Bethany Croak, Laura Rafferty, Marie-Louise Sharp, Alexandria Smith, Rafiyah Khan, Victoria Langston, Neil Greenberg, Nicola T. Fear, Sharon A. M. Stevelink
{"title":"Barriers and Facilitators to Successful Transition to Civilian Life for Ex-Servicewomen: The Perspective of Service Providers and Policymakers","authors":"Bethany Croak, Laura Rafferty, Marie-Louise Sharp, Alexandria Smith, Rafiyah Khan, Victoria Langston, Neil Greenberg, Nicola T. Fear, Sharon A. M. Stevelink","doi":"10.1155/hsc/2327743","DOIUrl":"https://doi.org/10.1155/hsc/2327743","url":null,"abstract":"<div>\u0000 <p>The role of women in the UK Armed Forces has changed considerably in the last decade. With the aim to increase the number of women serving in the military, research must consider the impact of both service and transition into civilian life on the health and well-being of service and ex-servicewomen (female veterans). This paper adds to the field by providing the perspective of service providers supporting ex-service personnel with their mental health, employment, housing, and other needs in addition to those working in policy affecting ex-servicewomen. This study aimed to explore their understanding of what constitutes a successful transition into civilian life, the barriers and facilitators to achieving this, and how transition might be impacted by the gender of the individual transitioning. Interviews and roundtable discussions were held with stakeholders (<i>n</i> = 28) and analysed using framework analysis. Four overarching themes were developed: ‘Successful transition is individual and all-encompassing’, ‘The conflicting identities of servicewomen’, ‘Sexism: women don’t belong in service’ and ‘The needs of servicewomen’. The first theme describes how the process and result of successful transition is individual to each ex-servicewoman, whilst the remaining themes outline common challenges faced by ex-servicewomen in this journey. There was no singular definition of ‘successful transition’, but stakeholders described barriers to a successful transition. They identified prominent gender-specific barriers rooted in misogyny and inequality during military service that permeated into civilian life and impacted support use and workplace experiences. Ex-servicewomen were often required to juggle multiple responsibilities, mother and partner, and identities, women and warrior, simultaneously. Policies should look to address elements of military culture that may reinforce gender inequality and ensure veteran services are inclusive, as stakeholders identified that these were factors that negatively affected military to civilian transition for women and could cause poor outcomes. Whilst in-service and veteran-focused interventions are needed, entrenched sexism in the general society should not be ignored.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/2327743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Sculptured Journey: A Photovoice Study About Information Sharing Among Unpaid Carers in England","authors":"Vita Snowden","doi":"10.1155/hsc/9914909","DOIUrl":"https://doi.org/10.1155/hsc/9914909","url":null,"abstract":"<div>\u0000 <p>This article explores the critical and often overwhelming task faced by unpaid carers: gathering and interpreting complex information so that health and social care systems can be accessed and understood. Based on a qualitative study centering the views and voices of unpaid carers, it provides a rich analysis of how carers share and interpret information within carer-centered group activities, offering practical insights for both practitioners and carers. In England, the Care Act 2014 places legal duties on local governments to provide information; however, this is often reduced to “signposting,” leaving carers with unresolved questions and significant frustration. Consequently, carers frequently rely on one another to fill these gaps and support those they care for. Adopting a critical realist ontology and a social constructionist epistemology, this study balances the external realities of the Care Act with the subjective experiences of unpaid carers. Using photovoice, a method combining visual and narrative techniques, the study enabled carers to convey their approaches to information sharing. Reflexive thematic analysis identified the key theme of “an information highway: a sculptured journey” along with its subtheme, “an information bridge.” This analysis deepens understanding of how and when carers share information effectively, addressing an underexplored area within the literature on carer-centered group activities. It illustrates how carer-led information sharing enhances carers’ knowledge of rights and resources while fostering a sense of connection and support.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/9914909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emilie McSwiggan, Eddie Donaghy, Jackie Gulland, Amy O’Donnell, Stewart W. Mercer
