Clinical Epidemiology and Global Health最新文献

{"title":"The role of health insurance in shaping cesarean section rates among Indonesian women","authors":"Agung Dwi Laksono ,&nbsp;Ratna Dwi Wulandari","doi":"10.1016/j.cegh.2026.102313","DOIUrl":"10.1016/j.cegh.2026.102313","url":null,"abstract":"<div><h3>Background</h3><div>Understanding how health insurance ownership is associated with cesarean section delivery is essential for assessing maternal health service utilization in Indonesia. This study examines the relationship between insurance type and cesarean delivery among Indonesian women, while accounting for the national survey design.</div></div><div><h3>Methods</h3><div>This study used secondary data from the 2023 Indonesian Health Survey, including 70,916 women who delivered within five years preceding the survey. Complex survey adjusted logistic regression was applied to account for the multistage and stratified sampling design. Health insurance ownership was categorized as uninsured, government-run, private-run, or hybrid. Adjusted odds ratios and predicted probabilities were estimated. Firth's penalized likelihood regression was conducted as a sensitivity analysis for the hybrid insurance group.</div></div><div><h3>Results</h3><div>Overall, 25.9% of women reported cesarean delivery. After survey adjustment, cesarean delivery was more prevalent among insured women than uninsured women. Predicted probabilities indicated a higher absolute probability of cesarean delivery among women with government-run, private-run, and hybrid insurance. Estimates for the hybrid insurance group were consistent in direction but should be interpreted cautiously due to the small sample size.</div></div><div><h3>Conclusion</h3><div>Health insurance ownership is associated with higher cesarean delivery rates in Indonesia. These findings reflect associations rather than causal effects and may be influenced by differences in clinical risk profiles and health system factors.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102313"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health and quality of life in older adults in southern Peru: A cross-sectional study","authors":"Carolina Cueto Chavez ,&nbsp;Stephanie Echevarria-Dulanto ,&nbsp;Sheein Vega Rojas ,&nbsp;Javier Flores-Cohaila ,&nbsp;Cesar Copaja-Corzo ,&nbsp;Brayan Miranda-Chavez","doi":"10.1016/j.cegh.2025.102276","DOIUrl":"10.1016/j.cegh.2025.102276","url":null,"abstract":"<div><h3>Problem considered</h3><div>Mental health disorders in older adults significantly impair quality of life; however, data from urban primary care in Peru is scarce. Therefore, our objective was to analyze mental health and its association with quality of life in older adults in a city in southern Peru.</div></div><div><h3>Methods</h3><div>A cross-sectional study evaluated 500 older adults randomly selected from the Ciudad Nueva Health Center in Tacna. Depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), and health-related quality of life (EQ-5D-5L utility index and EQ-VAS) were measured. Sociodemographic and clinical covariates were recorded. Adjusted β coefficients and 95% confidence intervals were estimated using multiple linear regression.</div></div><div><h3>Results</h3><div>Positive screen for depression (PHQ-9 ≥ 10) affected 51% and positive screen for anxiety (GAD-7 ≥ 10) affected 51.4%. The mean EQ-5D-5L utility index was 0.5 ± 0.30 and the mean EQ-VAS score was 65.8 ± 17.9. In the adjusted models, the presence positive screen for depression was associated with a reduction in quality of life, reflected by a decrease in the EQ-5D-5L utility index (adjusted β = −0.28; 95% CI: −0.36 to −0.20). Additionally, both being retired and receiving a salary or wage were independently associated with reductions in the EQ-5D-5L utility index (adjusted β = −0.11; 95% CI: −0.20 to −0.02 and adjusted β = −0.11; 95% CI: −0.20 to −0.02, respectively).</div></div><div><h3>Conclusion</h3><div>High depression rates were associated with markedly lower quality of life in this Peruvian geriatric cohort, underscoring the need for integrated mental health screening and interventions.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102276"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The state of disease research in the Middle East and North Africa from 1980 to 2023","authors":"Georges Choueiry ,&nbsp;Sola Aoun Bahous ,&nbsp;Pierre-Marie Preux ,&nbsp;Pascale Salameh ,&nbsp;Farid Boumediene","doi":"10.1016/j.cegh.2026.102316","DOIUrl":"10.1016/j.cegh.2026.102316","url":null,"abstract":"<div><h3>Background</h3><div>The production of disease research in the Middle East and North Africa (MENA) increased in recent decades. However, gaps remain in understanding the topics covered, study designs, funding sources, and institutional involvement. Our objective is to assess the state of disease research in MENA over the past 44 years and identify strengths, challenges, and opportunities for improvement.