Training Of Health Professionals Research Articles

Barriers for Responding to Pediatric Out-of-Hospital Cardiac Arrest During Emergency Medical Calls: A Qualitative Study.

Rapid recognition of pediatric out-of-hospital cardiac arrest (POHCA) is a critical component to prompt initiation of bystander interventions. We aimed to investigate barriers for responding to POHCA during emergency medical calls. We included all POHCA calls (aged 0-18 years) from the emergency dispatch center in the Capital Region of Denmark between 2018 and 2021 and excluded POHCAs with no resuscitation order, found dead, where trained health professionals were on site, or where there was no possibility for initiation of cardiopulmonary resuscitation. A qualitative analysis was undertaken. POHCA calls were divided according to the speed of telecommunicator-recognition into 3 groups: POHCA recognition within 90 seconds (group 1), POHCAs recognition >90 seconds (group 2), and POHCAs recognized by the emergency medical services at ambulance arrival (group 3). A total of 20 calls were included. We identified 3 major barriers to telecommunicator recognition of POHCA. First, prolonged conversations between callers and telecommunicators focusing on the cause of the child's condition rather than adherence to the assessment of consciousness and breathing. Second, challenges in assessing breathing such as cases where the child had agonal or unregular breathing or gasping breaths. Finally, callers who were unable to communicate or follow instructions from the telecommunicator. Telecommunicator recognition of POHCA is challenged by factors such as prolonged conversations focusing on causes rather than initiating bystander interventions, barriers in assessing breathing, as well as callers' abilities to partake in communication with telecommunicators. Efforts to address these barriers in current dispatch protocols may improve recognition of POHCA.

A Qualitative Analysis of Student Perspectives of Their Post-secondary Nutrition and Dietetics Program, Courses, and Instructors: Applying a Critical Pedagogies Perspective

Postsecondary dietetics education is in a time of transition in Canada and specifically in Manitoba. We sought to qualitatively investigate this cohort’s perspectives on the University of Manitoba’s dietetics program. In 2020/21, interviews were conducted with undergraduate dietetics students as well as dietetics interns and graduate students who had recently completed the undergraduate dietetics program. We recruited 25 participants, all of whom self-identified as female, with 60% identifying as white, with an average age of 25 years old. Informed by critical pedagogy, our analysis yielded four themes: motivations for studying dietetics; learning outside the classroom; development of critical awareness; and uncertain career futures and training improvements. Social media featured in each of the themes, particularly in how it exposed participants to various social justice movements. While students acknowledged developing more critical awareness in their programs, they nonetheless felt a disconnect between what they perceived they needed to learn and what was taught. Participants also described uncertainty associated with the future directions of their program or career. Analysis of their perspectives reveal ways dietetics and dietetics education could further incorporate critical pedagogies that highlight social justice issues, enhancing the field’s potential to contribute to public health and health promotion. In this time of transition for dietetics education in Manitoba, drawing inspiration from perspectives of this cohort, there is an opportunity for dietetics and pedagogy to evolve. There is also potential to apply critical pedagogy to analyze trainee perspectives of other health professional education and training programs.

A systematic review of training for mainstream mental health professionals working with people with intellectual disabilities and mental health needs

Purpose Policy in the UK and many other countries states that mainstream mental health services should be accessible to people with intellectual disabilities (ID). The purpose of this paper is to systematically review training and development needs assessments and delivered training and development for professionals working in mainstream mental health services who may work with people with IQ. Design/methodology/approach A systematic search of four databases (Web of Science; PsychInfo; PubMed; CINAHL) over the period of 2011–2023 was used. Papers were included if they described training or development delivered to, or specific training or development needs analyses of, mainstream qualified staff to support working with adults who have an ID. Findings Two papers were found that described training and development initiatives and six that described training and development needs analysis, five of these papers originated from Australia and were part of the development of a comprehensive workforce competency framework. Research limitations/implications Training and development approaches for mainstream mental health services to facilitate the support of people with IQ should be systematically developed and trialled. Originality/value To the best of the authors’ knowledge, this is the first study to review training and training needs analysis in this area since 2012. The review finds only a small number of papers in what is an important area for service development.

