Frontiers in health services最新文献

{"title":"Assessing the influence of lived-experience experts on healthcare providers in a virtual community of practice: a qualitative study.","authors":"Stephanie Sargent Weaver, Monique Carry, Jeanne Bertolli, Job Godino, Bruce Struminger, Douglas Taren, John D Scott, Sydney P Sharp, Jane Samaniego, Donna R Bean, Anindita Issa, Jin-Mann S Lin, Elizabeth R Unger, Christian B Ramers","doi":"10.3389/frhs.2025.1562651","DOIUrl":"10.3389/frhs.2025.1562651","url":null,"abstract":"<p><p>Long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other poorly understood post-acute infection syndromes (PAIS) can present with unexplained symptoms or conditions that may be misunderstood by healthcare providers, causing delays in diagnosis and care. To address these issues, the Centers for Disease Control and Prevention (CDC) funded the Long COVID and Fatiguing Illness Recovery Program (LC&FIRP), initiated as a pilot project to assess whether providing tele-mentoring and other online education for primary care providers could help them improve the quality of life and support the recovery of their patients with these conditions. The LC&FIRP multi-disciplinary team-based care approach is built on the Extension for Community Healthcare Outcomes (ECHO) learning model, which is an evidence-based virtual learning framework developed by the University of New Mexico and designed to disseminate and implement best practices, especially in under-resourced areas. A distinctive feature of LC&FIRP was the inclusion of lived-experience experts. To explore the influence of lived-experience experts on the care patients received, we collected the educational recommendations provided by the lived-experience experts during webinar sessions (January 2022-March 2024) and grouped these by themes. The major themes that emerged included validation of patients' illness experience; attitudes and beliefs about Long COVID, ME/CFS, and PAIS; understanding patients' challenges and communicating with empathy; navigating referrals; recognizing and supporting disability; and supporting self-care. Investigators also interviewed patients of the Family Health Centers of San Diego (FHCSD) about their experiences receiving care from participating primary care providers and employed content analysis methods to code interview transcripts to identify themes among patients' perspectives. Positive comments from the patients about topics emphasized by the lived-experience experts provided evidence of providers' uptake and application of the experts' recommendations and support the value of involving lived-experience experts in medical education to improve health services.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1562651"},"PeriodicalIF":1.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"You do it for the patient\": a qualitative analysis of changes to primary care nurses' workplace demands and resources during the COVID-19 pandemic in Canada.","authors":"Sarah Spencer, Lindsay Hedden, Julia Lukewich, Emily Gard Marshall, Maria Mathews, Samina Idrees, Jennifer E Isenor, Ruth Martin-Misener, Leslie Meredith, Crystal Vaughan, Dana Ryan","doi":"10.3389/frhs.2025.1557654","DOIUrl":"10.3389/frhs.2025.1557654","url":null,"abstract":"<p><strong>Introduction: </strong>Primary care in Canada was an essential component of the COVID-19 pandemic response, as well as continued provision of routine care. Yet, primary care settings were inadequately supported during the pandemic, leaving clinicians feeling vulnerable and overwhelmed. Existing pandemic research has focused on the health workforce broadly or those working in acute care settings. Accordingly, we sought to understand the personal and professional experiences of nurses working in primary care settings in Canada during the COVID-19 pandemic to inform future pandemic responses and health workforce planning that account for primary care nurses' mental and physical needs.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with licensed and registered practical nurses, registered nurses, and nurse practitioners working in primary care in four Canadian provinces: British Columbia, Newfoundland and Labrador, Nova Scotia, and Ontario. Interviews were recorded, transcribed, and thematically analyzed.</p><p><strong>Results: </strong>We interviewed 76 primary care nurses about their pandemic experiences. Using the National Academy of Medicine's systems model of clinician burnout and professional wellbeing, we categorized participants' experiences according to their job demands and job resources. These data describe how COVID-19 altered primary care nurses' professional experiences across a variety of areas, often with implications for their wellbeing.</p><p><strong>Discussion: </strong>Prior to the pandemic, primary care nurses could rely on their job resources to protect against the demands they regularly encounter; however, many of these resources were negatively affected by the pandemic. Improved pandemic preparedness, including primary care-specific supports to promote physical and psychological safety, workflow efficiency, worker rest and recovery, and preservation of primary care capacity are needed to uphold primary care nurse wellbeing during a pandemic or other extended health emergencies.