Comprehensive Health Services Research Articles

Applying the theory of planned behavior for prediction of oocyte donation intention among Iranian women

BackgroundOocyte donation is a complex and multifaceted behavior in women. Due to the acute deficiency of donated oocytes, it is necessary to identify the factors affecting the desire to donate. Planned behavior theory is a suitable model for explaining and predicting behavior in many behavioral domains. The aim of this study was to predict oocyte donation intention using the theory of planned behavior.MethodsThis cross-sectional study was performed on 556 women who were covered by the comprehensive health service centers in Gonabad and Neyshabour cities in 2020. Sampling was performed by the two-step method in Gonabad city and by the convenience sampling method in Neyshabour city. Data were collected online using researcher-made questionnaires included oocyte donation awareness questionnaire and oocyte donation intention questionnaire (based on the TPB constructs). The validity of the questionnaires was confirmed by face and content validity and its reliability was confirmed by Cronbach's alpha coefficient. Data were analyzed in SPSS software (version 16) using hierarchical linear regression. The statistical significance was considered as P < 0.05.ResultsThe results showed that there was a significant positive correlation between the oocyte donation intention with all constructs of planned behavioral theory (P < 0.050). Planned behavior theory constructs explained 47% of the variance of oocyte donation intention. In addition, constructs of perceived power (β = 0.461), control beliefs (β = 0.154) and normative beliefs (β = 0.125) were the strongest predictors of oocyte donation intention, respectively.ConclusionPlanning and implementing educational courses according to the constructs of the theory of planned behavior can be a great step toward the elimination of oocyte deficiency and infertility problems. Also performing of intervention or training strategies in the field of oocyte donation requires the enhancement of social norms and perceived behavioral control in the population under study.

Effects of Telenursing on the Management of Self-care Behaviors in Patients With Chronic Hypertension

Background: The high prevalence of hypertension worldwide and its severe effects on various body organs are major health concerns in every community. The present study aims to evaluate the effects of telenursing on the management of self-care behaviors in patients with chronic hypertension. Methods: This randomized clinical trial was conducted on two groups with a pretest-posttest. The sample population included 82 patients with hypertension referred to comprehensive urban and rural health service centers in Garme City, Iran who were initially selected via two-stage cluster sampling and allocated into two groups of intervention and control by permuted block randomization (six patients in each block). Data were collected using a demographic questionnaire, the hypertension self-care profile, and phone follow-up, which were completed at the beginning of the study. The patients received a two-hour training session. The intervention group was followed up (telenursing) for three months, and the control group received routine care. After the intervention, the self-care questionnaire in patients with chronic hypertension was completed by both groups. Data were analyzed with SPSS software, version 25 using the Mann-Whitney U test, paired t-test, and the analysis of covariance (ANCOVA). Results: Telenursing increased the mean score of a healthy diet by 1.3 units (P=0.04) and the score of disease management by 1.19 units (P=0.004). However, the intervention had no significant effects on weight (P=0.09), supervision of the awareness of food labeling (P=0.38), and medication regimen (P=0.62). Conclusion: According to the results, it is recommended to use this method to manage the disease and dietary habits of patients with chronic hypertension.

Social Health Status and Its Related Factors in Older Adults

Introduction: For successful aging, it is necessary to evaluate social health as a basic component of the health system. Older adults are an increasingly large proportion who are potential candidates for vulnerability in social health. Objective: This study aimed to determine social health and its related factors in older adults referred to urban comprehensive health service centers. Materials and Methods: This cross-sectional study was conducted on 400 older adults referred to urban comprehensive health service centers in Ardabil City, Iran, between February 2021 and April 2022. The multistage sampling method was used to select the older adults. The social health scale for older people was used for data collection. Data were analyzed using an independent t-test, one-way analysis of variance, the Tukey post hoc test, the Pearson correlation coefficient, and linear regression with a stepwise method. Results: The Mean±SD age of the participants was 69.49±7.16 years. The mean score of social health was 57.27±8.7, and for subscales of social support, social adjustment, and perceived environment resource were 30.16±5.9, 15.15±4.14, and 11.95±2.83, respectively. Multivariate analysis showed that marital status (B=4.68, 95% CI, 2.82%-6.54%, P=0.001), education (B=-2.89, 95% CI, -4.87% to -0.9%, P=0.004), job (B=-2.15, 95% CI, -4.1% to -0.21%, P=0.03), income (B=1.48, 95% CI, 0.63%-2.89%, P=0.04), visiting exhibitions (B=4.69, 95% CI, 2.39%-6.98%, P=0.001), and recreational or fun activities (B=-2.36, 95% CI, -3.99% to -0.72%, P=0.005) were predictors of social health in older adults (R2=20%). Conclusion: The social health of older adults is moderate. Our study showed that several factors would influence social health. Healthcare providers should plan necessary interventions to enhance the social health of older adults.

