Health Expectations最新文献

{"title":"Stakeholder Perspectives on Built Environmental Factors to Support Stroke Rehabilitation and Return to Everyday Life","authors":"Laila de Vries, Maya Kylén, Tony Svensson, Jodi Sturge, Ruby Lipson-Smith, Steven M. Schmidt, Hélène Pessah-Rasmussen, Marie Elf","doi":"10.1111/hex.70339","DOIUrl":"https://doi.org/10.1111/hex.70339","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The transition to undertaking rehabilitation in the home or local neighbourhood calls for an extensive understanding of which aspects of the built environment are important for people with stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This qualitative study aims to explore how home and local neighbourhood environments support or hinder rehabilitation for people who have had a stroke from the perspectives of various stakeholders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Through a purposive selection method, data were collected through semi-structured interviews with 16 stakeholders: people with stroke (<i>n</i> = 3), significant others (<i>n</i> = 3), healthcare professionals (<i>n</i> = 4), care managers (<i>n</i> = 3) and architects (<i>n</i> = 3). Content analysis was used to identify patterns and create themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Sixteen stakeholders, including 12 women and 4 men aged 30–74, participated in this study. Our findings identify areas linked to the WHO age-friendly environment framework, which addresses environmental limitations relevant to stroke rehabilitation. The categories used and factors identified: (1) Outdoor environments: accessibility, safety and supportiveness. (2) Transport and mobility: accessible and reach central services. (3) Housing: adaptations, layout and accessibility. (4) Social participation: spaces that are varied and flexible. (5) Social inclusion and non-discrimination: shared decision-making. (6) Civic engagement and employment: supporting environments. (7) Communication and information: digital accessibility. (8) Community and health services: patient-centred approach and access to varied rehabilitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study brings together multiple perspectives from key stakeholders with experience within stroke care. By integrating insights, these findings highlight how built environmental factors in the home and local neighbourhood can support the transition to home-based rehabilitation, which can improve recovery and return to everyday life. In turn, this study contributes to the innovative development of home and neighbourhood environments to influence and support stroke rehabilitation. Linking the findings to the WHO framework increases our understanding of a supportive environment for people with stroke, but also for people with other long-term conditions.</p>\u0000 </se","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524585","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":"Insights Into the Expectations of Infertile Men Regarding Multidisciplinary Reproductive Health Services","authors":"Mehrdad Abdullahzadeh,&nbsp;Zohreh Vanaki,&nbsp;Eesa Mohammadi,&nbsp;Jamileh Mohtashami","doi":"10.1111/hex.70327","DOIUrl":"https://doi.org/10.1111/hex.70327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This qualitative study sheds light on the expectations of infertile men regarding reproductive health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This descriptive qualitative study employed an inductive content analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In 2023, nurse researchers conducted in-depth interviews with 13 men with primary infertility using a semi-structured approach. The collected data were analysed using Graneheim and Lundman's inductive content analysis method, adhering to Guba and Lincoln's standards to ensure trustworthiness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis identified the central theme, ‘Male Infertility: Awareness, Support and Participation,’ as well as three categories: Male Infertility Awareness, which involves spreading the word in various ways; Male Infertility Support, encompassing all professional expertise; and Male Infertility Programme, which involves couples' joint participation in treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Men seeking reproductive health services necessitate a comprehensive treatment approach involving education, consultations with specialists and couple-centred care. This finding highlights the importance of multidisciplinary reproductive health services, which can help healthcare providers, nurses and policymakers enhance the quality of care for men and couples with male infertility. Adopting a multifaceted approach incorporating nursing skills and competencies can promote more inclusive and culturally sensitive patient-centred care in reproductive health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>Individuals with lived experiences analysed and interpreted data.