Counseling Support Research Articles

Sexual Function and Satisfaction among Women Undergoing In Vitro Fertilization (IVF) in the West of Iran: A Cross-Sectional Study

Background: We haven’t found any reported study that addressed sexual function and satisfaction in infertile women who are undergoing IVF treatment in the west of Iran. Objective: The present study was conducted to investigate sexual performance and satisfaction among women undergoing in vitro fertilization (IVF) in Western Iran. Methods: This cross-sectional study was conducted on 170 women from December 2022 to March 2023. The participants were selected by convenience sampling until the sample size was reached. The participants were included in the study as available sampling. Women completed the demographic questionnaire, FSFI (female sexual function index), and Linda Berg’s Sexual Satisfaction Questionnaire. For data analysis, we used the Stata version 14 (StataCorp, College Station, TX) and we considered the P-value less than 0.05 significant. Result: There was a significant relationship between husband occupations, economic status, marriage duration, period of infertility, cause of infertility, and intercourse times with sexual satisfaction (P<0.05). The highest percentage of the obtained score was related to pain (51.6%) and the lowest was related to desire (38%). All of the patients with weak sexual function had weak sexual satisfaction and 60.19% of the patients with good sexual function had good sexual satisfaction (P<0.001). Conclusion: Women with weak sexual function had weak sexual satisfaction. Policymakers should consider strategies, such as counseling and psychological support for women during the treatment process to help them cope with their problems, especially psychological problems.

The Role of Artificial Intelligence (AI) and machine learning in social work practice

The integration of Artificial Intelligence (AI) and Machine Learning (ML) into social work practice is transforming the landscape of service delivery and decision-making. This paper explores how these technologies enhance case management, predictive analytics, and resource allocation in critical areas such as child welfare, mental health, and substance abuse treatment. Key trends highlighted include the use of AI-based predictive analytics to identify at-risk populations and facilitate early interventions, as well as the deployment of chatbots and virtual assistants for providing accessible mental health counselling and social support. Furthermore, the paper addresses ethical considerations and challenges associated with AI implementation, particularly the potential biases in algorithms that may affect the assessment of social needs. Additionally, the integration of AI tools into social work education and training is examined to prepare future professionals for a technology-driven environment. By analysing the current applications of Natural Language Processing (NLP) for client data analysis, AI-powered software for predictive risk assessments, and automated case management systems, this paper advocates for a balanced approach to AI adoption, ensuring that the core values of social work, such as equity and social justice, remain central to practice. Ultimately, this exploration underscores the potential of AI and ML to enhance social work outcomes while also emphasizing the necessity of ethical frameworks and ongoing training for practitioners.

Psychological Impact Of Kidnapping On Social Reintegration And Academic Pursuits Of Female Undergraduates In Zamfara State

Although kidnapping and banditry are increasingly rampant in northern Nigeria, research on their psychological impact on female undergraduate students is lacking. To fill this gap, this study investigated the psychological impact of kidnapping on female undergraduate students in Zamfara State, Nigeria, focusing on their social reintegration and academic pursuits. Kidnapping and banditry have become pervasive in northern Nigeria, severely disrupting the lives of vulnerable communities including students in both pre-tertiary and tertiary institutions, particularly Zamfara State. The study adopted qualitative research design. Seven out of the female undergraduates of Federal University Gusau who had recently been released after prolonged captivity participated in the study. A combination of purposive and snowball sampling techniques was used to select participants based on availability, willingness, and ability to provide detailed accounts. Data was collected through structured interview. Thematic analysis revealed profound psychological trauma, including symptoms of Post-Traumatic Stress Disorder (PTSD), anxiety, and depression. Social reintegration challenges found in the study include stigmatization and alienation, while academic difficulties involved concentration, memory issues, and decreased motivation. The study recommends implementing comprehensive psychological support programmes within educational institutions located in high risk locations such as Zamfara State, including professional counseling and peer support groups, to address the long-term psychological effects and facilitate better social and academic reintegration of the victims

