Global health journal (Amsterdam, Netherlands)最新文献

{"title":"Gambling to public health in ageing populations: a life expectancy evaluation perspective","authors":"Stanley Chi-on Shiu","doi":"10.1016/j.glohj.2024.11.002","DOIUrl":"10.1016/j.glohj.2024.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>Gambling is a complex topic in relation to health systems. It is always unclear how to strike a balance between the gambling economy and the impact of gambling on public health or social wellbeing at any age. There are limited studies considering the association between determinants of gambling and the life expectancy of the ageing population in a country. From an evaluation perspective, this article aims to demonstrate the correlation between life expectancy and gambling and public health systems.</div></div><div><h3>Methods</h3><div>The approach of analysis has two parts. One is the influence of gambling prevalence in populations on life expectancy among old adults. Another is the association between the effect of changes in legal gambling provisions within public health systems and life expectancy among old adults. Healthy adjusted life expectancy at age 60 from the World Health Organization and gross gambling yield were used. ANOVA was performed with SPSS.</div></div><div><h3>Results</h3><div>The population groups with HALE at age 60 of 15 years or over are likely more active in gambling than the population groups with smaller HALE at age 60 of 14 years or less. On the other hand, the influence of a health policy may be sidelined when it is implemented for older adult populations because the resource distribution magnitude or number of strategical techniques may not be the same for younger adult populations. The study here is marked as a good practical start, and there is room for further research with big data analysis on additional gambling variables against other life expectancy variables, quality of life variables or public health system variables.</div></div><div><h3>Conclusion</h3><div>Associations between the determinants of gambling and the life expectancy of the ageing population in a country have not yet been identified. Continuous measurements of policy implementation and effectiveness and assessments of health equity, while gambling policies worldwide continue to change, have not yet been performed. Researchers and policy makers should understand the importance of holistic integration of the gambling economy and policy within a public health and social paradigm with the help of big data insights to achieve sustainability in their cities and health equity in their communities.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 4","pages":"Pages 206-212"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143266765","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":"An analysis of inequality in physical health status of women in India: 2015‒2021","authors":"Debolina Banerjee,&nbsp;Tamal Krishna Kayal","doi":"10.1016/j.glohj.2024.11.003","DOIUrl":"10.1016/j.glohj.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>We examine how inequality in women’s health has changed in India and its major states between 2015 and 2021. We also attempt to identify the sources of any change in this inequality using a decomposition analysis. In order to suggest suitable policies for reducing this inequality, we attempt to identify the factors that are strongly associated with it.</div></div><div><h3>Methods</h3><div>We construct an index of women’s health from five indicators using the principal component analysis. Based on this index we measure inequality in women’s health using the coefficient of variation and the Theil index. To identify the sources of change in this inequality, we apply Theil decomposition technique.</div></div><div><h3>Results</h3><div>We find that inequality in women’s health has increased significantly in India between 2015 and 2021. During this period, this inequality has increased significantly in six states, while it has decreased significantly in five states. The decomposition analysis suggests that the increase in this inequality between 2015 and 2021 has been driven by an increase in interstate inequality. We also find a strong positive association between inequality in women’s health and inequality in public health amenities and social development.</div></div><div><h3>Conclusion</h3><div>We suggest that for reducing inequality in women’s health in developing countries like India, policies should focus on eliminating disparities in income, female education and provision of public health amenities.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 4","pages":"Pages 213-221"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143266797","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":"Burnout and mental distress among community health workers in low- and middle-income countries: a scoping review of studies during the COVID-19 pandemic","authors":"Oluchi I. Ndulue ,&nbsp;Anand Chukka ,&nbsp;John A. Naslund","doi":"10.1016/j.glohj.2024.11.007","DOIUrl":"10.1016/j.glohj.2024.11.007","url":null,"abstract":"<div><div>Community health workers (CHWs) represent the backbone of primary health systems, especially in many low- and middle-income countries (LMICs). The coronavirus disease 2019 (COVID-19) pandemic stretched health systems and increased the workload for CHWs. The objective of this scoping review was to identify the mental health symptoms experienced among CHWs in LMICs during the COVID-19 pandemic. We searched PubMed for published literature, from January 1, 2020 to December 31, 2022 that focused on documenting the experiences of burnout, distress, and mental health symptoms among CHWs in LMICs. