Client Population Research Articles

Implementation of Food Safety Management System and its Effects on Business Performance in an Educational Institution Restaurant.

Food safety standard implementation is fundamental to the prevention, detection, and management of foodborne risks as well as the realization of food security, protection of health, and economic sustainability of food manufacturing, processing, and distributing enterprises. The global food safety standard, Hazard Analysis and Critical Control Point (HACCP) is one such instrument deployed to promote food safety in the hospitality industry worldwide. A higher educational institution in Kenya introduced HACCP ten years ago as part of its ongoing quality improvement policy to gain the advantages of implementing the standard in the food business, and as a reaction to incidents of food contamination in its restaurant that raised concerns among the customers and the leadership. Food contaminations were experienced even after the implementation of the HACCP food safety program, which brought to the fore the pitfalls that occur due to deviations from the HACCP plans and loss of control that expose consumers to food hazards. Despite the introduction of HACCP in the institution’s restaurant in 2014, there have been incidents of lapses in food quality among which was a suspected food contamination resulting in undesired customer experiences. This study aimed to evaluate the effects of the implementation of HACCP food safety management processes on food and beverage safety and business performance at the institution’s restaurant. The specific objectives of the study were to assess the implementation of the HACCP food safety management system in food production and sales; assess the customer perceptions and confidence levels in the quality and safety of food and beverages served, and to evaluate the effects of the HACCP food safety management programme in the delivery of safe food and the general business performance at the institution restaurant. The study design was exploratory and involved a survey of restaurant customers using a structured questionnaire, and interview of key informants using an interview guide. The researcher also observed food chain processes using a checklist. The study population was primarily the management and staff of the institution restaurant as well as the client population comprising students, instructors, administrative staff, institution managers, and regulatory agency representatives. The data obtained from primary sources was complemented with secondary data. Quantitative data were analysed using descriptive statistics and results were presented in tables, graphs, and pie-charts while qualitative data were analysed thematically. The key findings of the study were that despite some challenges and complexities in the implementation of HACCP, this food safety management system had significantly reduced the incidence of food contamination in the facility. Further, based on customer perceptions and feedback, the institution had registered high customer satisfaction scores (CSAT) and customer retention rates (CRR). In addition, the institution was able to generate sustained and increasing revenues and profits for the institution. The study therefore concluded that HACCP is an important instrument for promoting and safeguarding food safety in the hospitality industry and an important tool for building customer confidence and generating revenues for food businesses. The key recommendation from this study is that the institution should address identified issues of space, equipment, staff, and supplier knowledge and skills that compromise conformity with HACCP requirements.

DID COVID-19 CHANGE REPORTS OF LONELINESS AND SOCIAL ISOLATION AMONG OLDER AMERICANS ACT CLIENTS?

Abstract COVID-19 raised immediate concern about the exacerbation of already high levels of loneliness and social isolation of older adults. Using the cross-sectional 2019 and 2021 National Survey of Older Americans Act Participants, we explored changes among selected populations of OAA clients – family caregivers (CGs), home-delivered meal clients (HDMs), and congregate meal clients (CMs). Descriptive statistics, t-tests, and review of 95% confidence intervals between years were conducted to understand rates of loneliness (UCLA 3-items) and social isolation (1-item). Results were not statistically significant but yield important findings. First, there were more cases of loneliness (48-70%) and social isolation (31-50%) than was known for the general older adult population before COVID-19. Second, the changes between 2019 and 2021 varied by service and gender. Among CGs, there was little difference in the cases of social isolation and loneliness from 2019 to 2021; however, male CGs reported a 20.3% increase in cases of social isolation. For HDMs there was a little difference over time in cases of social isolation and loneliness. There was a 23.3% increase in the number of CMs reporting social isolation and a small increase (9.3%) in CMs reporting loneliness; however, there was an 18.4% increase in cases of loneliness among male CMs. These results warrant further investigation to understand whether OAA services are a protective factor for social connections and further implementation of innovative approaches to lower overall rates of social isolation and loneliness among OAA clients.

