BMC Health Services Research最新文献

{"title":"The significance of a dementia diagnosis from the perspective of the family caregivers: a qualitative study.","authors":"Inger Molvik, Grete Kjelvik, Geir Selbæk, Anne Marie Mork Rokstad","doi":"10.1186/s12913-025-12657-1","DOIUrl":"https://doi.org/10.1186/s12913-025-12657-1","url":null,"abstract":"<p><strong>Background: </strong>With the anticipated increase in dementia prevalence over the coming decade, understanding the experience of receiving a dementia diagnosis for people living with cognitive impairment remains limited. This study aims to explore the implications of a family member with cognitive impairment receiving a dementia diagnosis or not from the perspective of their next of kin.</p><p><strong>Methods: </strong>A qualitative descriptive design was applied using individual interviews for data collection. Participants were recruited based on the cognitive function level of their family members, which was compatible with dementia as assessed with the Montreal Cognitive Assessment Scale (MoCA). The sample consisted of eight participants, comprising family members of five individuals with confirmed dementia diagnoses and three undiagnosed. The analysis was performed using four steps of systematic text condensation to discern codes, categories, and the overarching theme.</p><p><strong>Results: </strong>Three main categories were created: (1) Impact of observed cognitive decline, (2) Impact of diagnosis on service engagement, and (3) Support and follow-up for family caregivers. The findings show that next of kin who have received a dementia diagnosis for their family members are more proactive in seeking help and services, are better informed about available resources, and are more concerned about future challenges. On the other hand, next of kin to family members without a diagnosis are more inclined to handle the situation on their own, have less access to information and services, and generally express less concern about future problems.</p><p><strong>Conclusion: </strong>The study reveals the benefits of receiving a timely dementia diagnosis in shaping more effective support systems and policies. This ensures that the next of kin and the person with cognitive impairment can navigate the complexities of dementia with greater confidence and preparedness, thereby enhancing their quality of life.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"487"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community pharmacy workforce willingness, readiness, and infrastructural capacity to deliver vaccination services: a cross-sectional survey in Nigeria.","authors":"Adewale Aderemi Oladigbolu, Ukamaka Gladys Okafor, Charles Oluwole Oluwaseyi, Omokhafe Mary Ashore","doi":"10.1186/s12913-025-12655-3","DOIUrl":"10.1186/s12913-025-12655-3","url":null,"abstract":"<p><strong>Background: </strong>There is a growing need for community pharmacists to support universal health coverage by providing vaccination services to address low coverage, as they are among the most accessible healthcare professionals. In some Nigerian states, community pharmacists were trained in vaccination, but there are concerns about their capacity to enroll as vaccination service providers. This study evaluated the community pharmacy workforce willingness, readiness, and infrastructural capacity to deliver vaccination services in Nigeria.</p><p><strong>Methods: </strong>We conducted a descriptive cross-sectional study using a self-administered structured questionnaire among community pharmacists in Nigeria using a Google Form and administered through WhatsApp platforms. Descriptive statistics were performed on the collected data using SPSS statistical software, version 21.</p><p><strong>Results: </strong>Of the 414 community pharmacists sampled, 395 (response rate = 95.4%) were retrieved and included in the final analysis. Although most community pharmacists did not currently practice vaccine administration in their pharmacies (n = 295, 74.9%), most were willing to start administering vaccines (n = 359, 91.3%), participate in routine and supplemental immunization services (n = 373, 95.4%), receive training related to vaccination (n = 374, 95.2%), and encourage patients to get vaccinated in their pharmacies (n = 367, 93.6%). Tetanus vaccine was the most common (n = 158, 40%) among the vaccines administered by the respondents. Infrastructure was inadequate in many critical areas: vaccine-specific equipment (n = 263, 67.8%), safety boxes (n = 216, 55.7%), medical waste bins (n = 178, 45.8%), portable vaccine refrigerators in case of power failures (n = 218, 56.1%), anaphylaxis response kit (n = 340, 87.4%), and anaphylaxis management guidance (n = 346, 88.9%). Barriers to the pharmacists' willingness to deliver vaccination services were inadequate funds to procure appropriate storage equipment (n = 269, 70.0%), inadequate training (n = 265, 69.1%), conflicts with other professionals (64.4%), concerns about patient safety (n = 185, 47.7%), and handling vaccines and disposal of sharps (n = 182, 47.4%).</p><p><strong>Conclusions: </strong>Community pharmacists have indicated their willingness to embrace the advanced role of vaccine administration. The government and other healthcare stakeholders should address the infrastructural gaps and other barriers highlighted in the study to help improve vaccine access and availability.