BMC Health Services Research最新文献

{"title":"A qualitative evaluation of stakeholder perspectives on the implementation of HIV services within adolescent and youth-friendly services for the youth in Nampula, Mozambique.","authors":"Phepo Mogoba, Joana Falcao, Tsidiso Tolla, Allison Zerbe, Eduarda Pimentel De Gusmao, Landon Myer, Elaine J Abrams","doi":"10.1186/s12913-025-13414-0","DOIUrl":"10.1186/s12913-025-13414-0","url":null,"abstract":"<p><strong>Background: </strong>Despite the well-documented challenges affecting HIV treatment for adolescents and young adults living with HIV (AYAHIV) in low- and middle-income countries, the implementation of recommended Adolescent and Youth-Friendly Services (AYFS) remains limited. In this qualitative study, we explored stakeholder perspectives on the implementation of HIV services for AYAHIV within AYFS in Nampula, Mozambique. This study forms part of a broader investigation on improving HIV care among adolescents and young adults living with HIV (AYAHIV) in Mozambique.</p><p><strong>Methods: </strong>Using a purposive sampling strategy in an exploratory qualitative research study, we conducted semi-structured in-depth interviews between September and December 2021 with stakeholders, including healthcare workers (HCWs) delivering HIV services and key informants managing HIV services for youth on ART in 12 health facilities participating in the CombinADO study. The interviews were analyzed using thematic analysis.</p><p><strong>Results: </strong>Participants included 59 stakeholders (44% HCWs and 56% KIs), the majority of whom were female (71%). The findings suggested variations in stakeholder perspectives on HIV service delivery, indicating disparities in service quality across different health facilities. While positive assessments prevail, notable barriers include inadequate staff training, staff shortages, limited privacy, absence of caregiver support, insufficient HIV literacy among AYAHIV and caregivers, and access constraints. Facilitators include patient-provider relationships, collaborative care, well-trained HCWs, support groups, effective dissemination of HIV awareness information, one-stop shops, and privacy.</p><p><strong>Conclusions: </strong>Stakeholders shared positive perceptions and experiences concerning the delivery of HIV services to AYAHIVs within the current AYFS framework in Nampula. However, they also identified barriers-such as limited staff capacity, insufficient training, and lack of private spaces-that hinder the effectiveness of these services in addressing challenges related to retention, ART adherence, and HIV stigma among AYAHIVs. Addressing these barriers is essential to optimize HIV service delivery and improving outcomes for adolescents and young adults. Notably, findings from this study informed the refinement of the CombinADO intervention, which integrated enhanced HCW training, infrastructure strengthening, and peer-led support to better respond to AYAHIV needs within AYFS.</p><p><strong>Trial registration number: </strong>ClinicalTrials.govNCT04930367. Registered on 18th June 2021.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1229"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198059","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":"Deciding on the location for receiving parenteral antimicrobial therapy: development and preliminary testing of a patient decision aid.","authors":"Marie Louise Thise Rasmussen, Dawn Stacey, Kirsten Lomborg, Hanne Konradsen","doi":"10.1186/s12913-025-13434-w","DOIUrl":"10.1186/s12913-025-13434-w","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1240"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197790","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":"Matching implementation strategies to barriers and facilitators for a lifestyle front office in the hospital: a qualitative study.","authors":"Marlinde Lianne van Dijk, Joyce Vrijsen, Leonie Mariëlle Te Loo, Inge van den Akker-Scheek, Martine de Bruijne, Rienk Dekker, Willem van Mechelen, Femke van Nassau, Judith G M Jelsma","doi":"10.1186/s12913-025-13452-8","DOIUrl":"10.1186/s12913-025-13452-8","url":null,"abstract":"<p><strong>Background: </strong>In Dutch hospitals, advice on healthy lifestyle during consultation with healthcare professionals is hindered by limited time, insufficient skills and limited knowledge on referral options. In order to organize a new care pathway in which care related to healthy lifestyle is provided through a dedicated lifestyle front office (LFO) in the hospital, implementation barriers and facilitators were identified and matched to tailored implementation strategies.</p><p><strong>Methods: </strong>Semi-structured interviews were held between March and August 2021 with healthcare professionals (i.e. specialists, physician assistants, dieticians, physiotherapist, (specialized) nurses) from different clinical departments (n = 33), and with patients (n = 27) diagnosed with a non-communicable disease (NCD) that were treated in out-patient clinics of the hospital and had a body mass index of 25 ≥ kg/m² and/or were current smokers. An inductive thematic analysis was conducted to identify barriers and facilitators for implementation. Barriers were matched to implementation strategies with the CFIR-ERIC Implementation Strategy Matching Tool and further operationalized for use in practice.