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1557654"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Community Health Worker academy: a novel healthcare and public health workforce development model.","authors":"Nate McCaughtry, Cheryl L Somers","doi":"10.3389/frhs.2025.1535804","DOIUrl":"10.3389/frhs.2025.1535804","url":null,"abstract":"<p><p>As the demand for an expanded Community Health Worker (CHW) workforce accelerates nationwide, the need for training, continuing education, professional development, and experiential field placements (internships and apprenticeships) with quality supervision has expanded dramatically. For example, the US state of Michigan recently received federal approval for the health education and social determinants of health services provided by CHWs to be eligible for Medicaid insurance reimbursement (governmental subsidized healthcare insurance), which has spurred tremendous demand for the CHW workforce by all types of employers. This paper describes a series of events and opportunities that led to the development of the Wayne State University Community Health Worker Academy (CHWA) in Detroit, Michigan, USA. Preliminary evidence suggests that the Academy's model and continuous process improvement strategies are successful. Implications of this model for other organizations involved in expanding and strengthening the CHW workforce development nationally and internationally are discussed, as are implications for career pathway opportunities for CHWs beyond their initial certification<b>.</b></p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1535804"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Medicaid accountable care on preventable emergency department and hospital admissions: rural-urban heterogeneity.","authors":"Jangho Yoon, Seungbeen Ghim, Jeff Luck","doi":"10.3389/frhs.2025.1475140","DOIUrl":"10.3389/frhs.2025.1475140","url":null,"abstract":"<p><strong>Background: </strong>Accountable care organizations provide a framework for collaboration among providers and payers to improve patients' health and care experiences while reducing costs. However, there is limited research on the realization of these benefits for low-income individuals across varying degrees of rurality. This study examined the heterogeneous impact of Coordinated Care Organizations (CCOs), an accountable care model implemented in Oregon Medicaid, on preventable emergency department (ED) and hospital admissions by rurality of residence.</p><p><strong>Methods: </strong>Using person-month panel data on 131,246 adults aged 18-64 continuously enrolled in Oregon Medicaid between 2011 and 2015, we employed a doubly-robust difference-in-differences approach to isolate the impacts of the CCO model on the number of ED visits and the probability of hospital admissions, separately for all-cause and preventable admissions.</p><p><strong>Results: </strong>The CCO model was associated with reductions of 25 all-cause ED visits and 22 preventable ED visits per 1,000 persons per month during the first three years. Significant decreases in all-cause and preventable ED visits were observed across different levels of rurality. However, the magnitude of these reductions decreased almost monotonically as rurality increased from urban to small/isolated rural areas. On average, the CCO model was associated with significant declines in preventable ED visits by 18, 9, and 5 visits per 1,000 persons per month among urban, large rural, and small/isolated rural residents, respectively. No statistically discernable relationship was found for hospital admissions.</p><p><strong>Conclusions: </strong>The CCO model led to significant overall reductions in preventable ED visits. However, this beneficial effect may diminish with increased rurality.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1475140"},"PeriodicalIF":1.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and strategies for maintaining nutrition services in the Democratic Republic of Congo during COVID-19: a qualitative study.","authors":"Marc Bosonkie, Benito Kazenza, Rawlance Ndejjo, Marie-Claire Muyer, Eric Mafuta, Ruphin Mbuyi, Branly Mbunga, Paul-Samsom Lusamba, Olufunmilayo I Fawole, Mala Ali Mapatano","doi":"10.3389/frhs.2025.1551131","DOIUrl":"10.3389/frhs.2025.1551131","url":null,"abstract":"<p><strong>Background: </strong>The rapid spread of COVID-19 forced governments to urgently implement non-pharmaceutical measures to stop the surge. These restrictions disrupted the provision of nutrition services. This study identified challenges faced by nutrition services using the six components of the health system and preventive strategies that can strengthen nutrition interventions during future outbreaks.</p><p><strong>Methods: </strong>A multiple-case qualitative study was carried out. Purposive sampling was used for recruitment of participants. 57 key informants were selected based on their role in the Nutrition sector at different levels of the health pyramid. The interview guide incorporated nutrition leadership, financing, workforce, infrastructure and commodities, service delivery and information system. Each topic had subtopics on challenges and adaptations. All transcripts were exported to Atlas Ti v22, and thematic analysis was conducted.