Effects of Multi-Month Dispensing on Clinical Outcomes: Retrospective Cohort Analysis Conducted in Kenya.

Multi-month dispensing (MMD) has been widely adopted by national HIV programs as a key strategy for improving the quality of HIV care and treatment services while meeting the unique needs of diverse client populations. We assessed the clinical outcomes of clients receiving MMD in Kenya by conducting a retrospective cohort study using routine programmatic data in 32 government health facilities in Kenya. We included clients who were eligible for multi-month antiretroviral therapy (ART) dispensing for ≥ 3 months (≥ 3MMD) according to national guidelines. The primary exposure was enrollment into ≥ 3MMD. The outcomes were lost to follow-up (LTFU) and viral rebound. Multilevel modified-Poisson regression models with robust standard errors were used to compare clinical outcomes between clients enrolled in ≥ 3MMD and those receiving ART dispensing for less than 3 months (< 3MMD). A total of 3,501 clients eligible for ≥ 3MMD were included in the analysis, of whom 65% were enrolled in ≥ 3MMD at entry into the cohort. There was no difference in LTFU of ≥ 180 days between the two types of care (aRR 1.1, 95% CI 0.7-1.6), while ≥ 3MMD was protective for viral rebound (aRR 0.1 95% CI 0.0-0.2). As more diverse client-focused service delivery models are being implemented, robust evaluations are essential to guide the implementation, monitor progress, and assess acceptability and effectiveness to deliver optimal people-centered care.

DO PUBLIC HOME CARE CLIENTS “LOSE OUT ON SERVICES” BECAUSE THEY HAVE A FAMILY CAREGIVER?

Abstract The public home care (PHC) system in Canada is heavily reliant on family caregivers to enable clients to stay in the community. When caregivers are present, there are concerns formal home care aide (HCA) services are less available. Using data from the Resident Assessment Instrument for Home Care (RAI-HC), we examined caregiver and client characteristics in relation to HCA service amounts. Our cohorts were individuals aged 60+ receiving an initial RAI-HC assessment in 2011-2013, and one subsequent assessment in two provincial jurisdictions: the Winnipeg Regional Health Authority (n=5,251) and Nova Scotia Health (n=5291). We measured weekly HCA hours and constructed a predictive model for hours of care controlling for client need. To identify the most underserved client population, we calculated the ratio between predicted to actual received hours of care ascertaining the lowest client quintile. In both jurisdictions, the odds of being underserviced were higher when the client co-resided or had a spouse. Clients living alone at initial intake were least likely to be underserved. Caregiver characteristics increasing the risk of being underserved in Winnipeg included providing IADLs/ADLs support, caring more than 14 hours per week and being unable to continue. Rurality increased risk of underservice in Nova Scotia. These findings contribute to the debate: is PHC a supplement or substitution for family care? PHC as a supplement to family care was more pronounced in Winnipeg and in rural Nova Scotia. Implications for greater equity across regions is explored using an Equity, Diversity and Inclusion lens.

The association between counselor ratings of working alliance and in‐session empathy among sex offender counselors

AbstractFactors such as the therapeutic relationship and working alliance have been shown to be important predictors for client outcomes in broad counseling settings with diverse client populations. The present study used linear multiple regression analysis to explore how relational factors such as in‐session empathy and mindfulness impact working alliance when providing sex offender counseling. Results from sex offender counselor participants (N = 109) showed that the perspective taking aspect of empathy was most impactful on working alliance and that in‐session mindfulness was less impactful on working alliance.

