Group Discussions Research Articles

Transdisciplinary teaching and learning in a master’s program in urban agriculture

Purpose This study aims to explore transdisciplinary teaching and learning in a transdisciplinary master’s course in an urban agriculture master’s program. Design/methodology/approach An action research approach was used, applying qualitative methods, such as reflection notes, classroom dialogues, focus group discussions and interviews. Findings The students expressed high-level inter- and intrapersonal competencies and provided thorough insights into how they developed ideas across disciplines. However, the potential for collaborating with partners outside the university (case owners) was not fully exploited and needs further development. Originality/value The study constitutes a detailed example of the benefits and challenges of transdisciplinary teaching and learning, suggesting an integral education. It adds to the knowledge of how to develop academia further to facilitate competence for sustainable development.

Reasons for contraceptive discontinuation among women of reproductive age in Kano, Nigeria: A qualitative study

Women’s attempts to achieve their desired levels of fertility are hindered when they stop using contraceptives, which could lead to unwanted pregnancies. This study aimed to assess reasons for contraceptive discontinuation among women of reproductive age in urban and rural areas of Kano State, Nigeria. Qualitative data were collected in urban and rural communities of Kano State in February to May, 2022 from women of reproductive age group, their male partners, family planning service providers, and community and religious leaders. Focus group discussions (FGD), and key informant interviews (KII), using multi-stage sampling methods explored previous experience with contraceptive use, fertility consequences and reasons for contraceptive discontinuation. Following data collection, digitally recorded data were transcribed verbatim, translated, and coded using thematic analysis through an inductive approach. Study reported the high discontinuation rates and identified side effects as the primary reason for discontinuation, with injectable contraceptives being the most commonly discontinued method. Other reported reasons for contraceptive discontinuation by respondents in both urban and rural groups were: method failure, intention to get pregnant, health concerns, husband disapproval, methods not available, inconvenience to use and interference with body structure or functions. The high contraceptive discontinuation poses significant risks of unintended pregnancies and unsafe abortions, thereby increasing maternal morbidity and mortality rates in Kano State. These consequences emphasize the need for family planning interventions that incorporate quality of care in service provision to address contraceptive discontinuation. Engaging men and other social influencers in family planning programs and services will help gather support for contraception, rather than focusing exclusively on women.

Religious monoglossia/heteroglossia and discourses of women leadership in Pakistani higher education

A growing body of literature reveals how women in higher education are either excluded from leadership roles or face challenges when they take such responsibilities. The role of religion in Muslim societies is vital to understand Muslim women's sense of “self” and their academic leadership roles and engagement in social and political activities. This study uses Bakhtin's writings as well as a feminist perspective in Islam to unpack how religious discourses shape and construe Muslim women's leadership roles in a public university in Pakistan. Data in this study was drawn from two sources: (a) semi-structured interviews with women academic leaders and academics and (b) focus group discussions with postgraduate students. Findings suggest that discourse around women's leadership in higher education in Pakistan is influenced by a male-centric religious monoglossia characterized by discourses on the hijab, masculinist religious epistemologies, and male-centric divine imagery. In addition, the study points to heteroglossic de-centering of the religious monoglossia by suggesting heteroglossic fluidity in Pakistani religious ethics that favors women's roles as leaders in higher education. A heteroglossic fluidity is characterized by how Islam is viewed as a national project, interpreted along sectarian and gendered lines, and often misused to discourage women from assuming leadership roles.

Opportunities and challenges in the implementation of the Community Environment Conservation Fund: Implications for conservation of endangered tree species

AbstractThe shea tree (Vitellaria paradoxa), one of the indigenous tree species in sub‐Saharan Africa, is facing extinction because of its hardwood, which provides the best fuel wood, and its charcoal is the best amongst all tree species in Uganda. To conserve these trees in Northern Uganda, the Community Environment Conservation Fund was implemented to help communities harness its benefits, such as carbon sequestration, microenvironment regulation and income generation through the sale of shea nuts and shea butter. As a result, there was a need to understand the opportunities and challenges in the implementation of the Community Environment Conservation Fund. Qualitative methods like the key informant interviews and focus group discussions were used and a participatory process mapping tool called the Process Net‐Map was applied to identify the actors involved and assess their level of influence in the implementation process, eliciting the opportunities and challenges faced. The research findings showed multiple opportunities in the conservation efforts, including enhanced adoption of community‐conservation by‐laws, positive mindset change towards shea tree and environmental conservation, improved credit access, diversification of income‐generating alternatives and asset creation. However, some challenges existed during the implementation phase, including moral hazard, strategic defaulting, free riding and limited financial resources. Each of these challenges significantly impacted the effectiveness and sustainability of the fund, enlightening the need for adaptive strategies. Some strategies identified were enhancing training, especially regarding fund management and enterprise selection; increasing the startup funds to at least UGX 3,000,000 ($790) per group; incorporating the declining balance approach; and lengthening the gestation period to at least 6 months. By addressing these challenges, more resilient and sustainable conservation efforts can be made, safeguarding the invaluable shea trees for future generations.

