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Amoakoh HB, De Kok BC, Yevoo LL, Olde Loohuis KM, Srofenyoh EK, Arhinful DK, Koi-Larbi K, Adu-Bonsaffoh K, Amoakoh-Coleman M, Browne JL. Co-creation of a toolkit to assist risk communication and clinical decision-making in severe preeclampsia: SPOT-Impact study design. Glob Health Action 2024; 17:2336314. [PMID: 38717819 PMCID: PMC11080670 DOI: 10.1080/16549716.2024.2336314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
Globally, the incidence of hypertensive disorders of pregnancy, especially preeclampsia, remains high, particularly in low- and middle-income countries. The burden of adverse maternal and perinatal outcomes is particularly high for women who develop a hypertensive disorder remote from term (<34 weeks). In parallel, many women have a suboptimal experience of care. To improve the quality of care in terms of provision and experience, there is a need to support the communication of risks and making of treatment decision in ways that promote respectful maternity care. Our study objective is to co-create a tool(kit) to support clinical decision-making, communication of risks and shared decision-making in preeclampsia with relevant stakeholders, incorporating respectful maternity care, justice, and equity principles. This qualitative study detailing the exploratory phase of co-creation takes place over 17 months (Nov 2021-March 2024) in the Greater Accra and Eastern Regions of Ghana. Informed by ethnographic observations of care interactions, in-depth interviews and focus group and group discussions, the tool(kit) will be developed with survivors and women with hypertensive disorders of pregnancy and their families, health professionals, policy makers, and researchers. The tool(kit) will consist of three components: quantitative predicted risk (based on external validated risk models or absolute risk of adverse outcomes), risk communication, and shared decision-making support. We expect to co-create a user-friendly tool(kit) to improve the quality of care for women with preeclampsia remote from term which will contribute to better maternal and perinatal health outcomes as well as better maternity care experience for women in Ghana.
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Affiliation(s)
- Hannah Brown Amoakoh
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Bregje C. De Kok
- Anthropology Department, University of Amsterdam, Amsterdam, Netherlands
| | - Linda Lucy Yevoo
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Obstetrics and Gynaecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Klaartje M. Olde Loohuis
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Emmanuel K. Srofenyoh
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Obstetrics and Gynaecology, Greater Accra Regional Hospital, Accra, Ghana
| | - Daniel K. Arhinful
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Kwame Adu-Bonsaffoh
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, Accra, Ghana
| | - Mary Amoakoh-Coleman
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Joyce L. Browne
- Department of Global Health and Bioethics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Wargers A, Polychronakis K, Nieboer D, Raat H, Jansen W. Co-creation and implementation of a healthy lunch at Dutch primary schools in disadvantaged neighbourhoods: design of a cluster randomised cross-over effectiveness study. BMJ Open 2024; 14:e083534. [PMID: 39414278 DOI: 10.1136/bmjopen-2023-083534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2024] Open
Abstract
INTRODUCTION The majority of children fails to have a healthy diet. Providing a healthy lunch at school is a way to target all children, regardless of ethnic and socioeconomic background. This study aims to investigate the effectivity and feasibility of a co-created healthy school lunch in disadvantaged neighbourhoods of the city of Rotterdam, the Netherlands. METHODS AND ANALYSIS This is a cluster randomised cross-over trial with five participating primary schools. Schools will be randomised to have an 18 week healthy school lunch the first or second half of the academic year. The other half of the academic year, children will bring their own lunch from home. A tailored lunch concept for each school will be co-created with school staff, parents, children and key-stakeholders.Primary outcome is the dietary content of children's lunches, assessed by observations for all children. Secondary outcomes include healthy lunch-related parameters, like general dietary behaviour, perceived health, taste preferences, concentration in class, and some feasibility outcomes, like satisfaction, implementation at school and affordability for parents. Secondary outcomes will be assessed by questionnaires for children (grades 5-8), parents and teachers. The observations and questionnaires for children and parents will be completed at baseline (September 2023), half way the academic year (January-February 2024) and at the end of the academic year (June-July 2024). Teachers will complete a monthly questionnaire starting in September 2023. ETHICS AND DISSEMINATION This study obtained ethical approval from the Institutional research Review Board Erasmus MC of Rotterdam, the Netherlands. Informed consent will be collected from all participants (parents, teachers and children 12 years or older) and/or their parents (for children under the age of 16). The findings will be disseminated by conference presentations and publications in scientific peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT06058325.
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Affiliation(s)
- Annemieke Wargers
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Daan Nieboer
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Wilma Jansen
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Social Development, City of Rotterdam, Rotterdam, the Netherlands
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Whitelaw S, Vijay D, Clark D. Where are the values in evaluating palliative care? Learning from community-based palliative care provision. Palliat Care Soc Pract 2024; 18:26323524241287223. [PMID: 39381713 PMCID: PMC11459518 DOI: 10.1177/26323524241287223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 09/10/2024] [Indexed: 10/10/2024] Open
Abstract
Background The World Health Organization Astana Declaration of 2018 sees primary healthcare as key to universal health coverage and gives further support to the goal of building sustainable models of community palliative care. Yet evaluating the benefits of such models continues to pose methodological and conceptual challenges. Objective To explore evaluation issues associated with a community-based palliative care approach in Kerala, India. Design An illuminative case study using a rapid evaluation methodology. Methodology Qualitative interviews, documentary analysis and observations of home care and community organising. Results We appraise a community palliative care programme in Kerala, India, using three linked 'canvases' of enquiry: (1) 'complex' multi-factorial community-based interventions and implications for evaluation; (2) 'axiological' orientations that foreground values in any evaluation process and (3) the status of evaluative evidence in postcolonial contexts. Three values underpinning the care process were significant: heterogeneity, voice and decentralisation. We identify 'objects of interest' related to first-, second- and third-order outcomes: (1) individuals and organisations; (2) unintended targets outside the core domain and (3) indirect, distal effects within and outside the domain. Conclusion We show how evaluation of palliative care in complex community circumstances can be successfully accomplished when attending to the significance of community care values.
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Affiliation(s)
- Sandy Whitelaw
- School of Social and Environmental Sustainability, University of Glasgow, Dumfries Campus, Bankend Road, Dumfries, DG1 4ZL, UK
| | - Devi Vijay
- Department of Organizational Behavior, Indian Institute of Management Calcutta, Kolkata, India
| | - David Clark
- School of Social and Environmental Sustainability, University of Glasgow, Glasgow, UK
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Palumbo L, Picchio CA, Barbier F, Calderon-Cifuentes A, James J, Lunchenkov N, Nutland W, Owen G, Orkin C, Rocha M, Shanley A, Stevenson L, Vinti P, Salvi C. Co-creating a Mpox Elimination Campaign in the WHO European Region: The Central Role of Affected Communities. Open Forum Infect Dis 2024; 11:ofae523. [PMID: 39355261 PMCID: PMC11443334 DOI: 10.1093/ofid/ofae523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 09/06/2024] [Indexed: 10/03/2024] Open
Abstract
Between May 2022 and September 2023, the World Health Organization (WHO) Regional Office for Europe engaged in a collaborative effort with affected communities to address the outbreak of mpox in the region. This concerted endeavor led to the development of a risk communication campaign specifically tailored to address the perceptions and needs of the target audience, thereby contributing to the control and the long-term goal of mpox elimination. Various community engagement interventions were implemented, including the establishment of an informal civil society organizations' working group to provide feedback on the WHO mpox campaign, webinars targeting event organizers, and roundtable discussions with country-level responders. The invaluable feedback garnered from the community was utilized to customize materials and extend outreach to groups that may have been overlooked in the initial response. This successful initiative underscored the immense potential of placing communities at the forefront of emergency response efforts, equipping them with the necessary resources, engagement, and empowerment. This offers 1 model of co-creation that can be applied to health emergencies. It is asserted that the pivotal role played by communities in this response should be recognized as a valuable lesson and incorporated into all emergency responses, ensuring sustained community involvement and empowerment throughout the entire emergency cycle.
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Affiliation(s)
- Leonardo Palumbo
- Risk Communication, Community Engagement, and Infodemic Management Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Camila A Picchio
- Risk Communication, Community Engagement, and Infodemic Management Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | | | | | - Jules James
- European Sex Worker Rights Alliance, Amsterdam, The Netherlands
| | - Nikolay Lunchenkov
- Health and Capacity Building Department, Eurasian Coalition on Health, Rights, Gender, and Sexual Diversity, Tallinn, Estonia
- School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
| | | | - Greg Owen
- PrEP Team, Terrence Higgins Trust, London, United Kingdom
| | - Chloe Orkin
- SHARE Collaborative, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Miguel Rocha
- Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | | | - Luca Stevenson
- European Sex Worker Rights Alliance, Amsterdam, The Netherlands
| | - Pietro Vinti
- Joint Infectious Diseases Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Cristiana Salvi
- Risk Communication, Community Engagement, and Infodemic Management Unit, World Health Organization European Regional Office, Copenhagen, Denmark
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Mygind A, Offersen SMH, Guldin MB, Christensen KS, Nielsen MK. How to support caregivers in general practice: development of the Caregiver Care Model. Palliat Care Soc Pract 2024; 18:26323524241272103. [PMID: 39346009 PMCID: PMC11437575 DOI: 10.1177/26323524241272103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 06/11/2024] [Indexed: 10/01/2024] Open
Abstract
Background Caring for a family member can be demanding, particularly when caregivers experience profound distress. Supportive interventions may help prevent mental and physical illness in the caregiver. General practice plays a key role by regularly engaging with patients and caregivers, thereby being able to identify their support needs, offer talk therapy and refer to care initiatives. Objective This study aimed to develop and pilot-test the Caregiver Care Model to mitigate grief reactions among caregivers in general practice. Design A participatory intervention development study. Methods A prototype was developed in a workshop with healthcare professionals. The prototype was refined based on a pilot-test among 40 caregivers from 5 general practice clinics and a workshop with general practitioners. The data were obtained from workshops, feedback questionnaires completed by healthcare professionals, and interviews with caregivers and general practitioners. The analysis focused on model development and mechanisms of impact. Results The prototype was refined by focusing the dialogue questionnaire, minimising the grief facilitation tools and expanding the target group. The prototype seemed to accommodate the needs among caregivers by acknowledging their situation. The final model includes up to seven caregiver consultations in general practice. A dialogue questionnaire filled in by the caregiver serves as a fixed starting point and preparation for the first consultation. If needed, talk therapy in general practice or referrals to other services are used. Conclusion The model offers promising support for caregivers. Its flexible structure allows for customisation. The viability of the model should be further tested.
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Affiliation(s)
- Anna Mygind
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark
| | | | | | - Kaj S Christensen
- Research Unit for General Practice, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
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Klager E, Teufel A, Eitenberger M, Bukowski N, Lintschinger JM, Manschein V, Metelka P, Willschke H, Schaden E, Frimmel C, Renner R, Hafner C. Expectations of healthcare professionals of community-based telemedicine in emergency medical service. PLoS One 2024; 19:e0310895. [PMID: 39298420 DOI: 10.1371/journal.pone.0310895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 09/04/2024] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND In times of demographic change and an immense shortage of qualified personnel in emergency medical services, telemedicine could offer more efficient solutions for better care. Given the community-based nature of emergency services, local communities play an important role. This study explored the expectations of healthcare professionals and volunteers for telemedicine tools in prehospital emergency medicine. METHODS This mixed-methods study was conducted in the rural region of Burgenland in Austria with stakeholders of the local emergency medical service in two focus groups (13 participants) and 99 quantitative questionnaires. RESULTS Combining quantitative and qualitative data, we found that a majority of respondents (almost 80%) already experienced basic telemedicine and consider it valuable. In particular, there is a strong expectation for diagnostic support and inquiries related to potential hospitalization. Findings from two focus groups emphasized the importance of cultivating an improved learning culture, developing a specific mindset, and refining soft skills. The optimal telemedicine solution includes a knowledgeable and experienced tele-emergency physician coupled with user-friendly technology. CONCLUSION To be clear about the expectations of stakeholders, it is essential to involve all stakeholders right from the beginning. The solution should prioritize the integration of existing structures and be seamlessly incorporated into an evolving learning culture, while also fostering the necessary mindsets alongside educational aspects.
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Affiliation(s)
- Elisabeth Klager
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
| | - Anna Teufel
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
| | | | - Nils Bukowski
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
- Department of Anaesthesia, Medical University of Vienna, General Intensive Care and Pain Medicine, Vienna, Austria
| | - Josef Michael Lintschinger
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
- Department of Anaesthesia, Medical University of Vienna, General Intensive Care and Pain Medicine, Vienna, Austria
| | - Valerie Manschein
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
| | - Philipp Metelka
- Department of Anaesthesia, Medical University of Vienna, General Intensive Care and Pain Medicine, Vienna, Austria
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
- Department of Anaesthesia, Medical University of Vienna, General Intensive Care and Pain Medicine, Vienna, Austria
| | - Eva Schaden
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
- Department of Anaesthesia, Medical University of Vienna, General Intensive Care and Pain Medicine, Vienna, Austria
| | - Christoph Frimmel
- Austrian Red Cross, State Association of Burgenland, Eisenstadt, Austria
| | - Reinhold Renner
- Austrian Red Cross, State Association of Burgenland, Eisenstadt, Austria
| | - Christina Hafner
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Vienna, Austria
- Department of Anaesthesia, Medical University of Vienna, General Intensive Care and Pain Medicine, Vienna, Austria
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Price J, Harris C, Praamsma N, Brunet J. Co-creating a yoga program for women diagnosed with gynecologic cancer: a consensus study. Support Care Cancer 2024; 32:656. [PMID: 39261318 PMCID: PMC11390796 DOI: 10.1007/s00520-024-08848-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 08/31/2024] [Indexed: 09/13/2024]
Abstract
PURPOSE Yoga may be uniquely suited to address bio-psycho-social concerns among adults with gynecologic cancer because it can be tailored to individuals' needs and can help shift focus inward towards self-reflection, body appreciation, and gratitude. This study describes the collaborative process guided by the Knowledge-to-Action framework used to develop a yoga program for adults diagnosed with gynecologic cancer and inform a feasibility trial. METHODS In 3 collaborative phases, yoga instructors and women diagnosed with gynecologic cancer formulated recommendations for a yoga program and evaluated the co-created program. RESULTS The program proposed is 12 weeks in length and offers two 60-min group-based Hatha yoga classes/week to five to seven participants/class, online or in person, with optional supplemental features. Overall, participants deemed the co-created program and instructor guidebook to be reflective of their needs and preferences, though they provided feedback to refine the compatibility, performability, accessibility, risk precautions, and value of the program as well as the instructor guidebook. CONCLUSION The feasibility, acceptability, and benefits of the program are being assessed in an ongoing feasibility trial. If deemed feasible and acceptable, and the potential for enhancing patient-reported outcomes is observed, further investigation will focus on larger-scale trials to determine its value for broader implementation.
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Affiliation(s)
- Jenson Price
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada
| | - Cheryl Harris
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada
| | | | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, 125 University Private, Montpetit Hall, Room 339, Ottawa, ON, K1N 6N5, Canada.
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.
- Institut du Savoir Montfort, Hôpital Montfort, Ottawa, ON, Canada.
