Experiences Of Health Services Research Articles

Challenges and opportunities of sustained public involvement in maternal health research: a practice case study with reflections from researchers and public contributors

It is widely agreed that collaboration with people with lived experience of specific health conditions or health services is both a moral imperative and a utility to improve research quality, validity and impact. However, there is little agreement about how to practise public involvement. In this article, we describe the formation and work of the Nottingham Maternity Research Network, an ongoing research reference panel that supports public involvement in maternal health research. Drawing on nine years’ experience, researchers and public contributors reflect together on the key issues to consider when co-producing research with maternity service users: first, pragmatic considerations, and second, creating a safe space for drawing on intimate and sometimes traumatic experiences. We argue that a sustained model of public involvement and engagement – that is, a standing group rather than a series of project-based, time-limited opportunities for involvement – brings opportunities to build trust and to develop a community that is supportive and inclusive. However, the sustained model of public involvement also brings practical challenges.

Experiences of health services for adults with cerebral palsy, their support people, and service providers.

https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.16037

Evaluating the impact of the Health Access for Refugees Project on people who are refugees or seeking asylum in Northern England.

Evidence demonstrates that people who are seeking asylum and refugees face individual, institutional and system-level barriers when accessing health services. Health Access for Refugees' Project (HARP) is a UK initiative increasing access to health care within this community through a series of interventions. This study explored the impact of HARP on health service access, experiences and outcomes for clients, and how volunteers and staff addressed institutional and system-level barriers. In summer 2020, we conducted qualitative telephone interviews with four HARP clients, eight clients who became volunteers, seven further volunteers and three staff members. The educational aspect of the interventions supported clients navigating the complex UK health care system while promoting independence in accessing health care. Advocacy by volunteers and staff was important in challenging barriers at individual and institutional levels. Staff challenged the asylum system, by improving information around entitlement to health care and addressing barriers to registering with a General Practitioner (GP). Interventions such as those provided by HARP can address different levels of barriers to support people accessing health care provision. This can be achieved through training health professionals and working with peers to support access to care and to develop self-advocacy. However, stable long-term funding is essential to ensure the sustainability of these initiative.

Health Service Experiences of War-injured Immigrant Populations in Canada in 2023

Health Service Experiences of War-injured Immigrant Populations in Canada in 2023

Exploring black women's experiences of mental health services: a literature review.

The prevalence of mental health issues among black women is high, but they are underrepresented among mental health service users. This article details a systematised review of the literature that explored black women's perceptions and experiences of, and barriers to, engaging with mental health services. A total of 16 articles from the UK and North America were included in the review. Four main themes were identified as presenting barriers to black women's engagement with services: mistrust; sociocultural factors; lack of awareness; and practical barriers. The intersection of gender and race was evident in the 'strong black woman' ideal, which may have hindered their recognition and disclosure of mental health conditions, as well as in practical barriers such as costs and caring responsibilities. Historical and cultural perceptions of mental health issues and healthcare services, alongside their previous negative experiences of services, may prevent many black women from accessing essential support. Nurses and other healthcare professionals have an important role in engendering trust, challenging racism and promoting positive mental health.

Listening to the Perspectives of Black Women on Perinatal Health Disparities: Reversing the Tide and Improving Outcomes.

Pregnancy-related health in the USA fares worse than similarly resourced countries and the gap continues to widen. This trend however is disproportionately experienced by women of color. We have come to understand that this is due to the systems and structures that perpetuate racism. Despite our awareness of this, the voices of the community impacted by these systems have been largely left out of research. The authors aimed to utilize participatory research methods within a qualitative design to askBlack pregnant and parenting women about their lived experiences of pregnancy and perinatal health services. Over three focus groups, the authors gathered information from 12 participants. Participants were Black women currently pregnant or pregnant in the last year, ages 22-37years old. Participants shared their experiences and views on racial disparities within perinatal health care. Our analytic goal was to explore the questions: "What are Black women talking about in relation to perinatal health"; "Where do Black women get information about perinatal health disparities?"; and "How do Black women feel when they hear or talk about perinatal health risks?". In general, participants felt that the burden to understand their pregnancy risks and options was theirs alone to carry. This resulted in their utilization of and reliance on the internet, social supports, and holistic providers such as doulas for information about how to reduce their risk for maternal morbidity and mortality. Results demonstrate patients' receptivity to frank conversation about perinatal health disparities, and their willingness to partner with their providers to reduce risks in pregnancy. While interventions to reduce perinatal health risks must be systemic, they cannot move forward without including the voices of and partnering with the community they hope to positively impact.

