Health Expectations最新文献

{"title":"Co-Designing Lived Experience Guide Support for First Responder Mental Health: Defining the Role and Considerations for Implementation","authors":"Hussain-Abdulah Arjmand, Tim Peck, Meaghan Louise O'Donnell, Nicole Sadler, Anita Savic, Michelle Spinks, Michael Symons, Tracey Varker","doi":"10.1111/hex.70461","DOIUrl":"https://doi.org/10.1111/hex.70461","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Improving the mental health and well-being of first responders has been a priority, leading to increased availability of treatments and services. However, access barriers continue to hinder the effectiveness of these services. Lived experience guides are mental healthcare service navigators who have real-world experience working as a first responder and understand mental health challenges first responders experience. The aim of this study was to use an experience-based co-design methodology to define the lived experience guide role and identify important considerations for implementation in first responder settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine current and former first responders from different agencies attended three co-design workshops facilitated by the research team. First responders provided feedback and responses to specific question prompts. Responses were analysed within workshops and collaboratively grouped into emergent themes by first responders and facilitators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across workshops, responses were collated into six core themes: (i) the role and purpose of a lived experience guide; (ii) the importance of privacy, confidentiality and independence; (iii) appropriate selection and recruitment of guides; (iv) provision of training; (v) provision of resources and support; and (vi) evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lived experience guides represent a critical step towards better supporting first responders to overcome barriers and access appropriate services to improve mental health outcomes. This study provides useful insights for first responder agencies, government bodies and insurance providers focusing on first responder well-being. Implementing the lived experience guide support stands to make a substantial impact on the mental health of first responders, contributing to more resilient and well-supported emergency services personnel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>This study was co-produced with a retired first responder with lived experience of mental health challenges who contributed substantially to study conceptualisation, methodology, investigation and manuscript preparation as a member of the author team. Additionally, current and former first responders with lived experience and knowledge of first responder mental health systems participated in co-design workshops","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Are People Undergoing Dialysis Expected to Benefit From Cognitive Behavioural Therapy? A Realist Analysis","authors":"Katrin Micklitz, Joanne Greenhalgh, Lori Suet Hang Lo, Richard Sawatzky, Kara Schick-Makaroff","doi":"10.1111/hex.70466","DOIUrl":"https://doi.org/10.1111/hex.70466","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Depressive symptoms remain inadequately addressed and undertreated in people who receive life-prolonging dialysis treatment. Cognitive behavioural therapy (CBT) has been shown to be effective for treating depression; however, we lack an understanding of how and under what circumstances people with depressive symptoms receiving dialysis may benefit from it. The aim of this study is to identify ideas underlying CBT in general and develop an initial programme theory that explains how these ideas might apply to people receiving dialysis. It is the first step of a theory-driven explanatory realist synthesis and realist evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included a broad literature search and interviews with seven CBT therapists across Canada and the United States. Search terms were derived from CBT and refined to theory-based literature, literature reviews and book chapters. Therapists were recruited through team collaborators and had experience in developing or providing CBT to adults with depressive symptoms, including those receiving dialysis. Qualitative analysis of data from the literature and interviews focused on identifying mechanisms through which CBT is expected to reduce depressive symptoms in people receiving dialysis and the circumstances that may shape these mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Based on our findings from 30 documents and the interview data, individuals living with dialysis treatment and experiencing depressive symptoms may benefit from CBT through (1) cognitive changes related to their illness and self; (2) experiencing pleasant emotions; and (3) feeling seen, understood and accepted. However, people's capacity to engage with CBT may be limited due to significant illness and treatment burdens, as well as the perceived stigma of mental health issues. Our findings can be explained by the cognitive behavioural model, illness adjustment theories such as the common-sense model of self-regulation, response shift theory, client-centred therapy, and the cumulative complexity model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study contributes to knowledge by explaining how the illness context of dialysis treatment might shape the mechanisms through which CBT is expected to work. Understanding the dialysis illness context when developing psychosocial interventions such as CBT