DETERMINATION OF ANTIMICROBIAL ACTIVITY OF COMMERCIALLY AVAILABLE THYME ESSENTIAL OIL SAMPLES

In this study, the antimicrobial efficacy of four commercial brands of thyme essential oil, sourced from four different vendors (pharmacy, e-commerce, herbalist, and supplier), was evaluated and compared according to their place of purchase. The research utilized standard strains, including Gram-negative bacteria Escherichia coli ATCC 25922 and Pseudomonas aeruginosa ATCC 27853; Gram-positive bacteria Staphylococcus aureus ATCC 29213 and Bacillus cereus ATCC 14579; and fungi Candida albicans ATCC 10231 and Candida tropicalis DSM 11953. Antimicrobial activity was determined using the Minimum Inhibitory Concentration (MIC) method. Among the four brands tested at ten different concentrations on four bacterial and two fungal strains, the thyme essential oil sourced from the pharmacy demonstrated the highest level of antimicrobial activity. Based on our experimental results, the essential oils demonstrated the strongest inhibitory activity against Candida albicans, whereas Staphylococcus aureus exhibited the highest resistance to the tested oils.. All tested concentrations of essential oil samples allowed the growth of S. aureus. These findings indicate that essential oils sold in the market and online, intended for therapeutic purposes, vary significantly in quality. Economic incentives may lead to adulteration of these oils, underscoring the importance of using plant material from the correct species and considering the geographical conditions that influence the plant’s chemical composition. The superior antimicrobial efficacy of the pharmacy-sourced thyme essential oil highlights the need to rely on trained health professionals when selecting products for health-related purposes.

Heavy Metals Screening Model in Primary Care: Experience in the Sierra Minera de Cartagena (Spain)

Soils contaminated by heavy metals such as lead, cadmium, and arsenic represent a significant health risk. The Sierra Minera of Cartagena (Spain) is an area historically contaminated by mining activities. This study evaluates the exposure to heavy metals and proposes a clinical screening model for its management in primary care. Descriptive cross-sectional study conducted between 2017 and 2020 with volunteers from the Sierra Minera of Cartagena who provided blood and urine samples. Primary care health professionals were trained in sample collection and analysis, risk communication, and clinical protocols on heavy metals were implemented. 203 participants, 66.5% women and 38 (18.7%) under 16 years old. The majority resided in Zone 0 (contaminated area). Mean blood lead level was 1.78μg/dl and 2.22μg/dl in those under 16 years old, with. Metal concentrations, particularly lead, increased with age, male sex, Arab ethnicity, and proximity to contaminated areas. Tobacco smoke was identified as a main source of lead exposure in children under 16 years. The primary care clinical screening model identified 12 (7%) and 22 (11%) participants exceeding 5μg/dl and 3.5μg/dl respectively, particularly six children and one pregnant woman, with significant levels that normalized within 2-3 months following PEHSU's clinical guidelines. The implementation of clinical and analytical screening for heavy metals in primary care, supported by pediatric environmental health units (PEHSU), proved effective in screening and reducing in children blood lead levels in a short period. Training health professionals is crucial to adequately address environmental risks and protect the health of affected populations.

Respectful Maternity Care During Facility-Based Childbirth and Its Predictors in Public Health Facilities in Central Ethiopia: A Multidimensional Communication as a Proximal Predictor: A Cross-Sectional Study.