Experiences of central child health services teams regarding a special governmental investment in child health services

BackgroundHistorically marked by a high infant mortality rate, Sweden’s healthcare reforms have successively led to a robust, decentralized universal child health system covering over 97% of the population 0–5 years. However, inequities in health have become an increasing problem and the public health law explicitly states that health inequities should be reduced, resulting in various government initiatives. This study examines the experiences of Central Child Health Services (CCHS) teams during the implementation of the Child Health Services Accessibility Agreement between the State and the regions starting in 2017. The agreement aimed to enhance child health service accessibility, especially in socio-economically disadvantaged areas, but broadly stated guidelines and the short-term nature of funding have raised questions about its effectiveness. The aim of this study was to understand the experiences of CCHC teams in implementing the Child Health Services Accessibility Agreement, focusing on investment decisions, implementation efforts, as well as facilitators and barriers to using the funds effectively.MethodsCCHC teams were purposefully sampled and invited via email for interviews, with follow-ups for non-respondents. Conducted from January to October 2023, the interviews were held digitally and recorded with individuals familiar with the agreement’s implementation within these teams. Both authors analyzed the transcripts thematically, applying Braun and Clarke’s framework. Participants represented a cross-section of Sweden’s varied healthcare regions.ResultsThree main themes emerged from the thematic analysis: “Easy come, easy go,” highlighting funding uncertainties; “What are we supposed to do?” expressing dilemmas over project prioritization and partner collaboration; and “Building castles on sand,” focusing on the challenges of staff retention and foundational program stability. Respective subthemes addressed issues like fund allocation timing, strategic decision-making, and the practical difficulties of implementing extended home visiting programs, particularly in collaboration with social services.ConclusionsThis study uncovered the challenges faced in implementing the Child Health Services Accessibility Agreement across different regions in Sweden. These obstacles underline the need for precise guidelines regarding the use of funds, stable financing for long-term project sustainability, and strong foundational support to ensure effective interprofessional collaboration and infrastructure development for equitable service delivery in child health services.

Discontinuities in and Perceptions of Mental Health Service Path of Violent Young Offenders: A Qualitative Descriptive Study.

Studies on mental health service use among juvenile violent offenders prior to their acts of violence are sparse. Mostly, their service use seems to be short-term, although there may have been several service periods. Little is known about how they have perceived those services. Using a qualitative content analysis on data from forensic psychiatric examination statements, we studied discontinuities in the use of mental health services of 15-22-year-old violent Finnish offenders and descriptions of their perceptions of those services. There were several types of discontinuities: limited youth engagement and subsequent dropping out from services, or partial or total refusal of the proposed examinations or treatments. Most discontinuations were instigated by the youth themselves, followed by the parents and the service system. The subjects had perceived mental health services to be not beneficial for the most part, although some experienced benefits from medication. When treating children and adolescents with behavioral symptoms clinicians should identify the early signs of the process of disengagement from treatment and pay attention to the perceptions of the treatment of both the youth and their parents. Also, more research is needed on the user experience of mental health services among violent offenders, as well as factors relating to discontinuities along their mental health service path.

Experiences of health services for adults with cerebral palsy, their support people, and service providers.

To explore the experiences of health services among adults with cerebral palsy (CP) in Ireland, from the perspectives of adults with CP, their support people, and service providers. A qualitative descriptive study design was used. In-depth semi-structured interviews were conducted between March and August 2021 with adults with CP, people who supported them, and health professionals. Thematic analysis was used to evaluate the data. Twenty-one adults with CP, seven support people (family carer[s], spouse or partner, or friend), and 15 service providers participated in the study. Adults had a mean age of 38 years 5 months (range 22-58 years) and were classified in Gross Motor Function Classification System levels I to V. Five themes were identified from the data: (1) access challenges in adult services; (2) knowledge and understanding of CP; (3) support people's role and care burden; (4) communication and interaction in adult services; and (5) health system challenges. Adults with CP in Ireland face multiple challenges accessing the health services they need. Services were reported to be inadequate, with limited resources and understanding of CP. Participants highlighted a need for system-level interventions, including enhanced training for health professionals to effectively meet the needs of adults with CP.

