Health Expectations最新文献

{"title":"Thinking Differently About Same Day Access: Qualitative Study of Primary Care Staff Experiences in England and Denmark.","authors":"Tina Drud Due, Sue Ziebland, Thomas Bo Drivsholm, Anna Dowrick","doi":"10.1111/hex.70921","DOIUrl":"https://doi.org/10.1111/hex.70921","url":null,"abstract":"<p><strong>Context: </strong>Rising demand for GP services alongside limited change in supply is placing unprecedented pressure on primary healthcare systems in many countries, including the UK and Denmark. The 2026 English GP contract requires practices to provide same day access to all patients considered to have an urgent need.</p><p><strong>Objectives: </strong>To study primary care staff reflections on their experiences of prioritising same day access through different approaches, which their practices had chosen and adapted over months and years.</p><p><strong>Design: </strong>A subset of three case studies (two in England, one in Denmark) from a larger focussed ethnography. These practices were selected for the sub-study because they all prioritised same day access but had developed different approaches. We draw on formal and informal interviews with staff and observations in the practices.</p><p><strong>Results: </strong>The different rationales for introducing same day access in these three practices had been to reduce long waiting times, to tackle non-attendance at pre-booked appointments and to help address limited GP capacity. Systems were maintained by weekly and daily tinkering with appointment capacity, by managing the balance of access and continuity, understanding where exceptions were important for different patient groups and, in the English case studies but not in Denmark, by channelling patients to allied health care professionals. In all cases, consideration was given to the trade-off for patients between urgency and continuity. Staff drew on their own experiences to caution against entirely open appointment booking systems. Staff in all three sub-study practices had, based on their experiences, started to think differently about how best to manage same day access. Our findings, comparing the English and Danish practices, raise the counter-intuitive possibility that, rather than opening the floodgates, making it easier for patients to access GP appointments when needed might help moderate total demand.</p><p><strong>Conclusions: </strong>These findings matter in relation to the 2026 GP contract, which has specified that 90% of appointments deemed 'urgent' by the practice must be seen on the same day. When dealing with seemingly overwhelming demand, it is tempting to introduce channels and diversions to protect supply, or even to question whether the demand is justified. Our findings suggest a pertinent metaphor: it is now recognised in flood prevention that the introduction of man-made channels has exacerbated the problem of flash flooding, while the use of open, naturally managed flood plains is beneficial. This metaphor may help practices to understand the consequences of their response to the new requirement for same day access.</p><p><strong>Patient and public contribution: </strong>The wider ethnographic study was guided from inception to completion by a PPI co-applicant and eight PPI representatives who, between them, ","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/PMC13693503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277377","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":"Involving People With Dementia in Research: Contributions, Barriers and Evaluation From a Meta-Synthesis and Qualitative Interview Study.","authors":"Jörg Meisser, Susanne de Wolf-Linder, Christina Ramsenthaler","doi":"10.1111/hex.70864","DOIUrl":"10.1111/hex.70864","url":null,"abstract":"<p><strong>Background: </strong>Patient and Public Involvement and Engagement (PPIE) can enhance the relevance, acceptability and quality of research; however, its meaningful implementation in dementia research remains insufficiently understood.</p><p><strong>Aim: </strong>(1) To identify methodological procedures for involving people with dementia (PwD) across the research lifecycle, and (2) to explore how members of a dementia PPIE group experience collaboration, contribution, and evaluation of their involvement.</p><p><strong>Methods: </strong>This mono-method, multi-strand qualitative study combined (1) a meta-synthesis of qualitative primary studies reporting explicit PPIE with PwD and (2) semi-structured interviews with members of a PPIE group. Both strands were analysed using qualitative thematic analysis. Findings were integrated through a crosswalk table and narrative synthesis.