The provision of compassionate, respectful, and caring healthcare is an essential component of health workforces because it builds deep relationships between healthcare practitioners and mothers. However, respectful maternity care has received less attention in practice, and existing research is inconclusive as well. Therefore, this study is aimed to assess respectful maternity care and its predictors during childbirth in Siltie Zone, Ethiopia. We conducted a cross-sectional study on 374 mothers from May 1 to 30, 2021. A systematic random sampling technique was used to select the study participants. A structured questionnaire was used to collect the data. The data was entered into Epi Data 3.1, and the analysis was done using SPSS 24.0. Binary logistic regression was employed to identify candidate variables for multivariable logistic regression. In the multivariable analysis, variables having a p-value of less than 0.05 were taken as measures of the degree of association between independent variables and the outcome variable. The result of the study revealed that the overall prevalence of respectful maternal care is 41.0%. Rapport built through communication during antenatal care (AOR = 6.32, 95% CI: 2.81, 16.67), pre-communication of husband and wife (AOR = 2.45, 95% CI: 2.01, 13.69), clearly known communication of family with mother (AOR = 0.35, 95% CI: 0.11, 0.69), caring culturally and appropriately (AOR = 7.45, 95% CI: 2.88, 19.28), perceived length of the stay during labor (AOR = 1.36, 95% CI: 0.230, 0.551), number of ANC received (AOR = 1.98, 95% CI: 0.037, 0.260), and number of deliveries (AOR = 1.36, 95% CI: 0.230, 0.551) were independent predictors of the outcome variable. The study revealed that respectful maternity care was provided very low. Multidimensional communication with the mother was identified as a significant proximal predictor of respectful maternity care. The study suggests that stakeholders should improve respectful maternity care through the provision of professional health training and create guidelines to identify and address challenges to its practice.

Behavioral weight loss interventions in college health centers: A qualitative analysis of barriers and facilitators to implementation.

Emerging adults are underrepresented in standard behavioral weight loss interventions (BWLIs). Offering BWLIs in college health centers may help to address obesity in emerging adulthood by reducing student barriers associated with participation; however, implementation barriers and facilitators for health centers are unknown. Health services center administrators and providers (n=14) and students eligible to participate in a BWLI (n=9, average BMI=29.8±4.2kg/m2) participated in semi-structured interviews. Interviews focused on the need for and appropriateness of BWLIs in health centers and perceived barriers and facilitators to their implementation. Participants generally believed that BWLIs delivered through a health center were appropriate and indicated that BWLIs would be a beneficial offering on-campus. Facilitators of health center implementation included availability of trained health professionals, intradepartmental relationships, supportive infrastructure and resources, and in-house planning and execution. Barriers included limited student use and knowledge of health center offerings, narrow referral/recruitment pathways related to stigma concerns, and challenges related to infrastructure, resources, and competing demands. College health centers are a feasible and appropriate setting to offer BWLIs, though barriers to implementation exist. It will be important to construct a plan for implementation to address unique barriers in health centers prior to BWLI implementation.

The Narrativist Turn in Healthcare and its Implications on the Experience of Perinatal Grief

The non-recognition of perinatal bereavement in society leads parents to an isolated condition that may hinder their psychological adjustment after the loss (Layne; Markin and Zilcha-Mano). Improving bereaved parents’ experiences of communication in healthcare practice thus seems to be crucial to lessening the risk of dysfunctional grief. This paper presents a research project on the topic of perinatal death, “Words Fail Me”: Naming the Unnamable (PERINAT), funded by the French National Agency for Research (2023-2027). By focusing on the metaphorical constructions used by bereaved parents in their narratives of perinatal death, PERINAT seeks to improve the communication experience of the bereaved by furthering health care practitioners’ understanding of this grief. The study is conducted by means of a dataset collected in 2022-23 from interviews with a hundred bereaved parents in France. The preliminary findings of this ongoing project are meant to be used to inform and improve the support offered by health care providers who are likely to come across a bereaved parent in their professional capacity. More specifically, from a perspective of narrative medicine, this contribution seeks to explore what the study of metaphor can potentially offer to the development of narrative competence in the training of health professionals. By developing higher awareness of bereaved parents’ narrative, more specifically of their use of figurative language, practitioners can make sense of parents’ needs and emotional responses to their experience of loss in order to ease it. As Norwood (122) has it, metaphor, like poetry, “can make unknown known and the unspeakable speakable”. This is also in line with the most recent promotion of a relationship-centered and patient-centred notion of care (Bensing; Pluut).