Community perception and experience of health services in the midst of an earthquake and COVID-19 pandemic: A phenomenological study

Indonesia is located on the Pacific Ring of Fire with various disasters occurring frequently and causing tremendous impacts. Recently, Mamuju Regency in West Sulawesi was hit by an earthquake during the COVID-19 pandemic, making primary health care (PHC) a major community health care provider facing several issues. This study aims to explore the challenges and supporting factors of the recovery of PHC after the earthquake during the COVID-19 pandemic using a descriptive phenomenology grounded in Edmund Husserl's philosophy. The Bamboo PHC (Puskesmas Bambu) was selected as the only PHC in Mamuju which was most affected by the earthquake. A focus group discussion method was conducted by involving 15 participants selected using purposive sampling and divided into three groups (health workers, health cadres, and community members). As a result, the community members acknowledged that the Bamboo PHC services programs in general were favorable before the pandemic, there were several basic and superior health service programs that the community felt were valuable. Yet, the COVID-19 pandemic worsened the situation and the use of healthcare facilities decreased. Coupled with the occurrence of natural disasters in vulnerable areas, it is increasingly causing fatalities. Therefore, disaster preparedness and community empowerment are the key to successful disaster management.

What supports the emotional well-being of peer workers in an NHS mental health service?

Purpose This study aims to explore the experiences of peers working in a range of roles within a single NHS mental health service. This study also aims to provide evidence of the impact of existing support, organisational structure and culture around peer working and provide recommendations for a Good Practice Guide for Peer Working. Peer roles require lived experience of mental health conditions and/or services. While the impact on them of using their own lived experience is not fully understood, anecdotal evidence suggests that peer workers may experience a greater emotional impact than other mental health workers. Burnout and retention are particular concerns. Design/methodology/approach This was a two-stage study using focus groups and reflexive thematic analysis in Stage 1. The key themes formed the basis of the Stage 2 workshop, which provided recommendations for a Good Practice Guide. The study team consisted of peer researchers with lived experience, supported by a Lived Experience Advisory Panel. Findings There is a perceived lack of support and an increased peer burden for peer workers. Recommendations included relevant ongoing training and development; support and supervision; and organisational cultural change. Originality/value Working within a peer-led co-production framework, this study contributes to the development of the evidence base for peer emotional labour. Based on the findings, a Good Practice Guide for Peer Working is being developed to promote good practice for the development of future peer worker roles.

Understanding the Retrospective and Current Health Care Needs and Service Experiences of Adult Survivors of Minor Sex Trafficking

Minor sex trafficking is an urgent public health problem, but we lack data about how such experiences impact health and health care access. Utilizing data collected from in-depth interviews with 35 adult survivors of minor sex trafficking across the U.S. we explored the physical and psychological healthcare access and healthcare experiences of adult survivors of minor sex trafficking. Negative healthcare experiences before, during, and following sex trafficking foster a lack of trust and confidence in healthcare systems as adults. Recommendations are provided to help overcome barriers to meeting healthcare needs and improving health care experiences for survivors of minor sex trafficking.

Client perspectives on creating supportive sexual health environments for people with persistent anxiety: a qualitative study

ObjectivesWe sought to explore sexual health service clients’ perspectives, preferences and suggestions for how to better address or alleviate anxiety among clients of sexual health services (eg, sexually transmitted infection...

Men’s Satisfaction with General Health Services is Associated with Future Use of HIV Testing in Malawi: A Community-Representative Survey

Across sub-Saharan Africa, men are less likely to know their HIV status than women, leading to later treatment initiation. Little is known about how experiences with general health services affect men’s use of HIV testing. We used data from a 2019 community-representative survey of men in Malawi to understand frequency and cause of men’s negative health service experiences (defined as men reporting they “would not recommend” a facility) and their association with future HIV testing. We conducted univariable and multivariable logistic regressions to determine which aspects of health facility visits were associated with would-not-recommend experiences and to determine if would-not-recommend experiences 12–24 months prior to the survey were associated with HIV testing in the 12 months prior to the survey. Among 1,098 men eligible for HIV testing in the 12 months prior to the survey, median age was 34 years; 9% of men reported at least one would-not-recommend experience, which did not differ by sociodemographics, gender norm beliefs, or HIV stigma beliefs. The factors most strongly associated with would-not-recommend experiences were cost (aOR 5.8, 95%CI 2.9–11.4), cleanliness (aOR 4.2, 95%CI 1.8–9.9), medicine availability (aOR 3.3, 95%CI 1.7–6.4), and wait times (aOR 2.7, 95%CI 1.5-5.0). Reporting a would-not-recommend experience 12–24 months ago was associated with a 59% decrease in likelihood of testing for HIV in the last 12 months (aOR 0.41; 95% CI:0.17–0.96). Dissatisfaction with general health services was strongly associated with reduced HIV testing. Coverage of high-priority screening services like HIV testing may benefit from improving overall health system quality.

