Health Expectations最新文献

{"title":"Public and Patient Involvement and Engagement in Clinical Trials: A Multi-Perspective Mixed-Methods Evaluation of the ROWTATE Programme.","authors":"Blerina Kellezi, Heather Peacock, Trevor Jones, Ali Gibson, Isabel Andrews, Steve Fallon, Rebecca Lindley, Kate Radford, Kay Bridger, Claire Mann, Cristina Roadevin, Marilyn James, Denise Kendrick","doi":"10.1111/hex.70636","DOIUrl":"10.1111/hex.70636","url":null,"abstract":"<p><strong>Background: </strong>Patient and public involvement and engagement (PPIE) has many benefits for the design, delivery and dissemination of health research, but this can be difficult to achieve. Systematic reporting and evaluation of PPIE in multi-year, multisite and complex clinical trials is very limited.</p><p><strong>Methodology: </strong>This evaluation presents a multi-perspective description and evaluation of patient and public involvement within a large-scale, multisite, longitudinal research programme focused on developing and evaluating a vocational rehabilitation and clinical psychology intervention for individuals recovering from traumatic injury. Conducted as part of the NIHR-funded ROWTATE research programme (2019-2026), the evaluation explores the scope, impact, and lived experiences of PPIE group members across all phases of the study, from development of the intervention, feasibility study and trial design to intervention delivery, data collection, analysis and dissemination. Employing multiple methods, including open-ended surveys with PPIE group members and researchers, a 'You Said, We Did' activity log, and minute taking, the study identifies key patterns related to PPIE group members' motivations, contributions, personal impact and barriers and facilitators to engagement.</p><p><strong>Results: </strong>Findings highlight the significant value of PPIE in enhancing study relevance, improving data collection and communication strategies, informing rehabilitation, clinical psychology and health economics components, and shaping intervention delivery. PPIE group members reported a strong sense of purpose and intellectual engagement, despite challenges including communication gaps and role clarity. Researchers valued PPIE contribution to the research, and the positive and enriching experience of working with PPIE group members. Both groups reflected on the barriers and facilitators to PPIE.</p><p><strong>Conclusion: </strong>The evaluation highlights the importance of inclusive, well-supported, and transparent PPIE practices and contributes novel insights into the PPIE role in under-researched domains such as clinical psychology and health economics.</p><p><strong>Patient or public contribution: </strong>Traumatic injury survivors were involved in all processes of this evaluation. This includes research design, funding acquisition, data collection, data analysis and interpretation and the write-up of this manuscript. Five traumatic injury survivors are co-authors of this manuscript.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70636"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445996","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":"Distributed Health Literacy Among People With Intellectual Disability, Their Supporters and Healthcare Professionals: A Scoping Review.","authors":"Maryann Barrington, Karen R Fisher, Ben Harris-Roxas, Julian N Trollor, Catherine Spooner, Julie M Christensen, Janelle Weise","doi":"10.1111/hex.70548","DOIUrl":"10.1111/hex.70548","url":null,"abstract":"<p><strong>Background: </strong>Health literacy is associated with improved healthcare experiences and health outcomes and is influenced by the social context in which it occurs. People with intellectual disability face stark health inequalities, yet the health literacy concept is underexplored for this group. Little is known about how health literacy is co-constructed between people with intellectual disability, supporters and healthcare professionals.</p><p><strong>Objective: </strong>The aim is to understand the experiences of people with intellectual disability accessing, understanding, appraising and applying health information together with their supporters and healthcare professionals.</p><p><strong>Search strategy: </strong>This scoping review followed Joanna Briggs Institute guidelines. Articles were identified and retrieved from CINAHL, PsycINFO, PubMed and EMBASE. Articles were included if they were published between 2000 and the present and focussed on aspects of how people with intellectual disability accessed, understood, appraised or used information or the role that socio-environmental influences, including support networks and healthcare professionals, have in this process.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers completed abstract and full-text screening, addressing any conflicts at each stage. Data were extracted and coded deductively, according to the integrated model of health literacy.</p><p><strong>Main result: </strong>Following search and screening, 90 articles were included for review. Interpretation of the evidence suggests that health literacy is a relational process between people with intellectual disability, support networks and healthcare professionals. Each group experiences particular barriers and facilitators to this process and is impacted by its wider social and environmental contexts. There was limited evidence about how personal characteristics might shape health literacy, particularly intersectional experiences.