can advance the provision of person-centred mental health kidney care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70466","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of a Persian-Language Self-Management Mobile Application for People With Spinal Cord Injury","authors":"Amir Hossein Daeechini,&nbsp;Azamossadat Hosseini,&nbsp;Reza Rabiei,&nbsp;Saeed Oraee-Yazdani,&nbsp;Somayeh Paydar","doi":"10.1111/hex.70454","DOIUrl":"10.1111/hex.70454","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Spinal cord injury (SCI) is associated with complex complications and long-term disability. Mobile health applications are crucial for managing their complications and challenges, given their high adoption rate among these patients. While previous studies have developed and evaluated self-management mobile applications for SCI in other languages and contexts, to date, no Persian-language application tailored to the unique needs of individuals with SCI in Iran and other Persian-speaking countries has been published. This study aims to develop and evaluate the short-term usability of a self-management mobile application through the participation of 20 people with spinal cord injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This applied developmental study was conducted in 2024 in two phases: the design and development phase and the usability evaluation phase. The application's key requirements and required capabilities were identified in the first phase, and a conceptual model was developed using Microsoft Visio. In the second phase, the application's usability was evaluated using the MAUQ questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The application's menu services included modules for autonomic dysreflexia, skin care, bowel management, lifestyle, bladder management and a specialist finder. In the usability evaluation phase of the SCI self-management mobile application, its usability score was 78.7%, signifying an acceptable level of usability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, the design and development of the application were tailored to the needs of Persian-speaking participants with SCI to ensure alignment with both the linguistic/cultural requirements and self-management needs of this population. Accordingly, usability evaluation was conducted to identify and address potential issues, ensuring that the final product is comprehensive and effectively covers most complications and challenges faced by individuals with SCI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70454","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Role of Peer Health Navigators in the Australian Health System: A Qualitative Interview Study","authors":"Natali Cvetanovska,&nbsp;Simone Said,&nbsp;Rebecca L. Jessup","doi":"10.1111/hex.70453","DOIUrl":"10.1111/hex.70453","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peer health navigators (PHNs) work with their own communities to provide health navigation support and connect with patients through shared experience and identity. The aim of this study was to explore the role of PHNs in the Australian health system from the perspective of managers and experts, with a focus on understanding how to build and sustain this workforce in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals who employ and manage PHNs, as well as subject matter experts in the navigation field from a range of health and academic organisations across Australia, participated in semi-structured interviews. A descriptive qualitative approach based on naturalistic inquiry was used to analyse the interview data. Themes were framed around an adapted socio-ecological model using four levels: individual, interpersonal, organisational and societal (combined community and policy).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventeen themes were identified within the four levels of the adapted socio-ecological model: individual (personal attributes, knowledge and skills, lived experience), interpersonal (boundary setting: professional, boundary setting: professional meets personal, boundary setting: self-care, supervision and debriefing), organisational (recruitment, qualifications and prerequisites, clear job description and expectations, training, role duties and tasks) and societal (value of peer navigators in Australia, government support, funding, strategic approach to workforce planning, workforce governance).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PHNs are a valuable part of the Australian health system. A cohesive, strategic, national approach is required to ensure the development of the workforce and the sustainability of programs and allow for navigators to be embedded within the Australian health system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>This study is part of a larger project that developed formal education and training courseware materials for health navigators in Australia. The materials were co-designed with patients, managers and subject matter experts. In this paper, we sought the perspective from managers and experts across Australia who work with diverse groups of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Advocacy Group Leaders' Perceptions on Primary Care's Role in Caring for Patients With a History of Breast Cancer","authors":"Kacie Barry,&nbsp;Sarah J. Fadem,&nbsp;Jennifer R. Hemler,&nbsp;Jenna Howard,&nbsp;Lisa Mikesell,&nbsp;Denalee M. O'Malley,&nbsp;Shawna V. Hudson,&nbsp;Benjamin F. Crabtree","doi":"10.1111/hex.70458","DOIUrl":"10.1111/hex.70458","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cancer advocacy groups engage patients, families and caregivers in navigating the cancer landscape, with a focus on early detection/screening and providing psychosocial and financial support during and after treatment. These groups are influential among their communities, funders and policymakers.