Access Services Research Articles

HAC-SAGIN: High-altitude computing enabled space-air-ground integrated networks for 6G

The space–air–ground integrated networks (SAGINs) provide a new paradigm for the evolution of the Internet of Things (IoT) networks by enhancing coverage and deploying computing resources near IoT devices, especially in emergency situations and disaster-hit regions. In the context of the IoT networks, aerial platforms such as unmanned aerial vehicles (UAVs) and high-altitude platforms (HAPs) present in the air layer of SAGINs with access and aerial computing (AC) capabilities have the potential to significantly expand coverage, enhance performance, reduce delay and handle complex computation tasks for IoT devices. Seeking the stated prospect, we propose a high-altitude computing (HAC)-enabled SAGIN leveraging millimeter waves (mmWave) frequency range in which the IoT devices are provided access services by low-earth orbit satellites (LEO-SATs) and HAPs while the HAPs offer AC facility as well. Non-orthogonal multiple access (NOMA) is used as a multiple access scheme with different clustering mechanisms in uplink (UL) and downlink (DL) communication. We aim to establish high-rate data transmission in DL along with minimizing the execution time of IoT devices offloading their data to the HAPs in UL communication. The mmWaves range is targeted to have high-rate data transmissions and NOMA implementation further enhances the bandwidth available for an individual IoT device. For efficient offloading in UL communication, we formulate an optimization problem aiming to minimize the execution time by using the Lagrangian function-based approach. Execution time is minimized by reducing the transmission and computation time, which is attained by the optimization of allocated power and computation resources. Simulation results demonstrate that the proposed HAC-SAGIN is able to establish high-rate transmissions in DL and exhibits a significant decrease in execution time in UL in contrast to the no optimization case. Optimum power assignment improves the achievable rate, leading to reduced transmission time, while optimum core assignment efficiently reduces the computation time. In addition, the offloaded data size-driven NOMA implementation in UL prominently improves the system effective throughput.

Exploring Journey Experiences of Disabled Passengers in Using Public Transport

This study aims to enhance the understanding of disabled passengers' experiences with public transport by addressing the challenges in measuring their satisfaction and service quality. The central problem is the difficulty in accurately assessing and improving the service quality for disabled passengers, given the diverse needs and barriers they face. Utilizing the SERVQUAL model, which focuses on Tangibility, Reliability, Responsiveness, Assurance, and Empathy, the study identifies and evaluates these key dimensions in the context of public transport services. Findings reveal both unique needs and commonalities among different disability groups: hearing-impaired passengers require visual signals and nonverbal communication, visually impaired passengers need clear auditory announcements and staff assistance, and physically disabled passengers require accessible infrastructure and supportive services. Commonalities include the appreciation for reliable train schedules, cleanliness, and the need for empathetic and responsive staff. Based on these insights, recommendations are provided to enhance service quality by improving physical accessibility features, enhancing communication methods, and providing targeted staff training. Implementing these recommendations will address specific needs and improve the overall satisfaction of disabled passengers, contributing to a more inclusive and effective public transport system. Future work should focus on integrating additional models and exploring other key variables to uncover further insights into service quality and passenger satisfaction. This approach will offer a more comprehensive understanding of how various factors interact and contribute to a more inclusive and effective public transport system.

Abstract B172: Evidence of behavioral research before and during cancer care in Sub-Saharan Africa: A scoping review

