Health Dialogue Research Articles

Health care professionals’ experiences and perceptions of health promotion through the health dialogue intervention in the scania region, Sweden: a qualitative interview study

BackgroundCardiovascular disease and type 2 diabetes are among the largest public health challenges in Sweden. Research indicates that a healthy lifestyle can prevent most cases. The health dialogue is an evidence-based public health programme for primary care with positive results in several regions of Sweden. This study aimed to describe health care professionals’ experiences and perceptions of health promotion through the health dialogue intervention during the pilot phase in the Scania region of Sweden.MethodsThe study consists of 12 individual interviews with health care professionals educated in the health dialogue method, implementing the intervention in Scania. Qualitative content analysis with an inductive approach was used.ResultsThe analysis resulted in 10 sub-categories and the four main categories: A more health-promoting mindset would benefit primary care; Empower individuals; Facilitate sustainable lifestyle changes; Challenges, tools and support for the implementation of the health dialogue. One overarching theme emerged: “Health dialogue, a potential start of a paradigm shift in Swedish primary care”.ConclusionsConclusions imply that the health dialogue is a well-structured method with tools to make health promotion and primary prevention an integrated part of primary care. A respectful and motivating approach during the health dialogue is recommended. It is important to have an ongoing discussion about the approach among the health care professionals. Incorporating the Health Belief Model in the health care professionals’ education in the method could increase the focus on self-efficacy during counselling, which could favour the participants’ change process.

Truth and Reconciliation in Medical Schools: Forging a Critical Reflective Framework to Advance Indigenous Health Equity.

In 2015, the Truth and Reconciliation Commission (TRC) of Canada outlined 94 Calls to Action, which formalized a responsibility for all people and institutions in Canada to confront and craft paths to remedy the legacy of the country's colonial past. Among other things, these Calls to Action challenge medical schools to examine and improve existing strategies and capacities for improving Indigenous health outcomes within the areas of education, research, and clinical service. This article outlines efforts by stakeholders at one medical school to mobilize their institution to address the TRC's Calls to Action via the Indigenous Health Dialogue (IHD). The IHD used a critical collaborative consensus-building process, which employed decolonizing, antiracist, and Indigenous methodologies, offering insights for academic and nonacademic entities alike on how they might begin to address the TRC's Calls to Action. Through this process, a critical reflective framework of domains, reconciliatory themes, truths, and action themes was developed, which highlights key areas in which to develop Indigenous health within the medical school to address health inequities faced by Indigenous peoples in Canada. Education, research, and health service innovation were identified as domains of responsibility, while recognizing Indigenous health as a distinct discipline and promoting and supporting Indigenous inclusion were identified as domains within leadership in transformation. Insights are provided for the medical school, including that dispossession from land lays at the heart of Indigenous health inequities, requiring decolonizing approaches to population health, and that Indigenous health is a discipline of its own, requiring a specific knowledge base, skills, and resources for overcoming inequities.

How do remittances impact child mortality and are there preconditions?

While recent research suggests that remittances affect child mortality, little is known about how remittances influence this outcome and what conditions may moderate its effectiveness. This article investigates whether and how remittances affect child mortality in developing countries. We examine the impact of remittances on the three leading causes of child mortality, explore potential channels through which this may occur and examine whether socioeconomic or political factors affect the remittances-mortality relationship. Using data for 122 developing countries over the period 2003–2018 and a dynamic panel estimator, with both internal instruments and a shift-share external instrument, we find that remittances reduce child mortality from diarrheal diseases. Our findings suggest that sanitation usage is a possible channel through which remittances affect diarrheal mortality. We also find that the mortality-reducing effect of remittances does not appear to be contingent on the level of governance or health infrastructure. However, it remains unclear whether the effect is influenced by other forms of health funding. These findings suggest that remittances serve an important role in improving child health, and the effectiveness of these inflows is not reliant on onerous preconditions being met. Thus, remittances may be important to public health dialogue, especially in developing countries where diarrheal diseases are prevalent.