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Included studies were grouped into the following broad thematic categories: (1) symptoms experienced; (2) drivers of different mental health symptoms; and (3) strategies for coping with different symptoms. We identified 10 cross-sectional, qualitative, and observational studies from 11 LMICs in South and Southeast Asia, South America, and Eastern/Southern Africa that assessed the mental health burden CHWs faced during the pandemic. The studies identified disorders and symptoms such as depression, anxiety, fear, burnout, worsened stress, and fatigue. Contributing factors included increased workload, financial constraints, and an understaffed and underequipped workplace. CHWs reported using different adaptive responses like humor, support from family and colleagues, denial, and substance use, and asked for recommended regular mental health checkups and counseling. More research and policies should be targeted towards promoting the mental wellbeing of CHWs to help ensure responsive and resilient health systems in LMICs in the face of future emerging public health threats.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 4","pages":"Pages 162-171"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143266754","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":"Health system interventions for the cost containment of drugs used for cardiovascular diseases: a systematic review and exploration of how the results could be adapted to the Sri Lankan context","authors":"Jayasekara Liyana Patabendige Chaminda ,&nbsp;Sanjeewa Kularatna ,&nbsp;Dilantha Dharmagunawardene ,&nbsp;Reece Hinchcliff ,&nbsp;Alexia Rohde ,&nbsp;David Brain ,&nbsp;Ruvini Manjula Hettiarachchi ,&nbsp;Sucharitha Rangi Weerasuriya ,&nbsp;Sunil Senarath Yapa ,&nbsp;Sameera Senanayake","doi":"10.1016/j.glohj.2024.11.005","DOIUrl":"10.1016/j.glohj.2024.11.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Cardiovascular disease (CVD) in low and middle-income countries (LMICs), accounts for over 80% of global CVD-related deaths. The high cost of drugs is a major concern in not of managing CVD. This study aimed to conduct a comprehensive review to identify interventions for cost containment of CVD drugs and use the intervention scalability assessment tool (ISAT) to examine the acceptability and application of relevant interventions in the Sri Lankan context, that can also be adaptable to other LMICs.</div></div><div><h3>Methods</h3><div>A systematic search across three databases (Medline, Web of Science and Embase) was completed to identify relevant health system interventions. The ISAT assessed the feasibility of adapting the identified interventions to Sri Lanka, using structured interviews with 25 Sri Lankan stakeholders representing five groups: health managers, cardiologists, pharmacists, nursing officers, and patients.</div></div><div><h3>Results</h3><div>The search yielded nine publications. Five were conducted on a national scale, while others were conducted at the regional levels. Seven were published in developed countries. The identified interventions were categorised into six intervention themes: Imposing a ceiling price or reference price; introduction of the polypill; introduction of volume price contract initiatives; prescribing generic and essential drugs; one intervention package including generics, essential medicine, 90-day drugs, and free delivery; and a second intervention package including discounts, rebates, cost-free medicine, and bundling. Assessment of six intervention themes revealed that methods of setting ceiling prices and controlling generic drug prescribing were the most popular, while other interventions were least popular.</div></div><div><h3>Conclusions</h3><div>The study provides a roadmap for future interventions based on successful scaling, emphasizing the importance of understanding contextual variables and encourages stakeholder participation in policy assessments and advocacy. The findings highlighted the potential for enhancing the access to affordable CVD drugs not only in Sri Lanka, but also adaptable to other LMICs. These outcomes can contribute to policy decisions, aimed at reducing the significant global burden of CVD.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 4","pages":"Pages 181-189"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143266762","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":"Regional deprivation and cause-specific mortality in Russian adults in 2006–2022","authors":"Anastasia Zelenina","doi":"10.1016/j.glohj.2024.11.006","DOIUrl":"10.1016/j.glohj.2024.11.006","url":null,"abstract":"<div><h3>Objective</h3><div>The relationship between cause-specific mortality and regional socio-economic and environmental indicators remains poorly studied in Russia. The study first aims to study regional differences in cause-specific mortality among the population aged 20 years and older in Russia, and second to investigate the association between regional deprivation and cause-specific mortality.</div></div><div><h3>Material and methods</h3><div>Russian deprivation index was used to measure level of deprivation. The index consists of three components: social, economic and environmental. The index measures general deprivation, and its components measure social, economic and environmental deprivation. The mortality data by age (five-year groups) and sex in the subjects of Russia from 2006 to 2022 were extracted from the Russian Fertility and Mortality Database of the Center of Demographic Research of the New Economic School.</div></div><div><h3>Results</h3><div>In the most general deprived areas, mortality rate from infectious and parasitic diseases increased by more than twice in the total population, women and men as compared to the least deprived quantile (Q1). Fully adjusted negative binomial regression showed an increase in mortality rate from injuries, poisoning and external causes and infectious and parasitic diseases in more social deprived areas as compared to Q1 in the total population, women and men. In men, there was a significantly higher mortality rate from neoplasms and from infectious and parasitic diseases in more economic deprived areas as compared to Q1. Both in total population and in women, there was a trend towards an increase in mortality from neoplasms depending on the level of environmental deprivation.