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"485"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of tuberculosis treatment outcomes among people experiencing homelessness: a scoping review.","authors":"Claudia Susana Pérez Guerrero, Tiago Augusto Cavalcante Oliveira, Willie Otávio Bueno Bernardi, Stephanie Ribeiro, Jeanne-Marie Stacciarini, Aline Aparecida Monroe, Hugo Fernandes, Paula Hino","doi":"10.1186/s12913-025-12230-w","DOIUrl":"https://doi.org/10.1186/s12913-025-12230-w","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis is an infectious, preventable and treatable disease that is socially determined. People experiencing homelessness represent a group that is highly vulnerable to this disease, presenting a challenge for its control and elimination. The aim of this review was to synthesize the existing scientific evidence on the outcomes of tuberculosis treatment in the context of the population experiencing homelessness.</p><p><strong>Methods: </strong>This scoping review was conducted following JBI guidelines. Six databases were consulted: MEDLINE, Web of Science, Scopus, LILACS, CINAHL and EMBASE. Scientific literature with quantitative or mixed-method approaches may be included, published from 2015 onward, in English, Portuguese and Spanish, involving participants aged 15 years or older. The Rayyan application was used to facilitate the selection process, and a descriptive analysis of the findings was performed.</p><p><strong>Results: </strong>Fourteen articles were included, comprising primarily cohort studies (n= 6) and cross-sectional studies (n= 5), along with two ecological studies and a systematic review. Eight articles were from South America (seven from Brazil), three from Europe and three from Asia. The rates of treatment success outcomes ranged from 89.7% to less than 30%, with nine studies reporting rates under 45%. The highest proportion of accumulated unsuccessful treatment outcomes was nearly 70%, with four studies indicating rates between 60% and 66%. Loss to follow-up was the most frequently reported negative outcome (n= 9), reaching rates of 53.6%. The \"failed\" treatment outcome was reported in low proportions, often less than 1% (n= 5) and \"not evaluated\" outcome was reported in half of the studies (n= 7). The proportions observed in the systematic review were consistent with these findings. Furthermore, the results revealed significant differences compared with those of the global general population. While both groups exhibited low proportions of treatment failures, other outcomes for the homeless population were markedly poorer.</p><p><strong>Conclusions: </strong>The homeless population experiences low success rates in tuberculosis treatment, with no study in this review meeting the international treatment success rate target. A comprehensive, collaborative and patient-centered care approach that addresses social determination of health is essential to improve outcomes and enhance health, social care, and educational services tailored to the needs of this population.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"497"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Holistic framing for improving care provision for older people with chronic diseases in Jordan: a phenomenological study.","authors":"Anas Shehadeh, Malakeh Z Malak, Ahmad Ayed","doi":"10.1186/s12913-025-12658-0","DOIUrl":"https://doi.org/10.1186/s12913-025-12658-0","url":null,"abstract":"<p><p>There is a sharp increase in the number of older people globally. Thus, it is important to adopt strategies to improve the care provided for older people, especially due to the increased prevalence of chronic conditions. However, very little evidence is available on what should be done, especially from the perspective of healthcare professionals responsible for providing care for older people in nursing homes. Thus, this study aimed to explore the opinions of healthcare professionals including nurses and physicians in nursing homes on adopting holistic framing for improving care provision for older people with chronic conditions in Jordan. The study employed a descriptive phenomenological design using semi-structured interviews with 13 nurses and two physicians in Amman governorate in Jordan during the period from June to September 2024. Inductive content analysis was used to analyze data. The findings revealed three overarching themes including: (1) offering dedicated courses and postgraduate programs; (2) improving facilities and resources; and (3) raising awareness and enhancing collaborations. The findings provide a holistic framing for improving healthcare provision for older people with chronic diseases in Jordan.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"492"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User journey method: a case study for improving digital intervention use measurement.","authors":"Lauri Lukka, Maria Vesterinen, Antti Salonen, Vilma-Reetta Bergman, Paulus Torkki, Satu Palva, J Matias Palva","doi":"10.1186/s12913-025-12641-9","DOIUrl":"10.1186/s12913-025-12641-9","url":null,"abstract":"<p><strong>Background: </strong>Many digital mental health interventions meet low levels of use. However, current use measurement methods do not necessarily help identify which intervention elements are associated with dropout, despite this information potentially facilitating iterative intervention development. Here, we suggest improving the comprehensiveness of intervention use measurement with the user journey method, which evaluates every intervention element to identify intervention-specific use barriers.