SEXIT as a screening tool to identify adolescents exposed to or at risk of sexual ill-health and sexual risk taking

Background: Mental ill health is increasing among adolescents, and self-injury is one expression of mental ill health. Sexual risk taking among adolescents is often associated with exposure to violence. Sex could be used as a strategy to regulate negative emotions and feelings of emptiness. The health promotion work of school nurses (SNs) can be one way to identify students who are exposed to or at risk of sexual ill-health and sexual risk taking. By using the SEXual health Identification Tool (SEXIT) in health dialogues, SNs can identify students exposed to or at risk of sexual ill-health and sexual risk taking. Aim: To describe SNs’ experience of using SEXIT in health dialogues with students. Methods: An exploratory design was used. Six SNs participated in semi-structured individual interviews, and the data were analysed with qualitative content analysis. Results: Three categories were identified: ‘SEXIT provides support and structure’, ‘SEXIT provides conditions for designing a good dialogue’, and ‘working with SEXIT includes managing challenges’. Conclusions: SNs have a critical role in the identification of students with sexual ill-health and sexual risk taking as well as those exposed to violence. SEXIT could be included and systematically used in the health dialogue as it enables a natural dialogue with students about a sensitive topic and creates the prerequisites to identify adolescents at risk of sexual ill health.

Agreement between questions about physical activity and sitting time, and device-based measures, used in Swedish targeted health dialogues in the context of primary health care

BackgroundIt is important that easy-to-use measures like subjective questions about physical activity (PA) and sedentary behaviour are valid and reliable providing accurate measures, when they are used in health promotion work aiming to support people to improve their lifestyle habits such as PA. The aim of this study was to evaluate the concurrent validity of a structured interview form estimating self-reported PA and a question about sitting time used in Swedish targeted health dialogues in the context of primary health care.MethodThe study was conducted in the southern part of Sweden. To evaluate concurrent validity of the interview form, time spent in moderate-to-vigorous physical activities (MVPA) and energy expenditure related to MVPA estimated by an interview form was compared with the same measures assessed by an ActiGraph GT3X-BT accelerometer. To evaluate a question about sitting time, the Swedish School of Sport and Health Sciences’ single-item question about sitting time (SED-GIH) was compared with measures from an activPAL inclinometer. Statistical analyses included deriving Bland‒Altman plots and calculating Spearman’s rank correlation coefficients.ResultBland‒Altman plots indicated lower absolute variation in the difference between self-reported and device-based PA measures for lower PA levels, both for energy expenditure and time spent in MVPA. No systematic over- or underestimation was observed. The Spearman’s correlation coefficient between self-reported and device-based PA measures was 0.27 (p = 0.014) for time spent in MVPA and 0.26 (p = 0.022) for energy expenditure. The correlation coefficient between the single item question and device-based sitting time measures was 0.31 (p = 0.002). Sitting time was underestimated by 74% of the participants.ConclusionThe PA interview form and the SED-GIH question on sitting time may be of value in targeted health dialogues in primary health care with the intention to support sedentary and insufficiently physically active persons in increasing their physical activity and limiting their sitting time. The questionnaires are easy to use and are more cost effective than device-based measures, especially regarding population-based interventions conducted in primary health care for thousands of participants such as targeted health dialogues.Clinical trial registrationNot applicable.

Help Me Heal: A Reinforced Polite and Empathetic Mental Health and Legal Counseling Dialogue System for Crime Victims

The potential for conversational agents offering mental health and legal counseling in an autonomous, interactive, and vitally accessible environment is getting highlighted due to the increased access to information through the internet and mobile devices. A counseling conversational agent should be able to offer higher engagement mimicking the real-time counseling sessions. The ability to empathize or comprehend and feel another person’s emotions and experiences is a crucial quality that promotes effective therapeutic bonding and rapport-building. Further, the use of polite encoded language in the counseling reflects the nobility and creates a familiar, warm, and comfortable atmosphere to resolve human issues. Therefore, focusing on these two aspects, we propose a Polite and Empathetic Mental Health and Legal Counseling Dialogue System (Po-Em-MHLCDS) for the victims of crimes. To build Po-Em-MHLCDS, we first create a Mental Health and Legal Counseling Dataset (MHLCD) by recruiting six employees who are asked to converse with each other, acting as a victim and the agent interchangeably following a fixed stated guidelines. Second, the MHLCD dataset is annotated with three informative labels, viz. counseling strategies, politeness, and empathy. Lastly, we train the Po-Em-MHLCDS in a reinforcement learning framework by designing an efficient and effective reward function to reinforce correct counseling strategy, politeness and empathy while maintaining contextual-coherence and non-repetitiveness in the generated responses. Our extensive automatic and human evaluation demonstrate the strength of the proposed system. Codes and Data can be accessed at https://www.iitp.ac.in/ ai-nlp-ml/resources.html#MHLCD or https://github.com/Mishrakshitij/Po-Em-MHLCDS