Clinical practice review on post-traumatic growth among healthcare professionals post COVID-19 and the facilitation of health outcomes for the patient and client population group

Clinical practice review on post-traumatic growth among healthcare professionals post COVID-19 and the facilitation of health outcomes for the patient and client population group

A Delphi Study Using Expert Consensus to Develop a Well-Defined Vision for a Centre of Excellence for Therapeutic Recreation in Continuing Care Settings

There is an increasing demand for evidence-based practice and the demonstration of client outcome achievement in therapeutic recreation (TR). There is also an ongoing need to research TR service provision in continuing care settings. The TR profession is well-suited to improving the well-being and quality of life of individuals living in continuing care homes, however, current TR services are not standardized and vary greatly between settings and practitioners. Centres of Excellence (CoE) are organizations that endeavour to establish high standards of practice in a specific profession or area of research. A CoE could be instrumental in improving the delivery of quality TR services in continuing care settings. A Delphi expert consensus method was used to obtain a well-defined vision for a CoE for TR in continuing care settings. Three rounds of online questionnaires were completed over a period of nine weeks by an expert panel of 11 TR professionals working in continuing care settings. The participants reached the consensus that the vision of the CoE should be, “To inspire and advocate for quality TR services in continuing care settings through increased research and evidence-based practice.” The findings from this study contribute to the development of a CoE for TR in continuing care settings. They could also contribute to the development of additional CoEs for TR with other client populations—a topic that has been largely unexplored in the research literature.

An Exploratory Study on Career Challenges of&amp;nbsp; Spa Therapists in Sri Lanka

Spa in Sri Lanka provides a rejuvenating experience for anyone looking to unwind from the stresses of everyday life or find relief from the pain of a severe illness. Professional spa therapists play a significant role in the Sri Lankan spa industry. They should work in various settings, specialising in knowledge concerning specific client populations, and learn multiple massage and spa bodywork systems that approach the body and healing from new perspectives; therefore, many professional therapists face various challenges. This exploratory study aimed to explore career challenges faced by spa therapists in Sri Lanka. According to the survey, We were able to locate eight spa therapists working in an SLDTA-registered spa in Colombo, the capital of Sri Lanka. Purposive and snowball sampling methods were used together to find information-rich cases. The thematic analysis has been used to analyse the data. According to the findings, different types of inherent and extrinsic challenges exist. These challenges include social, guest-related, health-related, workplace-place-related, economic, and regulatory-related. In addition, we were able to capture the response of Spa therapists to those challenges. The implications of this research would help understand the typical career challenges of Spa therapists and help the vocational training sector and industry regulators to develop measures to advance career development and establish the reputation of the occupation of the Spa therapist in Sri Lanka.

The Clinician’s Role in Managing Safety during Animal-Assisted Psychotherapy

Abstract In this case study, I explore some of the challenges in determining which animal or animal species to choose for an animal-assisted psychotherapy (AAP) intervention. While dogs make excellent introductory animals, prey animals can offer a greater challenge and hence potential growth experience for clients. Animal choice depends on an array of factors including the client’s ability to engage safely with the animal, the treatment goal, and most importantly, the animal’s well-being and willingness to engage. To help ensure animal welfare, I detail how to mitigate the welfare challenges for humans and animals and provide examples of ways to interrupt potentially harmful behavior. A table is provided to assist with choosing an appropriate animal for different client populations. Information © The Author 2023

Client characteristics and service use at the first hospital-based Canadian child and youth advocacy center: An analysis of case tracking data