Weight Management Challenges in Nulliparous Women Being Overweight or Obese Due to Pregnancy: A Qualitative Study.

Getting overweight after pregnancy is a common phenomenon and getting back to pre-pregnancy weight in the postpartum period is a major concern for mothers. This study aimed to explain the challenges in performing post-pregnancy weight-management behaviors in nulliparous women being overweight and obese due to pregnancy. The present qualitative study was conducted with the conventional qualitative content analysis method based on Granheim and Landman's approach from October to December in 2021. In this study, participants were 15 women who referred to comprehensive health service centers in Tehran, Iran; they were purposefully selected according to the inclusion criteria. Data were collected through individual, in-depth, and semi-structured face-to-face interviews and simultaneously analyzed using the MAXQ Data version 10 software. The mean age of the participants was 25.93±3.21 years. Data analysis resulted in three main categories: 1) failure to adhere to calorie-restricted diets, 2) inability to engage in physical activity, and 3) lack of adequate social support. Women with obesity due to pregnancy face many challenges to improve their weight-control behaviors. As such, improving healthy behaviors not only requires relevant stakeholders' commitment, but also demands women, their families and communities' intention to engage in healthy behaviors.

Investigating the self-care status of pregnancy and its relationship with social support and anxiety caused by corona disease in pregnant women following the implementation of the national COVID-19 vaccination program

Background and aims: COVID-19 has adverse effects on health. The best way to prevent it is vaccination. One of the high-risk groups for COVID-19 is pregnant women. Self-care of pregnancy can reduce the adverse consequences of pregnancy, which are affected by many factors. The present study aims to investigate the self-care status of pregnancy and its relationship with social support and anxiety caused by Corona in pregnant women following the implementation of the national vaccination program for COVID-19. Methods: A total of 199 pregnant women from comprehensive health service centers were included in the study and completed self-care questionnaires during pregnancy, social support, and anxiety questionnaires caused by corona. Data were analyzed by SPSS 18 software. Results: The average score of self-care was 41.19±5.21, the average score of social support was 65.14±11.45, and the average score of anxiety caused by Corona was 10.64±8.93. The Pearson correlation test showed that self-care was significantly associated with social support (P&lt;0.05, r: 0.347) but not coronavirus anxiety. The regression model showed that social support is the strongest predictor of pregnancy self-care (P&lt;0.001). Conclusion: Considering the favorable score of self-care and social support and the low score of corona anxiety of the participants in the study and comparing with the results of other studies in the COVID-19 pandemic and before vaccination, it seems that COVID-19 vaccination had a significant effect on the results. However, longitudinal studies are suggested to ensure the results.

Evaluating the Effect of Telenursing and Multimedia Self-Care Educational Program on the Level of Existential Anxiety in Patients with COVID-19: A Quasi-Experimental Study