Automated digital counselling promotes therapeutic change in mental health in patients with chronic heart failure or chronic kidney disease: ODYSSEE-vCHAT study

Abstract Background The efficacy of digital programs to improve the management of chronic heart failure (CHF) and chronic kidney disease (CKD) is not established. Building on related studies in digital health, behavioural counselling, and social support, we evaluated whether an automated digital counselling program with social network support (ODYSSEE-vCHAT) could improve mental health and health-related quality of life in patients with CHF or CKD. Purpose The primary objective was to examine whether engagement with ODYSSEE-vCHAT was associated with a minimal clinically important difference for improvement in the Mental Component Summary (MCS) of the SF-36 at end-of-study. Secondary outcomes included: ENRICHD Social Support Index (ESSI), Patient Health Questionnaire for Depression (PHQ-9) Godin-Shephard Leisure Time Physical Activity Scale (GSLTPAQ), and an index of the frequency to which patients engaged in goal-directed activities for living well (EUROIA). Methods ODYSSEE-vCHAT was a multi-centre, single group, open label study with assessments at baseline and end-of-study (approximately 11 months). Inclusion criteria were: ≥18 years of age, diagnosis of CHF (reduced ejection fraction (EF) ≤ 40%, mid-range EF, 41-49%, or preserved EF ≥ 50%); or CKD diagnosis (>10% risk for dialysis using the 4-variable, 2-year Kidney Failure Risk Equation, or on dialysis). Exclusion was based on inability to participate due to co-morbidities. The digital counselling protocol taught self-care skills to improve mental health, quality of life, and adherence to medications, exercise, diet, and smoke-free living (Figure 1). Patient engagement with ODYSSEE-vCHAT was defined as Not Engaged (0 logon minutes) vs. Engaged (> 0 logon minutes). The primary outcome was a minimal clinically important difference for MCS change: ΔMCS ≥ 3.8 or MCS ≥ 65 at baseline and study endpoint. It was assessed using multivariable binary logistic regression, controlling for exposure to COVID-19 and health literacy. Secondary outcomes were assessed using multivariable linear regression analyses with the same covariates. Results 215 patients were enrolled. There were 7 deaths and 34 withdrew. In our sample of 174 patients, mean age = 54.4 years (95% Confidence Interval, CI, 25, 81), gender identity as women, n = 68 (39%), ethno-racial group other than White, n = 83, (48%), primary diagnosis, CHF, n = 68 (39%), and CKD, n = 106 (61%). Duration of enrolment to end-of-study: median = 352 days, (95% CI, 159, 496). Engagement with ODYSSEE was associated with therapeutic change on the MCS (for both CHF and CKD patients, and CHF patients alone), GSLTPAQ, and EUROIA, but not the PHQ9 or ESSI (Figure 2). Conclusions Automated digital counselling with social network support promotes improvement in indices of mental health for patients with CHF and CKD. These findings support a follow-up randomized controlled trial.Figure 1.ODYSSEE-vCHAT Study ProtocolFiFigure 2.ODYSSEE-vCHAT Study Outcomes

Peak Flow Feedback Intervention Improves Under-Perception of Airflow Limitation in Pediatric Asthma: A Randomized Clinical Trial.