</p><p><strong>Results: </strong>The meta-synthesis (33 studies) identified sequential, interrelated methodological conditions for PPIE with PwD across four themes: (1) access and recruitment, through trusted organisations and existing networks; (2) facilitation and support, using adapted communication, flexible pacing, practical aids, and sustained researcher facilitation; (3) forms of involvement, from consultation to co-interviewing, co-analysis, co-authorship, and dissemination; and (4) evaluation of PPIE, which was inconsistently reported and rarely explicit about decision-making impact. Qualitative interviews with 11 PPIE group members generated four experiential themes: (1) group-related aspects (trust, appreciation, PwD representation), (2) structural conditions (organisation, preparation, continuity), (3) communication (clarity, accessibility, feedback), and (4) the handling and impact of contributions. Across strands, findings demonstrated strong convergence: methodological practices identified in the meta-synthesis directly aligned with conditions under which participants experienced involvement as meaningful. Conversely, gaps in reporting and evaluation identified in the literature reflected participants' concerns about limited visibility of impact.</p><p><strong>Conclusions: </strong>Effective PPIE with PwD requires sustained investment in relationship-building, structured processes, accessible communication and continuous feedback to enable meaningful and inclusive collaboration. By integrating meta-synthesis and experiential data, this study identified psychological safety, relational continuity and the visibility of influence as key in shaping meaningful involvement across research contexts.</p><p><strong>Patient or public contribution: </strong>Although people with dementia were not involved as research partners in study conception and design, the study sought to examine and incorporate lived-experience perspectives through the included literature, qualitative interviews and participant validation workshop. This limitation is acknowledged and shou","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70864"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901711","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":"Partnering With Lived Experience Experts to Co-Design and Co-Facilitate Trauma-Informed Practice Training for Health Professionals: Evaluation Findings.","authors":"Sarah Ciftci, Susan Heward-Belle, Nicole Pryor, Betty Luu, Hannah Mayjor, Portia Freeman, Fiona Rees, Renee Lovell","doi":"10.1111/hex.70883","DOIUrl":"10.1111/hex.70883","url":null,"abstract":"<p><strong>Background: </strong>There is growing demand for health professionals to be upskilled in trauma-informed practice to provide dignity-based healthcare responses to clients with lived experience of child sexual abuse and other adverse childhood experiences. Traditionally, such training has been developed and delivered by clinical experts or academics with specialised training, excluding those with lived experience expertise. Limited research has explored the involvement of lived experience experts in professional learning.</p><p><strong>Methods: </strong>This study evaluated the quality and impact of a trauma-informed practice training package for community health, mental health and drug health professionals that was co-designed and co-facilitated by women with lived experience of child sexual abuse. A feedback questionnaire utlising a single-assessment retrospective pre-post design coupled with open-ended questions was administered and qualitative interviews were conducted via a purposive sampling approach. In total, 97 survey responses and 10 qualitative interviews were included in the study. Descriptive and inferential statistics were generated to measure changes to knowledge and confidence as a result of the training and to examine which aspects of the training were most valuable. Thematic analysis of data was conducted to explore how lived experience co-facilitation supported learning.</p><p><strong>Results: </strong>There was an increase in both the proportion and mean scores of participants who reported feeling confident in understanding trauma informed practice immediately after the training. Paired sample t-tests indicate these increases were statistically significant (p < 0.001). Hearing directly from a trainer with lived experience was the most valued aspect of the training and was given the highest rating of 'excellent' by the highest proportion of participants (85%) compared to all other aspects of the training. Five key qualitative themes were identified, demonstrating how: (1) the depth and richness of lived experience perspective supported learning, (2) humanised trauma-informed practice beyond theory, (3) encouraged engagement through openness, (4) facilitated the translation of learning into practice, and (5) informed improvements to workplace practices.</p><p><strong>Conclusion: </strong>Future trauma-informed practice training for healthcare professionals can utilise lessons learned in this study to enact participatory co-design approaches and leverage the strengths of lived experience expertise for professional learning.