</div></div><div><h3>Methods</h3><div>We identified 300,417 PubMed articles affiliated to the MENA region, published between 1980 and 2023, including at least one MeSH term (or keyword) linked to a disease from the Global Burden of Disease database. Our analysis covered research topics, study designs, funding, collaborations, and institutional contributions.</div></div><div><h3>Results</h3><div>Top research areas included respiratory diseases (16.0%), cardiovascular diseases (10.9%), and neurological disorders (9.6%). Most studies were analytical (48.6%) and the top funder was the United States. We found that information on local funding is severely underrepresented in PubMed. High levels of international collaboration were seen, particularly in respiratory diseases, but large producers like Iran and Turkey had limited international collaborations. The COVID-19 pandemic had a positive impact on overall disease research production, increasing it by 59.2% between 2019 and 2023.</div></div><div><h3>Conclusion</h3><div>This study highlights strengths and challenges in disease research across MENA and emphasizes the need for tailored strategies to improve its quantity and quality. Despite the growth in output, our findings show dependency, inequality, and misalignment. As U.S. funding faces pressure, the sustainability of research depends on the efforts of each country to align its agenda with its own needs.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102316"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between postpartum depression and exclusive breastfeeding practices among urban mothers, Bhubaneswar, Odisha","authors":"Deepanjali Behera ,&nbsp;Manasmruti Sahu ,&nbsp;Manas Ranjan Behera ,&nbsp;Magnus Micchael Sichalwe ,&nbsp;Manatee Jitanan ,&nbsp;Janmejaya Samal ,&nbsp;Ranjit Kumar Dehury ,&nbsp;Damodar Jena","doi":"10.1016/j.cegh.2025.102259","DOIUrl":"10.1016/j.cegh.2025.102259","url":null,"abstract":"<div><h3>Problem considered</h3><div>Postpartum depression (PPD) involves persistent sadness, fatigue, and bonding difficulties, while exclusive breastfeeding (EBF) means feeding infants only breast milk for six months. Both are vital for maternal and child health, yet their relationship is understudied. This study examined the prevalence of PPD among mothers in urban Bhubaneswar, Odisha, and its association with EBF.</div></div><div><h3>Methods</h3><div>An analytical cross-sectional study was conducted among 107 postpartum mothers in urban Bhubaneswar from February to April 2024. A pre-designed questionnaire captured socio-demographic characteristics and breastfeeding practices. Data were analyzed using SPSS version 27. Univariate analysis described variables, bivariate analysis assessed associations between categorical variables, and multivariate analysis identified predictors of postpartum depression at a significance level of p ≤ 0.05.</div></div><div><h3>Results</h3><div>Among the mothers surveyed, 12.1 % reported postpartum depression, while 94.4 % practiced exclusive breastfeeding. Cesarean delivery was associated with over fourfold higher odds of depression compared to vaginal delivery (AOR = 4.41, 95 % CI: 2.19–16.27, p = 0.001). Mothers who planned to breastfeed for ≤12 months (AOR = 5.34, 95 % CI: 1.07–26.61, p = 0.04) and those intending 12–24 months (AOR = 10.28, 95 % CI: 1.14–93.14, p = 0.03) also had significantly greater odds of postpartum depression compared to those planning &gt;24 months.</div></div><div><h3>Conclusion</h3><div>Postpartum depression is linked to normal vaginal delivery and shorter planned breastfeeding durations. Early screening and breastfeeding support are essential to improve maternal mental health and infant care.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102259"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the childbirth experience of mothers underwent labour induction in Northwest Ethiopia: A Mixed-methods Study","authors":"Srawork Tesfaye ,&nbsp;Endeshaw Admasu ,&nbsp;Eden Bishaw Taye ,&nbsp;Mengstu Melkamu Asaye","doi":"10.1016/j.cegh.2026.102296","DOIUrl":"10.1016/j.cegh.2026.102296","url":null,"abstract":"<div><h3>Background</h3><div>Induction of labor is an obstetric intervention. It can be a significant biomedical and psychosocial event, resulting in a range of positive or negative childbirth experiences. Gaining in-depth knowledge in these areas may help improve the quality of care and the utilization of maternity services. However, in Ethiopia, no studies have been conducted to date.