</p><p><strong>Discussion and conclusions: </strong>Health literacy is a social practice, with roles and responsibilities shared among people and systems. Healthcare and disability sectors can facilitate health literacy by creating environments that support shared access and use of health information, as well as facilitate choice and decision-making.</p><p><strong>Patient or public contribution: </strong>Collaboration with people with intellectual disability in scoping reviews is an emerging area. We gained the perspectives and feedback of colleagues with lived experience of intellectual disability for the design of the review and interpretation of the evidence. This included meeting with a Lived Experience Reference Group of seven people with intellectual disability to discuss our process and findings and receive their guidance. Their contributions supported how we interpreted the findings and reported the review.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70548"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476249","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 of the First Patient-Reported Experience Measure (PREM) for Hearing Loss in Audiology Care-My Hearing PREM.","authors":"Kris English","doi":"10.1111/hex.70510","DOIUrl":"10.1111/hex.70510","url":null,"abstract":"","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70510"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596305","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 With Mental Health Family Carers: The Value, Outcomes and Benefits for Family Carers and Academic Researchers.","authors":"Caroline Walters, Melissa Petrakis, Sharon Lawn, Eileen McDonald, Carli Sheers, Hayley Solich, Jonathan Harms, Tony Stevenson, Melinda Goodyear, Marcelo Maghidman","doi":"10.1111/hex.70657","DOIUrl":"10.1111/hex.70657","url":null,"abstract":"<p><strong>Introduction: </strong>Family engagement in mental health service reform, design, treatment, and research is highlighted as important within government and governance guidelines; however, inconsistencies of inclusion continue to be experienced and reported. Within mental health and community research there are calls for the adoption of participatory and co-production methodologies.</p><p><strong>Objective: </strong>To add to the informed debate about patient and public involvement and engagement, this article explored the value, outcomes, and benefits of co-production as a way of working with and elevating mental health family carers in research.</p><p><strong>Methods: </strong>Thirteen family carer co-researchers participated in one of two focused-conversations alongside two university academics, to reflect upon their experiences of working together across a 9-month co-produced research project. Co-researchers were asked to consider experiences in relation to the meaning of participation, impacts of co-production, and how this co-produced research compared to involvement in other research. The co-researchers were invited to participate in co-analysing the focused-conversations transcriptions, determining the findings, and authoring this paper.</p><p><strong>Results: </strong>Utilising an inductive approach to reflexive thematic analysis, insights into the values and benefits for family carers, academic researchers, research evidence, and outcomes were established. Themes developed about the values and benefits as well as the mechanisms of co-production. Benefits were indicated for the researchers, participants, research process, evidence and outcomes. Mechanisms in relation to people's experiences of co-production included: processes were different to other research experiences, practices were relational, and ethos was collegial and supportive. The value of co-production was seen as privileging family carer voices, creating a sense of community and 'sitting around the kitchen table', leading to belonging and sharing within a space where people were safe, and participants felt validated.</p><p><strong>Conclusion: </strong>In recognising that co-production is fundamentally different to traditional research, this paper revealed the value, outcomes, and benefits of processes, practices and ethos that engaged and elevated family carer leadership in research. Family carer co-researchers experienced feelings of increased capability and identified that co-production, is right if the end result resonates with the whole experience.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70657"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640879","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":"Evaluating Patient and Public Involvement and Engagement Activity Within the 3DPiPPIn Trial: A Qualitative Exploration of Contributors' Perspectives on Their Impact.","authors":"Ime Umoabasi, Stephanie K Mansell, Swapna Mandal, Cherry Kilbride, Stephen T Hilton, Eleanor Main, Silvia Schievano, Tamsin Callaghan","doi":"10.1111/hex.70674","DOIUrl":"10.1111/hex.70674","url":null,"abstract":"<p><strong>Introduction: </strong>Patient and Public Involvement and Engagement (PPIE) is now considered essential to the delivery of high-quality, patient-centred and translational research. However, despite widespread recognition of this, PPIE remains poorly understood, inconsistently utilised and inadequately reported.</p><p><strong>Objective: </strong>This study aimed to report, discuss and analyse the PPIE activities undertaken within 3DPiPPIn-a randomised control trial investigating the feasibility of using 3D printing to develop customised masks for patients receiving positive airway pressure (PAP) therapy. Emphasis was placed on analysing the wider impacts of these activities, including the impact on Patient Advisory Group (PAG) members.