Influence of Forest Plantation Establishment Schemes on Community Livelihoods: A Case of Makutano Forest Kericho County, Kenya

Exploitation of forest resources has been a thorny issue to many countries. In efforts to restore degraded forests, countries have resulted to establishing forest plantations. There is also need to sustain livelihoods of these populations living around forests. Kenya on its part, adopted Plantation Establishment and livelihoods Improvement scheme (PELIS) program as part of participatory Forest management (PFM). PELIS involves the planting of food crops together with tree seedlings. It is however not clear whether balance has been strike between attaining forest cover and improving community livelihoods as was the intent of the program. Consequently, this study sought to shed light on this issue by looking at the influence of forest plantation on community livelihoods. This study adopted the decentralized forest management theory. Cross-sectional research design was adopted. Quantitative and qualitative methods were employed in data collection and analysis. The target population was 1719 which included forest adjacent community (FAC) members, and community based organization (CBO) leaders. From this a sample of 212 was selected. Systematic sampling was used in selecting the households and snowball sampling in selecting the CBO leaders involved in two tire focused group discussion. Questionnaire schedules were prepared to be used among household members. The findings indicated a significant influence of PELIS on community livelihood (f = 221.642, P=0.000). Those near the forest registered to have derived more economic benefits than those far away from the forest (f= 3.127, P= 0.000). A strong relationship between the frequency of attending CFA and CBO meetings, the level of involvement in decision making and planning of forest activities (B = 3.479, P< 0.05) was noted. The size of land available for cultivation was found to be statistically significant to food security among the community (f= 221.642, P= 0.000). The most important and most utilized forest products were firewood at 95%, fodder at 71% and droppers from tree pruning at 68%. Further research is needed on how more benefits from products like herbs, wild vegetables and honey cold be realized.

The feasibility of M-health for people with chronic low back pain in Shanghai, China: A qualitative study

Background: Mobile health (M-health) has emerged as a promising solution for enhancing the management of low back pain. However, the feasibility of M-health among the Chinese population and its influencing factors remain unclear. Objective: This study aimed to assess the acceptance of M-health among people with chronic low back pain (CLBP) and physiotherapists in Shanghai, China, and to explore the influencing factors of its utility in the treatment of CLBP. Methods: Semi-structured interviews and focus groups were conducted with 25 participants with CLBP and 20 physiotherapists, utilising a combination of group discussion and individual interview. Thematic analysis, supported by NVivo software, was employed to identify and examine the themes regarding the facilitators and barriers to the utility of M-health in Shanghai, China. Results: The focus group discussions revealed a broad spectrum of factors that drive or hinder participants’ acceptance of M-health. Three main themes related to the feasibility of M-health were identified from the interviews: (1) Reasons for embracing M-health; (2) Reasons for resisting M-health; (3) Recommendations to enhance the feasibility of M-health. In general, participants exhibited enthusiasm towards the prospect of offering M-health as a viable treatment. Conclusions: The findings of this study indicate that the feasibility of M-health depends on many factors in Shanghai, China. Efforts to promote the establishment of M-health policy or laws, rational integration of M-health and face-to-face model and improvement of the functions of M-health applications may increase its feasibility in Shanghai, China.

