Issue 263 - 13 October 2022

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 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

A review of localised Māori community responses to Covid-19 lockdowns in Aotearoa New Zealand
Aotearoa New Zealand has been commended for the overarching effectiveness of its Covid-19 response. Yet, the lockdowns challenged the health of whānau Māori (Māori families) alongside their social, cultural and financial well-being. However, Māori have repeatedly demonstrated innovative means of resilience throughout the pandemic. This review, published in AlterNative, aimed to document the local grassroots, community-level responses to Covid-19 lockdowns by Māori.

Health Equity (New Zealand)

Indigenous and Non-Indigenous Theories of Wellbeing and Their Suitability for Wellbeing Policy
A growing interest among governments in policies to promote wellbeing has the potential to revive a social view of health promotion. However, success may depend on the way governments define wellbeing and conceptualize ways to promote it. This paper, published in the International Journal of Environmental Research and Public Health, analyses theories of wellbeing to discern twelve types of wellbeing theory and assess the suitability of each type of theory as a basis for effective wellbeing policies. 

Quality Improvement (New Zealand)

Responding to the tāngata whai ora voice: an Aotearoa New Zealand quality improvement solution
Understanding and responding to the voice of people receiving mental health and addiction services is imperative. The policy environment in Aotearoa New Zealand is shifting to place greater value on gathering input and feedback from people accessing health services. This viewpoint article, published in the New Zealand Medical Journal, looks at the use of patient reported experience measures (PREMs), with a particular focus on mental health and addiction services and the development of the Mārama Real-Time Feedback tool (Mārama). 

Hospital Productivity (International)

Reducing delayed transfer of care in older people: A qualitative study of barriers and facilitators to shorter hospital stays
Growing numbers of older patients occupy hospital beds despite being ‘medically fit’ for discharge. These delayed transfers of care amplify inefficiencies in care and can cause harm. Delayed transfer because of family or patient choice is common; yet, research on patient and family perspectives is scarce. This study, published in Health Expectations, aims to understand and identify barriers to, and facilitators of, shorter hospital stays, and older people's and caregivers' thoughts and feelings about the benefits and harms of being in hospital and the decisions made at discharge. 

Cancer Services (New Zealand)

Human papillomavirus self‐testing among unscreened and under‐screened Māori, Pasifika and Asian women in Aotearoa New Zealand: A preference survey among responders and interviews with clinical‐trial nonresponders
Māori, Pasifika and Asian women are less likely to attend cervical screening and Māori and Pasifika women are more likely to be diagnosed with later-stage cervical cancer than other women in Aotearoa New Zealand. This study, published in Health Expectations, explored the acceptability of a human papillomavirus (HPV) self-test kit and the preferred method for receiving it.

Cardiovascular Disease and Diabetes (New Zealand)

They're sicker than we think: an exploratory study profiling the cardio-metabolic health in a sample of adults with pre-diabetes in Aotearoa New Zealand
Type 2 diabetes mellitus (T2DM) is a highly prevalent and potentially preventable condition associated with significant health, social, and economic costs. The detection and management of pre-diabetes is an important opportunity to prevent or delay the onset of T2DM and associated morbidities; however, its importance is controversial as the health risks associated with pre-diabetes are poorly understood. This study, published in the Journal of Primary Health, aims to understand the cardio-metabolic health profile of a sample of adults with pre-diabetes in Aotearoa New Zealand. The development of tools using multiple relevant variables and predicting a comprehensive range of outcomes would improve timely risk stratification and treatment effect monitoring of pre-diabetes populations. 

Understanding barriers to diabetes eye screening in a large rural general practice: an audit of patients not reached by screening services
Diabetes is a leading cause of blindness in New Zealanders, yet a significant proportion of patients with diabetes are not reached by diabetes eye screening. This study, published in the Journal of Primary Care, audited patients with diabetes in a large New Zealand rural general practice, to identify addressable barriers preventing patients from attending diabetes eye screening.

Primary Health Care (New Zealand)

Process evaluation of the Safer Prescribing and Care for the Elderly (SPACE) cluster randomised controlled trial in New Zealand general practice
This process evaluation, published in the Journal of Primary Health Care, explores research participation, intervention uptake, and effect on GPs of the Safer Prescribing and Care for the Elderly (SPACE) cluster randomised controlled trial.

Understanding and experience of climate change in rural general practice in Aotearoa-New Zealand
The public health effects of Climate Change are varied and complex, and rural primary care staff will be at the front line of effects and responses. However, little is known about their understanding and experience. This mixed-methods survey of rural general practice staff was published in Family Practice. Responses were thematically analysed using a deductive framework based on Te Whare Tapa Whā.

Primary Health Care (International)

Better self-care through co-care? A latent profile analysis of primary care patients' experiences of e-health–supported chronic care management
Efficient self-care of chronic conditions requires that an individual's resources be optimally combined with healthcare's resources, sometimes supported by e-health services (i.e., co-care). This calls for a system perspective of self-care to determine to what extent it involves demanding or unnecessary tasks and whether role clarity, needs support, and goal orientation are sufficient. This study, published in Frontiers in Public Health, aims to explore typical configurations of how the co-care system is experienced by individuals with chronic conditions who used an e-health service supporting self-monitoring and digital communication with primary care.

Recommendations for community pharmacy to improve access to medication advice for people from ethnic minority communities: A qualitative person‐centred codesign study
Medicines-centred consultations are vital to support medicine effectiveness and optimise health outcomes for patients. However, inequalities negatively impact ethnic minority populations when accessing medicines advice. It is important to identify opportunities to improve access for these communities however, knowledge of how best to achieve this is lacking. This study, published in Health Expectations, will generate recommendations to improve access to medicines advice from community pharmacies for people from ethnic minority communities.

