Ministry of Health Library Health Improvement and Innovation Digest

on 31 January

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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 183 - 31 January 2019

Welcome to the fortnightly Health Improvement and Innovation Digest (formerly the HIIRC digest). The Digest has links to key evidence of interest, with access to new content arranged by topic.

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Have you heard about Grey Matter?

We'd like to introduce you to another newsletter that the Ministry of Health Library prepares.  The Grey Matter newsletter provides monthly access to a selection of recent NGO, Think Tank, and International Government reports related to health. Information is arranged by topic, allowing readers to quickly find their areas of interest.  If you'd like to subscribe to Grey Matter, email

Article access

For articles that aren't open access, contact your DHB 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.

Quality Improvement (New Zealand)

Progress in implementing national policies and strategies for health literacy - what have we learned so far?
The purpose of this study, published in the International Journal of Environmental Research & Public Health, was to analyze a selection of existing policy documents for their strengths, limitations and themes, and offer observations about their potential to improve health literacy and health outcomes. In doing so the intention is to offer lessons and advice from early adopters that will have usefulness for future policy development and implementation. Six policies were selected for review: Australia, Austria, China, New Zealand, Scotland, and the United States.

Open book: dispensing errors: learning from the national primary care patient experience survey (Jan 2019)
This report, from the Health Quality & Safety Commission, alerts providers to key medication-related findings from the national primary care patient experience survey, and includes some recommendations for improvement. It is relevant to pharmacy staff involved in the dispensing and supply of medicines to patients.

Reducing inappropriate urine testing at Hutt Valley District Health Board using Choosing Wisely principles
Choosing Wisely is an international campaign which aims to reduce unnecessary and low-value patient care by encouraging medical colleges and speciality societies to identify clinical practices which should be questioned or avoided. In this study, published in the New Zealand Medical Journal, the Antimicrobial Stewardship (AMS) Team at Hutt Valley District Health Board aimed to reduce the number of inappropriate urinalyses for inpatients. The campaign began in March 2016 with the cessation of routine urine testing prior to orthopaedic implant surgery. Other interventions included removal of urine dipsticks from inpatient wards and education of staff about guidelines for diagnosis and treatment of UTIs.

Disability Sector Quality Improvement (International)

A review of strategies to increase comfort and compliance with medical/dental routines in persons with intellectual and developmental disabilities
Noncompliance with basic health care can have profound effects on long term health and well-being for everyone, but especially for individuals with intellectual and developmental disabilities (IDD). Perhaps the factor most responsible for noncompliance is the fear associated with medical and dental procedures. The authors of this study, published in the Journal of Developmental and Physical Disabilities, reviewed the research literature to identify the empirical support for interventions designed to address noncompliance with medical routines in the IDD population.

Park-based physical activity interventions for persons with disabilities: a mixed-methods systematic review
Park-based physical activity (PA) interventions improve health in the general population, but it is unknown if the evidence can be translated to persons with disabilities. The objectives of this study, published in the Disability and Health Journal, were to conduct a mixed-methods systematic synthesis of the evidence for park-based physical activity interventions for persons with disabilities and secondarily, to consider the health benefits across the lifespan (children and adolescents, young, middle, and older adults).

Hospital Productivity (International)

A model of access combining triage with initial management reduced waiting time for community outpatient services: a stepped wedge cluster randomised controlled trial
Long waiting times are associated with public community outpatient health services. This trial, published in BMC Medicine, aimed to determine if a new model of care based on evidence-based strategies that improved patient flow in two small pilot trials could be used to reduce waiting time across a variety of services. The key principle of the Specific Timely Appointments for Triage (STAT) model is that patients are booked directly into protected assessment appointments and triage is combined with initial management as an alternative to a waiting list and triage system.

Cardiovascular Disease and Diabetes (New Zealand)

Carbohydrate quality and human health: a series of systematic reviews and meta-analyses    
Previous systematic reviews and meta-analyses explaining the relationship between carbohydrate quality and health have usually examined a single marker and a limited number of clinical outcomes. This study, published in The Lancet, aimed to more precisely quantify the predictive potential of several markers, to determine which markers are most useful, and to establish an evidence base for quantitative recommendations for intakes of dietary fibre.

Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial
The objective of this study, published in BMJ, was to determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes.

Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control - a qualitative study using the theoretical domains framework
Glycaemic target recommendations vary widely between international professional organisations for women with gestational diabetes mellitus (GDM). Some studies have reported women's experiences of having GDM, but little is known how this relates to their glycaemic targets. The aim of this study, published in BMC Pregnancy & Childbirth, was to identify enablers and barriers for women with GDM to achieve optimal glycaemic control.