BackgroundThe Child and Youth Advocacy Center (CYAC) model supports a coordinated response for young victims of abuse and their families. The model is prevalent in the United States, with more recent growth across Canada. ObjectiveThis descriptive study summarizes case tracking data to profile the client population, referral characteristics, use of services, and associations between client characteristics and service use in child maltreatment investigations referred to the first hospital-based Canadian CYAC over time. This data illustrates the potential to use CYAC case tracking data in understanding the use of, and client populations served by, this emerging collaborative service model in Canada.Participants and Setting Participants included children and youth served at SeaStar Child and Youth Advocacy Center in Halifax, Nova Scotia (N = 1,364) in its first seven years of operation. MethodsDescriptive statistics were calculated for client and case characteristics. Differences in characteristics between time periods were assessed using Chi-square tests. Risk ratios (RR) with 95% confidence intervals (CI) for the associations between characteristics and the use of specific services were estimated using log-binomial regression. ResultsThe most common indication for referral to this CYAC was sexual assault (53.3 %). Most clients were female (60.9 %), with a median client age of 10.0 years (IQR 6.0 to 13.0 years). In over half of all cases the alleged perpetrator was a family member (56.0 %) and most alleged perpetrators were adults (79.9 %). Medical exams were provided in 13.4 % of referrals and were less likely in children aged > 7 years (age 7–12, RR = 0.38, CI 0.27–0.51; and age > 12, RR = 0.41, CI 0.29–0.58), in referrals for sexual assault compared to physical assault (RR = 0.69, CI 0.52–0.90), and when the alleged perpetrator was an acquaintance rather than a family member (RR = 0.48, CI 0.34–0.67). Child and youth advocate support was provided in 76.1 % of cases and was slightly more likely in sexual assault and ‘other’ types of referrals (RR = 1.14, CI 1.06–1.22; and RR = 1.13, CI 1.02–1.26, respectively). Canine Assisted Intervention (CAI) was offered in 38.6 % of cases and was more likely in referrals for sexual assault (RR = 1.23, CI 1.01–1.50). Of those who had CAI, 41 % had an Accredited Facility Dog present with them during their forensic interview; this accompaniment in interview was more likely for clients who were older (RR = 2.15, CI 1.15–4.01) and female (RR = 2.56, CI 1.34–4.90). There were few differences in client and case characteristics or service use over time. ConclusionsThis study provides descriptive context of child maltreatment investigations referred to a Canadian hospital-based CYAC. Given the recognized variability among CYACs in scope and setting, this profile contributes to a broader understanding of the client population and service uptake at a CYAC which varies from the prototypical US-based model most often represented in the existing literature. This information contributes to a more detailed understanding of the CYAC model in practice in Canada, which can help to inform the growth and development of CYACs in the future.

A Delphi Study Using Expert Consensus to Develop a Well-Defined Vision for a Centre of Excellence for Therapeutic Recreation in Continuing Care Settings

There is an increasing demand for evidence-based practice and the demonstration of client outcome achievement in therapeutic recreation (TR). There is also an ongoing need to research TR service provision in continuing care settings. The TR profession is well-suited to improving the well-being and quality of life of individuals living in continuing care homes, however, current TR services are not standardized and vary greatly between settings and practitioners. Centres of Excellence (CoE) are organizations that endeavour to establish high standards of practice in a specific profession or area of research. A CoE could be instrumental in improving the delivery of quality TR services in continuing care settings. A Delphi expert consensus method was used to obtain a well-defined vision for a CoE for TR in continuing care settings. Three rounds of online questionnaires were completed over a period of nine weeks by an expert panel of 11 TR professionals working in continuing care settings. The participants reached the consensus that the vision of the CoE should be, “To inspire and advocate for quality TR services in continuing care settings through increased research and evidence-based practice.” The findings from this study contribute to the development of a CoE for TR in continuing care settings. They could also contribute to the development of additional CoEs for TR with other client populations—a topic that has been largely unexplored in the research literature.

“I Don’t Think There’s a Cookie-Cutter Way of Working With People With Autism”: Mothers of Children With Autism and Their Experiences With Counseling Services

Clinical mental health counselors can play a critical role in treating children diagnosed with autism spectrum disorder (ASD) as they age toward adulthood. While best practice for treatment of children with ASD should be individualized and include a family-centered approach, the experience of the mother receiving mental health services has not been previously explored in counseling research. For this study, we utilized interpretative phenomenological inquiry to examine the lived experiences of mothers (n = 8) who navigated the complexities of the counseling services for their child(ren) with ASD. Implications for clinical mental health counselors and counselor educators were presented to better serve this ever-increasing client population.