</p><p><strong>Patient and public contribution: </strong>Three women with lived experience of child sexual abuse were employed in the study as lived experience experts alongside the academic researchers. They provided input into the design and development of the training content and co-facilitated each training session alongside a clinical expert. They reviewed this manuscript and are co-authors. The ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70883"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082733","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":"Nothing About Us Without Us: Principles for Lived Experience-Informed Psycho-Oncology Education and Training.","authors":"Darren Haywood, Sue Woodall, Annika Hegde, Jai Carmichael, Evan Dauer, Alexia Samiotis, Nicolas H Hart","doi":"10.1111/hex.70898","DOIUrl":"10.1111/hex.70898","url":null,"abstract":"<p><p>Lived experience is increasingly recognised as an essential source of expertise in healthcare research, service design, policy and quality improvement. In psycho-oncology, consumer involvement is now widely encouraged in research and service development; however comparatively little attention has been paid to the role of lived experience in educating and training the psycho-oncology workforce. We argue that involving people with lived experience should become a minimum requirement in developing, delivering, and evaluating psycho-oncology education and training. Given that psycho-oncology is fundamentally concerned with understanding and responding to the lived experience of cancer consumer involvement in education and training must be expected. To support meaningful implementation, we provide Principles for Lived Experience-Informed Psycho-Oncology Education and Training: representation, partnership, support, and accountability. Embedding lived experience expertise throughout psycho-oncology workforce development will strengthen the relevance, authenticity, and person-centredness of future education and training initiatives and may improve consumer outcomes.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70898"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129341","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 a Women's Empowerment Nurse-Led Group Intervention for Benzodiazepine and Z-Hypnotic Deprescription in Primary Healthcare: Results of a Co-Creation Process.","authors":"Amaia Cuesta-Zigorraga, Carlota Las Hayas Rodríguez, Garazi Aldanondo Aristizabal, Clara Sánchez Sánchez","doi":"10.1111/hex.70895","DOIUrl":"10.1111/hex.70895","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The aim of this study was to co-create a nurse-led women's empowerment group intervention to facilitate the deprescription of benzodiazepines and Z-hypnotics in primary care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;User-centred design based on co-creation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A literature review was conducted to identify female empowerment programmes that served as an initial prototype. The subsequent user-centred design applied a co-creation methodology in two structured phases: (1) Exploratory, to identify contextual needs and barriers, and (2) Development, to collaboratively define the intervention's final structure and content. Participants included chronic users of benzodiazepines and Z-hypnotics and primary care professionals (doctors, nurses, and pharmacists) who actively engaged in the collaborative design process.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The Exploratory phase identified structural and clinical deprescribing barriers, and female clients' knowledge gaps. Empowerment was confirmed as a key facilitator. The Development phase prioritised content (self-esteem, self-image, and healthcare) and adjusted the group intervention's format (duration, frequency, and structure) based on participant input.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The co-creation process resulted in an eight-session intervention, with support cards and a training video for nurse-facilitators. This collaboration ensured the final design was precisely tailored to women's needs and clinical practice, maximising its feasibility and relevance. The intervention facilitates the tapering of benzodiazepines and Z-hypnotics by combining women's empowerment with individualised and supervised dose reduction by primary care clinicians. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Demonstrates how co-creation with clients and healthcare professionals can lead to contextually adapted nurse-led interventions centred on women's empowerment. Highlights the role of women's empowerment as a catalyst for deprescribing long-term benzodiacepines and Z-hypnotics in primary healthcare. Introduces a structured and co-created eight-session intervention supported by a nurse-training video and support cards, offering practical toolkits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Public contribution: &lt;/strong&gt;Clients (as users) and primary care healthcare professionals actively participated in the design of the intervention aimed at empowering women. Their involvement included participation in co-creation workshops, in which needs and everyday realities relevant to the process of deprescribing benzodiazepines and Z-hypnotics were identified. The structure and content of the group intervention, as well as its relevance and feasibility, were defined collaboratively. This direct participation made it possible to develop an intervention that was more client-centred, equitable, and aligned with clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Reporting method: &lt;/strong&gt;This manuscript follows ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70895"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129417","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 Constant Battle for Services': Parents' Experiences on Healthcare Services for Children With 22q11 Deletion Syndrome.","authors":"Sophie Ayoub, Sandra Meier, Cheryl Cytrynbaum, Ann Swillen, Patricia Lingley-Pottie, Andrea Shugar, Nicolas Graf, Holly Carbyn, Abiaz Hossain, Nathan Rowarth, Bernice S Elger, Eva De Clercq","doi":"10.1111/hex.70911","DOIUrl":"10.1111/hex.70911","url":null,"abstract":"<p><strong>Introduction: </strong>22q11 deletion syndrome (22q11DS) is a rare disease with a neurodevelopmental component, and the most common microdeletion in humans, that affects many systems. The diagnosis is most often made in childhood. Parents may experience a high burden of care due to the multiple medical consultations and services needed.