{"title":"The Role of Place in Social Prescribing: A State-of-the-Art Literature Review","authors":"Emilie McSwiggan, Eddie Donaghy, Jackie Gulland, Amy O’Donnell, Stewart W. Mercer","doi":"10.1155/hsc/9920046","DOIUrl":"https://doi.org/10.1155/hsc/9920046","url":null,"abstract":"<div>\u0000 <p><b>Introduction:</b> Social prescribing seeks to connect people to community-based resources, to improve their health and wellbeing. It is often framed as a response to health inequalities. However, the impact of place-based differences is seldom considered. As social prescribing depends on local resources, this is a significant knowledge gap. This review aims to examine the extent to which social prescribing research to date has engaged with places and communities.</p>\u0000 <p><b>Methods:</b> This state-of-the-art literature review has three components: (1) Four databases (PubMed, ASSIA, Web of Science and Scopus) were searched for social prescribing literature reviews; key characteristics were charted and a timeline created. (2) Each review was assessed for its engagement with concepts of place, and findings were synthesised narratively. (3) Exploratory searches were conducted in PubMed for primary research on place in social prescribing, and findings summarised descriptively.</p>\u0000 <p><b>Results:</b> A total of 97 eligible literature reviews were identified. A timeline of these reviews and their characteristics was created, including population, referral reasons, social prescribing model, intervention and aim. No reviews had ‘complete’ engagement with concepts of place. Thirty-one had ‘partial’ engagement. These suggested five ways of thinking about place: place as healing, experience of societal inequalities and its effect on place, how deprivation shapes place, place as the context for social prescribing and alternative conceptions of place. We found eight primary studies addressing social prescribing and place. Six looked in detail at a particular place or characteristic of places, and two contributed theoretical understandings of the relationship between place and social prescribing.</p>\u0000 <p><b>Discussion:</b> The role of place in social prescribing remains understudied. Future research could develop theory and frameworks to account for place or identify which elements of place-based community infrastructure are particularly relevant for social prescribing, especially as deprivation and austerity continue to diminish community resources in the areas which most need them.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/9920046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144117840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Simon J. Armour, Gemma Yarwood, Hugh McLaughlin, Julia Robinson
{"title":"Volunteering, Identities and Wellbeing in Contexts of Health Inequalities","authors":"Simon J. Armour, Gemma Yarwood, Hugh McLaughlin, Julia Robinson","doi":"10.1155/hsc/1690870","DOIUrl":"https://doi.org/10.1155/hsc/1690870","url":null,"abstract":"<div>\u0000 <p>The causes of health inequalities are complex, involving material, psychosocial dimensions and power relations. Denigrating neoliberal discourses of individual responsibility shape and underpin policies which exacerbate poverty and compound its psychosocial impacts on people’s lives. Community asset-based approaches, which mobilise voluntary action, have been proposed as a means of addressing health inequalities, and a substantial body of research suggests that participating in volunteering can bring benefits to psychological wellbeing. This study explores the experiences of volunteers with lived experience of poverty and other intersecting disadvantages, using an ethnographic psychosocial approach, adapted from the free association narrative interview method. It draws on participant observation and interviews with 11 volunteers and four managers within two settings within disadvantaged communities in a city in the north of England. The analysis of this data considers these experiences of volunteering in relation to theorised social and psychological drivers of health inequalities, as well as concepts commonly used in the literature on volunteering and health. Using a psychosocial lens reveals the significance of identity validation as a pathway through which volunteers within disadvantaged communities may resist denigrating narratives and make claims to ‘respectability’, which facilitate experiences of acceptance and belonging. While volunteering may ameliorate the impacts of inequalities on individual and community health and wellbeing, the individual, organisational and wider social contexts within which volunteering takes place are integral to these effects.