Health Expectations最新文献

{"title":"‘The Second Arrow’: A Collaborative Autoethnographic Exploration of What Can Be Learned From One Long COVID Journey","authors":"Sarahjane Belton, Kate Sheridan","doi":"10.1111/hex.70227","DOIUrl":"https://doi.org/10.1111/hex.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Long COVID is a complex multisystem illness with multiple relapsing-remitting symptoms, which can vary in severity and impact people's daily lives. This study utilises the first author's experience of falling ill with and recovering from long COVID to investigate the lived experience of the illness. Learnings that could positively influence how people with long COVID, and health professionals, approach rehabilitation and recovery from the illness going forward are identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Employing collaborative autoethnography, the first author investigated her personal experience of falling ill with, and rehabilitating from, long COVID, while soliciting input of the second author (an athletic therapist and physiotherapist, and researcher with expertise in chronic pain) for the purpose of analysis and interpretation. Reflexive thematic analysis was employed across a number of data sources available to the first author, including journal entries, text messages, emails, and pharmacy receipts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes were generated from the data, supported by a number of subthemes: (i) Psychosocial impact of long COVID, (ii) Invalidated, (iii) Validated, and (iv) Power and Ownership. The negative impact of a siloed and reductionist approach to care for long COVID is evident in the findings of this study. In addition, the need for healthcare environments that enhance autonomy and empowerment, and that implement patient-centred care, where the person living with chronic illness is supported to engage in management strategies that meet their needs, is underlined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the detrimental cost, both personally and financially, of the ongoing use of the biomedical model of care in the treatment of long COVID. Findings support the need for an interdisciplinary approach to care that considers the whole person and adopts a biopsychosocial approach to care. Furthermore, the need for healthcare professionals to actively listen to, respect, validate and support the person living with long COVID on their individualised recovery journey is evident.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The first author was a long COVID patient, the context and extent of this is explained within the paper. As such, this paper is developed and written primarily from the perspective o","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70227","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861941","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 Coproduced Youth Priorities Project: Australian Youth Priorities for Mental Health and Substance Use Prevention Research","authors":"Kate Ross,&nbsp;Jessica Houston,&nbsp;Emma Barrett,&nbsp;Felicity Duong,&nbsp;Tanya Dearle,&nbsp;Smrithi Ravindra,&nbsp;Cheryl Ou,&nbsp;Kirsty Rowlinson,&nbsp;Marlee Bower,&nbsp;Louise Birrell,&nbsp;Katrina Prior,&nbsp;Lucinda Grummitt,&nbsp;Chloe Conroy,&nbsp;Anna Grager,&nbsp;Maree Teesson,&nbsp;Catherine Chapman","doi":"10.1111/hex.70274","DOIUrl":"https://doi.org/10.1111/hex.70274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>New approaches to mental health and substance use prevention, that bridge research and diagnostic silos are urgently needed to address rising trends in mental illness amongst young people. Engaging diverse stakeholders, including young people, in setting research priorities could aid the development of innovative responses, enhance research and improve translation. While previous activities have identified priorities for Australian mental health and substance use prevention research, none have centred young people as a primary stakeholder. The current study is a critical next step to understand youth perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This Youth Priorities Project was coproduced with members of The Matilda Centre and PREMISE NHMRC Centre of Research Excellence Youth Advisory Board. The project involved three iterative stages: (1) an online survey; (2) consultations via focus groups and (3) a final consensus workshop to summarise key recommendations for principles, priorities and actions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A diverse group of young people aged 16–25 were recruited for Stage 1 (<i>n</i> = 653), Stage 2 (<i>n</i> = 7) and Stage 3 (<i>n</i> = 3). Youth participants emphasised the need for increased investment in prevention research targeting a broad range of social determinants and health behaviours and their intersecting effects on youth mental ill health. There were strong calls to government to address economic drivers of mental health, to increase timely access to subsidised mental health support, and to better equip schools to support student wellbeing and mental health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Young people had valuable and unique insights on how research and policy responses regarding youth mental health and substance use could be improved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Public Contribution</h3>\u0000 \u0000 <p>A coproduction Research Team (CPRT) was established, including two youth researchers who guided all stages of the research from conceptualisation, ethics approval, survey and study design, analysis and write-up. A Youth Advisory Board was also consulted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861940","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":"‘I Have Never Been in That Kind of All-Consuming Pain … I Did Not Know What Else to Do’: The Journey to Hospital Admission With Low Back Pain From the Perspectives of Patients","authors":"Joseph F. Orlando,&nbsp;Matthew Beard,&nbsp;Anne L. J. Burke,&nbsp;Michelle Guerin,&nbsp;Saravana Kumar","doi":"10.1111/hex.70269","DOIUrl":"https://doi.org/10.1111/hex.70269","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;There is a need to better understand patient factors contributing to low back pain (LBP)-related hospitalisations to improve health service delivery and reduce avoidable admissions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study explored the experiences of people with LBP leading up to and resulting in hospital admission.