</p><p><strong>Aims: </strong>This study aimed to examine the parental perceptions of healthcare services for families of children with 22q11DS.</p><p><strong>Methods: </strong>This interview study was a component of a broader mixed-methods research project. The qualitative segment focused on insights from purposively selected families caring for children with 22q11DS, using semi-structured interviews. In this paper, we report our results, following the availability, accessibility, acceptability and quality (AAAQ) framework for humanitarian settings adapted to the 22q11DS context.</p><p><strong>Results: </strong>Interviews were conducted with 40 parents of children of various ages, from Europe, Canada and the United States of America. Regarding the availability theme, parents expressed concerns about the lack of multidisciplinary clinics and specialists. Accessibility to services depended on the location of the clinics, healthcare coverage, administrative burden and access to information. Acceptability was influenced by harmful language in healthcare around 22q11DS and the lack of services. The quality of available services depended on the support of healthcare providers.</p><p><strong>Discussion: </strong>This study examined healthcare service provision for children with 22q11DS using the AAAQ framework. It identified key challenges, including limited access to specialised, empathetic providers, a lack of caregiver support, and systemic issues such as unequal resource distribution and bureaucratic barriers. The framing of (ab)normality and inadequate language further hinders equitable care. Improving service quality requires continuous support, better access to information, and education.</p><p><strong>Lived experience or public contribution: </strong>Caregivers with lived experience participated in this study and shared perspectives that informed the interpretation of the findings. Representatives of patient organisations also provided valuable support and input.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70911"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139492","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 Medication Safety Interventions for Community Pharmacy: Bringing Together People Living With Visual Impairments and Community Pharmacists Using a Modified Nominal Group Technique Approach.","authors":"Isabel Adeyemi, Lisa Riste, Penny Lewis, Adam Pearson, Sumaira Naseem, Rebecca Morris, Darren Ashcroft, Maria Panagioti, Caroline Sanders, Sally Giles","doi":"10.1111/hex.70904","DOIUrl":"10.1111/hex.70904","url":null,"abstract":"<p><strong>Introduction: </strong>People living with visual impairment (VI), defined as a reduction in visual acuity or visual field that cannot be corrected by spectacles or contact lenses, experience health inequalities and are at increased risk of medication-related safety incidents. This study aimed to identify challenges contributing to medication errors and to co-design potential solutions with people living with VI and community pharmacy professionals.</p><p><strong>Methods: </strong>A modified Nominal Group Technique (mNGT) was conducted with seven adults living with VI and six community pharmacy professionals. The process comprised four stages: problem identification, solution generation, decision making and prioritisation, implementation and intervention development.</p><p><strong>Results: </strong>Participants identified twelve medication safety challenges and generated twenty-four potential solutions spanning pharmacist training, patient and pharmacist resources, pharmacy consultations, system changes and assistive technologies. Following discussion and prioritisation, three interventions were selected for further development: (1) an accessible Patient Safety Guide (PSG) to support communication between pharmacists, patients and carers regarding safe medication use; (2) a training video for pharmacists to improve awareness and understanding of the needs of people living with VI; and (3) pharmacy system changes, such as alerts or pop-up notifications, to improve identification of people living with VI and facilitate personalised support.</p><p><strong>Conclusion: </strong>Co-design involving people living with VI and community pharmacy professionals successfully identified practical and acceptable interventions with potential to improve medication safety. The findings highlight the importance of communication, pharmacist awareness and system-level support in reducing medication-related risks for people living with VI.