Background &amp; Objective: For patients, COVID-19 disease is a reminder of non-existence and death. For this reason, these patients experience existential anxiety. One of the effective factors in the control and treatment of this disease is to educate patients on self-care to reduce the burden of these psychological problems on them. The present study was designed and conducted with the aim of evaluating the effect of self-care educational program using telemedicine and multimedia methods on the level of existential anxiety in COVID-19 patients.Materials &amp; Methods: This study was a quasi-experimental research conducted on 88 COVID-19 patients referred to the comprehensive health service centers of Bandar Abbas, Iran from 2020 to 2021. Th0ey were selected using a convenience sampling method. The samples were randomly assigned to the multimedia (44 patients) and telenursing (44 patients) groups. Patients in both groups received education on self-care during COVID-19 disease for 21 days. The Existence Anxiety Scale was completed before and immediately after the intervention. Data were analyzed with SPSS software version 26. Descriptive statistics, normality test, independent t-test, homogeneity of variance and covariance, univariate and multivariate analysis of covariance were used.Results: The mean score of existential anxiety at the beginning of the study was 90.50± 12.57 and 85.25 ±16.12, respectively, in the telenursing and multimedia groups, and after the intervention, it was 46.88 ± 6.38 and 65.40 ± 9.59, respectively, in the telenursing and multimedia groups. After the intervention, the existential anxiety score was significantly reduced in the telenursing group compared to the multimedia group (p &lt;0.001).Conclusions: Based on the findings of this study, self-care education programs and knowledge about necessary care during COVID-19 illness should be considered for patients in comprehensive health centers, and telenursing should be used for more effective self-care education.

Contraceptive access experiences and perspectives of Mexican-origin youth: a binational qualitative study

Access to comprehensive contraceptive services for youth is essential to improving sexual and reproductive health. However, youth in many countries still face substantial obstacles to contraceptive access and use. The purpose of this study is to compare the contraceptive access experiences and perspectives of pregnant and parenting Mexican-origin youth in Guanajuato, Mexico, and Fresno County, California. Focus groups and in-depth interviews were conducted in Spanish and English among female youth in Mexico (n = 49) and California (n = 25). Participants also completed a brief sociodemographic survey. Using a modified grounded theory approach, qualitative data were coded and thematically analysed based on Penchansky and Thomas's Theory of Access, and results were compared by location. Although knowledge of a service provider was high among youth in both locations, access was affected by social, cultural, and institutional dynamics and contraceptive use was mixed. Across locations, participants described obstacles to accessing their preferred method. Participants worried about parental and peer opinions about their use of contraception (acceptability), and about perceived side effects including infertility and pain (adequacy). Contextual differences included lack of contraceptive choice in Guanajuato (availability) and incomplete knowledge about options in Fresno County (awareness). The power to request and receive their method of choice (agency) emerged as an important dimension that was not part of the original theory. Latina youth living in Mexico and the United States face multiple challenges accessing needed contraceptive options and services. Recognising and reducing these barriers can strengthen the contraceptive care landscape and promote the reproductive health and agency of young people. DOI: 10.1080/26410397.2023.2216527 Plain language summary: Although sexually active youth need access to comprehensive sexual and reproductive health services, youth in many countries face substantial barriers to care. This study compares the experiences of pregnant and parenting youth in accessing contraceptive services in Mexico and the United States. We conducted interviews and focus groups with 74 Mexican-origin young women and found that contraceptive use and access was affected by their concerns about parental and peer opinions as well as by provider attitudes. In Mexico, several participants reported being denied their preferred method by their provider. Identifying and addressing barriers to services can improve the quality of care and the reproductive health of young people.

Designing a Strategy Map for Healthcare Centers with Balanced Scorecard Approach

Background: Due to the level of complexity of healthcare organizations, many factors play a role in improving health services. Therefore, it is necessary to develop a systematic approach to evaluate their efficiency and management system. Balanced scorecard can play a role in this field as an evaluation system by examining the cause-and-effect relationship of goals and drawing a strategy map. Therefore, the purpose of this research was to develop a strategy map for healthcare centers with a balanced scorecard approach.&#x0D; Methods: This was a qualitative and applied research conducted using mixed methods in 2019. The statistical population of the research included all health experts from medical sciences universities across the country, 15 of whom were selected based on a targeted snowball sampling. First, through the review of texts and articles related to the literature on the subject with a general search in foreign and domestic electronic databases, a list of balanced scorecard views and the goals related to health and treatment centers of comprehensive health service centers was identified. After that, through a researcher-made questionnaire, by asking experts their opinions using fuzzy Delphi method in 2 steps, the views and goals related to comprehensive health service centers were identified. Then, through the relationships of improved network analysis process technique based on DEMETEL, in 4 steps by Excel 2016 and Matlab 2014 software, the relationships between them were examined. Finally, the effect of goals and views on each other was determined, and a strategy map was drawn.&#x0D; Results: In this research, social responsibility, as a new perspective and the attitudes of patients and society, financial status and performance improvement, growth and development, and internal processes, replaced the main perspectives of the balanced scorecard, and social responsibility was designated as a new perspective. By examining the relationship between them, the perspectives of growth and development, intra-organizational processes, social responsibility, and other views were found to be effective.&#x0D; Conclusion: Considering the complexity of the activities regarding comprehensive health service centers, replacing the views appropriate to the comprehensive health service centers with the main views provided by Kaplan and Norton (2004) can obtain the best results regarding the goals and strategy. Based on the cause-effect relationship of views, strengthening views and effective goals creates value for effective goals. Investing on influential views and goals will empower and promote the development of balance between income and expense, and the optimal use of resources will improve the views of society and patients and the quality of services, which is the main goal of comprehensive health service centers.

