Counties Manukau District Research Articles

Exploring older people’s attitudes and preferences around the use of their routinely collected healthcare data in brain health research

AbstractBackgroundOver 50% of dementia in NZ may be due to high prevalence of risk factors such as hypertension, diabetes and cardiovascular disease. If so, a better understanding of the relationships may present ways to mitigate the risk of dementia. Community‐based epidemiological studies would provide definitive evidence but are resource‐intensive so we need to explore alternative sources of data such as routinely collected health information.The overarching aim of our research is to use a machine learning model to identify population groups at high risk of cognitive decline and/or dementia. But first we need to gauge the appetite of service users to have their personal data used in this way. This study aimed to explore the attitudes and preferences of people aged 55+ living in Counties Manukau regarding the use of their de‐identified health data and understanding their concerns and degree of comfort in different scenarios.MethodAn anonymous online survey was conducted with people aged 55+ from NZ European, Māori, Pacific, Chinese and Indian communities currently engaged with older adult health services in Counties Manukau District in 2022. We offered service users the opportunity to complete the survey by telephone if preferred, and the opportunity to be interviewed in languages other than English to ensure adequate representation of the local population.ResultOver 85% of the participants were aware of how their health information was used for service development and assessing population trends, and about 80% were comfortable or very comfortable with data being used in this way, assuming data were stored securely and confidentiality was assured. Participants generally felt that patients’ permission was required if data were being analysed by people other than health professionals or being used by commercial companies, and that there should be transparency about these uses. There were some specific cultural concerns about patients’ data being used after their death.ConclusionThis study supports the idea that the local population are generally supportive of researchers using their de‐identified routinely collected data for research purposes that will benefit the population from which the data were taken, but specific cultural concerns need to be addressed.

Co-design of youth appropriate services for young people with rheumatic fever/rheumatic heart disease in Counties Manukau District.

To co-design a rheumatic fever service model which enables young people with acute rheumatic fever/rheumatic heart disease (ARF/RHD) and their families to access the health and wellbeing services they need. Co-design, a collaborative and participatory approach, was used to gather experiences and ideas from 21 consumers and 30 health professionals. Thematic analysis was undertaken. Māori and Pacific patients and their whānau/aiga identified the importance of whānau/aiga support and involvement throughout their ARF/RHD journey. They described that the way care was delivered was often frustrating, fragmented and lacked effective communication. Participants expressed the need for information to improve their understanding of ARF/RHD. Health professionals identified the need for better continuity of care and felt that they were currently working siloed from other professionals with little visibility of other roles or opportunity for collaboration. The ideas for improvement were grouped into themes and resulted in development and prototyping of peer support groups, patient and staff education resources, clinical dashboard and pathway development, and an enhanced model of care for delivery to patients receiving penicillin prophylaxis. The co-design process enabled consumers and staff of ARF/RHD services to share experiences, identify ideas for improvement, co-design prototypes and test initiatives to better support the needs of those delivering and receiving ARF/RHD services.

The Use of Victim Video Statements in Family Violence Cases Increases the Rate of Early Guilty Pleas.

A natural experiment is used to determine the effect of victim video statements (VVS) on the rate of early guilty pleas in cases of domestic violence. Participants were part of a trial conducted in 2017-2018 by New Zealand Police, in Counties Manukau District, South Auckland. Cases that met the eligibility criteria but did not result in a VVS formed the control group with written statements taken. Analyses were restricted to cases that proceeded to a court hearing (VVS group: n = 168, control group: n = 108). The key question was whether taking a VVS would increase the rate of early guilty pleas. A logistic regression model controlled two additional factors: (a) being bailed or remanded and (b) the seriousness of charges. VVS cases resulted in 44% early guilty pleas compared with 30% for those with written statements. VVS have a statistically significant increase in the odds of making a guilty plea, adjusted odds ratio (AOR) =1.77, 95% confidence interval (CI) = [1.02, 3.06], when controlling for the other factors. The results indicate that VVS can be used to reduce demand pressure on the criminal justice system. The findings are considered in terms of the complex relationship between offenders and victims that commonly results in the retraction of written statements.