Abstract Introduction: Understanding the behavioral aspects of cancer care in Sub-Saharan Africa (SSA) is crucial for developing effective interventions and improving outcomes, particularly during the peri-treatment phase. Synthesizing knowledge sets the stage for prioritizing cancer-focused research in SSA. Therefore, this scoping review aims to synthesize current knowledge on cancer behavioral research during the peri-treatment phase in SSA, focusing on the behavioral and psychosocial aspects of care. Method: Comprehensive literature searches were conducted across multiple databases and grey literature sources. Studies were selected if they included participants > 18 years old undergoing peri-treatment care, randomized controlled trials, or qualitative/quantitative methodologies focused on behavioral oncology. Only full-text articles published in English were included. Data from the selected studies were systematically extracted and organized. Results: A total of 1,897 cancer patients were included across 18 out of the 24 articles analyzed, with participants aged 8-80 years old. The studies mainly included participants recently diagnosed with cancer or undergoing treatment, covering various cancer types, including prostate, cervical, gastric, liver, and colon cancer, from stage I-III. Only three of the 24 studies referenced theoretical frameworks. Each study identified behavioral factors and outcomes among their sample population. Key findings across the studies underscored significant psychological distress manifested through a spectrum of emotional and psychosocial challenges, including poor social and psychological well-being, depression, anxiety, insomnia, and agoraphobia. Cultural influences, cost considerations, and non-interference of symptoms with day-to-day activities delayed healthcare seeking, especially among women. Despite these challenges, instances of psychological resilience were noted, driven by perceived social support, religiosity, hope, and optimism. The review highlighted the complex interplay between cultural norms, stigma, and health behaviors, with stigma often rooted in cultural beliefs. Spiritual beliefs and practices were central to many participants’ cancer journey, shaping their views on illness, treatment, and recovery. Key factors affecting cancer care include healthcare accessibility, financial limitations, social support networks, healthcare provider attitudes, family involvement in treatment decisions, and emotional support. Conclusion: The findings from this scoping review reveal significant psychological distress and barriers to care among cancer patients in SSA, highlighting the urgent need for comprehensive, culturally sensitive interventions that addresses emotional, social, and cultural dimensions. This approach should integrate accessible mental health services, enhance social support networks, and promote culturally appropriate educational programs to reduce stigma and encourage timely healthcare-seeking. Citation Format: Opeyemi O. Bolajoko, Danneta S. Hooks, Motolani Adedipe, Jessica Saintibert, OluwaSeyi Toye, Clifton Sheri, Folakemi T Odedina. Evidence of behavioral research before and during cancer care in Sub-Saharan Africa: A scoping review [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B172.

Beyond administrative burden: Activation and administrative harm

AbstractWithin recent public policy and administration scholarship, there has been a growing focus on the concept of “administrative burden” to describe the learning, compliance and psychological costs incurred by citizens when trying to access services and exercise social and political rights. Specifically, in the context of activation and welfare‐to‐work programmes, scholars have highlighted the effects of administrative burdens on claimants' autonomy, dignity and well‐being. We bring critical social policy scholarship on administrative harm into conversation with Adam and Balfour's concept of “administrative evil” to highlight the underlying dynamics of masking, moral inversion and dehumanisation that facilitate street‐level workers to adopt dispositions of enforcement of administrative burdens. To illustrate the applicability of Adam and Balfour's work to understanding how experiences of administrative burden can be intensified by the practices and dispositions of street‐level workers, we draw on examples of from an ethnographic study of the delivery of welfare‐to‐work in Australia.

Co-producing and co-assessing a new service solution for enhancing health and social care integration: a participatory research protocol

BackgroundThis paper describes a study protocol for co-producing and co-assessing a new sustainable and scalable service solution that enhances health and social integration by involving providers and volunteers delivering services for elderly people in the province of Cremona (Italy), where the elderly population will reach 27% in 2023.MethodsThis upcoming study involves mixed-method participatory research and is structured in three study phases and related objectives. First, it will co-produce a new, accessible and sustainable service solution using an iterative design and management method, Plan-Do-Check-Act by involving professionals and volunteers of a heterogeneous group of health, social and third sector organizations located in the city of Cremona (Italy). Second, the study protocol will co-assess the outcomes of the new service solution using a mixed-method approach for measuring the outcomes on: professionals and volunteers (micro level) and their health, social and third sector organizations (meso level). Third, this study will co-investigate the scalability of the new solution promoting health and social integration in other similar urban areas of the Province of Cremona via the Intervention Scalability Assessment Tool (macro level). The data will be collected through the analysis of official documents, websites, policies and participatory workshops.DiscussionThis protocol proposes an innovative intervention, a novel participatory approach, and an unexplored scalability assessment tool in the context of health and social care integration. This study aims to support professionals from health and social care service providers and volunteers from third-sector organizations to collaborate and integrate each other’s resources. In doing so, the participatory approach will facilitate the co-creation of an effective response to the need of health and social integration, and the development of trustful relationships between health and social care service providers. Moreover, the adoption of Plan-Do-Check-Act and Intervention Scalability Assessment Tool will ensure the quality, scalability and sustainability of the new service solution in other settings.

