aged 65-80 when delivered as group or individual training: Non-inferiority-clinical-trial
The Otago Exercise Programme is an effective intervention for falls prevention. However, there is limited evidence in relation to studies that compare efficacy for falls prevention when delivered Otago Exercise Programme in a group or individual format in a primary care context. The objective of this study, published in BMC Nursing, was to compare the Otago Exercise Programme delivered as a group vs. individual format for community dwelling older adults, over a one year period.

Nurses' work in relation to patient health outcomes: an observational study comparing models of primary care
Māori are over-represented in Aotearoa New Zealand morbidity and mortality statistics. Other populations with high health needs include Pacific peoples and those living with material deprivation. General practice has evolved into seven models of primary care: Traditional, Corporate, Health Care Home, Māori, Pacific, Trusts / Non-governmental organisations (Trust/NGOs) and District Health Board / Primary Care Organisations (DHB/PHO). This study, published in the International Journal for Equity in Health, describes nurse work in relation to these models of care, populations with high health need and patient health outcomes.

Primary Health Care (International)

Psychological and educational interventions for preventing falls in older people living in the community
Older adults are at increased risk of both falls and fall‐related injuries. Falls have multiple causes and many interventions exist to try and prevent them, including educational and psychological interventions. Educational interventions aim to increase older people's understanding of what they can do to prevent falls and psychological interventions can aim to improve confidence/motivation to engage in activities that may prevent falls. The objective of this Cochrane Review was to assess the benefits and harms of psychological interventions (such as cognitive behavioural therapy; with or without an education component) and educational interventions for preventing falls in older people living in the community.

Patient navigator programmes for children and adolescents with chronic diseases
Despite a substantial global improvement in infant and child mortality from communicable diseases since the early 1990s there is now a growing burden of chronic disease in children and adolescents worldwide, mimicking the trend seen in the adult population. Chronic diseases in children and adolescents can affect all aspects of their well‐being and function with these burdens and their health‐related consequences often carried into adulthood. The objective of this Cochrane Review was to assess the effectiveness of patient navigator programmes in children and adolescents with chronic diseases.

Primary Mental Health (New Zealand)

Current approaches to the identification and management of gambling disorder: a narrative review to inform clinical practice in Australia and New Zealand
This review, published in The Medical Journal of Australia, explores current approaches for the identification and management of gambling disorders in Australia and New Zealand.

Primary Mental Health (International)

A Nunavut community-directed Inuit youth mental wellness initiative: making I-SPARX fly
Inuit youth in Nunavut (NU) are resilient but face a protracted suicide crisis. The SPARX serious game and e-intervention, developed originally in New Zealand, teaches youth cognitive behavioural therapy (CBT) skills to ameliorate stress and depression. This study, published in the International Journal of Circumpolar Health, explores its adaption for Inuit youth.

Smoking Cessation (International)

Identifying the ways in which tobacco cessation interventions have been tailored for sexual and gender minority individuals: A systematic review
Sexual and gender minority (SGM) individuals smoke at higher rates than their heterosexual and cisgender peers. SGM persons, especially transgender and gender diverse (TGD) individuals, face unique, adverse health effects associated with smoking. As such, SGM individuals may benefit from smoking cessation interventions that are tailored to meet their needs. This systematic review, published in the Journal of Health Psychology, aims to describe the ways in which these interventions have been tailored for SGM individuals and summarize available acceptability and efficacy data.

Health Sector Initiative

Nurse-led Bay of Islands Chemotherapy Infusion Unit saves hours of travel
A nurse-led chemotherapy infusion unit has opened at Bay of Islands Hospital. The unit will operate up to two days a week initially. With 22 percent of our population living in the Mid North, this will allow some of these patients to receive their cancer therapy locally, reducing the need for long, stressful travel to Whangārei.

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.