Under-perception of asthma symptoms is associated with poor asthma outcomes. We assessed the effects of a behavioral intervention for improving perception of airflow limitation and asthma outcomes. A two-arm randomized controlled trial compared peak expiratory flow (PEF) feedback versus supportive counseling. Latino and Black adolescents with asthma ages 10-17 years old and caregivers were recruited from hospitals in the Bronx, NY. PEF feedback sessions reviewed accuracy of PEF guesses and medication adherence data, and targeted behavior change using motivational interviewing and problem-solving skills training. Supportive counseling received emotional support related to asthma. Both groups received 3 sessions across 6 weeks. All participants were blinded to PEF while guessing PEF during pre-intervention, 1, 6, and 12-month follow-up. Children in PEF feedback saw actual PEF after guesses were locked in during the 6-week intervention. Participants and assessors were blinded to group assignment. The primary outcome was under-perception of airflow limitation (divergence between actual PEF and guesses) on home spirometers. Secondary outcomes included daily PEF and forced expiratory volume in 1 second (FEV1), inhaled corticosteroid adherence measured by electronic monitors, Asthma Control Test, and emergency healthcare use for asthma. The sample comprised 354 children (M = 13.2±2.2 years; 62% Latino, 38% Black) and caregivers. PEF feedback (N = 153 analyzed) demonstrated greater improvements at 1-month follow-up on under-perception of airflow limitation (difference-in-differences, -12.64; 95% CI, -17.54 to -7.74), % personal best PEF (9.89; 95% CI, 7.13 to 12.65), % predicted FEV1 (4.93; 95% CI, 0.95 to 8.90) and ICS adherence (16.02; 95% CI, 7.15 to 24.89) compared with supportive counseling (N = 152 analyzed). At 12-month follow-up PEF feedback maintained improvements on under-perception of airflow limitation (-13.87; 95% CI, -19.03 to -8.71), higher PEF (14.23; 95% CI, 11.37 to 17.08) and %FEV1 (5.62; 95% CI, 1.56 to 9.67), and had smaller declines in ICS adherence (17.51; 95% CI, 7.12 to 27.89) versus pre-intervention than supportive counseling. No between-group differences existed for asthma control or healthcare use. The efficacy and sustainability of PEF feedback was established in improving children's perception of airflow limitation, pulmonary function, and medication adherence. Clinical trial registration available at www. gov, ID: NCT02702687.

The study of acceptability HIV self-testing among Iranian injecting drug users: a qualitative study

BackgroundIn 2016, The World Health Organization introduced HIV self-testing (HIVST) as an alternative to traditional HIV testing (1), the present study aims to study the acceptability of HIV self-testing among Iranian women injecting drug users (WIDUs). The results of this study are expected to provide valuable evidence for the proper implementation of this program in Iran. Methods: This study employed a content analysis approach to gather qualitative data. The investigation was conducted from April to July 2023. We have chosen the following five provinces, namely Mashhad, Tehran, Kurdistan, Mazandaran, and Kerman, as the designated areas for our study. A sample of Iranians (17–62 years) was selected by purposeful and snowball sampling methods to participate in the study, and 31 semi-structured interviews were conducted. The data collection tool was an interview guide, which was designed based on a review of the literature. The data were analyzed using conventional content analysis. The interviews continued until data saturation was reached. Results: Based on our findings, we distilled 2 main themes and 9 categories including Inhibiting factors (Access and Affordability, Accuracy Concerns, Low knowledge, linkage to HIV treatment, the window period, Ignoring the danger) and Focalizing factors (Empowerment and autonomy, Stigma and privacy.ConclusionIran’s HIV stigma may discourage regular testing, but self-testing can help overcome challenges. Support for counseling, care links, and accurate information dissemination are crucial.

Impact of Small Group Counseling and Family Support on Increasing Complete Basic Immunization (CBI) Coverage at Siak Health Center

Complete Basic Immunization (CBI) is a crucial public health goal at the Siak Health Center. In recent years, the coverage has decreased from 48% in 2022 to 45.9% in 2023, necessitating effective interventions. This study assesses the impact of small group counseling and family support on increasing CBI coverage. The methodology involves direct small-group sessions and ongoing family visits in informal settings. Counseling materials were supported with visual aids to improve knowledge among mothers about the importance of immunization. Results indicate a positive response from participants, highlighting increased understanding and motivation. This study underscores the need for continuous counseling and monitoring to ensure higher immunization rates.