Unplanned births and their effects on maternal Health: Findings from the Constances Cohort

Unplanned births remain relatively common, even in regions with high contraceptive prevalence and accessible abortion services, such as contemporary France. Previous studies have shown that unplanned births can have numerous negative consequences for the well-being of mothers and children, including poorer maternal health behaviors, delayed and insufficient prenatal care, and depression during or immediately after pregnancy. However, these studies do not provide conclusive evidence on whether the observed outcomes are a consequence of unplanned births or of the conditions in which they likely occur. Furthermore, scant attention has been given to other dimensions of maternal well-being, such as physical health.This study uses longitudinal data from the French Constances Cohort and applies fixed-effects event study models to examine how women's self-rated general health and risk of depressive symptoms are affected in the years following an unplanned birth. Results show that women who had an unplanned birth reported a sudden, significant drop in their general health in the year following the birth, particularly among the youngest, while health outcomes following planned births showed a gradual, slight decrease over the time-period considered. The risk of depressive symptoms increased similarly after birth for both unplanned and planned births. This study contributes to the literature by using a longitudinally constructed measure of unplanned births based on pre-birth fertility intentions, rather than commonly used retrospective measures prone to ex post rationalization. It also distinguishes between unwanted and mistimed births while further examining their consequences on medium-term maternal health.

Are GPTs the Answer to Small Clinics’ Digital Struggles? A Comprehensive Implementation Study

Small clinics in North America often struggle to keep pace with the digital transformation sweeping the healthcare industry due to limited financial resources and technological expertise. This digital divide has become more pronounced with the increasing reliance on digital solutions, such as online booking systems and telehealth services, exacerbated further by the COVID-19 pandemic. This paper evaluates whether Generative Pre-trained Transformers (GPTs), introduced by OpenAI, can effectively bridge this gap by providing a cost-effective and efficient solution for small clinics. We detail the implementation of a GPT-based online booking system tai lored to the needs of small clinics. The methodology includes a flowchart of the system’s components and descriptions, supplemented by code and scripts in the appendix. Our findings show that GPTs can significantly improve booking efficiency, reduce administrative workload, and enhance patient experience. However, we also identify drawbacks such as technical issues and the need for staff adaptation. We discuss potential issues, including error handling, privacy concerns, and appointment conflicts. The paper concludes with recommendations for small clinics on leveraging GPT technology to enhance their digital capabilities, ultimately aiming to provide more efficient and accessible healthcare services.

Perception and barrier in access to sexual and reproductive health services among youth (aged 18-24) in Xiangkhuang province: A mixed-method study study