</p><p><strong>Results: </strong>Initially excluded from the national COVID-19 response, nutrition services were later integrated through advocacy by the National Nutrition Program. Despite limited funding, the government maintained support, and health workers adapted with flexible staffing approaches. Commodity shortages, including Ready-to-Use Therapeutic Food, led to the use of locally produced substitutes. Movement restrictions and fear of infection disrupted essential services such as growth monitoring and immunization. To sustain access, mitigation strategies were implemented, including tailored education, modified weighing methods, and decentralized care. Key innovations included rapid registration with anthropometric protocols, additional service points for child health activities, double-weighing scales to reduce contact, crowd control during Growth Monitoring Promotion, community-based service delivery, and improved digital integration.</p><p><strong>Conclusions: </strong>COVID-19 disrupted all pillars of nutrition services in the DRC but also spurred innovation. Institutionalizing adaptive strategies, securing sustainable funding, and supporting local Ready-to-Use Therapeutic Food production are essential to strengthen resilience and ensure continuity of nutrition services in future health emergencies.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1551131"},"PeriodicalIF":1.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family-based substance use screening and intervention for adolescents with chronic medical conditions: a study protocol to implement SBIRT-family within school-based health centers.","authors":"Faith Summersett Williams, Natalie A Larez, Lauren Mondesir, Kennedy Curtis, Sara Valdivia, Sara Becker, Kenneth Papineau, Aaron Hogue","doi":"10.3389/frhs.2025.1469198","DOIUrl":"10.3389/frhs.2025.1469198","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with a chronic medical condition (CMC) have an increased risk of developing a substance use (SU) disorder, despite the impact that SU may have on disease-related outcomes. School-based health centers (SBHCs) offer universal screening, brief intervention, and referral for adolescents with chronic medical conditions for substance use treatment. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based early intervention used to detect and address risky substance use that has yet to be broadly adopted in public schools. Moreover, despite extensive research supporting caregiver involvement in treatment for adolescent substance use, SBIRT models that actively engage caregivers are lacking. The primary goal of this qualitative study is the identification of contextual determinants (e.g., barriers and facilitators) of SBHCs implementation potential and adaptation needs of a family-based SBIRT protocol for integration into SBHCs.</p><p><strong>Methods: </strong>We are conducting this study in two SBHCs within the Chicago Public School system. In these SBHCS we are conducting focus groups with school partners (∼ 30 SBHC staff,∼25 adolescents with chronic medical conditions, and∼25 caregivers). Focus groups will be audio recorded and conducted in English. The semi-structured focus group guides were designed based on the Health Equity Implementation Framework (HEIF) and the Consolidated Framework for Implementation Research (CFIR). We will develop a codebook based on emerging codes from the transcripts and constructs from HEIF and CFIR. Emerging themes will be summarized highlighting similarities and differences between and within the different groups and SBHCs. Descriptive statistics and chi-square tests of associations will be used to assess the distribution of responses on the assessments between the different sites.</p><p><strong>Discussion: </strong>This study will describe key implementation determinants and SBIRT-Family adaptation needs from the perspective of multiple end-users. Results will provide insights for a randomized pilot hybrid type 2 effectiveness implementation study of the adapted SBIRT-Family model in two SBHCs assessing effectiveness outcomes (SU and linkage to treatment) and implementation outcomes (reach, adoption, equity, and cost). This research protocol will provide formative data to inform the development of a highly scalable approach that can be used in SBHCs across the country to serve a vulnerable population of adolescents with chronic medical conditions.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1469198"},"PeriodicalIF":1.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to implementation of interventions to mitigate moral injury among nurses.","authors":"Cassandra M Godzik, Jennifer K DiBenedetto, Timothy J Usset, Heather Stiles, Heather Klein, Karen Fortuna, Renee Pepin, Hannah Wright, Amy Locke, Helen Thomason, Andrew J Smith","doi":"10.3389/frhs.2025.1582700","DOIUrl":"10.3389/frhs.2025.1582700","url":null,"abstract":"<p><strong>Background: </strong>In the post-pandemic recovery era, addressing moral injury is critical due to high prevalence and impact on mental and occupational health. Interventions that address moral injury in hospital settings are limited. Further, engaging HCWs in any mental health interventions has proven challenging for a variety of reasons and exacerbated by factors such as a rural setting. Implementation science aimed at understanding barriers and facilitators to interventions is needed in order to build and offer interventions that are usable, feasible, acceptable, and effective. The current study aimed to understand such barriers and facilitators to building moral injury interventions for nurses on the medical intensive care unit (MICU).