Health Expectations最新文献

{"title":"The #chatsafe Youth Participation Model: Evaluating Participatory Workshops Involving Young People in the Design of Suicide Prevention Initiatives.","authors":"L La Sala, E R Carrotte, C Cooper, M Lamblin, E Brown, J Robinson","doi":"10.1111/hex.70885","DOIUrl":"10.1111/hex.70885","url":null,"abstract":"<p><strong>Background: </strong>#chatsafe is a programme aiming to empower young people to communicate safely on social media about self-harm and suicide. This study aimed to assess the feasibility, acceptability, safety, and impact associated with attending a #chatsafe participatory workshop, using the #chatsafe Youth Participation Model. The workshops aimed to educate young people on safe communication practices and gather their insights to inform new #chatsafe social media intervention content.</p><p><strong>Methods: </strong>Quantitative data were collected in a pre- and post-workshop survey using bespoke items measuring perceived feasibility, acceptability, and safety of the workshops, and self-efficacy in communicating online about suicide. Qualitative data were collected during the workshop (via participant feedback, field notes, audio recordings, and facilitator debriefing notes) and in open-text responses in the post-workshop survey.</p><p><strong>Results: </strong>Nine workshops were held with 107 participants (age M = 19.7 years, SD = 2.7 years). Two thirds (64.5%) reported lifetime suicidal thoughts. Eighty-seven (81.3%) completed both the pre- and post-workshop survey. Feedback was positive, with 94.3% of participants reporting satisfaction with the workshop, 96.5% reported enjoying the workshop, and no adverse events were recorded. There was a significant increase in confidence when communicating online about suicide following participation in a #chatsafe workshop, z = -5.99, p < 0.001. Workshop insights informed two national Australian #chatsafe Instagram campaigns, that reached 950,000 young people and 818,000 young people respectively.</p><p><strong>Conclusions: </strong>The #chatsafe workshops were highly feasible, acceptable, safe, and led to young people feeling better equipped to communicate safely online about suicide. To further encourage the involvement of young people in the design of suicide prevention, mental health, and similar initiatives, a #chatsafe Youth Participation Toolkit is publicly available for other researchers and outlines the steps taken to plan, conduct, and translate the outcomes of such workshops.</p><p><strong>Lived experience or public contribution: </strong>This study summarises the views of 87 young people who attended a #chatsafe participatory workshop and provided feedback. The #chatsafe Youth Participation Toolkit was also shaped by seven workshop participants who attended a subsequent focus group, which focused on what recommendations the researchers should share with others who wish to use these participatory methods in the future.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70885"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118893","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":"Decision-Making Balance in Co-Produced Priority Setting for a Parent Carer Empowerment Intervention.","authors":"Nezihe Köker Özer, Ercan Yılmaz, Didem Tatar","doi":"10.1111/hex.70952","DOIUrl":"10.1111/hex.70952","url":null,"abstract":"","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13711357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277235","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":"Digital Patient Decision Aids for Endometriosis Management: A Scoping Review.","authors":"Océane Pittet, Marion Delvallée, Nicola Pluchino, Kevin Selby, Glyn Elwyn, Marie-Anne Durand","doi":"10.1111/hex.70881","DOIUrl":"10.1111/hex.70881","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis treatment requires women to navigate complex, preference-sensitive decisions. Patient Decision Aids (PtDAs) help patients make value-aligned choices. However, the scope and quality of digital PtDAs for endometriosis, and the cap acity of conversational AI platforms to act as PtDAs, remain unclear.</p><p><strong>Objectives: </strong>Systematically map digital PtDAs for women of reproductive age with endometriosis, describe their content, development, and evaluation, and assess quality and replicability.</p><p><strong>Search strategy: </strong>Electronic databases, Google Scholar, grey literature, and web searches were conducted from inception to July 2025.</p><p><strong>Selection criteria: </strong>We included digital PtDAs for women aged 18-49 with a clinical diagnosis of endometriosis that met the minimum criteria established to qualify as a PtDA. Additionally, we developed a prompt to generate five PtDAs using conversational AI platforms, mirroring patient or clinician decision-support queries.</p><p><strong>Data collection and analysis: </strong>Two independent reviewers extracted data per Joanna Briggs Institute (JBI) scoping reviews methodology. IPDAS criteria (requirements for PtDAs) and TIDieR items (intervention reporting) were applied; data were summarised descriptively and qualitatively.</p><p><strong>Results: </strong>Ten PtDAs were included (five expert-developed; five AI-generated). Overall, most addressed pharmacological and surgical options, while AI-generated PtDAs included more complementary therapies. All described the health condition, decision, and options with balanced pros/cons, but most failed on important IPDAS criteria for high-quality PtDAs. Most expert-developed PtDAs also lacked transparent development reporting and had not been formally evaluated.