Primary health care research & development最新文献

{"title":"Evaluation of the effects of addiction levels and physical activity capacities of smokers on exhaled carbon monoxide level.","authors":"Ecem Çakir Altinyaprak, İzzet Fidanci, Fatma Birgül Kumbaroğlu, Tülin Düger","doi":"10.1017/S1463423625100108","DOIUrl":"https://doi.org/10.1017/S1463423625100108","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to evaluate the effect of smokers' nicotine addiction levels and physical activity capacities (aerobic capacities) on exhaled carbon monoxide (CO) measurement values in respiratory air.</p><p><strong>Methods: </strong>This study is a cross-sectional epidemiological descriptive type study. About 146 smokers, aged 18 and above, who applied to Hacettepe University Family Medicine outpatient clinics between March and May 2023 were included in the study. The Fagerström Test for Nicotine Dependence (FTND) and 6-minute walk test (6-MWT) were performed to the participants, and the relationship of the data with exhaled CO level was examined.</p><p><strong>Results: </strong>In the data we obtained, it was observed that the addiction score evaluated by the FTND had a positive, moderately statistically significant effect on the CO level (r = 0.483 p < 0.001). Although the percentage of aerobic capacity (physical activity capacities) assessed by the 6-MWT appeared to have a very weak negative relationship with the exhaled CO level, it was found to be not statistically significant (r = -0.112 p = 0.177).</p><p><strong>Conclusion: </strong>The data we obtained showed that smoking addiction has harmful effects such as increasing CO in the body, but there is no relationship between physical activity and the amount of exhaled CO. It has been observed that quitting smoking and complying with lifestyle change recommendations are an important necessity for a healthier life. To improve patients' overall health outcomes, family physicians are crucial in helping patients quit smoking and encouraging lifestyle modifications. This study might have encouraged the reflection of smoking habits and thus motivated quitting.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e46"},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of health and family planning: impact of food and financial insecurity on contraceptive use and pregnancy intention.","authors":"Breanna Sharp, Covenant Elenwo, Jordan Lowrimore, Caroline Markey, Micah Hartwell","doi":"10.1017/S1463423625000325","DOIUrl":"10.1017/S1463423625000325","url":null,"abstract":"<p><strong>Aim: </strong>In the United States, roughly one million pregnancies occur every year from the misuse and discontinuation of oral contraceptives - which may be affected by an individual's exposure to social determinants of health (SDOH). For those experiencing poorer SDOH, significant barriers may exist when family planning. Thus, our primary objective is to examine associations between domains of SDOH and contraceptive use as well as pregnancy intention using the Behavior Risk Factor Surveillance System (BRFSS).</p><p><strong>Methods: </strong>A cross-sectional analysis of 2017 BRFSS was conducted using the SDOH module to examine differences in family planning. We used bivariate and multivariable logistic regression models to measure associations, via odd ratios, between SDOHs and contraceptive use and pregnancy intention controlling for other sociodemographic variables.</p><p><strong>Results: </strong>We found that individuals experiencing negative SDOH who reported running out of food (AOR: 0.65; CI: 0.50-0.86), were unable to afford balanced meals (AOR: 0.64; CI:0.49-0.84), or had no money left at the end of the month (AOR: 0.45; CI: 0.32-0.64) were less likely to have used contraceptive methods compared to those not experiencing challenges within these SDOH domains. Among women not utilizing contraceptive methods, individuals not intending to get pregnant were more likely to report difficulty affording balanced meals or having financial stability compared to women attempting to become pregnant.</p><p><strong>Conclusions: </strong>Our study found that the SDOH domains of monthly financial instability and food insecurity are significantly associated with women not using contraceptive measures but not wanting to become pregnant. Addressing barriers to contraceptive access and FP is becoming more important with shifting policies regarding women's reproductive healthcare. For women seeking contraceptive and FP advice, increased funding may help provide a solution.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e44"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082698","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":"Comorbidities and prescribed medications in expectant mothers attending antenatal clinic: a cross-sectional study in Windhoek, Namibia.","authors":"Bonifasius Siyuka Singu, Magdalena Maketo, Martha Siwombe","doi":"10.1017/S1463423625000350","DOIUrl":"10.1017/S1463423625000350","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this study was to report on the prevalence of hypertension and anaemia, and types of medications prescribed to expectant mothers attending antenatal clinics at Intermediate Hospital Katutura in Windhoek, Namibia.</p><p><strong>Background: </strong>Millennium Development Goals 4 and 5 speak to reduction of child mortality and improvement of maternal health by 2015, respectively. Gestational hypertension is a major contributor to maternal and perinatal mortality and is reported to affect up to 10% of women world-wide. Prevalence of anaemia among pregnant women is reported higher in low- and middle-income countries than in developed countries.