Scaling-up Evidence-based Interventions for Communities of Color With Marked Health Disparities: Lessons Learned From COVID-19 Can Be Applied to Reduce Morbidity and Mortality and Achieve Health Equity.

Scaling-up Evidence-based Interventions for Communities of Color With Marked Health Disparities: Lessons Learned From COVID-19 Can Be Applied to Reduce Morbidity and Mortality and Achieve Health Equity.

Swedish school nurses' experience of identifying students who are exposed to violence – a qualitative study

Aim: This study aims to describe how school nurses identify students who are being exposed to violence. Design: The study has a qualitative design focusing on illuminating the meanings embodied in lived experiences Method: Fourteen qualitative interviews with school nurses were conducted and a descriptive qualitative meaning analysis was used to cast light on the phenomenon. The COREQ checklist was used to ensure trustworthiness. Results: Four themes were highlighted: opportunity in the health dialogue, necessity to create and prove trustworthiness, cooperation with other professionals, and awareness of factors that could complicate reporting exposure to violence. The study provided new insights such as the school nurse having an important role in the identification of students exposed to violence. It is important that school nurses have an open approach and are systematic in the health dialogue, using questions about violence to create opportunities for students to talk about their living conditions.

Transition to hybrid teaching of mathematics: challenges and coping strategies of Swedish teachers

Sweden was one of the few countries that did not close down their schools during the Covid-19 pandemic. Different hybrid teaching methods were adopted, some of which are here to stay. This qualitative study explores the challenges that Swedish mathematics teachers had transitioning from face-to-face to hybrid teaching and the coping strategies that they adopted to reduce the effect of these challenges on their practices, well-being and students’ learning experiences. The results from the study were gathered from some 51 primary and secondary mathematics teachers in Stockholm using a semi-structured questionnaire. The data were analysed with cognisance of Lazarus and Folkman’s coping theory and Simonson’s equivalence theory. The results revealed that hybrid teaching had some negative impact on teaching quality, student achievement, student health, teacher workload, and teacher-student dialogue, which underpins the Swedish school curriculum. This lack of dialogue and high-quality interaction undermines the equivalency theory principle, which suggests that the format of instruction should not influence the quality of students’ learning experiences. Also, the results revealed that majority of the teachers ascribed positively to problem-based coping strategies as compared to the emotion-based coping strategy as they worked hard to provide students with good learning opportunities.

Using environmental health dialogue in a Diné-centered approach for individualized results reporting in an environmental exposure study following the Gold King Mine Spill

BackgroundOn August 5, 2015, the Gold King Mine Spill (GKMS) resulted in 3 million gallons of acid mine drainage spilling into the San Juan River impacting the Diné Bikeyah (traditional homelands of the Navajo people). The Gold King Mine Spill Diné Exposure Project was formed to understand the impacts of the GKMS on the Diné (Navajo). Reporting individualized household results in an exposure study is becoming more common; however, materials are often developed with limited community input with knowledge flowing in one direction - from researcher to participant. In this study we examined the development, dissemination, and evaluation of individualized results materials. MethodsIn August 2016, Navajo Nation Community Health Representatives (Navajo CHRs) sampled household water, dust, and soil, and resident blood and urine for lead and arsenic, respectively. From May–July 2017, iterative dialogue with a wide range of community partners and a community focus groups guided the development of a culturally-based dissemination process. In August 2017, Navajo CHRs reported individualized results and they surveyed the participants on the report-back process at that time. ResultsAll of the 63 Diné adults (100%) who participated in the exposure study received their results by a CHR in person and 42 (67%) completed an evaluation. Most of those participants (83%) were satisfied with the result packets. Respondents ranked the individual and overall household results as the most important information they received (69% and 57%, respectively), while information on metals exposures and their health effects were the least helpful. ConclusionsOur project illustrates how a model of environmental health dialogue, defined by iterative, multidirectional communication among Indigenous community members, trusted Indigenous leaders, Indigenous researchers, non-Indigenous researchers, can improve reporting individualized study results. Findings can inform future research to encourage multi-directional environmental health dialogue to craft more culturally responsive and effective dissemination and communication materials.