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/1690870","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introducing a Computerized Care-Pathways System for Older Adults in Home-Care Settings","authors":"Nicole Dubuc, Afiwa N’Bouke, Cinthia Corbin, Nathalie Delli-Colli","doi":"10.1155/hsc/5535495","DOIUrl":"https://doi.org/10.1155/hsc/5535495","url":null,"abstract":"<div>\u0000 <p>Introducing computerized care pathways for older adults living at home may be a promising way to improve the clinical dimension of integrated care. Evidence on how to implement them in various home-care contexts is, however, sparse. A prospective, comparative multiple case study with nested analysis units was conducted across three home-care settings. Participants included managers, healthcare professionals, and home-care clients. We used a variety of frameworks and both qualitative and quantitative methods to understand the implementation process. The implementation research logic model (IRLM) presents links among determinants, strategies, mechanisms, and outcomes. Twelve barriers and 35 facilitators were similarly perceived, and 40 strategies were commonly adopted during implementation. After 12 months, OCCI implementation was feasible, appropriate, and acceptable at moderate-to-high levels. They were delivered with a moderate level of fidelity, but the level of penetration after 24 months was high. Participants perceived the OCCIs as supporting a holistic approach, good relationships, clinical decision-making, information sharing, and interprofessional coordination, but not as much productivity and efficiency. Home-care clients had a high level of satisfaction with health care and services. They were satisfied about their involvement in decision-making and with computer use by professionals. We identified four causal pathways: engaging interest holders in a partnership model throughout the study; providing an information system that supports clinical processes; building a conducive environment with deliberate efforts to increase buy-in and engagement; facilitating capacity and relationship building to increase adoption; and embedding the OCCIs in usual practice. The results illustrate how a real understanding of contexts was important to elucidate the mechanisms at work during this study. Adapting the innovation to achieve a better fit between it and the clinical contexts was fundamental. Positive outcomes relied on time, appropriated resources, and a continual, iterative process corresponding to “Make It Happen.”</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/5535495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does Contracting With a Family Doctor Affect the Medical Expenditures of Residents in China?","authors":"Jiayi Song, Xizi Wan, Shaojie Zhou, Miao Yu","doi":"10.1155/hsc/6697562","DOIUrl":"https://doi.org/10.1155/hsc/6697562","url":null,"abstract":"<div>\u0000 <p>The Chinese government implemented a nationwide family doctor policy in 2016 as a component of the Healthy China 2030 plan. Previous studies on the role of family doctors in reducing medical expenditures in China have produced inconsistent results. This study employed large-sample microsurvey data from across China to analyze the effects of family doctor contracts on actual medical and hospitalization expenditures. Utilizing both ordinary least squares (OLS) regression and instrumental variable (IV) regression, we analyzed data from 11,221 participants in the 2021 National China Livelihood Survey. The OLS and IV regression results suggested that engaging with a family doctor enhanced actual medical and hospitalization costs. This study conducted two additional analyses to delve deeper into this finding. The mechanistic analysis indicated that the association between contracting with a family doctor and increased medical spending was mediated by improved medical accessibility, prompt medication adherence, and regular hospital visits. Furthermore, a heterogeneity analysis showed that this increase in medical expenditures was particularly pronounced among residents with an educational level of high school and below, those suffering from chronic diseases, and individuals residing in regions with superior infrastructure and health resource availability. Consequently, our study indicates that contracting with a family doctor, although it raises medical costs for Chinese residents, is also associated with enhancements in health status.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/6697562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144100565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paulette V. Hunter, Abigail Wickson-Griffiths, Susan M. Tupper, Allison Cammer, Lynn McCleary, Sharon Kaasalainen, Tamara Sussman, Genevieve Thompson
