Issue 320 - 17 April 2025

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)

"We do not stop being Indigenous when we are in pain": An integrative review of the lived experiences of chronic pain among Indigenous peoples
Chronic non-cancer pain is a major burden worldwide. Indigenous communities experience additional inequities in pain care and management influenced by long-standing impacts of colonisation, including systemic racism, oppression, and marginalization. Traditional healing knowledges, practices and methods are valued by Indigenous people when managing their pain. However, mainstream health services often disregard this knowledge and fail to provide culturally safe management strategies. The aim of this review, published in Social Science & Medicine, was to understand how Indigenous peoples across the globe make sense of pain when experiencing chronic non-cancer pain.

"Let All Identities Bloom, Just Let Them Bloom": Advancing Trans-Inclusive Perinatal Care Through Intersectional Analysis
Intersectionality, as a praxis and methodology, enables researchers to attend to their social justice goals. Yet, intersectionality has been under-employed in research centering trans people's healthcare experiences. Not attending to intersectionality has been argued to reinforce the very structural inequities researchers are trying to challenge. This article, published in Qualitative Health Research, presents a re-analysis of interview data of 20 Trans Pregnancy Care Project participants in Aotearoa New Zealand.

Health Equity (International)

Integrating health equity in artificial intelligence for public health in Canada: a rapid narrative review
The application of artificial intelligence (AI) in public health is rapidly evolving, offering promising advancements in various public health settings across Canada. AI has the potential to enhance the effectiveness, precision, decision-making, and scalability of public health initiatives. However, to leverage AI in public health without exacerbating inequities, health equity considerations must be addressed. This rapid narrative review, published in Frontiers in Public Health, aims to synthesise health equity considerations related to AI application in public health.

Addressing health service equity through telehealth: A systematic review of reviews
The objective of this review, published in Digital Health, was to synthesise existing reviews on the impact of telehealth programs on health service equity in non-urban areas, focusing on six dimensions of access: accessibility, availability, acceptability, affordability, adequacy, and awareness.

A Scoping Review of Family-Based Interventions for Immigrant/Refugee Children: Exploring Intergenerational Trauma
Immigrant and refugee families often experience significant trauma, which can be transmitted across generations. Nonetheless, little is known about interventions that mitigate intergenerational trauma within these populations. This scoping review, published in the Community Mental Health Journal, was to synthesise research evidence on family-based trauma interventions for immigrant and refugee children and their families, focusing on intergenerational trauma.

Quality Improvement (International)

Effectiveness of nursing interventions on patient experiences with health care: A systematic review and meta‐analysis
The aim of this review, published in the International Nursing Review, was to synthesise and evaluate the effects of nurse‐led or nursing‐focused interventions for improving patient experience with health care in hospitals.

Cancer Services (New Zealand)

Prevalence of surgery in Indigenous people with cancer: a systematic review and meta-analysis
As cancer incidence increases globally, so does the prevalence of cancer among Indigenous peoples. Indigenous peoples face significant barriers to healthcare, including access to and uptake of surgery. To date, the synthesis of access to and uptake of surgery for Indigenous peoples living with cancer has not yet been reported. This systematic literature review and meta-analysis, published in The Lancet Regional Health: Western Pacific, explored access to and uptake of surgery for Indigenous peoples in Canada, Australia, New Zealand, and the United States.

Nurse-Led Models of Service Delivery for Skin Cancer Detection: A Systematic Review
The aim of this review, published in Journal of Advanced Nursing, was to consolidate evidence on nurse-led models for skin cancer detection by focusing on their roles, comparing their effectiveness to physician-led care and highlighting any value-added benefits.

Capturing diversity in cancer incidence and outcomes among the New Zealand Pacific population using linked administrative data
The New Zealand population defined as "Pacific" is ethnically diverse, but this diversity is seldom examined in health research. This paper, published in The New Zealand Medical Journal, applies novel methods for describing health outcomes for specific Pacific populations in New Zealand using all-cancer and gastric cancer incidence and mortality as examples.

Cancer Services (International)

Determining the most suitable target age-group for breast cancer screening in Samoa
Cancer is the second leading cause of non-communicable related deaths in Samoa, accounting for 15% of deaths after cardiovascular diseases. Samoa’s incidence of cancer has increased from 28.5 per 100,000 in 2007 to 65.2 per 100,000 in 2016. Samoans are at risk of various cancers, including breast, because of their high prevalence of major risk factors such as obesity, overweight, physical inactivity, alcohol and smoking. Breast cancer is the most common cancer type in females, and it is the leading cause of deaths from cancer among the Samoan female population. This retrospective study, published in Pacific Health Dialog, analysed laboratory confirmed breast cancer cases diagnosed in the Tupua Tamasese Meaole Hospital at the Clinical Laboratory from 2007-2020.