</div></div><div><h3>Objective</h3><div>To assess mothers’ childbirth experiences and influencing factors among those who underwent induction of labor.</div></div><div><h3>Methods</h3><div>A facility-based mixed-methods study was conducted from 5 May to August 20, 2025 among 422 mothers. Data were collected using contextualized tools. Audio transcription and translation were performed for the qualitative data. Logistic regression analysis was used, with a P-value of less than 0.05 considered significant. Thematic analysis was applied to the qualitative data.</div></div><div><h3>Results</h3><div>The proportion of positive childbirth experiences was 236 (55.9 %) (95 % CI: 51.2–60.7). Being multiparous (AOR = 8.63, 95 % CI: 5.21–14.27), having a vaginal delivery (AOR = 2.11, 95 % CI: 1.31–3.41), age under 20 (AOR = 4.65, 95 % CI: 1.53–14.13), and age 21–30 (AOR = 2.35, 95 % CI: 1.22–4.51) were associated factors. The identified facilitators were trust building at admission, clear communication, and labour pain coping strategies. In contrast, feeling disturbed and lack of involvement were barriers that negatively affected mothers' childbirth experiences.</div></div><div><h3>Conclusion</h3><div>The proportion of positive childbirth experiences was moderate. Building trust, clear communication with healthcare providers, and strategies to manage labour pain were facilitators. Emotional disturbances and lack of involvement were barriers to a positive childbirth experience.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102296"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and correlates of metabolic syndrome in type 2 diabetes patients: A cross sectional study at the provincial diabetes center in Meknes, Morocco","authors":"Daoud Daoudi ,&nbsp;Nouriya Elghoulam ,&nbsp;Nadia El Mahri ,&nbsp;Aichetou Bouh ,&nbsp;Youssef Aboussalah ,&nbsp;Abdellah Zinedine ,&nbsp;Saber Boutayeb ,&nbsp;Souad Benaich ,&nbsp;Slimane Mehdad","doi":"10.1016/j.cegh.2026.102320","DOIUrl":"10.1016/j.cegh.2026.102320","url":null,"abstract":"<div><h3>Problem considered</h3><div>Metabolic syndrome (MetS) is a key contributor to cardiovascular complications among adults with type 2 diabetes (T2D). However, information regarding the prevalence and factors related to MetS among adults with T2D is scarce in Morocco. The aim of this study was to estimate the prevalence of MetS and identify the risk and protective factors among adults with T2D in Meknes, Morocco.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 425 adult patients with T2D attending the provincial diabetes center in Meknes, Morocco. Data were collected using structured questionnaires and medical records. MetS was defined using the 2009 harmonized IDF/AHA/NHLBI criteria.</div></div><div><h3>Results</h3><div>Overall, 72.9% of participants met the criteria for MetS, with a higher prevalence in women (81.2%) than men (58.4%; p &lt; 0.001). Overweight and obesity were the strongest risk factors (AOR = 14.25; 95% CI: 6.77–29.96; p &lt; 0.001), followed by insufficient sleep (AOR = 2.44; p = 0.004) and a family history of cardiovascular disease (AOR = 2.64; p = 0.004). Protective factors included male sex (AOR = 0.13; p &lt; 0.001), rural residence (AOR = 0.51; p = 0.029), higher education (AOR = 0.20; p = 0.029), adherence to the Mediterranean diet (AOR = 0.23; p = 0.003), and moderate to high physical activity (AOR = 0.23–0.31; p ≤ 0.022).</div></div><div><h3>Conclusion</h3><div>MetS is very common among adults with T2D in Meknes, with most risk factors being modifiable. There is a need for targeted interventions, especially among women, urban dwellers, and those with lower education, to reduce the burden of MetS.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102320"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"May Measurement Month (MMM) program 2021–2024: Results of a community screening program in can Tho city, Vietnam","authors":"Son Kim Tran ,&nbsp;Cuong Tan Vo ,&nbsp;Phuong Minh Nguyen ,&nbsp;Dung The Bui ,&nbsp;Chau Minh Tran ,&nbsp;Toan Hoang Ngo ,&nbsp;Minh Van Huynh","doi":"10.1016/j.cegh.2026.102302","DOIUrl":"10.1016/j.cegh.2026.102302","url":null,"abstract":"<div><h3>Problem considered</h3><div>Hypertension (HTN) remains one of the most pressing global health challenges, straining healthcare systems. The May Measurement Month (MMM) campaign aims to raise blood pressure (BP) awareness and address screening gaps. This study screened volunteers aged ≥18 for HTN and cardiovascular risk factors to assess prevalence, awareness, and management effectiveness.