{"title":"The Development and Preliminary Evaluation of the “SPA-LTC Voices” Video Series as a Means of Articulating a Palliative Approach in Long-Term Care Settings","authors":"Paulette V. Hunter, Abigail Wickson-Griffiths, Susan M. Tupper, Allison Cammer, Lynn McCleary, Sharon Kaasalainen, Tamara Sussman, Genevieve Thompson","doi":"10.1155/hsc/3998877","DOIUrl":"https://doi.org/10.1155/hsc/3998877","url":null,"abstract":"<div>\u0000 <p>Palliative care has earned its place as a respected approach to medicine that focuses on quality of life, symptom management, a team approach, and family involvement, typically following the diagnosis of a life-limiting illness. To improve health equity, it is important to encourage the adaptation of palliative care practice and philosophy beyond hospices and within a range of care settings. To support further adaptation in long-term care, our research team Strengthening a Palliative Approach in Long-Term Care (SPA-LTC) created the video education resource “SPA-LTC Voices” to explore what a palliative approach entails in a long-term care context and to dispel persistent myths about palliative care. After consulting with palliative care experts and family caregivers, we designed a four-part series using a storytelling approach (i.e., presenting accounts of lived experience) within a three-act narrative structure (i.e., setup, tension, and resolution). We then employed an embedded intervention mixed methods design to pilot-test the acceptability of the video series and the outcome of knowledge transfer during structured interviews with 16 participants, who were either family caregivers (12) or healthcare providers (4). Integrated qualitative and quantitative findings confirmed potential for positive impact on knowledge transfer across both audiences, including an improved understanding of the values and practices involved in palliative care. Integrated findings also confirmed high acceptability of the narrative format and the diversity of the storytellers. Overall, this pilot research suggests that the “SPA-LTC Voices” video series holds promise as a tool to support education within long-term care settings.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/3998877","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melissa Kilian, Tania Rauch van der Merwe, Itumeleng Tsatsi, Ronelle Jansen, Marieta Visser, Rayne Stroebel, Sanetta Henrietta Johanna du Toit
{"title":"The Potential Impact of Social Prescribing on Meaningful Engagement in Collective Aged Care Settings: Perspectives From the Global South","authors":"Melissa Kilian, Tania Rauch van der Merwe, Itumeleng Tsatsi, Ronelle Jansen, Marieta Visser, Rayne Stroebel, Sanetta Henrietta Johanna du Toit","doi":"10.1155/hsc/3848622","DOIUrl":"https://doi.org/10.1155/hsc/3848622","url":null,"abstract":"<div>\u0000 <p><b>Background:</b> Promoting collective care philosophies in residential aged care homes that enhances person-centred care remains a global challenge. More success is evident when an organisation’s approach to care impacts the well-being of everyone who lives and works in the home. However, funding systems are seldom applied in favour of a collective approach. The uptake of social prescribing is potential yet another obstacle in eradicating the prevailing dominance of the medical model of care in aged care homes.</p>\u0000 <p><b>Objective:</b> In the Global South, institutionalised care is becoming a more acceptable and viable option to ensure health and well-being of older adults. Introducing person-centred care philosophies, such as the Eden Alternative (EA), in settings where care approaches are not predetermined by stringent funding schemes (i.e., related to addressing ‘challenging behaviours’ or specifying social prescribing), provides an opportunity to explore the intricacies of collective approaches. This project specifically considered how the EA philosophy impacted the quality of collective care within state-wide organisations in South Africa.</p>\u0000 <p><b>Methods:</b> A qualitative, descriptive research design supported the investigation of four residential aged-care settings in South Africa. Ten focus groups, guided by the nominal group technique, were conducted with 68 participants, including residents, operational staff, and management staff. Quantitative and qualitative findings were deductively analysed using the EA’s domains of well-being as the guiding framework.</p>\u0000 <p><b>Results:</b> The findings mostly indicated agreement between staff and residents on the positive contributions of the EA to support well-being associated with security, autonomy, identity, growth, connectedness, meaning and joy. Overall, security was the most prevalent theme and linked with needs for physical and emotional safety.</p>\u0000 <p><b>Conclusion:</b> Partnerships with external bodies, such as the EA, could support cross-national learning and exchange to support stakeholders working more closely with government agencies in creating realistic and supportive operational and funding policies for collective long-term care settings.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/3848622","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qin Zhou, Yue-Hui Yu, Karen Eggleston, Gordon G. Liu