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519996","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":"The Experience of Manual Wheelchair Training for People With Chronic and Progressive Conditions: Perspectives of Users and Trainers","authors":"Kimberly Charlton,&nbsp;Carolyn Murray,&nbsp;Natasha Layton,&nbsp;Stacie Attrill","doi":"10.1111/hex.70342","DOIUrl":"https://doi.org/10.1111/hex.70342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Global ageing and the rise of chronic and progressive health conditions that lead to mobility changes will see increased need for manual wheelchair (MWC) provision and training. Existing training guidelines and training programmes are frequently tailored towards younger users. There is a knowledge and practice gap regarding the needs of people with chronic or progressing conditions who require a wheelchair. To inform practice guidelines and training practices, this study sought the perspectives of both MWC users and trainers on their experience of MWC training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a qualitative descriptive approach, semi-structured in-depth interviews were conducted with 11 MWC trainers and 6 MWC users. Data from the two participant groups were inductively coded and thematically analysed using NVivo and concept mapping to synthesise the data into themes and sub-themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three main themes were identified: <i>guided support in wheelchair training</i> reflected the need for basic support when commencing wheelchair use, <i>person-centred training</i> recognised the importance of tailoring training to individuals, their goals and contexts, and <i>creating safe and supportive environments</i> addressed how to foster acceptance of training through building a supportive training environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Access to skilled MWC trainers is essential for MWC users commencing MWC use due to a chronic or progressive condition; however, the Australian healthcare system does not currently meet this need. There is a need to explore alternate models of service delivery, such as peer-led training or upskilling of other key stakeholders, such as assistive technology suppliers. The creation of supportive environments and tailored training aligned with the abilities and goals of individual users must take precedence over resource-driven or one-size-fits-all approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient Contribution</h3>\u0000 \u0000 <p>During the development of semi-structured interview guides, feedback was sought from an MWC user and MWC trainer to ensure the relevance and appropriateness of the questions and allow for the refinement of questions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514986","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":"Migrants Living in the United Kingdom and Their Perceptions of Participation in Health Research: A Mixed-Methods Study","authors":"Mayuri Gogoi,&nbsp;Rebecca F. Baggaley,&nbsp;Luisa Silva,&nbsp;Zainab Lal,&nbsp;Holly Reilly,&nbsp;Vishant Modhwadia,&nbsp;Daniel Pan,&nbsp;Paul Bird,&nbsp;Laura Nellums,&nbsp;Manish Pareek","doi":"10.1111/hex.70337","DOIUrl":"https://doi.org/10.1111/hex.70337","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;Migrants' participation in health research is essential to give voice to their needs and inform evidence-based practice. We conducted a mixed-methods study with migrants living in Leicester, United Kingdom, to understand their perceptions of participation in health research and factors influencing participation.&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;Our study included a questionnaire and focus groups with migrants. Interviews and focus groups were also conducted with key informants. The study was carried out at two sites in Leicester. Questionnaire data were analysed descriptively in R. The COM-B framework was used to thematically analyse interview and focus group transcripts. Workshops with public members of migrant origin helped with data interpretation and 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;119 questionnaires and 4 focus groups (&lt;i&gt;n&lt;/i&gt; = 28) were completed with migrants. Seven interviews and one focus group (&lt;i&gt;n&lt;/i&gt; = 7) were conducted with key informants. Questionnaire respondents originated from 34 different countries, with a significant proportion (25%) identifying themselves as asylum seekers/refugees. Migrants in the focus groups were from 16 different countries and were mainly asylum seekers/refugees (&lt;i&gt;n&lt;/i&gt; = 18). The three components of the COM-B model (Capability, Opportunity and Motivation) were identified as the main themes, and descriptive statistics from the questionnaire data have been used to supplement the 16 sub-themes. Individual capabilities encompassing awareness and perception of research, language abilities and skills in the use of technology significantly influenced participation. Simultaneously, the presence or absence of opportunities such as costs, competing needs and priorities, healthcare access and experiences in the United Kingdom, language barriers, opportunities for learning and taking part, precarious living conditions and socio-cultural norms and perceptions about health were found to be important for research participation. Motivations to take part in research included trust, context of the research, need-based research, altruism, desire to be heard and receiving incentives.&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;Our study contributes to the limited evidence base exploring migrants' participation in health research. Our findings, grounded in the COM-B model, exhibit how migrants' motivations, influenced by a host of individual capabilities and environmental and social opportunities, can influence motivation and impact research p","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514682","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":"Public Involvement in a Systematic Review Project: Reporting Our Approach Using the ACTIVE Framework","authors":"Carmel McGrath,&nbsp;Sarah R. Davies,&nbsp;Ifra Ali,&nbsp;Blessing Dick,&nbsp;Prakash Dewani,&nbsp;Clare E. French","doi":"10.1111/hex.70323","DOIUrl":"https://doi.org/10.1111/hex.70323","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;Public involvement in research improves its relevance and accessibility to ensure it reflects the population it serves. However, there is a lack of information about how patients and the public are involved in shaping systematic reviews. There is also a need to address the lack of diversity in public involvement, particularly around the inclusion of underserved communities. This paper outlines the practical approaches taken to involve a diverse group of public contributors in a systematic review process and offers recommendations to support future practices.