Mixed Methods Systematic Review Research Articles

Preparing Early Interventionists/Early Childhood Special Educators with Knowledge and Practices to Collaborate with Families: A Mixed-Methods Systematic Review

Due to the important impact family-professional collaboration has on child outcomes for infants, toddlers, children, and students with disabilities, research in special education preservice personnel preparation has evaluated the impact of higher education programs and curricula geared towards improving preservice educators’ knowledge and practices regarding family-professional collaboration in inclusive settings. The resulting literature has provided the field with insights as to instructional strategies faculty have implemented to better prepare preservice special educators to collaborate with families. The purpose of this mixed-methods systematic review was to identify and synthesize the current state of knowledge behind these instructional strategies intended to increase preservice educators’ knowledge and practices to collaborate with families. A total of 15 peer-reviewed journal articles published between 1968-2024 were included in the study. Findings indicate that various instructional strategies and outcome measures were used to measure preservice educators' knowledge and practices. Implications for future research are described.

A Mixed Method Systematic Review Into the Impact of ED Treatment in Autistic People and Those With High Autistic Traits.

Our understanding of the impact of eating disorders (ED) treatment in Autistic people remains elusive. Research has begun to explore ED treatment outcomes and experiences in this population, however current understandings are poorly integrated. The current review therefore sought to explore the impact of ED treatment on Autistic people and those with higher Autistic traits. A convergent, segregated approach was used, independently evaluating quantitative then qualitative studies before integrating findings into a coherent narrative synthesis. Autistic people and people with higher Autistic traits report poorer experiences of treatment and may be at increased risk of inpatient admission and prolonged inpatient treatment, possibly explained by difficulties with treatment timeframes and a lack of autism-informed support. Both groups reported similar improvements in ED symptoms and BMI. Higher rates of psychosocial difficulties pre-and post-treatment were reported in those with higher Autistic traits, and emotion-focused interventions were felt to be particularly relevant to Autistic presentations of EDs. Concerns were reported as to how well aligned group-based programs and cognitive-based interventions are for Autistic individuals and those reporting higher Autistic traits. Future research in diagnosed autism samples is urgently needed to develop a more robust understanding of Autistic outcomes and experiences. Review findings demonstrate the need for increased understanding of ED presentations and the possible need for treatment adaptations, for Autistic people or those with higher Autistic traits.

Do Therapeutic Recreation Mental Health Clinical Placements Provide Educational Experiences to Pre-Registration Student Nurses?: A Mixed Methods Systematic Review.

Clinical placements are a critical component in any pre-registration student nurse's skill development and play an influential role in career specialisation upon registration. However, students are reporting to feel anxious and under prepared attending clinical placements, especially within mental health settings. Such a concern was highlighted in the Australian Government's Productivity Commission into Mental Health (2020). With recommendations for clinical placements to occur in therapeutic recreation environments, allowing increased interactions between students and individuals with a lived experience. Hence, this mixed methods systematic review aims to explore the experiences of pre-registration student nurses completing their mental health clinical placement within a therapeutic recreation environment. Six databases were searched for the review; CINHAL, Medline, PsycINFO, Web of Science, Scopus and the ProQuest Dissertation and Theses database, yielding 10 214 articles. Data were imported to COVIDENCE for management and screening processes. Risk of bias was undertaken by two authors utilising the Joanna Briggs Institute's Critical Appraisal Checklist for qualitative and quasi-experimental studies and McGill's Mixed Methods Appraisal Tool 2018 Version for mixed methods studies. Data were extracted manually for the 13 included articles which met the review inclusion criteria. Following a thematic analysis of the extracted data, three themes emerged: an optimal learning environment, impact on stigmatising beliefs and influence on future career. Findings identified that therapeutic recreation environments pose numerous education benefits for pre-registration student nurses. It is apparent through an immersive mental health clinical placement; student nurses are able to increase their mental health understanding through the lens of those with lived experiences. Such environments challenge stigmatising beliefs held by students prior to clinical placements and can lead to an increased desire to pursue a career within the mental health speciality. This review offers an insight into the many benefits for pre-registration student nurses who complete their mental health clinical placements in therapeutic recreation environments, including reduced stigmatising beliefs, increased mental health knowledge and improved clinical confidence. Trial Registration: PROSPERO: CRD42023476280.