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Qualitative descriptive methodology using semi-structured interviews.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients admitted with non-specific LBP at a large Australian tertiary public hospital meeting specific inclusion and exclusion criteria were pragmatically identified and recruited, and they consented to participate. Interviews were audio-recorded, and thematic analysis generated codes and themes from the data.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Sixteen patients consented to participate. The cohort had an average age of 52 years (SD = 17) and had an average hospital length of stay of 13 days (SD = 10.8, range = 2–31). Two themes were identified. The first related to the impact of LBP on patients' lives, with sub-themes including difficulty coping with pain, difficulty managing daily activities and escalating distress. The second theme related to unmet treatment needs, with sub-themes including ineffectiveness of past treatments, inability to access timely and affordable community healthcare, and expectations for emergency care.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients impacted by severe LBP regarded hospitals as a last resort for management of pain when community healthcare was perceived to be ineffective or inaccessible. This study highlights the practice gaps before hospitalisation for LBP from the perspectives of patients and the need to improve the delivery and access of healthcare for this condition.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study sought insights from patients with low back pain (LBP) who were admitted to hospital with LBP. The findings will inform stakeholders, including consumers, on the co-design of an optimal system of care to improve the delivery and access of health services for LBP. All patients were offered the oppor","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 3","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865616","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":"Communication Processes Related to Decision-Making in Medication Management Between Healthcare Providers, Older People and Their Carers: A Systematic Review","authors":"Deana M. Copley,&nbsp;Elizabeth Manias,&nbsp;Vanessa Watkins,&nbsp;Alison M. Hutchinson","doi":"10.1111/hex.70252","DOIUrl":"https://doi.org/10.1111/hex.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine decision-making between healthcare providers (HCPs), older people and their carers in relation to medication management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four databases were systematically searched up to June 2023. Two authors screened the search results. Extracted quantitative data were analysed descriptively, and qualitative data were analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-three papers reporting on 49 studies were included. A variety of research methods were utilised. Few authors provided a definition of shared decision-making (SDM). Three major themes were identified: provider-driven decision-making, patient-driven decision-making and a shared role in decision-making. Some older people preferred or deferred to provider-driven decision-making, mainly due to trust in the HCP's expertise. Other reasons for provider-driven decision-making were patient anxiety, declining health, lack of medical knowledge or poor communication during the clinical encounter. Evidence of patient-driven decision-making was often prompted by concerns about the adverse effects of medication. Most older people preferred or adopted a shared role in decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Whilst most patients and carers preferred to engage in SDM related to medication management, at times, they felt unable to do so, deferring to provider-driven decision-making. There is a need for a standardised definition and measurement of SDM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>This systematic review did not directly involve older people or carers of older people in the design or conduct of the review. However, the findings will inform a qualitative study aimed at exploring older people and their carers' experiences of medication-related decision-making in collaboration with their healthcare provider.</p>\u0000 \u0000 <p><b>Trial Registration:</b> CRD42019124862.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852905","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 an Ecosystem of Services to Support Veteran Well-Being and Reduce Excessive Alcohol Consumption","authors":"Julia Carins,&nbsp;Ann-Marie Kennedy,&nbsp;Ekant Veer","doi":"10.1111/hex.70262","DOIUrl":"https://doi.org/10.1111/hex.70262","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Alcohol consumption among veterans has been shown to be higher than that among the general population. Many veterans experience difficulties during the transition to post-service life, and alcohol is used as a coping mechanism. Excessive alcohol use leads to a significant decrease in mental health, quality of life and social functioning, further exacerbating veteran's readjustment to civilian life after service.