&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;This paper uses the ACTIVE framework developed by Pollock et al. (2019) to structure our reflections on public involvement in an NIHR-funded systematic review project on the effectiveness of interventions used to increase vaccination uptake.&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 present the practical approaches used to recruit and engage a diverse group of public contributors in a systematic review project. They had continuous, hands-on involvement in various aspects of the systematic review process. Our approach enabled the public involvement group to play an integral role in adapting and refining a coding framework, contributing to the development and refining of codes and categories used for the analysis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our paper highlights the importance of involving public contributors who have a range of experiences and backgrounds in the systematic review process. By investing time in relationship-building, creating a safe environment and recruiting a diverse group of contributors, we gained richer insights that enhanced the coding framework. The complexity and nature of the methodology could make it challenging to identify where public contributors can make a real difference to research. Our experiences demonstrate that such involvement is possible and generates mutual benefits, including research that is better designed to reflect the diversity of the population.&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;This paper outlines the steps undertaken to involve public contributors in the systematic review process. Key suggestions include investing time to build relationships, providing ongoing feedback, incorporating creative activities and developing strategies for disseminating research findings to wider audiences. These recommendations build on existi","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 4","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70323","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514613","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":"Transforming Community-Based Rehabilitation Services: A National Redesign Using Experience-Based Co-Design","authors":"Shamala Thilarajah,&nbsp;Karina Dancza,&nbsp;Zhen Zhen Chen,&nbsp;Clara X. Q. Wong,&nbsp;Clement C. Yan,&nbsp;Susan Niam,&nbsp;Yee Sien Ng,&nbsp;Elizabeth Lynch,&nbsp;Leonid Churilov,&nbsp;Wei Kang Tan,&nbsp;Emelin Tan,&nbsp;Li Khim Kwah","doi":"10.1111/hex.70330","DOIUrl":"https://doi.org/10.1111/hex.70330","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;To understand the experiences of clients, caregivers and staff in community day rehabilitation centres (DRCs) and identify areas for improvement in service processes and the clinical care of stroke, frailty and hip fracture, a national quality improvement project was undertaken using experience-based co-design (EBCD). The goal was to prioritise and co-design system-level changes for community-based rehabilitation care in Singapore.&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 EBCD methodology comprised of eight stages: (1) site observations/time-motion studies, (2) interviews, (3) development of trigger film, (4) staff feedback events, (5) client/caregiver feedback events, (6) joint workshop, (7) small co-design groups and (8) celebration event. In addition, we collected surveys and case note reviews to capture the perceived and actual delivery of guideline-based care for stroke, frailty and hip fracture.&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;Over a period of 2.6 years, we engaged over 80 clients and caregivers and 250 staff from 20 DRCs in the EBCD process. Triangulation of data from the site observations, interviews, surveys and case note reviews identified four themes: (1) Best practice care, (2) Person-centred care, (3) Allied health professional needs and (4) Service design. Person-centred care was desired by clients, caregivers and staff but was sometimes hindered by factors like tight scheduling and high turnover. Care was partially aligned with international guidelines, though some strongly recommended interventions were inconsistently delivered. Staff interviews and site observations revealed potential for more direct client care, teaching, research and quality improvement, with fewer administrative duties. New care models were sought, including social connections beyond DRCs, clearer maintenance rehabilitation criteria and financial incentives for transitioning to maintenance rehabilitation. A 12-min trigger film based on client/caregiver interviews was used during the feedback events and workshops. Three co-design workgroups were formed to develop clinical practice guidelines for stroke rehabilitation, a workplace learning framework for allied health, and community rehabilitation recommendations.&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;EBCD was successfully used to identify gaps and co-design system-level solutions to improve community-based rehabilitation care in Singapore. Further solutions at the organisational and individual levels are needed.