Intervention components of link worker social prescribing programmes: A scoping review
In the United Kingdom (UK), link worker social prescribing has emerged as an option to improve long-term condition management and address primary care patients' non-medical needs by linking patients with community-based activities and support. Social prescribing is a complex, heterogenous intervention, and there is currently no taxonomy of components to guide its implementation and evaluation. This scoping review, published in Health & Social Care in the Community, aimed to identify and categorise the components of link worker social prescribing schemes in the United Kingdom. 

Primary Mental Health (New Zealand)

Equitable Access to Wellbeing framework
The Equitable Access to Wellbeing framework, published by Te Pou, is a knowledge and skills framework for mental health, addiction, and disability workforces working in primary, secondary, and tertiary contexts. The framework aims to strengthen the workforce to provide better support and improve outcomes for disabled people experiencing mental distress and their whānau. 

Primary Mental Health (International)

Digital Health Interventions for Depression and Anxiety Among People With Chronic Conditions: Scoping Review
Chronic conditions are characterised by their long duration, need for ongoing medical attention, and limitations in activities of daily living. These can often co-occur with depression and anxiety as common and detrimental comorbidities among the growing population living with chronic conditions. Digital health interventions (DHIs) hold promise in overcoming barriers to accessing mental health support for these individuals; however, the design and implementation of DHIs for depression and anxiety in people with chronic conditions are yet to be explored. This study, published in the Journal of Medical Internet Research, aimed to explore what is known in the literature regarding DHIs for the prevention, detection, or treatment of depression and anxiety among people with chronic conditions. 

Increased Immunisation (New Zealand)

Mapping the maternal vaccination journey and influencing factors for Māori women in Aotearoa New Zealand: a qualitative study
Uptake of maternal vaccinations (MVs) is suboptimal in Aotearoa New Zealand, particularly for Māori. This study, published in the Journal of Primary Health, aims to describe Māori women’s journeys regarding maternal pertussis and influenza vaccinations and explore influences on uptake. Women’s decisions appeared largely straight-forward, with influences including awareness, knowledge, underlying beliefs and previous MVs. 

Smoking Cessation (International)

Effectiveness of non-pharmacological community-based nursing interventions for smoking cessation in adults: A systematic review
The purpose of this systematic review, published in Public Health Nursing, was to determine the effectiveness of non-pharmacological community-based nursing interventions for smoking cessation in adults. 

Weight Management (International)

Effectiveness of mobile health interventions targeting parents to prevent and treat childhood Obesity: Systematic review
Childhood obesity is a high prevalence condition that causes a high burden of disease in adulthood. Mobile phone app are increasingly used to prevent it. This systematic review, published in Preventative Medicine Reports, summarises the evidence on the effectiveness of mobile apps for devices used by parents to prevent and treat childhood and adolescent obesity. 

Disability Services (New Zealand)

Community‐based social care models for indigenous people with disability: A scoping review of scholarly and policy literature
Disability is experienced and understood by Indigenous people internationally in distinct ways from other populations, requiring different approaches in disability services. Furthermore, Indigenous populations access disability services at low rates. In response, policymakers, service providers and Indigenous organisations have developed specific models of care for Indigenous people with disability. To inform policy and practice, this scoping review of community-based models of social care designed to meet the needs of Indigenous peoples in Australia, Aotearoa New Zealand, Canada and the United States was conducted, and was published in Health & Social Care in the Community.

Key Ministry of Health Publications

Office of the Director of Mental Health and Addiction Services Regulatory Report 1 July 2020 to 30 June 2021
The Office of the Director of Mental Health and Addiction Services Regulatory Report 1 July 2020 to 30 June 2021 provides information and statistics relating to the role of the Director of Mental Health and Addiction Services in the mental health and addiction sector. 

COVID-19 Mortality in Aotearoa New Zealand: Inequities in Risk
This publication provides an analysis of COVID-19 mortality in Aotearoa New Zealand and the inequities of risk associated with several factors including ethnicity, age, vaccination and deprivation. 

New Zealand Maternity Clinical Indicators 2019 and 2020
The New Zealand Maternity Clinical Indicators present comparative maternity interventions and outcomes data for pregnant women/people and their babies giving birth in New Zealand, by maternity facility and district health board region. 

Ministry of Health Consultations & Events

Workforce Survey Abortion Services [Contraception, Sterilisation and Abortion Act 1977 ] - New Zealand Ministry of Health - Citizen Space
This survey is aimed at individual health practitioners who currently provide, are looking to provide, or who want to know more about providing abortion care. This includes anyone who can provide an aspect of abortion care under the Act, including medical practitioners, nurses, midwives, as well as social workers or counsellors who may provide counselling. The survey will run from 15 September until 31 October 2022 

Health Sector Initiative

Whangārei Community Mental Health Services Boosted By New Employment Support Roles
Whangārei community mental health services have been boosted by two employment support roles over the past year, with the most recent appointee beginning to work with clients just this week. The two roles are with the Te Whatu Ora – Te Tai Tokerau IPS (individual placement support) employment service. IPS is a specific type of supported employment programme (co-funded by Te Whatu Ora – Te Tai Tokerau and the Ministry of Social Development) that was originally developed for people experiencing mental health and addiction issues to receive services from community mental health teams. IPS offers intensive, individually tailored support to help people find a job of their choosing, and ongoing support for the employer and employee to help ensure the person keeps their job. 

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.