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aimed to co-design a transition programme to reduce problematic alcohol use. The objectives were to (1) understand which life domains need to be considered within programmes to support successful transition without harmful alcohol consumption and (2) co-design a transition programme with New Zealand veterans (and service providers) to avoid harmful alcohol consumption.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study offers a novel approach to the development of programmes to reduce excessive alcohol consumption by veterans through the use of a participatory design method. The study involved four co-design workshops with veterans and Defence health professionals, in Aotearoa-New Zealand, and abductive analysis of qualitative data. The analysis compared perspectives obtained from veterans and health professionals with existing well-being and transition frameworks.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Findings supported recommendations within those frameworks for strategies to support mental, physical, social/family and spiritual well-being, as well as finding meaningful work or employment. Themes emerged beyond those frameworks, including a need for programmes to manage loss of identity; lack of trust, scepticism and stigma; and a desire for connected records and networked services.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The research offers practical recommendations for a co-designed veteran well-being ecosystem. This involved early prevention, in-service elements and ongoing support through transition and in post-service life. This was supported with the suggestion for a network of services that is promoted well and makes it easy for veterans to identify services that can increase their feeling of competence as they navigate transition.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study u","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840523","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":"Determinants and Experiences of Care-Seeking for Childhood Pneumonia in a Rural Indian Setting: A Mixed-Methods Study","authors":"Barsha Gadapani Pathak,&nbsp;Sarmila Mazumder,&nbsp;Yasir Bin Nisar,&nbsp;Aditya Bhatt,&nbsp;Mandeep Singh,&nbsp;Tarun Madhur,&nbsp;Ingvild Fossgard Sandøy","doi":"10.1111/hex.70263","DOIUrl":"https://doi.org/10.1111/hex.70263","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Pneumonia is a leading cause of under-five mortality, with 30 million annual cases in India. Despite national guidelines, significant barriers to timely and appropriate care-seeking persist. Caregivers often face financial constraints, lack of awareness, mistrust in government facilities and a preference for non-registered medical practitioners (non-RMPs), delaying effective treatment. This study explores care-seeking behaviours, associated socio-demographic factors and barriers to access to appropriate healthcare for childhood pneumonia in rural India.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study is part of a broader implementation research (IR) initiative and represents its formative phase. This mixed-methods study was conducted in Palwal district, Haryana, covering 42 villages (population: 107,440). A cross-sectional survey identified suspected pneumonia cases among 9593 under-five children through house-to-house visits using a structured checklist. Data on socio-demographic characteristics, health insurance, care-seeking patterns and provider preferences were collected. Directed acyclic graphs (DAGs) identified potential confounders in the association between care-seeking behaviour and key exposure variables. Additionally, qualitative in-depth interviews explored caregivers' perceptions, decision-making and healthcare barriers to pneumonia management. Quantitative data were analysed using logistic regression, while qualitative data were thematically analysed using the Three Delays Model. Suspected under-five pneumonia cases' caregivers and families were actively engaged in this formative phase to inform Phase II implementation strategies of broader IR, ensuring community-driven and contextually relevant strategies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 231 suspected pneumonia cases, 97% of caregivers sought medical care, but 71% consulted non-RMPs, and only 3.6% visited government facilities. Seeking appropriate care was associated with higher maternal education (AOR 6.5, 95% CI: 2.7–9.7) and higher wealth index (AOR 1.7, 95% CI: 1.0–2.6). Thematic analysis revealed delays due to symptom misinterpretation, reliance on home remedies, financial constraints, gender biases, mistrust in public healthcare services and logistical barriers.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Despite high care-seeking rates, provider preferences, socio-cultural factors and systemic barriers delay appropriate pneumonia treatment. Addressing these challenges requires improving awareness, enh","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840781","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":"Widening Patient Engagement for Rare Disease Drug Trials: The Perspectives of Patients With Idiopathic Pulmonary Fibrosis on Participating in Clinical Drug Trials and Drug Trial Design","authors":"Julia Frost,&nbsp;Widening Engagement Patient Advisory Group,&nbsp;Jessica Mandizha,&nbsp;Steve Jones,&nbsp;Chantal van den Dungen,&nbsp;Lauren Asare,&nbsp;Catherine Pope","doi":"10.1111/hex.70260","DOIUrl":"https://doi.org/10.1111/hex.70260","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Research about patient engagement for people with rare diseases has identified how the experiences of some members of the public are overlooked in relation to clinical trial design and trial participation. As part of a knowledge transfer partnership (KTP), the authors were granted access to patient insight reports about the needs of people with idiopathic pulmonary fibrosis (IPF), to inform clinical trial design and marketing strategy. These were contrasted with data from qualitative interviews, informed by and collected from people with IPF and the clinical staff who recruit them to trials.