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McCaffrey L, McCann B, Giné-Garriga M, An Q, Cardon G, Chastin SFM, Chrifou R, Lippke S, Loisel Q, Longworth GR, Messiha K, Vogelsang M, Whyte E, Dall PM. Adult co-creators' emotional and psychological experiences of the co-creation process: a Health CASCADE scoping review protocol. Syst Rev 2024; 13:231. [PMID: 39261897 PMCID: PMC11389324 DOI: 10.1186/s13643-024-02643-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 08/22/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND There is a growing investment in the use of co-creation, reflected by an increase in co-created products, services, and interventions. At the same time, a growing recognition of the significance of co-creators' experience can be detected but there is a gap in the aggregation of the literature with regard to experience. Therefore, the purpose of this scoping review is to uncover the breadth of existing empirical research on co-creation experience, how it has been defined and assessed, and its key emotional and psychological characteristics in the context of co-created products, services, or interventions among adults. METHODS The development of the search strategy was guided by the research question, Arksey, and O'Malley's scoping review methodology guidelines, and through collaboration with members of the Health CASCADE consortium. The results of the search and the study inclusion process will be reported in full and presented both narratively and by use of the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flow diagram. Comprehensive searches of relevant electronic databases (e.g. Scopus) will be conducted to identify relevant papers. Snowball searches to identify additional papers through included full-text papers will be done using the artificial intelligence tool, namely, Connected Papers. All review steps will involve at least two reviewers. Studies in English, Dutch, Chinese, Spanish, and French, published from the year 1970 onwards, will be considered. Microsoft Excel software will be used to record and chart extracted data. DISCUSSION The resulting scoping review could provide useful insights into adult co-creators' experience of participating in the co-creation process. An increased understanding of the role of emotional and psychological experiences of participating in co-creation processes may help to inform the co-creation process and lead to potential benefits for the co-creators and co-created outcome. SYSTEMATIC REVIEW REGISTRATION 10.5281/zenodo.7665851.
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Affiliation(s)
- Lauren McCaffrey
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
| | - Bryan McCann
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maria Giné-Garriga
- Faculty of Psychology, Education and Sport Sciences Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Qingfan An
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Greet Cardon
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Sebastien François Martin Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Rabab Chrifou
- Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Sonia Lippke
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany
| | - Quentin Loisel
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Katrina Messiha
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mira Vogelsang
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Emily Whyte
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
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Corsini N, Dorman F, Scott J, Wright A, Turnbull D, Williams C, Bates D, Reading B, Everuss H, Peng F, Pearse R, Eckert M. A project co-created with the community to mitigate loneliness in midlife women. Front Public Health 2024; 12:1425641. [PMID: 39346582 PMCID: PMC11428996 DOI: 10.3389/fpubh.2024.1425641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 08/30/2024] [Indexed: 10/01/2024] Open
Abstract
This paper describes how a team of researchers, policy stakeholders and community members came together to co-create prevention-oriented and community-informed solutions to address loneliness in women-The Loneliness Project. Our aim is to encourage community partnerships and collective effort to address public health approaches to loneliness by developing a shared understanding of the issue from multiple perspectives and through the co-creation process, highlighting the key factors for co-creating a funding application for a community demonstration project.
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Affiliation(s)
- Nadia Corsini
- Co-Lab, Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Fiona Dorman
- Premier's Council for Women, Adelaide, SA, Australia
| | - Jodie Scott
- Co-Lab, Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Amanda Wright
- Co-Lab, Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Deborah Turnbull
- School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Carmel Williams
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
- Centre for Health in All Policies Research Translation, Health Translation SA, SAHMRI, Adelaide, SA, Australia
| | | | | | | | - Fanke Peng
- UniSA Creative, University of South Australia, Adelaide, SA, Australia
| | | | - Marion Eckert
- Co-Lab, Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
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Zhang K, Cao B, Fang Y, Liang X, Ye D, Chen YQ, Zhong R, Cao H, Hu T, Li T, Cai Y, Zou H, Wang Z. Comparing the Efficacy of 2 WeChat Mini Programs in Reducing Nonmarital Heterosexual Contact by Male Factory Workers: Randomized Controlled Trial. J Med Internet Res 2024; 26:e49362. [PMID: 39250213 PMCID: PMC11420611 DOI: 10.2196/49362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 04/25/2024] [Accepted: 06/25/2024] [Indexed: 09/10/2024] Open
Abstract
BACKGROUND Male factory workers in China are vulnerable to HIV transmission. Commercial and nonmarital noncommercial contacts are the driving forces of heterosexual HIV transmission among male factory workers in China. There is a lack of effective HIV interventions for male factory workers in China. OBJECTIVE The primary objective of this randomized controlled trial was to compare the efficacy of an enhanced versus the standard version of a WeChat mini program in reducing sexual intercourse with nonregular female sex partners and female sex workers among male factory workers in Shenzhen, China. METHODS A nonblinded 2-arm parallel randomized controlled trial was conducted between December 2021 and April 2023. Participants were adult male factory workers in Shenzhen who had access to a smartphone and WeChat. Those who had oral or anal sex with a man or self-reported as HIV positive were excluded. A total of 247 participants were randomly assigned to the intervention group (n=125, 50.6%) or the control group (n=122, 49.4%); 221 (89.5%) and 220 (89.1%) completed follow-up surveys at T1 (6 months after completion of the interventions) and T2 (6 months after T1). Participants in the control group had access to the standard WeChat mini program that provided basic HIV-related knowledge and information about local free HIV testing services. Participants in the intervention group had access to the enhanced WeChat mini program. The enhanced mini program covered all the information in the standard mini program. In addition, the enhanced mini program assessed users' behaviors and invited users to watch different web-based videos on reducing nonmarital sexual contacts and promoting HIV testing based on their behavioral characteristics at months 0 and 1. The videos were developed based on in-depth interviews with male factory workers. Intention-to-treat analysis was used for outcome analyses. Multiple imputation was used to replace missing outcome values at T1 and T2. RESULTS At T1, fewer participants in the intervention group reported sexual intercourse with a nonregular female sex partner in the past 6 months compared with the control group (1/125, 0.8% vs 8/122, 6.6%; relative risk=0.12, 95% CI 0.02-0.96; P=.02). However, there were no between-group differences in sexual intercourse with a nonregular female sex partner at T2 (10/125, 8% vs 14/122, 11.5%; P=.36) or sexual intercourse with a female sex worker at T1 (2/125, 1.6% vs 2/122, 1.6%; P=.98) or T2 (8/125, 6.4% vs 8/122, 6.6%; P=.96). CONCLUSIONS The enhanced WeChat mini program was more effective than the standard WeChat mini program in reducing sexual intercourse with nonregular female sex partners among male factory workers in the short term but not in the longer term. Improvements should be made to the WeChat mini program before implementation. TRIAL REGISTRATION ClinicalTrials.gov NCT05811611; https://clinicaltrials.gov/study/NCT05811611.
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Affiliation(s)
- Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Bolin Cao
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xue Liang
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Danhua Ye
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Ya Qi Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Ruilan Zhong
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen, China
| | - Ting Li
- School of Media and Communication, Shenzhen University, Shenzhen, China
| | - Yong Cai
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
| | - Zixin Wang
- Centre for Health Behaviours Research, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
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11
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Muir D, McLarty L, Drinkwater J, Bennett C, Birks Y, Broadway-Parkinson A, Cooksey V, Gleeson P, Holland C, Ledger L, Lowe DJ, McGoverin A, Nixon J, Perry T, Sandoz H, Rawson B, Rawson Y, Stubbs N, Walker K, Whitaker H, Coleman S. Pressure ulcer prevention for people with long-term neurological conditions (LTNCs) who self-manage care and live at home. J Tissue Viability 2024:S0965-206X(24)00131-1. [PMID: 39289092 DOI: 10.1016/j.jtv.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Accepted: 08/23/2024] [Indexed: 09/19/2024]
Abstract
AIM To develop a Theory of Change (ToC) pathway to facilitate the development of a multi-component intervention package supporting pressure Ulcer (PU) risk identification and management, in partnership with people with Long Term Neurological Conditions (LTNC) who self-manage care and live at home, their informal carers and PAs. METHODS A participatory approach, with extensive input from those whose lives are the focus of the research, was used throughout the 4 interlinked work packages (WP): Iterative data analysis was undertaken with emerging findings from each WP informing subsequent stages of the study. FINDINGS Overall, 74 participants contributed across the 4 WPs, incorporating 31 Service Users (SU), 8 carers, 9 Personal Assistants (PAs) and 26 professional stakeholders. We identified 8 key themes related to PU prevention, incorporating, learning, safe routines, third sector and peer support, navigating complex systems, adapting and reacting to change, perceptions of risk, risk negotiation and supporting roles. The findings indicate systemic and professional barriers which hamper people's ability to self-care and seek help. CONCLUSIONS The study highlights the complexities and impact of managing PU prevention activities at home for people with LTNC and areas of learning for health professionals and systems. By understanding these complexities we developed a systems map, identified resource requirements and illustrated a Theory of Change (ToC) pathway, to underpin future work to develop and user test an interactive, multi-component intervention.
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Affiliation(s)
- Delia Muir
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.
| | - Laura McLarty
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK
| | - Jessica Drinkwater
- Centre for Primary Care and Health Service Research, The University of Manchester, UK
| | | | - Yvonne Birks
- School for Business and Society, University of York, UK
| | | | | | - Phil Gleeson
- Pressure Ulcer at Home Co-operative Inquiry Group, UK
| | | | - Lisa Ledger
- NIHR Coordinating Centre, 21 Queen Street, Leeds, LS1 2TW, UK
| | | | | | - Jane Nixon
- Institute of Health Sciences, University, of Leeds, Leeds, LS2 9JT, UK
| | - Tanya Perry
- Pressure Ulcer at Home Co-operative Inquiry Group, UK
| | - Heidi Sandoz
- Pressure Ulcer at Home Co-operative Inquiry Group, UK
| | - Brian Rawson
- Pressure Ulcer at Home Co-operative Inquiry Group, UK
| | - Yvonne Rawson
- Tissue Viability CNS, Hertfordshire Community NHS Trust, UK
| | | | - Kay Walker
- Pressure Ulcer at Home Co-operative Inquiry Group, UK
| | | | - Susanne Coleman
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, LS2 9JT, UK.
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12
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Cao H, Chen S, Liu Y, Zhang K, Fang Y, Chen H, Hu T, Zhong R, Zhou X, Wang Z. Parental Hesitancy toward Seasonal Influenza Vaccination for Children under the Age of 18 Years and Its Determinants in the Post-Pandemic Era: A Cross-Sectional Survey among 1175 Parents in China. Vaccines (Basel) 2024; 12:988. [PMID: 39340020 PMCID: PMC11435664 DOI: 10.3390/vaccines12090988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/23/2024] [Accepted: 08/28/2024] [Indexed: 09/30/2024] Open
Abstract
Children's susceptibility to influenza increased after COVID-19 control measures were lifted. This study investigated parental hesitancy toward seasonal influenza vaccination (SIV) for children and its determinants in the post-pandemic era. An online survey of full-time adult factory workers was conducted in Shenzhen, China in December 2023. This analysis was based on 1175 parents who had at least one child under the age of 18 years. Among all parents, 37.1% were hesitant to have their index child receive SIV. Mothers exhibited lower parental hesitancy toward SIV compared to fathers (31.9% versus 41.3%, p < 0.001). After adjusting for significant background characteristics, mothers and fathers who were more satisfied with the SIV health promotion materials, perceived more severe consequences of seasonal influenza for their children, and perceived more benefits, cues to action, and self-efficacy related to their children's SIV were less likely to exhibit hesitancy toward SIV. Higher frequency of exposure to information about the increasing number of patients or severe cases due to seasonal influenza and other upper respiratory infections on social media was associated with lower parental hesitancy toward SIV among fathers but not mothers. There is a strong need to address parental hesitancy toward SIV for children in the post-pandemic era.
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Affiliation(s)
- He Cao
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (H.C.); (K.Z.); (H.C.); (T.H.); (R.Z.); (X.Z.)
| | - Siyu Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (S.C.); (Y.L.)
| | - Yijie Liu
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (S.C.); (Y.L.)
| | - Kechun Zhang
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (H.C.); (K.Z.); (H.C.); (T.H.); (R.Z.); (X.Z.)
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, China;
| | - Hongbiao Chen
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (H.C.); (K.Z.); (H.C.); (T.H.); (R.Z.); (X.Z.)
| | - Tian Hu
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (H.C.); (K.Z.); (H.C.); (T.H.); (R.Z.); (X.Z.)
| | - Rulian Zhong
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (H.C.); (K.Z.); (H.C.); (T.H.); (R.Z.); (X.Z.)
| | - Xiaofeng Zhou
- Longhua District Center for Disease Control and Prevention, Shenzhen 518110, China; (H.C.); (K.Z.); (H.C.); (T.H.); (R.Z.); (X.Z.)
| | - Zixin Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (S.C.); (Y.L.)
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13
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Kerr A, Grealy M, Slachetka M, Wodu CO, Sweeney G, Boyd F, Colville D, Rowe P. A Participatory Model for Cocreating Accessible Rehabilitation Technology for Stroke Survivors: User-Centered Design Approach. JMIR Rehabil Assist Technol 2024; 11:e57227. [PMID: 39177660 PMCID: PMC11363806 DOI: 10.2196/57227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 07/09/2024] [Accepted: 07/26/2024] [Indexed: 08/24/2024] Open
Abstract
Background Globally, 1 in 3 people live with health conditions that could be improved with rehabilitation. Ideally, this is provided by trained professionals delivering evidence-based dose, intensity, and content of rehabilitation for optimal recovery. The widely acknowledged inability of global health care providers to deliver recommended levels of rehabilitation creates an opportunity for technological innovation. Design processes that lack close consideration of users' needs and budgets, however, mean that many rehabilitation technologies are neither useful nor used. To address this problem, our multidisciplinary research group have established a cocreation center for rehabilitation technology that places the end user at the center of the innovation process. Objective This study aims to present the participatory cocreation model that has been developed from our center and illustrate the approach with 2 cases studies. Methods The model is built around user participation in an intensive rehabilitation program (2-hour sessions, 2-5 times per week, and 8-week duration), supervised by qualified therapists but delivered exclusively through commercial and prototype technology. This provides participants (chronic stroke survivors with movement and/or speech disability) with a rich experience of rehabilitation technology, enabling them to provide truly informed feedback, as well as creating an observatory for the research team. This process is supported by short-term focus groups for specific product development and a longer-term advisory group to consider broader issues of adoption and translation into everyday health care. Results Our model has been active for 3 years with 92 (92%) out of 100 participants completing the program. Five new technologies have evolved from the process with further ideas logged for future development. In addition, it has led to a set of cocreated protocols for technology-enriched rehabilitation, including recruitment, outcome measures, and intervention structure, which has allowed us to replicate this approach in an acute hospital ward. Conclusions Suboptimal rehabilitation limits recovery from health conditions. Technology offers the potential support to increase access to recommended levels of rehabilitation but needs to be designed to suit end users and not just their impairment. Our cocreation model, built around participation in an intensive, technology-based program, has produced new accessible technology and demonstrated the feasibility of our overall approach to providing the rehabilitation that people need, for as long as needed.