</p><p><strong>Methods: </strong>We applied user journey method in a clinical trial that investigated the efficacy of a novel game-based intervention, Meliora, for adult Major Depressive Disorder. We modelled the intervention for its four technological (Recruitment, Website, Questionnaires, Intervention Software) and two interpersonal elements (Assessment, Support). We then applied the user journey method to measure how many users proceeded from one element to the next combining social media analytics, website use data, signup data, clinical subject coordinator interview data, symptom questionnaire data, and behavioral intervention use data. These measurements were complemented with the qualitative analysis of the study discovery sources and email support contacts.</p><p><strong>Results: </strong>Recruitment: The intervention recruitment reached at least 145,000 Finns, with social media, word-of-mouth, and news and web sources being the most effective recruitment channels. Website: The study website received 16,243 visitors, which led to 1,007 sign-ups.</p><p><strong>Assessment: </strong>895 participants were assessed and 735 were accepted. Intervention Software: 498 participants were assigned to the active intervention or comparator, of whom 457 used them at least once: on average, for 17.3 h (SD = 20.4 h) on 19.7 days (SD = 20.7 d) over a period of 38.9 days (SD = 31.2 d). The 28 intervention levels were associated with an average dropout rate of 2.6%, with two sections exhibiting an increase against this baseline. 150 participants met the minimum adherence goal of 24 h use. Questionnaires: 116 participants completed the post-intervention questionnaire.</p><p><strong>Support: </strong>313 signed-up participants contacted the researchers via email.</p><p><strong>Conclusion: </strong>The user journey method allowed for the comprehensive evaluation of the six intervention elements, and enabled identifying use barriers expediting iterative intervention development and implementation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT05426265. Registered 28 June 2022, https://clinicaltrials.gov/ct2/show/NCT05426265 .</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"479"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring challenges in accessing primary healthcare for pregnant women in Pakistan: a qualitative descriptive study.","authors":"Bushra Asif Ali Khan, Humaira Mahmood, Jawaria Mukhtar Ahmed, Bushra Anwar, Ameer Muhammad, Rawshan Jabeen","doi":"10.1186/s12913-024-11637-1","DOIUrl":"https://doi.org/10.1186/s12913-024-11637-1","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal and newborn mortality are critical global health concerns. Achieving Sustainable Development Goal 3.8 (SDGs), which aims to improve these outcomes, is hindered by the poor quality of care in health facilities, a significant barrier to the utilization of antenatal care (ANC) services in Pakistan. This study aimed to explore the barriers to the underutilization of ANC services in Tehsil (sub-division of a district) Hazro, Punjab, Pakistan, from the perspective of pregnant women.</p><p><strong>Method: </strong>The study employed four focus group discussions (FGDs) with 36 pregnant women who had attended at least three ANC visits. Data were collected through purposive sampling and analyzed using NVivo 12, ensuring rigor through Lincoln and Guba's guiding principles.</p><p><strong>Result: </strong>The findings revealed three key themes, following the three delays model: 1. Decision to Seek Care, 2. Delay in Reaching Healthcare Facilities, and 3. Delay in Acquiring Satisfactory and Appropriate Health Care. Women often made the decision to seek care with the support of their spouse, family, and lady health workers, highlighting the importance of their decision-making autonomy. Financial constraints did not significantly hinder access to healthcare services. However, long distances, travel time, and associated costs were identified as major barriers. Most importantly, the majority of women lacked awareness of danger signs and the importance of seeking timely medical help. This issue was compounded by the unavailability of healthcare personnel, negative staff attitudes, insufficient medicines and equipment, and a lack of referral services.</p><p><strong>Conclusion: </strong>This descriptive study underscores the urgent need for affordable, accessible, and responsive maternal and child healthcare. To address these barriers, stakeholders - including policymakers, public health experts, and maternal, neonatal, and child health (MNCH) providers - must prioritize MNCH initiatives and reforms. Collaborative efforts are crucial to translating MNCH policies into effective strategies at the community level.