Engaging nursing home residents in clinical research: insights from a patient advisory board, a patient advocate, and a study team

BackgroundPatient and Public Involvement (PPI) is increasingly recognized as an essential aspect of clinical research, particularly for ensuring relevancy and impact of research to those most affected. This study addresses the gap in involving older patients, particularly nursing home residents, in the research process by exploring motivations, expectations, and experiences of nursing home residents in Bremen, Germany, involved in PPI for developing a clinical trial on polypharmacy.MethodsTwo Patient Advisory Boards (PABs) were established in nursing homes as part of the INVOLVE-Clin project. A Patient Advocate (PA) facilitated communication between nursing home residents and researchers. A qualitative case study approach was employed, involving semi-structured interviews and group discussions with nursing home residents and researchers. Data was analyzed using structured qualitative content analysis.ResultsThe study found varied motivations and expectations between nursing home residents and researchers. Nursing home residents valued the social interaction and the opportunity to voice their health concerns, while researchers aimed to incorporate patients’ perspectives into study design. The PA was considered crucial in facilitating communication between nursing home residents and researchers. Challenges included the complexity of the study topic and the need for methodological adjustments to suit nursing home residents´ cognitive abilities. Generally, PAB participation was experienced to provide mental stimulation and increased confidence among nursing home residents in discussing their medication management. The PAB’s influence led to the decision not to conduct a polypharmacy study.DiscussionThe findings underscore the importance of flexible approaches to PPI, particularly when involving older nursing home residents. Methodological adjustments, such as tailoring content and structure of PABs, and the inclusion of additional boards for diverse perspectives, are vital for effective involvement. The study also highlights the need for ongoing innovation in PPI methods to ensure meaningful engagement of older patients in clinical research.ConclusionThis study contributes essential insights into the practical implementation of PPI with nursing home residents, highlighting the need for patient-centric approaches that recognize their unique challenges and contributions. These findings are critical for shaping scientifically robust but also socially relevant and impactful research, especially in an aging society.

Improving Learning Outcomes on History of World War II Material Through the Application of the Problem-Based Learning Model for Class XII-2 Students at SMA Negeri 5 Medan

This research aims to measure how effective the problem-based learning model is in increasing the understanding of class XII-2 students at SMA Negeri 5 Medan regarding World War II. Using the Classroom Action Research (PTK) method in two cycles, this research involved learning results tests and observations to collect data. The results of research using a problem-based learning model in class XII-2 students at SMA Negeri 5 Medan showed a significant increase in learning outcomes for World War II material. This is evidenced by the increase in the average student test score from 78 in the first cycle to 82 in the second cycle. Apart from that, observations also show an increase in student learning activities, such as group discussions and information seeking.

Parent's Perspectives on Boarding Schools in Primary Education Settings: The Case of Std Vi and Vii in Magharibi B District Unguja

This paper is set to determine the Parents' perspectives on boarding schools in Zanzibar. The study is expected to provide insights into the Parents' perspectives and experiences regarding boarding schools in primary school settings, especially for STD VI and VII. The study will shed light on the benefits, challenges, and potential outcomes associated with boarding in primary school settings from different parents. The study utilized the Social Learning Theory developed by Albert Bandura, which is a psychological framework that emphasizes the role of observation, imitation, and modeling in the learning process. This theory highlighted the impact of models in shaping behavior, both positive and negative, and demonstrated how children could imitate aggressive behavior they witnessed in adults. In this study, data was gathered directly from primary sources through various methods such as interviews, Questionnaires, and group discussions in order to give chances for any respondent to give out his or her view about boarding schools in primary education settings in confidence and freeway. The findings indicate that parents prefer boarding schools as they provide a conducive learning environment, help in students' social development, and safety in boarding schools is well-managed. Also, boarding schools have adequate resources and facilities and communication between parents and boarding schools is effective. The study concludes that parents hold varied perspectives on boarding schools, emphasizing their perceived benefits such as conducive learning environments, social development opportunities, and well-managed safety protocols. These positive views are complemented by concerns about resource adequacy, communication effectiveness, and the rigidity of the boarding school environment

Diversity challenges in German nursing teams: a participatory organizational development approach