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Affiliation(s)
- Andrew Kerr
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, United Kingdom, 44 01415482855
| | - Madeleine Grealy
- Department of Psychological Sciences & Health, University of Strathclyde, Glasgow, United Kingdom
| | - Milena Slachetka
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, United Kingdom, 44 01415482855
| | - Chioma Obinuchi Wodu
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, United Kingdom, 44 01415482855
| | - Gillian Sweeney
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, United Kingdom, 44 01415482855
| | - Fiona Boyd
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, United Kingdom, 44 01415482855
| | - David Colville
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, United Kingdom, 44 01415482855
- Department of Psychological Sciences & Health, University of Strathclyde, Glasgow, United Kingdom
| | - Philip Rowe
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, United Kingdom, 44 01415482855
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Lin Z, Chen S, Su L, Liao Y, Chen H, Hu Z, Chen Z, Fang Y, Liang X, Chen J, Luo B, Wu C, Wang Z. Influences of HPV disease perceptions, vaccine accessibility, and information exposure on social media on HPV vaccination uptake among 11,678 mothers with daughters aged 9-17 years in China: a cross-sectional study. BMC Med 2024; 22:328. [PMID: 39135035 PMCID: PMC11320960 DOI: 10.1186/s12916-024-03538-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/22/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Mothers play a crucial role in influencing their daughters' HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels. METHODS From July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9-17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data. RESULTS Among 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02-1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake. CONCLUSIONS These findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls.
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Affiliation(s)
- Zian Lin
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lixian Su
- Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yuxue Liao
- Center for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Zhiqing Hu
- Shenzhen Futian The Second People's Hospital, Xinyidai Industrial Park Social Health Station, Shenzhen, China
| | - Zhuolin Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yuan Fang
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianan Chen
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Biyun Luo
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chuanan Wu
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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15
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Coulston F, Spittle A, McDonald C, Toovey R, Cameron KL, Attard K, Binstock L, Fletcher I, Delaney A, Murphy T, Keating C, Sellick K. Development and Evaluation of a Framework for Authentic Online Co-Design: Partnership-Focussed Principles-Driven Online Co-Design. Health Expect 2024; 27:e14138. [PMID: 38982761 PMCID: PMC11233779 DOI: 10.1111/hex.14138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/20/2024] [Accepted: 06/19/2024] [Indexed: 07/11/2024] Open
Abstract
INTRODUCTION Co-design in health research involves patient and public involvement and engagement (PPIE) in intervention or service design. Traditionally, co-design is undertaken in-person; however, exploring online delivery is warranted. PPIE in co-design must be considered carefully, and assumptions that in-person approaches will transition automatically to an online environment should be avoided. Currently, there are a lack of evidence-informed approaches to facilitating co-design online. This study aimed to develop and evaluate a framework for authentically adapting health research co-design into an online environment. MATERIALS AND METHODS The initial framework was developed through a literature review, synthesis of in-person co-design principles, and alignment of online strategies. The framework was then applied to a co-design project with 10 participants across relevant PPIE groups (end-users [n = 4], clinicians [n = 2], coaches [n = 2] and clinician-researchers [n = 2]). Participants' experiences of the online co-design process were evaluated via a mixed-methods design using surveys and semi-structured interviews. Evaluation data were analysed using descriptive statistics and reflexive thematic analysis to inform a revised framework. RESULTS The developed framework, Partnership-focussed Principles-driven Online co-Design (P-POD) was used to design eight 90 min online co-design workshops. Evaluation data involved 46 survey responses, and eight participants were interviewed on project completion. Survey data indicated that the process was satisfying, engaging and adhered to the P-POD framework. Themes derived from interview data describe a respectful and collaborative online culture, valuing of diverse perspectives and space for healthy debate, how power was perceived as being shared but not equal and multiple definitions of success within and beyond the process. A final, refined P-POD framework is presented. CONCLUSION With evaluation of the initial P-POD framework showing evidence of adherence to co-design principles, positive participant experiences and goal achievement for both the project and the participants, the refined P-POD framework may be used and evaluated within future intervention or service design. PATIENT OR PUBLIC CONTRIBUTION This study involved the participants (end-users, clinicians and service providers) in the co-design process described, interpretation of the results through member-checking interview responses, assisting in development of the final framework and as co-authors for this manuscript.
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Affiliation(s)
- Free Coulston
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Alicia Spittle
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
- Newborn ServicesThe Royal Women's HospitalParkvilleVictoriaAustralia
| | - Cassie McDonald
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Allied HealthAlfred HealthMelbourneVictoriaAustralia
| | - Rachel Toovey
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Kate L. Cameron
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Clinical SciencesMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Kimberley Attard
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Loni Binstock
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
- Consumer Advisory Group, Centre for Research Excellence in Newborn MedicineMurdoch Children's Research InstituteParkvilleVictoriaAustralia
| | - Isaac Fletcher
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Adie Delaney
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Tayla Murphy
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Caroline Keating
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
| | - Kath Sellick
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneParkvilleVictoriaAustralia
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16
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Lin Z, Chen S, Su L, Cao H, Chen H, Fang Y, Liang X, Chen J, Luo B, Wu C, Wang Z. Associations of mothers' decisional conflicts and satisfaction with governmental health promotion materials with their daughters' HPV vaccination uptake in China: A cross-sectional survey. Vaccine X 2024; 19:100529. [PMID: 39161948 PMCID: PMC11331965 DOI: 10.1016/j.jvacx.2024.100529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/25/2024] [Accepted: 07/16/2024] [Indexed: 08/21/2024] Open
Abstract
Background China started to implement the HPV vaccination program for females in 2016. This study investigated associations between mothers' decisional conflicts, satisfaction with governmental health promotion materials, and their daughters' HPV vaccination uptake. Methods A cross-sectional online survey was conducted between July and October 2023 among mothers of girls aged 9-17 years in Shenzhen, China. Participants were mothers having a daughter aged 9-17 years at the survey date and a smartphone with internet access. About 3 % of all primary and secondary schools in Shenzhen were randomly selected by the research team (11 primary schools and 13 secondary schools). Teachers at the selected schools invited mothers of female students aged 9-17 years to complete an anonymous online questionnaire. Multivariate logistic regression was fitted. Results Among 11,728 mothers who completed the survey, 18.9% of their index daughters received at least one dose of HPV vaccination. In multivariate analysis, less decisional conflict about the choice of HPV vaccines for their daughters (AOR: 1.07, 95%CI: 1.05, 1.10), more satisfaction with the government's health promotional materials related to HPV vaccines (AOR: 1.15, 95%CI: 1.12, 1.19), receiving more cue to action from significant others (AOR: 1.23, 95%CI: 1.19, 1.27), and perceived higher self-efficacy related to HPV vaccines (AOR: 1.79, 95%CI: 1.67, 1.92) were associated with a higher uptake of HPV vaccines. Perceived susceptibility to HPV (AOR: 0.79, 95%CI: 0.74, 0.85), perceived barriers to having the index daughter receive HPV vaccines (AOR: 0.82, 95%CI: 0.80, 0.84), and mothers who were hesitant to receive HPV vaccination (AOR: 0.75, 95%CI: 0.68, 0.84) were associated with a lower uptake. Conclusion HPV vaccination uptake was low among girls in China. Future health promotion should address mothers' decisional conflicts about the choice of HPV vaccines for their daughters and improve the health promotional materials. School-based HPV vaccination programs might be useful.
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Affiliation(s)
- Zian Lin
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Siyu Chen
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Lixian Su
- Shenzhen Futian District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - He Cao
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Hongbiao Chen
- Department of Epidemiology and Infectious Disease Control, Longhua Key Discipline of Public Health for the Prevention and Control of Infectious Diseases, Longhua Centre for Disease Control and Prevention, Shenzhen, China
| | - Yuan Fang
- Department of Health and Physical Education, the Education University of Hong Kong, Hong Kong SAR, China
| | - Xue Liang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jianan Chen
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Biyun Luo
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Chuanan Wu
- Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Zixin Wang
- Centre for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
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17
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Jacobsen JS, O'Brien MJM, Christensen JR, Risberg MA, Milne L, Balakumar J, Jakobsen SS, Mechlenburg I, Kemp J. Rehabilitation following periacetabular osteotomy for acetabular dysplasia: A qualitative interview study exploring challenges, hopes and expectations among patients in Denmark and Australia. Int J Orthop Trauma Nurs 2024; 54:101116. [PMID: 38925029 DOI: 10.1016/j.ijotn.2024.101116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/13/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Guidelines have been proposed for post-operative rehabilitation following periacetabular osteotomy (PAO). However, the perspectives of individuals undergoing PAO have not been considered. AIM The present study aimed to explore the perceived challenges of everyday life and hopes for and expectations of post-PAO rehabilitation from the perspective of individuals with acetabular dysplasia living in Denmark and Australia. METHODS In this qualitative study, we used a hermeneutic phenomenological approach with semi-structured interviews to explore the perspectives of 25 participants (four males), aged 16-43 years, who underwent a PAO. Purposeful sampling was used to provide variations in age and sex. Inclusion criteria were age above 15 years, radiographic evidence of acetabular dysplasia, PAO within the last seven weeks and undergoing post-operative rehabilitation. Inductive content analysis was adopted to code and analyse interviews. RESULTS The analysis of the interview transcripts revealed four major themes: different expectations, self-confidence, tailored rehabilitation and aligning expectations. Several subthemes emerged within each theme, and similar patterns with minor variations were identified across countries. However, the financial burden of self-funded surgery and rehabilitation challenged some Australian participants, whereas none of the Danish participants mentioned this challenge. CONCLUSION Our findings elucidate the diverse range of hopes and expectations in individuals undergoing PAO, and how these relate to their perceived challenges. In particular, the findings highlight the importance of aligning expectations between individuals and clinicians when designing the rehabilitation.
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Affiliation(s)
- Julie S Jacobsen
- Research Centre for Rehabilitation, VIA University College, Aarhus, Denmark; Research Unit for General Practice, Aarhus, Denmark.
| | - Michael J M O'Brien
- La Trobe Sport Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia. m.o'
| | - Jeanette Reffstrup Christensen
- Research Unit for General Practice, Aarhus, Denmark; Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
| | - May Arna Risberg
- Division of Orthopaedic Surgery, Oslo University Hospital and Department of Sport Medicine, Norwegian School Sport Sciences, Oslo, Norway.
| | | | | | | | - Inger Mechlenburg
- Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark.
| | - Joanne Kemp
- La Trobe Sport Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
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18
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Elf M, Norin L, Meijering L, Pessah-Rasmussen H, Suhonen R, Zingmark M, Kylén M. Rehabilitation at Home With the Development of a Sustainable Model Placing the Person's Needs and Environment at Heart: Protocol for a Multimethod Project. JMIR Res Protoc 2024; 13:e56996. [PMID: 39042448 PMCID: PMC11303889 DOI: 10.2196/56996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 04/15/2024] [Accepted: 04/18/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Each year, more than 1.5 million people in Europe have a stroke, and many experience disabilities leading to activity and participation restrictions. Home-based rehabilitation is the recommended approach for stroke rehabilitation, in line with the international shift to integrated care. Despite this, rehabilitation often focuses on the person's physical functions, not the whole life situation and opportunities to live an active life. Given that rehabilitation today is often provided in the person's home, there is a need to develop new models that consider the rehabilitation process as situated in the everyday living environment of persons with stroke. This project is grounded in experiences from our ongoing research, where we study the importance of the home environment for health and participation among persons with stroke, rehabilitated at home. This research has shown unmet needs, which lead to suboptimal rehabilitation outcomes. There is a need for studies on how to use environmental resources to optimize stroke rehabilitation in the home setting. OBJECTIVE The overarching objective of the project is to develop a new practice model for rehabilitation where the needs of the person are the starting point and where the environment is considered. METHODS The project will be conducted in partnership with persons with stroke, significant others, health care professionals, and care managers. Results from a literature review will form the base for interviews with the stakeholders, followed by co-designing workshops aiming to create a new practice model. Focus groups will be held to refine the outcome of the workshops to a practice model. RESULTS This 4-year project commenced in January 2023 and will continue until December 2026. The results of the literature review are, as of April 2024, currently being analyzed. The ethics application for the interviews and co-design phase was approved in October 2023 and data collection is ongoing during spring 2024. We aim to develop a practice model with stakeholders and refine it together with care managers and decision makers. The outcome is a new practice model and implementation plan, which will be achieved in autumn 2026. CONCLUSIONS The project contributes with a prominent missing puzzle to optimize the rehabilitation process by adding a strong focus on user engagement combined with integrating different aspects of the environment. The goal is to improve quality of life and increase reintegration in society for the large group of people living with the aftermath of a stroke. By co-designing with multiple stakeholders, we expect the model to be feasible and sustainable. The knowledge from the project will also contribute to an increased awareness of the importance of the physical environment for sustainable health care. The findings will lay the foundation for future upscaling initiatives. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/56996.
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Affiliation(s)
- Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Lizette Norin
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - Hélène Pessah-Rasmussen
- Department of Neurology, Rehabilitation Medicine, Memory disorders and Geriatrics, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Turku, Finland
- Turku University Hospital, The Wellbeing Services County of Southwest Finland, Turku, Finland
| | - Magnus Zingmark
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
| | - Maya Kylén
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
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Queral J, Wargers A, Llauradó E, Jansen W, Solà R, Tarro L, Mölenberg FJM. Effectiveness of Participatory Research Interventions on Obesity and Obesity-Related Behaviors in Adolescents: A Systematic Review and Meta-analysis. Nutr Rev 2024:nuae067. [PMID: 38976588 DOI: 10.1093/nutrit/nuae067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024] Open
Abstract
CONTEXT Adolescence is an optimal period to promote healthy lifestyles because behavior patterns are established in this stage. It has been suggested that engaging youth increases the effectiveness of interventions, but an overview is lacking. OBJECTIVE This study aims to evaluate the effectiveness of participatory research (PR) interventions, where adolescents (11-18 years old) from high-income countries had a significant role in the intervention development and/or delivery, compared with no (PR) intervention control groups on obesity-related outcomes and healthy lifestyle behaviors (HLBs). DATA SOURCES Eight databases (Embase, Medline ALL, Web of Science Core Collection, PsycINFO, ERIC, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials) and Google Scholar were searched from 1990 to 2024 for randomized controlled trials (RCTs) and non-RCTs (in English). DATA EXTRACTION Two researchers independently performed the data extraction and risk-of-bias assessment. DATA ANALYSIS Sixteen studies were included and outcomes have been narratively described. Seven studies evaluated youth-led interventions, 3 studies evaluated co-created interventions, and 6 studies evaluated the combination of both. Six studies focused on physical activity (PA), 2 on nutrition, and 8 on a combination of PA, nutrition, and/or obesity-related outcomes. Ten studies presented at least 1 significant effect on PA, nutrition, or obesity-related outcomes in favor of the intervention group. Additionally, 12 studies were pooled in a meta-analysis. Whereas a small desired effect was found for fruit consumption, a small undesired effect was found for vegetable consumption. The pooled analysis found no significant effects on moderate-vigorous PA, total PA, and PA self-efficacy. CONCLUSION We found some evidence that youth empowerment in research may have positive effects on obesity-related HLBs, specifically an increased fruit consumption. However, the overall evidence was inconclusive due to limited studies and the heterogeneity of the studies included. This overview may guide future public health interventions that aim to engage and empower adolescents. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration Nº CRD42021254135.