</p><p><strong>Methods: </strong>This was a cross-sectional study involving the review of outpatient and clinic health records for patients attending antenatal clinics at Intermediate Hospital Katutura, Windhoek during October to November 2022. Data for patients on first antenatal clinic visit were obtained from facility antenatal clinic patient registers while that of follow-up patients were from patient health passports. All expectant mothers over 18 years of age who had provided written consent to participate, were included. Data collected were: age, body weight, haemoglobin concentration, blood pressure, gravida, number of babies delivered, pregnancy stage, comorbidities, and prescribed medications. The results were summarised using descriptive statistics. A p-value <0.05 is considered to be statistically significant.</p><p><strong>Findings: </strong>354 records were included: 303 (85.6%) first visit, and 51 follow-up (14.4%). There was a significant correlation between systolic blood pressure (BP) and body weight (r = 0.31, p < 0.001). 13.5% of first-time visitors had haemoglobin levels lower than the normal range (11 g/dL). Difference in haemoglobin levels between trimesters 1 and 3 were significant (p < 0.001). Methyldopa was prescribed for all hypertensive expectant mothers. To reduce the incidences of anaemia and hypertension during pregnancy, women of childbearing age should be encouraged to attend antenatal visits earlier in pregnancy and to take measures for body weight reduction, respectively.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082694","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":"Capturing factors associated with frailty using routinely collected electronic medical record data in British Columbia, Canada, primary care settings.","authors":"Manpreet Thandi, Morgan Price, Jennifer Baumbusch, Sharde Brown, Sabrina Wong","doi":"10.1017/S1463423625000337","DOIUrl":"10.1017/S1463423625000337","url":null,"abstract":"<p><strong>Background: </strong>Electronic medical record (EMR) systems in primary care present an opportunity to address frailty, a significant health concern for older adults. Researchers in the UK used Read codes to develop a 36-factor electronic frailty index (eFI), which produces frailty scores for patients in primary care settings.</p><p><strong>Aim: </strong>We aimed to translate the 36-factor eFI to a Canadian context.</p><p><strong>Methods: </strong>We used manual and automatic mapping to develop a coding set based on standardized terminologies used in Canada to reflect the 36 factors of the eFI. Manual mapping was completed independently by two coders, followed by group consensus among the research team. Automatic mapping was completed using Apelon TermWorks. We then used EMR data from the British Columbia Canadian Primary Care Sentinel Surveillance Network. We searched structured data fields related to diagnoses and reasons for patient visits to develop a list of free text terms associated with any of the 36 factors.</p><p><strong>Results and conclusions: </strong>A total of 3768 terms were identified; 3021 were codes. A total of 747 free text terms were identified from 527,521 reviewed data entries. Of the 36 frailty factors, 24 were captured mostly by codes; 7 mostly by free text; and 4 approximately equally by codes and free text. Three key findings emerged from this study: (1) It is difficult to capture frailty using only standardized terminologies currently used in Canada and a combination of standardized codes and free text terms better captures the complexity of frailty; (2) EMRs in primary care can be better optimized; (3) Output from this study allows for the development of a frailty screening algorithm that could be implemented in primary care settings to improve individual and system level outcomes related to frailty.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e41"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999833","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":"'Midlife care to migrant women: primary healthcare providers' beliefs about barriers and facilitators'.","authors":"Karin Stanzel, Mary Pham, Karin Hammarberg, Jane Fisher","doi":"10.1017/S1463423625000349","DOIUrl":"10.1017/S1463423625000349","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to understand primary healthcare providers' beliefs about barriers and facilitators providing culturally competent midlife care to migrant women.</p><p><strong>Background: </strong>Primary healthcare is the entry level to the health system. It is usually the first point of contact in accessing the healthcare system and provides a range of services including health promotion and prevention. Migrant women are less likely to access and engage in health screening and health promotion activities and consequently may miss out on optimal health in older age.</p><p><strong>Methods: </strong>A cross-sectional study including two free-text questions, part of an online survey, was thematically analysed. 76 primary healthcare providers answered the free-text questions.</p><p><strong>Findings: </strong>Competing priorities as a result of migration and settlement experiences, the healthcare systems' limited resources to respond to the needs of migrant population and culturally informed beliefs and behaviour about menopause were viewed as barriers to midlife care for migrant women. Flexible models of primary healthcare and coordinated engagement with community groups were proposed to address these barriers. Primary healthcare providers perceived the current primary healthcare model to be inadequate to address the additional needs of migrant women. A review of the model of care may include 'task shifting' where nurses provide advanced care to migrant women in midlife. Perceptions of midlife and menopause are informed by culture. Hence, a culturally informed health promotion programme led by migrant women may be one strategy to address the limited participation in preventative healthcare including health screening at the time around menopause.