Background: Sexual activity during youthful age is common in Lao People’s Democratic Republic. However, youth insufficiently use the sexual and reproductive health (SRH) services and subsequently suffer from poor sexual and reproductive health. To stimulate evidence-informed decision-making in health policies, context specific research describing the barriers preventing Lao youth from accessing sexual and reproductive health services is needed. Objectives: To explore the barriers in access to sexual and reproductive health services among unmarried young people in Laos. Methods: Mixed methods were employed to conduct this study in Xiangkhuang province with 444 youths. Face-to-face interviews using questionnaires classified accessibility as geographical (availability), affordability, and approachability, acceptability, and appropriateness. IDIs and FGDs were used to investigate cognitive, psychosocial, and geographic accessibility, affordability, and SRH service quality. Data were entered into Epi-data 3.1 and exported to STATA 14 for analysis. Univariable and multivariable analysis identified predictors of total accessibility, reported as Adjusted OR with a 95% CI and P-value < 0.05. Results: The results found the mean age of the participants with 19.9 years and 68.6% were female,66.9% of them stayed in urban area, 79.9% were Lao, and 93.5% were single. More than half of the participants had poor level of perception toward accessibility of SRH services (51.4%), and 55.1% encountered barriers, highlighting significant challenges in accessing essential services. In multivariable analysis, spiritual individuals had lower odds in perceiving SRH as accessible than Buddhists (AOR = 0.4, 95%CI: 0.2-0.7, p = 0.004), but no significant difference existed among Christians. Those earning over 1,500,000 LAK were more likely to perceive SRH as accessible than those below this threshold (AOR = 2.7, 95%CI: 1.0-7.0, p = 0.041). Additionally, individuals with sexual experience had higher odds of seeing SRH as accessible compared to unexperienced (AOR = 1.9, 95%CI: 1.2-3.1, p = 0.006). Conclusion: The study on youth's perception and barriers to accessing sexual and reproductive health services revealed unique challenges, including Lao ethnicity and Buddhism, financial obstacles, and family influence. The study suggested that targeted interventions should focus on culturally sensitive service delivery, addressing financial barriers, promoting education, and improving internet access to enhance accessibility and overall well-being among youth populations.

User needs for coastal inundation at climate time scales: A multi‐sectoral case study in the coproduction of knowledge

AbstractCoastal regions are becoming increasingly vulnerable to flooding. Due to growing risk, there is a need for a variety of accessible flood inundation services and information to improve resilience and adaptation outcomes. To better understand these needs the National Oceanic and Atmospheric Administration's Office for Coastal Management and the Center for Operational Oceanographic Products and Services collaborated to host five virtual workshops during the COVID‐19 pandemic to understand inundation needs and deficits of five professional sectors: coastal planning, transportation and navigation, realty and insurance, health and human services, and natural resource and floodplain managers. This paper outlines the information collected from these workshops, shares recommendations for future research to improve equitable coastal resilience and highlights the value of remote engagement for knowledge coproduction. From the project results, we share cross‐cutting topics that emerged and propose a need for greater equity, inclusive engagement, interagency coordination and future research directions through scientist‐stakeholder coproduction workshops for improved coastal resilience.

FINANCIAL INCLUSION AND THE INFORMAL SECTOR DURING AND POST-COVID 19 ERAS: STATUS, CHALLENGES AND WAY FORWARD

COVID 19 is one of the major disasters that significantly disrupted the socio-economic statuses of various businesses and nations at large. The purpose of the study was to explore the extent to which COVID 19 affected financial inclusion in Zimbabwe. The quantitative research methodology and the purposive sampling technique were employed. Data was collected using in-depth and focus discussion group interviews from 35 participants. Data was analysed using thematic data analysis approach. Barred people in rural areas from accessing financial services which directly and indirectly increased the magnitude of poverty among people running informal businesses. Financial inclusion, is a key driver to poverty reduction; hence the negative impact of on financial inclusion significantly propels poverty in societies. Digitalizing financial services is one of the strategies which can be utilized to promote financial inclusion in the post- era. Financial institutions should use technology in financial services, so that those in rural areas do not incur transport and logistical costs for accessing financial services. Digital finance and other various financial innovations should be used to achieve financial inclusion in rural areas. Policies that encourage the delivery of formal financial services in rural areas should be developed. Governments should consider granting subsidy to providers of financial services so that they can offer basic financial services at low cost to the excluded population. Thus, governments ought to commit themselves to the delivery of accessible, affordable, appropriate and cost-effective financial services to unserved or underserved households. The study provides managers of financial institutions with various techniques of providing financial services to the informal sector in the post- eras in rural areas. It also provides managers with information pertaining to the risks in providing financial services in post-pandemic era in rural areas. Managers of internet service providers has a role in making sure that the rural folk have access to the facility so that digital banking systems become realizable.