Supporting bereaved students: Qualitative insights from Danish college student counselors

This article investigates bereavement support among Danish college students, focusing on the role of student counselors across seven colleges. Twenty-one counselors participated in semi-structured interviews, revealing challenges in identifying and supporting bereaved students while juggling academic priorities. They acknowledge their focus on academics, while often feeling they lack adequate training for broader emotional support. Key themes include counselor roles, identifying bereaved students, and balancing academic and emotional needs. Recommendations highlight the necessity of tailored counselor roles, specialized training in bereavement and communication, and establishing clear support structures. These findings underline a critical gap in college bereavement support and advocate for practical improvements. Enhancing counselor education and support structures could better address the needs of bereaved students, reflecting broader challenges faced by counselors and the importance of continuous education in effectively supporting them.

Network Analysis to Visualize Qualitative Results: Example From a Qualitative Content Analysis of The National Child Abuse Hotline.

Data visualization, such as figures created through network analysis, may be one way to present more complete information from qualitative analysis. Segments of qualitatively coded data can be treated as objects in network analysis, thus creating visual representations of the code frequency (i.e., nodes) and the co-occurrence (i.e., edges). By sharing an example of network analysis applied to qualitative data, and then comparing our process with other applications, our goal is to help other researchers reflect on how this approach may support their interpretation and visualization of qualitative data. A total of 265 de-identified transcripts between help-seekers and National Child Abuse Hotline crisis counselors were included in the network analysis. Post-conversation surveys, including help-seekers' perceptions of the conversations, were also included in the analysis. Qualitative content analysis was conducted, which was quantified as the presence or absence of each code within a transcript. Then, we divided the dataset based on help-seekers' perceptions. Individuals who responded that they "Yes/Maybe" felt more hopeful after the conversation were in the "hopeful" dataset, while those who answered "No" were in the "unhopeful" dataset. This information was imported to UCINET to create co-occurrence matrices. Gephi was used to visualize the network. Overall, code co-occurrence networks in hopeful conversations were denser. Furthermore, the average degree was higher in these hopeful conversations, suggesting more codes were consistently present. Codes in hopeful conversations included information, counselor support, and problem-solving. Conversely, non-hopeful conversations focused on information. Overall, network analysis revealed patterns that were not evident through traditional qualitative analysis.

Supportive Counselling As A Therapeutic Intervention For Women With Infertility: A Meta-Analysis On Its Role In Mitigating Psychological Trauma And Enhancing Quality Of Life

Supportive Counselling As A Therapeutic Intervention For Women With Infertility: A Meta-Analysis On Its Role In Mitigating Psychological Trauma And Enhancing Quality Of Life

Prostate cancer survivorship of Australian men living with prostate cancer: Patient support programs in Australia.

Treatment for prostate cancer (PC) is associated with adverse effects, especially in patients receiving androgen deprivation therapy (ADT). The Australian Government, non-governmental organisations and pharmaceutical companies responsible for marketing ADT have initiated and sponsored various strategic support programs for patients diagnosed with PC. This professional article provides an overview of available PC patient support programs in Australia to assist general practitioners (GPs) to direct patient referrals and optimise clinical care. These PC support programs provide useful assistance on educational materials, decision support, clinical care management and referral to specialised services (eg continence advice, sexual health counselling and psychological support). More concerted efforts and smarter investment in PC survivorship programs are necessary to engage, educate and improve the lives of men living with PC more effectively.

The Effect of Mindfulness and Loneliness on Sense of Purpose in Individuals in the Age of Quarter Life Crisis

Sustainable Development Goals (SDGs) represent a global effort to achieve sustainable prosperity for all, with a strong focus on the quality of the next generation, particularly the youth. The future of a nation is closely tied to the quality of its young population. Early adulthood is a crucial period for determining career paths and life goals, which directly impact personal development and self-quality. One of the critical challenges faced during this period is the quarter life crisis (QLC), characterized by confusion over life purpose. In Indonesia, data shows that more than half of youth experience QLC, typically occurring between the ages of 18 and 35. This study aims to explore the factors influencing a sense of purpose to offer effective strategies for addressing the quarter life crisis. The research was conducted using a quantitative approach with non-probability sampling and survey methods. The sample consisted of 196 respondents (71.7% female and 28.3% male). Data analysis was performed using multiple linear regression with the assistance of SPSS version 8.0 software. Results revealed that mindfulness and loneliness have a significant impact (p<0.05) on the sense of purpose in individuals experiencing QLC, with an R-squared value of 0.090, indicating a 9% influence. These findings highlight the need for targeted counseling and psychological support services to address the quarter life crisis. Providing counseling that focuses on enhancing mindfulness and reducing loneliness can help individuals strengthen their sense of purpose, ultimately enabling them to navigate this challenging life stage more effectively.

