Ministry of Health Library Health Improvement and Innovation Digest

on 3 October

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Ministry of Health Library

Health Improvement and Innovation Digest

Issue 200 - 26 September 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.


Māori Innovation

Innovation to prevent sudden infant death: the wahakura as an Indigenous vision for a safe sleep environment
This article, published in the Australian Journal of Primary Health, discusses the bassinet-like wahakura an Indigenous initiative for the prevention of Sudden Unexpected Death in Infancy (SUDI). It was developed by New Zealand Māori in 2005 when Māori were rejecting the 'stop bedsharing' SUDI prevention message and the SUDI disparity between Māori and non-Māori had become entrenched. Made of native flax, the wahakura was promoted as a culturally resonant, in-bed safe sleep device that would disrupt the SUDI risk associated with 'bedsharing where there was smoking in pregnancy' without relying on smoking cessation.

Whānau Māori explain how the Harti Hauora Tool assists with better access to health services
This paper, published in the Australian Journal of Primary Health, highlights how a Kaupapa Māori-centred intervention (the Harti Hauora Tamariki tool, hereafter Harti tool) has improved interactions with health services.


Health Equity (New Zealand)

Maternal experiences of ethnic discrimination and subsequent birth outcomes in Aotearoa New Zealand
Interpersonal discrimination experience has been associated with adverse birth outcomes. Limited research has evaluated this relationship within multicultural contexts outside the United States where the nature and salience of discrimination experiences may differ. Such research is important in order to help identify protective and risk factors that may mediate the relationship between discrimination experience and adverse birth outcomes. This study, published in BMC Public Health, evaluated the relationship between perceived discrimination, as measured in pregnancy, with birth weight and gestation length among Māori, Pacific, and Asian women from Aotearoa New Zealand.


Cancer Services (New Zealand)

A targeted promotional DVD fails to improve Māori and Pacific participation rates in the New Zealand bowel screening pilot: results from a pseudo-randomised controlled trial
New Zealand's Bowel Screening Pilot (BSP) used a mailed invitation to return a faecal immunochemical test. As a pilot it offered opportunities to test interventions for reducing ethnic inequities in colorectal cancer screening prior to nationwide programme introduction. Small media interventions (e.g. educational material and DVDs) have been used at both community and participant level to improve uptake. This study, published in BMC Public Health, tested whether a DVD originally produced to raise community awareness among the Māori population would have a positive impact on participation and reduce the proportion of incorrectly performed tests (spoiled kits) if mailed out with the usual reminder letter.


Cancer Services (International)

Cost-effectiveness of patient navigation for breast cancer screening in the National Breast and Cervical Cancer Early Detection Program
Patient navigation (PN) services have been shown to improve cancer screening in disparate populations. This study, published in Cancer Causes and Control, estimates the cost-effectiveness of implementing PN services within the National Breast and Cervical Cancer Early Detection Program.


Shorter Stays In Emergency Departments (International)

Substituting emergency services: primary care vs. hospital care
Overcrowding in emergency departments (EDs) is inefficient, especially if it is caused by inappropriate visits for which primary care physicians could be equally effective as a hospital ED. This paper, published in Health Policy, investigates the extent to which both ambulatory ED visits and inpatient ED admissions are substitutes for primary care emergency services (PCES) in Germany.


Primary Health Care (International)

Meta-analysis of Primary Care Interventions to Address Frailty Among Adults Aged 65+
Frailty can contribute to poor clinical outcomes including disability, illness, and death. Intervention against frailty may help older adults maintain overall health and independence, and a growing body of recent literature describes interventions specifically targeting frailty. The diversity of measurement constructs and intervention types raises a challenge for those seeking to identify best-practice strategies to manage frailty in the primary care setting. This study, published in Age and Ageing, aimed to quantify the relative effectiveness of reported interventions.

Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study
Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study, published in BMC Family Practice, is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings.

Interventions for supporting the initiation and continuation of breastfeeding among women who are overweight or obese
Exclusive breastfeeding is recommended for all infants until six months of age due to the many health benefits for both the mother and infant. Evidence suggests that mothers who are overweight (body mass index (BMI) 25.0 to 29.9 kg/m²) or obese (BMI ≥ 30.0 kg/m²) are less likely to initiate breastfeeding and to breastfeed for a shorter duration. Considering the rising prevalence of overweight and obesity globally and the known benefits of breastfeeding particularly in reducing the long‐term risks of obesity and diabetes for infants, establishing effective ways to support and promote breastfeeding in women who are overweight or obese is paramount in achieving the goal of healthier communities. The objective of this Cochrane Review was to assess the effectiveness of interventions to support the initiation or continuation of breastfeeding in women who are overweight or obese.