&lt;/p&gt;\u0000 &lt;/section&gt;","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70330","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339579","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 and Implementation of ‘Count Me In’: A Bottom-Up Approach to Inclusive Research and Participation in a National Health Service in England","authors":"Oladayo Bifarin,&nbsp;Jahanara Miah,&nbsp;Michelle Harvey,&nbsp;Gail Faragher,&nbsp;Jade Thai,&nbsp;Dennis Dewar,&nbsp;Jenny Garden,&nbsp;Lindsey Nicholson,&nbsp;Nicola Wilson,&nbsp;Nusrat Husain,&nbsp;Dan W. Joyce","doi":"10.1111/hex.70326","DOIUrl":"https://doi.org/10.1111/hex.70326","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;Research-active National Health Service (NHS) services are linked to better care quality and health outcomes. However, traditional research participant recruitment methods, such as ‘opt-in’ strategies, often face challenges in reaching diverse populations. The ‘Count Me In’ (CMI) system was introduced to address these barriers through an ‘opt-out’ model, aiming to normalise research participation and promote inclusivity. At Mersey Care NHS Foundation Trust, a bottom-up approach was employed to adapt CMI, ensuring meaningful engagement with service users, carers and communities in its design and implementation.&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;CMI was co-produced with stakeholders through a series of workshops, discussion groups and consultations with over 300 participants, including service users, carers and NHS staff. Key activities included listening exercises to understand concerns, co-designing campaign materials and forming a Patient and Public Involvement and Engagement (PPIE) Advisory Group. The group provided ongoing guidance to ensure that the system aligned with the needs of underserved communities and upheld ethical and cultural sensitivity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Stakeholders widely supported the ‘opt-out’ approach, recognising its potential to improve research inclusivity. Participants highlighted the importance of clear communication, cultural sensitivity and robust data protection measures. Specific research priorities, such as mental health and social isolation, were identified. Co-produced materials, including plain-language guides and culturally appropriate visuals, addressed concerns about privacy, stigma and accessibility, fostering trust and confidence in the system.&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 CMI system is an acceptable and scalable model for inclusive research recruitment, embedding research into routine care. The bottom-up approach ensured the system was tailored to local needs, promoting equity and accessibility.&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;A partnership approach working with PPIE leads at the Mental Health Research for Innovation Centre (M-RIC) ensured that service users, carers and community members shaped the CMI system through extensive co-production activities. The development of the system, therefore, reflected their lived experiences and priorities, thereby enhancing its inc","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339580","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":"A Different Way of Working: Embedding Clinical Psychology Placements in Third Sector Organisations Supporting People Experiencing Homelessness","authors":"Hannah Frith,&nbsp;Mary John,&nbsp;Leah Sharkah,&nbsp;Jane Iles","doi":"10.1111/hex.70334","DOIUrl":"https://doi.org/10.1111/hex.70334","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>People experiencing homelessness experience high levels of trauma and psychological distress, but rarely access or engage with formal mental health services. The National Framework for Inclusion Health highlights collaboration between the NHS and third sector organisations as essential for reducing health inequalities. Providing clinical placements in third sector organisations for clinical psychology trainees may offer a valuable route to addressing this gap, whilst providing a beneficial learning experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Qualitative semi-structured interviews with clinical psychology trainees, staff in homeless settings and a clinical supervisor were used to explore perceptions of clinical placements and the benefits and challenges experienced by those involved in delivering these placements. Reflective thematic analysis was used to identify key themes in the perceptions of staff, supervisors and trainees.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three key themes were developed. (1) <i>Bringing a psychological mindset</i> reflected the value that homelessness organisations placed on being helped to think about their client work through a psychological lens and extending this lens to also consider staff well-being. (2) <i>Breaking barriers and building bridges</i> describes how trainees were positioned as brokers who could connect homelessness organisations to formal mental health systems and could advocate for homeless people within these systems in ways which may have long-term effects. (3) <i>Working and learning differently</i> captures how these placements required trainees to work differently by crafting new roles and by adopting different working practices, including navigating complex issues around risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinical psychology placements within homelessness organisations may help meet the objectives of the NHS National Framework for Inclusion Health by helping create PIEs in homelessness organisations, navigating connections between statutory and third sector organisations, and creating a skilful workforce adept at managing cultural mistrust.