EConsult Provides a Novel Opportunity to Evaluate Hematuria Referrals for Medicaid Patients in the "Real-World" Community.

We utilized an eConsult program to assess the appropriateness and completeness of hematuria evaluation among one of the largest Medicaid networks in California, the Inland Empire Health Plan. We retrospectively reviewed all hematuria consults from May 2018 to August 2020. Patient demographic and clinical data were extracted from the electronic health record and dialogues between primary care provider and specialist including laboratory results and imaging. We calculated the proportions of imaging types and the outcome of the eConsults among patients. χ2 and Fisher's exact tests were used for statistical analysis. A total of 106 hematuria eConsults were submitted. Primary care provider evaluation for risk factors rates were low: 37% gross hematuria, 29% voiding symptoms/dysuria, 49% other urothelial risk factors or benign etiology, and 63% smoking. Only 50% of all referrals were deemed appropriate based on a history of gross hematuria or ≥3 red blood cells/high-power field on urinalysis without evidence of infection or contamination. Thirty-one percent of patients received a renal ultrasound, 2.8% received CT urography, 5.7% received other cross-sectional imaging, and 64% received no imaging. By the conclusion of the eConsult only 54% of patients were referred for a face-to-face visit. The use of eConsults allows for urological access in the safety-net population and presents a means to assess the urological needs in the community. Our findings suggest eConsults represent an opportunity to reduce the morbidity and mortality associated with hematuria among safety-net patients who are otherwise less likely to receive a proper evaluation.

Parents’ recalled experiences of the child centred health dialogue in children with overweight: a qualitative study

BackgroundBecause overweight and obesity are still increasing and prevention of childhood obesity is more likely to be effective when initiated in preschool children, the Child Health Service in the south of Sweden developed a structured child-centred health dialogue model targeting all 4-year-old children and their families. The aim of this study was to describe parents’ recalled experiences of this health dialogue in children with overweight.MethodsA qualitative inductive approach with purposeful sampling was used. Thirteen individual interviews with parents (including 11 mothers and 3 fathers) were conducted and analysed with qualitative content analysis.ResultsThe analysis resulted in two categories: ‘A valuable visit with a subtle individual impact’ that described parents’ recalled experiences of the health dialogue and ‘There is a complex interaction between weight and lifestyle’ that reflected the parents’ perceptions of the relationship between their children’s weight and lifestyle.ConclusionsParents recalled the child-centred health dialogue as important and described discussing a healthy lifestyle as one of the obligations of the Child Health Service. Parents wanted confirmation that their family lifestyle was healthy; however, they did not want to discuss the relationship between their family lifestyle and their children’s weight. Parents expressed that when their child followed the child’s growth curve, then this indicated healthy growth. This study supports using the child-centred health dialogue as a model to provide structure for discussing a healthy lifestyle and growth but highlights the difficulties of discussing body mass index and overweight, especially in the presence of children.