Abstract Background Migration of health care professionals, demographic change and the transformation of the health care system result in highly diverse nursing teams in German hospitals and nursing homes. Different orientations (regarding qualification, generation or migration background) collide in a working environment characterized by staff shortage, time pressure and decisions about life and death. But team cooperation not only has a strong impact on patient safety, but on job satisfaction and therefore retention management. Little is known on how teams cope with diversity challenges and how this is linked with organizational structures. Methods Based on qualitative content analysis of 197,5 hours of participatory observation, 8 group discussions and 25 interviews in 6 nursing teams in 2 hospitals and 2 nursing homes situated in a major German city, we developed workshops on the topic of team diversity and cooperation. 10 workshops (4-16 participants each) were in held in 2023/24 both on team- and management-level. Results All teams are struggling with diversity-related problems, but in their specific ways, depending on the particular neighbourhood of the facility and team composition among other things. Due to the strong team spirit and identity, the teams have a fundamental tendency to integrate diverse perspectives and orientations. But they need time capacities and supportive organizational structures. The workshops created a space to discuss the team specific problems. Starting points for structural changes could be identified and further discussed in the workshops at the next higher hierarchical level. Conclusions Organisational structures provide the framework conditions that enable teams to integrate different perspectives resulting from diversity in a productive way. One-fits all solutions are not suitable to address those problems and improve teamwork. A participatory bottom-up process seems to be the most appropriate approach. Key messages • Institutions need to provide structures in which diversity is not perceived as an additional burden. • The best way to initiate improvements is through a participatory bottom-up approach.

Stakeholder involvement in the development of a serious game for and with healthcare professionals

Abstract Increasing pressure on the quality, accessibility and affordability of Dutch health services underlines the need for integrated approaches to healthcare that include lifestyle as preventive measure. Integrated healthcare requires coordinated collaboration between healthcare providers, which is facilitated by the concept of Positive Health as a unifying language. To support primary care providers (PCP) in developing knowledge and skills related to lifestyle as prevention, interdisciplinary collaboration and the concept of Positive Health, we are developing education in the form of a serious game: Game2Connect. Co-creation by active involvement of a consortium of educational institutes, healthcare organisations, a game developer, and PCP as end-users of Game2Connect plays a key role in its development. Data from interviews with PCP (on barriers and facilitators for health-promoting and collaborative behaviours), healthcare recipients (on input for case studies) and consortium meetings were incorporated into an initial version of Game2Connect, which is currently being piloted to assess and improve its utility and usability. Pilot sessions included an observed playthrough, followed by a usability questionnaire and a semi-structured group discussion. So far, 2 pilot sessions were held with consortium members (n = 16), and 3 sessions were held with PCP (n = 22). Learning indicators (e.g. PCP clarifying fellow players’ misconceptions) were observed in all sessions. Usability scores indicate high levels of challenge, content relevance, and positive affect, ranging between 3.3-3.6 on a 4-point scale. Qualitative feedback from group discussions resulted in the development of new case studies to appeal to a broader range of PCP, and the adjustment of a goal-setting exercise as a game component to encourage its use. These results suggest that serious gaming may be a viable and engaging method to educate PCP, especially when developed in active collaboration with stakeholders.

Empowerment and interprofessional collaboration in health promotion centre Murska Sobota

Abstract Background Health promotion centres (HPCs) were introduced in Slovenian primary health care centres to provide interventions against risk factors for noncommunicable diseases (NCDs). HPCs integrate a multidisciplinary and community-based primary care approach to the prevention of NCDs and provide free lifestyle intervention programmes. This study aims to explore the perspectives of health care professionals on promoting health of local community members, as well as their perceptions of interprofessional collaboration in HPCs. Methods Two group discussions were conducted with a total of 11 health care professionals at the HPC Murska Sobota. Data collection was accompanied by a dual role interpreter in accordance with the principles of cross-language qualitative research. The data was transcribed, semantically translated and thematically analysed. Results Health care professionals emphasize the importance of health-related empowerment of individuals for the success of health promotion activities and therefore for the improvement of individuals’ quality of life. This is based on shared decision-making, self-management and educational measures in a combination of population- and individual-based approaches. The need for efficient interprofessional communication, characterized by a flat hierarchy, is stressed. Structured cooperation with other health care facilities, as well as close collaboration with communities and local media, are described as crucial for reaching all individuals and promoting health equity. Conclusions Interprofessional collaboration, health-related empowerment of individuals and collaboration with local communities are fundamental for the success of health promotion activities, achieving health equity and preventing NCDs. Understanding how these activities are implemented from the health care professionals’ perspective can help other health facilities developing and improving local health promotion strategies. Key messages • Slovenian health care professionals see interprofessional collaboration as fundamental for the implementation of health-promotion strategies. • Health-related empowerment of individuals and collaboration with local communities play an important role in achieving health equity in health promotion activities.