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315247","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":"Using Codesign to Develop a Health Literacy Intervention to Improve the Accessibility and Acceptability of Cardiac Services: The Equal Hearts Study","authors":"Denise Azar,&nbsp;Sofia Wang,&nbsp;Liz Flemming-Judge,&nbsp;Anna Wong Shee,&nbsp;Rebecca Jessup,&nbsp;Laveena Sharma,&nbsp;Shihoko Fukumori,&nbsp;Jason Talevski,&nbsp;Stephen J. Nicholls,&nbsp;James Harris,&nbsp;Laura Alston,&nbsp;Catherine Martin,&nbsp;Ernesto Oqueli,&nbsp;William van Gaal,&nbsp;Alison Beauchamp","doi":"10.1111/hex.70328","DOIUrl":"https://doi.org/10.1111/hex.70328","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 burden of coronary heart disease (CHD) is disproportionately greater among socio-economically disadvantaged groups. Health services play a crucial role in addressing this social gradient by ensuring equitable access to care. However, there is limited evidence on effective strategies to improve health service accessibility for CHD patients, particularly those that are codesigned with people with lived experience and clinicians. The Equal Hearts study aimed to codesign a health literacy-based intervention to improve the accessibility of hospital-based cardiac services for underserved population groups with CHD.&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;This study employed a mixed-methods approach based on codesign principles. The study comprises three phases: identifying and understanding the problem, codeveloping an intervention, and translating the intervention into practice. Phases 1 and 2 are reported in this paper and included focus groups, interviews and an intervention development workshop. Participants for focus groups and interviews were recruited from four health services in [Victoria] and included patients with CHD, health consumers from culturally diverse communities and clinicians. Findings from focus groups and interviews were analysed via thematic analysis using Levesque's conceptual framework to identify health literacy barriers to accessibility of cardiac services. These barriers were prioritised in a codesign workshop with cardiac patients, health consumers and clinicians.&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-seven cardiac patients, 10 clinicians and 44 culturally diverse health consumers participated in focus groups/interviews. Among these participants, eight cardiac patients/carers and five clinicians attended the workshop. Cardiac patients reported a lack of preparedness for hospital discharge and feeling ‘lost’ and uncertain about how to confidently manage their health at home after a cardiac event. A codesigned intervention—The Patient Discharge Action Plan—aims to improve patients' transition from hospital to home.&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;Using a codesign approach and health literacy principles, a health service intervention was developed to improve accessibility of cardiac services. The Patient Discharge Action Plan is currently being evaluated in a pilot RCT.&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;Two cons","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308674","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":"Designing a Flexible and Inclusive Approach for Public and Community Involvement in Research With People Who Are Homeless or Vulnerably Housed: Critical Reflections From the I Am More Than… Project","authors":"Mel Hughes,&nbsp;Kate Jupp,&nbsp;Cathy Beresford,&nbsp;Jim Robertson,&nbsp;Annabel Wathen,&nbsp;Tanya Bailey,&nbsp;Siobhan Lennon-Patience,&nbsp;Mike Graham,&nbsp;Deano Pickering,&nbsp;Helena Posnett","doi":"10.1111/hex.70325","DOIUrl":"https://doi.org/10.1111/hex.70325","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;People who are homeless or vulnerably housed face significant health inequities and yet are rarely involved in health and social care research as participants, public contributors or co-researchers. The &lt;i&gt;I Am More Than…&lt;/i&gt; project was developed to address this lack of inclusion by working in partnership with community organisations and individuals with lived experiences of being homeless or vulnerably housed.&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;To co-design a flexible and inclusive approach for public and community involvement in research (sometimes referred to as public and patient involvement or PPI).&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 project drew on a range of co-production and participatory research strategies, with input from various stakeholders, to identify and address enablers and barriers to participation. Community researchers with lived experience of homelessness or being vulnerably housed were central to all stages of the project, including the co-design of strategies to engage people through conversations, interviews, creative outputs and stakeholder events.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We identified core principles for inclusive public and community involvement in research. including the need to: develop relationships first and tasks second; gain a deep understanding of communities and their priorities; harness lived experience expertise; however someone may choose to share it; go at the pace of trust; and work in partnership with voluntary and community sector organisations who are embedded in their communities.&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;Developing a flexible and inclusive approach to public and community involvement in research required shifting from a transactional approach to a relational approach. The project demonstrated the importance of building trust, working in partnership and being flexible and responsive to people's everyday realities for genuine inclusion to be achieved.&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;This is a co-produced project between a university, an integrated care system, two community organisations and people experiencing homelessness or being vulnerably housed. Individuals with lived experience participated as community researchers, shaping the design, methods and o","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144273449","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}