Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Establishing First Age-Friendly Health System Tele-Palliative Care Clinic - Facilitators, Challenges, Lessons Learned to Improve Care for Rural, Older Veterans.","authors":"Stephanie Hartz, Alexander Garbin, Courtney McGuire, Jill Steagall, Jocelyn McCauliff, Kathryn Allen Nearing","doi":"10.1177/00469580251352727","DOIUrl":"10.1177/00469580251352727","url":null,"abstract":"<p><p>Age Friendly Health Systems (AFHS) promote geriatric best practices to improve healthcare quality, minimize harms and support older adults' care preferences. AFHS-designated clinics consistently address the Geriatric 4Ms: Mentation, Mobility, Medication, and What Matters Most. The VA Eastern Colorado Health Care System tele-Palliative Care clinic achieved AFHS Level 1 and 2 recognition in 2021, becoming the first AFHS-designated telemedicine clinic in the nation. An interprofessional team and older Veterans guided planning and implementation. Using existing staff and clinic workflows, we consistently addressed the Geriatric 4Ms during visits. Specific metrics include: (1) AFHS Level 1 and 2 recognition, (2) maintenance in addressing Geriatric 4Ms in tele-Palliative Care, (3) number of patients served, (4) travel-miles saved. FY23-24, we conducted 192 AFHS tele-Palliative Care visits, 81% with rural/highly rural Veterans. We served 108 unique patients (FY23:57; FY24:51; percent decrease = 10.5%). Compared to Colorado's Veteran population, Veterans from racial/ethnic minority backgrounds and women were underrepresented; older Veterans were overrepresented. In FY23/FY24, the majority of patients were White (82%/73%), not Hispanic/Latino (83%/73%), male (100%/98%), and ≥65 (90%/89%). All 4Ms were addressed for 86% (FY23) and 76% (FY24) of unique patients. AFHS tele-Palliative Care saved Veterans/caregivers 23 622 (FY23) and 18 632 (FY24) miles of travel. Congruent with AFHS, Palliative Care focuses on physical, emotional, and psychosocial aspects of serious illness. AFHS designation in a tele-Palliative Care clinic is novel nationally. We demonstrated that evidence-based care can be provided to every older adult, regardless of care modality, without expanding staff or changing clinical workflows.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251352727"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592897","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":"Understanding Family Caregivers' Experiences With Live-in Migrant Care Workers in Dementia Care: Challenges and Perspectives From a Qualitative Study in Taiwan.","authors":"Chia-Ming Yen","doi":"10.1177/00469580251355826","DOIUrl":"10.1177/00469580251355826","url":null,"abstract":"<p><p>Live-in migrant care workers constitute a vital labor force in home-based eldercare in Taiwan; where demographic changes have heightened the demand for such assistant. Despite this, qualitative research exploring the experiences of family caregivers who employ these workers for relatives with dementia remains scarce in the Taiwanese context. This qualitative study aimed to investigate the motivations behind families' decisions to hire migrant workers for home-based dementia care within Taiwan, as well as to assess the associated benefits and challenges they encounter. In-depth interviews were conducted with 4 family caregivers, aged between 52 and 63 years, who had hired live-in migrant care workers between April and August 2022. The transcripts from these interviews were analyzed thematically to derive insights from the findings. The results revealed that family caregivers in Taiwan opted to hire migrant workers for dementia care following a thorough evaluation of their personal circumstances and available resources. Live-in migrant care workers acted as surrogate caregivers, enabling family members to alleviate their daily caregiving burden, improve their emotional well-being, and sustain their personal lives. However, family caregivers faced several challenges, including resistance from dementia-affected relatives toward migrant workers, difficulties in recruiting care workers amidst fluctuating external conditions, and instances of migrant care workers displaying irresponsibility or lacking essential knowledge and skills related to dementia care. Notably, as family caregivers' understanding of dementia evolved, they recognized the critical need to utilize public long-term care services to bolster the dementia-related knowledge and skills of their migrant employees. The study suggests implementing additional dementia-specific training programs tailored for both family caregivers and live-in migrant care workers in Taiwan. Such initiatives would enhance caregiving knowledge and competencies, ultimately improving the quality of life for both caregivers and care recipients.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251355826"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12254537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592899","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":"From Policy to Practice: A Qualitative Study on Reforms and Frontline Retention in Healthcare.","authors":"Anik Dubé, Stéphanie Collin, Jennifer Hakim, Claire Johnson, Marie-Eve Laforest, Michel H Landry, Martin Lauzier","doi":"10.1177/00469580251365821","DOIUrl":"10.1177/00469580251365821","url":null,"abstract":"<p><p>In Canada, healthcare reforms typically aim to improve the quality of care and access while making healthcare systems more efficient. These reforms have led to a 2-level healthcare system consisting of provincial and regional health authorities (RHAs). RHAs are responsible for providing and administering health services within specific