Improvement of Cadres' Skills and Knowledge to Provide Comprehensive Health Services for the Elderly

Highlights: Due to the increasing elderly population in Indonesia, this study must address the knowledge and skill gaps among health cadres in a number of Integrated Health Posts for the Elderly (Pos Layanan Terpadu Lanjut Usia/ Posyandu Lansia). Through this study, the health cadres increased their knowledge and skills, enabling them to provide comprehensive health services for the elderly. Abstract Numerous issues have arisen as a result of the large size and rapid growth of the elderly population, attesting to the need for serious efforts from all sectors to enhance their welfare. However, the health cadres at the Integrated Health Post for the Elderly (Pos Layanan Terpadu Lanjut Usia/ Posyandu Lansia) lacked the training that would have equipped them with the necessary knowledge and skills to carry out their duties. This study aimed to evaluate the significance of training for enhancing the cadres' knowledge and skills in providing comprehensive health services for the elderly. This study was quasi-experimental research with a pre-test and post-test design. The data analysis was performed using the Shapiro-Wilk test (p&gt;0.05) and the Wilcoxon test (p&lt;0.05). A total of 30 health cadres at Songgon Community Health Center were measured for their levels of knowledge and skills before and after the training. The training included filling out health evaluation charts, providing leaflets containing health counseling materials for the elderly, practicing exercise for the elderly, and singing an elderly marching song. Before filling out the health evaluation chart, the cadres had to measure the elderly's degree of independence as well as their mental, emotional, and nutritional status. The cadres also had to measure the weight, height, and blood pressure of the elderly. Prior to training, the cadres' knowledge of hospitalization referrals, independence, and physical exercise for the elderly was limited. The cadres' skills in filling out health evaluation charts, assessing mental, emotional, and nutritional status, measuring blood pressure, and instructing physical exercise were also inadequate. There was a significant difference in the knowledge and skills of the health cadres before and after training (p&lt;0.05). In conclusion, there was an improvement in the health cadres' knowledge and skills regarding comprehensive health services for the elderly at the Posyandu Lansia.

“Almost like it was really underground”: a qualitative study of women’s experiences locating services for unintended pregnancy in a rural Australian health system

Rural women in Australia are more likely than urban women to experience unintended pregnancy, yet little is known about how this issue is managed in a rural health setting. To address this gap, we conducted in-depth interviews with 20 women from rural New South Wales (NSW) about their unintended pregnancy. Participants were asked about accessing healthcare services and what was uniquely rural about their experience. The framework method was used to conduct an inductive thematic analysis. Four themes emerged from the data: (1) fragmented and opaque healthcare pathways, (2) a limited number of willing rural practitioners, (3) small town culture and community ties and (4) interrelated challenges of distance, travel and money. Our findings highlight how pervasive structural issues related to accessibility of health services intersect with small-town culture to create compounding obstacles for rural women, especially those seeking an abortion. This study is relevant to other countries with similar geographies and models of rural healthcare. Our findings point to the necessity for comprehensive reproductive health services including abortion to be an essential – not optional – part of healthcare in rural Australia.

Rationing of resources in the National Health Service.