Complex economic effects of balanced nutrition for athlete-schoolchildren in ethno-intellectual sports

The present research conducts an intricate economic analysis on targeted nutritional interventions for a specific demographic: 60 athlete-schoolchildren between the ages of 11 and 13 in Central Asia. These children are actively engaged in the ethno-intellectual sport of Togyz Kumalak which from an ethnohistorical perspective is a part of the socio-cultural heritage of the nomadic societies of Central Asia. Spanning a timeframe of 12 months, this multi-faceted study was articulated in a three-stage design framework. The initial stage involved a baseline assessment of the children’s nutritional statuses, utilizing anthropometric measurements and dietary recall surveys as empirical tools. Medical experts and biologists collaborated to identify the economic implications of nutrient imbalances that could lead to metabolic disorders and subsequent healthcare costs. The second stage encompassed the formulation and execution of nutritional interventions that were economically vetted for sustainability and impact. These interventions were derived from the baseline data and involved dietary supplementation, counseling, and a well-balanced nutritional regimen designed in consultation with coaches, trainers, and parents. During this stage, economic considerations were central to the discourse as experts across disciplines expounded on the optimal ratio of vital macro- and micronutrients, adequate caloric content, and even distribution of nutrients throughout the day. Such a comprehensive approach to diet structuring amplifies the economic viability by elucidating how a balanced nutritional intake can enhance athletic and intellectual performance, impact competition outcomes positively, and improve post-training recovery – thereby potentially mitigating of long-term healthcare expenditures. The study culminated in a rigorous post-intervention assessment that employed both cost-effectiveness analysis (CEA) and cost-benefit analysis (CBA) methodologies. The results revealed not only a statistically significant improvement in the nutritional statuses of the children but also confirmed the cost-effectiveness and scalability of the interventions implemented. The economic aspects were augmented by metrics that interlinked the immediate benefits of the interventions with broader economic considerations, such as the potential reduction in healthcare-related costs over time. Research contributes profoundly to public health dialogues, offering insights into the optimization of resources to heighten the general well-being and performance, particularly in the specialized arena of ethno-intellectual sports like Togyz Kumalak. It successfully straddles the crossroads of health economics, cultural sports, and public health, emphasizing the potential for integrative approaches in the amelioration and proliferation of community-centered health programs. This multifaceted economic analysis thus serves as a robust model for scalable and economically viable public health strategies that satisfy both individual health and community development needs.

DO PROVIDERS FAIL TO RECOGNIZE ANXIETY IN SOCIALLY VULNERABLE PATIENTS WITH INFLAMMATORY BOWEL DISEASE?

Abstract INTRODUCTION Social determinants of health (SDOH) are increasingly recognized for their role in perpetuating an inequitable healthcare system, particularly for those with chronic disease. Patients with inflammatory bowel disease (IBD) are likely subject to many of the same inequities, but data on SDOH and IBD outcomes are lacking. The social vulnerability index (SVI) is a publicly available tool from the Centers for Disease Control that provides neighborhood-level estimates of social need with higher values on a 0-1 scale indicating greater social vulnerability. The SVI has been used in other chronic diseases to determine which patients are at risk for poor outcomes, such as anxiety and depression. Utilizing census tract-level SVI data, we aimed to identify the relationship between SDOH and diagnoses of anxiety and depression in patients with IBD. METHODS We used a retrospective cohort of patients at a single IBD center between 01/01/2015 and 08/31/2022. Using the current address in the electronic medical record, we geocoded patients to individual census tracts and linked them to corresponding SVI and subscales (Figure 1). Controlling a priori for age, gender, race, ethnicity, marital status, English proficiency, religious affiliation, and tobacco use, we used multivariable logistic regression to examine the relationship between SVI and the diagnoses of depression and anxiety in patients with IBD. RESULTS Depression was increased but not significantly associated with higher total social vulnerability (OR 1.12, 95% CI 0.93-1.34, p=0.2). Depression was associated with higher scores on Socioeconomic Status (SES) (OR 1.36, 95% CI 1.05-1.76, p= 0.020) and Minority Status/Language (OR 1.22, 95% CI 1.03-1.44, p= 0.018). In contrast, anxiety was significantly associated with lower levels of social vulnerability (OR 0.77, 95% CI 0.64-0.92, p= 0.005) but associated with higher scores on Minority Status/Language (OR 1.36, 95% CI 1.16-1.60, p<0.001). The remainder of SVI sub-scores either had no relationship with anxiety and depression or had a negative association with the outcome (Table 1). CONCLUSIONS Depression and anxiety were associated with living in socioeconomically disadvantaged and racially diverse neighborhoods; however, patients with higher total SVI and higher scores on the Household Composition were unexpectedly found to have reduced odds of developing anxiety. While these findings were initially surprising, we found them to be in line with current literature that suggests racial/ethnic minorities and low SES individuals are less likely to receive mental health diagnoses, yet suffer from these conditions at similar rates as their white and more affluent counterparts. Future research is needed to improve the mental health dialogue between providers and minority patients and ensure that minority and low SES patients are receiving equitable care.

