Issue 314 - 28 November 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)

Wāhine Māori and Contraception – A Collaborative Research Study
This report, published by Katoa Ltd for Sexual Wellbeing Aotearoa, fills an important gap in existing research and highlights systemic, structural barriers which prevent wāhine from accessing the services and specific contraception options they prefer to use. These barriers include limited accessibility to information and services, challenges with affordability, availability of services, stigma, and experiences of culturally unsafe care.

Compulsory Community Treatment Orders and health outcomes for Māori in New Zealand
This study, published in The Australian and New Zealand Journal of Psychiatry, analysed outcomes for all community treatment orders commenced during a 10-year period in New Zealand. Given Te Tiriti O Waitangi obligations to scrutinise health and consider equity for Māori, this analysis was completed to consider community treatment-order outcomes according to ethnicity.

Nutrition & Physical Activity (International)

Umbrella review of systematic reviews to inform the development and translation of community-based childhood obesity prevention interventions 
Community-based interventions (CBIs) can be effective and feasible for the prevention of childhood obesity. The aim of this umbrella review, published in Obesity Reviews, was to determine if systematic reviews report sufficient information to guide replication or adaptation of CBIs to a variety of contexts and aid in further development of childhood obesity prevention CBIs.

Quality Improvement (New Zealand)

Collaborating for quality: A framework for clinical governance
This guidance document, published by the Health Quality & Safety Commission, sets out a high-level framework for clinical governance in health services in Aotearoa New Zealand. Clinical governance was created to provide accountability for quality of care and to improve patient experience and outcomes. The framework contains updated views on system safety, quality, and equity to achieve a learning and responsive system for all populations that help teams improve care and reduce harm. 

Quality Improvement (International)

The utility of website-based quality improvement tools for health professionals: a systematic review
As technology continues to advance, it is important to understand how website-based tools can support quality improvement. Website-based tools refer to resources such as toolkits that users can access and use autonomously through a dedicated website. This review, published in the International Journal for Quality in Health Care, examined how website-based tools can support healthcare professionals with quality improvement, including the optimal processes used to develop tools and the elements of an effective tool.

‘We listened and supported and depended on each other’: a qualitative study of how leadership influences implementation of QI interventions
There is growing recognition in the literature of the ‘Herculean’ efforts required to bring about change in healthcare processes and systems. Leadership is recognised as a critical lever for implementation of quality improvement (QI) and other complex team-level interventions; however, the processes by which leaders facilitate change are not well understood. The aim of this study, published in BMJ Quality & Safety, is to examine ‘how’ leadership influences implementation of QI interventions.

Consumer Involvement in the Design and Development of Medication Safety Interventions or Services in Primary Care: A Scoping Review
Medication‐related problems remain a significant burden despite the availability of various interventions and services in primary care. Involving health care consumers to design interventions or services across health disciplines is becoming more widely used as this type of engagement reportedly leads to more accessible, acceptable and sustainable health services and quality of life. This scoping review, published in Health Expectations, aimed to examine when and how consumers have been involved in the design and development of medication safety interventions or services within the primary care.

Emergency Department Services (International)

Innovations in Emergency Nursing: Adapting Patient Flow Management to Emergency Department Overcrowding
The coronavirus disease-2019 pandemic brought greater attention to nurses' innovation and adaptability. Emergency nurses continue to adjust their patient flow management strategies in response to high levels of overcrowding, but this work has been poorly described. This paper, published in the Journal of Emergency Nursing, describes findings from a grounded theory study that included 29 focus groups and interviews with emergency nurses.

Cardiovascular Disease and Diabetes (New Zealand)

The composition and mode of delivery of diabetes-related footcare education provided by podiatrists in Australia and Aotearoa (New Zealand): A systematic review
Diabetes-related foot disease (DFD) is a significant and costly complication of diabetes in Australia and Aotearoa New Zealand (NZ). Diabetes footcare education is considered a cornerstone of DFD prevention and management, with podiatrists playing a key role in education provision. This systematic review, published in the Journal of Foot and Ankle Research, evaluated the nature and composition of diabetes footcare education provided by podiatrists to people living with diabetes in Australia and NZ.

Cardiovascular Disease and Diabetes (International)

Interventions in women with type 2 diabetes mellitus in the pre‐pregnancy, pregnancy and postpartum periods to optimise care and health outcomes: A systematic review
Type 2 diabetes is a chronic condition affecting increasing numbers of women of reproductive age. Recent UK data show more severe adverse offspring outcomes (stillbirth, neonatal death) than in infants of those with Type 1 diabetes. This systematic review, published in Diabetic Medicine, aimed to evaluate randomised controlled trials undertaken in the pre‐pregnancy, pregnancy and the postpartum periods in women with Type 2 diabetes, to optimise care and health outcomes.

Identifying Key Moments in Type 2 Diabetes Management: A Qualitative Study of the Experiences of People With Type 2 Diabetes and Diabetes Health Coaches
For people with type 2 diabetes who are overweight, weight loss increases the likelihood of achieving diabetes remission. The aim of this study, published in Health Expectations, was to draw on the experiences of people living with type 2 diabetes and coaches who deliver type 2 diabetes prevention and remission programmes. This was done to develop a service that increases the proportion of people who achieve remission by identifying an effective weight management service.