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To identify patient and professional perspectives for IPF drug trials to create opportunities for innovation in patient engagement.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ethnography. Qualitative researcher embedded in a pharmaceutical organisation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;International patient insight reports to inform a clinical trial protocol (&lt;i&gt;n&lt;/i&gt; = 1) and marketing strategy (&lt;i&gt;n&lt;/i&gt; = 6), including the experiences of over 100 patients with IPF. In the United Kingdom, interviews with patients with IPF (&lt;i&gt;n&lt;/i&gt; = 32) and the staff who support them clinically and recruit them to trials of new medicines (&lt;i&gt;n&lt;/i&gt; = 19) at one specialist interstitial lung disease (ILD) centre.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Methodological practices inherent in inpatient insight reports ensured the perspectives of some people with IPF were overlooked. Interviews with a more marginalised population of people with IPF, and the staff who support them, identified that some found trial information confusing, trial practices frustrating and the opportunities to engage in trial design absent.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Current pharmaceutical practices of working with contract research organisations and patient organisations exclude the perspectives of patients with IPF who do not engage with either. Trial recruitment information needs to be tailored to the needs of individuals, and trial processes need to enable a wider group of patients to participate.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;People wit","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836237","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":"Barriers and Facilitators of NHS Health Checks in Socioeconomically Deprived Communities in the North East of England: A Qualitative Study With Peer Researchers","authors":"Judith Eberhardt,&nbsp;Laura Kane,&nbsp;Robert Portman,&nbsp;Jonathan Ling,&nbsp;Tracy Goddard,&nbsp;Mark Johnston,&nbsp;Claire Robinson,&nbsp;Abigail Reay,&nbsp;Andrew Divers,&nbsp;Dorothy Newbury-Birch","doi":"10.1111/hex.70199","DOIUrl":"https://doi.org/10.1111/hex.70199","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Preventive health services, such as the NHS Health Check programme, aim to identify and address key health risks, yet participation is particularly low in socioeconomically deprived areas, such as the North East of England. Understanding barriers and facilitators to engagement is critical to improving access and outcomes for these communities. This study aimed to explore barriers and facilitators to NHS Health Check attendance in these underserved communities using a participatory research approach.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study employed a qualitative design with a participatory approach, involving peer researchers from the target communities. Two peer research associates (PRAs) from socioeconomically deprived areas were trained to conduct semi-structured online or telephone interviews with 12 community members eligible for NHS Health Checks. Additionally, 5 stakeholders involved in the programme's delivery were interviewed. Thematic analysis was conducted in collaboration with the PRAs to ensure community perspectives were authentically captured.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Barriers to participation included limited awareness, cultural perceptions of self-reliance, fear of health-related discoveries, mistrust of healthcare systems and logistical challenges exacerbated by structural inequalities. Participants emphasised the need for culturally tailored communication and flexible, accessible health checks. Stakeholders highlighted the role of collaboration, targeted outreach and digital tools in addressing these barriers.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study highlights key barriers to NHS Health Check uptake in socioeconomically deprived communities in the North East of England. Improving communication, increasing accessibility through community-based services and building trust in healthcare are recommended key strategies to enhance participation and reduce health inequalities in these regions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribution&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Peer researchers, individuals with lived experience of being from socioeconomically deprived communities in North East England and eligible for NHS Health Checks, were involved in the design and conduct of this study. They were trained to conduct interviews with community members and contributed to the thematic analysis, ensuring that public perspectives were integral to the interpre","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143836238","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 Intersection of Gender, Culture and Society for Caregivers of Older Adults Ageing in Place in Ontario, Canada","authors":"Danielle Jacobson,&nbsp;Tashani Parker,&nbsp;Lauren Cadel,&nbsp;Elizabeth Mansfield,&nbsp;Kerry Kuluski","doi":"10.1111/hex.70259","DOIUrl":"https://doi.org/10.1111/hex.70259","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;It is reported that women are more likely to be caregivers than men, experience a higher burden of care and increased emotional health sequelae as a result. Social location (a person's gender, culture, ethnicity, etc.) is known to influence caregiving experiences. However, there is limited work that draws attention to how cultural and linguistic diversity shapes the experiences and expectations of informal caregivers.