Sexual health services for adolescents on Reunion Island: results from a descriptive interview-based study

ObjectivesTo describe the experiences of sexual health services available for adolescents aged 15–19 years on Reunion Island.DesignA qualitative descriptive study was conducted from 3 December 2022 to 24 October 2023....

Adolescent boys’ experiences of mental health and school health services - an interview study from Norway

BackgroundMental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys’ experiences of mental health and school health service.MethodsAn inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study.ResultsThe overall theme “barriers towards seeking help”, and three categories— navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking—described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness.ConclusionsLack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.

'I'm still su!c!dal when you're done with the paperwork': an inductive framework thematic analysis of #camhs on TikTok.

Young people are sharing their experiences of Child and Adolescent Mental Health Services (CAMHS) in the United Kingdom on TikTok. Little is known about the content of these videos and their influence on young people's attitudes towards seeking professional mental health support. This study explored how CAMHS is represented in a sample of 100 #camhs TikTok videos using participatory inductive framework thematic analysis. Four themes were developed alongside young people as co-researchers: (a) CAMHS can be frustrating and unhelpful, but sometimes life-saving, (b) Young people can feel their distress is invalidated by CAMHS, (c) CAMHS makes young people feel responsible for their distress, and (d) Young people may not feel CAMHS professionals are trustworthy. Video content described dismissive responses to expressions of suicidal ideation, professional knowledge being privileged over lived experience, and breaches of confidentiality. Some shared positive experiences of CAMHS helping to keep them safe. Together, the themes reflect a representation of CAMHS as a service where adults are powerful and young people occupy a subjugated position. This may influence young people's professional help-seeking behaviour. Recommendations for clinical practice and future research are presented.

Debate: Involuntary treatment and detention are a necessary part of mental health care for children and young people.

People of all ages are subject to involuntary psychiatric detention and treatment worldwide but there is current discussion about whether this complies with modern human rights law. The use of involuntary psychiatric hospitalisation among children and young people has largely eschewed research and policy interest to date. In this debate section, we hear from people with experience of child mental health services in the UK, USA and low- and middle-income countries about their views on the use of involuntary treatment in young people.

Prosumers' experiences of stigma dimensions within the clinical psychology field.

Lived experiences of mental illness and stigmatizing attitudes toward psychiatric diagnoses are common throughout the world. Research demonstrates that clinical psychologists are not exempt from having lived experiences of mental illness, nor experiencing, witnessing and perpetuating stigma. However, no research has examined prosumers' (providers and consumers of mental health services) experiences of witnessing discrimination within the field of clinical psychology. The purpose of this study was to explore prosumer's experiences of stigma within clinical psychology. A total of 175 doctoral level prosumers (graduated N = 39 and N = 136 in-training) completed a mixed-method online survey regarding their stigma experiences within the field. Emergent qualitative themes from grounded theory analyses included: witnessed discrimination (invalidation, over pathologizing, clinical psychologists as experts and training as a breeding ground for stigma, psychological distress, negative feelings related to field), anticipated stigma (agency and identity rejected, degree of acceptance), internalized stigma (perceived competence and social desirability), and stigma resistance (academia in action, engaging communities, comes with a risk, worthwhile). Our findings have implications for the role of clinical psychology in perpetuating stigmatizing views and attitudes toward individuals with lived experiences of mental illness, specifically in-training and academic settings. Further research should strive to evaluate how clinical psychologists, including prosumers, engage in stigma, and the associations between discrimination and other stigma dimensions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perspectives of potentially eligible Indigenous Māori on a lung cancer screening programme: a qualitative study

aims: Lung cancer causes more deaths than any other cancer, globally and in Aotearoa New Zealand, where it disproportionately affects Māori. We aimed to understand Māori perspectives on lung cancer screening in Aotearoa New Zealand to guide its equity focussed implementation, including identifying enablers and barriers. methods: We took a Kaupapa Māori based co-design approach to inform future screening, recruiting Māori current/ex-smokers and members of their whānau (family) for three focus group phases held in Auckland, Aotearoa New Zealand in August 2019. Participants responded to a proposed lung cancer screening pathway and shared their attitudes and beliefs about lung cancer and screening. Results were thematically analysed. results: The 21 Māori participants supported future lung cancer screening in Aotearoa New Zealand. Perceived benefits included being more informed about lung cancer and screening and enabling healthier future generations. Barriers to screening were previous negative health service experiences; fear; stigma; and access, including time, cost and transport. Enablers included providers’ cultural competence; clear communication; a one-stop shop; and support with transport. A range of factors could potentially influence a decision to participate in screening. conclusions: Participants favoured future lung cancer screening and identified key barriers and facilitators of screening.