</p><p><strong>Methods: </strong>We conducted semi-structured qualitative interviews using the Consolidated Framework for Implementation Science Research (CFIR) and Peer and Academic Model of Community Engagement with 25 participants in a rural hospital system, 19 nurses currently working in the MICU and six nurses who left their MICU employment. Interviews were transcribed and analyzed using a thematic analysis approach.</p><p><strong>Results: </strong>There were five CFIR domains and 14 associated CFIR constructs that impacted intervention implementation in this population. Barriers included resource costs, skepticism regarding the effectiveness of new resources, lack of support from leaders, concerns that emotions affect professional image, inability to take breaks, and a disconnect between nurses' lived experiences and community perceptions. Facilitators included interventions specifically tailored for the MICU, strengths in teaming and social support among fellow nurses, and a desire for change because of factors such as a high turnover rate. Participants also highlighted a strong motivation to provide the best care possible and a desire to build resilience by supporting each other.</p><p><strong>Conclusion: </strong>Analysis of barriers and facilitators suggests value in improving the opportunities for HCWs to process morally injurious experiences with interventions specific to a particular unit and resources such as peer support and chaplains. There is a demonstrated need for high-level organizational change to address the dynamic needs of our nurses.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1582700"},"PeriodicalIF":1.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error disclosure: what residents say and what patients find effective.","authors":"Emily Grossniklaus, Angelo D'Addario, Ann King, Thomas H Gallagher, Kathleen Mazor, Andrew A White","doi":"10.3389/frhs.2025.1577092","DOIUrl":"10.3389/frhs.2025.1577092","url":null,"abstract":"<p><strong>Background: </strong>Medical error disclosure to patients is a critical skill that is often not taught effectively in medical training. The Video-based Communication Assessment (VCA) software enables trainees to receive feedback on their error disclosure communication skills. The VCA method also allows examination of the specific types of error disclosure responses that patients value most.</p><p><strong>Objective: </strong>The primary aim of this study was to describe the language medical residents use to disclose a hypothetical harmful medical error, and to determine the language associated with higher ratings by crowdsourced laypeople. A secondary aim of this study was to examine the alignment between error disclosure content recommended by experts and the communication behaviors that contribute to higher layperson ratings of disclosure.</p><p><strong>Methods: </strong>102 resident physician responses to a case depicting a delayed diagnosis of breast cancer and their crowdsourced ratings were analyzed using thematic content analysis. We assessed the presence of specific themes in response to three sequential video prompts within a clinical case. Linear regressions were then performed for each prompt's response to examine the extent to which each theme predicted overall communication scores from layperson raters.</p><p><strong>Results: </strong>Nearly all (<i>N</i> = 92, 90.2%) residents provided responses which included either a general apology or a specific apology in at least one of the three prompt's responses, and nearly all (<i>N</i> = 98, 96.1%) residents provided at least one response expressing a component of empathy. However, only 57.8% of residents openly acknowledged that the care was delayed, and 67.8% expressed a plan to prevent future errors. A few residents used rationalization (5.9%) or minimization (4.9%) behaviors; responses with these behaviors were associated with negative beta-coefficients, although this finding did not reach statistical significance. In a linear regression analysis, the strongest positive associations between resident responses and patient ratings were clustered around expressions of accountability (0.48), personal regret (0.47), apology (0.34), and intentions to prevent future mistakes (0.34).</p><p><strong>Conclusion: </strong>Resident physicians vary in which communication elements and themes they include during error disclosure, missing opportunities to meet patient expectations. While infrequent, some residents employed minimization or rationalization in their responses. Utilizing an assessment and feedback system that encourages responders to include themes layperson raters value most and to omit harmful expressions could be an important feature for future software for error disclosure communication training.