Association of health anxiety, fatalism and medication adherence among geriatric clients: An exploratory study

ObjectivesThis study explored the relationship between health anxiety, fatalistic beliefs, and medication adherence among geriatric clients. Also, it determines the extent to which health anxiety and fatalism can predict the variance in medication adherence among the same population of geriatric clients. DesignA cross-sectional analytical survey on 200 eligible participants using the Arabic Version of the Short Health Anxiety Inventory, Fatalism Scale, and Morisky Medication Adherence Scale-8 items. ResultsThe study found a statistically significant negative relationship between the studied geriatric clients' fatalism and health anxiety and their medication adherence (r = -0.160, - 0.187, and P = 0.024, 0.008), respectively. ConclusionThis study highlights the importance of considering psychological factors such as health anxiety and fatalistic beliefs in addressing medication adherence among geriatric clients. By addressing these factors, healthcare providers can develop more effective strategies to improve medication adherence and ultimately improve the health outcomes of geriatric clients.

Examining the use of geriatric standardized patients with baccalaureate nursing students

ABSTRACT The need for clinical placements for undergraduate nursing programs heightened during the COVID-19 pandemic as nursing schools across the country faced restrictions with the high-risk geriatric client population. Nursing students experienced increased anxiety levels, decreased learning opportunities, and uncertainties about the decision to enter the workforce as healthcare professionals. In turn, this amplified the need for faculty support and feedback imperative for student success. One method for mitigating the gap between didactic content and clinical placement is using simulation-based learning experiences. The purpose of this observational study was to examine the impact of a newly developed home health geriatric simulation on student satisfaction and self-confidence in learning among 133 senior-level Baccalaureate nursing students from a large public university. Study measures included the National League of Nursing’s Self-Confidence in Learning Scale (SCLS) and Simulation Design Scale (SDS). The primary outcome was satisfaction and self-confidence in learning. Higher SDS component scores were significantly correlated with higher SCLS scores (all p = <.0001), indicating that high satisfaction among Baccalaureate nursing students in simulation design relates to increased satisfaction and self-confidence in learning. Study findings support using standardized geriatric simulation scenarios to prepare students to communicate and care for older adults.

Promoting Health Equity Through Holistic Admissions in Occupational Therapy Education.

As the U.S. population shifts away from a White majority, it is imperative that the health care workforce reflect the diversity of client populations served. Increased diversity in the health care workforce fosters access to more personalized, culturally responsive, and client-centered care, thereby facilitating improved outcomes and reduced health disparities. Occupational therapy education programs function as gatekeepers for diversity and need to be accountable for representation in the profession and to produce graduates who reflect the diversity of the broader population. Holistic admission practices, which ensure that no single factor excludes an applicant from admission, are recognized as a meaningful strategy for increasing student diversity in higher education and provide a pathway to create a representative workforce with the ability to improve care disparities and client outcomes. As one of the largest occupational therapy programs in the country, and located in a diverse urban area, the University of Southern California's Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy has embraced the profession's responsibility toward greater health equity through holistic admissions. In this column, we discuss holistic admission best practices and report diversity outcomes resulting from enactment of these practices within our occupational therapy education program.

Double counting of clients using services in Iran: implications for assessing the reach of harm reduction programs

BackgroundMany people with high-risk sexual or injection behaviors use harm reduction services with different identities and are therefore counted more than once in client databases. This practice results in inaccurate statistics on the number of clients served and the effective reach of these services. This study aimed to determine the levels of double counting of clients of harm reduction services, including needle and syringe programs, condom distribution, HIV testing and counseling, and methadone maintenance in five cities in Iran.MethodsBetween September and March 2020, our study included 1630 clients, 115 staff of harm reduction centers, and 30 experts in the field of harm reduction in five cities in Iran. Clients of harm reduction services were asked about using harm reduction services multiple times at the same center or at different centers in the last year using different identities. Estimates of double counting derived from client responses were validated by panels of center staff and experts in harm reduction.ResultsSynthesizing data from clients, staff, and experts, the final estimates of double counting of clients using harm reduction services were: HIV testing 10% (95% confidence interval [CI] 0–15), needle and syringe programs 17% (95% CI 8.5–20), condom distribution programs 13% (95% CI 3–19), HIV/STI counseling 10% (95% CI 0–16), and methadone maintenance 7% (95% CI 2–10).ConclusionDouble counting of clients in harm reduction services in Iran is substantial. Data on clients reach by harm reduction services need to be corrected for double counting to improve program planning, client population size estimation, and efficient resource allocation.