</div></div><div><h3>Methods</h3><div>This study employed a cross-sectional, opportunistic survey design. Data were collected from adults aged ≥18 years between 2021 and 2024 as part of the MMM initiative.</div></div><div><h3>Results</h3><div>Among 4105 participants (mean age 53.0 ± 15.3 years), 37.2 % had HTN. Of untreated individuals, 72.5 % were hypertensive, while 53.4 % of treated cases remained uncontrolled (BP ≥ 140/90 mmHg). HTN prevalence rose from 28.9 % (2021) to 47.8 % (2024), with BP control improving to 46.5 % (p &lt; 0.001). HTN was highest in ≥60 years (46.8 %) and lowest in &lt;45 years (15.4 %), while BP control remained stable (33.5 %–35.1 %). Males had higher HTN prevalence, though BP control differences were not significant (p &gt; 0.05). In univariate analyses, HTN was associated with smoking, alcohol use, overweight–obesity, pregnancy, and cardiovascular comorbidities. In the multivariate model from MMM 2021–2024, independent contributors to HTN included older age, heart attack, stroke, diabetes, and physical inactivity, whereas smoking and male sex did not retain statistical significance.</div></div><div><h3>Conclusion</h3><div>The MMM 2021–2024 campaign, conducted during COVID-19, highlighted the need for BP screening in Vietnam. Despite pandemic challenges, undiagnosed and uncontrolled HTN remain major concerns. Standardized screening like MMM remains crucial for detecting high BP and improving HTN management.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102302"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LDL-cholesterol goal achievement and guideline adherence among middle-to older-age Irish adults in a primary care setting","authors":"Rehab Elhiny ,&nbsp;Linda M. O'Keeffe ,&nbsp;Seán R. Millar ,&nbsp;Stephen Byrne ,&nbsp;Margaret Bermingham ,&nbsp;Maria Donovan","doi":"10.1016/j.cegh.2026.102286","DOIUrl":"10.1016/j.cegh.2026.102286","url":null,"abstract":"<div><h3>Background</h3><div>A significant gap exists between recommended low-density lipoprotein cholesterol (LDL-C) treatment goals and the achievement of these goals in clinical practice. In addition, there remains suboptimal utilization of lipid-lowering therapies (LLT). This study examines the prescribing pattern of LLT and the level of LDL-C goal achievement among Irish adults in a primary care setting. In addition, it identifies patient factors associated with the prescribing of LLT and LDL-C goal achievement.</div></div><div><h3>Methods</h3><div>This was a cross-sectional analysis of rescreen data from the Mitchelstown Cohort Study. Demographic, medication and diagnosis data were obtained from participant electronic health records. Cardiovascular risk was assessed using the SCORE tool. LDL-C goal achievement was determined using the LDL-C goals set out in the 2011 ESC/EAS guidelines for the management of dyslipidemia.</div></div><div><h3>Results</h3><div>Among 1183 participants (median age = 65 years), 48.5 % were prescribed LLT, 42 % of whom attained their LDL-C goal. Only 17.5 % were prescribed high-intensity statin therapy and 13 % were prescribed combination therapy. In multivariable analysis, diabetes history, polypharmacy, and hyper-polypharmacy were associated with prescribing LLT. Being male or ≤59 years of age was associated with lower likelihood of LLT prescription. Target LDL-C goal achievement was associated with male sex and age ≤64 or ≥70 years, while BMI 25–29 kg/m² was associated with lower LDL-C goal achievement.</div></div><div><h3>Conclusion</h3><div>Dyslipidemia is undertreated in this Irish primary care population with limited use of high-intensity statins. This study highlights the gap between guideline recommendations for LLT prescription and LDL-C target goals and real-world implementation of guidelines.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102286"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undernutrition and recovery in Pulmonary Tuberculosis: Insights from a study in Lucknow, India","authors":"Purnoor Kaur ,&nbsp;Monika Agarwal ,&nbsp;M.A. Akshata ,&nbsp;V.K. Singh ,&nbsp;Surya Kant","doi":"10.1016/j.cegh.2025.102270","DOIUrl":"10.1016/j.cegh.2025.102270","url":null,"abstract":"<div><h3>Problem considered</h3><div>Undernutrition is a major risk factor for tuberculosis (TB), compromising immunity and adversely affecting treatment outcomes. India bears the highest global TB burden, with a large proportion of patients experiencing poor nutritional status.