The National Health Service was set up to provide healthcare to every citizen, based not on the ability to pay, but on need. However, the Secretary of State for Health's duty under section 1 of the National Health Service Act 2006 to promote a comprehensive health service is to provide services that can be provided within the resources available. As those resources are not unlimited, it is necessary to ration them. The issue of rationing of resources in the NHS came up again in R (Wallpott) v Welsh Health Specialised Services Committee and Aneurin Bevan University Health Board [2021] EWHC 3291 (Admin). This paper reviews that case and comments on it, looking at why there is rationing of NHS resources and at the approach of the courts to the issue. It concludes that, although rationing of NHS resources is controversial, it is lawful and necessary.

Evaluation and Analysis of Physical Resilience of Comprehensive Health Service Centers against Earthquakes: A Case Study of Comprehensive Health Service Centers in Babol City in 2021

Evaluation and Analysis of Physical Resilience of Comprehensive Health Service Centers against Earthquakes: A Case Study of Comprehensive Health Service Centers in Babol City in 2021

Community Pharmacists' Experiences and Attitudes towards the Provision of Sexual and Reproductive Health Services: An International Survey.

Access to comprehensive sexual and reproductive health (SRH) services remains a challenge worldwide. Describing community pharmacists' SRH services in countries with different scopes of practice will aid in understanding how pharmacists view their roles and how to support them in providing needed services. A cross-sectional web-based survey was administered to pharmacists working in community pharmacies in Japan, Thailand, and Canada. The survey covered 7 SRH categories: pregnancy tests, ovulation tests, contraception, emergency contraception, sexually transmitted and blood-borne infections, maternal and perinatal health, and general sexual health. Descriptive statistics were used to analyze the data. A total of 922 eligible responses were included in the analysis (Japan = 534, Thailand = 85, and Canada = 303). Most Thai and Canadian participants reported dispensing hormonal contraceptives (Thailand = 99%, Canada = 98%) and emergency contraceptive pills (Thailand = 98%, Canada = 97%). Most Japanese participants provided patient education on barrier contraceptives for men (56%) and information on the safety of medications in pregnancy (74%) and breastfeeding (76%). The majority of participants expressed interest in additional training and expanding their roles in SRH. Sharing international experiences can guide challenges faced by the evolution of pharmacists' practice in SRH. Providing pharmacists support could help their readiness for this role.

Burnout Among Psychiatry Residents and One Program's Approach to Creating a Culture of Wellness.

Psychiatry residency training includes unique characteristics that can predispose trainees to burnout, including vicarious traumatization, prevalence of patient suicide and violence in the workplace, and social stigma surrounding mental health. For the purposes of this article, the authors examine these contributing factors and address how psychiatry residency training programs, specifically the Kaiser Permanente Oakland program, are responding to these unique challenges with wellness initiatives. Initiatives to promote wellness at Kaiser Permanente Oakland include a resident and faculty-led wellness committee, work-hour limits, reasonable call schedules, a robust mentorship program, funded social and networking events programs, and comprehensive mental health services.

Estimating induced abortion incidence and the use of non-recommended abortion methods and sources in two provinces of the Democratic Republic of the Congo (Kinshasa and Kongo Central) in 2021: results from population-based, cross-sectional surveys of reproductive-aged women

The changing abortion legal and practice landscape in the DRC in recent years calls for a re-examining of induced abortion experiences. The current study provides population-level estimates of induced abortion incidence and safety by women’s characteristics in two provinces using direct and indirect approaches to assess indirect method performance. We use representative survey data on women aged 15–49 in Kinshasa and Kongo Central collected from December 2021 to April 2022. The survey had questions on respondents’ and their closest friends’ experience with induced abortion, including methods and sources used. We estimated one-year abortion incidence and proportion using non-recommended methods and sources overall and by background characteristics for each province separately for respondents and friends. The fully adjusted one-year friend abortion rate was 105.3 per 1000 women of reproductive age in Kinshasa and 44.3 per 1000 in Kongo Central in 2021; these were substantially higher than corresponding respondent estimates. Women earlier in their reproductive lifespan were more likely to have had a recent abortion. Approximately 17.0% of abortions in Kinshasa and one-third of abortions in Kongo Central involved non-recommended methods and sources according to respondent and friend estimates. The more accurate friend abortion incidence estimates indicate that women in the DRC often rely on abortion to regulate their fertility. Many use non-recommended means and sources to terminate, thus, significant work remains to actualise the commitments made in the Maputo Protocol to provide comprehensive reproductive health services that combine primary and secondary prevention services to reduce unsafe abortion and its consequences.