CUIDADOS PALIATIVOS NA ATENÇÃO PRIMÁRIA: REFLEXÕES TEÓRICO-PRÁTICAS

The study aims to know the interface between palliative care and primary health care. A theoretical-reflective study was carried out based on the concepts of continuing education and health promotion. Articles retrieved through the secondary databases Virtual Health Library (VHL), Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (Scielo) and Online System for Search and Analysis of Medical Literature (MEDLINE) were analyzed based on the specific descriptors retrieved through the health sciences descriptors. Studies published in Portuguese, English or Spanish and that dealt directly with the theme under study were considered. Palliative care is a real requirement in the face of the epidemiological transition of society and the technological advances that have made it possible to increase the life expectancy of individuals, in this sense, there is no possibility that only the tertiary level of health care is responsible for palliative care, thus, primary care must assume its role as an organizer of the health system, above all, considering the attributes of territoriality, first contact, longitudinality and comprehensiveness of care; It is urgent to transform the training of health professionals so that people can face finitude in a less aggravated way.

Garden EngAGEment: Cultivating Cultures of Care Through Artful Place-Making

ABSTRACT By describing the practices of Garden EngAGEment, a community garden project at Minnesota State University, Mankato (MNSU), we articulate the concept of artful place-making as an alternative, experiential approach to organizing and teaching care for people with Alzheimer’s dementia and other associated dementias (AD/OADs). Drawing from arts-based research, place-based education, and sensory studies, we describe how artful place-making involves the dynamic interplay of knowing, making, and being in the garden where Garden EngAGEment’s activities take place. Our analysis describes how Garden EngAGEment, through the process of artful place-making, seeds a new culture of care for health professions training, grows connections through multi-sensorial experiences, and cultivates personal, relational, and community transformations.

Perinatal death, collective action and legislation against obstetric violence in Argentina

This article explores the interconnections between perinatal death, collective action, and legislation against obstetric violence in Argentina. It employs a comprehensive methodological approach, including in-depth interviews, document reviews, a survey, and intensive ethnographic fieldwork to provide a multidimensional understanding of how collective actions influence legislative outcomes. Johanna Piferrer’s case, a poignant example detailed in this study, illustrates how personal tragedy catalyzed public and legislative acknowledgement of obstetric violence. This article argues that her advocacy, coupled with the broader feminist movement’s support, was crucial in transforming personal grief into a public issue that led to significant legislative changes. These changes include the creation of “Johanna’s Law,” which mandates improved hospital protocols and health professional training to handle perinatal deaths more sensitively and effectively. The study concludes that collective action is a powerful catalyst for creating transformative legislation that addresses the systemic issues of obstetric violence in Argentina.

Transfusions, disease-modifying treatments, and curative therapies for sickle cell anemia in Africa: where are we now?

The mortality burden of sickle cell anemia (SCA) is centered in sub-Saharan Africa. In addition to a lack of systematic programs for early diagnosis, access to disease-modifying treatments is limited to only a few urban centers. Providing a safe and adequate blood supply is a major challenge, heightening mortality from SCA-associated complications that require urgent blood transfusion and making the delivery of regular transfusion therapy for stroke prevention nonfeasible. Hydroxyurea therapy with proven clinical benefits for pain episodes, acute chest syndrome, malaria, transfusions, hospitalizations, and stroke prevention is the most feasible treatment for SCA in Africa. Access barriers to hydroxyurea treatment include poor availability, unaffordable costs, health professionals' reluctance to prescribe, a lack of national guidelines, and exaggerated fears about drug toxicities. Strategies for the local manufacture of hydroxyurea combined with the systematic education and training of health professionals using guidelines supported by the World Health Organization can help surmount the access barriers. Hematopoietic stem cell transplantation as a curative therapy is available in only 7 countries in Africa. The few patients who have suitable sibling donors and can afford a transplant must usually travel out of the country for treatment, returning to their home countries where expertise and resources for posttransplant follow-up are lacking. The recently developed ex-vivo gene therapies are heavily dependent on technical infrastructure to deliver, a daunting challenge for Africa. Future in-vivo gene therapies that bypass myeloablation and ex-vivo processing would be more suitable. However, enthusiasm for pursuing these gene therapies should not overlook strategies to make hydroxyurea universally accessible in Africa.

