Issue 315 - 12 December 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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Thank you for reading the Health Improvement and Innovation Digest this year. Our next issue will be sent on the 20th of February 2025. Wishing you all the best over the holidays!

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

Rangatahi Māori and the Whānau Chocolate Box: Rangatahi wellbeing in whānau contexts
Whānau are comprised of unique and vital relationships that support and scaffold rangatahi (youth) wellbeing, yet are often reduced to nuclear family structures within individualised notions of wellbeing. While rangatahi contend with racialised discourses in a colonial socio-cultural context, their whānau can be an important site for mitigating these challenges, supporting rangatahi agency and wellbeing. This article, published in Explore, explores how whānau practices inform rangatahi wellbeing, drawing upon photo-projects and interviews with 51 rangatahi and their whānau.

Public Health (New Zealand)

Healthy Homes Initiative: Five-year outcomes evaluation - Health New Zealand | Te Whatu Ora
The report, published by Health New Zealand, highlights that the Healthy Homes Initiative has had a significant impact for over 200,000 referred whānau members, including children resulting in fewer hospital visits and trips to the GP. 

Public Health (International)

Psychological interventions for weight reduction and sustained weight reduction in adults with overweight and obesity: a scoping review
The key objectives of this scoping review, published in BMJ Open, focused on mapping the types and characteristics of psychological interventions versus usual care for weight reduction and sustained weight reduction in adults with overweight or obesity.

Quality Improvement (New Zealand)

Analysing programme implementation across districts: a qualitative study of a national falls prevention initiative for older people in New Zealand
Falls among older people are a major cause of the global burden of disease. This study, published in Injury Prevention, investigated the implementation of the Falls and Fracture Prevention Programme, a multicomponent population-based intervention, across diverse districts in New Zealand.

Hospital Productivity (International)

Global strategies to reduce elective surgery waiting times for sustainable health outcomes: a systematic review
Long waiting times for elective surgery reflect not just backlog issues but systemic inefficiencies that disrupt the smooth flow of patients through the surgical care pathway. This systematic review, published in Hospital Practice, adopts a holistic approach to summarise global policies, strategies, and interventions aimed at reducing elective surgery wait times.

Cancer Services (New Zealand)

Outcomes following the introduction of an interdisciplinary shared decision-making clinic for older patients with colorectal cancer
Colorectal cancer (CRC) incidence is highest in older patients, who also have high rates of concurrent multimorbidity and frailty. Shared decision making is important when deciding treatment. The aim of this study, published in The New Zealand Medical Journal, was to compare outcomes before and after introduction of a shared decision-making (SDM) pathway, which includes an anaesthetist and geriatrician, for older patients with CRC at Waikato Hospital.

Cancer Services (International)

Understanding the effectiveness and quality of virtual cancer multidisciplinary team meetings (MDTMs): a systematic scoping review
Cancer multi-disciplinary team meetings (MDTM) assemble clinical experts to make diagnostic and treatment recommendations. MDTMs can take place in person, virtually, or in a hybrid format. Virtual and hybrid MDTMs have been in use for over two decades. This systematic scoping review, published in BMC Health Services Research, aims to map the evidence on virtual and hybrid MDTM formats over time, providing insights into their quality, and the facilitators and barriers to their effective delivery.

Emergency Department Services (International)

Challenges and perceived impacts of ambulance diversions during emergency department overcrowding: a multi-stakeholder study
Ambulance diversion has emerged as a strategy to address Emergency Department (ED) overcrowding, but the question of when or whether diversion should be triggered is widely debated. Although the positive and adverse impacts of diversion have been primarily studied using quantitative data, little is known about the experience and perceptions of key stakeholders involved in diversions. This study, published in Prehospital Emergency Care, aims to explore the challenges and impacts of ambulance diversion as experienced by key stakeholders and their suggestions for improving the diversion process.