{"title":"Impact of Urban–Rural Health Insurance Integration on Mental Health Among Rural Adults in China: Evidence From a Quasiexperimental Study","authors":"Qin Zhou, Yue-Hui Yu, Karen Eggleston, Gordon G. Liu","doi":"10.1155/hsc/1601163","DOIUrl":"https://doi.org/10.1155/hsc/1601163","url":null,"abstract":"<div>\u0000 <p><b>Objective:</b> Few studies have examined the psychological effects of expanding and integrating health insurance programmes. This study aimed to examine the effects of health insurance on mental health based on a large natural experiment in China: the integration of the rural and urban resident health insurance programmes.</p>\u0000 <p><b>Methods:</b> Using four waves of data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2011, 2013, 2015 and 2018, this study adopted a time-varying DID approach to capture the effect of urban–rural health insurance integration on depressive symptoms among rural residents in China. The group heterogeneity of the policy effect and possible mechanisms through which the reform produced psychological effects were further analysed.</p>\u0000 <p><b>Results:</b> The average CES-D score of rural adults decreased by 0.424 and the likelihood of depressive symptoms decreased by 3.5% after the implementation of the urban–rural health insurance integration policy. The positive effects may be due to the reduced cost sharing rates as well as improvements in health satisfaction, social interactions and physical activity. However, the integration reform had a limited impact on improving the mental health of those with the lowest economic status, the worst health status and those aged 40–49 or over 70.</p>\u0000 <p><b>Conclusion:</b> Urban–rural health insurance integration had a positive psychological effect among rural residents in China. Additional improvements in mental health could flow from further expanding the beneficiary population and improving benefit equity under urban–rural integrated basic medical insurance.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/1601163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Food Insecurity, Diabetes Self-Management and Support for Self-Management in High-Income Countries: A Qualitative Systematic Review and Synthesis (2008 to 2024)","authors":"Flora Douglas, Emma MacIver, Catriona Kennedy","doi":"10.1155/hsc/7249750","DOIUrl":"https://doi.org/10.1155/hsc/7249750","url":null,"abstract":"<div>\u0000 <p>People living with diabetes and food insecurity in high-income countries have poorer health-related outcomes than those who are food secure. Diabetes is a significant global health challenge. At the same time, the prevalence of household food insecurity continues to increase. This qualitative systematic review and synthesis explored the lived experience of diabetes self-management and support for self-management for people living with diabetes and food insecurity in high-income countries. Keywords and search terms were developed using the PICo framework with searches conducted between January 2008 and August 2024. Titles and abstracts were screened against inclusion and exclusion criteria, and the methodological quality of included papers was assessed using the Critical Appraisal Checklist for Qualitative Research and CERQual. Findings from 18 articles (detailing 17 studies) identified four interlinked themes: structural challenges, day-to-day challenges, ways of being for people living with food insecurity and diabetes, and self and support for self-management needs. Structural challenges (poverty, sociocultural and discrimination) were identified as the main determinants of the day-to-day challenges for people living with diabetes and food insecurity. Those challenges included the following: (i) limited access to suitable foods and food management resources; (ii) stress, (iii) poverty and diabetes stigma, (iv) limited informal support, (v) perceived lack of appropriate support from healthcare practitioners, and limited knowledge, confidence and understanding and access to information. The resulting ways of being for people affected were characterised by experiences of subsisting, avoiding, balancing and prioritising. Self and support for self-management needs were characterised by two themes improve[ing] clinical conversations and, support beyond health <i>services</i>. People living with diabetes and food insecurity are adopting methods of self-management, due to economic necessity, which may not be appropriate from a healthcare perspective, and which may be impacting their short and long-term health. There is an urgent need to address these issues in the post COVID-19 pandemic context for effective diabetes prevention and management.</p>\u0000 </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/7249750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143939168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}