Exploring Community Workshops on Health and Arts

This review examines the intersection of health and the arts within community workshops, highlighting how these programs foster individual and community well-being, expand professional health training, and offer new frameworks for understanding health holistically. By using creative expression as a pathway to enhance mental, social, and emotional health, these participant-centered workshops promote adaptive capacities, social bonds, and cultural inclusion. This paper examines relevant research agendas, particularly those that study health outcomes related to arts-based engagement, and advocates for the integration of arts into public health strategies. Attention is given to designing inclusive, trauma-informed practices that respond to community needs, with case studies illustrating both successful implementation and areas for improvement. A future-focused section encourages the creation of policy-driven frameworks and resource hubs that prioritize sustainable community arts initiatives in public health. Keywords: Community health, arts integration, well-being, mental health, social engagement, public health.

ELDERLY HEALTH: PUBLIC POLICIES FOR ELDERLY HEALTH

This final project aims to analyze public health policies aimed at the elderly population in Brazil, focusing on their effectiveness and the challenges faced during their implementation. The research is exploratory and descriptive in nature, using documentary analysis and bibliographic review to examine official documents, legislation, and academic studies related to the topic. The results indicate that, although Brazil has made progress in creating specific policies, such as the Elderly Statute and the National Health Policy for the Elderly, there are significant gaps in their implementation. Regional inequalities in access to health services, lack of adequate training for health professionals, and insufficient resources are the main challenges identified. Regions such as the North and Northeast face greater difficulties compared to the South and Southeast, reflecting an unequal distribution of infrastructure and resources. The research also highlights the need to adapt international best practices, such as home care programs and the integration of different levels of health care, to improve the effectiveness of public policies in Brazil. It is concluded that, in order to promote active and healthy aging, it is essential that public policies are continuously improved, with a focus on equity and professional training. This study contributes to the understanding of the limitations and potential of health policies for the elderly in Brazil, offering support for the formulation of more effective strategies that can guarantee the quality of life of the elderly population.

The Effect of Digital Health Interventions on Postpartum Depression or Anxiety: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

(Am J Obstet Gynecol. 2024;230(1):12–43. https://doi.org/10.1016/j.ajog.2023.06.028) Around 15% of women experience postpartum depression (PPD) and 20% encounter postpartum anxiety (PPA) within the first year after childbirth. Research has shown that psychoeducation, psychotherapies, and mindfulness can effectively prevent and treat PPD and PPA. However, <20% of women with these conditions can access these interventions due to a shortage of trained mental health professionals during the perinatal period. Digital health interventions (DHIs) offer a potential solution by providing evidence-based psychoeducation and psychotherapy through the Internet, smartphone apps, or text messaging services. DHIs are highly accessible, as nearly all reproductive-age individuals in the US own smartphones, and a majority have broadband internet access. They also overcome barriers such as lack of childcare and unreliable transportation, which hinder adherence to in-person postpartum care. In addition, DHIs can be scaled effectively without compromising intervention fidelity.

Enhancing Temporomandibular Disorders Education for Initial Care Clinicians Through Interprofessional Education.