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e40"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014179","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":"Healthcare use and its variation in people with fibromyalgia: a systematic review protocol.","authors":"Ailish Katherine Byrne, Helen Twohig, Sara Muller, Ian C Scott","doi":"10.1017/S1463423625000362","DOIUrl":"10.1017/S1463423625000362","url":null,"abstract":"<p><strong>Aim: </strong>A crucial step towards improving the care of people with fibromyalgia is understanding current practice. Our systematic review aims to address this by synthesising the global evidence around healthcare use in people with fibromyalgia, including its variation across groups of people, geographical locations, and over time.</p><p><strong>Background: </strong>Fibromyalgia is a chronic condition characterized by widespread pain alongside a broad range of non-pain symptoms. Its substantial impact on peoples' lives and high prevalence mean that ensuring people with fibromyalgia receive evidence-based and appropriate care is a clinical and research priority. Whilst guidelines recommend that people with fibromyalgia receive a prompt diagnosis, care that focuses on non-pharmacological interventions, and in many countries should be predominantly managed in the community, existing evidence indicates they often wait many years for a diagnosis, commonly receive long-term opioid medicines, and see multiple hospital specialists.</p><p><strong>Methods: </strong>Relevant databases will be searched, with 25% of screening, data extraction, and quality appraisal conducted by two reviewers. Eligible studies will have evaluated healthcare use in adults with fibromyalgia using data obtained from electronic health record, registry, or insurance databases (providing generalizable findings in large, representative datasets). Data will be synthesized using meta-analysis and/or synthesis without meta-analysis where possible.</p><p><strong>Results: </strong>By providing an in-depth analysis of healthcare use and its variation in people with fibromyalgia, the results from this systematic review could be used to benchmark practice, inform targeted management strategies to those with the highest levels of healthcare use (and therefore care need), and provide insight into whether certain countries require specific guideline/policy changes.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054906","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":"Measuring contraceptive self-efficacy in women: the Turkish validity and reliability study.","authors":"Aliye Dogan Gangal, Ayten Senturk Erenel","doi":"10.1017/S146342362500026X","DOIUrl":"10.1017/S146342362500026X","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the validity and reliability of the Turkish version of the Contraceptive Self-Efficacy in Women in Sub-Saharan Africa (CSESSA) scale.</p><p><strong>Background: </strong>Contraceptive self-efficacy is a crucial predictor of utilization of modern contraceptive methods. However, the existing tools for comprehensively assessing contraceptive self-efficacy are limited. Methods: The sample of this methodological study consisted of 510 female participants of reproductive age. The translation and cultural adaptation of the scale were performed. For validity, content validity and construct validity were tested. For reliability, test-retest reliability, Cronbach's alpha coefficient, and item-total score correlations were evaluated. Findings: The goodness-of-fit indices showed an overall acceptable fit with the three-factor model. Cronbach's alpha for the overall CSESSA scale was 0.867, and for the three subscales, it ranged from 0.77 to 0.84. The scale's test-retest reliability was found to be r = 0.83 (p < 0.001), and the item-total correlations score ranged from 0.495 to 0.646. The Turkish version of the scale is a valid and reliable tool to measure the contraceptive self-efficacy of women of reproductive age. This scale can provide a comprehensive understanding of self-efficacy by assessing various dimensions of contraceptive self-efficacy.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e36"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030926","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":"Diffusion of community heart failure service innovation in Northamptonshire, England: a qualitative study.","authors":"Taliha Samar, Gupteswar Patel, Aloysius Niroshan Siriwardena","doi":"10.1017/S1463423625000301","DOIUrl":"https://doi.org/10.1017/S1463423625000301","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure is a complex disorder, that can require hospitalization and specialist care, which patients may experience challenges accessing. In Northamptonshire, an innovative approach to heart failure services was introduced to address these challenges. This study aimed to explore and understand the diffusion dynamics of the heart failure service in Northamptonshire, focusing on adoption and implementation determinants.</p><p><strong>Methods: </strong>This qualitative study involved 11 in-depth interviews with four patients, two community carers, one general practitioner, one nurse, one programme director, and two interviews with a community cardiologist. The diffusion of innovation-guided inductive and deductive thematic analyses were used to identify themes and subthemes.