Barriers to creating value with cognitive accessibility features in digital services

AbstractDigital services should be designed so that as many people as possible can use them. Designing digital services to be cognitively accessible brings value to the user if the user can use the digital service and understands its content. The benefits of cognitive accessibility, e.g., better customer experience or better usability in digital services, have been studied from the perspective of both users and organisations. Despite the benefits, there can be barriers to designing and implementing usable and understandable digital services. This paper aims to identify service providers’ perceptions of barriers to designing cognitively accessible digital services. When the barriers are understood, entrepreneurs can be supported to design digital services that generate value for customers. To better understand the barriers, qualitative research with semi-structured in-depth interviews was conducted with Finnish entrepreneurs. The results revealed different kinds of barriers to designing and implementing cognitively accessible digital services.

Research Trends and Hot Spots in Telemedicine for the Elderly: A Scientometric Analysis.

As the elderly population rapidly grows, age-related health issues are increasing. Telemedicine helps older adults adapt by providing efficient and accessible health management and medical services. This study employs bibliometric analysis to examine research focus areas, emerging trends, and collaboration networks in telemedicine for older adults over the past three decades. The Web of Science Core Collection served as the primary data source for the publications on telemedicine and the elderly since the database's inception through June 2024. Using CiteSpace.6.2.R4 software, keyword and collaboration network visualizations were generated, including clusters, co-authors, and co-citations. This study analyzed 586 papers from 252 countries or regions, which were published across 246 journals and written by 2750 authors. The analysis revealed three primary research directions encompassing 42 clusters: (1) health literacy and technology adaptation; (2) telemedicine technology and health management; and (3) social interaction and economic impact. Research hotspots include elderly fitness, mobile health, technology acceptance, telemedicine, elderly care, and health literacy. Despite the potential benefit of telemedicine, challenges persist in areas such as technology acceptance, usability, effectiveness, service quality, and privacy concerns. This review provides a comprehensive overview of current research on telemedicine for the elderly and highlights emerging trends in the field.

Outcomes that Matter to Youth and Families in Behavioral Health Services.

Patient-centered outcomes research helps youth and families using behavioral health services make informed decisions about treatments to help them achieve the outcomes most important to them. However, there are few efforts to identify the outcomes valued by youth and families systematically. This project aimed to support the development of behavioral health services that deliver outcomes valued by families by identifying the outcomes that youth and young adults with behavioral health needs and caregivers say matter most to them. We engaged 34 youth and young adults (YYA) with behavioral health needs, alongside 42 caregivers from six U.S. regions, in two rounds of one-hour virtual focus groups. The initial round involved participants identifying what they hoped to gain from using behavioral health services for personal, familial, and parental or child well-being and the attributes of positive service experiences. We coded responses using qualitative analytical software, culminating in synthesized reports. Subsequently, the second round entailed participants' review and refinement of initial findings. Across sessions, each group reported the top three outcomes deemed most important for children, YYA, parents, families, and their service experiences. YYA identified being understood by others, improving their interpersonal relationships, and feeling heard as the highest priority behavioral health service outcomes. Caregivers of children and youth with behavioral health needs identified having accessible services that meet their needs, having providers that collaborate effectively with parents and other service systems, and experiencing consistent and continuous behavioral health care for their child as the most important behavioral health service outcomes. Both YYA with behavioral health needs and caregivers of children and youth prioritized gaining the necessary knowledge, resources, and tools to support their or their child's behavioral health. Additionally, both participant groups emphasized the importance of effective communication with providers, within their families, and with peers. Minimizing judgment and stigma from society, providers, and other professionals also emerged as a critical outcome for these groups. It is essential for research and policy development to focus on and cater to the outcomes that are important and valued by YYA and their families to maximize family engagement in care.