</p><p><strong>Patient or public contribution: </strong>People living with visual impairment (PwVI) were involved throughout the design, conduct, and interpretation of this study. A stakeholder consultation group comprising PwVI and a carer informed the development of the study protocol, accessibility adaptations, workshop structure, and supporting materials. PwVI participated directly in the co-design workshops, identifying problems, generating solutions, and contributing to prioritisation of intervention ideas. Several PwVI also provided feedback on interpretation of findings and contributed to refining accessible outputs, including adaptations to the patient safety guide. Their involvement ensured that the research remained grounded in lived experience, and that the interventions developed reflected the priorities and practical realities of those directly affected.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70904"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13648018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139520","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-Design of the MAGNET Intervention to Enhance Medicines Self-Management in Community-Dwelling People With Dementia and Their Family Carers.","authors":"Catherine Powell, Lubena Mirza, Mohammed Akhlak Rauf, Justine Tomlinson, Zoe Edwards, Rozeena Khan, Jan Speechley, John L O'Dwyer, Catherine Quinn, Beth Fylan","doi":"10.1111/hex.70760","DOIUrl":"10.1111/hex.70760","url":null,"abstract":"<p><strong>Background: </strong>With appropriate support people living with mild-moderate dementia and family carers can self-manage their medicines. However, existing interventions often focus on enhancing adherence to a medication regimen rather than supporting people with other areas, such as monitoring side effects or checking for errors. A person-centred psychosocial intervention, empowering community-dwelling people living with mild-moderate dementia and family carers to self-manage their medicines, is warranted. The method of developing such an intervention needs to reflect this person-centred approach.</p><p><strong>Objective: </strong>To co-design a psychosocial intervention to support medicines self-management for community-based people living with mild-moderate dementia and family carers.</p><p><strong>Design: </strong>An Experience-Based-Co-Design (EBCD) approach was applied to develop the 'Enhancing medicines self-management in community-dwelling people living with dementia and family carers (MAGNET)' intervention. The EBCD method involves intervention design through service users identifying problems they face and co-designing solutions with service providers. A film about experiences of medicines self-management was shown to people with dementia, family carers, and professionals; followed by a priority setting workshop, six intervention co-design workshops and a celebration event. Feedback was collated. A complex psychosocial healthcare intervention was developed.</p><p><strong>Setting and stakeholders: </strong>Community-dwelling people living with dementia and family carers, dementia care professionals, an expert facilitator, members of the MAGNET patient public involvement (PPI) group and members of the MAGNET research team.</p><p><strong>Results: </strong>The resulting co-designed intervention focused on five key priority areas: 'how can living with dementia affect how you organise medicines', 'knowing my medicines', 'who can help', 'making it right for you' and 'planning for the future'. A guide, video and reminder postcard for the person, and training and an implementation guide for professionals were created, alongside a logic model. Stakeholders reported positive experiences in developing the intervention, including giving back to the community, and the opportunity learn from and gain support from others.</p><p><strong>Conclusion: </strong>The process of co-designing the intervention had an immediate important social impact. Further work is underway to feasibility test the intervention.</p><p><strong>Patient or public contribution: </strong>Patient public involvement members have had a key role in co-designing the intervention, participating in and co-leading workshops and reviewing iterations.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 5","pages":"e70760"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197975","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":"Working Together With Consumers to Develop Falls Prevention Education for Older People Receiving Homecare - a Community-Based Participatory Study.","authors":"Jacqueline Francis-Coad, Jo-Aine Hang, Vanessa Jessup, Sharmila Vaz, Elissa Burton, Cheng Yen Loo, Bethwyn Joy, Anne-Marie Hill","doi":"10.1111/hex.70948","DOIUrl":"10.1111/hex.70948","url":null,"abstract":"<p><strong>Introduction: </strong>Frail, older people receiving homecare services have a 50% higher rate of falls compared with age-matched peers. Falls prevention education can assist older people in understanding risks and preventing falls, but it needs to be relevant and appropriate for both consumers and context. Consumer experience and perspectives can shape decisions that improve programme relevance and health outcomes. This study aimed to revise a novel falls prevention education programme with older homecare clients (consumers) and staff (stakeholders) for implementation in the homecare setting.