Religious Moderation among The Nahdlatul Ulama and Muhammadiyah

In recent times in Indonesia, the outlook and attitudes of a person or group of people with religious devotion are likely to be severe, extreme, and intolerant. Furthermore, some are too liberal. Based on the phenomenon, the authors were moved to seek a solution of a sensible way of view and religious attitude (taking a middle and peaceful path) through religious moderation performed by the Nahdlatul Ulama and the Muhammadiyah. This type of research is field research with a qualitative approach, and the method used is a comparative description. A combination of interviews, observation, and documentary studies do the writer’s data collection. As for the analysis, the authors used descriptive analytic data analysis techniques. According to research, Nahdlatul Ulama is an Islamic organization practicing modernity and religion, accommodating tradition and culture, culinary activity, and its deep-rooted message base. In comparison, Muhammadiyah’s religious moderation was performed through Muhammadiyah charity enterprises in formal education, health, and religious dialogue. Nahdlatul Ulama and Muhammadiyah, in certain aspects, are different, though not principles, only branches in the doctrine of Islam. When it comes to religious moderation, both are moderate, having a tolerant attitude with members of other faiths and those of differing religious people, being impartial and neither extreme.

Impact of Metaverse Cultural Communication on the Mental Health of International Students in China: Highlighting Effects of Healthcare Anxiety and Cyberchondria.

Objectives: Students' mental health issues often adversely affect their physical as well as emotional well- being. Mental health includes much more than the absence of mental illnesses or diseases. The current study evaluated international students' mental health through a cultural communication approach in Metaverse to examine the moderating influences of cyberchondria and healthcare anxiety in the context of China. The idea of virtual reality in the Metaverse is currently one of the world's most significant and contentious issues. It has influenced the growth of the Internet, which directly affects the physical world. Methods: The data extraction method employed in the study was the questionnaire method, distributed to the Chinese Students. Various units for the variables were used in the questionnaire development, which aided in assessing the variable using measurement scales. Results: The findings showed a substantial connection between internal Chinese students at medical universities' mental health and cross-cultural dialogue in the Metaverse. Healthcare anxiety was observed to have a significant moderating effect, but cyberchondria had a negligible effect on student mental health and cultural communication in the Metaverse. Conclusion: The current study would help foster cross-cultural interaction among international and home-country students to foster a better interchange of cultural values.

The Mediating Role of Healthy Lifestyle Behaviours on the Association between Perceived Stress and Self-Rated Health in People with Non-Communicable Disease.

Perceived stress can affect people’s lifestyle behaviours and self-rated health. A balanced, healthy lifestyle can alleviate experiences of stress. For clinicians to use evidence-based and theory-based knowledge in health dialogues with people with non-communicable diseases, and in order to develop more effective behavioural counselling, more knowledge is needed. Hence, this study aimed to examine the mediating role of sedentary behaviour, daily physical activity, physical exercise, and dietary habits on the association between perceived stress and self-rated health in people with or without one to four self-reported non-communicable diseases (myocardial infarction, stroke, hypertension, diabetes). The study used a cross-sectional design. Responses from in total 10,583 individuals were collected in 2016 and 2019 by a self-report questionnaire. A series of simple and multiple regression analyses were conducted to examine the mediating effects of healthy lifestyle behaviours on the association between perceived stress and self-rated health. The results show that the investigated healthy lifestyle behaviours partly mediated the association between perceived stress and self-rated health in people with no diagnosis, and in people with one or two diagnoses. It can be concluded that healthy lifestyle behaviours could probably be targeted in relation to the number of noncommunicable diseases that the individuals have.