Do Service Quality, Price, and Location affect on Customer Satisfaction in Kampoeng SPA, Sumenep?

This study aimed to determine the effect of service satisfaction, price, and location on customer satisfaction. The type of examination is quantitative exploration, with the client population of Kampoeng SPA in the Sumenep, Madura. The testing strategy in this exploration is a purposive testing method. Information was collected using surveys, interviews, perception, and documentation methods. The information tests used are Illustrated Insights, Exploration Instrument Tests, Traditional Assumptions Tests, Tests for Various Straight Relapse Conditions, and Suitability Tests. The results of this study indicate that the quality, cost, and extent of consumer loyalty in Kampoeng SPA as a whole affect consumer loyalty in Kampoeng SPA. Judging from the t-test shows that the administrative quality factors, costs, and area as a whole influence consumer loyalty. This research can be a benchmark for Kampoeng SPA in the Sumenep Regime to retain consumers to buy their products. The success of Kampoeng SPA employees and owners in the Sumenep Regime in determining prices, selecting locations, and providing service forms following consumer wants and needs and satisfying consumers

Efficient Client Selection Based on Contextual Combinatorial Multi-Arm Bandits

To overcome the challenge of limited bandwidth, client selection has been considered an effective method for optimizing Federated Learning (FL). However, since the volatility of the learning environment, the available clients exhibit some volatility over the training process in terms of client population, client data, training status, and transmitting status, which greatly increases the difficulty of client selection. To find a practical solution, we explore a client selection problem in volatile federated learning (Volatile FL). Specifically, we first derive the convergence analysis for non-convex and strongly convex cases to illustrate the main factors affecting the convergence speed. Then, we introduce the client utility to quantify the client’s contribution to model training and discuss the key problems of client selection in Volatile FL. For an efficient settlement, we propose CU-CS, a Combinatorial Multi-Arm Bandit (C <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sup> MAB) based decision scheme for the proposed selection problem. Theoretically, we prove that the regret of CU-CS is strictly bounded by a finite constant, justifying its theoretical feasibility. The experimental results demonstrate that our method significantly boosts FL by speeding up model convergence, promoting model accuracy, and reducing energy consumption.

Impacts of the COVID-19 Public Health Crisis on Caring for Sex-Trafficked Persons.

Sex trafficking of persons, a pervasive public health issue disproportionately affecting the most marginalized within society, often leads to health as well as social consequences. Social service provision to meet the resulting needs is critical, however, little is known about the current pandemic's impact on providers' capacity to deliver requisite care. To examine social service providers' perspectives of care provision for domestically sex-trafficked persons in Ontario, Canada, during the COVID-19 pandemic, we conducted semi-structured interviews with 15 providers and analyzed these using Braun and Clarke's analytic framework. Impacts of the COVID-19 pandemic on social service care provision were connected to individuals' increased vulnerability to trafficking, difficulties safely and effectively providing services to sex-trafficked persons amid pandemic restrictions, and reduction in in-person educational activities to improve providers' capacity to serve this client population. Securing safe shelter was particularly difficult and inappropriate placements could at times lead to further trafficking. The pandemic created novel barriers to supporting sex-trafficked persons; managing these sometimes led to new and complex issues. Future efforts should focus on developing constructive strategies to support sex-trafficked persons' unique needs during public health crises.