What approaches to social prescribing work, for whom, and in what circumstances? A realist review
The use of non‐medical referral, community referral or social prescribing interventions has been proposed as a cost‐effective alternative to help those with long‐term conditions manage their illness and improve health and well‐being. However, the evidence base for social prescribing currently lags considerably behind practice. This paper, published in Health and Social Care in the Community, explores what is known about whether different methods of social prescribing referral and supported uptake do (or do not) work.


Primary Mental Health (International)

The Collaborative Chronic Care Model for Mental Health Conditions: From Evidence Synthesis to Policy Impact to Scale-up and Spread
Extensive evidence indicates that Collaborative Chronic Care Models (CCMs) improve outcome in chronic medical conditions and depression treated in primary care. This paper, published in Medical Care, begins with an evidence synthesis which indicated that CCMs are also effective for multiple mental health conditions. It also describes a multistage process that translated this knowledge into evidence-based health system change in the US Department of Veterans Affairs (VA).

Strategies to strengthen the provision of mental health care at the primary care setting: An Evidence Map
In a deinstitutionalised mental health care system, those with mental illness require complex, multidisciplinary and intersectoral care at the primary or community service setting. This paper, published in PLoS One, describes an Evidence Map of different strategies to strengthen the provision of mental health care at the primary health care (PHC) setting, the quality of the evidence, and knowledge gaps.


Increased Immunisation (International)

Barriers to vaccination service delivery within general practice: opportunity to make a sustainable difference in Aboriginal child health?
The objective of this study, published in the Australian and New Zealand Journal of Public Health, was to identify behavioural barriers of service provision within general practice that may be impacting the vaccination coverage rates of Aboriginal children in Perth, Western Australia (WA).


Better Help for smokers to Quit (New Zealand)

Beliefs among Adult Smokers and Quitters about Nicotine and De-nicotinized Cigarettes in the 2016-17 ITC New Zealand Survey
This study, published in Tobacco Regulatory Science, explores understanding of addiction and nicotine, as well as support and interest in low-nicotine cigarettes among New Zealand (NZ) smokers and recent quitters.

Nicotine patches used in combination with e-cigarettes (with and without nicotine) for smoking cessation: a pragmatic, randomised trial
Combination nicotine replacement therapy shows additive cessation benefits. This study, published in The Lancet: Respiratory Medicine, aimed to find out the effectiveness of combining nicotine patches with an e-cigarette (with and without nicotine) on six-month smoking abstinence.

Disparities related to the age of smoking initiation and transition into daily smoking in New Zealand
Understanding trends and disparities related to the age of smoking initiation and transition into daily smoking is important for monitoring the progress of tobacco control strategies. This report, published by the Health Promotion Agency, explores the age of smoking initiation and transition into daily smoking using a nationally representative sample of New Zealanders aged 15 years and over (the 2018 Health and Lifestyles Survey, HLS). The study examined the mean age of smoking initiation and transition into daily smoking as a whole and by age, gender, ethnicity and deprivation status. This study also compared results over time.


Weight Management (New Zealand)

A co-designed mHealth programme to support healthy lifestyles in Māori and Pasifika peoples in New Zealand (OL@-OR@): a cluster-randomised controlled trial
The OL@-OR@ mobile health programme was co-designed with Māori and Pasifika communities in New Zealand, to support healthy lifestyle behaviours. This study, published in The Lancet Digital Health, aimed to determine whether use of the programme improved adherence to health-related guidelines among Māori and Pasifika communities in New Zealand compared with a control group on a waiting list for the programme.


Childhood Obesity (New Zealand)

The relationship between transport-to-school habits and physical activity in a sample of New Zealand adolescents
Adolescents using active transport (AT) to school have higher levels of physical activity (PA) compared with motorized transport (MT) users. This study, published in the Journal of Sport and Health Science, compared school day and weekend day PA in adolescents using AT, MT, or combined AT and MT (AT + MT) to travel to school.

Ranked Importance of Childhood Obesity Determinants: Parents' Views across Ethnicities in New Zealand
This study, published in Nutrients, explores Māori, Pacific, Indian, and New Zealand European pre-school children's caregivers' views on determinants of childhood obesity to help inform strategies that will reduce disparities in prevalence.


Key Ministry of Health Publications

Improving New Zealand’s childhood immunisation rates
This report was commissioned by the Ministry in May 2019 to explore the factors leading to declining immunisation rates and to inform the development of interventions and policy solutions to counter it.


District Health Board Initiative

Starship's paediatric antibiotics prescribing app sees downloads in every DHB
Starship Children's Hospital has adapted Auckland District Health Board's Script app for paediatric patients, promising to make prescribing antibiotics for children more efficient and safer for clinicians. The Script for Paediatrics app brings over 250 separate web-based guidelines together, feeding into multiple algorithms which map a path for users to identify the correct antibiotic and treatment plan and helping to ensure the most targeted antibiotic is prescribed.


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.


Ministry of Health - Manatū Hauora
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