</p><p><strong>Methods: </strong>Mixed methods design using a community-based participatory approach. Consumer and stakeholder focus groups were undertaken using a co-design framework. Qualitative data were analysed using deductive content analysis and the revised resources were scored using the quantitative Patient Education Materials Assessment Tool.</p><p><strong>Results: </strong>Twelve consumers and eleven stakeholders (n = 23) participated in revising the education programme and valued the opportunity to engage in co-design. Consumers were aware of environmental risk factors and strategies to prevent falls but identified they lacked knowledge about why falls occurred and appreciated the clear and simple information presented in the programme. The education resources (message cards and video) were deemed sensible, important and very good motivational reminders but needed aesthetic and cultural revisions. The revised resources scored above > 87.3% for understandability and actionability, being synonymous with high-quality.</p><p><strong>Conclusion: </strong>Consumers and stakeholders greatly valued the co-design experience and contributed to the successful revision of a falls prevention education programme. The revised programme will be evaluated in a larger research trial aimed at preventing falls and enabling older homecare clients to remain safely at home.</p><p><strong>Patient or public contribution: </strong>The older consumers who participated in this study were recipients of homecare support services with lived experience of falls. They contributed to the revision and co-production of a novel falls prevention education programme that originated through consumer and community involvement. The research team includes a consumer investigator and co-author (BJ) who provided feedback and input at all stages of the research, including project design, data analysis and manuscript review.</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/PMC13700112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277156","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-Producing an Implementation Package for the Patient-Directed Management of Post-Discharge General Practice Care for Older Persons.","authors":"Rachel Ann Spencer, Naomi Klepacz, Annabelle Long, Jeremy Dale","doi":"10.1111/hex.70946","DOIUrl":"https://doi.org/10.1111/hex.70946","url":null,"abstract":"<p><strong>Background: </strong>Interdisciplinary working for the safety improvement of older patients' care after discharge is complex. As part of the General Practice Management After Transitions Events (GP-MATE) study, a consensus workshop was convened bringing together patients, carers, secondary and primary care clinicians to co-produce and prioritise recommendations for how a patient-directed post-discharge communication tool for older people should be implemented in the NHS.</p><p><strong>Methods: </strong>We conducted a day-long, face-to-face consensus workshop involving 21 participants: 10 patients, carers and public representatives; 5 secondary care frailty leaders and 6 general practice leaders. Using Nominal Group Technique, in small groups participants generated statements based on pre-identified key 'tensions' derived from the 4-year GP-MATE study. These were then combined and moderated by the wider group and rated for acceptability and feasibility using RAND/UCLA voting across two rounds; round 2 conducted online.</p><p><strong>Results: </strong>Participants produced 52 statements; 35 were considered acceptable and feasible. The highest‑ranked emphasised patient autonomy, clarity of purpose, and involvement of community‑based professionals (including District Nursing and Urgent Community Response teams) to reach frail or housebound patients. Complete digitisation was the only statement rated inappropriate. The importance of distinguishing GP-MATE from current ways of working was also prioritised.</p><p><strong>Conclusion: </strong>The workshop generated a set of co‑produced, theory‑informed recommendations to guide a definitive trial of GP‑MATE and support wider implementation of patient‑held communication tools in post‑discharge care. The study also demonstrated that RAND/UCLA can be successfully adapted for co‑production with mixed Public and Patient Involvement (PPI) and professional groups.</p><p><strong>Patient or public contribution: </strong>The GP-MATE study was centred on Experience-Based Co-Design as a method for participatory action research. We began with a patient experience film featuring patients from general practice in the West-Midlands. Our intervention was developed by three teams of older patients and carers of older persons and is reported in the US patient-focused journal Patient Education and Counselling. In the workshop described in this paper, patients and their carers were brought to power by working in parity of numbers with hospital professionals in smaller breakout groups. Our three breakout groups were planned to be co-facilitated by PPI-E contributors (but on the day, only one was well enough to undertake this role). We also included a local Healthwatch lead among our participants.</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/PMC13693403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149277216","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}