Frontiers in health services最新文献

{"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}

{"title":"Challenges and strategies in building a foundational digital health data integration ecosystem: a systematic review and thematic synthesis.","authors":"Radha Ambalavanan, R Sterling Snead, Julia Marczika, Gideon Towett, Alex Malioukis, Mercy Mbogori-Kairichi","doi":"10.3389/frhs.2025.1600689","DOIUrl":"10.3389/frhs.2025.1600689","url":null,"abstract":"<p><strong>Background: </strong>Chronic conditions require robust healthcare data integration to support personalized care, real-time decision-making, and secure information exchange. However, fragmented data ecosystems disrupt interoperability, complicate patient-centered care (PCC), and present challenges for incorporating genomic data into clinical workflows.</p><p><strong>Objective: </strong>This systematic review with thematic synthesis aims to identify key challenges and synthesize existing strategies from the literature to inform the development of a foundational digital health data integration ecosystem.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we systematically screened literature across multiple databases. A thematic synthesis approach was used to categorize findings into three primary themes: interoperability, PCC, and genomic data integration.</p><p><strong>Results: </strong>A total of 161 studies were included. Key challenges identified include semantic misalignment across commonly used healthcare standards such as HL7 FHIR and SNOMED CT, limited cross-system data exchange, inadequate patient engagement features in EHRs, and concerns regarding the security and clinical utility of genomic data. Strategies described across the literature include ontology-based interoperability models, AI-supported PCC frameworks, and blockchain-enabled genomic data governance.</p><p><strong>Conclusion: </strong>By analyzing current methodologies, research gaps, and implementation challenges, this review offers an evidence-based foundation to guide future advancements in healthcare data integration. It supports the development of scalable, privacy-preserving, and ethically governed data-sharing infrastructures that enable personalized medicine and real-time clinical interventions.</p><p><strong>Systematic review registration: </strong>https://osf.io/c2xvw.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1600689"},"PeriodicalIF":1.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577131","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":"Exploring barriers and drivers to a modified WHO safe childbirth checklist implementation in three West African countries: a qualitative study using the updated consolidated framework for implementation research.","authors":"Kadidiatou Raïssa Kourouma, Wambi Maurice Evariste Yaméogo, Daouda Doukouré, Alpha Oumar Sall, Marie Laurette Agbré Yacé, Tiéba Millogo, Mamadou Diouldé Baldé, Issaka Tiembré, Alexandre Delamou, Séni Kouanda","doi":"10.3389/frhs.2025.1593083","DOIUrl":"10.3389/frhs.2025.1593083","url":null,"abstract":"<p><strong>Introduction: </strong>Sub-Saharan Africa faces the highest maternal and newborn mortality and morbidity rates globally. The World Health Organization Safe Childbirth Checklist (WHO SCC) was developed to address this issue by promoting evidence-based practices during childbirth. This study explored the barriers and drivers to implementing a modified WHO SCC (mSCC) in Burkina Faso, Cote d'Ivoire, and Guinea.</p><p><strong>Methods: </strong>A qualitative multiple case study design was conducted from May to June 2023, involving individual interviews with diverse stakeholders (<i>n</i> = 110) across four regional hospitals in each country. The mSCC was implemented in these hospitals along with training and coaching. Data was analyzed using thematic analysis, guided by the updated CFIR framework. Nvivo 14 was used for coding.</p><p><strong>Results: </strong>The study identified 17 drivers and 7 barriers. Key drivers included the mSCC's clarity, simplicity and alignment with national guidelines, training, coaching, and stakeholders' engagement. in these 3 countries. Barriers were mainly related to resource constraints (medicines, supplies, staffing, and space), increased workload, and lack of incentives. Specific barriers for Burkina Faso and Cote d'Ivoire were the lack of incentives and the positioning of the Kakemono in confined space only in Cote d'Ivoire. Despite these challenges, the mSCC was generally well-received, with strong support from leadership and implementation facilitators contributing to its integration into routine care.</p><p><strong>Conclusion: </strong>This study highlighted the importance of addressing resource limitations, optimizing workload, and providing incentives to ensure successful mSCC implementation. Findings underscored the need for context-specific strategies and strong leadership support when introducing similar interventions in resource-constrained settings.