Perception of community reintegration among individuals with spinal cord injury in northwest Nigeria: a qualitative description

Purpose To explore the meaning of community reintegration and strategies for promoting community reintegration based on the lived experiences of individuals with spinal cord injury in northwest Nigeria. Material and Methods Using a qualitative description, we purposively recruited people with spinal cord injury residing in Kano, Nigeria. Eight focus groups were conducted to gather relevant information about the meaning and strategies for community reintegration, based on the lived experiences of the participants. Results A total of 64 people aged 18-60 years completed the study. Most of the participants had lived with spinal cord injury for more than five years. The individuals perceived community reintegration as a multi-dimensional concept reflected by five major themes namely: living life as usual, gainful engagement, a basket of opportunities, courage and support, and acceptance of destiny. Furthermore, the participants considered education and awareness about spinal cord injury, supportive and enabling environment, equal opportunities, care and moral support, and accessible health and rehabilitation services as critical for promoting community reintegration. Conclusion Community reintegration is a multidimensional process, and its promotion in northwest Nigeria requires a multisectoral approach.

Analysis of Access, Quality and Health Services on the Effectiveness of Health Insurance System

Analysis of Access, Quality and Health Services on the Effectiveness of Health Insurance System

Switching pattern of healthcare services and its determinants among patients with communicable and non-communicable diseases in India

BackgroundThe current study investigates the switching behaviour and patterns among patients in India, particularly in the context of various ailments such as Non-Communicable Diseases (NCDs), Communicable Diseases (CDs), and other health issues. To evaluate people's behaviour towards accessing healthcare facilities in public and private healthcare providers separately for CDs, NCDs, and other ailments. Material and methodsThe study design is observational and cross-sectional. The study included data from NSS 71st, NSS 75th, and LASI wave-1 datasets, which provide information on the incidence of switching behaviour among patients with different types of ailments. Statistical analysis usedThe Binary logistic regression analysis has been used to examine the determinants of switching behaviour in usage of healthcare facilities. Prevalence estimates were exhibited using weighted % and 95 % confidence intervals (CI). P values < 0.05 were considered statistically significant. ResultsPresent study revealed that patients' behaviour in accessing healthcare facilities is influenced by a multitude of factors, including the nature of their ailment, socio-economic status, education, and regional disparities. Notably, patients suffering from NCDs exhibit a higher propensity for switching between public and private healthcare services, with a preference for the latter. The study found that among patients who were paying for special types of wards, there were significantly lower odds of switching behaviour. ConclusionsThe research highlights the nuanced dynamics of healthcare service utilization in India and underscores the need for tailored strategies to address the specific challenges posed by NCDs and communicable diseases while ensuring equitable and accessible healthcare services for all.

Navigating Higher Education Challenges: A Review of Strategies among Students with Disabilities in Indonesia

Access to higher education has been widely open for students with disabilities (SwD) as also enforced by the Government of Indonesia (GoI). However, challenges evidently face SwD in their survival of university life including limited accessible services and facilities, as well as negative stereotypes surrounding SwD. This study aimed to explore the diverse strategies adopted by SwD in navigating these challenges, examining the nuances and implications of the deployed strategies. This review explored the experiences of SwD in higher education institutions in Indonesia and adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Review) guidelines. Data were gathered from seven databases, including Scopus, Web of Science, ERIC, ProQuest, Google Scholar, and Portal Garuda. In total, 17 of 1777 articles were selected based on two inclusion criteria viz. peer-reviewed articles derived from empirical studies and utilizing life experiences of SwD in Indonesian HE as the primary data source. The study identified the five key strategies employed by SwD: Adaptation, Technology Assistive Optimization, Requesting Support, Building Relationships, and Passive Action. Detailed elaboration of the findings is presented to shed light on the prominent insight to improve the quality of education services for SwD in Indonesia.