</p><p><strong>Methods: </strong>Data were collected from PAG members via 1:1 semi-structured interviews, which took place either face-to-face or online as per members' preference. Interviews were recorded, transcribed verbatim and analysed in NVivo using Braun and Clarke's Six-Phase Reflexive Thematic Analysis.</p><p><strong>Results: </strong>Three PAG members were interviewed; two were conducted remotely via Microsoft Teams, while the third took place face-to-face. Analysis resulted in the identification of three themes: 'Disparate perceptions of PPIE influence in research', 'Empowered and enriched through PPIE' and 'Navigating the evolving experience and hurdles of PPIE'. PAG members described their influence on the trial as variable, feeling their involvement was impactful in some instances and insignificant in others. Despite this, they unanimously agreed that PAG involvement had a positive personal impact and that their experiences of PPIE were diverse and dynamic. Within the subtheme 'Supports and stumbling blocks for PPIE', members reflected on facilitators and barriers to PPIE. For example, the relaxed environment created by the Principal Investigator was seen to have promoted open discussion, while personal challenges sometimes diverted their focus from their role as a PAG member.</p><p><strong>Conclusion: </strong>This Reflexive Thematic Analysis explored the impact of PPIE on the 3DPiPPIn trial from the perspective of its PAG members. It exemplifies PPIE best practice and highlights areas for improvement to other researchers, advocating for meaningful rather than tokenistic PPIE. By encouraging excellence in PPIE, this report could enhance public engagement in research and, by demonstrating the impact and importance of quality PPIE, could inspire funders to ensure the provision of adequate PPIE resources.</p><p><strong>Trial registration: </strong>Embedded within the 3DPiPPIn trial (ISRCTN 74082423).</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70674"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13094355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724626","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-Designing a Culturally Tailored Nutrition Resource With African Migrant Women and Healthcare Professionals in Australia.","authors":"Bolanle R Olajide, Paige van der Pligt, Vidanka Vasilevski, Fiona H McKay","doi":"10.1111/hex.70649","DOIUrl":"10.1111/hex.70649","url":null,"abstract":"<p><strong>Background: </strong>Deciding what foods to consume during pregnancy can be overwhelming. Accurate and culturally appropriate nutrition resources are particularly important for migrant women navigating different cultural influences. Research with African migrant women has highlighted the need for tailored pregnancy nutrition resources, yet this need remains unmet. Providing African migrant women with appropriate resources can support informed food choices and contribute to improved maternal and foetal health outcomes. This study explored the views and opinions of African migrant women and healthcare professionals (HCPs) in Australia on the development of a culturally appropriate pregnancy nutrition resource.</p><p><strong>Methods: </strong>The authors drew on previously prioritised needs for culturally tailored pregnancy nutrition resources as a starting point for co-design workshops. Four workshops were conducted via Zoom with seven African migrant women and five HCPs. Participants included women and HCPs from an earlier study as well as new participants recruited through convenience sampling. Data were analysed using reflexive thematic analysis, combining deductive and inductive approaches.</p><p><strong>Results: </strong>Three themes captured the preferred formats and features of a tailored pregnancy nutrition resource. Among the suggested formats, the top four preferred were a mobile application, website, pamphlet, and food guide. Key features included incorporating African foods, identifying suitable alternatives available in Australia, providing information on common cultural food restrictions, and listing where African and substitute foods could be purchased. Across all formats, participants emphasised the importance of concise, visually engaging resources.</p><p><strong>Conclusions: </strong>Co-designed, culturally tailored nutrition resources can support women's nutritional needs, foster culturally sensitive care, and improve maternal and foetal health outcomes.</p><p><strong>Patient or public contribution: </strong>African migrant women and HCPs contributed to co-design workshops, guiding the development of culturally tailored pregnancy nutrition resources.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70649"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13087440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516606","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":"Addressing Medical Deserts in Europe: Lessons From a Comparative Analysis.","authors":"Alicja Domagała, Katarzyna Dubas-Jakóbczyk, Ana Isabel Gonzalez Gonzalez, Robert Likic, Kamila Michalska, Iwona Kowalska-Bobko, Christoph Sowada, Linda Flinterman, Sorin Dan, Ronald Batenburg","doi":"10.1111/hex.70606","DOIUrl":"10.1111/hex.70606","url":null,"abstract":"<p><strong>Background: </strong>European countries face a common problem of medical deserts-areas where the population has limited access to healthcare services.</p><p><strong>Objective: </strong>This article aims to define medical deserts and provide an in-depth overview of the factors driving desertification and the solutions applied to reduce its negative consequences across six European countries: the Netherlands, Spain, Poland, Croatia, Germany and Ireland.