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1593083"},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562244","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":"Pilot implementation projects in low- and middle-income countries to guide surgical quality improvement using best practice recommendations.","authors":"Lye-Yeng Wong, Saad Hussain, Michael Labib, Richard Henker, Chizoba Efobi, Ndubuisi Mokogwu, Jeremiah Agbons Igunma, Seye Mesfine Minas, Tsegazeab Laeke, Mark Ferguson, Cheng Har Yip, Andrew Hill, Jaymie Henry","doi":"10.3389/frhs.2025.1423429","DOIUrl":"10.3389/frhs.2025.1423429","url":null,"abstract":"<p><strong>Background: </strong>Adherence to Best Practice Recommendations (BPRs) has been shown to improve morbidity and mortality in surgical healthcare delivery in low and middle-income countries (LMICs).</p><p><strong>Methodology: </strong>Three LMIC healthcare centres in Laos, Nigeria, and Ethiopia were chosen to participate in the implementation pilots through existing cross-collaborative partnerships. Local teams were assembled to conduct needs assessment analyses prior to implementation study design. The projects are ongoing, and preliminary results are presented using descriptive analysis.</p><p><strong>Results: </strong>The BPRs chosen for each site were: hand hygiene in Lao PDR, antimicrobial stewardship in Nigeria, and trauma in Ethiopia. The World Health Organization (WHO) hand hygiene observation tool was used to determine baseline hand hygiene compliance in a children's hospital in Lao People Democratic Republic (PDR), revealing that 56.1% of hand hygiene opportunities were missed. A gap analysis was conducted in an academic Nigerian hospital to investigate antibiotic use in surgical patients, which found that 81.2% of antibiotic use was for prophylactic vs. empiric indications. Lastly, the emergency medical technician national curriculum as set by the Ethiopian Ministry of Health was reviewed by local experts and a 15-module supplemental curriculum was developed to include additional topics such as managing large-scale events, transport of emergency patients, advanced life support, and establishing quality standards.</p><p><strong>Conclusion: </strong>Through international collaboration spearheaded by local stakeholders, we initiated baseline needs assessments in 3 countries to identify pillars on which to build-up implementation projects based on BPRs. These scalable pilot projects can be used as a framework to promote further optimization and standardization of safe and quality surgical care in LMICs.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1423429"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546373","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":"Development and contextual analysis of a person-centered professional practice model in a home care service in French-speaking Switzerland.","authors":"Cedric Mabire, Sandra Panchaud, Jessica Wey, Justine Wicht","doi":"10.3389/frhs.2025.1566997","DOIUrl":"10.3389/frhs.2025.1566997","url":null,"abstract":"<p><strong>Background: </strong>The Swiss healthcare system faces increasing challenges with an aging population and rising prevalence of chronic conditions, necessitating better-coordinated care delivery, particularly in home care settings.</p><p><strong>Objectives: </strong>This study aimed to develop (objective 1) and conduct a contextual analysis for implementation (objective 2) of a person-centered professional practice model for home care services in French-speaking Switzerland.</p><p><strong>Methods: </strong>A multi-method approach was used. For objective 1, concept mapping with 157 healthcare professionals (86% response rate) was conducted to develop the model. For objective 2, a contextual analysis was guided by the Intervention Mapping framework, involving focus groups with stakeholders (<i>n</i> = 14) and field validation with frontline staff (<i>n</i> = 6). Data analysis included both quantitative and qualitative methods.</p><p><strong>Results: </strong>The concept mapping process identified 13 core values rated on importance (scale 1-5), with health promotion scoring highest (4.4) and interprofessionalism lowest (3.7). Implementation analysis revealed key facilitators including leadership support (83% agreement) and barriers such as linguistic/cultural differences. Eight implementation strategies were identified and validated through a Delphi process, including continuous training (67% strong agreement) and safety culture promotion (83% strong agreement).</p><p><strong>Conclusions: </strong>The study demonstrates that developing and implementing a person-centered professional practice model is feasible in home care settings when supported by strong leadership commitment and structured implementation strategies. The model's alignment with the Person-centred Practice Framework of McCance and McCormack provides theoretical validation while offering practical guidance for implementation.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1566997"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546372","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}