Cardiovascular Disease and Diabetes (International)

Impact of technology-based interventions for children and young people with type 1 diabetes on key diabetes self-management behaviours and prerequisites: a systematic review
The role of technology in the self-management of type 1 diabetes mellitus (T1DM) among children and young people is not well understood. Interventions should aim to improve key diabetes self-management behaviours (self-management of blood glucose, insulin administration, physical activity and dietary behaviours) and prerequisites (psychological outcomes and HbA1c) highlighted in the UK guidelines of the National Institute for Health and Care Excellence (NICE) for management of T1DM. The purpose of this study, published in BMC Endocrine Disorders, was to identify evidence to assess the effectiveness of technological tools in promoting aspects of these guidelines amongst children and young people.

The efficacy of mobile phone apps for lifestyle modification in diabetes: systematic review and meta-analysis
Efforts in lifestyle modification, such as daily physical activity and healthy diets, can reduce the risk of prediabetes, improve the health levels of people with diabetes, and prevent complications. Lifestyle modification is commonly performed in a face-to-face interaction, which can prove costly. Mobile phone apps provide a more accessible platform for lifestyle modification in diabetes. This review, published in JMIR mHealth and uHealth, aimed to summarize and synthesize the clinical evidence of the efficacy of mobile phone apps for lifestyle modification in different subtypes of diabetes.

Effectiveness, acceptability and usefulness of mobile applications for cardiovascular disease self-management: systematic review with meta-synthesis of quantitative and qualitative data   
Mobile technologies are innovative, scalable approaches to reducing risk of cardiovascular disease but evidence related to effectiveness and acceptability remains limited. This study, published in the European Journal of Preventive Cardiology, aimed to explore the effectiveness, acceptability and usefulness of mobile applications (apps) for cardiovascular disease self-management and risk factor control.

Primary Health Care (New Zealand)

Lessons learned from the ARFNZ Partnership Pilot with Turuki Health Care: combining school-based screening with in-home assessments to improve asthma diagnosis and management
This Pilot combined school-based screening with in-home assessments for children identified as potentially in need of an asthma diagnosis and/or support with asthma management. The school-based screening initially involved sending home a brief questionnaire to be completed by whānau which included questions about asthma and asked whether whānau would be willing to receive an in-home assessment if required. The in-home assessments were carried out by a dedicated Asthma Nurse. The first in-home assessment provided whānau education and led to referrals, subsequent assessments, and to the eventual development of a Child Asthma Action Plan.

Better Help for smokers to Quit (New Zealand)

Perceptions and reasons regarding e-cigarette use among users and non-users: a narrative literature review
This paper, published in the International Journal of Environmental Research & Public Health, aimed to provide an in-depth understanding of the attractiveness of e-cigarettes for several different groups. For this purpose, perceptions of and reasons for e-cigarette use were systematically reviewed as reported by e-cigarette users, cigarette smokers, dual users, and non-users, among both adults and youth.

Weight Management (New Zealand)

Cost and affordability of diets modelled on current eating patterns and on dietary guidelines, for New Zealand total population, Maori and Pacific households
In this study, published in the International Journal of Environmental Research & Public Health, the affordability of diets modelled on the current (less healthy) diet compared to a healthy diet based on Dietary Guidelines was calculated for population groups in New Zealand. Diets using common foods were developed for a household of four for the total population, Maori and Pacific groups. Maori and Pacific nutrition expert panels ensured the diets were appropriate. Each current (less healthy) diet was based on eating patterns identified from national nutrition surveys.

Childhood Obesity (International)

Systematic review of natural experiments for childhood obesity prevention and control
The National Academy of Medicine recommends childhood obesity prevention efforts making healthier options the passive choice. This review, published in the American Journal of Preventive Medicine, evaluated the effectiveness of population-level policies and programs from natural experiments for childhood obesity prevention.

The role and impact of community health workers in childhood obesity interventions: a systematic review and meta-analysis
Childhood obesity increases the risk for poor health during childhood, as well as for adult obesity and its associated comorbidities. Children from racial/ethnic minority groups or who live in poverty experience elevated rates of obesity. One potential method for reducing childhood obesity disparities is to involve community health workers (frontline public health workers who are trusted members of and/or have an unusually close understanding of the community served). The purpose of this systematic review and meta-analysis, published in Obesity Reviews, was to explore the role and effectiveness of community health workers in childhood obesity interventions.

Key Ministry of Health Publications

Heat Health Plans
There is conclusive evidence that extreme heat and heatwaves have negative impacts on health. Even modest increases above average temperatures can have negative impacts on those most vulnerable to heat, but effective planning can reduce the effects of heat on health. These guidelines are intended to raise awareness of the risks of hot weather to health, and to encourage and support the development of Heat Health Plans. Heat Health Plans outline the actions and systems in place to support those most at risk during periods of extreme heat and it is recommended that individuals, health and community service providers, district health boards, public health units and local government prepare their own Heat Health Plans as part of their emergency planning.

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.

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