</p><p><strong>Methods: </strong>Applied methods include five consecutive steps: (1) development of a case study template; (2) defining criteria and selecting case study countries, (3) desk research, (4) consultation with national experts and (5) comparative analysis.</p><p><strong>Results: </strong>There is no formally recognised definition of medical deserts in all the analysed countries. Nevertheless, the concept is often associated with sparsely populated, isolated areas with limited access to healthcare services. The factors driving desertification are similar across the six countries and include: ageing and depopulation, health workforce deficits, unattractive working conditions and geographical factors. Solutions implemented to mitigate the negative effects of medical deserts can be classified into several broad categories: health workforce planning and monitoring, training and career pathways, innovative healthcare models, support mechanisms and infrastructure development.</p><p><strong>Conclusions: </strong>The factors driving medical deserts in European countries are complex and multidimensional. In consequence, the policy approaches aimed at limiting their negative consequences also require a comprehensive approach. Addressing medical deserts requires focusing on both the supply and demand sides of health services provision and comprehensive strategies tailored to each country's or region's specific circumstances.</p><p><strong>Patient or public contribution: </strong>This study was conducted within the ROUTE-HWF project framework, which emphasised the importance of patient and public involvement throughout the research process. Their contribution was particularly valuable during national and international workshops with key stakeholders, including community representatives, healthcare professionals and policymakers. These stakeholder workshops focused on discussing the root causes of medical deserts and exploring national and regional strategies to address them. This inclusive approach ensured that the analysis of the factors driving desertification and potential solutions incorporated the perspectives and lived experiences of affected populations.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70606"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12970483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379501","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":"Consortium-Based Patient and Public Involvement and Engagement for Long COVID Research: A Pirit-Focused Impact Evaluation of the PHOSP-COVID Study.","authors":"Linzy Houchen-Wolloff, Joanna Bell, Rebecca Pritchard, Krisnah Poinasamy, Kate Holmes, Samantha Walker, Nikki Smith, Claire Hastie, Natalie Rogers, Dawn Adams, Rashmita Nathu, Rhyan Gill, Jenny Bunker, Lily Staunton, James Chalmers, Ling-Pei Ho, Victoria Harris, Alexander Horsley, Michael Marks, Betty Raman, Louise V Wain, Christopher Brightling, Rachael Evans","doi":"10.1111/hex.70591","DOIUrl":"10.1111/hex.70591","url":null,"abstract":"<p><strong>Background: </strong>At the start of the coronavirus disease-2019 (COVID-19) pandemic in early 2020, the long-term outcomes for survivors of COVID-19 were unknown. The PHOSP-COVID cohort study was set up at scale and pace in Spring 2020 to determine the short- to long-term health consequences of COVID-19 in post-hospitalisation survivors; to understand the impact of interventions during and after the acute illness on these long-term sequelae and to build the foundation for multiple in-depth studies. A consortium infrastructure of hospital trusts, academic partners, industry, patients and charities was created. From the study inception, patients were central to the PHOSP-COVID consortium, whereby a Patient and Public involvement and Engagement (PPIE) group was convened, including charity groups, people with lived experience recruited through clinical care from NHS sites, and patient support groups through Long Covid Support. Embedding high-quality, meaningful PPIE within a large consortium brings challenges and benefits. In this article, we describe our experiences of setting up and sustaining the PHOSP-COVID Consortium PPIE group, including a PIRIT-focussed evaluation of the impact of our PPIE work and provide top tips for researchers to take forward when embedding PPIE in future consortium research.</p><p><strong>Methods: </strong>This article outlines the set-up and sustainability of the PHOSP-COVID study PPIE group, in consultation with the National Institute for Health and Care Research (NIHR) guidance. To evaluate PPIE impact, we used PIRIT (Public Involvement in Research Impact Tool, 2023- Cardiff), and we provide our honest reflections of our PPIE work according to the PIRIT planning tool. The results highlight the benefits of a consortium approach to PPIE as well as the challenges, with quotes from PPIE contributors and academics. In addition, we have created top tips for researchers to take forward when embedding PPIE in future consortium research, linked to the NIHR standards.</p><p><strong>Learning and reflection: </strong>This manuscript has identified gaps in PPIE considerations for the PHOSP-COVID study and specific challenges around a consortium-based approach for PPIE. These are largely due to time scale (i.e. the pace of setting up the study within a pandemic) and communication factors (diverse and large numbers of people to include/inform). Through reflection on the challenges and successes experienced in the PHOSP-COVID consortium PPIE via a PIRIT-focused impact evaluation, we have developed recommendations to support future good practice.