</p><p><strong>Conclusions: </strong>Few digital PtDAs for endometriosis were identified; most showed limited adherence to IPDAS criteria, poor reporting transparency, and absent formal evaluation.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70881"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042218","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":"Engaging With a Participatory Research Team: Evaluation of Involving Older Co-Researchers With Experience of Falls in the SeFallED Project.","authors":"Nadja Reeck, Tim Stuckenschneider, Laura Himmelmann, Georg Lehmann, Margarethe Mammes, Margrit Pape, Bettina Reineking, Tania Zieschang, Anna Levke Brütt","doi":"10.1111/hex.70908","DOIUrl":"10.1111/hex.70908","url":null,"abstract":"<p><strong>Introduction: </strong>There is increasing emphasis on the involvement of older patients in research. A comprehensive and systematic evaluation of this involvement, using established tools, is essential to ensure its effectiveness and impact. This study aims to describe this involvement of older individuals in a geriatric research project and to examine its outcome and impact.</p><p><strong>Methods: </strong>A participatory research team (PRT) consisting of a heterogeneous group of older adults with experience of falls was set up. The public and patient engagement evaluation tool (PPEET) was used as a means of evaluation. Process documentation was also used for evaluation. All data were analysed descriptively.</p><p><strong>Results: </strong>Eight older individuals were selected for the PRT, and 29 meetings were held during the 3-year project period. Due to health-related absences, three new PRT members were admitted after the first half of the project. The positive atmosphere at the meetings was emphasised. Nevertheless, at the initial stage, there was some ambiguity regarding the purpose. The PRT had an influence on various research phases (e.g., design of the focus groups). All persons involved emphasised the supportive contextual factors, but in the beginning PRT members highlighted the need for more information.</p><p><strong>Conclusion: </strong>The PRT is a promising strategy for involving older people; however, health-related absences must be considered. A personal approach is a crucial factor for PRT members (e.g., time in meetings to share own experiences). The PRT had a multifaceted influence on the project, with a heightened emphasis on public relations. The contextual factors (e.g., infrastructure) were supportive, but greater emphasis should be placed on information structures for PRT members in future projects.</p><p><strong>Patient or public contribution: </strong>A PRT consisting of a heterogeneous group of older individuals with a history of falls was involved throughout the entire project duration. All four members who were part of the PRT at the end of the project read and revised this paper.</p><p><strong>Trial registration: </strong>German clinical trial identifier: DRKS00025949.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70908"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167702","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 Acceptability and Experiences of Participating in a Preoperative Intentional Weight-Loss Programme From Diagnosis to Surgery for Colorectal Cancer.","authors":"Amelia Talbot, Claire Foster, Susan A Jebb, Pete Wheatstone, Simon Buczacki, Dimitrios A Koutoukidis","doi":"10.1111/hex.70896","DOIUrl":"10.1111/hex.70896","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer surgery has a higher risk of complications for patients carrying excess weight. Preoperative weight loss might reduce this risk. However, it is unclear how patients perceive engagement with an intensive weight-loss programme in the short window between diagnosis and surgery. This qualitative study, embedded within the CARE randomised controlled trial, aimed to understand the acceptability and experiences of following an intensive weight-loss programme with dietetic support as prehabilitation before colorectal cancer surgery.</p><p><strong>Methods: </strong>Thirty-one participants (65% male, mean (SD) BMI 36.0 (5.5) kg/m², 65 (7) years) took part in a semi-structured interview based on the Theoretical Framework of Acceptability after following the programme for an average of 24 (12) days and 12 (7) days before surgery. Data were thematically analysed using the four constructs of Normalisation Process Theory (NPT).</p><p><strong>Results: </strong>Participants understood, via interactions with healthcare professionals, that the programme could potentially make their operation technically easier and expedite hospital discharge (coherence). Continued adherence was supported by the dietitians (cognitive participation), and improvements in health markers and rapid weight loss helped to reframe some participants' views that their bodies were failing due to cancer (reflexive monitoring). However, some families' distrust of the programme's safety, social eating occasions, and side effects prevented full acceptability and total adherence (collective action). This highlighted how collective action sometimes overrode the consistently strong coherence, cognitive participation, and reflexive monitoring components of NPT.</p><p><strong>Conclusion: </strong>The weight-loss programme was mostly acceptable to people who had already joined the intervention. Addressing challenges with collective action may support more patients to adhere.</p><p><strong>Clinical trial registration: </strong>ISRCTN39207707, Registration date 13/03/2023.