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We wished to understand perceptions of breast cancer advocacy group leaders on primary care's role in breast cancer survivorship care, given limited primary care engagement despite endorsement by the National Cancer Institute (NCI).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;As part of a larger NCI-funded study, we used purposive sampling to select leaders from a diversity of patient advocacy groups for in-depth interviews (&lt;i&gt;n&lt;/i&gt; = 9). After obtaining consent, interviews were conducted and recorded on Zoom, professionally transcribed, and analysed using an established immersion–crystallisation process to identify themes and patterns.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We interviewed leaders (&lt;i&gt;n&lt;/i&gt; = 9) from two local, three regional and four national advocacy groups, five of whom had personal experiences with breast cancer. These advocates emphasised that transitions away from the safety of oncology to primary care are difficult for patients. They felt patients with a history of breast cancer have unique and complex needs that are different from the standards of care found within primary care settings, and primary care clinicians are not adequately prepared to address these. In reflecting on the ideal role of primary care, they highlighted listening to patients, identifying issues and referring patients to appropriate specialists, but ultimately stressed that patients needed to advocate for themselves in the current healthcare environment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Advocacy groups typically start as grass root efforts motivated by perceptions of inadequate support and care for cancer patients. As such, there is potential for advocacy groups to shape the conversation to improve collaboration between oncology and primary care by articulating and advocating for better primary care involvement in survivorship care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The project's steering committee included cance","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Every Voice Matters’: A Photovoice Study on the Personal Impacts of Co-Production in Recovery Colleges","authors":"Lisa D. Hawke,&nbsp;Shelby McKee,&nbsp;Holly Harris,&nbsp;Amy Hsieh,&nbsp;James Svoboda,&nbsp;Maral Sahaguian,&nbsp;Gail Bellissimo,&nbsp;Melissa Hiebert,&nbsp;Kelly Lawless,&nbsp;George James,&nbsp;Sean Patenaude,&nbsp;Jordana Rovet,&nbsp;Sophie Soklaridis","doi":"10.1111/hex.70441","DOIUrl":"10.1111/hex.70441","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The engagement of people with lived experience (PWLE) of mental health and substance use health challenges in the co-production of health services, programming and research has many benefits, but how co-production impacts those involved remains unclear. Recovery Colleges are low-barrier, generally co-produced education programmes focused on mental health and wellness. Designed to support individuals on their personal recovery journeys, they provide a meaningful setting to explore the impacts of co-production.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This co-produced study explored the impact of co-production within recovery-oriented programming using a photovoice methodology. Photovoice captured the lived experiences and expertise of people involved in Canadian Recovery Colleges as curriculum designers, facilitators and/or students.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A sample of 21 participants with co-production experience took part in seven photovoice workshops. These culminated in a final photo submission that illustrated how co-production has impacted them. Eighteen participants completed a focus group discussion on the topic, which was audio recorded, transcribed and analysed using codebook thematic analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Five themes were generated from the data. Participants found that co-production (1) reduced stigma, (2) provided a space to collectively share lived experience, (3) helped them develop a sense of belonging, (4) helped them advance their personal recovery journeys and (5) supported their personal growth.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study demonstrated that co-production in Recovery College settings has a wide range of positive impacts for the individuals involved, across a range of personal factors. The co-production of services, programme development and research can create positive meaning for those involved in mental health and substance use health settings, as well as potentially other broader health settings, which may aid in their recovery journeys.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A Recovery College research subcommittee, including individuals with lived experience of mental health and/or substance use challenges, co-produced every phase of this study.&lt;/p&gt;\u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post Covid-19 Condition as a Diagnosis: A Qualitative Study on Epistemological Tensions Among Experts in Sweden","authors":"Anna Bredström,&nbsp;Sofia Morberg Jämterud","doi":"10.1111/hex.70463","DOIUrl":"10.1111/hex.70463","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;At the onset of the Covid-19 pandemic, it became clear that some individuals experienced lingering symptoms after the infection. This condition, known as post Covid-19 condition (or long Covid), is defined by WHO as persistent or new symptoms 3 months after the initial infection, lasting for at least 2 months, and not attributable to another diagnosis. Hence, the definition is very broad.