Assessing the Impact of a Gastrointestinal Cancer Diagnosis on Mental Health Claims Among Co-Insured Household Family Members

BackgroundGastrointestinal (GI) cancer diagnosis can adversely impact the mental health (MH) of a patient’s household members, including spouses and children. The objective of the current study was to explore the potential change in MH claims among households following a patient’s GI cancer diagnosis. MethodsHouseholds of patients with GI cancer diagnosis were identified using the IBM MarketScan Database (2014-2019) and matched with households of patients without cancer. MH-related visits of spouses and children were assessed in the 12 months before and after the index date of diagnosis. Changes were compared between the two cohorts using difference-in-difference (DID) analysis. ResultsAmong 40,650 households in the spouses’ analysis and 20,014 households in the children’s analysis, 25.1% (n=10,210) and 26.8% (n=5,368) were households with GI cancer. Univariable DID analysis demonstrated that households with GI cancer had a greater increase in anxiety-related (spouses:2.2% vs. 0.7%; children:2.0% vs. 1.1%), mental illness-related (spouses:3.2% vs. 1.2%; children:3.0% vs. 1.6%), and overall MH-related visits (spouses:3.3% vs. 1.4%), relative to the control group (all p<0.05). In adjusted DID analysis, spouses, children, and households with GI cancer had 2.1%, 1.6%, and 2.3% absolute risk increase of mental illness-related visits, respectively, compared to non-cancer households (all p<0.05). ConclusionIn this cohort study of privately-insured households, co-insured spouses and children of patients diagnosed with GI cancer presented a higher risk of having MH-related claims than households not experiencing cancer diagnosis. Interventions should focus on the importance of counseling and psychological support in the aftermath of a loved one’s cancer diagnosis.

Balancing benefits and risks of exercise in pregnancy: a qualitative analysis of social media discussion

Exercise improves pregnancy outcomes, but few pregnant individuals meet physical activity guidelines. The main objective of this study was to explore the perception of exercise during pregnancy using posts and...

Prevalence and Predictors of Depression Symptoms Among Afghan Hypertensive Patients: Secondary Analysis of a Multi-Center Cross-Sectional Study.

Although depression is a frequently occurring mental disorder in patients with hypertension, little is known about the symptoms of depression among Afghan hypertensive patients. This study aimed to analyze the prevalence and predictors of depression symptoms among Afghan hypertensive patients. This was a secondary analysis of a multi-center cross-sectional study conducted between August and December 2022 across three major provinces in Afghanistan. Socio-demographic and clinical characteristics of the eligible participants were used in the analysis. A score of ≥ 5 on the PHQ-9 (Patient Health Questionnaire) was considered the cut-off point for labeling hypertensive patients as screening positive for depressive symptoms. We performed binary logistic regression to determine the predictors of depression symptoms among hypertensive patients. Out of 853hypertensive patients, 51.8% (95% CI: 48.4-55.2%) had depressive symptoms. Binary logistic regression revealed that low monthly household income [AOR=1.42, 95% CI (1.01-1.97), low education level [2.41 (1.57-3.71)], physical inactivity [1.81 (1.22-2.71)], poor blood pressure control [2.41 (1.57-3.71)], and the presence of medical comorbidity [1.59 (1.15-2.19)] were the predictors of depression symptoms. This study showed a high prevalence of depressive symptoms among Afghan hypertensive patients. Moreover, we found that low monthly household income, physical inactivity, low education level, poor blood pressure control, and the presence of medical comorbidity were the predictors of depression symptoms. Our findings suggest that hypertensive patients should be screened for mental health symptoms, and those most at risk for depression should seek supportive counseling.