Factors influencing the uptake of antenatal care in Uganda: a mixed methods systematic review

BackgroundIn 2016, the World Health Organization (WHO) recommended increasing antenatal care (ANC) visits from four to eight to reduce maternal morbidity and mortality. However, many low-middle income countries (LMICs), including Uganda, struggle to achieve even the basic four ANC visits. To further improve ANC attendance, understanding the perceptions and beliefs of end users is crucial. This systematic review explores the perceptions, experiences, and behavior of pregnant or previously pregnant women, their families and healthcare workers on ANC attendance in Uganda.MethodsThe review includes qualitative and quantitative studies published from January 2012 to September 2022. Outcomes include early initiation of ANC visits and any attendance or utilization of routine ANC services. The Critical Appraisal Skills Programme (CASP) checklist was used to assess the quality of included studies.ResultsWe searched 7 databases, identified 725 references and assessed 107 in full text for eligibility based on selected inclusion criteria. Forty-seven studies were eligible and are included in this review. Quantitative findings highlight socioeconomic factors like occupation, wealth index, and marital status as key determinants of ANC uptake and timely uptake of care, favoring higher wealth, younger age, marriage, and media access. Qualitative evidence reveals challenges to ANC attendance including financial constraints, cultural beliefs, gendered decision-making, and geographical distance from healthcare facilities. Potential solutions involve financially empowering women, providing reliable ANC equipment and medication, and community engagement and education.ConclusionsThis review offers valuable insights for policymakers and healthcare providers seeking to tailor interventions that address the unique needs and challenges faced by pregnant women, their families, and healthcare workers in Uganda. By doing so, it may enhance ANC accessibility and quality, ultimately aligning with the WHO’s recommendation of eight ANC contacts (ANC8) and contributing to reducing maternal morbidity and mortality rates.

Interactive Conversational Agents for Cigarette-Smoking and Vaping Cessation: A Mixed-Methods Systematic Review

Interactive Conversational Agents for Cigarette-Smoking and Vaping Cessation: A Mixed-Methods Systematic Review

Effectiveness, efficacy, acceptability, and feasibility of trauma-informed depression, anxiety, and substance use prevention programs for young people aged 12-25 years: A mixed-methods systematic review.

Mental ill-health and substance use bear significant public health burden on young people. Prevention is key. Trauma-informed approaches to prevention of mental ill-health and substance use demonstrate significant promise, yet it is unclear how well existing approaches work for young people targeting mental ill-health and substance use. This review aimed to assess the effectiveness, feasibility, and acceptability of trauma-informed mental ill-health and/or substance use prevention programs for young people. We searched the PsycINFO, CINAHL, Embase, MEDLINE, and Cochrane Library reference databases for peer-reviewed studies of trauma-informed mental ill-health and/or substance use prevention programs for young people published between 2013 and 2022. Studies in any language were included and reference lists of included articles were scanned for additional studies of relevance. In total, 30 studies were included in this review, comprising five randomized controlled trials (RCTs), seven non-RCTs, 10 quasi-experimental designs, and eight qualitative studies. Among the 30 studies, 27 unique trauma-informed prevention interventions were detailed. Eighteen studies reported statistically significant decreases in mental ill-health, and two studies reported significant decreases in substance use outcomes among participants, up to 6 months following the interventions. Most preventative interventions with statistically significant effects were selective (rather than universal or indicated) in their approach (n = 10, 55%). Broad acceptability and feasibility of trauma-informed prevention programs was observed among studies reporting this information though most quantitative studies were at high risk of bias and/or did not include a control group, whilst qualitative studies tended to report research conducted without a priori research aims. This review synthesizes for the first-time evidence on the effectiveness (or efficacy), feasibility, and acceptability of trauma-informed mental ill-health and/or substance use programs for young people, especially for those exposed to traumatic or adverse experiences. While there are promising efficacy outcomes, further research conducting rigorous, well-powered RCTs is required for large-scale evaluation and scaling of the potential preventative benefits of such programs.