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aims to examine how post Covid-19 condition as a diagnosis is viewed and interpreted by Swedish stakeholders, showing how these understandings carry a range of epistemological tensions. The study also seeks to understand the implications of these epistemological tensions for treatment and care organisation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Qualitative interviews with 36 experts and key individuals in Sweden have been conducted.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Result&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Experts agree that post Covid-19 condition is a complex syndrome and that persons who suffer are in need of care. However, several tensions in post Covid-19 condition as a diagnosis can be discerned. Most experts agreed on the gender and racial disparity where white women with Swedish background were a majority of post Covid-19 sufferers, while migrant patients and the elderly are largely absent. In relation to social categories, the question if children can have post Covid-19 condition is here a highly contested question. There is also disagreement on the aetiology of post Covid-19 condition, with some experts viewing it as a new, unique condition requiring specialised treatment, while others see it as similar to other post-viral conditions, treatable in primary care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The article concludes that experts are divided in their understanding and that this affects Swedish policy on post Covid-19 care and treatment, showing that post Covid-19 condition is not only a medical issue but also a political battleground where science, expert opinion and patient experience shape policy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient and Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The article focuses on studying stakeholders' perspectives as these are key for informing public opinion and policy. In this article, all main organisations and authorities involved in post Covid-19 care ar","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-Production, Co-Creation and Co-Design in Primary Health Care: A Scoping Review of Design, Implementation, Impact and Sustainability","authors":"Cate Dingelstad,&nbsp;Nicolette Hodyl,&nbsp;Rebecca Wyse,&nbsp;Suzanne Lewis,&nbsp;Alison Koschel,&nbsp;Nicholas Goodwin","doi":"10.1111/hex.70447","DOIUrl":"https://doi.org/10.1111/hex.70447","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The terms coproduction, co-creation and codesign (called the ‘Three-Cs’ in this article) are applied to activities that include stakeholders in the design and implementation of health services. This scoping review sought to understand how Three-Cs approaches have been designed and implemented sustainably in the primary health care context.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three databases (Medline, Embase and CINAHL) were searched for articles published between 2013 and 2024 using key words related to the Three-Cs and primary health care (Appendix A) and limited to articles available in English. Dual blind review against specific inclusion and exclusion criteria was carried out at both title/abstract and full text screening stages. The SPICE Framework was used to consider design, implementation, impact and sustainability. An assessment of quality and risk of bias was completed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist [1]. The Framework to Assess the Impact of Translational (FAIT) health research [2] was used to review and assess the impact of the design and implementation of Three-Cs approaches in each study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirty articles were included in this review with 33% (&lt;i&gt;n&lt;/i&gt; = 10) providing a clear definition of their Three-Cs approach: 10% (&lt;i&gt;n &lt;/i&gt;= 3) identified their approach as Coproduction, 20% (&lt;i&gt;n&lt;/i&gt; = 6) as co-creation, and 70% (&lt;i&gt;n&lt;/i&gt; = 21) as Codesign. Implementation contexts included clinical settings (10%, &lt;i&gt;n&lt;/i&gt; = 3), for example prediabetes programs; community settings (50%, &lt;i&gt;n&lt;/i&gt; = 15) such as care navigation support; and health systems settings (40%, &lt;i&gt;n&lt;/i&gt; = 12) including health service development. Approaches were implemented across metropolitan (37%, &lt;i&gt;n&lt;/i&gt; = 11), regional (43%, &lt;i&gt;n&lt;/i&gt; = 13), and rural (17%, &lt;i&gt;n&lt;/i&gt; = 5) settings.&lt;/p&gt;\u0000 \u0000 &lt;p&gt;Three-Cs approaches in primary health care settings were most typically used for health promotion, and to support improved health equity and health access. Key outcomes included novel solutions to problems, improvements to health and health systems, and solutions that met consumer needs. While nine of the 30 studies undertook some form of evaluation, limited evidence on impact and sustainability was found (7%, &lt;i&gt;n&lt;/i&gt; = 2), where only two studies assessed whether the change that was implemented using a Three-Cs approach was maintained in the longer term.