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The authors aimed to study how to reallocate health and social service resources to better support older adults ageing in place. However, some participants felt strongly about the role of gender. This report addresses the gap for better understanding (1) how gender influences informal caregiving for older adults ageing at home in Ontario, Canada, and (2) how culture may influence gendered caregiving expectations for this population.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A critical social justice paradigm and balance of care framework guided the research. Focus groups (15) and one-one-one interviews (7) were carried out. A collaborative approach to codebook thematic analysis was conducted.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study was carried out in Peel, a diverse region in Ontario, Canada. 42 individuals participated in the study (14 older adults, 10 caregivers and 18 healthcare providers).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Four themes were found regarding the role of gender in caregiving: (1) women caregivers as catalysts for ageing in place, (2) gender norms, generational standards and the societal expectation for women to be caregivers, (3) the intersection of culture and gender on caregiving for older adults and (4) health service workforce as women-dominant and linguistically diverse.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion and Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Service needs not currently met by Canada's healthcare system often become absorbed by women caregivers who facilitate ageing in place. Further research is required to better understand: (1) how a larger breadth of communities experience the intersection of gender and culture in the care of older adults in Ontario, Canada, and (2) how to better harness the diversity within Canada's homecare workforce to allow for cultural, linguistic and/or gender ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70259","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143826970","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":"What Are the Experiences, Views and Perceptions of Patients, Carers and Clinicians of Glucagon-like Peptide-1 Receptor Agonists (GLP-1 RAs)? A Scoping Review","authors":"Sam Febrey,&nbsp;Michael Nunns,&nbsp;Jill Buckland,&nbsp;Rebecca Abbott,&nbsp;Alison Bethel,&nbsp;Rebecca Whear,&nbsp;Kate Boddy,&nbsp;G. J. Melendez-Torres,&nbsp;Jo Thompson Coon,&nbsp;Liz Shaw","doi":"10.1111/hex.70251","DOIUrl":"https://doi.org/10.1111/hex.70251","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a pharmacological treatment option for both diabetes and weight loss. Qualitative evidence is vital in providing greater understanding of patients, practitioners and carers experience of taking or delivering GLP-1 RAs. This evidence can inform the current or future configuration and delivery of services. We conducted a scoping review to better understand the quantity, nature and key characteristics of qualitative primary evidence which explores the experiences, views and perceptions of patients, carers and clinicians regarding the use of GLP-1 RAs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Four bibliographic databases were searched on 10 July 2024: MEDLINE, APA PsycInfo via Ovid, CINAHL Ultimate via EBSCOhost, ProQuest Dissertations and Theses Global via ProQuest. We also searched Google Scholar, two clinical trials registries, the pre-print server medRxiv and conducted citation searches. We sought qualitative research about the experiences of patients, carers and practitioners about any aspect of taking or prescribing GLP-1RAs, for any indication. Study selection and data extraction were performed by two independent reviewers. The included studies were collated, and their characteristics were described.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;After de-duplication 1545 titles and abstracts were screened for relevance, with 77 full-text articles assessed for eligibility, resulting in 25 included studies. More studies were focused on type 2 diabetes (&lt;i&gt;n&lt;/i&gt; = 12) than weight loss (&lt;i&gt;n&lt;/i&gt; = 9) or any indication (&lt;i&gt;n&lt;/i&gt; = 4). The experiences of carers were not represented. No one area of experience (e.g. different indications or viewpoints) was well represented, either due to the absence or narrow focus of studies or lack of an in-depth analytical approach.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Whilst primary qualitative evidence exploring patient and clinician experience of GLP-1 RAs was identified in this scoping review, the findings highlight a need for more robust qualitative research to be conducted across all user groups, in particular involving carers, and especially for the indication of weight loss within service settings. This evidence gap needs to be urgently addressed to ensure GLP-1 RAs are appropriately prescribed and patients and carers receive support from services suited to their needs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Patient or Public Contribut","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143827079","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}