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Affiliation(s)
- Judit Queral
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Annemieke Wargers
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Elisabet Llauradó
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Wilma Jansen
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
- Department of Social Development, City of Rotterdam, 3000 LP Rotterdam, The Netherlands
| | - Rosa Solà
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
- Internal Medicine, Hospital Universitari Sant Joan de Reus, Reus, 43204, Spain
| | - Lucia Tarro
- Metabolic diseases and nutrition, Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
- Functional Nutrition, Oxidation, and Cardiovascular Diseases Group (NFOC-Salut), Facultat de Medicina i Ciències de la Salut, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Famke J M Mölenberg
- Department of Public Health, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands
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Longworth GR, de Boer J, Goh K, Agnello DM, McCaffrey L, Zapata Restrepo JR, An Q, Chastin S, Davis A, Altenburg T, Verloigne M, Giné-Garriga M. Navigating process evaluation in co-creation: a Health CASCADE scoping review of used frameworks and assessed components. BMJ Glob Health 2024; 9:e014483. [PMID: 38964878 PMCID: PMC11227756 DOI: 10.1136/bmjgh-2023-014483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/13/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Co-creation is seen as a way to ensure all relevant needs and perspectives are included and to increase its potential for beneficial effects and uptake process evaluation is crucial. However, existing process evaluation frameworks have been built on practices characterised by top-down developed and implemented interventions and may be limited in capturing essential elements of co-creation. This study aims to provide a review of studies planning and/or conducting a process evaluation of public health interventions adopting a co-creation approach and aims to derive assessed process evaluation components, used frameworks and insights into formative and/or participatory evaluation. METHODS We searched for studies on Scopus and the Health CASCADE Co-Creation Database. Co-authors performed a concept-mapping exercise to create a set of overarching dimensions for clustering the identified process evaluation components. RESULTS 54 studies were included. Conceptualisation of process evaluation included in studies concerned intervention implementation, outcome evaluation, mechanisms of impact, context and the co-creation process. 22 studies (40%) referenced ten existing process evaluation or evaluation frameworks and most referenced were the frameworks developed by Moore et al (14%), Saunders et al (5%), Steckler and Linnan (5%) and Nielsen and Randall (5%).38 process evaluation components were identified, with a focus on participation (48%), context (40%), the experience of co-creators (29%), impact (29%), satisfaction (25%) and fidelity (24%).13 studies (24%) conducted formative evaluation, 37 (68%) conducted summative evaluation and 2 studies (3%) conducted participatory evaluation. CONCLUSION The broad spectrum of process evaluation components addressed in co-creation studies, covering both the evaluation of the co-creation process and the intervention implementation, highlights the need for a process evaluation tailored to co-creation studies. This work provides an overview of process evaluation components, clustered in dimensions and reflections which researchers and practitioners can use to plan a process evaluation of a co-creation process and intervention.
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Affiliation(s)
| | - Janneke de Boer
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Kunshan Goh
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | | | - Lauren McCaffrey
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Qingfan An
- Department of Community Medicine and Rehabilitation, Umeå University, Umea, Sweden
| | - Sebastien Chastin
- Department of Movement and Sports Sciences, Ghent University, Gent, Belgium
- Glasgow Caledonian University, Glasgow, UK
| | - Aaron Davis
- UniSA Creative, University of South Australia, Adelaide, South Australia, Australia
| | - Teatske Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Maite Verloigne
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Maria Giné-Garriga
- Faculty of Psychology, Education and Sport Sciences, Universitat Ramon Llull, Barcelona, Spain
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21
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Kiss N, Jongebloed H, Baguley B, Marshall S, White VM, Livingston PM, Bell K, Young L, Sabesan S, Swiatek D, Boltong A, Britto JM, Ugalde A. Meaningful consumer involvement in cancer care: a systematic review on co-design methods and processes. JNCI Cancer Spectr 2024; 8:pkae048. [PMID: 38897655 PMCID: PMC11240760 DOI: 10.1093/jncics/pkae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 05/30/2024] [Accepted: 06/13/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE Although the benefits of consumer involvement in research and health care initiatives are known, there is a need to optimize this for all people with cancer. This systematic review aimed to synthesize and evaluate the application of co-design in the oncology literature and develop recommendations to guide the application of optimal co-design processes and reporting in oncology research, practice, and policy. METHODS A systematic review of co-design studies in adults with cancer was conducted, searching MEDLINE, CINAHL, Embase, and PsycINFO databases and included studies focused on 2 concepts, co-design and oncology. RESULTS A total of 5652 titles and abstracts were screened, resulting in 66 eligible publications reporting on 51 unique studies. Four frameworks were applied to describe the co-design initiatives. Most co-design initiatives were designed for use in an outpatient setting (n = 38; 74%) and were predominantly digital resources (n = 14; 27%) or apps (n = 12; 23%). Most studies (n = 25; 49%) used a co-production approach to consumer engagement. Although some studies presented strong co-design methodology, most (n = 36; 70%) did not report the co-design approach, and 14% used no framework. Reporting was poor for the participant level of involvement, the frequency, and time commitment of co-design sessions. Consumer participation level was predominantly collaborate (n = 25; 49%). CONCLUSIONS There are opportunities to improve the application of co-design in oncology research. This review has generated recommendations to guide 1) methodology and frameworks, 2) recruitment and engagement of co-design participants, and 3) evaluation of the co-design process. These recommendations can help drive appropriate, meaningful, and equitable co-design, leading to better cancer research and care.
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Affiliation(s)
- Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Hannah Jongebloed
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Brenton Baguley
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Skye Marshall
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia
- Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Victoria M White
- School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Patricia M Livingston
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
- Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Kathy Bell
- Clinical Oncology Society of Australia, Sydney, NSW, Australia
| | - Leonie Young
- Clinical Oncology Society of Australia, Sydney, NSW, Australia
| | - Sabe Sabesan
- Clinical Oncology Society of Australia, Sydney, NSW, Australia
- Department of Medical Oncology, Townsville Cancer Centre, Townsville, QLD, Australia
| | - Dayna Swiatek
- Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Anna Boltong
- Kirby Institute, University of New South Wales, NSW 2052, Australia
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton 3800, Victoria, Australia
| | - Joanne M Britto
- Victorian Comprehensive Cancer Centre Alliance, Parkville, VIC, Australia
| | - Anna Ugalde
- Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
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22
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Lohman D, Kononchuk Y, Iovita A, Golichenko M, Rachinska V, Skala P, Gvozdetska O, Myroniuk S, Amon JJ. An implementation evaluation of the Breaking Down human rights barriers to HIV services initiative in Ukraine. J Int AIDS Soc 2024; 27 Suppl 3:e26328. [PMID: 39030861 PMCID: PMC11258427 DOI: 10.1002/jia2.26328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 06/12/2024] [Indexed: 07/22/2024] Open
Abstract
INTRODUCTION Globally, stark inequities exist in access to HIV treatment and prevention. The eastern European and central Asian region is experiencing the sharpest rise in new HIV acquisition and deaths in the world, with low rates of treatment and prevention services, especially for key and vulnerable populations who face a range of human rights-related barriers to HIV prevention and treatment. METHODS An implementation learning evaluation approach was used to examine the implementation of the Breaking Down Barriers initiative targeting key and vulnerable populations in Ukraine. Between September 2022 and April 2023, researchers conducted 23 key informant interviews with individuals from the Ukrainian government, implementing organizations and human rights experts. Using a concurrent triangulation design, researchers and key informants, in a process of co-creation, sought to describe programme accomplishments, challenges and innovations in implementation, between 2021 and 2023, including periods before and after Russia's February 2022 full-scale invasion. RESULTS Eight rights-based interventions related to HIV were identified in Global Fund programme documents and key informant interviews as making up the core of the Breaking Down Barriers initiative in Ukraine. These included programmes seeking to: eliminate stigma and discrimination; ensure the non-discriminatory provision of medical care; promote rights-based law enforcement practices; expand legal literacy ("know your rights"); increase access to justice; improve laws, regulations and policies; reduce gender discrimination, harmful gender norms and violence against women and girls; and mobilize communities for advocacy. These programmes received US$5.9 million in funding. Key informants reported that significant progress had been made addressing human rights barriers and scaling up interventions, both before and after Russia's invasion. Programme implementors adopted innovative approaches, including using paralegals, hotlines and other community-led interventions, to ensure that key and vulnerable populations, including displaced individuals, were able to access prevention and care. CONCLUSIONS An implementation learning evaluation approach examining programmes addressing human rights barriers to HIV services, designed as a process of co-creation between researchers, programme implementors, government officials and human rights experts, can provide a robust assessment of programme outputs, outcomes and evidence of impact, despite a challenging operational environment.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Joseph J. Amon
- Office of Global Health, Drexel University Dornsife School of Public HealthPhiladelphiaPennsylvaniaUSA
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23
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Muir C, Kedzior SGE, Barrett S, McGovern R, Kaner E, Wolfe I, Forman JR. Co-design workshops with families experiencing multiple and interacting adversities including parental mental health, substance use, domestic violence, and poverty: intervention principles and insights from mothers, fathers, and young people. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:67. [PMID: 38926798 PMCID: PMC11202333 DOI: 10.1186/s40900-024-00584-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/09/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Clustering and co-occurring of family adversities, including mental health problems, substance use, domestic violence and abuse, as well as poverty can increase health and behavioural risks for children, which persist throughout the life course. Yet, interventions that acknowledge and account for the complex interactive nature of such risks are limited. This study aimed to develop intervention principles based on reflections from mothers, fathers, and young people who experience multiple and interacting adversities. These principles will show how family members perceive an intervention may bring about positive change and highlight key insights into design and delivery. METHODS A series of six co-design workshops with mothers, fathers, and young people who experienced multiple and interacting adversities (n = 41) were iteratively conducted across two regions in England (London and North-East) by four researchers. Workshop content and co-design activities were informed by advisory groups. Data from facilitator notes and activities were analysed thematically, resulting in a set of intervention principles. RESULTS The intervention principles highlighted that: (1) to reduce isolation and loneliness parents and young people wanted to be connected to services, resources, and peer support networks within their local community, particularly by a knowledgeable and friendly community worker; (2) to address feelings of being misunderstood, parents and young people wanted the development of specialised trauma informed training for practitioners and to have the space to build trusting, gradual, and non-stigmatising relationships with practitioners; and (3) to address the needs and strengths of individual family members, mothers, fathers, and young people wanted separate, tailored, and confidential support. CONCLUSIONS The current study has important implications for practice in supporting families that experience multiple and interacting adversities. The intervention principles from this study share common characteristics with other intervention models currently on offer in the United Kingdom, including social prescribing, but go beyond these to holistically consider the whole families' needs, environments, and circumstances. There should be particular focus on the child's as well as the mothers' and fathers' needs, independently of the family unit. Further refinement and piloting of the developing intervention are needed.
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Affiliation(s)
- Cassey Muir
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
| | - Sophie G E Kedzior
- Department of Women and Children's Health, King's College London, London, UK
| | - Simon Barrett
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth McGovern
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ingrid Wolfe
- Department of Women and Children's Health, King's College London, London, UK
| | - Julia R Forman
- Department of Women and Children's Health, King's College London, London, UK
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24
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Samsudin NA, Othman H, Siau CS, Zaini Z'II. Exploring community needs in combating aedes mosquitoes and dengue fever: a study with urban community in the recurrent hotspot area. BMC Public Health 2024; 24:1651. [PMID: 38902692 PMCID: PMC11191142 DOI: 10.1186/s12889-024-18965-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/27/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Aedes mosquitoes are the main vector of dengue infection, a global health threat affecting millions of people annually. Conventional prevention and control methods against dengue outbreaks have only achieved marginal success. Recognizing the complex issue at hand, a multilevel participatory approach is crucial. Thus, alternative strategies that involve community engagement are increasingly being considered and attempted. While community-based vector control programs have been conducted, sustaining behavioral changes among the population remains a challenge. This study aimed to identify the specific community needs in combating Aedes mosquitoes and dengue fever as a basis to guide the development of community-driven initiatives and foster a deeper sense of ownership in the fight against dengue. METHODS Between 1 August 2022 and 30 November 2022, we conducted a study in Hulu Langat district, Selangor, using a mixed-method design. All participants consented to the study, which comprised 27 participants (FGDs) and 15 participants (IDIs). The IDIs included two participants with a history of dengue fever, one community leader, one faith leader, seven local authorities, and four district health officers. Semi-structured interviews and discussions were performed among stakeholders and community members recruited via purposive and snowball sampling techniques. All interviews were audio-recorded before being analyzed using reflexive thematic analysis. RESULTS These results derived from qualitative data explored the perspectives and needs of communities in combating Aedes mosquitoes and dengue fever. Interviews were conducted with various stakeholders, including community members, leaders, and health officers. The study identified the necessity of decisive actions by authorities to address the impact of the dengue epidemic, the importance of community engagement through partnerships and participatory approaches, the potential benefits of incentives and rewards to enhance community participation, and the need for sustained community engagement and education, especially via the involvement of young people in prevention efforts. These findings provide valuable insights into the design of effective strategies against Aedes mosquitoes and dengue fever. CONCLUSIONS In short, there is an urgent need for a comprehensive approach involving multiple stakeholders in the fight against Aedes mosquitoes and dengue fever. The approach should incorporate efforts to raise awareness, provide practical resources, and foster community responsibility. The active involvement of teenagers as volunteers can contribute to long-term prevention efforts. Collaboration, resource allocation, and community engagement are crucial for effective dengue control and a healthier environment.
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Affiliation(s)
- Nurul Adilah Samsudin
- Centre for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 53000, Malaysia
| | - Hidayatulfathi Othman
- Centre for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 53000, Malaysia.
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 53000, Malaysia
| | - Zul-'Izzat Ikhwan Zaini
- Department of Basic Science, Faculty of Health Sciences, Universiti Teknologi Mara (UiTM), Cawangan Pulau Pinang, Kampus Bertam, Kepala Batas, Penang, 13200, Malaysia
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25
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Buffey AJ, Langley CK, Carson BP, Donnelly AE, Salsberg J. Participatory Approaches in the Context of Research Into Workplace Health Promotion to Improve Physical Activity Levels and Reduce Sedentary Behavior Among Office-Based Workers: Scoping Review. JMIR Public Health Surveill 2024; 10:e50195. [PMID: 38896458 PMCID: PMC11222769 DOI: 10.2196/50195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/06/2023] [Accepted: 02/15/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Participatory research (PR) involves engaging in cocreation with end users and relevant stakeholders throughout the research process, aiming to distribute power equitably between the end users and research team. Engagement and adherence in previous workplace health promotion (WHP) studies have been shown to be lacking. By implementing a PR approach, the insights of end users and stakeholders are sought in the co-design of feasible and acceptable intervention strategies, thereby increasing the relevance of the research. OBJECTIVE This scoping review aims to explore, identify, and map PR techniques and their impact when used in office-based WHP interventions designed to improve physical activity (PA) or reduce sedentary behavior (SB). METHODS The reporting of this scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). A systematic literature search of 5 electronic databases-Web of Science, PubMed, Scopus, Google Scholar, and OpenGrey-was conducted, searching from January 1, 1995, to February 8, 2023. In total, 2 independent reviewers first screened the retrieved articles by title and abstract, and then assessed the full texts based on the inclusion and exclusion criteria. The search strategy and eligibility criteria were developed and guided by an a priori population (office-based working adults), intervention (a PA WHP intervention that took a PR approach), comparison (no comparison required), and outcome (PA or SB) framework. Data were charted and discussed via a narrative synthesis, and a thematic analysis was conducted. The included studies were evaluated regarding the degree of end user engagement throughout the research process and power shared by the researchers, using Arnstein's ladder of citizen participation. RESULTS The search retrieved 376 records, of which 8 (2.1%) met the inclusion criteria. Four key strategies were identified: (1) end user focus groups, (2) management involvement, (3) researcher facilitators, and (4) workplace champions. The degree of engagement and power shared was relatively low, with 25% (2/8) of the studies determined to be nonparticipation studies, 25% (2/8) determined to be tokenistic, and 50% (4/8) determined to provide citizen power. CONCLUSIONS This review provides a foundation of evidence on the current practices when taking a PR approach, highlighting that previous office-based PA WHP studies have been largely tokenistic or nonparticipative, and identified that the end user is only engaged with in the conception and implementation of the WHP studies. However, a positive improvement in PA and reduction in SB were observed in the included studies, which were largely attributed to implementing a PR approach and including the end user in the design of the WHP intervention. Future studies should aim to collaborate with workplaces, building capacity and empowering the workforce by providing citizen control and letting the end users "own" the research for a sustainable WHP intervention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2021-054402.