territories. One of the 2 language-based RHAs in New Brunswick (NB) operates in French-speaking rural minority communities. This study explored key factors affecting the retention of nurses and physicians within a RHA operating in a language minority context. This descriptive qualitative study explored how macro-level decisions are experienced on the frontlines. Data were collected through semi-structured interviews with 21 physicians and 37 registered nurses, as well as 2 focus groups involving 20 key informants in managerial roles. Thematic analysis was used to identify key themes. Three main factors emerged: organizational accountability and frustration, local autonomy and contextual responsiveness, and a culture of openness and perceived loss of control. These factors are associated with policy changes that affect operational settings and resource distribution within the RHA and influence the retention of nurses and physicians. Stakeholders in health system reforms, including governments and RHAs, must recognize that policy adjustments can have direct implications on everyday care. Participants expressed a growing disconnect from decision-making hierarchies and a perceived loss of control. Both are seen as barriers to delivering quality care. Ensuring adequate support and resources for implementing system-level changes is key to fostering professional engagement and enhancing job satisfaction.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251365821"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859958","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":"Adverse Health Consequences of Poor Air Quality in Nepal: A Wake-Up Call.","authors":"Nabin Pathak, Shreya Dhungana, Prashant Bidari, Sunil Shrestha, Meghnath Dhimal","doi":"10.1177/00469580251375858","DOIUrl":"10.1177/00469580251375858","url":null,"abstract":"<p><p>Literatures shows that poor air quality index (AQI) is associated with several adverse health impacts, such as asthma, chronic obstructive pulmonary disease, diabetes mellitus, tuberculosis, cancer, pneumonia, cataracts, heart diseases, and mental health disorders. Nepal, one of the lower-middle-income countries, has become vulnerable to adverse health impacts due to poor AQI over time. The capital city of Nepal, Kathmandu, is frequently placed as one of the most polluted cities by IQAir. As such, this statement marks a caution for policymakers and the public to be aware of the future effects of prolonged exposure to air pollution and highlights its causative factors. To solve this burgeoning issue, because of the significant rise in urbanization and population growth, mitigation strategies such as creating awareness, reducing vehicular emission, reducing forest fires, creating and identifying vulnerability maps risk zones for forest fires, switching to electronic vehicles and personal interventions such as staying indoors and reducing physical outdoor activity, wearing face masks must be focused and given priority. Although our study is limited in its methodology and findings, it helps establish a policy base to underscore the need for longitudinal cohort studies to generate further evidences pertaining to not up to par air quality levels and their subsequent health impacts in the Nepalese population.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251375858"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071085","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":"Understanding Structural Violence in Community Violence Intervention (CVI): A Multi-City Qualitative Analysis of Practitioner Perspectives.","authors":"Asia S Ivey, Julia J Lund, Amanda J Aubel, Shani A L Buggs","doi":"10.1177/00469580251376234","DOIUrl":"10.1177/00469580251376234","url":null,"abstract":"<p><p>The discourse on community violence has expanded over the years, shifting from a focus on interpersonal physical harm to a broader understanding that includes systemic and structural harm. Structural violence, characterized by institutionalized inequities in health, education, and generational wealth, disproportionately impacts marginalized communities and reflects deliberate systems of oppression designed to maintain power imbalances. In community-based violence intervention and prevention (CVIP), identifying how harm can be systematically perpetuated is critical for developing and advancing structurally grounded evaluative measures and training strategies for practitioners. This qualitative study involved interviews and focus groups with community violence intervention (CVI) practitioners (N = 45) from Sacramento, Milwaukee, and Baltimore. We analyzed participants' narratives to explore their understandings of the root causes of community-based firearm violence, with particular attention to the core tenets of structural violence: power, marginalization, oppression, adversity, and trauma. Findings revealed that CVI practitioners hold varying levels of structural violence expertise, ranging from individual-level explanations of violence to critical accounts of how systemic forces cultivate and reproduce structural harm. Participants discussed how government divestment, institutional neglect, and collective and vicarious trauma shape the conditions contributing to community violence. Their reflections underscore the need for standardized training and professional development that embeds structural frameworks into CVIP operations and program evaluations. As key actors in CVIP, CVI practitioners must be equipped with the knowledge and skills to address the structural drivers of community violence. Investing in their capacity for research and advocacy will strengthen the field's effectiveness, scale, and legitimacy in preventing community-based firearm violence through structurally informed practice and evaluation.