</p><p><strong>Results: </strong>The community heart failure services incorporated community cardiology clinics and community asset groups. Implementation of these innovations was characterized by competent leadership, positive managerial relationships between community cardiologists, general practitioners, and third-sector professionals, a 'tension for change' to reduce hospital admissions, improve access, and dedicated funding ('slack resources'). The 'relative advantage' identified by both service providers and patients was access to specialist care closer to home, rehabilitation, education, and nutrition services. The heart failure innovation aligned with the organizational values of primary care and third-sector organizations, facilitating readiness for adoption and implementation. Challenges emerged from limited management accountabilities, such as inadequate administrative and information technology support, hindering the implementation.</p><p><strong>Conclusion: </strong>The heart failure innovation was perceived to improve care, navigating both facilitators and challenges. The diffusion of innovation theory highlighted the importance of governance and the performance of community heart failure services within a complex intervention context.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e39"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043550","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":"TOPSE for babies in Norwegian: examining the reliability of a tool to measure parenting self-efficacy.","authors":"Marit Burkeland-Lie, Mari Hysing, Anders Dovran, Sally Kendall, Jens Christoffer Skogen","doi":"10.1017/S1463423625000295","DOIUrl":"https://doi.org/10.1017/S1463423625000295","url":null,"abstract":"<p><strong>Background: </strong>Parents' confidence in their parenting abilities, or parenting self-efficacy (PSE), is an important factor for parenting practices. The Tool to measure Parenting Self-Efficacy (TOPSE) is a questionnaire created to evaluate parenting programmes by measuring PSE. Originally, it was designed for parents with children between the ages of 0-6 years. A modified version specifically for parents of infants aged 0-6 months (TOPSE for babies) is currently being piloted. In this study, we translated TOPSE for babies and investigated the reliability of the Norwegian version.</p><p><strong>Aim: </strong>To investigate the reliability of the Norwegian version of TOPSE for babies.</p><p><strong>Methods: </strong>The study included 123 parents of children aged 0-18 months who completed a digital version of the TOPSE questionnaire. Professional translators performed the translation from English to Norwegian and a back translation in collaboration with the author group. Mean and standard deviation were calculated for each of the questionnaire's six domains, and a reliability analysis was conducted using a Bayesian framework for the total sample (parents of children aged 0-18 months) and specifically for the parents of the youngest group of children (0-6 months).</p><p><strong>Findings: </strong>The Norwegian version of TOPSE for babies is a reliable tool for measuring parenting self-efficacy. However, some variations exist across the children's age groups and domains. The overall Bayesian alpha coefficient for the suggested domains ranged from 0.54 to 0.83 for the entire sample and from 0.63 to 0.86 for parents with children aged 0-6 months. For two of the domains, one item in each proved to largely determine the low alpha coefficients, and removing them improved the reliability, especially for parents with children aged 0-6 months.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e38"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014057","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":"Mental health screening in unaccompanied asylum-seeking children: screening tool selection and feasibility in the UK National Health Service.","authors":"Krsna Mohnani, Paula Seery, Hana Jayadel, Sophie Raghunanan, Alexandra M Cardoso Pinto, Francesca Mathias, Dougal Hargreaves, Caroline Foster","doi":"10.1017/S1463423624000586","DOIUrl":"https://doi.org/10.1017/S1463423624000586","url":null,"abstract":"<p><p>There has been an increasing number of applications from unaccompanied asylum-seeking children (UASC) in the United Kingdom in recent years. It is well-known that this population is at high-risk of developing mental health disorders, which require early detection and intervention to facilitate successful integration. This paper describes the introduction of mental health screening for unaccompanied asylum-seeking children in a National Health Service (NHS) outpatient clinic in central London. This follows the results of a two-year retrospective analysis of the health needs of the population in our clinic, which identified a high incidence of disturbance to mood and sleep. We describe the selection process for a culturally appropriate and validated screening tool, piloting the Refugee Health Screener (RHS) tool with 20 UASC in clinic, and using preliminary findings to inform a more targeted referral to community Child and Adolescent Mental Health Services (CAMHS). We conclude that implementation of the RHS-13 is feasible for widespread mental health screening for UASC in an NHS setting, and provide suggestions for future research directions within this field.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e37"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994117","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}