Ministry of Health Library

Health Improvement and Innovation Digest

Issue 217 - 10 September 2020

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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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.

Health Equity (New Zealand)

Ethnic differences in cardiovascular risk profiles among 475,241 adults in primary care in Aotearoa, New Zealand
In Aotearoa, New Zealand, cardiovascular disease (CVD) burden is greatest among Indigenous Māori, Pacific and Indian people. The aim of this study, published in the New Zealand Medical Journal, was to describe CVD risk profiles by ethnicity.

Estimated inequities in COVID-19 infection fatality rates by ethnicity for Aotearoa New Zealand
There is limited evidence as to how clinical outcomes of COVID-19 including fatality rates may vary by ethnicity. This study, published in the New Zealand Medical Journal, aims to estimate inequities in infection fatality rates in New Zealand by ethnicity.

Racism and health in Aotearoa New Zealand: a systematic review of quantitative studies
Racism is an underlying cause of ethnic health inequities both in Aotearoa New Zealand and internationally. It is timely to synthesise racism and health research within New Zealand particularly given the current policy environment and shift towards addressing the health effects of racism. The aim of this study, published in the New Zealand Medical Journal, was to review quantitative research examining self-reported experiences of racial discrimination and associations with measures of health (health conditions, health risk, health status and healthcare) in New Zealand.

Health Equity (International)

Costs and effectiveness of a culturally tailored communication training program to increase cultural competence among multi-disciplinary care management teams
Several studies have demonstrated that cultural competence improves patient-provider communication, which promotes adherence to established care plans and improves patient satisfaction and health outcomes. However, there is very little data available regarding the costs associated with the development and implementation of cultural competence training, or the cost-effectiveness of these programs. To that end, this evaluation, published in BMC Health Services Research, aims to describe costs, program effectiveness, and cost-effectiveness of a culturally tailored communication training program to improve cultural competence among multi-disciplinary care management teams.

Hospital Productivity (International)

Transit Care Hub pharmacist: improving patient flow within the hospital
The Transit Care Hub (TCH) is an inpatient ward traditionally used as a waiting area for patients who require transport to return home. In July 2018, a six-month pilot of a TCH pharmacist was funded to improve the flow of patients through the hospital. The objective of this study, published in the International Journal of Clinical Pharmacy, was to determine the effect that the TCH pharmacist had on patient flow within the hospital and on the time saved for other clinical pharmacists, as well as estimating cost savings.

Cancer Services (International)

Adult cancer patients’ barriers toward pain management: A literature review
Cancer pain is the most common symptom among cancer patients. Despite strategies to control cancer pain, cancer patients’ beliefs and attitudes influence the effectiveness of cancer pain management. The aim of this literature review, published in the Journal of Nursing Education and Practice, was to identify and explore adult cancer patients’ barriers toward pain management.

Cardiovascular Disease and Diabetes (New Zealand)

Pregnancy outcomes among multi‐ethnic women with different degrees of hyperglycaemia during pregnancy in an urban New Zealand population and their association with postnatal HbA1c uptake
Adverse pregnancy outcomes are more common in women with hyperglycaemia. Many women have suboptimal uptake of HbA1c testing postdelivery. The aim of this study, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, was to compare pregnancy outcomes among multi‐ethnic women with different degrees of hyperglycaemia during pregnancy, and their association with postnatal HbA1c uptake after the introduction of email reminders.

Cardiovascular Disease and Diabetes (International)

Evidence generated from a realist synthesis of trials on educational weight loss interventions in type 2 diabetes mellitus
Obesity and diabetes are major public health problems. Current approaches to weight loss show varying success. Complex community‐based interventions work through several interconnected stages. An individual’s actions in response to an intervention depend on many known and unknown factors, which vary among individuals. The aim of this article, published in Diabetic Medicine, was to conduct a realist synthesis to identify in which context, for whom, in what circumstances, and how weight loss interventions work in obese or overweight individuals with type 2 diabetes.

Primary Health Care (International)

Competencies to promote collaboration between primary and secondary care doctors: an integrative review
In a society where ageing of the population and the increasing prevalence of long-term conditions are major issues, collaboration between primary and secondary care is essential to provide continuous, patient-centred care. Doctors play an essential role at the primary-secondary care interface in realising ‘seamless’ care. Therefore, they should possess collaborative competencies. However, knowledge about these collaborative competencies is scarce. This review, published in BMC Family Practice, explored what competencies doctors needed to promote collaboration between doctors at the primary-secondary care interface.