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"482"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate risks, multi-tier medical insurance systems, and health inequality: evidence from China's middle-aged and elderly populations.","authors":"Hongyan Yang, Yang Yang, Dequan Li","doi":"10.1186/s12913-025-12648-2","DOIUrl":"https://doi.org/10.1186/s12913-025-12648-2","url":null,"abstract":"<p><strong>Background: </strong>Against the backdrop of increasing population aging, the uncertainty and irreversibility of climate change have a significant impact on the health and healthcare burden of the elderly. However, it remains uncertain whether the multi-tiered medical insurance system disproportionately influences the health impacts of climate risks.</p><p><strong>Methods: </strong>Using data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, matched with urban climate risk variables, we employ a multi-dimensional panel fixed effects model and an instrumental variable model to examine the impact of climate risks on the health of the middle-aged and elderly, while also investigating the unequal effects of the multi-tiered medical insurance system.</p><p><strong>Results: </strong>Climate risks significantly worsened the self-reported health of the middle-aged and elderly (β = 0.073, P = 0.089), and increased both total medical costs (β = 2.570, P = 0.012) and out-of-pocket expenses (β = 2.652, P = 0.003). Notably, the increases in hospitalization costs (β = 0.721, P = 0.004) and out-of-pocket hospitalization expenses (β = 0.706, P = 0.036) are particularly prominent. The current multi-tiered medical insurance system results in unequal impacts of climate risks on health and medical costs. Specifically, urban employee medical insurance and commercial medical insurance effectively improve the health outcomes of elderly individuals affected by climate risks. Urban residents' medical insurance significantly reduces both total medical costs and out-of-pocket expenses for the elderly, whereas the new rural cooperative medical insurance shows no significant mitigating effect. Additionally, there is no evidence to suggest that the integration of urban and rural resident medical insurance can reduce the medical burden on rural elderly populations caused by climate risks. Our long-term projections indicate that, under both the SSP245 and SSP585 scenarios, the increase in elderly healthcare costs due to climate risks is irreversible. However, restrictive climate policies would yield significant health benefits, potentially reducing per capita medical costs for the elderly by nearly 50%.</p><p><strong>Conclusions: </strong>The decentralized multi-tier medical insurance system leads to significant inequality in the health impacts of climate risks. Our study emphasizes the critical role of reforming the existing social medical insurance system and implementing climate policies to protect the health of elderly populations.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"481"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the efficiency of health resource allocation in the western region of China-based on three-stage DEA and Tobit regression analysis.","authors":"Dongxue Zhao, Hua Huang, Yu Zhang, Shuanghang Li","doi":"10.1186/s12913-025-12630-y","DOIUrl":"10.1186/s12913-025-12630-y","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the allocation efficiency of health resources in the western region of China, and to explore the influence of external environmental factors on the allocation efficiency, to provide reference for optimizing the allocation of resources.</p><p><strong>Methods: </strong>In this study, we employed a three-stage Data Envelopment Analysis (DEA) model alongside Tobit regression analysis to evaluate the efficiency of health resource allocation and explore the factors that influence it across western China. This analysis focused on data from 2021, covering ten provinces. Through this combined approach, the study aimed to uncover key insights into the determinants and variations in resource allocation efficiency within western China.</p><p><strong>Results: </strong>Following the three-stage DEA analysis, the results showed that health resource allocation in western China achieved a comprehensive efficiency of 0.979, a pure technical efficiency of 0.980, and scale efficiency of 0.999. Notably, six provinces, specifically Chongqing, Guizhou, Yunnan, Tibet, Qinghai, and Ningxia, maintained efficient performance both before and after adjustment. The extensive efficiency of 3 provinces, including Sichuan, Shaanxi, and Gansu decreased. Xinjiang's comprehensive efficiency improved. The comprehensive efficiency of the southwest area was higher than that of the northwest area. The Tobit regression analysis revealed that factors such as per capita disposable income, the share of government spending in total healthcare expenditure, and the medical service price index significantly influenced the efficiency of health resource allocation in Western China.</p><p><strong>Conclusion: </strong>Environmental factors appeared to inflate the efficiency estimates of health resource allocation in China's western region, with considerable disparities across different areas. To address these issues, the government should advance reforms in medical resource distribution, enhance management practices and technology, optimize resource allocation structures, and minimize resource wastage. At the same time, strategies should be formulated according to provincial characteristics, and interregional cooperation and resource sharing should be strengthened to achieve complementary advantages and common development.