</p><p><strong>Patient or public contribution: </strong>Patients and members of the public were involved in all aspects of this work from idea inception, design and conduct of the work, analysis and interpretation of the data. Eight patients prepared the manuscript and are included as co-authors.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70591"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488662","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":"Mental-Health Help-Seeking Among Muslims in the Liverpool City Region: A System-Informed Qualitative Study of Knowledge, Attitudes, Practices.","authors":"Ashraf Tannerah, Amy Webster, Shelley O'Connor, Charlie Douglas-Brown, Imran Khan, Oladayo Bifarin","doi":"10.1111/hex.70663","DOIUrl":"10.1111/hex.70663","url":null,"abstract":"<p><strong>Background: </strong>Muslims in United Kingdom (UK) minority contexts remain underrepresented in mental health research, despite evidence of unequal access and experience. In deprived and superdiverse settings such as the Liverpool City Region (LCR), culturally unsafe encounters, low service literacy and stigma may combine to delay help-seeking and widen inequities.</p><p><strong>Aim: </strong>To explore knowledge, attitudes and practices (KAP) related to mental health among Muslims in the LCR, and to identify actionable system leverage points to improve access, engagement and culturally responsive care.</p><p><strong>Methods: </strong>A qualitative study informed by social constructivism. Purposive sampling recruited Muslim adults (n = 11; age 18-59; 6 women/5 men) from diverse backgrounds (Yemeni, Somali, Egyptian, Algerian, Pakistani, Bangladeshi). Recruitment was community-enabled through mosques and community networks. Semi-structured interviews (in person or MS Teams) were audio-recorded, transcribed, anonymised and analysed using Reflexive Thematic Analysis with an audit trail, reflexive memoing and team debriefs.</p><p><strong>Results: </strong>Three interlinked themes were generated: (1) Barriers to access and engagement: stigma and reputational risk, communication difficulties, confidentiality concerns and perceived stereotyping reduced disclosure and trust; (2) Cultural and religious context in mental health: participants endorsed integrating faith-based coping and clinical care, with mosques and imams functioning as trusted entry points but with variable mental health capability; (3) System and service provision challenges: limited knowledge of access routes, crisis visibility of services, perceived Islamophobia, and resource/leadership gaps reinforced late presentation. Findings suggested an accumulating pathway from stigma and low trust to delayed access and crisis-driven contact.</p><p><strong>Conclusions: </strong>Inequities reflected system design and relational safety as much as individual knowledge. Co-designed, community-enabled pathways, faith-literate practice, safeguarded referral interfaces with faith leaders, and routine equity monitoring are key mechanisms for improving engagement and outcomes in the LCR and similar UK city regions.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70663"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624251","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-Creation of Interventions to Promote Critical Health Literacy in the Community: Study Protocol.","authors":"Sandro Zacher, Martin Kalteis, Gabriele Meyer, Anke Steckelberg, Jana Hinneburg","doi":"10.1111/hex.70670","DOIUrl":"10.1111/hex.70670","url":null,"abstract":"<p><strong>Background: </strong>A new community centre in a district with a high amount of equity deserving populations in Halle (Saale), Germany provides a space to design and implement health-related services that reflect the needs and priorities of local residents. Health information often fails to meet existing quality standards. Therefore, strengthening critical health literacy is essential. Co-creation is a participatory approach that addresses needs by involving community members as equal partners in the joint development of ideas, concepts and interventions. The study aims to co-create interventions with residents of the community to promote critical health literacy.</p><p><strong>Methods: </strong>The study will be conducted as an iterative co-creation process and feasibility study using both qualitative and quantitative methods, based on the PRODUCES+ framework and guided by the UK Medical Research Council (MRC) framework for developing and evaluating complex interventions. In phase I, co-creators engage in a multi-step co-creation process involving participatory workshops and focus group interviews to explore community health needs, information behaviours and to co-develop tailored interventions. Interest-holders representing local institutions are continuously involved to ensure contextual relevance and sustainability. The co-creation process will be evaluated using the PROSECO framework. In phase II, the developed interventions will undergo feasibility testing and pilot implementation within the newly established community centre, using qualitative and quantitative methods such as think-aloud, observations, interviews and questionnaires.</p><p><strong>Conclusions: </strong>The study is expected to develop interventions that will strengthen critical health literacy and empower residents to make informed health decisions. It will also provide insights into mechanisms and success factors of co-creation.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 2","pages":"e70670"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646908","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}