Tinjauan Kebijakan Kesehatan Mental di Indonesia: Menuju Pencapaian Sustainable Development Goals dan Universal Health Coverage

Mental health is a harmony in life that is created between the functions of the soul and the ability to overcome problems. Mental health policies are still limited and not yet integrated. Indonesia is also committed to achieving SDGs and UHC. The purpose of this research is to review mental health policies in Indonesia and evaluate the extent to which these policies support the achievement of the SDGs and UHC. This study uses a literature study to examine different methods. The article search strategy uses an online database, namely Google Scholar and this research uses a literature review methodology. There is a need for comprehensive mental health services to be made part of the SDGs and UHC. The government continues to pursue various mental health policies in order to reduce the prevalence of mental disorders in Indonesia. However, several mental health programs that have been prepared still have deficiencies in the implementation process. The lack of availability of psychotropic drugs at the puskesmas and the existence of a report format that is not yet uniform and the presence of mental health recording and reporting officers are obstacles in the practice of mental health policy in Indonesia. Therefore, sufficient quality data is needed to formulate effective policies so that efforts to deal with mental health at the primary and secondary health service levels are far more optimal. So that continuous improvement can be carried out to reduce the prevalence of mental disorders in Indonesia.

Addressing reproductive healthcare disparities: strategies for achieving health equity

Reproductive health care disparity is a significant public health issue that affects many populations. This disparity stems from various factors, including race, ethnicity, socioeconomic status, geographic location, and education level. Such inequality results in adverse health outcomes such as unintended pregnancy, infertility and sexually transmitted infections among certain populations. Therefore, addressing reproductive health care disparities requires increasing access to affordable and comprehensive reproductive health services, promoting culturally competent care, improving access to family planning services and addressing barriers to care. Furthermore, promoting comprehensive sexuality education and addressing the root causes of inequality are also crucial in eliminating reproductive health care disparities. By addressing these disparities, we can ensure that all individuals have equal access to quality reproductive health care and services, leading to improved health outcomes for everyone.

Barriers to and enablers of the HIV services continuum among gay and bisexual men worldwide: Findings from the Global Men's Health and Rights Study.

To assess ecological, structural, community and individual level correlates of health services utilization along a continuum of HIV care, and sexual health and support services among gay and bisexual men worldwide. Using a nonprobability internet sample of 6,135 gay and bisexual men, we assessed correlates of utilization of health services. Chi-Square Tests of Independence were performed to assess drop off along a continuum of HIV care. Multivariable logistic regression analyses using generalized estimating equation models were conducted adjusting for geographic region and clustering by country. In multivariable analyses, we determined the association between utilization outcomes, and ecologic, structural, community and individual correlates by fitting separate generalized estimating equation (GEE) logistic regression models for each of the outcomes, fitted with robust SEs, and accounting for clustering by country. Stratified by sexual identity, analyses adjusted for variables that could influence HIV-related health outcomes including racial/ethnic minority status, participant age, insurance, ability to make ends meet, as well as country-level income (income of country of residence defined by the World Bank). Among men living with HIV (n = 1001), being in HIV care (n = 867) was associated with being on ART (X2 = 191.17, p < .001), and viral load suppression (X2 = 14.03, p < .001); and using ART (n = 840) was associated viral load suppression (X2 = 21.66, p < .001). Overall, the pattern of utilization outcomes were similar for both gay and bisexual men. For example, utilization of PrEP, being in HIV care and utilization of most of the sexual health and support services were negatively associated with sexual stigma. Whereas, utilization of most HIV prevention, and sexual health and support services were positively associated with provider discrimination. Utilization of all HIV prevention and all sexual health services were positively associated with greater community engagement, and receiving services from LGBT-led organizations. Bisexual men had higher odds of reporting provider discrimination when utilizing condom services (gay: AOR = 1.14, [0.95-1.36]; bisexual: 1.58, [1.10-2.28]), PrEP (gay: AOR = 1.06, [0.77-1.45]; bisexual: AOR = 2.14, [1.18-3.89], mental health services (gay: AOR = 1.03, [0.86-1.23]; bisexual: AOR = 1.32, [1.07-1.64]), and community-based support (gay: AOR = 1.23, [1.05-1.45]; bisexual: AOR = 1.49, [1.14-1.93]) than gay men. Bisexual men also reported higher odds of accessing services from LGBT-led organizations when utilizing PrEP (gay: AOR = 5.26, [2.50-11.05]; bisexual: AOR = 7.12, [3.16-16.04]), and community-based support/self-help groups/individual counseling (gay: AOR = 2.63, [1.72-4.01]; bisexual: AOR = 3.35, [2.30-4.88]. It is essential that barriers to health services utilization be addressed at structural and community levels. Structural interventions should be designed to reduce sexual stigma, as well as train and sensitize healthcare providers; and strengthen community level interventions that bring gay and bisexual men together to lead comprehensive health services.