Initiation of buprenorphine in the emergency department or emergency out-of-hospital setting: A mixed-methods systematic review

Initiation of buprenorphine in the emergency department or emergency out-of-hospital setting: A mixed-methods systematic review

Global Cancer Nurse's Experiences and Perceptions of Potential Occupational Exposure to Cytotoxic Drugs: Mixed Method Systematic Review With Framework Synthesis.

To conceptualise experiences and perceptions of cancer nurses' potential for occupational exposure when dealing with cytotoxic drugs (CDs). A mixed methods systematic review with framework synthesis. A literature search was conducted in February 2022 in CINAHL PubMed, Web of Science, Ovid Nursing, and PsycINFO, and it was reported using the PRISMA guidance. A synthesis of 38 studies revealed new categories of perceived solutions, side effects, and risky behaviour as well as three levels of experience and perception: individual, shared, and cultural, rather than the a priori theory. The review conclude that individuals espouse safe handling and administration of CDs. Synthesis highlights a complex interplay between self-reported perception and the observed experience of potential occupational exposure to cytotoxic drugs. The framework synthesis highlights the difference between the perception of espoused practice and the experience of practice. Observation and risk assessment must be used to enhance safe practice. Organisations must take seriously the perception and experience of the adverse effects of administering cytotoxic drugs to support cancer nurses. Joanna Briggs Institute's (JBI) methodology for systematic reviews and framework synthesis indexed studies deductively and inductively. No patient or public contribution. PROSPERO: CRD42022289276.

Burnout in Infection Control Practitioners During Public Health Crisis Events: A Mixed Methods Systematic Review Protocol

Background Infection prevention and control work environments are highly complex in nature and have long been associated with crisis events including serious infectious disease outbreaks. The role of infection control practitioners shifted exponentially during the COVID-19 pandemic and with this rapid and nebulous change came anxiety, emotional exhaustion and ultimately burnout. Burnout at work generally occurs as a response to chronic and prolonged exposure to emotionally challenging events, causing emotional exhaustion, feelings of cynicism, and lack of accomplishment at work. This systematic review aims to investigate burnout in infection control practitioners during public health crisis events (major outbreaks, epidemics, and pandemics) in upper-middle and high-income countries on a global scale. Methods A mixed-methods systematic review will be carried out and will include qualitative, quantitative and primary mixed-methods studies that investigate the different elements of burnout, during public health crisis events. After an initial scoping literature search, up to six databases will be searched for studies on burnout in relation to infection prevention practitioners. Study quality will be checked using standardised JBI critical appraisal tools. The proposed review will follow the JBI convergent integrated approach for mixed methods systematic reviews. Following data extraction, quantitative data will then be converted into ‘qualitized data’ in the form of textual descriptions. Discussion It is well documented that adverse conditions during public health crisis events can lead to burnout. This systematic review will investigate of burnout in infection control practitioners in upper-middle and high-income countries during public health crisis events. The findings will inform healthcare professionals, senior policy makers and researchers and will help contribute to a richer understanding of burnout and associated factors in infection control practitioners. Protocol registration number PROSPERO 2024 CRD42024508996.

The Types and Effectiveness of Mobile Health Applications Used in Improving Oral Cancer Knowledge: A Mixed Methods Systematic Review

