Issue 312 - 31 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

Traditional healing and medicine in dementia care for Indigenous populations in North America, Australia, and New Zealand: Exploring culturally-safe dementia care policy from a global perspective
This scoping review, published in Alzheimer's & Dementia, aimed to summarise the existing dementia care literature regarding strategies for the integration of traditional healing in dementia care and the roles of traditional healers.

Health Equity (New Zealand)

Tū Kaha: he mōhio ki ngā Māori o te kōmaoa waewae (Stand Strong: A qualitative study of Māori with venous leg ulcers in Aotearoa New Zealand)
Venous leg ulcers have impact on people's lives far beyond that of a skin lesion but these impacts have not been explored from an Indigenous perspective. This study, published in the Journal of Health Psychology, used a Māori-centered narrative approach to interview 13 Māori in Aotearoa New Zealand with venous leg ulcers.

Comparing the Health Status of Immigrant and New Zealand-Born Older Adults in Aotearoa New Zealand: The Role of Socioeconomic Position
This study, published in the Journal of Aging and Health, investigated the health status of older migrants relative to their New Zealand-born peers.

The physical health and premature mortality of Indigenous Māori following first-episode psychosis diagnosis: A 15-year follow-up study
People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis. The objective of this study, published in The Australian and New Zealand Journal of Psychiatry, was to compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis.

Nutrition & Physical Activity (New Zealand)

Intermediate and secondary school food environment in New Zealand: Food and drink menu assessment
Nutrition-related obesity is rising among adolescents in New Zealand with an estimated one in eight children being obese. The school environment is an ideal community setting for encouraging a healthy lifestyle as schools contain a diverse population and involve students and parents. However, the healthiness of food available to intermediate and secondary school students (Years 7-13) is unknown. This study, published in the Health Promotion Journal of Australia, assessed how food and drink menus from schools align with policy guidelines for healthy school food environments.

Enablers and barriers to dietary change for Māori with nutrition-related conditions in Aotearoa, New Zealand: a scoping review
Māori, the Indigenous population of Aotearoa New Zealand, face a substantial burden of nutrition-related diseases, especially obesity and type 2 diabetes. Weight loss, through dietary change, is a central component of obesity and diabetes prevention and management; however, most approaches have not been designed with or evaluated specifically for Māori. The aim of this study, published in Public Health Nutrition, was to review literature on the enablers and barriers to dietary change, for Māori.

Nutrition & Physical Activity (International)

School-based healthy eating interventions for adolescents aged 10-19 years: an umbrella review
The benefits of healthy eating are well known, yet adolescent diet is often poor. School based interventions offer a promising option to promote healthy eating, however, evidence is unclear. This umbrella review, published in the International Journal of Behavioral Nutrition and Physical Activity, synthesised the current evidence on school-based interventions for healthy eating in adolescents (10-19 years old).

Public Health (New Zealand)

He Kāinga Oranga: reflections on 25 years of measuring the improved health, wellbeing and sustainability of healthier housing
This paper, published in the Journal of the Royal Society of New Zealand, reflects on the influences and outcomes of He Kāinga Oranga/Housing and Health Research Programme over 25 years, and their impact on housing and health policy in Aotearoa and internationally.

Cancer Services (New Zealand)

Polokalama Fekumi ki he Kanisā 'o e Halanga-me'atokoní-Ko e vakai 'a e Tongá: Tongan New Zealanders' views on how to ensure the National Bowel Cancer Screening Programme works well for the Tongan community
The National Bowel Screening Programme (NBSP) fails to deliver screening equitably to Pacific New Zealanders. This research, published in the The New Zealand Medical Journal, explored Tongan New Zealanders' experiences of participating in the NBSP and their views on ensuring the programme works well for the Tongan community.

Emergency Department Services (International)

Lean-Based Approach to Improve Emergency Department Throughput
Lean methodology can be utilised to increase throughput in a fast-track care area without changing staffing in a busy, urban emergency department (ED). This study, published in Cureus, used a retrospective before-and-after analysis to analysis an improvement process in a fast-track care area within an ED.

Cardiovascular Disease and Diabetes (International)

Blood pressure targets for hypertension in people with chronic renal disease
Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease, development of end‐stage renal disease, and all‐cause mortality. The objective of this Cochrane Review was to compare the effects of standard and lower‐than‐standard blood pressure targets for hypertension in people with chronic kidney disease on mortality and morbidity outcomes.

Primary Health Care (International)

Organizational innovations related to Primary Care Access Points (GAP) for unattached patients in Quebec: a multi-case qualitative study
Being attached to a primary care (PC) provider is at the core of a strong primary health care system. Centralised waiting lists (CWL) for unattached patients have been implemented in eight provinces of Canada to support the attachment process. In Quebec, the Ministry of Health mandated the implementation of Primary Care Access Points (GAP) across the province to help unattached patients navigate the health system while awaiting attachment through the CWL. Several local health territories developed complementary innovations to the GAP to respond to local population needs. This paper, published in BMC Primary Care, aims to describe five organisational innovations implemented locally.