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three-Cs approaches ha","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70447","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Priorities for Enhancing Village Health Volunteer's Mental Health Recovery Practices in Thai Rural Communities: A Nominal Group Technique Study","authors":"Chonmanan Khanthavudh,&nbsp;Annmarie Grealish,&nbsp;Vasiliki Tzouvara,&nbsp;Mary Leamy","doi":"10.1111/hex.70455","DOIUrl":"10.1111/hex.70455","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;World Health Organization (WHO) and Thailand's national policy both advocate for recovery-oriented, community-based mental healthcare. Village Health Volunteers (VHVs) in Thailand have limited involvement in mental health services despite their pivotal role in Thai primary healthcare, especially in rural settings. This study aims to engage stakeholders to identify and prioritise key areas for VHVs' role expansion, stigma reduction, training needs, and common mental health conditions, thereby enhancing VHVs' contributions to recovery-oriented mental healthcare in rural Thai communities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study utilised the Nominal Group Technique (NGT). Eight VHVs, six individuals with mental health challenges and caregivers, and four healthcare professionals (HCPs), from three rural sub-districts in Northern Thailand, were purposively and conveniently recruited. Three NGT groups were formed: in-person for service providers (VHVs and HCPs) and service users/caregivers, and online for HCPs. Through structured stages of idea generation, sharing, discussion and ranking, participants identified their top five priorities. Ranked priorities were synthesised, and transcripts were analysed using content analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Eighteen participants attended one of three NGT groups. Collectively, these groups generated 94 ideas in response to four questions. Four themes were identified: (1) Expansion of VHV's mental health role, including vocational support, family support, emotional support and community reintegration; (2) Stigma reduction, focusing on changing attitudes, implementing a buddy system and enhancing mental health literacy; (3) Training needs including training related to stigma reduction, improving communication skills and providing mental health awareness education; and (4) Common mental health conditions, including psychosis and depression.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The prioritisation among the three groups varies. High priorities include vocational support, family support, community reintegration and counselling skills. Addressing stigma is a starting point and can be achieved through increased awareness and literacy. Future research should focus on tailored stigma interventions and trainings to support VHVs in providing effective, recovery-oriented care in these communities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Delivering and Providing Culturally and Linguistically Tailored Cardiovascular Disease and Stroke Prevention Education: A Qualitative Exploratory Study","authors":"Sabine M. Allida,&nbsp;Della Maneze,&nbsp;Scott William,&nbsp;Maree Hackett,&nbsp;Caleb Ferguson","doi":"10.1111/hex.70456","DOIUrl":"10.1111/hex.70456","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Cardiovascular disease (CVD) and stroke disproportionately affect culturally and linguistically diverse (CALD) communities, where access to prevention programmes is often limited by cultural, language, and systemic barriers. Understanding the experiences of healthcare professionals and nongovernment organisations in delivering and providing education to these communities is essential for developing effective, culturally tailored strategies that support equitable cardiovascular outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To explore (i) healthcare professionals', key health networks' and non-government organisations' experiences of delivering CVD or stroke prevention education; (ii) the context i.e., barriers and enablers to delivering education; and (iii) and identify core components and ideal approach to deliver a CVD and stroke prevention education and behaviour change programme for CALD communities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A qualitative exploratory study using semi-structured interviews. Deductive thematic analysis was completed using NVivo 15.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fourteen participants were recruited and interviewed via Zoom; seven cardiovascular and stroke healthcare professionals and seven representatives from a range of federal- and state-level cardiovascular and stroke nongovernment organisations and multicultural health networks.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two key themes were identified: (1) challenges when providing and delivering culturally and linguistically tailored education and (2) components of an ideal education programme. Challenges in delivering CVD and stroke prevention education include the need to navigate diverse cultural health beliefs and worldviews, limited access to qualified interpreters and a lack of culturally relevant and translated resources. An ideal education programme was considered one that is simple, evidence-based, culturally appropriate, and delivered in accessible, preferred formats. Key to sustained behaviour change beyond the programme are family and community engagement, the use of codesign approach to foster ownership and relevance from the inception, trust-building, and ongoing reinforcement of educational content through reminders.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion and Conclusion&lt;/h3&gt;\u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 5","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}