Temporomandibular disorders (TMDs) are common musculoskeletal pain conditions that can significantly impact daily activities such as eating, talking, breathing, intimacy, and expressing emotion. TMDs are often complex and multifactorial, and many patients experience overlapping pain conditions, sleep difficulties, and mental health challenges. The National Academies of Sciences, Engineering and Medicine (NASEM) has called for improved TMD education and training for health professionals, as current training opportunities are limited. To prepare health professionals to care for patients who have a TMD, we designed a 5-hour, interactive, module-based curriculum aligned with the 2020 NASEM recommendations. The four-part module set addresses TMD physiology and pathophysiology, assessment, diagnosis, and management. Instructional methods are founded on the Cognitive Theory of Multimedia Learning and include engaging videos, clinical evaluation and education tools, and interactive digital simulation scenarios. Thirty learners from diverse health professional backgrounds (medicine, dentistry, physician assistant, nursing, physical therapy) participated. Multiple-choice question assessments and pre/post retrospective survey scores demonstrated enhanced knowledge (M = 2.9 vs. M = 4.2, p < .001) and perceived competence (M = 1.9 vs. M = 3.4, p < .001), respectively. Encouragingly, all participants indicated applicability to their clinical practice. Our modules offer educators and clinicians a valuable resource to improve TMD knowledge and facilitate best practices. Supplementary resources included in the curriculum are conducive to clinical implementation, fostering improved clinician assessment and patient education.

Ideas of Coherence Between Theory and Practice in the Training of Health Professionals: A Scoping Review

The main objective of this scoping review is to collect and systematically map research literature on pedagogical strategies and activities that target the relationship between theory and practice in clinical education within undergraduate healthcare programmes. We searched the Scopus and CINAHL databases for peer-reviewed papers in English, Swedish, Norwegian and Danish, published since 2016, and specific to professional undergraduate programmes in biomedical laboratory science, midwifery, nursing, nutrition and health, occupational therapy, physiotherapy, psychomotor therapy and radiography that explicitly refer to curriculum activities aiming to bridge the theory–practice gap. The process was guided by two research questions: (1) In connection with which undergraduate healthcare programmes are there published studies on pedagogical strategies and activities designed to help students integrate academic and clinical knowledge; how are they described; and what kind of clinical activities do they address? and (2) What epistemological assumptions underpin (explicitly and implicitly) these strategies and activities, as well as the definitions and the understanding of relationships between forms of knowledge? We identified 5,693 studies and found 24 eligible for inclusion. The studies employed different methodologies, with qualitative design the most frequent across all studies (n = 15). Most studies originated from North America and Australia (n = 11), and about a third were from Scandinavian countries. The 24 papers cover pedagogical strategies and activities ranging widely from technology-based models to peer support and tools for reflective learning. The vast majority (n = 18) referred to nursing programmes. The results show that the relationship between theory and practice is addressed mainly in clinical education in connection with nursing education. Definitions of central concepts and an outline of epistemological underpinnings are lacking. The pedagogical strategies and activities identified in clinical education can provide information for managers, policymakers, and academic and clinical educators, and guide future curriculum reforms. The review identifies a knowledge gap concerning pedagogical strategies and activities in clinical education within a range of healthcare programmes that extend beyond nursing.

The effectiveness of diabetes training of psychiatric health professionals on individuals with diabetes and psychiatric disorders – a pragmatic controlled trial in Denmark

BackgroundIndividuals with diabetes and co-existing psychiatric disorders have more diabetes complications and lower life expectancy than those with diabetes but no co-existing psychiatric disorders. Psychiatric health professionals may have a role in improving these outcomes but often lack diabetes knowledge and skills. This study aims to examine the effectiveness of a diabetes training course for psychiatric health professionals on their diabetes knowledge and skills and clinical outcomes, diabetes support and diabetes distress among individuals with diabetes and psychiatric disorders treated in psychiatric outpatient clinics.MethodsA pragmatic non-randomized controlled cluster trial was conducted in eight psychiatric outpatient clinics in Denmark. All psychiatric health professionals from four clinics participated in the diabetes training course (the intervention) and completed a questionnaire on experience of the training course and a 20-item pre- and post-test to measure diabetes knowledge and skills. Difference in pre- and post-tests were analyzed using t-tests. From August 2018 – June 2019, individuals with diabetes were recruited from the intervention clinics (n = 49) and from four control clinics continuing usual clinical practice (n = 57). Differences in clinical outcomes, diabetes support and diabetes distress between the intervention and control groups at six and 12 months after the training course, were analyzed using logistic and linear regression models adjusted for baseline levels.ResultsPsychiatric health professionals (n = 64) had more correct answers after completing the course, with a mean increase of 6.3 [95% CI 5.6 to 7.0] correct answers. A total of 49 and 57 individuals were recruited for the intervention and control group, respectively. At follow-up, individuals treated in the intervention group had lower levels (clinical improvement) of systolic blood pressure, but had lower receipt of annual assessment of blood pressure, and body mass index (BMI) (worsening of process measures). While there were observed differences in odds and means for several other outcomes, none of these received statistical significance (see Table 2 and Fig. 2).ConclusionsTraining psychiatric health professionals in diabetes care improved their diabetes knowledge and skills and improved clinical levels of systolic blood pressure in individuals treated in the intervention group. However, this training intervention was associated with a lower likelihood of receiving annual assessment of blood pressure and BMI.Trial registrationISRCTN registry registration number ISRCTN15523920, registration date: 02/10/2019.