Pushing health data access boundaries - adapting NHS governance for 3 challenges: clinical free-text, safe commercial access and AI development

This presentation will demonstrate expansions to TRE governance frameworks developed to facilitate safe data access in three advanced areas: commercial access, clinical free-text, and innovation with AI/Machine Learning. NHS research governance frameworks - originally set up for clinical trials and expanded into the TRE and secondary data use space – are not an immediate fit for advanced techniques in data science research. Over 2 years, public, expert and user engagement approaches were utilised to support developing frameworks within DataLoch, a Health and Social Care TRE and data access service in South-East Scotland. Surveys, workshops and continuous user and data controller feedback allowed the testing of tools and assessments to adapt traditional NHS governance structures. These frameworks utilise the Five Safes framework to make NHS data controllers supportive of innovative research in the public and health service’s benefit. The presentation will summarise the challenges faced for one TRE and researchers working to support these areas, and the frameworks that are now are being tested within an NHS Scotland Health Board. The development and implementation demonstrates that governance structures can be adapted collaboratively and paves the way for more flexible TRE governance to allow the use of NHS patient data to remain legally and ethically robust while supporting advanced techniques of analysis.

An Overview of Health Care Support of Intimate Partner Violence Survivors

Intimate Partner Violence (IPV) has severe physical and psychological effects on survivors. Despite growing awareness, accessing comprehensive health care remains a challenge for many survivors. This review aims to assess the impact of IPV on the survivors, health care needs, and interventions for IPV survivors, evaluate their effectiveness, and identify areas for improvement. This paper reviewed literature and guidelines from reputable journals with a focus on studies about health care support, including interventions and outcomes for IPV survivors. The paper found there is a need for routine IPV screening in health settings, effective multidisciplinary care, and better training for healthcare providers. Barriers such as stigma, resource limitations, and inadequate referral systems were common. Survivors also face difficulties accessing the healthcare system due to fear and confidentiality issues. Quality and effective support requires universal screening, trauma-informed care, and accessible services. While some practices are beneficial, there is a need for standard and improved provider training. Policymakers should focus on overcoming systemic barriers and enhancing support services. The support system for IPV survivors is improving but still faces significant challenges. Addressing these issues through better policies, resources, and training is crucial for providing effective care and reducing the long-term impact of IPV. Keywords: Intimate Partner Violence, Health Care Support, Survivor support, Multidisciplinary Approaches, Trauma-Informed Care

Effectiveness of demographic policy measures in addressing population decline in contemporary Russia

Demographic policy is one of the key tasks of almost any state at the present time. It correlates with the solution of pressing problems in the economic and social spheres, directly depends on the state of healthcare, education, migration policy and other factors and directly affects the socio-economic development of both individual regions and the country as a whole. Many Russian and foreign researchers believe that demographic indicators very accurately reflect the socio-economic and political situation of the state. The relevance of the study is due to the fact that for the progressive socio-economic development of any country, positive demographic dynamics are necessary. The main sign of the negative demographic situation that has developed in modern Russia and a number of countries, primarily European, is the growing scale of depopulation (population extinction). The purpose of this work was to analyze the existing demographic policy of Russia and compare demographic trends in Russia and other countries. The work uses methods of statistical data analysis, comparison of statistical indicators of fertility, mortality, natural population decline, migration, marriage rates in Russia and the Republic of Srpska, methods of retrospective analysis, research of the institutional environment created by the action of state and national programs “Demography”, “Providing accessible and comfortable housing and public services for citizens of the Russian Federation”, “Strategy of socio-economic development for the period until 2024”, Presidential decrees, etc. Research has shown that despite measures taken to overcome the demographic crisis, Russia’s population continues to decline. According to the Federal State Statistics Service of the Russian Federation (Rosstat), as of 1 January 2023, 146.45 million people lived in Russia. By 1 January 2046, according to a Rosstat forecast published in October 2023 the country’s population will decrease to 138.77 million people. To solve demographic problems in the Russian Federation, a national project “Demography” was developed and approved. The government has allocated more than 3 trillion rubles for its implementation. However, it is not possible to completely overcome the negative trend. The authors proposed a number of economic and ideological measures within the framework of agglomeration, migration, and family support policies that can be used within the framework of socio-economic development strategies and national programs aimed at overcoming the demographic crisis.