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Affiliation(s)
- Aidan John Buffey
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Brian P Carson
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alan E Donnelly
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Jon Salsberg
- Public and Patient Involvement Research Unit, School of Medicine, University of Limerick, Limerick, Ireland
- Public and Patient Involvement Research Unit, Health Research Institute, University of Limerick, Limerick, Ireland
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Shaw N, Hardman CA, Boyle NB, Craven J, Dooley J, Mead BR, Morgans L, Mumby H, Pettinger C. What does 'co-production' look like for food system transformation? Mapping the evidence across Transforming UK Food Systems (TUKFS) projects. NUTR BULL 2024. [PMID: 38872404 DOI: 10.1111/nbu.12690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/15/2024]
Abstract
Co-production is a collaborative way of working which emphasises the exchange of diverse forms of knowledge in an equal partnership for equal benefits. Co-produced research is a key strategic aim of the UK Research and Innovation (UKRI) Transforming UK Food Systems (TUKFS) Strategic Priorities Fund; this research programme brings together researchers, policymakers, industry and communities to create positive change in the way food is produced, accessed and consumed. However, more generally, there are diverse understandings of co-production and a lack of consensus on what 'good practice' looks like. Therefore, this study aimed to identify and map examples of co-production methods employed across the TUKFS programme. Two creative workshops (n = 15 participants), conversations with TUKFS researchers and stakeholders (n = 15), and systematic analysis of project documents were used to critically explore co-production activities within six TUKFS projects. A range of co-production activities were identified. Findings highlighted areas of 'messiness' and complexity, challenges associated with applying co-production approaches and practical solutions. Four key shared principles for co-production were identified: (1) Relationships: developing and maintaining reciprocity-based partnerships; (2) Knowledge: recognising the contribution of diverse forms of expertise; (3) Power: considering power dynamics and addressing imbalances; and (4) Inclusivity: ensuring research is accessible to all who wish to participate. Opportunities for reflection and reflexivity were considered crucial across all these areas. Findings contribute important insights towards a shared conceptual understanding of co-production for food system transformation research. This paper makes recommendations for researchers, practitioners, academic institutions and funders working in this area of research and practice.
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Affiliation(s)
- Naomi Shaw
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - Charlotte A Hardman
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | | | | | - John Dooley
- School of Agricultural Sciences and Practice, Royal Agricultural University, Cirencester, UK
| | - Bethan R Mead
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Lisa Morgans
- School of Agricultural Sciences and Practice, Royal Agricultural University, Cirencester, UK
| | | | - Clare Pettinger
- School of Health Professions, University of Plymouth, Plymouth, UK
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Salazar J, Andersen C, Øzhayat EB. Effect of oral health interventions for dependent older people-A systematic review. Gerodontology 2024; 41:200-219. [PMID: 37847812 DOI: 10.1111/ger.12720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND There is an increasing proportion of older people in the population worldwide, with a large group being dependent on the care of others. Dependent older people are more vulnerable to oral diseases, which can heavily impact their quality of life (OHRQoL) and general health. OBJECTIVE The purpose of this systematic review was to comprehensively assess interventions to improve oral health or guarantee access and adherence to dental treatment of dependent older people. METHODS We searched MEDLINE, EMBASE, CENTRAL and clinical trial registries. Two reviewers performed the selection, data extraction, risk of bias evaluation using the Cochrane Risk of Bias tool and assessment of certainty of the evidence. When possible, we conducted a meta-analysis to calculate effect estimates and their 95%CIs. Primary outcomes were OHRQoL, oral/dental health, and use of the oral care system. RESULTS We included a total of 30 randomised clinical trials assessing educational and non-educational interventions for community-dwelling older people (n = 2) and those residing in long-term care facilities (n = 28). Most studies assessed oral hygiene and showed that interventions may result in a reduction in dental plaque in the short term (with low certainty of evidence), but there is limited evidence for long-term effectiveness. Only one study assessed OHRQoL, and none evaluated changes in the use of the oral health care system. CONCLUSION Our findings do not provide strong conclusions in favour of any specific intervention, mainly due to study quality and imprecision. There is limited information about the long-term effect of interventions, and further research is needed, especially targeting community-dwelling older people. PROSPERO ID CRD42021231721.
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Affiliation(s)
- Josefina Salazar
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christina Andersen
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Esben Boeskov Øzhayat
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Visser M, ‘t Hart N, de Mul M, Weggelaar‐Jansen AM. The Perspectives of Healthcare Professionals and Managers on Patient Involvement in Care Pathway Development: A Discourse Analysis. Health Expect 2024; 27:e14101. [PMID: 38855873 PMCID: PMC11163266 DOI: 10.1111/hex.14101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND The WHO advocates patient and public involvement as an ethical imperative, due to the value of the lived experience of patients. A deeper understanding of the shared meanings and underlying beliefs of healthcare professionals and managers for and against including patients in care pathway development. OBJECTIVE To explore the considerations of healthcare professionals and managers on the involvement of patients and public in care pathway development. METHODS In a medical rehabilitation centre we conducted a single case study that was part of a 2-year action research programme on blended care pathway development. Following 14 semistructured interviews with healthcare professionals and managers, we analysed their discourses on the value of patient involvement as well as the potential threats and opportunities. RESULTS We identified four discourses. Patient as expert frames involvement as relevant, as adding new perspectives and as required to fully understand the patient's needs. Skills and representation is based on the construct that obtaining valuable insights from patients requires certain skills and competences. Self-protection focusses on personal, interprofessional objections to patient involvement. Professional knows best reveals expertise-related reasons for avoiding or postponing involvement. CONCLUSION These discourses explain why patient and public involvement in care pathway development is sometimes postponed, limited in scope and level of participation, and/or avoided. The following strategies might minimise the paralysing effect of these discourses: strengthen the capabilities of all stakeholders involved; use a mix of complementary techniques to gain involvement in distinct phases of care pathway development; and create/facilitate a safe environment. Put together, these strategies would foster ongoing, reciprocal learning that could enhance patient involvement. PATIENT OR PUBLIC CONTRIBUTION This study belonged to an action research programme on blended care pathway development (developing an integrated, coordinated patient care plan that combines remote, digital telehealth applications, self-management tools and face-to-face care). Multidisciplinary teams took a quality collaborative approach to quality improvement (considering patients as stakeholders) to develop 11 blended care pathways. Although professionals and managers were instructed to invite patients onto their teams and to attend care pathway design workshops, few teams (3/11) actually did. Unravelling why this happened will help improve patient and public involvement in care pathway development.
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Affiliation(s)
- Mildred Visser
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
| | - Naomi ‘t Hart
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
| | - Marleen de Mul
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
| | - Anne Marie Weggelaar‐Jansen
- Erasmus School of Health Policy & ManagementErasmus UniversityRotterdamThe Netherlands
- Clinical InformaticsEindhoven University of TechnologyEindhovenThe Netherlands
- Tranzo, Tilburg School of Social and Behavioural SciencesTilburg UniversityTilburgThe Netherlands
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Takens FE, Indyk I, Chinapaw MJM, Ujčič-Voortman JK, van Nassau F, Busch V. Qualitative multi-stakeholder evaluation of the adoption, implementation and sustainment of the school-based dietary intervention "Jump-in". BMC Public Health 2024; 24:1337. [PMID: 38760727 PMCID: PMC11102190 DOI: 10.1186/s12889-024-18814-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Comprehensive school-based programs applying the WHO Health Promoting School Model have the potential to initiate and sustain behavior change and impact health. However, since they often include intervention efforts on a school's policies, physical environment, curriculum, health care and involving parents and communities, they significantly 'intrude' on a complex system that is aimed primarily at education, not health promotion. More insights into and concrete strategies are therefore needed regarding their adoption, implementation, and sustainment processes to address the challenge to sustainable implementation of HPS initiatives in a primarily educational setting. This study consequently evaluates adoption, implementation and sustainment processes of Amsterdam's Jump-in healthy nutrition HPS intervention from a multi-stakeholder perspective. METHODS We conducted semi-structured interviews and focus groups with all involved stakeholders (n = 131), i.e., Jump-in health promotion professionals (n = 5), school principals (n = 7), at-school Jump-in coordinators (n = 7), teachers (n = 20), parents (n = 50, 9 groups) and children (n = 42, 7 groups) from 10 primary schools that enrolled in Jump-in in the school year 2016-2017. Included schools had a higher prevalence of overweight and/or obesity than the Dutch average and they were all located in Amsterdam's low-SEP neighborhoods. Data were analyzed using a directed content analysis, in which the Determinants of Innovation Model was used for obtaining theory-based predetermined codes, supplemented with new codes emerging from the data. RESULTS During intervention adoption, all stakeholders emphasized the importance of parental support, and accompanying workshops and promotional materials. Additionally, parents and teachers indicated that a shared responsibility for children's health and nuanced framing of health messages were important. During implementation, all stakeholders needed clear guidelines and support structures. Teachers and children highlighted the importance of peer influence, social norms, and uniform application of guidelines. School staff also found further tailoring of the intervention and dealing with financial constraints important. For long-term intervention sustainment, incorporating the intervention policies into the school statutes was crucial according to health promotion professionals. CONCLUSIONS This qualitative evaluation provides valuable insights into factors influencing the adoption, implementation, and sustainment processes of dietary interventions, such as the importance of transparent and consistent intervention guidelines, clear communication regarding the rationale behind intervention guidelines, and, stakeholders' involvement in decision-making.
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Affiliation(s)
- Froukje E Takens
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands.
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Indira Indyk
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Joanne K Ujčič-Voortman
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Vincent Busch
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
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Haenssgen MJ, Elliott EM, Phommachanh S, Phomkong S, Kounnavong S, Kubota S. Trust in healthcare: methodological and conceptual insights from mixed-method research in Lao People's Democratic Republic. BMJ Glob Health 2024; 9:e014640. [PMID: 38754897 PMCID: PMC11097858 DOI: 10.1136/bmjgh-2023-014640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/14/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Global health foregrounds trust as a key requirement for the achievement of international health initiatives, but it remains an elusive concept that is often mobilised without consideration of its dimensions, drivers and downstream behavioural consequences. This paper aims to contribute to the conceptual development and measurement of 'patient trust in primary healthcare' from the lower middle-income country perspective of rural Lao PDR. METHODS A two-phase mixed-method research design was implemented between January 2021 and April 2023. Phase 1 involved exploratory qualitative research to understand the local expressions and dimensions of patient trust in primary healthcare, with 25 semistructured interviews and 17 focus group discussions (120 participants) in eight villages in Bokeo Province. Phase 2 involved explanatory research to assess patterns of trust systematically at scale in 14 villages across four provinces, wherein 26 cognitive interviews, 17 expert interviews and non-participant community observations informed a community census survey with 1838 participants. We analysed qualitative data through content-oriented thematic analysis and developed an 8-item trust scale on that basis. Quantitative data analysis used descriptive statistical and regression analysis. RESULTS We found that trust in primary healthcare is readily understood and intrinsically valuable in rural Lao PDR. Key dimensions included communication, respectful care, relationship, fairness, integrity, reputation, assurance of treatment and competence. The survey highlighted that reputation, competence, integrity and respectful care had the lowest trust scores. Health centre operations predicted the local expressions of trust. The behavioural consequences of trust were limited to a positive statistical association with antenatal care uptake among pregnant women but outweighed by alternative measures that also captured the availability of healthcare facilities. CONCLUSIONS Overall, the development of our quantitative trust scale offers a process model for future researchers. We conclude that interpersonal, institutional and service-related trust require more explicit recognition in health system development and integration into health policy.
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Affiliation(s)
- Marco J Haenssgen
- Department of Social Science and Development, Chiang Mai University, Chiang Mai, Thailand
| | - Elizabeth M Elliott
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | | | - Sylivanh Phomkong
- World Health Organization Representative Office, Vientiane, Lao People's Democratic Republic
| | - Sengchanh Kounnavong
- Lao Tropical and Public Health Institute, Vientiane, Lao People's Democratic Republic
| | - Shogo Kubota
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
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Carl J, Grüne E, Popp J, Hartung V, Pfeifer K. Implementation and dissemination of physical activity-related health competence in vocational nursing training: study protocol for a cluster-randomized controlled intervention trial. Trials 2024; 25:322. [PMID: 38750590 PMCID: PMC11094863 DOI: 10.1186/s13063-024-08153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Although the nursing sector gains growing importance in an aging society, students representing the future workforce often show insufficient health. Acknowledging the health-enhancing effects of adequate physical activity, the educational system in Bavaria, Germany, has recently integrated the promotion of physical activity-related health competence (PAHCO) into the nursing curriculum. However, it cannot be assumed that PAHCO has sufficiently permeated the educational practices and routines of the nursing schools. Therefore, the goal of the present study is to examine and compare the effectiveness as well as implementation of different intervention approaches to address PAHCO in the Bavarian nursing school system. METHODS We randomly assign 16 nursing schools (cluster-based) to four study arms (bottom-up, top-down led by teachers, top down led by external physical activity experts, control group). Schools in intervention group 1 (IG-1) develop multicomponent inventions to target PAHCO via cooperative planning (preparation, planning, and implementation phase). Intervention groups 2 and 3 (IG-2, IG-3) receive both an expert-based intervention (developed through intervention mapping) via trained mediators to address PAHCO. External physical activity experts deliver the structured PAHCO intervention in IG-2, while teachers from the nursing schools themselves conduct the PAHCO intervention in IG-3. In line with a hybrid effectiveness implementation trial, we apply questionnaire-based pre-post measurements across all conditions (sample size calculation: nfinal = 636) to examine the effectiveness of the intervention approaches and, simultaneously, draw on questionnaires, interview, and protocol data to examine their implementation. We analyze quantitative effectiveness data via linear models (times-group interaction), and implementation data using descriptive distributions and content analyses. CONCLUSION The study enables evidence-based decisions about the suitability of three intervention approaches to promote competencies for healthy, physically active lifestyles among nursing students. The findings inform dissemination activities to effectively reach all 185 schools of the Bavarian nursing system. TRIAL REGISTRATION Clinical trials NCT05817396. Registered on April 18, 2023.