Cardiovascular Disease and Diabetes (New Zealand)

Comparative risk of type 2 diabetes development between women with gestational diabetes and women with impaired glucose tolerance over two decades: a multiethnic prospective cohort in New Zealand
The purpose of this study, published in BMJ Open Diabetes Research & Care, was to evaluate the long-term risk of developing type 2 diabetes (T2D) among women with a history of gestational diabetes mellitus (GDM) compared with those with impaired glucose tolerance (IGT).

Primary Mental Health (New Zealand)

Primary care experience in people with mental health conditions: results from a national patient experience survey
This study, published in The New Zealand Medical Journal, explored whether the reported experience of primary healthcare differs for survey respondents in Aotearoa New Zealand who self-report having a mental health (MH) condition in comparison with those who do not.

Smoking Cessation (New Zealand)

Lived experiences of stigma and altered self-perceptions among young people who are addicted to ENDS: a qualitative study from Aotearoa New Zealand
Rising use of electronic nicotine delivery system (ENDS) among young people, especially those who have never smoked, has received considerable attention from the health community. However, fewer studies have examined the mental health impacts of ENDS use. This study, published in Tobacco Control, addressed this gap by exploring the stigma, altered self-perceptions and negative affect experienced by adolescents who assessed themselves as addicted to using ENDS.

Smoking Cessation (International)

Non-combustible nicotine product cessation interventions in adolescents and young adults: A systematic review
New nicotine products such as e-cigarettes, heated tobacco and smokeless tobacco/nicotine products, are popular among young people. Most regret having started using these products, but little is known about how to help adolescents and young adults to quit most effectively. This systematic review, published in Tobacco Use Insights, aimed to identify all existing studies on the efficacy of cessation interventions on the use of novel nicotine and tobacco products in adolescents and young adults.

Interventions for smoking cessation: An overview of Cochrane reviews
Evidence of different smoking cessation interventions varies and has been assessed in many Cochrane reviews. This overview of Cochrane reviews, published in Tobacco Induced Diseases, was to summarise the effects of current interventions for smoking cessation.

Does socioeconomic position moderate the associations between the content and delivery features of digital behaviour change interventions for smoking cessation and intervention effectiveness? A systematic review and meta-analysis
Prior research indicates that digital smoking cessation interventions can be effective, but little is known about their active ingredients. Therefore, this review, published in Health Psychology Review, aimed to examine the associations of content (behaviour change techniques [BCTs]), delivery features (delivery mode, readability, ease-of-use), and socioeconomic position with effectiveness.

Key Ministry of Health Publications

Clearing the Air: Assessing real-world ventilation practices in New Zealand
Most New Zealand’s buildings are ‘naturally’ ventilated, meaning they rely on the opening of windows (and/or doors) by occupants. Ventilation habits are often inefficient, probably because we have a relatively poor innate sense of when a room is under-ventilated. Most members of the public under-estimate how effective windows can be in improving ventilation and air quality. With increased recognition following the COVID-19 pandemic of the role of ventilation in reducing the risk of spreading illness, National Institute of Water and Atmospheric Research (NIWA) were commissioned by the Ministry of Health to: assess the state of ventilation (inferred from measurements of carbon dioxide) in a sample of mostly naturally ventilated buildings occupied by people more vulnerable to the acute health effects of COVID-19 infection explore the potential for improving ventilation through changes in ventilation behaviour explore the potential for using carbon dioxide monitoring data to promote pro-ventilation behaviour change.

Community Water Fluoridation: An evidence review
The 2014 report from the Royal Society of New Zealand (RSNZ) and the 2021 report from the Office of the Prime Minister’s Chief Science Advisor (OPMCSA) on the risks and benefits of community water fluoridation (CWF) concluded that CWF is a safe and effective public health intervention to prevent dental caries. This current review updates the evidence regarding CWF published since the OPMCSA report of 2021.

Health Sector Initiative

Breaking the silence: New Pasifika resource for child sexual abuse prevention
Le Va is breaking the silence surrounding child sexual abuse with new resources to help prevent sexual violence in Pasifika communities.

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.