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251376234"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071146","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":"The Impact of Intelligent Delivery Systems and Automated Rail Logistics on the Efficiency and Safety of Clinical Item Transportation: A Observational Studies.","authors":"Yi Li, Ping He, Xue-Lian Peng, Min Peng","doi":"10.1177/00469580251314760","DOIUrl":"10.1177/00469580251314760","url":null,"abstract":"<p><p>This paper aims to establish an intelligent delivery system integrated with track logistics and explores its impact on the clinical transportation of goods. The study analyzed hospital delivery items before and after the implementation of an intelligent delivery system combined with automated track logistics in 2023. Delivery conditions prior to the system's activation served as the control group, while those post-implementation formed the observation group. This research assesses the effects on transportation efficiency, resource allocation, transport safety, and satisfaction among medical staff. The average delivery time of goods significantly decreased following the adoption of the intelligent delivery system combined with automated track logistics (<i>P</i> < .01). The total number of adverse delivery-related events was reduced from 25 to 4 (<i>P</i> < .01). Departmental medical staff reported substantial increases in scores for delivery efficiency, error incidence, and overall satisfaction with the delivery process (<i>P</i> < .01). The integration of the intelligent delivery system with automated track logistics significantly enhances the efficiency of clinical goods transportation, optimizes resource allocation, ensures the safe transport of items, and improves the patient experience and clinical staff satisfaction with delivery operations. Regular system maintenance and adjustments, supported by professional technical personnel, are essential to fully leverage the system's advantages.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251314760"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054387","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":"4 Steps to 4Ms: A Navigation Guide for a Hospital-Based Composite Measure of 4Ms Care and the Implications for Outcomes Assessment.","authors":"Benjamin Rosner, Robert Thombley, Stephanie Rogers, Julia Adler Milstein","doi":"10.1177/00469580251323135","DOIUrl":"10.1177/00469580251323135","url":null,"abstract":"<p><p>The 4Ms Framework is the foundation of the Age-Friendly Health System (AFHS) movement. While the framework is based on standalone evidence for each M, there is limited evidence about the impact on outcomes when practiced as a set. A composite measure capturing adherence to the many care processes that comprise the 4Ms is a necessary but complex component of closing the evidence gap. We offer a navigation guide that addresses key considerations for developing a hospital-based composite measure of 4Ms care. The Institute for Healthcare Improvement operationalizes the 4Ms Framework as a minimum set of Assessment and Act On care processes. In developing a composite measure of inpatient 4Ms adherence, we offer a 4 step framework with associated discussion of considerations related to composite measure type (eg, continuous, dichotomous), and synchrony within and across the Ms containing these care processes. Using real-world electronic health record data capturing care process adherence in the 4Ms implementation at a large academic hospital, we illustrate the considerations, and report the implications for sample size and composite measure scoring. We also present our selected composite measure-a dichotomous measure delineating 4Ms care when all encounter-level processes (those needing to be done only once during the hospital encounter) are followed and all day- and shift-level processes are followed for at least 50% of hospital days. While there is no single, standard approach to create a 4Ms composite at this early stage of the AFHS movement, as organizations develop their measure(s), our guide and the considerations we suggest should serve to inform this process and support progress toward meaningful measurement.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251323135"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532228","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":"Challenges and Opportunities in Implementing a Multicomponent Dementia Caregiver Program in a Complex Healthcare System.","authors":"Connor M Warren, Laura Ellen Ashcraft, Amanda Peeples, Kirstin Manges Piazza, Octavia Goodman, Laura N Gitlin, Judith A Long, Robert E Burke, Rachel M Werner, Rebecca T Brown","doi":"10.1177/00469580251322364","DOIUrl":"10.1177/00469580251322364","url":null,"abstract":"<p><p>The Tailored Activity Program (TAP), an intervention for people living with dementia (PLWD) and their caregivers, has been shown to reduce behavioral symptoms for PLWD and caregiver burden. While TAP is proven as an evidence-based practice (EBP), it has yet to be implemented at scale. The Department of Veterans Affairs (VA) has prioritized the Age-Friendly Health System (AFHS) initiative, providing an opportunity to test implementation of TAP in a complex healthcare system. We conducted semi-structured pre-implementation interviews with leaders and clinicians at 6 VA Medical Centers (VAMCs) to engage key implementation partners and understand their unique implementation contexts. We utilized team-based rapid qualitative analysis to identify themes related to implementation determinants. We interviewed 65 unique