</p><p><strong>Results: </strong>Barriers and facilitators were clustered according to different organizational stages of the identified care pathway. Referral to LFO includes six topics: healthcare professionals' beliefs about lifestyle; patient motivation for lifestyle change; referral skills and knowledge of healthcare professionals; digital resource support for referral; feedback after referral; and responsibility for referral. Appointment at LFO was affected by six topics: financial burden of the additional visit; time, skills and knowledge of lifestyle broker; physical location of LFO; efficiency in care planning; fragmentation; and prevention as task of the general practitioner. Regarding referral to community-based lifestyle initiatives four barriers were identified: financial burden of community-based lifestyle initiative; geographical availability; quality assurance of community-based lifestyle initiatives; and collaboration. Implementation strategies included building an infrastructure, creating a learning collaborative, preparing a referral tool, identifying local champions, informing stakeholders, conducting training, building a coalition, collecting testimonials and accessing new funding.</p><p><strong>Conclusions: </strong>Insights from the current qualitative study were based on a large and diverse stakeholder group and provided important insights for the implementation of an LFO in the hospital. Future research should provide information on effectiveness of actual implementation of the implementation strategies in an LFO in the hospital.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1241"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197913","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":"A qualitative exploration of multi-level factors that support effective community health worker-social worker collaboration.","authors":"Nidhi Monga Nakra, Liana J Petruzzi, Alexander B Diller, Julie Smithwick, Lily Lee, Geoff Wilkinson, Joshua Collier, Sarah Chang","doi":"10.1186/s12913-025-13347-8","DOIUrl":"10.1186/s12913-025-13347-8","url":null,"abstract":"<p><strong>Background: </strong>Interdisciplinary collaboration is critical for improving healthcare delivery through coordinated care and streamlined healthcare navigation. Community health workers (CHWs) and social workers (SWs) are uniquely positioned to address the needs of individuals with complex social and health challenges. Despite the integration of CHWs and SWs into health and community settings, there is a paucity of literature on what facilitates successful collaboration between these two workforces. This qualitative study, conducted from April 2022 to June 2023, explores multilevel factors related to CHW-SW collaboration in health and community settings.</p><p><strong>Methods: </strong>We conducted eight, 90-min virtual focus groups with CHWs (n = 20) and SWs (n = 17) collaborating in four healthcare and community health settings across the United States (California, Texas, New Jersey, and South Carolina). Focus groups were conducted between April 2022 and June 2023.</p><p><strong>Results: </strong>Themes were thematically organized according to the socio-ecological model. Individual and relationship-level factors included: roles and scopes of practice, communication, mutual respect, supportive supervision, and power dynamics. Organizational and community-level factors comprised: commitment to equity, leadership buy-in, standardized training, clear workflows, and shared documentation and physical space. Societal-level factors included: power dynamics, supportive policies and sustainable funding.</p><p><strong>Conclusions: </strong>Findings highlighted that CHW-SW collaboration can promote patient-centered care and address social determinants of health when both workforces are well integrated in healthcare systems. Key organizational commitments, community rapport, and relational dynamics should be established to optimize interdisciplinary collaboration and advance health equity.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1248"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198041","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":"Improving healthcare quality in Sudan: situation and factors influencing healthcare professionals' engagement.","authors":"Swsan A M Elsharif, Elaf M H Abdelraheem, Hajar Saad Salih, Arwa Nasr, Mohamed Eltayeb Elnour, Reem A A Mohamedelmugadam, Zuhal Yahya Mohammed Omer, Reem Azmi A Yousif, Ayat Abdelbagi Ahmed Mohamed","doi":"10.1186/s12913-025-13481-3","DOIUrl":"10.1186/s12913-025-13481-3","url":null,"abstract":"<p><strong>Background: </strong>Quality improvement (QI) projects depend on the active involvement of healthcare professionals. However, their engagement remains suboptimal, specially in humanitarian settings such as Sudan. Our study aimed to describe healthcare professionals' engagement and to identify facilitators and barriers to conducting QI projects.