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Affiliation(s)
- Johannes Carl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Eva Grüne
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Johanna Popp
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Verena Hartung
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Zacharuk A, Ferguson A, Komar C, Bentley N, Dempsey A, Louwagie M, O’Hoski S, D’Amore C, Beauchamp M. The effects of co-designed physical activity interventions in older adults: A systematic review and meta-analysis. PLoS One 2024; 19:e0297675. [PMID: 38728263 PMCID: PMC11086838 DOI: 10.1371/journal.pone.0297675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 01/11/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Physical activity (PA) declines with age despite the knowledge that physical inactivity is a leading cause of disease, death, and disability worldwide. To better tailor PA interventions to older adults, researchers are turning to the collaborative principles of co-design. The purpose of this systematic review was to compare the effectiveness of co-designed PA interventions and standard care for increasing PA and other health outcomes (i.e., physical function, quality of life, mental health, functional independence, attendance and attrition rates) in older adults. METHODS A search was conducted in MEDLINE, AgeLine, CINAHL, Embase, and SPORTDiscus. Records were screened by independent pairs of reviewers. Primary research studies conducted among community-dwelling older adults (age 60+) comparing co-designed PA interventions to standard care were considered for inclusion. Controls included wait-list control, usual care, sham interventions, PA interventions without the use of co-design, and no intervention. A random effects meta-analysis was conducted, and the standardized mean difference (SMD) was used to report effect estimates. Quality of evidence was rated using GRADE. RESULTS Of 16,191 studies screened, eight (N = 16,733) were included in this review. Most studies reported results favouring the effect of co-design on physical activity; however, only two studies (N = 433) could be pooled for meta-analysis resulting in a SMD of 0.28, (95% CI = -0.13 to 0.69; p = 0.19; I2 = 56%) immediately post-intervention. The GRADE quality of evidence was very low. The quantitative analysis of three studies reported improved physical function. CONCLUSION This review did not demonstrate that co-designed PA interventions are more effective than standard care for increasing PA in older adults; however, evidence was limited and of very low quality. Further well-designed trials are warranted to better understand the impacts of co-designed PA interventions and how to best implement them into practice. TRIAL REGISTRATION PROSPERO registration number: CRD42022314217.
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Affiliation(s)
- Amanda Zacharuk
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Alison Ferguson
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Chelsea Komar
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Nicole Bentley
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Alexandra Dempsey
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Michelle Louwagie
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Sachi O’Hoski
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Cassandra D’Amore
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Marla Beauchamp
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Research Institute at St Joseph’s Healthcare, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
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Ekblad S, Gramatik O, Suprun Y. Increasing perceived health and mental health literacy among separated refugee Ukrainian families with urgent needs occasioned by invasion-a group intervention study with participatory methodology in Sweden. Front Public Health 2024; 12:1356605. [PMID: 38799690 PMCID: PMC11122463 DOI: 10.3389/fpubh.2024.1356605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/15/2024] [Indexed: 05/29/2024] Open
Abstract
Background With the increasing numbers of refugees from Ukraine affected by the ongoing war, there is a high risk of trauma-related stress due to low local health and mental health literacy care. Perceived good health is a human right. Earlier studies show that intervention for refugees can reduce and prevent post-migration stress and anxiety. The present explorative study aimed to investigate the feasibility and effectiveness of a short, trauma-focused group intervention (in Swedish "hälsoskola") for Ukrainian-speaking refugees (EU's mass refugee directive). This intervention was part of an ESF project aiming to get the subjects closer to the labor market in Västernorrland County, Sweden. Materials and methods A mixed-methods design, a participatory methodology, and an evaluation were used. Data were obtained with a short questionnaire in Ukrainian. It included a visual analogue health-rating scale, an observation, and an oral evaluation in groups. For practical and ethical reasons, there was no control group. Each group met five times for 2 h, a total of 10 h excluding pre- and post-assessment. There were eight sets of five group sessions per set, a total of 40 sessions. Brief initial and concluding breathing exercises sought to reduce stress among the participants. Results Baseline data were obtained from 99 participants, mostly females. Data gathered directly after the group intervention from 57 participants who had filled in both the pre- and post-questionnaires showed that (1) perceived anxiety/stress was significantly reduced (chi-2 25,53, df = 4, p < 001). (2) The participants showed significantly better perceived health as assessed on a visual analogue scale (average change from 63.16 to 71.18, p < 0.001). This result was supported by the participants' questions, which were qualitatively evaluated using thematic content analysis. Five general themes stemmed from questions raised in dialogue with the participants plus observation with the respective local expert. The participants received answers to their questions, and their perceived negative attitudes to authorities changed to more positive ones. Conclusion By dialogue between the participants' needs of knowledge and direct answers by the local expert, respectively, was feasible and effective as they perceived trust and health and mental health literacy increased. Implications for primary prevention are discussed.
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Affiliation(s)
- Solvig Ekblad
- Cultural Medicine Research Group, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
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Mac Fadden I, Cocchioni R, Delgado-Serrano MM. A Co-Created Assessment Framework to Measure Inclusive Health and Wellbeing in a Vulnerable Context in the South of Europe. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:510. [PMID: 38673421 PMCID: PMC11050556 DOI: 10.3390/ijerph21040510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/05/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024]
Abstract
Rapid urbanisation exacerbates health and wellbeing disparities in vulnerable contexts and underscores the imperative need to develop innovative and participatory co-creation approaches to understand and address the specificities of these contexts. This paper presents a method to develop an assessment framework that integrates top-down dimensions with bottom-up perspectives to monitor the impact of inclusive health and wellbeing interventions tailored to the neighbourhood's needs in Las Palmeras, a vulnerable neighbourhood in Cordoba (Spain). Drawing upon studies in the literature examining urban health and wellbeing trends, it delineates a participatory and inclusive framework, emphasising the need for context-specific indicators and assessment tools. Involving diverse stakeholders, including residents and professionals, it enriches the process and identifies key indicators and assessment methods. This approach provides valuable insights for managing innovative solutions, aligning them with local expectations, and measuring their impact. It contributes to the discourse on inclusive urban health by advocating for participatory, context-specific strategies and interdisciplinary collaboration. While not universally applicable, the framework offers a model for health assessment in vulnerable contexts, encouraging further development of community-based tools for promoting inclusive wellbeing.
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Affiliation(s)
- Isotta Mac Fadden
- Department of Agriculture Economics, Universidad de Córdoba, E-14005 Córdoba, Spain;
| | | | - María Mar Delgado-Serrano
- WEARE Research Group, Department of Agriculture Economics, Universidad de Córdoba, E-14005 Córdoba, Spain
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Hughes R, Ahuja KDK, Patterson KAE, Holloway TP, Soward R, Jayasinghe S, Byrne NM, Hills AP. An exploration of the determinants of overweight and obesity and the capacity to intervene in North-West Tasmania: A stakeholder consultation. Health Promot J Austr 2024; 35:385-392. [PMID: 37331377 DOI: 10.1002/hpja.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/20/2023] Open
Abstract
ISSUE ADDRESSED The capacity of communities to develop effective obesity prevention initiatives varies and should be a focus for obesity prevention intervention planning and investment. This research aimed at engaging and consulting local community stakeholders to identify determinants, needs, strategic priorities and capacity to act on overweight and obesity prevention in North-West (NW) Tasmania. METHODS A series of semi-structured interviews and thematic analyses was implemented to explore the knowledge, insights, experiences and attitudes of stakeholders. RESULTS Mental health and obesity were identified as major concerns and were often reported to share similar determinants. This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). CONCLUSIONS This study has identified health promotion capacity assets (existing partnerships, community capital, local leadership and some pockets of health promotion activity), and a range of capacity deficits (limited investment in health promotion, a small workforce, limited access to pertinent health information). SO WHAT?: Broad upstream socio-economic, cultural and environmental determinants underpin the conditions by which the local community develops overweight/obesity and/or health and wellbeing outcomes. Including stakeholder consultations as a significant technique within a comprehensive plan of action aimed at achieving a sustainable, long-term strategy for obesity prevention and/or health promotion, should be considered in future programs.
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Affiliation(s)
- Roger Hughes
- School of Health Sciences, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Kira A E Patterson
- Faculty of Education, University of Tasmania, Launceston, Tasmania, Australia
| | - Timothy P Holloway
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Robert Soward
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Sisitha Jayasinghe
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Nuala M Byrne
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
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Albitres-Flores L, Perez-Leon S, Bernabe-Ortiz A, Tenorio-Mucha J, Cardenas MK, Vetter B, Safary E, Gamboa R, Cordova V, Gupta R, Moran A, Beran D, Lazo-Porras M. Co-creation process of an intervention to implement a multiparameter point-of-care testing device in a primary healthcare setting for non-communicable diseases in Peru. BMC Health Serv Res 2024; 24:401. [PMID: 38553724 PMCID: PMC10981306 DOI: 10.1186/s12913-024-10809-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 02/29/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Point-of-care testing (POCT) devices are diagnostic tools that can provide quick and accurate results within minutes, making them suitable for diagnosing non-communicable diseases (NCDs). However, these devices are not widely implemented in healthcare systems and for this reason is relevant to understand the implementation process. AIM To describe the process and define a strategy to implement a multiparameter POCT device for diagnosing and managing NCDs in one region of Peru. METHODS A descriptive and non-experimental study, using the participatory methodologies of co-creation process. It was conducted in one region of Peru (Tumbes) to design an intervention for implementing a multiparameter POCT device. Two co-creation sessions were conducted involving five groups: community members, primary healthcare workers, these groups in both rural and urban settings, and regional decision-makers. These sessions included activities to understand patient journeys in receiving care for NCDs, identify facilitators and barriers to POCT devices usage, and define an implementation strategy for POCT devices in both rural and urban settings of Tumbes. The research team analysed the data and summarized key topics for discussion after each session. RESULTS A total of 78 participants were enrolled across the five groups. Among community members: 22.2% had only diabetes, 24.1% had only hypertension, and 18.5% had both diagnoses. In the patient journey, community members mentioned that it took at least three days to receive a diagnosis and treatment for an NCD. Most of the participants agreed that the POCT devices would be beneficial for their communities, but they also identified some concerns. The strategy for POCT devices implementation included healthcare workers training, POCT devices must be placed in the laboratory area and must be able to perform tests for glucose, glycated haemoglobin, cholesterol, and creatinine. Advertising about POCT devices should be displayed at the healthcare centres and the municipality using billboards and flyers. CONCLUSIONS The co-creation process was useful to develop strategies for the implementation of multiparameter POCT devices for NCDs, involving the participation of different groups of stakeholders guided by moderators in both, rural and urban, settings in Peru.
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Affiliation(s)
- Leonardo Albitres-Flores
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvana Perez-Leon
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Antonio Bernabe-Ortiz
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Janeth Tenorio-Mucha
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Kathia Cardenas
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Ricardo Gamboa
- Global Health Center, Universidad Peruana Cayetano Heredia, Tumbes, Peru
| | | | - Reena Gupta
- Resolve to Save Lives, New York, NY, USA
- Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, USA
| | | | - David Beran
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
| | - María Lazo-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals & University of Geneva, Geneva, Switzerland.
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Longworth GR, Goh K, Agnello DM, Messiha K, Beeckman M, Zapata-Restrepo JR, Cardon G, Chastin S, Giné-Garriga M. A review of implementation and evaluation frameworks for public health interventions to inform co-creation: a Health CASCADE study. Health Res Policy Syst 2024; 22:39. [PMID: 38549162 PMCID: PMC10976753 DOI: 10.1186/s12961-024-01126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/22/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND By including the needs and perspectives of relevant stakeholders, co-creation is seen as a promising approach for tackling complex public health problems. However, recommendations and guidance on how to plan and implement co-creation are lacking. By identifying and analysing existing implementation and evaluation frameworks for public health, this study aims to offer key recommendations for professional stakeholders and researchers wanting to adopt a co-creation approach to public health interventions. METHODS Firstly, PubMed and CINAHL databases were screened for articles introducing original implementation and evaluation frameworks for public health interventions. Backwards snowballing techniques were applied to the included papers. Secondly, identified frameworks were classified and relevant data extracted, including steps and constructs present in the frameworks. Lastly, recommendations were derived by conducting thematic analysis on the included frameworks. RESULTS Thirty frameworks were identified and data related to their nature and scope extracted. The frameworks' prominent steps and constructs were also retrieved. Recommendations related to implementation and evaluation in the context of co-creation were included. CONCLUSION When engaging in co-creation, we recommend including implementation considerations from an early stage and suggest adopting a systems thinking as a way to explore multiple levels of influence, contextual settings and systems from an early planning stage. We highlight the importance of partnering with stakeholders and suggest applying an evaluation design that is iterative and cyclical, which pays particular attention to the experience of the engaged co-creators.
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Affiliation(s)
| | - Kunshan Goh
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Danielle Marie Agnello
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road Glasgow, Scotland, G4 0BA, UK
| | - Katrina Messiha
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | | | - Jorge Raul Zapata-Restrepo
- Department of Physical Activity and Sport Sciences, FPCEE Blanquerna, Universitat Ramon Llull, Carrer del Císter, 34, 08022, Barcelona, Spain
| | - Greet Cardon
- Department of Movement and Sports Sciences, Physical Activity and Health, Ghent University and Policy Research Center Sport, Krijgslaan 281 - S2, 9000, Ghent, Belgium
| | - Sebastien Chastin
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road Glasgow, Scotland, G4 0BA, UK
- Department of Movement and Sports Sciences, Physical Activity and Health, Ghent University and Policy Research Center Sport, Krijgslaan 281 - S2, 9000, Ghent, Belgium
| | - Maria Giné-Garriga
- Department of Physical Activity and Sport Sciences, FPCEE Blanquerna, Universitat Ramon Llull, Carrer del Císter, 34, 08022, Barcelona, Spain
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Shi Y, Stanmore E, McGarrigle L, Todd C. Social-media based Health Education plus Exercise Programme (SHEEP) to improve muscle function among community-dwelling young-old adults with possible sarcopenia in China: A study protocol for intervention development. PLoS One 2024; 19:e0286490. [PMID: 38547178 PMCID: PMC10977808 DOI: 10.1371/journal.pone.0286490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 02/07/2024] [Indexed: 04/02/2024] Open
Abstract
Possible sarcopenia refers to low muscle strength. Prevalence of possible sarcopenia is estimated to be significantly higher in community-dwelling older adults than that of confirmed or severe sarcopenia. However, there are currently far fewer non-pharmacological intervention strategies for possible sarcopenia than for sarcopenia in the community. Meanwhile, one type of non-pharmacological intervention in sarcopenic area, health education, is under-researched, and older people's awareness about sarcopenia is extremely low, necessitating an immediate dissemination tool for prevention. Social media may be a potential, scalable, low-cost tool for this. This study protocol outlines how a social media-based multicomponent intervention will be co-designed with stakeholders to address this evidence gap. Guided by the Medical Research Council's framework, the proposed research covers two phases that employ a co-design approach to develop a theory-based multicomponent intervention to increase sarcopenia prevention in the community. The participants will be recruited from young-old adults (60~69) with possible sarcopenia in the community of Changsha, China. Maximum sample size will be 45 participants in total, with 18~25 participants in the development phase and 15~20 participants in the pre-test phase. During two rounds of focus groups with older adults, a social-media based intervention strategy will be developed from a theory-based conceptual model and an initial intervention plan formulated by the research group. After this, there will be a three-week pre-test phase, followed by a semi-structured interview to further modify the theory-based conceptual model and the social-media based intervention strategy. The focus of the data analysis will be on thematic analysis of qualitative data primarily derived from the group interview and the semi-structured interview with key stakeholders.