informants in 58 interviews (5 VAMC leaders, 36 department leaders, and 17 frontline clinical staff). Informants identified 4 key factors critical to consider prior to implementing TAP: (1) alignment with organizational priorities; (2) perceived value and fit with existing clinical workflows; (3) competition with existing organizational and clinical priorities; and (4) considerations about the effect of caregiver burden on participation. We identified key factors to consider for successful implementation of a multicomponent intervention for PLWD and their caregivers within a complex healthcare system. As the AFHS initiative expands, there is a growing need for EBPs focused on the care of PLWD and their caregivers. These factors can guide clinicians, leaders, and implementation scientists in planning for implementation and sustainment of EBPs to bolster AFHS initiatives.Trial RegistrationRegistered 05 May 2021, at ISRCTN #60,657,985.Reporting GuidelinesThe COnsolidated criteria for REporting Qualitative research (COREQ) checklist was used to ensure proper standards for reporting qualitative studies (see attached).</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251322364"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607207","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":"End-of-Life Health Costs Were Predicted Primarily by Prior Health Costs, and Secondarily by Temporal, Health and Demographic Factors.","authors":"Jiska Cohen-Mansfield, Michal Skornick-Bouchbinder, Moshe Hoshen","doi":"10.1177/00469580251326315","DOIUrl":"10.1177/00469580251326315","url":null,"abstract":"<p><p>We examined regression models predicting health services standardized costs (HSSC) during the years preceding death using varied temporal parameters related to the dependent and independent variables. The regression models sought to elucidate how costs before the final year of life, temporal factors, and demographics are associated with costs in the final year. Anonymized data were derived from the records of Israel's largest health maintenance organization for 71,855 people aged 65+ in 2006, who died between 2008 and 2011. In the regression models, the Independent Variables of <i>age</i>, <i>sex</i>, and <i>comorbidity</i> (as measured by the Charlson Comorbidity Index) were significant predictors of the dependent variable of <i>HSSC during the final year of life</i>. However, the strongest predictor (independent variable) of the dependent variable, <i>HSSC in the final year of life</i> was the independent variable, <i>HSSC in the years preceding the final year of life</i>. Prediction was more accurate when the predicting period was closer to the predicted period. Accuracy declined as the predicted period approached death. The results provide insights into methodological considerations in the process of prediction of end-of-life expenditures, which may assist in setting methodological standards that may facilitate arriving at consistent findings in this field. While end-of-life is associated with aberrant increases in costs, that is, increases that deviate from prior predictions, significant predictions can still be made.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251326315"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11954452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744434","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":"Behavioral Innovations to Access Abortion Post-Dobbs: A Qualitative Thematic Analysis of Reddit's r/abortion Community in 2022.","authors":"Eliza Dolgins, Lindsay Parham, Karen Weidert, Emma Anderson, Coye Cheshire, Ndola Prata, Elizabeth Pleasants","doi":"10.1177/00469580251351192","DOIUrl":"10.1177/00469580251351192","url":null,"abstract":"<p><p>Following the leak of the Dobbs decision in 2022, abortion access in the United States has faced heightened barriers, including legal restrictions, financial constraints, and logistical challenges. In response, individuals seeking abortion care can employ innovative behavioral strategies to overcome these barriers and reshape their abortion experiences (ie, \"behavioral innovations\"). This paper explores the behavioral innovations to access abortion that people discussed and recommended within a geographically dispersed community of peers on an abortion-supportive Reddit community (r/abortion). Using a hybrid inductive and deductive thematic qualitative analysis approach with a purposive sample of comments in the r/abortion community in 2022 following the <i>Dobbs</i> leak (May-December, n = 131 comments), we identified discussion of abortion access innovations related to getting in-clinic care, self-managed abortion (SMA), funding assistance, privacy, and emotional support. Innovations included sharing online resources for clinic locations, specific travel recommendations to less restrictive states, accessing abortion medications through online services, and navigating the SMA process. Additionally, other less tangible innovations were discussed, including strategies for keeping abortions private and seeking emotional support. Our findings highlight how individuals within the r/abortion community discuss and share creative strategies for navigating the evolving barriers to abortion care. The r/abortion platform serves as a crucial resource for individuals seeking innovative solutions to these barriers, underscoring the need for diverse information-sharing practices to improve access to care as shifting legislation increasingly demands approaches beyond conventional norms.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251351192"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512837","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}