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1577092"},"PeriodicalIF":1.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the delivery of integrated physical health care for adults experiencing serious mental illness: a scoping review of interventions in mental health settings.","authors":"Munazzah Ambreen, Sihan Zhang, Osnat C Melamed, Christopher Canning, Brian Lo, Sri Mahavir Agarwal, Amer M Burhan, M Elisabeth Del Giudice, Mary Rose van Kesteren, Barna Konkolÿ Thege, Sanjeev Sockalingam, Terri Rodak, Tania Tajirian, Caroline Walker, Vicky Stergiopoulos","doi":"10.3389/frhs.2025.1570100","DOIUrl":"10.3389/frhs.2025.1570100","url":null,"abstract":"<p><p>Individuals living with serious mental illness (SMI) face significant barriers to accessing appropriate physical health care, poorer associated health outcomes and premature mortality compared to the general population. This scoping review examines service delivery models and clinical practices supporting the integration of physical health care for adults with SMI within mental health settings, and their outcomes. Searches of four academic databases yielded 65 academic articles. Most integrated service delivery models were implemented in community mental health settings in the United States and incorporated elements of Wagner's Chronic Care Model, emphasizing delivery-system redesign, patient self-management support and use of clinical information systems. In most outcome studies, integrated care models were associated with improvements in primary care access and preventative screening rates, while other physical health indicators and emergency and inpatient service use demonstrated promising but mixed results. Implementation challenges of integrated service delivery models included securing financial resources and maintaining effective use of clinical information systems, among others. Successful implementation was facilitated by effective teamwork, care coordination, and administrative and leadership support. Study findings highlight the complexity of integrating physical health care in mental health settings, and the longer timeframes needed to observe changes in some outcomes. The review further underscores the need for ongoing efforts to advance integrated care delivery in mental health settings and the importance of longitudinal data collection to fully assess and optimize the implementation and outcomes of these interventions. <b>Systematic Review Registration:</b> https://doi.org/10.17605/OSF.IO/3T9VK.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1570100"},"PeriodicalIF":1.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using content validity index methodology for cross-cultural translation of a patient-reported outcome measure for head and neck cancer.","authors":"Janet H Van Cleave, Alizendie Guerra, Eva Liang, Carolina Gutiérrez, Ron J Karni, Marcely Tsikis, Geanise Pearl C Nguyen, Allison P Squires","doi":"10.3389/frhs.2025.1582127","DOIUrl":"10.3389/frhs.2025.1582127","url":null,"abstract":"<p><strong>Introduction: </strong>Translations of patient-reported measures may not account for structural and cultural differences in shared languages spoken in multiple countries, such as English, Spanish, Arabic, or Russian. The objective of this research was to create a cross-cultural Spanish translation of the New York University (NYU) Electronic Patient Visit Assessment (ePVA)^© for head and neck cancer (HNC), a patient-reported symptom measure available only in English.</p><p><strong>Methods: </strong>Using the Content Validity Index (CVI) methodology, an expert panel of nurses (<i>n</i> = 6) proficient in Spanish and English independently reviewed and rated a forward translation of the ePVA, a measure consisting of 21 categories of symptoms common to HNC. The panel rated the cultural relevance (1 = not relevant, 2 = somewhat relevant, 3 = very relevant, 4 = highly relevant) and translation equivalence (1 = yes or 0 = no) of each ePVA item. The CVI cultural relevance and translation equivalence scores for each item (item CVI) were calculated as the proportion of experts agreeing that the item was very relevant or highly relevant and the translation was equivalent. The scale CVI score was an average of the item CVI scores; the minimum accepted scale CVI score was .80. Items with CVI scores <0.59 were labeled as problematic items and evaluated through cognitive interviews with native Spanish-speaking patients (<i>N</i> = 4) diagnosed with HNC.</p><p><strong>Results: </strong>The translation was acceptable in cultural relevance (average CVI score = 0.95) and equivalence (average CVI score = 0.84). Cognitive interviews revealed 9 problematic items that differed in words and meaning, primarily addressing pain and swallowing symptoms. These items were refined and included in the final translation of the Spanish ePVA.</p><p><strong>Conclusion: </strong>These study findings underscore the need for survey instrument translations that account for variations in shared languages spoken across countries.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1582127"},"PeriodicalIF":1.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}