Studi Teoritis: Strategi Promosi Pelayanan Kesehatan Rumah Sakit Swasta Di Era Jaminan Pelayanan Kesehatan (JKN)

Facing the JKN era is not easy, especially for private hospitals. Private hospitals need strategy, understanding, understanding and mutual agreement throughout the internal hospital, both doctors, nursing staff, general staff and management. The strategy for promoting health services in hospitals and other health facilities is not much different from the marketing strategy in general. It aims to promote and introduce the Hospital and the services provided. The purpose of writing this scientific article is to find out and review from a theoretical point of view how the strategy is carried out by private hospitals in this JKN era. The method used is a theoretical study by analyzing and comparing existing theories. It then learns more about a subject in theory or research and helps readers understand it better and with implications. The results of this theoretical study are private hospital services by implementing strategies and principles for implementing the National Health Insurance Program (JKN) such as mutual cooperation, non-profit, openness, portability, membership, trust funds, and management. It can be concluded that the strategy for promoting health services in private hospitals is to implement them in accordance with established standards and laws. The health service quality strategy is also the main key to service promotion to increase patient satisfaction in receiving care. It is expected that hospital institutions will continue to provide excellent and comprehensive health services and meet the basic health needs of patients.

"Prescriptive authority for psychologists: The next step": Correction.

Reports an error in "Prescriptive authority for psychologists: The next step" by Steven Eric Curtis, Samantha Hoffmann and Maeve O'Leary Sloan (Psychological Services, Advanced Online Publication, May 05, 2022, np). In the original article, changes were needed to clarify the timeline of state legalizations of prescriptive authority for psychologists (RxP) and the current status of RxP with regard to the Federal Bureau of Prisons (BOP). In the second paragraph of the "RxP From 2011 to Present" section, the citations relating to legalization in Idaho and Iowa were corrected, and the year in the Prescribing Psychologist reference was corrected in the References section and in text citations throughout. Additionally, in the last paragraph of the "RxP From 2011 to Present" section, the text was updated to clarify that at the present time, prescribing psychologists are not able to prescribe for the BOP. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2022-58802-001). Since the endorsement of prescriptive authority for psychologists (RxP) by the American Psychological Association (APA) in 1995, it has become legal in five states (Idaho, Illinois, Iowa, Louisiana, and New Mexico). The Department of Defense, including the U.S. Air Force, U.S. Army, and U.S. Navy, as well as the Public Health Service, and the Indian Health Service, continue to utilize prescribing psychologists as well. There are now over 200 prescribing psychologists in the United States. Five APA-designated RxP training programs offer a pathway to attain prescription privileges and future board certification when approved. The purpose of this article is to provide information for those with minimal exposure to RxP, updates for those more informed, and recommendations for the next phase of RxP. This article examines scholarship related to RxP as well as newsletter columns, state legislative efforts, current RxP laws, policies, training programs, and critical events in the RxP history. Public access to quality and comprehensive mental health services can be expected to improve as more psychologists complete the necessary RxP training and licensure requirements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).