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70896"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129392","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":"Developing Glow: A Co-Designed Support Framework Integrating Behavioural and Psychological Needs in Coeliac Disease.","authors":"Rose-Marie Satherley, Shakira Hollyfield, Areeba Shahab, Angie Pitt, Nick Trott, Liz Toft, Aftab Ala, Christina J Jones","doi":"10.1111/hex.70905","DOIUrl":"10.1111/hex.70905","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Strict management of a gluten-free diet (GFD) is the only effective treatment for coeliac disease; support in current healthcare frameworks focususes primarily on dietary support and intestinal recovery. However, psychological and social processes that shape gluten-free living are less often addressed, despite high levels of emotional burden among people with coeliac disease. There is limited guidance on how these needs should be met in routine support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To co-design an evidence-informed framework integrating dietary, behavioural and psychological support for adults living with coeliac disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Co-design, using iterative workshops and interviews, underpinned by a constructivist epistemology and a reflexive framework approach. The Theory of Planned Behaviour and Acceptance and Commitment Therapy were used as sensitising lenses to interpret behavioural and experiential mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and participants: &lt;/strong&gt;Sixty-two stakeholders in the UK, including 35 adults with coeliac disease and 27 healthcare providers. Recruitment prioritised groups under-represented in coeliac research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analysis produced three interpretive themes: (1) fragmented and inconsistent support landscapes shape expectations, confidence, and responsibility; (2) gluten-free living requires ongoing identity reconstruction amid misrecognition and life transitions; and (3) GFD management involves sustained cognitive, emotional and relational work, with fluctuating capacity. These informed development of the GLOW (Gluten-free Living: Optimised Wellbeing) framework, which defines three dimensions of support: Orientation and Adjustment, Sustained Support, and Specialist Psychological Input. GLOW describes support functions rather than roles, to enable delivery across healthcare, community, digital, and voluntary-sector settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;For adults with coeliac disease, GFD management involves ongoing psychological work that is insufficiently addressed by current models of care. GLOW offers a mechanism-oriented approach to integrate behavioural and emotional support into routine coeliac disease services and wider support environments. Future work will evaluate implementation and resource requirements across settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient or public contribution: &lt;/strong&gt;People with lived experience of coeliac disease were involved throughout the study, including design, data collection, analysis, and development of the GLOW framework. Two lived experience advisors contributed as members of the Project Advisory Panel, providing input into study design, interpretation of findings, and refinement of the framework, and another as a lived experience researcher. Adults with coeliac disease also participated in co-design workshops and interviews, shaping the identification of key challenges, support needs, and proposed so","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70905"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139531","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":"'Some of Them Were Created by People Who Have Never Had a Stroke': Understanding Desired Physical and Occupational Therapy Research Study Features for People With Chronic Stroke.","authors":"Sarah M Schwab-Farrell, Jasmine Ficke, Daria Pressler, Kelly Farrell, Becca Rose, Valerie Miller","doi":"10.1111/hex.70918","DOIUrl":"10.1111/hex.70918","url":null,"abstract":"<p><strong>Background: </strong>People with stroke have historically had limited involvement in physical and occupational therapy research studies. Scientists and funders, rather than those most affected by the outcomes of research, largely make decisions about what studies should focus on. When research is not informed by the lived experiences of people with disability, researchers may ask the wrong questions or make incorrect assumptions about disability.</p><p><strong>Objective: </strong>The purpose of this study was to identify desired features and characteristics for physical and occupational therapy research studies, from the perspective of people with chronic stroke.</p><p><strong>Methods: </strong>We completed four iterative focus group discussions with a small group of adults with chronic stroke. The group was purposively sampled to ensure a range of prior stroke research experiences and stroke-related impairments. Thematic analysis was conducted on discussion content to identify desired study features.</p><p><strong>Results: </strong>Four major desired study features were constructed: (1) Desire for relationships; (2) Understand the purpose; (3) Capability-oriented; and (4) Focused on individual participation needs. Participants expressed a desire for physical and occupational therapy studies to focus on what they can do (rather than what they cannot do) while also embracing the heterogeneity of stroke presentation. Studies involving elements of stroke community support and an understanding of potential benefits or information about stroke are also desired.