The Safety and Efficacy of Psychosocial Adherence Interventions in Young People with Early Psychosis: A Systematic Review.

Background: The role of antipsychotic medication in supporting young people in their recovery from early psychosis is complex and controversial. It is common for young people, often given antipsychotic medication for the first time, to express a choice to stop treatment, potentially increasing the risk of relapse and admission to hospital. Our systematic review aimed to evaluate the safety and effectiveness of psychosocial interventions to enhance antipsychotic medication adherence in young people with early psychosis. Methods: We reviewed studies using any experimental design of psychosocial interventions specifically focused on enhancing adherence with antipsychotic medication in young people with early psychosis. Cochrane CENTRAL Register, Medline, Embase, PsychINFO and CINAHL were searched on 19 November 2021 without time restriction. Studies were assessed for quality using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Results: Our initial search identified 3469 documents. Following title, abstract and full-text screening, we included three published studies and one unpublished experimental study that met our inclusion criteria. Outcome data were available for three studies that tested adherence–coping–education, adherence therapy, and a health dialogue intervention, all having a positive effect on medication adherence. None of the trials reported data on the safety of the experimental interventions. Conclusion: There is a paucity of evidence from high-quality randomized controlled trials that establish the safety and effectiveness of any type of psychosocial intervention to enhance medication adherence in young people with early psychosis. Further high-quality trials are warranted. This review was registered on the Open Science Framework prior to undertaking out initial searches.

Structured assessment of modifiable lifestyle habits among patients with mental illnesses in primary care

Patients with mental illness have an increased risk of cardiovascular morbidity. The Swedish-developed Health Dialogue is a pedagogical tool to individualize lifestyle counselling, used in specific age-groups to improve lifestyle habits and decrease mortality, but not tested specifically for patients with mental illness. Patients > 18 years old seeking primary care due to symptoms related to mental illness and diagnosed with depression, sleeping disorders, stress and anxiety, were included. A nurse-led health dialogue was conducted, focusing on lifestyle habits, anthropometric measurements, and blood samples, resulting in tailored advice regarding the individual’s risk profile. All 64 participants had lifestyle areas with increased risk level. Approximately 20% had elevated fasting glucose, blood pressure or cholesterol levels, and over 40% had highest risk level in Waist–Hip-Ratio. 30% were overweight, or physical inactive. The results suggest the need of a larger cohort study with long-term follow up, to establish potentially positive effects on wellbeing, and decreased cardiovascular risk in patients with mental illness.Clinical trial registration: The study was registered at ClinicalTrials.gov January 6th, 2022, registration number NCT05181254.

Relational experiences of community members participating in a rural health initiative with interprofessional students

Background. A South African faculty of health sciences created a forum for the community to voice their relational experiences with interprofessional students through visual projections. No other studies that explore such experiences using the Mmogo method could be located.
 Objective. To gain an understanding of the relational experiences of community members participating in Lifestyle-groups as part of a rural health initiative with interprofessional student groups.
 Methods. The Mmogo method is a qualitative, structured, observation technique. Participants constructed visual projections representing specific relationships. Thereafter, during a group discussion, participants explained the meaning of their projections. The visual data were analysed according to their literal presentation and subjective, symbolic meaning. A thematic analysis was used for the transcribed data.
 Results. Thirteen of the 24 visual projections were of a quality that allowed visual analysis; all 24 members participated in the discussions. Light was identified as an overarching theme to represent the community-student interaction. Sub-themes and categories associated with light were healthier lifestyles (knowledge sharing, lifestyle transformation, improved health outcomes), solidarity (reciprocity, collaboration, person centredness, multidimensional approach) and affirmation (gratitude and acceptance).
 Conclusion. Though some statements by participants related to health education as opposed to health dialogue highlighted areas requiring improvement, the findings correlated with the outcomes prescribed for students by this rural health initiative. Emotional connections in relational experiences could facilitate higher levels of self-efficacy in communities. The question is whether a stronger emphasis on health dialogue can be a catalyst for improved self-efficacy.