</div></div><div><h3>Conclusions</h3><div>This is the first study examining the relationship of contextual factors with cause-specific mortality that takes into account sex, age and year of death at the population level in Russia. General, social, economic and environmental deprivation are associated with cause-specific mortality.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 4","pages":"Pages 190-205"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143266764","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":"Building a transdisciplinary science of One Health with a global vision","authors":"Xiaonong Zhou ,&nbsp;Jinxin Zheng","doi":"10.1016/j.glohj.2024.08.004","DOIUrl":"10.1016/j.glohj.2024.08.004","url":null,"abstract":"<div><div>One Health has been recognized as a cost-effectiveness approach that intricate connections between human health, animal health, and ecosystem health. This holistic perspective is crucial for addressing complex health challenges that arise at the intersection of these domains, such as emerging infectious diseases, antimicrobial resistance, food safety &amp; food security, and environmental degradation. The beneficiaries of the One Health approach have been demonstrated by many case studies worldwide, and summarized by The World Bank that not only support poverty alleviation in developing countries, but also can reduce pandemic risk globally. It is essential for us to understand the means of promoting the initiatives in building the transdisciplinary science of One Health that requires a global vision with integration of various disciplines, stakeholders, and resources. Therefore, we introduce the role of the transdisciplinary science of One Health, and the key steps and strategies necessary to implement One Health approach in the real world. We also propose three research priorities, including emphasizing climate change and health, enhancing global health security, and promoting equity and inclusivity which is crucial for the success of One Health initiatives. Hence, building a transdisciplinary science of One Health will not only improve holistic health between human, animal, and environmental domains, but also contribute to the global health security and sustainable development.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 3","pages":"Pages 99-102"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318699","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":"Demographic and socioeconomic determinants of urinary arsenic concentration for elementary school children in Bangladesh","authors":"Raisa Sara ,&nbsp;Khalid M. Khan ,&nbsp;Shelbin Mattathil ,&nbsp;Munachimso Nwankwo ,&nbsp;Mohammad Aminul Islam ,&nbsp;Faruque Parvez","doi":"10.1016/j.glohj.2024.08.005","DOIUrl":"10.1016/j.glohj.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Arsenic (As) is a toxic element that can lead to various health issues in humans. The primary exposure to As is through the consumption of water contaminated with high As levels, particularly in Bangladesh. Previous studies have shown that urinary arsenic (UAs) concentration can reflect As exposure and metabolism in individuals. However, little is known about how other factors, such as age, sex, and socioeconomic status, may affect UAs concentrations in children.</div></div><div><h3>Objective</h3><div>This study aimed to investigate the influence of factors such as age, sex, and socioeconomic status on UAs concentrations in children, in addition to the impact of drinking water arsenic (WAs) levels.</div></div><div><h3>Methods</h3><div>We conducted our study on elementary school-going children aged 8‒11 years from rural Araihazar in Bangladesh. We measured UAs (available for a subset of 391 children) and WAs levels and collected information on demographic and socioeconomic characteristics. We employed regression analysis and <em>t</em>-tests to analyze the data.</div></div><div><h3>Results</h3><div>Our findings revealed that younger children (<em>β</em> = 197.95, 95% confidence interval [CI]: 111.97 to 283.94), female children (<em>β</em> = 93.95, 95% <em>CI</em>: 8.49 to 179.40), and children with less educated fathers (<em>β</em> = 138.03, 95% <em>CI</em>: 26.47 to 249.58) had higher UAs levels, particularly when they consumed water with high As content.</div></div><div><h3>Conclusion</h3><div>The study concludes that children’s As exposure and UAs concentration may vary depending on their age, sex, and socioeconomic status. Therefore, these factors should be considered when assessing the health risks associated with As.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 3","pages":"Pages 119-127"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318703","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":"Combating obesity in Southeast Asia countries: current status and the way forward","authors":"E Siong Tee,&nbsp;Siok Hui Voon","doi":"10.1016/j.glohj.2024.08.006","DOIUrl":"10.1016/j.glohj.2024.08.006","url":null,"abstract":"<div><div>Obesity is gaining prominence as a serious public health challenge in the Southeast Asia (SEA) region, with an alarming rate of increase in its prevalence. Countries in the region have shown commitment to curbing the rise of obesity by establishing policies, strategies, and action plans. This paper summarises the current situation and strategies undertaken to combat obesity and related chronic diseases. Although a range of policies and strategies have been developed, including national nutrition action plans, community intervention programmes, fiscal measures, nutrition labelling to promote healthier choices, countries in the region are struggling to make significant progress toward halting the scourge of obesity. It is imperative to strengthen existing health systems with a paradigm shift from a focus on “sick care” to and enhancing