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted in 2022 among 272 adult pulmonary TB patients enrolled in six tuberculosis units of Lucknow district. Data were collected through a semi-structured questionnaire, anthropometric measurements, and 24-h dietary recall. Nutritional status was assessed using body mass index (BMI), and dietary intake was analysed for adequacy of energy and protein. Treatment outcomes were obtained from programmatic records.</div></div><div><h3>Results</h3><div>The mean age of participants was 33 ± 12 years, with males comprising 62.8 %. At treatment initiation, 61 % were undernourished (BMI &lt;18.5), and only 32 % attained normal weight by completion. The mean caloric intake was 1662.9 kcal, which was below recommended requirements, while protein intake was also insufficient. Although 99 % were enrolled in Nikshay Poshan Yojana, only 4.7 % reported receiving benefits. Dietary diversity was adequate in 66.9 % of participants. Overall, 89.3 % achieved successful treatment outcomes, but no statistically significant association was observed between BMI at treatment completion and outcome.</div></div><div><h3>Conclusion</h3><div>Undernutrition was highly prevalent among TB patients, with minimal nutritional recovery despite treatment. Suboptimal dietary intake and poor implementation of nutritional support schemes highlight the need for integrated interventions. Strengthening delivery of schemes like Nikshay Poshan Yojana and promoting dietary adequacy are critical to improving TB outcomes.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102270"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146038882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived realities of family engagement: A thematic exploration of the family adoption program","authors":"Amogha shree,&nbsp;S. Rashmi,&nbsp;K. Shruddha,&nbsp;Anchu R. Nath,&nbsp;D. Sunil Kumar","doi":"10.1016/j.cegh.2026.102305","DOIUrl":"10.1016/j.cegh.2026.102305","url":null,"abstract":"<div><h3>Background</h3><div>The Family Adoption Program (FAP) was introduced to strengthen community engagement and foster experiential learning in Indian medical education. While most evaluations focus on student perspectives, the lived experiences of families remain underexplored. This study aimed to explore the perceptions, experiences, and suggestions of families participating in the FAP in rural Karnataka.</div></div><div><h3>Methodology</h3><div>A qualitative study was conducted in June 2025 in the villages of Hanchya and Rammanahalli, Karnataka, using a phenomenological approach. Purposive sampling method was used to identify the families who had participated in the program for at least three years. Data were collected through semi-structured, in-depth interviews conducted in Kannada, audio-recorded, and transcribed verbatim. Thematic analysis was performed to identify key patterns across narratives.</div></div><div><h3>Results</h3><div>Twenty families participated in this study. Seven themes emerged(Chepuru et al., 2025 Jan) 1: navigating language and communication,(Shekhawat et al., 2025 Jan 31) 2 disruption versus engagement in daily life,(Shree et al., 2024 Jul 1) 3 scope and nature of student interventions,(Yalamanchili et al., 2023 Feb) 4 perceived gaps in continuity of care,(Shikha et al., 2024 Feb) 5 engagement with health camps,(Reshmi et al., 2024 Aug) 6 relationship dynamics with student visitors, and(Arumugam et al., 2022 Jul 28) 7 community suggestions for program enhancement. Families valued students’ ability to communicate in the local language, provide health education, and offer basic clinical checks, which raised trust and better rapport. However, barriers such as linguistic disconnect, inconvenient scheduling, limited follow-up, and predominantly survey-based interactions diminished program effectiveness.</div></div><div><h3>Conclusion</h3><div>Families perceive FAP as beneficial when visits are regular, with lesser language barrier, and service-oriented. Continuous and regular visits with adaptable schedules to family needs, and including organized feedback mechanisms can improve both community impact and student learning.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"38 ","pages":"Article 102305"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147397804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}