Building the OAChangeMap to Improve the Service Delivery of the New South Wales Osteoarthritis Chronic Care Program: A Worked Example of Using a Codesign Framework.

The Osteoarthritis Chronic Care Program (OACCP) has been implemented in Australian public hospitals to deliver best evidence osteoarthritis (OA) care. It is important to ensure that the OACCP continues to deliver evidence-based OA care as intended. We aimed to identify barriers and enablers to delivering the OACCP, prioritize the barriers, and generate strategies to address them. This study provides a worked example of a seven-step theory-informed codesign framework. We invited OACCP coordinators to participate in semistructured interviews (analyzed thematically) and complete a questionnaire to identify barriers and enablers to delivery of the OACCP. We then invited a broader group of stakeholders (OACCP coordinators, health managers, policy makers, consumers, and researchers) to prioritize the barriers via a short survey (survey 2). We held five codesign workshops in which we mapped the priority barriers to the Theoretical Domains Framework and developed strategies to address them. Sixteen coordinators were interviewed, and the main barriers identified were as follows: (1) patients often have beliefs that are inconsistent with best evidence care, (2) there are aspects of clinical care that are not delivered optimally, and (3) system-level factors are a barrier to optimal patient care and sustainability of the OACCP. We codesigned a plan for action with patient educational materials, shared decision-making tools, and health professional education and training. Our worked example of codesign used a theory-based, data-driven approach with key stakeholders, identified and prioritized barriers to the delivery of the OACCP, acknowledged enablers, and generated a plan for feasible strategies to improve the program.

INTEGRATION OF TECHNOLOGY AND LITERATURE IN HUMANISTIC HEALTH TRAINING: EFFECTS OF TEXTS ON THE HUMANIZATION OF CARE

Given the need to develop educational practices that transcend technical knowledge, promoting ethical reflection and empathetic understanding of patients, this study aimed to analyze how the use of literary texts in health education can promote the humanization of care, integrating digital technology to maximize educational impact and improve the training of professionals. The proposal explores the potential of digital technologies to maximize educational impact and improve the training of future health professionals. A mixed methodological approach was used, with qualitative and quantitative analyses, applied in the discipline of Nursing in Women's Health at a private university in São Paulo. The research was conducted remotely, due to restrictions imposed by the pandemic, and involved 58 undergraduate nursing students. During the study, students read and discussed the works The Death of Ivan Ilyich and Little Doctor through the Google Classroom platform. The activities included guided readings, weekly discussions, and questionnaires to assess the impact of the readings on students' understanding and practice in relation to the humanization of care. Quantitative analysis revealed a significant increase in student participation and depth of reflections after the introduction of literary texts, while qualitative analyses highlighted the importance of literature in fostering a more empathetic and humanized perspective in health practice. It is concluded that the integration of literary texts, mediated by digital technologies, proved to be effective in improving the understanding and practice of humanization in care, contributing to a more sensitive and reflective professional training.