</p><p><strong>Methods: </strong>An online-based cross-sectional survey was conducted in Sudan between July and November 2024 using convenience sampling. The survey was distributed to healthcare professionals through different social media platforms. Data were manually cleaned in Excel sheet and analysed using Statistical Package for the Social Sciences Version 20 (SPSS 20). Chi Square test, Mann Whitney U test and Kruskal Walis test were used to identify factors associated with experience and self-efficacy in QI.</p><p><strong>Results: </strong>A total of 1007 healthcare professionals were included in the study; the mean age was 27 ± 5 years, and the majority (67.9%) were females. Most of the participants (74.7%) were physicians, and (15.7%) were nurses. Only (18%) of participants reported that they have prior experience with QI projects. Older age, male gender and increased years of experience were found to be significantly associated with QI experience (p value < 0.05). Factors that influence self-efficacy in conducting QI projects were older age groups and increased years of experience, in addition to professional development opportunities such as formal training in QI, professional workshops in QI, and QI organisational membership. Barriers to conducting QI projects were lack of organisational support (59.1%), no access to QI content (48.6%), lack of time (39.8%), and lack of mentorship (31.5%).</p><p><strong>Conclusion: </strong>The study reveals low engagement of healthcare professionals in QI projects. Organisational support and professional development opportunities are essential to ensure effective healthcare professionals' engagement in QI projects, thereby enhancing the quality of care and ensuring favourable outcomes.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1237"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197871","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":"Lived experience in Italian mental health services: a national survey of peer support and co-production practices.","authors":"Antonio Lasalvia, Luca Bodini, Veronica Fin, Chiara Bonetto","doi":"10.1186/s12913-025-13407-z","DOIUrl":"10.1186/s12913-025-13407-z","url":null,"abstract":"<p><strong>Background: </strong>Peer support has become a cornerstone of recovery-oriented mental health systems worldwide, with increasing recognition of its value in promoting recovery, empowerment, and inclusion. In Italy, despite a long-standing tradition of community-based care, the integration of peer support services (PSSs) remains fragmented and understudied.</p><p><strong>Methods: </strong>A national cross-sectional online survey was conducted between January and February 2025 targeting all Italian Mental Health Departments (MHDs). The survey explored the presence, organization, and perceived impact of peer support and co-production practices.</p><p><strong>Results: </strong>A total of 61 out of 135 MHDs (45%) responded. Among them, 55.7% reported implementing peer support initiatives, primarily within community-based services. Peer support workers (PSWs) were generally perceived as effective in fostering recovery and reducing stigma. However, major barriers included lack of formal recognition, insufficient funding, and cultural resistance (e.g., reluctance among some professionals to acknowledge experiential knowledge or to integrate non-clinical roles into multidisciplinary teams). Co-production practices were reported by more than half of the MHDs, though they remained largely consultative.</p><p><strong>Conclusions: </strong>Peer support and co-production are emerging within in Italy's mental health system but face substantial structural and cultural barriers. National frameworks and dedicated resources are required to support sustainable implementation and the full integration of experiential knowledge into mental health services.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1235"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197880","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":"Enhancing mental health outcomes through a theory of change: supporting open-source data science platforms to promote FAIR data and evidence-based decisions.","authors":"Bylhah Mugotitsa, Pauline Andeso, Henry Owoko, Reinpeter Momanyi, Dorothy Mailosi, Joshua Ssebunnya, Benjamin Tsofa, Jay Greenfield, Agnes Kiragga, Jim Todd","doi":"10.1186/s12913-025-13474-2","DOIUrl":"10.1186/s12913-025-13474-2","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1239"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197902","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":"Shaping older adults' care policy: a scoping review of key determinants in post-acute and community reintegration transitions.","authors":"Saina Sehatkarlangrodi, Manaf Zargoush, Christopher J Longo, Somayeh Ghazalbash","doi":"10.1186/s12913-025-13433-x","DOIUrl":"10.1186/s12913-025-13433-x","url":null,"abstract":"","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1236"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198027","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":"Perioperative