In development intervention, professionals aim to enhance working practices and interaction

Abstract Background The social services and healthcare professions are experiencing a global labor shortage. Enhancing the appeal and retention requires the development of work and processes through community-level interventions that reduce workload and bolster resources. Further research into such interventions is necessary. This study focuses on a systematic community-based practice development model (Breakthrough Collaboratives) to evaluate the change in alignment with the development intervention’s objectives and the prerequisites for change. The evaluation will utilize the process evaluation model for well-being at work projects and health promotion interventions. Methods This qualitative process evaluation employs a multi-case study approach to depict the changes occurring during the development intervention. It assesses the development processes of fifteen workplaces across Finland. The research material includes recorded group discussions from the initial workshop, where professionals establish goals and development targets for their work. The qualitative data are analyzed using content analysis. The analysis is guided by questions such as: What goals and development objectives do participants set for their work? What workplace-specific characteristics inform these objectives? Results Preliminary findings indicate that the work units’ development objectives concentrate on updating the unit’s common rules, enhancing the induction process for new employees, improving work behavior, and refining meeting practices. Workplace-specific characteristics differ based on the work unit’s sector, the level of trust among professionals, and their willingness to critically evaluate management. Additionally, competence and professionalism emerge as prominent themes in group discussions. Conclusions In a workplace development intervention, professionals aim to enhance common working practices and interaction, with the goal of improving well-being at work. Key messages • Enhancing operational practices and promoting positive interpersonal conduct among colleagues constitutes a pivotal goal in advancing social and health care work units. • The Community based intervention provides workplaces with concrete models to support co-creation and permanent changes in working practices.

Implementasi Strategi Pembelajaran Inquiry pada Mata Pelajaran Akidah Akhlak di MTs Pondok Pesantren Modern Darul Hikmah TPI Medan

This research aims to involve students directly in the learning process of Class VII students at MTs Islamic Boarding school Modern Darul Hikmah TPI Medan through the application of inquiry-based learning strategies to instill scientific skills and motivate students. This research uses qualitative methods with a phenomenological approach. The data collection methods used were interviews, observation, documentation and group discussions. Class VII students were participants in this research. The data analysis method in this research was carried out from pre-field implementation to completion in the field. Data validation was carried out using source triangulation. The data analysis used uses Hyberman's opinion, namely data reduction activities or making reports from start to finish which selects basic data found in the field, presents the data, reviews incomplete data, and finally draws conclusions. From the results of observations and interviews conducted by the author, it is known that the application of inquiry learning strategies increases students' learning motivation and increases their learning motivation.

Bridging the gap: mapping co-creation methods for public health impact and innovation

Abstract Background Co-creation offers a promising approach to public health innovation, particularly for tackling complex issues. However, the lack of a standardized methodology limits its reliability and reproducibility, especially across diverse contexts. This study explores co-creation methods used by researchers and practitioners, aiming to shed light on their implications for public health. Understanding this methodological landscape can enhance the effective implementation of co-creation processes to address complex challenges. Methods Utilizing the Systematic Methods Overview approach, we examined co-creation methods. Data were gathered from the Health CASCADE Co-Creation Database and grey literature using an artificial intelligence-assisted recursive search strategy and a two-step screening process. We conducted textual, comparative, and bibliometric analyses to evaluate methodological underpinnings and relationships between methods. Results Analysis of 2,627 academic articles and grey literature sources identified over 900 co-creation methods. While surveys, focus groups, and group discussions were prevalent, participatory methods were underutilized. Notably, 91.3% of methods co-occurred, with a predominant combination of qualitative approaches. Furthermore, a significant discrepancy between research and practice was evident, with only 10.2% convergence. Conclusions This study revealed a critical gap between co-creation in research and practice, emphasizing the need to bridge this methodological divide for advancing co-creation as a reliable approach in public health. The over-reliance on qualitative methods raises concerns about tokenistic engagement and undermines meaningful public participation in co-creation. Addressing this trend is vital to preserve the essence of true co-creation and maximize its potential for addressing complex public health challenges. Key messages • Mapping the diverse methods of co-creation in public health reveals both richness and disparities in approach, from surveys to participatory methods. • Addressing the discrepancy between co-creation in research and practice is vital for establishing a reliable and effective approach to tackling public health challenges.