교사의 소진 경험 및 지원 요구에 관한 CQR-M 연구

Purpose: This study aimed to identify factors influencing burnout experienced by teachers, understand their coping behaviors for overcoming burnout, and determine the support they need for burnout prevention and recovery. Methods: A total of 340 teachers from elementary, middle, and high schools in Chungcheongnam Province responded to open-ended questions online. Data were analyzed using the Modified Consensual Qualitative Research (CQR-M) method. Results: Factors influencing teacher burnout were grouped into seven categories. These categories include 'severity of student problem behavior, crises, and guidance challenges (25.8%)', 'complaints and infringement on teachers' rights by students and parents (19.3%)', 'unfair task assignments and workload (15.4%)', 'conflicts with parents and their negative attitudes (14.0%)', and 'lack of social support and cooperation within the school (14.0%)'. Coping strategies for overcoming burnout were grouped into nine categories, including 'seeking social support and cooperation (24.7%)', 'engaging in self-care activities (24.0%)', 'waiting or leaving it alone (14.0%)', and 'participating in counseling, therapy, or training (9.7%)'. Teachers’ needs for support for preventing and overcoming burnout were analyzed into eight categories, including 'restoration and enhancement of teachers' rights (24.2%)', 'improvement of the work environment to focus on teaching (20.5%)', 'support for counseling, therapy, and training (14.1%)', 'support for student guidance (10.9%)', and 'support for rest (10.1%)'. Conclusion: These findings provide insights into teachers' experiences of burnout and offer implications for preventing and alleviating teacher burnout.

Forgotten Victims of War: A Rapid Review of Counseling Needs and a Proposed Intervention Model for Civilian Survivors

The counseling needs of civilian war victims, particularly those not classified as refugees, have been largely neglected in academic counseling research. This study addresses this gap by conducting a rapid literature review to evaluate the current state of counseling services available to these individuals. Using Google Scholar and Web of Science, we identified and reviewed studies on counseling services for war veterans, refugees, and civilians in conflict zones. This review revealed a significant lack of structured counseling support for non-refugee civilian war victims, despite their high vulnerability. Findings indicate that while substantial efforts have been made to support refugees and veterans, the mental health needs of civilians who remain in conflict areas are often unmet, with existing services being sparse and inadequately documented. To address this issue, we propose a preliminary model that includes culturally sensitive counseling programs, training for local counselors, and international collaboration to provide sustainable support. This study highlights the urgent need for focused research and practical interventions to develop comprehensive counseling programs for these overlooked victims of war, and encourages researchers to address this critical gap in mental health services.

The impact of social participation on the quality of life among older adults in China: a chain mediation analysis of loneliness, depression, and anxiety.

This cross-sectional study investigates the impact of social participation on the quality of life (QOL) among older adults in China. Using convenience sampling, data were collected from 508 individuals aged 60 and above (M_age = 70.53 ± 7.90 years; 56.5% women). Statistical analyses were conducted using SPSSAU software, including Pearson correlation analysis to assess relationships between social participation, psychological health indicators (loneliness, depression, and anxiety), and QOL. Multiple regression analysis and chain mediation analysis were subsequently performed to explore the mediating effects of loneliness, depression, and anxiety on the relationship between social participation and QOL. The results indicated significant correlations between social participation and loneliness (r = -0.313, p < 0.001), depression (r = -0.487, p < 0.001), anxiety (r = -0.305, p < 0.001), and QOL (r = 0.476, p < 0.001). The mediation analysis revealed significant chain mediation effects of loneliness, depression, and anxiety on the relationship between social participation and QOL (β = 0.006, p < 0.001, 95% CI [0.001, 0.007]). Higher levels of social participation were associated with lower levels of loneliness, which in turn reduced depression and anxiety, thereby enhancing QOL. These findings highlight the importance of promoting social participation to improve psychological wellbeing and QOL among older adults in China. The study advocates for active social engagement and the provision of relevant services, as well as psychological support and emotional counseling for those facing mental health challenges due to insufficient social participation.