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"480"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitators and barriers to smoking cessation: a qualitative study among health professionals in Germany.","authors":"Frederike Bokemeyer, Paulina Kiefer, Lea Schmidt, Kathleen Gali","doi":"10.1186/s12913-025-12646-4","DOIUrl":"https://doi.org/10.1186/s12913-025-12646-4","url":null,"abstract":"<p><strong>Background: </strong>Tobacco consumption remains a leading cause of global morbidity and mortality and is a significant preventable health concern. Despite the known benefits of smoking cessation, many smokers face difficulties in maintaining abstinence and preventing relapse. In Germany, approximately 30% of individuals aged 14 and older are smokers, which reflects low smoking cessation rates and limited use of evidence-based smoking cessation interventions.</p><p><strong>Purpose: </strong>This qualitative study aimed to explore experts' views on smoking cessation through interviews with health practitioners.</p><p><strong>Methods: </strong>Fifteen semi-structured in-depth interviews were conducted with professionals from diverse fields, including medical doctors, psychologists, and addiction therapists, from July to November 2022. The data were analyzed using qualitative content analysis. A deductively developed categorization system was applied to identify sub-themes within categories and to systematically code the data. All data were thencategorized under two main categories: facilitators and barriers to smoking cessation.</p><p><strong>Results: </strong>Key facilitators included the self-motivation of participants, the communication skills of the intervention leader, and the provision of knowledge about addiction mechanisms. Important barriers were smokers' fears of quitting, external environmental pressures, and inadequate counseling structures.</p><p><strong>Conclusion: </strong>The findings suggest that improving smoking cessation interventions in Germany require comprehensive strategies involving both structural adjustments in health care settings and enhanced training for tobacco treatment specialists.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"483"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing user experience with the Bioline™ HCV point-of-care test in primary healthcare settings: a mixed-methods study.","authors":"Evans Duah, Evans Mantiri Mathebula, Kuhlula Maluleke, Tinyiko Violet Baloyi, Richard Kobina Dadzie Ephraim, Tivani Mashamba-Thompson","doi":"10.1186/s12913-025-12634-8","DOIUrl":"10.1186/s12913-025-12634-8","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C Virus (HCV) is a major public health challenge, particularly in resource-limited settings with inadequate diagnostic services. The Bioline™ HCV Point-of-Care (POC) test provides a promising solution for improving diagnosis in Primary Healthcare (PHC) clinics without laboratory infrastructure. This study evaluated the test's usability, acceptability, and deliverability in Ghana using user-oriented REASSURED criteria.</p><p><strong>Methods: </strong>A convergent parallel mixed-methods design was adopted. Quantitative data was collected through direct observation of Healthcare Workers (HCWs) using audit checklists and analyzed with Stata 16. The analysis included descriptive statistics, inter-rater concordance assessment, and the application of the System Usability Scale (SUS). Qualitative data, analyzed using Atlas.ti 24.2.0, explored user experiences, confidence, storage infrastructure, and suggestions for test design improvement through in-depth interviews.</p><p><strong>Results: </strong>The quantitative audit included 81 non-laboratory HCWs, with 22 participating in in-depth interviews. The test scored 88.7 on the SUS (95% CI: 86.40-90.88), with 88% of HCWs rating it as easy or very easy to use. Most HCWs (81.5%) successfully completed all testing steps independently, achieving 100% inter-rater concordance, but 83% made errors in at least one step, primarily during pre-testing. Qualitative findings revealed widespread acceptance, confidence, and adaptability despite challenges with storage infrastructure.</p><p><strong>Discussion: </strong>The Bioline™ HCV POC test demonstrated high usability and acceptance among HCWs in resource-limited settings. Enhancements such as improved packaging, simplified information sheets, refined droppers, and additional components like gloves could further optimize usability. These findings support the Sustainable Development Goal (SDG) 3 by enhancing access to timely HCV diagnosis, contributing to Universal Health Coverage, and strengthening health systems in underserved areas.</p><p><strong>Trial registration: </strong>This study is part of a diagnostic trial registered in the Pan African Clinical Trial Registry ( https://pactr.samrc.ac.za ) on 24th October 2024 with trial registration number: PACTR202410837698664.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"484"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}