Patients’ experiences of racism in German inpatient healthcare

Abstract Background Racism is recognised as a social determinant of health. An evolving concern in research and policymaking has been the impact of racism in the healthcare system, particularly regarding the quality of healthcare and barriers for healthcare. Little is known about patients’ experiences of racism in hospitals and rehabilitation facilities in Germany and their coping strategies in dealing with racism. Methods As part of a joint project on racism in healthcare (RiGeV) funded by the Federal Ministry of Education and Research, twenty qualitative interviews and two group discussions with patients and their next of kin about their experiences in hospitals and rehabilitation facilities were conducted and analysed using the documentary method. Ethical approval for this study was obtained from the Ethics Committee of Fulda University of Applied Sciences. Results Interviews with patients and their next of kin revealed that the most significant experiences of racism in hospitals are attributions of dramatisation and exaggeration of pain, embedded in a general perception of not being taken seriously and/or being ignored. Patients try to avoid such experiences that compromise their trust and sense of security, as well as the quality of treatment they receive. Healthcare for refugees is impacted by structural barriers (AsylBLg) which jeopardise the healing process and represent a considerable psychosocial burden. Conclusions Recommendations for policies and practice include a mission statement for non-discriminatory treatment and the sanctioning of racism within healthcare institutions. A complaints office should manage implementation and offer support for affected patients. The topic of racism must be addressed in the training and further education of doctors and healthcare professionals. Patient trust in a safe and high-quality form of healthcare should be strengthened by addressing their complaints. Health care for refugees has to be improved. Key messages • Racism in German inpatient healthcare represents a considerable psychosocial burden for patients and impairs the quality of treatment they receive. • Policies for reducing racism inpatient healthcare have to be implemented.

Navigating complexity: an evaluation framework for assessing co-creation in public health

Abstract Background Co-creation aims to democratize research and bridge the gap between research and practice. Key characteristics like empowerment and meaningful participation shape sustainable outcomes. However, existing frameworks like Arnstein’s Ladder of Citizen Participation broadly overlook individual method contributions. This study aims to address this gap by creating and validating a framework for intrinsic evaluation, guiding stakeholders and researchers in genuine co-creation of public health interventions. Methods We systematically screened and extracted frameworks aligned with five key co-creation characteristics to identify and evaluate methods. Through iterative testing, we identified key features for distinguishing methods and integrated them into a novel framework. Co-creation experts validated and refined this framework using the closed card sort method, qualitative assessment, and group discussions. Results The Co-Creation Rainbow framework includes key features from 20 existing frameworks, with an Individual-to-Collective Continuum, five sections (Informing, Understanding, Stimulating, Collaborating, and Collective Decision-making), and three overarching themes (Engage, Participate, and Empower). Analysis showed successful categorization of 436 methods and revealed a significant disparity in co-creation practices between researchers and practitioners. Conclusions The Co-Creation Rainbow framework provides a structured approach to evaluating and reporting co-creation processes. Acknowledging co-creation’s diversity, the framework aids in tailoring approaches for meaningful participation. By offering a unified language for diverse co-creation methods, the framework also facilitates transparent evaluation, enhancing the reliability and reproducibility of co-created public health interventions. Key messages • Employing a universal language across diverse co-creation methods is pivotal in fostering transparent evaluation, thereby bolstering the reliability of co-created public health interventions. • Effective collaboration of key stakeholders necessitates the use of suitable methods. By integrating diverse perspectives, public health interventions gain relevance, efficacy, and sustainability.

Stakeholders’ perspectives on informed decision-making for migrant women in CC prevention programs

Abstract Background This study gathered the perspectives of stakeholders regarding participation in cervical cancer (CC) screening and human papilloma virus (HPV) vaccination among migrant women in the Netherlands. Considering their perspectives by developing interventions that are tailored to migrant women’s information needs regarding CC screening and HPV vaccination will support informed decision-making. Methods In total five focus group discussions were held with community leaders, healthcare professionals and communication experts separately. The focus group discussions were transcribed verbatim in Dutch, and analyzed thematically according to the Grounded Theory. Results The analysis resulted in six themes. The first theme describes the existing views and misconceptions regarding CC (screening) and HPV vaccination in the target population according to the stakeholders. The second theme is about the current approach of informing about these health programs, and its belonging barriers. Theme three dives into the differences within the target population, such as generations and level of language. Theme four describes the conditions to which interventions should adhere. In theme five and six suggestions for interventions were introduced, focused on the target population and their (social) network respectively. Conclusions The results of this study showed that stakeholders are willing to play a role to support informed decision-making regarding CC (screening) and HPV vaccination among migrant women, but they need more training to support. Community leaders express a need for training to gather more medical knowledge of CC and its prevention programs. Healthcare professionals expressed a need for more insight into the practical, cultural, religious and emotional aspects that play a role within this target population. Communication experts emphasize the need for customized information materials and a more district-oriented approach. Key messages • Stakeholders operating at different levels are willing to play a role in increasing informed decision-making regarding CC screening and HPV vaccination. • Migrant women’s (social) network need more training and support to be able to provide tailored information regarding CC screening and HPV vaccination.