outcomes and economic impact of benign prostatic hyperplasia surgeries in Brazil's public health system.","authors":"Lucas Seiti Takemura, Ivan Kirche-Duarte, Gabriel Franco de Camargo Galindo, Felipe Arakaki Gushiken, Julio Silva Nogueira Luz, Jonathan Doyun Cha, Marcelo Langer Wroclawski, Luiz Vinicius de Alcantara Souza, Laercio da Silva Paiva, Gustavo Caserta Lemos, Bianca Bianco, Arie Carneiro","doi":"10.1186/s12913-025-13261-z","DOIUrl":"10.1186/s12913-025-13261-z","url":null,"abstract":"<p><strong>Background: </strong>Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in aging men, and significantly affects their quality of life and productivity. In Brazil, where most of the population relies on the Public Health System (SUS), transurethral resection of the prostate (TURP) and simple prostatectomy (SP) are the primary surgical modalities. These procedures vary in cost-effectiveness, influencing clinical decisions and healthcare resource allocation. Therefore, we aimed to describe the perioperative outcomes of surgical modalities (TURP and SP) and the financial impact of these treatments in major Brazilian regions in recent years.</p><p><strong>Method: </strong>This ecological study utilized data from the Brazilian Public Health System database (DATASUS) from 2009 to 2022. The records of patients diagnosed with BPH and undergoing TURP or SP were analyzed across Brazil's major geographic regions. The key outcomes included annual surgery volumes, patient demographic characteristics, hospitalization characteristics (e.g., length of stay and intensive care unit utilization), intrahospital mortality rates, and government reimbursements to hospitals. Statistical analyses included descriptive statistics, comparisons between the two techniques, and regression models to assess the temporal trends in mortality rates.</p><p><strong>Results: </strong>Over the 14-year period analyzed, Brazil recorded 204,358 BPH surgeries, with the Southeast region accounting for 46.56% of the procedures. TURP was the predominant procedure nationwide (61.44%), particularly in the higher-income regions. Perioperative outcomes favored TURP, with lower intrahospital mortality rates (0.25% vs. 0.55% for SP) and shorter hospital stays (median, 3 days vs. 5 days for SP). Both procedures resulted in decreasing mortality trends, although the differences were not statistically significant. Government reimbursements for hospitals were lower for TURP than for SP and did not keep pace with inflation during this period.</p><p><strong>Conclusion: </strong>This study underscores the prominent role of the Southeast region in BPH surgeries within Brazil's public health system and highlights TURP's favorable perioperative outcomes of TURP over SP. It also showed a financial deficit in surgery reimbursements, which may impact the sustainability of the public health system.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1225"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145197992","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":"The impact of digital channels on public health services to enhance city resilience during the public health emergency response in Thailand (2020-2023).","authors":"Watcharaporn Chutarong, Roongaroon Thammalikhit, Anurak Sawangwong, Yuqian Guo, Muhammad Fawad, Supaporn Lonapalawong, Weiwen Zhang","doi":"10.1186/s12913-025-13480-4","DOIUrl":"10.1186/s12913-025-13480-4","url":null,"abstract":"<p><strong>Background: </strong>This study examines the impact of digital channels on public health services and their role in enhancing city resilience.</p><p><strong>Methods: </strong>Conducted in Thailand, this study employed an online questionnaire distributed in both Thai and English from December 2023 to February 2024. A total of 824 valid responses from Thai nationals and foreigners were analyzed. Exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were performed using IBM SPSS 23 and AMOS 23.</p><p><strong>Results: </strong>Digital channels have a strong positive direct effect on public health services (β = 0.70, p < 0.001), public health services have a strong positive direct effect on resilient cities (β = 0.69, p < 0.001), and digital channels have a low positive direct and a moderate positive indirect effect on resilient cities (β = 0.19, p < 0.001, and β = 0.48, p < 0.001, respectively). The model demonstrated excellent fit with the empirical data: X²/df = 2.189, CFI = 0.954, GFI = 0.900, NFI = 0.919, TLI = 0.946, RMSEA = 0.038, and RMR = 0.047.</p><p><strong>Conclusions: </strong>Digital channels are critical tools for collecting, analyzing, and disseminating public health service data. They improve public health services across five dimensions-product, facility, service, process, and price-while also strengthening city resilience in disaster management, economic stability, quality of life, and institutional capacity.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"1249"},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198062","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}