nutrition initiatives to support obesity prevention. A comprehensive and coordinated approach is essential, one that emphasises high-level coordination across all levels of government and multiple sectors, and a unified plan rather than fragmented initiatives. For strategies to be effective and sustainable, they must address the fundamental environmental determinants of poor dietary choices and nutritional inequalities. A more holistic approach is clearly needed to improve the entire food environment, which in SEA countries must include the multitude of eating places where large segments of the population “eat out” everyday to meet their energy and nutrient needs. There is a recognised need for more comprehensive measures to promote healthy eating among school children and ensure a supportive environment for lifelong healthy habits. This paper calls for a whole-of-government, whole-of-society approach that combines changes to the fundamental food environment and accompanied by systematic monitoring and surveillance systems to achieve long-lasting health outcomes.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 3","pages":"Pages 147-151"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319410","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":"Plain language in the healthcare of Japan: a systematic review of “plain Japanese”","authors":"Hatsune Kido ,&nbsp;Soichiro Saeki ,&nbsp;Mayu Hiraiwa ,&nbsp;Masashi Yasunaga ,&nbsp;Rie Tomizawa ,&nbsp;Chika Honda ,&nbsp;Toshio Fukuoka ,&nbsp;Kaori Minamitani","doi":"10.1016/j.glohj.2024.08.007","DOIUrl":"10.1016/j.glohj.2024.08.007","url":null,"abstract":"<div><h3>Objective</h3><div>Despite the decrease in the number of foreign visitors and residents in Japan due to the coronavirus disease 2019, a resurgence is remarkable from 2022. However, Japan’s medical support system for foreign patients, especially residents, is inadequate, with language barriers potentially causing health disparities. Comprehensive interpretation and translation services are challenging, but “plain Japanese” may be a viable alternative for foreign patients with basic Japanese language skills. This study explores the application and obstacles of plain Japanese in the medical sector.</div></div><div><h3>Methods</h3><div>A literature review was performed across these databases: Web of Science, PubMed, Google Scholar, Scopus, CINAHL Plus, Springer Link and Ichushi-Web (Japanese medical literature). The search covered themes related to healthcare, care for foreign patients, and scholarly articles, and was conducted in July 2023.</div></div><div><h3>Results</h3><div>The study incorporated five papers. Each paper emphasized the language barriers foreign residents in Japan face when accessing healthcare, highlighting the critical role and necessity of plain Japanese in medical environments. Most of the reports focused on the challenges of delivering medical care to foreign patients and the training of healthcare professionals in using plain Japanese for communication.</div></div><div><h3>Conclusion</h3><div>The knowledge and application of plain Japanese among healthcare professionals are inadequate, and literature also remains scarce. With the increasing number of foreign residents in Japan, the establishment of a healthcare system that effectively uses plain Japanese is essential. However, plain Japanese may not be the optimal linguistic assistance in certain situations, thus it is imperative to encourage more research and reports on healthcare services using plain Japanese.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 3","pages":"Pages 113-118"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318702","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":"Shared decision making in rural general practices: a qualitative exploration of older rural South Australians’ perceived involvement in clinical consultations with doctors","authors":"Mohammad Hamiduzzaman ,&nbsp;Noore Siddiquee ,&nbsp;Harry James Gaffney ,&nbsp;Frances Barraclough ,&nbsp;Aziz Rahman ,&nbsp;Jennene Greenhill ,&nbsp;Vicki Flood","doi":"10.1016/j.glohj.2024.08.003","DOIUrl":"10.1016/j.glohj.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Shared decision-making (SDM) implementation is a priority for Australian health systems, including general practices but it remains complex for specific groups like older rural Australians. We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.</div></div><div><h3>Methods</h3><div>We conducted a patient-oriented research, partnering with older rural Australians, families, and health service providers in research design. Participants who visited general practices were purposively sampled from five small rural towns in South Australia. A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.</div></div><div><h3>Results</h3><div>Telephone interviews were held with 27 participants. Four themes were identified around older rural adults’ involvement in SDM: (1) Understanding of “patient involvement”; (2) Positive and negative outcomes; (3) Barriers to SDM; and (4) Facilitators to SDM. Understanding of patient involvement in SDM considerably varied among participants, with some reporting their involvement was contingent on the “opportunity to ask questions” and the “treatment choices” offered to them. Alongside the opportunity for involvement, barriers such as avoidance of cultural care and a lack of continuity of care are new findings. Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices. Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers.</div></div><div><h3>Conclusion</h3><div>Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia. Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians’ involvement in general.</div></div>","PeriodicalId":73164,"journal":{"name":"Global health journal (Amsterdam, Netherlands)","volume":"8 3","pages":"Pages 140-146"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319409","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}