</p><p><strong>Conclusion: </strong>Collaborative research design can contribute to future research that is authentic and valuable to people with lived experience while concurrently lessening harmful disability narratives that are often unintentionally maintained by non-disabled researchers. By working with a group of adults with chronic stroke, we were able to identify valued study features that can be incorporated into future stroke research studies.</p><p><strong>Lived experience or public contribution: </strong>Individuals with lived experience of stroke engaged in the discussions presented in this paper to collaboratively identify desired stroke study features. People with stroke were also involved in the developing interpretation of the presented data and reviewed the final version of the manuscript.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70918"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139534","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":"Young People's Voices in Developing Messages on Brain Health: An Initiative to Promote Brain-Protective Lifestyle Habits Among Young Adults.","authors":"Soraya Moradi-Bachiller, David Bartrés-Faz, Holger Fröhlich, Jean Georges, Dianne Gove, Jesús Rodrigo, Jussi Tohka, Ana Díaz-Ponce","doi":"10.1111/hex.70926","DOIUrl":"https://doi.org/10.1111/hex.70926","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The work presented in this article was conducted as part of two European-funded projects (ADIS and Pattern-Cog) examining the topics of dementia risk reduction and timely diagnosis. Health messages promoting and educating people about brain health (defined by the World Health Organisation as the state of brain functioning across cognitive, sensory, social-emotional, behavioural and motor domains, allowing a person to realise their full potential over the life course, irrespective of the presence or absence of disorders) are beginning to appear in the public domain. However, to the best of our knowledge, there are no campaigns specifically developed to inform, educate and promote brain health among young adults. This seems counterintuitive given the potential for prevention, particularly at this important transitional phase in a young person's life. This article reports feedback collected during consecutive four online and face-to-face Public Involvement (PI) consultations with nine young adults from Spain that focused on understanding their perspectives on dementia and brain health promotion messages. A subsequent aim was to describe how this informed the development of a brain health campaign.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Approach: &lt;/strong&gt;Notes from the consultations were summarised and organised using thematic analysis techniques. Meeting summaries informed the development of a brain health campaign targeting young adults in Spain-'Yo Me Celebro'. The campaign was developed in a partnership approach with the young adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcomes: &lt;/strong&gt;Four main topics related to brain health were summarised from the PI consultations: (1) understanding, (2) terminology, (3) barriers and limitations to change and (4) preferred approach. Many learning points and limitations were identified from these topics (i.e., framing brain health in a positive, tailored and flexible way), and significantly shaped the subsequent campaign. This learning might be useful for future public health campaign developers tasked with designing initiatives for similar target audiences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;To promote brain health among younger populations, it is imperative to acknowledge their perspectives and needs. Targeted education was recognised as the first step towards raising awareness about the importance of maintaining brain health; this should address gaps in knowledge and the lack of accessible, accurate information. Approaching the topic of dementia, risk factors for neurodegenerative diseases and healthy lifestyle habits in a positive, tailored and flexible way were also perceived as key to influencing young people's motivation to engage in brain health promotional activities. These perspectives and preferences were reflected in the 'Yo Me Celebro' campaign.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient or public contribution: &lt;/strong&gt;Four online and face-to-face meetings with a Young Adults Advisory Board of people aged 22 years were conduct","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277184","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":"When Menstrual Pain Becomes Care-Worthy: A Qualitative Study of Delayed Care-Seeking Among Young Women With Function-Limiting Dysmenorrhoea in Southwest China.","authors":"Qingqing Zhu, Bentao Jia, Qi Yu, Mingqiang Wang, Wei Xie, Ling Qi, Hongbo Chen, Min Wang, Xiping Li","doi":"10.1111/hex.70930","DOIUrl":"https://doi.org/10.1111/hex.70930","url":null,"abstract":"<p><strong>Background: </strong>Dysmenorrhoea can disrupt education, work, sleep, mobility and other daily activities, yet recurrent pain that limits daily functioning does not always prompt timely formal care-seeking.</p><p><strong>Objective: </strong>The aim of this study was to explore how young women in Southwest China interpret recurrent function-limiting dysmenorrhoea and decide whether to seek formal care.