Healthcare workers' perceptions and experiences of primary healthcare integration: a scoping review of qualitative evidence.

Primary healthcare (PHC) integration has been promoted globally as a tool for health sector reform and universal health coverage (UHC), especially in low-resource settings. However, for a range of reasons, implementation and impact remain variable. PHC integration, at its simplest, can be considered a way of delivering PHC services together that sometimes have been delivered as a series of separate or 'vertical' health programmes. Healthcare workers are known to shape the success of implementing reform interventions. Understanding healthcare worker perceptions and experiences of PHC integration can therefore provide insights into the role healthcare workers play in shaping implementation efforts and the impact of PHC integration. However, the heterogeneity of the evidence base complicates our understanding of their role in shaping the implementation, delivery, and impact of PHC integration, and the role of contextual factors influencing their responses. To map the qualitative literature on healthcare workers' perceptions and experiences of PHC integration to characterise the evidence base, with a view to better inform future syntheses on the topic. We used standard, extensive Cochrane search methods. The latest search date was 28 July 2020. We did not search for grey literature due to the many published records identified. We included studies with qualitative and mixed methods designs that reported on healthcare worker perceptions and experiences of PHC integration from any country. We excluded settings other than PHC and community-based health care, participants other than healthcare workers, and interventions broader than healthcare services. We used translation support from colleagues and Google Translate software to screen non-English records. Where translation was not feasible we categorised these records as studies awaiting classification. For data extraction, we used a customised data extraction form containing items developed using inductive and deductive approaches. We performed independent extraction in duplicate for a sample on 10% of studies allowed for sufficient agreement to be reached between review authors. We analysed extracted data quantitatively by counting the number of studies per indicator and converting these into proportions with additional qualitative descriptive information. Indicators included descriptions of study methods, country setting, intervention type, scope and strategies, implementing healthcare workers, and client target population. The review included 184 studies for analysis based on 191 included papers. Most studies were published in the last 12 years, with a sharp increase in the last five years. Studies mostly employed methods with cross-sectional qualitative design (mainly interviews and focus group discussions), and few used longitudinal or ethnographic (or both) designs. Studies covered 37 countries, with close to an even split in the proportions of high-income countries (HICs) and low- and middle-income countries (LMICs). There were gaps in the geographical spread for both HICs and LMICs and some countries were more dominant, such as the USA for HICs, South Africa for middle-income countries, and Uganda for low-income countries. Methods were mainly cross-sectional observational studies with few longitudinal studies. A minority of studies used an analytical conceptual model to guide the design, implementation, and evaluation of the integration study. The main finding was the various levels of diversity found in the evidence base on PHC integration studies that examined healthcare workers' perceptions and experiences. The review identified six different configurations of health service streams that were being integrated and these were categorised as: mental and behavioural health; HIV, tuberculosis (TB) and sexual reproductive health; maternal, women, and child health; non-communicable diseases; and two broader categories, namely general PHC services, and allied and specialised services. Within the health streams, the review mapped the scope of the interventions as full or partial integration. The review mapped the use of three different integration strategies and categorised these as horizontal integration, service expansion, and service linkage strategies. The wide range of healthcare workers who participated in the implementation of integration interventions was mapped and these included policymakers, senior managers, middle and frontline managers, clinicians, allied healthcare professionals, lay healthcare workers, and health system support staff. We mapped the range of client target populations. This scoping review provides a systematic, descriptive overview of the heterogeneity in qualitative literature on healthcare workers' perceptions and experience of PHC integration, pointing to diversity with regard to country settings; study types; client populations; healthcare worker populations; and intervention focus, scope, and strategies. It would be important for researchers and decision-makers to understand how the diversity in PHC integration intervention design, implementation, and context may influence how healthcare workers shape PHC integration impact. The classification of studies on the various dimensions (e.g. integration focus, scope, strategy, and type of healthcare workers and client populations) can help researchers to navigate the way the literature varies and for specifying potential questions for future qualitative evidence syntheses.