Cardiovascular Disease and Diabetes (New Zealand)

Assessing the gaps in cardiovascular disease risk assessment and management in primary care for Māori and Pacific peoples in Aotearoa New Zealand- a systematic review
Māori and Pacific peoples carry the highest burden of cardiovascular disease in New Zealand (NZ). This systematic review, published in The Lancet Regional Health: Western Pacific, aimed to determine access to evidence-based cardiovascular disease risk assessment (CVDRA) and management in primary care for Māori and Pacific peoples compared with other ethnicities in NZ, as well as factors contributing to reduced access.

Metabolic risk factors and long COVID: a cross-sectional study in Aotearoa New Zealand
The aim of this study, published in The New Zealand Medical Journal, was to describe the association between metabolic risk factors and the risk of developing long COVID in Aotearoa New Zealand.

Primary Health Care (International)

Digital tracking, provider decision support systems, and targeted client communication via mobile devices to improve primary health care
Digital tracking on mobile devices, combined with clinical decision support systems and targeted client communication, can facilitate service delivery and potentially improve outcomes. The objective of this Cochrane Review was to assess the effects of using a mobile device to track service use when combined with clinical decision support, with targeted client communications, or both.

How has the integration of midwives into primary healthcare settings impacted access to care? A qualitative descriptive study from Ontario, Canada
Most midwives in Canada work in community-based midwifery-led continuity of care models that are not integrated into interprofessional primary healthcare settings. The aim of this study, published in BMC Health Services Research, was to investigate perceptions of how integrating midwives into primary health care teams impacts access to care.

Primary Mental Health (New Zealand)

Effectiveness of suicide postvention service models and guidelines 2014-2024: A scoping review
Effective suicide postvention services provide immediate and ongoing support for suicide loss survivors. This review, published in Preventive Medicine, synthesises peer-reviewed and grey literature exploring which suicide postvention service models have demonstrated effectiveness in reducing distress and supporting recovery in families, friends, and communities impacted by suicide.

Common mental disorders and psychological distress among Pacific adults living in Aotearoa New Zealand
The aim of this study, published in The New Zealand Medical Journal, was to examine common mental disorders and psychological distress in Pacific adults and between Pacific ethnic groups.

Increased Immunisation (New Zealand)

Are there any sociodemographic factors associated with non-uptake of HPV vaccination of girls in high-income countries with school-based vaccination programmes? A systematic review
Uptake of human papillomavirus (HPV) vaccination is generally high in high-income countries with school-based vaccination programmes. This review, published in Journal of Epidemiology & Community Health, explored lower uptake in certain population subgroups and how this could continue pre-immunisation inequalities in cervical cancer.

Oral Health (New Zealand)

Pacific oral health: a scoping review
A growing body of literature reports on the oral health of Pacific peoples but a synthesis of the existing knowledge on Pacific oral health epidemiology is absent. This scoping review, published in Frontiers in Oral Health, aims to summarise the evidence on Pacific oral health epidemiology.

Key Ministry of Health Publications

Review of Certain Matters under the Contraception, Sterilisation, and Abortion Act 1977
This is the first periodic Review of Certain Matters under the Contraception, Sterilisation, and Abortion Act 1977. The review identifies that some good progress has occurred. There is increased access to abortion services, with more providers, and an increase of locations of provision. In addition, we have Increased access to early abortion services through the telehealth services DECIDE as well as in primary health care and community settings through funded EMA medicines and clarification of funding available through the Primary Maternity Services Notice. The introduction of clinical guidelines to support clinical practice in abortion care and the Standard for Abortion Counselling in New Zealand have also been beneficial.

Abortion Is a Human Right and Health Issue: Disabled people’s experiences of abortion services in Aotearoa New Zealand
This research report was commissioned by the Ministry to help inform the Review of Certain Matters under the Contraception, Sterilisation, and Abortion Act 1977. It was one of three reports commissioned for three different consumer groups. The research report focuses on the experiences of disabled people and provides insights into how abortion health care services are perceived and accessed by this group since changes to the law in 2020.

‘It Just Adds Another Layer of Stress’: Rainbow people’s experiences of abortion services in Aotearoa New Zealand
This research report was commissioned by the Ministry to help inform the Review of Certain Matters under the Contraception, Sterilisation, and Abortion Act 1977. It was one of three reports commissioned for three different consumer groups. The research report focuses on the experiences of rainbow people and provides insights into how abortion health care services are perceived and accessed by this group since changes to the law in 2020.

Abortion Services in Aotearoa New Zealand: The voices of wāhine on improving access
This research report was commissioned by the Ministry to help inform the Review of Certain Matters under the Contraception, Sterilisation, and Abortion Act 1977. It was one of three reports commissioned for three different consumer groups. The research report focuses on the experiences of Māori and Pacific peoples and provides insights into how abortion health care services are perceived and accessed by this group since changes to the law in 2020.

Health Sector Initiative

New psychology qualification will expand NZ mental health support
Auckland University of Technology will be helping develop training for the new associate psychologist role to help more New Zealanders access mental health and addiction support.

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.