Primary Mental Health (New Zealand)

Pacific Islands Families Study: Young Adult Gambling Behaviours and Associated Risk Factors 
In 2000, a cohort of 1,398 Pacific infants, born in South Auckland, was recruited into the Pacific Islands Families (PIF) longitudinal study. In this study, the PIF cohort, aged 22 years, was surveyed about their gambling behaviours. This study, published by the Auckland University of Technology, Gambling and Addictions Research Centre, follows previous surveys (at ages 9, 14 and 17 years) to examine gambling behaviour across time.

Factors associated with mental health outcomes in a Muslim community following the Christchurch terrorist attack
On 15 March 2019, a white supremacist terrorist attacked two mosques in Christchurch, New Zealand. Fifty-one people were killed and another 40 sustained non-fatal gunshot injuries. The aim of this study, published in BJPsych Open, was to examine the mental health of the Muslim community, and individual and exposure-related factors associated with mental health outcomes.

Protective and risk factors for social and emotional well-being of Indigenous children and adolescents: A rapid review
Indigenous children and adolescents experience life circumstances that significantly affect their social and emotional well-being (SEWB) and limit their capacity to fulfil their potential. This contributes to inequities in health, education, employment, and justice system involvement. The aim of this review, published in the Journal of Child and Adolescent Mental Health, aimed to synthesise the existing literature to comprehensively understand the protective and risk factors for SEWB of Indigenous youth in Canada, Australia, New Zealand, and the United States (CANZUS).

Primary Mental Health (International)

Discussing poverty within primary-care consultations: implications for mental health support
Poverty can have significant impacts on health and wellbeing. However, asking patients about their broader socio-economic circumstances is not routine within primary care consultations. The aim of this study, published in BJGP Open, was to understand healthcare professionals' experiences of communicating with patients about their socio-economic circumstances and how a bespoke training programme supported these conversations in routine consultations.

Videocall delivered psychological interventions for treating depressive symptoms in primary care - a systematic review
Depression is a very common disorder and comorbidity. Primary care providers are the first medical contacts to diagnose and treat depression. Video calls are emerging communication tools to deliver psychological interventions. The aim of this study, published in the Journal of Mental Health, was to examine the effectiveness of videocall delivered psychological interventions to treat depressive symptoms in adult patients in primary care, as well as a systematic assessment of implementation factors.

Smoking Cessation (International)

Evaluating the effectiveness of mailout smoking cessation support: A systematic review and meta-analysis
One of the main barriers to smoking cessation support is accessibility. Mailout supports can potentially mitigate access barriers, but their effectiveness has not been explored. The aim of this review, published in Preventive Medicine, is to evaluate the effectiveness of mailout smoking cessation support.

Oral Health (New Zealand)

Hospital Dental Admissions and Caries Experience Among Children With Neurodevelopmental Disabilities: A Population-Based Record Linkage Cohort Study
Within New Zealand, rates of largely preventable severe caries and dental hospitalisations among children are increasing and inequalities exist. However, little population-based empirical evidence exists describing this oral health burden among children with neurodevelopmental disabilities (NDDs). This study, published in Community Dentistry and Oral Epidemiology, aimed to estimate and compare the rates of dental hospital admissions in a near-national population of children aged ≤ 14 years with attention-deficit hyperactivity disorder, autism, intellectual disability or any NDD after accounting for key confounding variables.

Key Ministry of Health Publications

Annual Update of Key Results 2023/24: New Zealand Health Survey
The Annual Data Explorer presents results from the 2023/24 New Zealand Health Survey, with comparisons to earlier surveys where possible. Results are available by gender, age group, ethnic group, neighbourhood deprivation and disability status.

Review of the End of Life Choice Act 2019
In 2024, the Ministry of Health completed the first review of the End of Life Choice Act 2019. The End of Life Choice Act is the law that makes assisted dying legal in New Zealand. The Act came into force on 7 November 2021, following a public referendum held alongside the 2020 General Election. The Act is administered by the Ministry of Health. Under the legislation, the Ministry of Health is required to review the operation of the Act within three years of it coming into force, and every five years after that.

Position Statement on the Use of Puberty Blockers in Gender-Affirming Care
This position statement accompanies the release of an evidence brief which examines the safety and long-term impacts of puberty blockers when used in the context of gender-affirming care. 

Ministry of Health Consultations & Events

Consultation on safety measures for the use of puberty blockers in young people with gender-related health needs
The Government has tasked the Ministry of Health with consulting on whether there should be additional safety measures for puberty blockers, such as regulations under the Medicines Act. On 21 November 2024 the Ministry of Health published its evidence brief and position statement on puberty blockers. The Evidence Review found a lack of good quality evidence for the effectiveness or safety of puberty blocking treatment in young people with gender dysphoria. We do not have good evidence to say that the medicines used improve the longer-term outcomes for young people with gender-related health needs – nor that the potential longer-term risks are low. Submissions on this consultation close Monday, 20 January 2025 5:00pm.

Health Sector Initiative

South Canterbury pilot programme for grommet surgeries reduces ENT Outpatient follow ups by 70% - Health New Zealand
A Health New Zealand/Te Whatu Ora child grommet surgery pilot programme has drastically decreased the number Ear, Nose, and Throat (ENT) outpatient follow ups and also helped to reduce wait times for planned ENT treatments in South Canterbury.

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.