</p><p><strong>Methods: </strong>This qualitative study was based in Guiyang, Guizhou Province, Southwest China. Seventeen women aged 18-31 years with recurrent dysmenorrhoea affecting daily functioning took part in semi-structured interviews. Interviews were conducted face-to-face or online, audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Five themes were developed: making pain ordinary across family, peers and clinics; keeping pain within the logic of warmth and regulation; when pain becomes care-worthy: functional disruption as a threshold; reproductive expectations and delayed medicalisation; and normal tests, uncertain explanations and delayed re-entry into care. Care-seeking was often delayed as participants normalised menstrual pain, relied on culturally familiar warming or body-regulating practices, had concerns about analgesics or expected pain to improve after childbirth. Non-specific clinical explanations could also temporarily reassure participants and contribute to delay. Participants described seeking formal care when pain disrupted study, work, sleep, mobility or daily activities, when medication or self-management no longer worked, or when reproductive or gynaecological concerns emerged.</p><p><strong>Conclusions: </strong>Delayed care-seeking was shaped by whether menstrual pain became recognised as a legitimate reason for formal care. Menstrual health education and clinical communication should validate function-limiting pain, clarify when assessment is needed and provide clear follow-up guidance.</p><p><strong>Patient or public contribution: </strong>Four women with lived experience of function-limiting dysmenorrhoea helped develop parts of the interview guide. Their feedback during pilot interviews led to additional questions about healthcare access and practical barriers to seeking care. They also supported recruitment and contributed to discussions of interview accounts and developing themes.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13693398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277313","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":"Health Behaviour Change in Weight Management for People With Higher Weight and Symptoms of Common Mental Health Problems: A Qualitative Study.","authors":"Veronika Rysinova, Sarah Brown, Nicola Marie Stock","doi":"10.1111/hex.70906","DOIUrl":"https://doi.org/10.1111/hex.70906","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adults with higher weight experience disproportionate rates of common mental health problems (CMHPs), including depression, anxiety and post-traumatic stress disorder. Tier 2 Weight Management Services (T2WMS) in the United Kingdom emphasise diet and physical activity with limited psychological input. Evidence on how people with co-occurring CMHPs symptoms experience health behaviour change within these programmes remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore how adults with higher weight and symptoms of CMHPs engage with health behaviour change in T2WMS, incorporating service user and practitioner perspectives, and to identify barriers, facilitators and service implications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Qualitative study using semi-structured interviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and participants: &lt;/strong&gt;Service users (n = 11) and healthcare professionals (n = 11) recruited from UK T2WMS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main variables studied: &lt;/strong&gt;Barriers and facilitators to eating behaviours, physical activity, emotion regulation and self-regulation behaviours.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Thematic patterns were analysed using codebook thematic analysis within a critical realist frame, with deductive mapping to the COM-B model and Theoretical Domains Framework (TDF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Five themes captured a dynamic interplay of emotional, social and structural factors: (1) The emotional weight of change, (2) Health on the margins of daily life, (3) Connection and judgement shape the journey, (4) Treating the whole person, and (5) Self-care as a foundation for lifelong change. Barriers to health behaviour change included emotional fluctuation, stigma, low self-efficacy, relational pressures and structural constraints. Facilitators included self-compassion, emotional regulation, small achievable goals, inclusive groups and supportive practitioner relationships.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion and conclusions: &lt;/strong&gt;Provision centred on weight loss as the primary measure of success, delivered in a standardised format, was poorly aligned with the needs of those with symptoms of CMHPs. Embedding trauma sensitivity, relational safety, flexible pacing and broader outcome measures may better support sustained engagement. Mapping to COM-B/TDF and Behaviour Change Wheel intervention functions offers a psychologically informed framework to guide commissioners and practitioners.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patient or public contribution: &lt;/strong&gt;An advisory group of four members (two with lived experience of higher weight and symptoms of CMHPs, two healthcare professionals delivering T2WMS) contributed to study design, recruitment materials and interview guides shaping the study's non-stigmatising terminology. All research participants were also invited to review preliminary findings, which informed refinements to thematic language. Patient and public involvement was documented using the GRIPP2 short-form f","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13696040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277339","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}