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Affiliation(s)
- Ya Shi
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- School of Nursing & School of Public Health, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Emma Stanmore
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Lisa McGarrigle
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, Faculty of Biology, Medicine & Health, The University of Manchester, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Labrosse D, Vié C, Hajjam H, Tisseron C, Thellier D, Montagni I. An Escape Game on University Students' Mental Health During the COVID-19 Pandemic: Cocreation Study. JMIR Serious Games 2024; 12:e48545. [PMID: 38498033 PMCID: PMC10985612 DOI: 10.2196/48545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/16/2023] [Accepted: 02/09/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a severe impact on students' mental health. Interventions are needed to promote their psychological well-being and prevent mental illnesses in the aftermath of this unprecedented situation. Digital escape games can be an effective tool to support students' mental health. A cocreation approach can improve the acceptability of these interventions by involving different stakeholders (eg, end users, game designers, and health professionals) to obtain audience-specific games. OBJECTIVE This study aims to describe the process of testing and optimizing the game "EscapeCovid" on students' mental health, to serve as a model for the cocreation of future similar interventions. METHODS The PRODUCES (Problem, Objective, Design, End Users, Cocreators, Evaluation, Scalability) framework was used. Cocreation steps (test and optimization) were detailed for replicability. A total of 45 students tested a pilot version of the game, with 10 undergoing a semistructured interview. Meetings with a group of stakeholders and brainwriting were organized to optimize the game. RESULTS We produced a new version of the game incorporating the suggestions provided by student testers and following the stakeholders' guidelines. Improvements were made to both the content and the form of the new version of the pilot game. The storyline, including the protagonist and the scenes, was adapted to the student population. CONCLUSIONS Our results suggested that cocreation can contribute to the design of more widely accepted interventions aimed at promoting mental health and preventing psychological disorders. Results also suggest that an end user-centered approach can facilitate intervention tailoring. When conceiving a health-related escape game for students, we recommend using the cocreation approach to enhance players' experience, thus positively influencing their learning process and overall well-being.
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Affiliation(s)
| | - Clara Vié
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center U1219, Bordeaux, France
| | | | - Clément Tisseron
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center U1219, Bordeaux, France
| | | | - Ilaria Montagni
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center U1219, Bordeaux, France
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Servais J, Vanhoutte B, Aguirre-Sánchez-Beato S, Aujoulat I, Kraus C, T'Sjoen G, Tricas-Sauras S, Godin I. Integrating perspectives of transgender and gender-diverse youth, family members, and professionals to support their health and wellbeing - a mixed-method study protocol. Arch Public Health 2024; 82:40. [PMID: 38500212 PMCID: PMC10949725 DOI: 10.1186/s13690-024-01270-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/11/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The current literature highlights a strong link between the poor health outcomes of transgender and gender diverse (TGD) individuals and their negative experiences in various areas of life. Most of these publications rely on adults' memories, lacking a focus on the current experiences and needs of young transgender and gender-diverse individuals. Furthermore, previous studies on support for these young people often solely consider the perspectives of TGD adults or professionals and rarely involve parents' viewpoints. METHODS This study will use a mixed sequential method with a participatory approach. Firstly, the qualitative phase will explore the difficulties and needs of TGD (15-20 years old) and of the families and professionals who support them. Results from this part will be used to develop the questionnaire for the quantitative phase, with the help of a community board. Secondly, based on participatory epidemiological research, the quantitative phase will use an intersectional perspective to measure the impact of individual and structural factors on the quality of life and well-being of transgender and gender-diverse young people. Finally, a co-creation phase will be undertaken to formulate recommendations based on the results of the first two phases. DISCUSSION This research aims at better understanding the influence of gender identity on the quality of life and health of TGD young people and their families and to identify protective and risk factors that affect their vulnerabilities. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of the Erasme Faculty Hospital (CCB B4062023000140). As this research is participatory and part of a PhD dissertation, we aim to disseminate the results through our partners' networks and structures locally, and internationally through conferences and peer-reviewed journals.
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Affiliation(s)
- Julie Servais
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium.
| | - Bram Vanhoutte
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium
| | - Sara Aguirre-Sánchez-Beato
- Faculty of Psychology and Education, Université Libre de Bruxelles, CP 122, Avenue F.D. Roosevelt, 50, Brussels, 1050, Belgium
| | - Isabelle Aujoulat
- Health and Society Research Institute - UCLouvain, Clos Chapelle-Aux-Champs 30/B1.30.15, Woluwe-Saint-Lambert, 1200, Belgium
| | - Cynthia Kraus
- Faculty of Social and Political Sciences - UNIL, CH-1015, Lausanne, Switzerland
| | - Guy T'Sjoen
- Faculty of Medicine and Health Sciences, Ghent University Hospital, C. Heymanslaan 10, Ghent, 9000, Belgium
| | - Sandra Tricas-Sauras
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium
| | - Isabelle Godin
- School of Public Health, Université Libre de Bruxelles, CP 596, Route de Lennik, 808, Brussels, 1070, Belgium
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Langford R, Brockman R, Banks J, Jago R, Gillison F, Coulman K, Moore T, Nobles J. Co-designing adult weight management services: a qualitative study exploring barriers, facilitators, and considerations for future commissioning. BMC Public Health 2024; 24:778. [PMID: 38475750 DOI: 10.1186/s12889-024-18031-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Weight management services have not always benefitted everyone equally. People who live in more deprived areas, racially minoritised communities, those with complex additional needs (e.g., a physical or mental disability), and men are less likely to take part in weight management services. This can subsequently widen health inequalities. One way to counter this is to co-design services with under-served groups to better meet their needs. Using a case study approach, we explored how co-designed adult weight management services were developed, the barriers and facilitators to co-design, and the implications for future commissioning. METHODS We selected four case studies of adult weight management services in Southwest England where co-design had been planned, representing a range of populations and settings. In each case, we recruited commissioners and providers of the services, and where possible, community members involved in co-design activities. Interviews were conducted online, audio-recorded, transcribed verbatim, and analysed using thematic analysis. RESULTS We interviewed 18 participants (8 female; 10 male): seven commissioners, eight providers, and three community members involved in co-designing the services. The case studies used a range of co-design activities (planned and actualised), from light-touch to more in-depth approaches. In two case studies, co-design activities were planned but were not fully implemented due to organisational time or funding constraints. Co-design was viewed positively by participants as a way of creating more appropriate services and better engagement, thus potentially leading to reduced inequalities. Building relationships- with communities, individual community members, and with partner organisations- was critical for successful co-design and took time and effort. Short-term and unpredictable funding often hindered co-design efforts and could damage relationships with communities. Some commissioners raised concerns over the limited evidence for co-design, while others described having to embrace "a different way of thinking" when commissioning for co-design. CONCLUSIONS Co-design is an increasingly popular approach to designing health in services but can be difficult to achieve within traditional funding and commissioning practices. Drawing on our case studies, we present key considerations for those wanting to co-design health services, noting the importance of building strong relationships, creating supportive organisational cultures, and developing the evidence base.
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Affiliation(s)
- Rebecca Langford
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK.
| | - Rowan Brockman
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - Jonathan Banks
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - Russell Jago
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and University of Bristol, Oakfield House, Oakfield Grove, BS8 2BN, Bristol, UK
| | - Fiona Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, BA2 7AY, Bath, UK
| | - Karen Coulman
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, BS8 1NU, Bristol, UK
| | - Theresa Moore
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, BS1 2NT, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, BS8 2PS, Bristol, UK
| | - James Nobles
- Health, Nutrition & Environment, Leeds Beckett University, Calverley Building, City Campus, LS1 3HE, Leeds, UK
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Aitken SJ, James S, Lawrence A, Glover A, Pleass H, Thillianadesan J, Monaro S, Hitos K, Naganathan V. Codesign of health technology interventions to support best-practice perioperative care and surgical waitlist management. BMJ Health Care Inform 2024; 31:e100928. [PMID: 38471784 DOI: 10.1136/bmjhci-2023-100928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/10/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVES This project aimed to determine where health technology can support best-practice perioperative care for patients waiting for surgery. METHODS An exploratory codesign process used personas and journey mapping in three interprofessional workshops to identify key challenges in perioperative care across four health districts in Sydney, Australia. Through participatory methodology, the research inquiry directly involved perioperative clinicians. In three facilitated workshops, clinician and patient participants codesigned potential digital interventions to support perioperative pathways. Workshop output was coded and thematically analysed, using design principles. RESULTS Codesign workshops, involving 51 participants, were conducted October to November 2022. Participants designed seven patient personas, with consumer representatives confirming acceptability and diversity. Interprofessional team members and consumers mapped key clinical moments, feelings and barriers for each persona during a hypothetical perioperative journey. Six key themes were identified: 'preventative care', 'personalised care', 'integrated communication', 'shared decision-making', 'care transitions' and 'partnership'. Twenty potential solutions were proposed, with top priorities a digital dashboard and virtual care coordination. DISCUSSION Our findings emphasise the importance of interprofessional collaboration, patient and family engagement and supporting health technology infrastructure. Through user-based codesign, participants identified potential opportunities where health technology could improve system efficiencies and enhance care quality for patients waiting for surgical procedures. The codesign approach embedded users in the development of locally-driven, contextually oriented policies to address current perioperative service challenges, such as prolonged waiting times and care fragmentation. CONCLUSION Health technology innovation provides opportunities to improve perioperative care and integrate clinical information. Future research will prototype priority solutions for further implementation and evaluation.
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Affiliation(s)
- Sarah Joy Aitken
- Sydney Medical School, The University of Sydney Faculty of Medicine and Health, Camperdown, New South Wales, Australia
- Concord Institute of Academic Surgery, Sydney Local Health District, Concord West, New South Wales, Australia
| | - Sophie James
- The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Amy Lawrence
- Anaesthetics, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Anthony Glover
- The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Department of Surgery and Endocrinology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Henry Pleass
- The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia
| | - Janani Thillianadesan
- The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Geriatrics, Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Sue Monaro
- Clinical Excellence Commission, Sydney South, New South Wales, Australia
- Concord Repatriation General Hospital, Concord, New South Wales, Australia
| | - Kerry Hitos
- The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Westmead Hospital, Westmead, New South Wales, Australia
| | - Vasi Naganathan
- The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
- Concord Repatriation General Hospital, Concord, New South Wales, Australia
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Sandi F, Mercer G, Geneau R, Bassett K, Bintabara D, Kalolo A. Alternative community-led intervention to improve uptake of cataract surgery services in rural Tanzania-The Dodoma Community Cataract Acceptance Trial (DoCCAT): a protocol for intervention co-designing and implementation in a cluster-randomized controlled trial. Biol Methods Protoc 2024; 9:bpae016. [PMID: 38566775 PMCID: PMC10987207 DOI: 10.1093/biomethods/bpae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
Age-related lens opacification (cataract) remains the leading cause of visual impairment and blindness worldwide. In low- and middle-income countries, utilization of cataract surgical services is often limited despite community-based outreach programmes. Community-led research, whereby researchers and community members collaboratively co-design intervention is an approach that ensures the interventions are locally relevant and that their implementation is feasible and socially accepted in the targeted contexts. Community-led interventions have the potential to increase cataract surgery uptake if done appropriately. In this study, once the intervention is co-designed it will be implemented through a cluster-randomized controlled trial (cRCT) with ward as a unit of randomization. This study will utilise both the qualitative methods for co-designing the intervention and the quantitative methods for effective assessment of the developed community-led intervention through a cRCT in 80 rural wards of Dodoma region, Tanzania (40 Intervention). The 'intervention package' will be developed through participatory community meetings and ongoing evaluation and modification of the intervention based on its impact on service utilization. Leask's four stages of intervention co-creation will guide the development within Rifkin's CHOICE framework. The primary outcomes are two: the number of patients attending eye disease screening camps, and the number of patients accepting cataract surgery. NVivo version 12 will be used for qualitative data analysis and Stata version 12 for quantitative data. Independent and paired t-tests will be performed to make comparisons between and within groups. P-values less than 0.05 will be considered statistically significant.
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Affiliation(s)
- Frank Sandi
- Department of Ophthalmology, The University of Dodoma Medical School, Dodoma, Tanzania
| | - Gareth Mercer
- Department of Ophthalmology & Visual Sciences, University of Toronto, Toronto, Canada
| | - Robert Geneau
- Division of Ophthalmology, University of Cape Town, Cape Town, South Africa
| | - Kenneth Bassett
- Department of Ophthalmology, The University of British Columbia, Vancouver, Canada
| | - Deogratius Bintabara
- Department of Community Medicine, The University of Dodoma Medical School, Dodoma, Tanzania
| | - Albino Kalolo
- Department of Public Health, St Francis University College of Health and Allied Sciences, Morogoro, Tanzania
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Weber M, Raab AM, Schmitt KU, Büsching G, Marcin T, Spielmanns M, Puhan MA, Frei A. Efficacy of a digital lifestyle intervention on health-related QUAlity of life in non-small cell LUng CAncer survivors following inpatient rehabilitation: protocol of the QUALUCA Swiss multicentre randomised controlled trial. BMJ Open 2024; 14:e081397. [PMID: 38453202 PMCID: PMC10921523 DOI: 10.1136/bmjopen-2023-081397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/09/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Non-small cell lung cancer (NSCLC) survivors suffer from impaired physical and psychological functioning and reduced health-related quality of life (HRQoL) that persist after active treatment ends. Sustaining rehabilitation benefits, promoting a healthy lifestyle and facilitating self-management at home require a multifaceted aftercare programme. We aim to investigate the effect of a 12-week digital lifestyle intervention on HRQoL and lifestyle-related outcomes in NSCLC survivors after completion of inpatient rehabilitation. METHODS AND ANALYSIS QUAlity of life in LUng CAncer Survivors (QUALUCA) is a multicentre randomised controlled trial that follows a hybrid type 1 design. We randomly allocate participants in a 1:1 ratio to the intervention group (digital lifestyle intervention) or the control group (standard care) using block randomisation stratified by tumour stage and study site. Four accredited Swiss inpatient rehabilitation centres recruit participants. Key inclusion criteria are a diagnosis of NSCLC, an estimated life expectancy of ≥6 months and access to a smartphone or tablet. The 12-week intervention comprises physical activity, nutrition and breathing/relaxation, delivered through a mobile application (app). The primary outcome is the change in HRQoL from baseline (1 week after rehabilitation) to follow-up (3 months after baseline), assessed by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Secondary outcomes include body mass index, self-reported physical activity, exercise capacity, risk of low protein intake, appetite, psychological distress, cancer-related fatigue, enablement and self-rated health. Explanatory outcomes in the intervention group include app usability, acceptability, appropriateness, and feasibility of the intervention, experiences and satisfaction with the intervention, and app usage data. We aim to enrol 88 participants. For the main statistical analysis, we will use analysis of covariance, adjusted for baseline measures, stratification variables, age and sex. ETHICS AND DISSEMINATION The Ethics Committees of the Canton of Zurich (lead), the Canton of Bern and Northwest and Central Switzerland approved the study (2023-00245). We will disseminate study results to researchers, health professionals, study participants and relevant organisations, and through publications in international peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT05819346.