Assessing inequalities and inequities in Health Impact Assessment: a systematic review

Abstract Background Health Impact Assessment (HIA) procedures can include the assessment inequalities and inequities associated with the distribution of environmental health risks and benefits, attenuating the exacerbation of health disparities in this domain. However, prevailing approaches to tackle inequalities in accessing ecosystem services exhibit limitations. We explored how this kind of assessment in HIA procedures is documented within the international literature. Methods Following PRISMA Guidelines, we conducted a systematic review of scientific literature by searching in MEDLINE/PubMed, Scopus, and Embase databases up to 8 March 2024. Moreover, a grey literature analysis was conducted, examining the World Health Organization’s Institutional Repository for Information Sharing (IRIS) to identify guidance considering equity in HIA. Results Eight out of 158 documents identified on IRIS, using ‘health impact assessment’ as a filter, underscore the importance of integrating the equity domain into the HIA; of these, only 1 employs methodologies to actively consider it. Of the 806 literature studies analyzed, only 14 included used methods to evaluate inequalities and equity in HIA in various contexts, ranging from urban planning, such as green or redeveloped areas, and transport planning, to mining. Preliminary results show that in most studies, data were collected through surveys, focus group discussions, and peculiar “walks” with local experts. The predominant approaches in extant literature entail the use of socioeconomic status and health determinants as metrics for assessing equity and inequalities within HIA. Conclusions Our findings highlight a critical gap in integrating equity into HIA practices, with limited attention and methodological diversity observed across the analysed documents and studies. Strategies for probing and mitigating inequalities can be strengthen by engaging different stakeholders and the residing population. Key messages • There are few and highly heterogeneous methods for assessing inequality in HIA. • An effective and standardized strategy to asses inequality in HIA could involve stakeholders and the resident population.

Examining Barriers to the Utilization of Malaria Control and Prevention Services in the South West Region, Cameroon

Purpose: The purpose of this study is to examine the barriers to the utilisation of malaria control and prevention services in the southwest region of Cameroon precisely in the Fako division. Cultural beliefs and practices significantly influence health-seeking behaviours in communities, even when faced with life-threatening diseases like malaria. Methodology: Qualitative data were collected through structured interviews to understand the preferred treatment methods for malaria, the rationale behind the disease's continuous prevalence within the community, and the low usage of prevention methods prescribed in the hospitals. The data were analysed using a thematic technique, and presented following the themes that were elicited during the in-depth interviews and focus group discussions. Findings: This study found that herbal medical practices are deeply rooted in the community's culture and need to be more quickly supplanted by modern medical practices. The study found that the resistance to malaria prevention methods was fueled by a lack of awareness about the importance of malaria prevention and control, contributing to the high malaria prevalence rate in the community. Also, the study found that the current healthcare system needs to be culturally sensitive, potentially leading to a lack of trust and confidence among community members. Additionally, financial constraints significantly impact the utilisation of preventive and treatment measures like mosquito nets, health centres, and community health workers. Unique Contribution to Theory, Practice and Policy: These findings aligned with the Health Belief Theory (HBT), which explains that individuals' beliefs and attitudes towards malaria prevention in these communities constitute a significant barrier to malaria eradication. Community members perceive malaria as a severe disease and believe they are at risk of contracting it, leading to action due to susceptibility. However, traditional remedies are preferred due to perceived barriers to mosquito nets, such as cost, lack of access, and perceived ineffectiveness of the mosquitoes’ nets. The study concluded that a culturally sensitive approach to malaria treatment and prevention, built on the community's beliefs and practices, can improve health outcomes. Therefore, organisations in charge of malaria prevention must adapt their approach to align better with the community's cultural values. The study further recommended that education and awareness campaigns about malaria prevention and control should be tailored to the community's cultural realities.