A parenting program delivered through existing community-based peer groups to improve early child development in Homabay and Busia Counties, Kenya: study protocol for a cluster-randomized controlled trial

BackgroundPoor early childhood development (ECD) is a major global health concern that is associated with various adverse outcomes over the lifecourse. Parenting interventions especially during the earliest years of life can benefit ECD. However, there is limited evidence from Kenya about the effectiveness of parenting interventions for improving ECD outcomes especially across rural disadvantaged communities. This paper describes the study protocol for an impact and implementation evaluation of a community-based group parenting program that aims to improve ECD in rural Kenya.MethodsWe will conduct a cluster-randomized controlled trial to determine the effectiveness of a parenting program for caregivers of young children in Homabay and Busia counties in Western Kenya. Sixty-four village clusters will be randomly assigned to either the parenting intervention arm or the waitlist control arm with stratification by county. In each village, 10 primary caregivers with a child aged 0–24 months will be enrolled. The parenting program will be delivered through existing peer groups within communities whereby caregivers will receive counseling and psychosocial support to enhance their parenting skills and wellbeing to in turn promote ECD. The intervention curriculum comprises 21 sessions targeting various nurturing care messages, including early learning, responsive caregiving, child nutrition, health, protection, and caregiver mental health. Group sessions are facilitated by a trained volunteer biweekly for a total of 11 months. The primary trial outcome is an overall measure of ECD using the Global Scales of Early Development long form version. Secondary outcomes include various caregiver outcomes (e.g., parenting practices, mental health) and other child outcomes (e.g., socioemotional development, dietary diversity). All outcomes will be assessed at baseline and endline. We will also conduct a qualitative implementation evaluation at endline and interview various stakeholders to assess program fidelity, quality, and sustainability.DiscussionThis trial will evaluate the effectiveness of a parenting intervention on ECD and caregiving outcomes and assess program implementation quality as delivered through existing community-based peer groups. This study will provide rigorous evidence that can be used to inform scale-up of this program model that leverages existing community social networks and resources for improving caregivers’ parenting skills and promoting ECD in rural Kenya and other similar settings across LMICs.Trial registrationClinicalTrials.gov #NCT06165315. Registered on December 11, 2023.

Barriers and facilitators of retention in care after cervical cancer screening: patients’ and healthcare providers’ perspectives

BackgroundCervical cancer continues to threaten women’s health, especially in low-resource settings. Regular follow-up after screening and treatment is an effective strategy for monitoring treatment outcomes. Consequently, understanding the factors contributing to patient non-attendance of scheduled follow-up visits is vital to providing high-quality care, reducing morbidity and mortality, and unnecessary healthcare costs in low-resource settings.MethodsA descriptive qualitative study was done among healthcare providers and patients who attended the cervical cancer screening clinic at Mbarara Regional Referral Hospital in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analysed in line with the social-ecological model to identify barriers and facilitators.ResultsWe conducted 23 in-depth interviews with 5 healthcare providers and 18 patients. Health system barriers included long waiting time at the facility, long turnaround time for laboratory results, congestion and lack of privacy affecting counselling, and healthcare provider training gaps. The most important interpersonal barrier among married women was lacking support from male partners. Individual-level barriers were lack of money for transport, fear of painful procedures, emotional distress, and illiteracy. Inadequate and inaccurate information was a cross-cutting barrier across the individual, interpersonal, and community levels of the socio-ecological model. The facilitators were social support, positive self-perception, and patient counselling.ConclusionsOur study revealed barriers to retention in care after cervical cancer screening, including lack of partner support, financial and educational constraints, and inadequate information. It also found facilitators that included social support, positive self-perception, and effective counselling.