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Affiliation(s)
- Manuel Weber
- Academic-Practice-Partnership between School of Health Professions at Bern University of Applied Sciences and University Hospital of Bern, Bern, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja Maria Raab
- Academic-Practice-Partnership between School of Health Professions at Bern University of Applied Sciences and University Hospital of Bern, Bern, Switzerland
| | - Kai-Uwe Schmitt
- Academic-Practice-Partnership between School of Health Professions at Bern University of Applied Sciences and University Hospital of Bern, Bern, Switzerland
| | - Gilbert Büsching
- Barmelweid Academy, Klinik Barmelweid, Barmelweid, Switzerland
- Department of Therapeutics, Klinik Barmelweid, Barmelweid, Switzerland
| | - Thimo Marcin
- Berner Reha Zentrum, Rehabilitation & Sports Medicine, Insel Group, University Hospital of Bern, University of Bern, Heiligenschwendi, Switzerland
| | - Marc Spielmanns
- Department of Pulmonary Medicine, Zürcher RehaZentren - Klinik Wald and Klinik Davos, Wald & Davos, Switzerland
- Faculty of Health, Department for Pulmonary Medicine, Witten/Herdecke University, Witten, Germany
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Enlow PT, Thomas C, Osorio AM, Lee M, Miller JM, Pelaez L, Kazak AE, Phan TLT. Community Partnership to Co-Develop an Intervention to Promote Equitable Uptake of the COVID-19 Vaccine Among Pediatric Populations. Dela J Public Health 2024; 10:30-38. [PMID: 38572140 PMCID: PMC10987021 DOI: 10.32481/djph.2024.03.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Objective To describe the process of engaging community, caregiver, and youth partners in codeveloping an intervention to promote equitable uptake of the COVID-19 vaccine in non-Hispanic Black (Black) and Hispanic youth who experience higher rates of COVID-19 transmission, morbidity, and mortality but were less likely to receive the COVID-19 vaccine. Methods A team of 11 Black and Hispanic community partners was assembled to codevelop intervention strategies with our interdisciplinary research team. We used a mixed-methods crowdsourcing approach with Black and Hispanic youth (n=15) and caregivers of Black and Hispanic youth (n=20) who had not yet been vaccinated against COVID-19, recruited from primary care clinics, to elicit perspectives on the acceptability of these intervention strategies. Results We codeveloped five strategies: (1) community-tailored handouts and posters, (2) videos featuring local youth, (3) family-centered language to offer vaccines in the primary care clinic, (4) communication-skills training for primary care providers, and (5) use of community health workers to counsel families about the vaccine. The majority (56-96.9%) of youth and caregivers rated each of these strategies as acceptable, especially because they addressed common concerns and facilitated shared decision-making. Conclusions Engaging community and family partners led to the co-development of culturally- and locally-tailored strategies to promote dialogue and shared decision-making about the COVID-19 vaccine. This process can be used to codevelop interventions to address other forms of public health disparities. Policy Implications Intervention strategies that promote dialogues with trusted healthcare providers and support shared decision-making are acceptable strategies to promote COVID-19 vaccine uptake among youth from historically underserved communities. Stakeholder-engaged methods may also help in the development of interventions to address other forms of health disparities.
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Affiliation(s)
- Paul T Enlow
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Courtney Thomas
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware
| | - Angel Munoz Osorio
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware
| | - Marshala Lee
- Harrington Value Institute Community Partnership Fund, ChristianaCare Health System
| | - Jonathan M Miller
- Inclusion, Diversity, Equity, and Alignment, Nemours Children's Health; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Lavisha Pelaez
- Inclusion, Diversity, Equity, and Alignment, Nemours Children's Health
| | - Anne E Kazak
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
| | - Thao-Ly T Phan
- Center for Healthcare Delivery Science, Nemours Children's Hospital Delaware; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University
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Vainre M, Dalgleish T, Watson P, Haag C, Dercon Q, Galante J, Hitchcock C. Work Engagement and Well-being Study (SWELL): a randomised controlled feasibility trial evaluating the effects of mindfulness versus light physical exercise at work. BMJ MENTAL HEALTH 2024; 27:e300885. [PMID: 38423582 PMCID: PMC10910646 DOI: 10.1136/bmjment-2023-300885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/05/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Mindfulness-based programmes (MBPs) are increasingly offered at work, often in online self-guided format. However, the evidence on MBPs' effect on work performance (WP) is inconsistent. OBJECTIVE This pragmatic randomised controlled feasibility trial assessed procedural uncertainties, intervention acceptability and preliminary effect sizes of an MBP on WP, relative to an alternative intervention. METHODS 241 employees from eight employers were randomised (1:1) to complete a 4-week, self-guided, online MBP or a light physical exercise programme (LE)(active control). Feasibility and acceptability measures were of primary interest. WP at postintervention (PostInt) was the primary outcome for preliminary assessment of effect sizes. Secondary outcomes assessed mental health (MH) and cognitive processes hypothesised to be targeted by the MBP. Outcomes were collected at baseline, PostInt and 12-week follow-up (12wFUP). Prospective trial protocol: NCT04631302. FINDINGS 87% of randomised participants started the course. Courses had high acceptability. Retention rates were typical for online trials (64% PostInt; 30% 12wFUP). MBP, compared with the LE control, offered negligible benefits for WP (PostInt (d=0.06, 95% CI -0.19 to 0.32); 12wFUP (d=0.02, 95% CI -0.30 to 0.26)). Both interventions improved MH outcomes (ds=-0.40 to 0.58, 95% CI -0.32 to 0.18); between-group differences were small (ds=-0.09 to 0.04, 95% CI -0.15 to 0.17). CONCLUSION The trial is feasible; interventions are acceptable. Results provide little support for a later phase trial comparing an MBP to a light exercise control. To inform future trials, we summarise procedural challenges. CLINICAL IMPLICATIONS Results suggest MBPs are unlikely to improve WP relative to light physical exercise. Although the MBP improved MH, other active interventions may be just as efficacious. TRIAL REGISTRATION NUMBER NCT04631302.
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Affiliation(s)
- Maris Vainre
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UK
- Institute of Psychology, University of Tartu, Tartu, Estonia
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UK
| | - Peter Watson
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UK
| | - Christina Haag
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Quentin Dercon
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UK
- Institute of Mental Health, University College London, London, UK
| | - Julieta Galante
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Contemplative Studies Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge University, Cambridge, UK
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Jolles MP, Fort MP, Glasgow RE. Aligning the planning, development, and implementation of complex interventions to local contexts with an equity focus: application of the PRISM/RE-AIM Framework. Int J Equity Health 2024; 23:41. [PMID: 38408990 PMCID: PMC10898074 DOI: 10.1186/s12939-024-02130-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
For the fields of implementation science and health equity, understanding and being responsive to local contexts is of utmost importance to better inform the development, implementation, and evaluation of healthcare and public health interventions to increase their uptake and sustainment. Contexts are multi-level and include political, historical, economic, and social factors that influence health, as well as organizational characteristics, reflecting the richness of members' views, resources, values, and needs. Poor alignment between solutions and those contextual characteristics could have an impact on inequities. The PRISM (Practical Robust Implementation and Sustainability Model) is a context-based implementation science framework that incorporates RE-AIM outcomes (Reach, Effectiveness, Adoption, Implementation, Maintenance) and offers guidance to researchers, practitioners, and their patient and community partners on how to conceptualize, assess, and address contextual domains with a focus on health equity. Drawing from systems thinking, participatory engagement, and health equity principles, this commentary expands on previous work to 1) offer a novel perspective on how to align an intervention's core functions and forms with the PRISM's contextual domains, and 2) foster an ongoing and iterative engagement process with diverse partners throughout the research and practice process using a co-creation approach. We recommend intervention-to-context alignment through iterative cycles. To that end, we present the RE-AIM Framework's 'outcomes cascade' to illustrate touch points of opportunity and gaps within and across each of the five RE-AIM outcomes to illustrate 'where things go wrong'. We present a case study to illustrate and offer recommendations for research and practice efforts to increase contextual responsiveness, and enhance alignment with context before, during, and after implementation efforts and to ensure equity is being addressed. We strive to make a conceptual contribution to advance the field of pragmatic research and implementation of evidence-based practices through the application of the contextually-based PRISM framework with a focus on health equity.
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Affiliation(s)
- Monica Pérez Jolles
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Anschutz Medical Campus, Mailstop F443, 1890 North Revere Court, Aurora, CO, 80045, USA.
- Department of General Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA.
| | - Meredith P Fort
- Department of Health Systems, Management and Policy and Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO, USA
| | - Russell E Glasgow
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Anschutz Medical Campus, Mailstop F443, 1890 North Revere Court, Aurora, CO, 80045, USA
- Department of Family Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, CO, USA
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Porri D, Morabito LA, Cavallaro P, La Rosa E, Li Pomi A, Pepe G, Wasniewska M. Time to act on childhood obesity: the use of technology. Front Pediatr 2024; 12:1359484. [PMID: 38434727 PMCID: PMC10904600 DOI: 10.3389/fped.2024.1359484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Childhood obesity is rapidly increasing worldwide and there is an urgent need to implement treatment and prevention programs. Over the last decade, in addition to increasing rates of childhood obesity, we have also observed rapid technological and digital development. The Covid-19 pandemic has largely contributed to both expansions but has also allowed an opening towards a broader vision of medicine, through new therapeutic opportunities such as mobile healthcare. The digital and technological delivery of obesity prevention and treatment programs can represent an innovative tool to support children and families to overcome some limitations and barriers such as the accessibility of programs that prevent them from adopting healthy lifestyle changes. This review aimed to summarize the impact of different digital interventions for children and adolescent affected by obesity.
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Affiliation(s)
| | | | - Paola Cavallaro
- Unit of Pediatrics, Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
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Butscher F, Ellinger J, Singer M, Mall C. Influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low socioeconomic status: a systematic review. Implement Sci Commun 2024; 5:12. [PMID: 38347649 PMCID: PMC10860312 DOI: 10.1186/s43058-024-00548-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Health inequity (HI) remains a major challenge in public health. Improving the health of children with low socioeconomic status (SES) can help to reduce overall HI in children. Childhood obesity is a global problem, entailing several adverse health effects. It is crucial to assess the influencing factors for adoption, implementation, and sustainment of interventions. This review aims to identify articles reporting about influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low SES. It aims to critically appraise the articles' quality, assess influencing factors, categorize and evaluate them, and to discuss possible implications. METHODS A systematic search was conducted in 7 databases with the following main inclusion criteria: (1) school-based interventions and (2) target group aged 5-14 years. The Consolidated Framework for Implementation Research, its five domains (intervention characteristics, inner setting, outer setting, characteristics of individuals, process) along with 39 categories within these domains were used as deductive category system for data analysis. We grouped the articles with regard to the characteristics of the interventions in simple and complex interventions. For each domain, and for the groups of simple and complex interventions, the most commonly reported influencing factors are identified. RESULTS In total, 8111 articles were screened, and 17 met all eligibility criteria. Included articles applied mixed methods (n=11), qualitative (n=5), and quantitative design (n=1). Of these, six were considered to report simple interventions and eleven were considered to report complex interventions. In total, 301 influencing factors were assessed. Aspects of the inner setting were reported in every study, aspects of the outer setting were the least reported domain. In the inner setting, most reported influencing factors were time (n=8), scheduling (n=6), and communication (n=6). CONCLUSION This review found a wide range of influencing factors for implementation and contributes to existing literature regarding health equity as well as implementation science. Including all stakeholders involved in the implementation process and assessing the most important influencing factors in the specific setting, could enhance implementation and intervention effectiveness. More empirical research and practical guidance are needed to promote obesity prevention behaviors among children with low SES. REGISTRATION CRD42021281209 (PROSPERO).
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Affiliation(s)
- Friederike Butscher
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany.
| | - Jan Ellinger
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
| | - Monika Singer
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
| | - Christoph Mall
- TUM School of Medicine and Health, Department Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany
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van der Laag PJ, Dorhout BG, Heeren AA, Veenhof C, Barten DJJA, Schoonhoven L. Identification and development of implementation strategies: the important role of codesign. FRONTIERS IN HEALTH SERVICES 2024; 4:1305955. [PMID: 38385048 PMCID: PMC10879593 DOI: 10.3389/frhs.2024.1305955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/12/2024] [Indexed: 02/23/2024]
Abstract
Background To date, implementation strategies reported in the literature are commonly poorly described and take the implementation context insufficiently into account. To unravel the black box of implementation strategy development, insight is needed into effective theory-based and practical-informed strategies. The current study aims to describe the stepwise development of a practical-informed and theory-based implementation strategy bundle to implement ProMuscle, a nutrition and exercise intervention for community-dwelling older adults, in multiple settings in primary care. Methods The first four steps of Implementation Mapping were adopted to develop appropriate implementation strategies. First, previously identified barriers to implementation were categorized into the constructs of the Consolidated Framework for Implementation Research (CFIR). Second, the CFIR-ERIC matching tool linked barriers to existing implementation strategies. Behavioral change strategies were added from the literature where necessary. Third, evidence for implementation strategies was sought. Fourth, in codesign with involved healthcare professionals and implementation experts, implementation strategies were operationalized to practical implementation activities following the guidance provided by Proctor et al. These practical implementation activities were processed into an implementation toolbox, which can be tailored to a specific context and presents prioritized implementation activities in a chronological order. Results A previous study identified and categorized a total of 654 barriers for the implementation of a combined lifestyle intervention within the CFIR framework. Subsequently, the barriers were linked to 40 strategies. Due to the fact that many strategies impacted multiple barriers, seven overarching themes emerged based on the strategies: assessing the context, network internally, network externally, costs, knowledge, champions, and patient needs and resources. Codesign sessions with professionals and implementation experts resulted in the development of supported and tangible implementation activities for the final 20 strategies. The implementation activities were processed into a web-based implementation toolbox, which allows healthcare professionals to tailor the implementation activities to their specific context and guides healthcare professionals to prioritize implementation activities chronologically during their implementation. Conclusion A theory-based approach in combination with codesign sessions with stakeholders is a usable Implementation Strategy Mapping Method for developing a practical implementation strategy bundle to implement ProMuscle across multiple settings in primary care. The next step involves evaluating the developed implementation strategies, including the implementation toolbox, to assess their impact on the implementation and adoption of ProMuscle.
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Affiliation(s)
- Patricia J. van der Laag
- Julius Center for Health Sciences and Primary Care, Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
| | - Berber G. Dorhout
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Aaron A. Heeren
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
| | - Cindy Veenhof
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
- Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, Netherlands
| | - Di-Janne J. A. Barten
- Research Group Innovation of Human Movement Care, Research Centre for Healthy and Sustainable Living, Utrecht University of Applied Sciences, Utrecht, Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Lisette Schoonhoven
- Julius Center for Health Sciences and Primary Care, Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
- Faculty of Health Sciences, University of Southampton, Southampton, United Kingdom
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