Primary Mental Health (New Zealand)

Skills for integration in community/primary health setting - draft for consultation
This document, from Te Pou, describes a process of integration, development and change, which supports enhanced mental health and addiction services in primary health and community settings.

Primary Mental Health (International)

An overview of systematic reviews on mental health promotion, prevention, and treatment of common mental disorders for refugees, asylum seekers, and internally displaced persons
Migrants who have been forced to leave their home, such as refugees, asylum seekers, and internally displaced persons (IDP), are likely to experience stressors which may lead to mental health problems. The efficacy of interventions for mental health promotion, prevention, and treatment may differ in this population. This Cochrane Review overview of systematic reviews, will map the characteristics and methodological quality of existing systematic reviews and registered systematic review protocols on the promotion of mental health and prevention and treatment of common mental disorders among refugees, asylum seekers, and IDPs.

Primary Substance Use Prevention Programs for Children and Youth: A Systematic Review
The objective of this systematic review, published in Pediatrics, was to assess the strength of the scientific evidence for psychoactive substance abuse prevention programs for school-aged children and youth.

Effects of Internet-Based Cognitive Behavioral Therapy in Routine Care for Adults in Treatment for Depression and Anxiety: Systematic Review and Meta-Analysis
Although there is evidence for the efficacy of internet-based cognitive behavioral therapy (iCBT), the generalizability of results to routine care is limited. This study, published in the Journal of Medical Internet Research, systematically reviews effectiveness studies of guided iCBT interventions for the treatment of depression or anxiety.

Weight Management (International)

Parent Involvement in Adolescent Obesity Treatment: A Systematic Review
Family-based lifestyle interventions are recommended for adolescent obesity treatment, yet the optimal role of parents in treatment is unclear. The objective of this review, published in Pediatrics, was to examine systematically the evidence from prospective randomized controlled and/or clinical trials (RCTs) to identify how parents have been involved in adolescent obesity treatment and to identify the optimal type of parental involvement to improve adolescent weight outcomes.

Efficacy of a Multi-component m-Health Weight-loss Intervention in Overweight and Obese Adults: A Randomised Controlled Trial
This study, published in the International Journal of Environmental Research and Public Health, compared the efficacy of two multi-component m-health interventions with a wait-list control group on body weight (primary outcome), and secondary outcomes of cardiovascular risk factors, lifestyle behaviours, and mental health.

Childhood Obesity (International)

Communication tools used in childhood obesity discussions: A scoping review
Paediatric healthcare professionals (HCPs) play an essential role in the prevention and management of childhood obesity; however, many report considerable barriers to having weight‐related conversations, including a lack of confidence. One way to address this is to use communication tools, such as charts, pictures and handouts. The objective of this scoping review, published in Child: Care, Health and Development, was to identify the extent and nature of available tools in the published literature that aimed to support HCPs in having positive weight‐related conversations with children and families.

Disability Services (International)

Self-Determination in People with Intellectual Disability: The Mediating Role of Opportunities
The Convention on the Rights of Persons with Disabilities have proclaimed the basic right of people to make one’s own choices, have an effective participation and inclusion. Research in the field of disability have stressed self-determination as a key construct because of its impact on their quality of life and the achievement of desired educational and adulthood related outcomes. Self-determination development must be promoted through specific strategies and especially, by providing tailored opportunities to practice those skills. Providing these opportunities across environments could be especially relevant as a facilitator of self-determination development. This manuscript, published in International Journal of Environmental Research and Public Health, aims to ascertain if opportunities at home and in the community to engage in self-determined actions are mediating the relationship between people intellectual disability level and their self-determination.

Key Ministry of Health Publications

National Framework for Home and Community Support Services (HCSS)
The National Framework for  Home and Community Support Services (HCSS) provides guidance for district health boards for future commissioning, developing, delivering and evaluating HCSS to improve national consistency and quality of care.

Primary Maternity Services Notice Review 2021
This consultation is seeking feedback on the Ministry of Health’s proposed changes to the Primary Maternity Services Notice pursuant to Section 88 of the New Zealand Public Health and Disability Act 2000 (the Notice). Submissions close 5.00 pm, Friday 13 November 2020.

District Health Board Initiative

New service benefits patients with diabetic foot disease
People with diabetes in Southland, who are at high risk or have active foot disease, will benefit from a new service that brings patients together with a multidisciplinary team of specialists every Friday.

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.