Exploration of primary care models and timely access to care in New Brunswick (Canada)
This correlative study, published in BMC Primary Care, aimed to examine how the different primary care models (physicians in solo practice, physicians in collaborative practice, physicians and nurse practitioners in collaborative practice, after-hours clinics, community centres, or emergency rooms) were associated with their capability to offer timely access to their patients.

Primary Mental Health (International)

Higher levels of social support predict lower psychological distress for Pacific peoples living in Aotearoa New Zealand
Recent research indicates that rates of psychological distress are almost 1.5 times higher for adult Pacific peoples versus non-Pacific peoples. This study, published in Scientific Reports, examined changes in psychological distress across time for adult Pacific peoples in Aotearoa New Zealand.

Evidence-Based Youth Suicide Prevention and Intervention in Pediatric Primary Care Settings
Suicide is a leading cause of death in youth. Evidence highlights the importance of identifying youth at risk for suicide in pediatric primary care, and suggests this is a crucial setting for improving youth mental health. The American Academy of Pediatrics recommends primary care providers not only screen and assess for suicide risk, but also become educated on how to better manage certain mental health conditions. This article, published in Pediatric Clinics of North America, discusses the epidemiology of youth suicide in the United States and describes evidence-based strategies and innovative practices for suicide prevention in pediatric primary care including suicide risk screening, assessment, intervention, and follow-up care.

Increased Immunisation (New Zealand)

Cognitive flexibility predicts attitudes towards vaccination: evidence from a New Zealand sample
Vaccine hesitancy (the reluctance or refusal to vaccinate) poses a significant threat to public health worldwide, with declining vaccination coverage resulting in the resurgence of vaccine-preventable diseases (e.g., measles) in recent years. Despite efforts to combat vaccine hesitancy through information-based campaigns and other interventions, vaccine-hesitant attitudes persist. Given that such interventions likely expose individuals to information that conflicts with their own viewpoints about vaccination, cognitive flexibility - the ability to adapt one's thoughts, attitudes, beliefs, or behaviour in response to changing information or environmental demands - may play a role in vaccine hesitancy. The current study, published in BMC Psychology, investigated the relationship between cognitive flexibility and attitudes towards vaccination in a sample of New Zealand residents.

Increased Immunisation (International)

Enhancing HPV vaccine uptake in girls and boys – A qualitative analysis of Canadian school-based vaccination programs
The purpose of this study, published in Vaccine, was to better understand barriers and enabling conditions for HPV vaccination in school-based vaccination programs in Canada.

Smoking Cessation (International)

Commercial Tobacco Cessation Interventions for American Indian and Alaska Native Persons Living in the United States: A Narrative Systematic Review of Effectiveness Using a Health Equity Lens
The objective of this study, published in the American Journal of Health Promotion, was to identify cessation interventions for commercial tobacco use (the use of tobacco for non-ceremonial reasons) in American Indian and Alaska Native communities, focusing on strategies used to advance health equity, including strategies to address social determinants of health (SDOH), community engagement, and cultural tailoring.

Key Ministry of Health Publications

Health National Adaptation Plan 2024 - 2027
Our climate is changing. These changes are affecting what we value most in our lives, including our health and wellbeing. This first Health National Adaptation Plan (HNAP) is an important step towards placing health considerations at the forefront of the climate response of Aotearoa New Zealand. It sets the strategic direction and provides national-level priority actions for health-focused adaptation to climate change.

Ministry of Health Annual Report for the year ended 30 June 2024
The Ministry of Health/Manatū Hauora Annual Report for the year ended 30 June 2024 summarises the Ministry’s progress towards our Strategic Intentions, and reports on our financial and non-financial performance for 2023/24 as required under the Public Finance Act 1989.

Strategic Intentions 2024–2028
The Strategic Intentions 2024–2028 informs Parliament and the public about the Ministry of Health/Manatū Hauora and its role as the chief steward of health and the health system, and the lead advisor to Government on health.

Health Sector Initiative

Taking Health Care off the grid with Starlink
A car fitted with a satellite on the roof is enhancing the health care being delivered in the most remote area of Hawke’s Bay. In Wairoa, Health New Zealand/Te Whatu Ora kaimahi like district nurses, midwives, and physios travel long distances across remote, back country roads to visit patients. Until recently this meant working long periods out of mobile coverage – making the job much harder. The installation of a Starlink satellite on top of a Toyota RAV4 has removed all mobile black spots. It’s providing mobile and internet coverage to previously unconnected areas.

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.