ABSTRACTBackground and AimsThe global burden of oral cancer (OC) is enormous. Mobile health applications have been found to play a promising role in cancer prevention; however, no known systematic review evidence exists on whether the use of mobile health applications is effective in increasing public knowledge of OC or not. Therefore, this systematic review aimed to synthesize evidence on the types and effectiveness of mobile health applications used for improving OC knowledge.MethodsThis study adopted a mixed methods systematic review design. The review methodology was informed by Joanna Brigg's Institute's PRISMA checklist and the AMSTAR‐2 guidelines. The literature used for this review were obtained through the search of multiple sources, including 12 electronic databases, web sources, and manual searching of the reference lists and citations of the included articles. Quality appraisal of the included articles was done using the Mixed Methods Appraisal Tool, after which relevant data were collected, synthesized, and configured.ResultsA total of three high‐quality articles, from two studies conducted in India, were included in this review. The studies investigated 574 participants, who are predominantly doctors and community members, on two Android‐based mobile health applications (M‐OncoED and Prayaas). Only Prayaas was found to significantly increase OC knowledge among its users (p < 0.05). Only M‐OncoED was found to significantly increase the practice of OC screening advice provision among a selected group of users. No other significant finding was reported on the effect of OC knowledge obtained from the use of these applications on clinical, behavioral, and epidemiological outcomes.ConclusionMobile health application‐based education is a highly underutilised but very promising strategy that can be used to improve public knowledge of OC. This strategy needs to be adopted in public education programmes on OC.

Strengthening the quality of primary healthcare services and interdisciplinary collaboration

Abstract Background Political organisations stress the need for preventive strategies to reduce the amount of avoidable hospital admissions, i.e. admissions that could have been avoided given timely and adequate care in the primary healthcare setting. Interdisciplinary collaboration has been suggested as a means to prevent hospitalizations, but effective implementation remains a challenge. Thus, there is a need for evidence-based strategies to prevent avoidable admissions and support interdisciplinary collaboration. The aim was to develop an evidence-based framework for preventive and coordinated interventions strengthening the quality of primary healthcare services and supporting interdisciplinary collaboration. Methods The project consists of three sub-studies: 1) a mixed methods systematic review following the JBI methodology; 2) a focus group study with primary healthcare providers in the Central Denmark Region, including general practitioners, physiotherapists, occupational therapists, home care providers, registered nurses and nurse specialists; and 3) a study using participatory design, where a framework for coordinated interventions were developed based on the results from study 1 and 2, supported by all stakeholders. Results Findings suggest that some hospitalizations can be prevented by intervening on mental factors, e.g., through trustful relations, and social factors, e.g., living situation. Also, a strong collaboration between healthcare providers from different disciplines and healthcare services is needed to improve the care pathway and prevent hospitalization. The collaboration may be strengthened if the health providers share a common language regarding the citizens’ health status. Conclusions Stakeholders at all levels should be informed about the relevance of considering mental, social and physical factors to improve the quality and responsiveness of primary healthcare services and to develop initiatives to support interdisciplinary collaboration. Key messages • By focusing on the whole person, it could be possible to provide more person-centred care through interdisciplinary collaboration and ultimately to prevent some admissions. • Well-established primary healthcare services are important to provide person-centred care through interdisciplinary collaboration.

Parents' experiences of psychotherapeutic support on the neonatal unit: A mixed methods systematic review to inform intervention development for a multicultural population.

Parents of infants admitted to neonatal intensive care require support to minimize the impact on their mental health and to encourage engagement with their infants to support infant neurodevelopment. Many interventions aim to address this need, but there is a lack of research considering the accessibility of these for a multicultural population. To systematically identify sources of psychotherapeutic support available for parents with infants admitted to neonatal care (NNU, neonatal intensive care unit [NICU] and special care units), assess their accessibility and acceptability and identify challenges and facilitators. Six electronic databases with no restrictions on language or date were used to identify relevant studies following Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Publications were included in the review if they reviewed parent experience of an intervention actively in place to support parent experience during the neonatal unit stay. Any studies where the intervention's primary aim was infant focused, such as developmental care, were excluded. All publications were quality-assessed using quality appraisal tools appropriate for their design type. Data were extracted line by line using Sekhon et al.'s theoretical acceptability framework and questionnaire. A total of 3309 studies were found, of which 36 studies met the inclusion criteria. Included studies were published worldwide between 2000 and 2023 and explored 15 different interventions. Challenges for parental engagement were due to preconceived ideas about intervention requirements and parents' ability to participate in them. Timely information and providers' experience in delivering the intervention were reported to support engagement and as being valuable for enhancing participant knowledge. The emotional content of interventions was found to be challenging by parents across most studies. This was prominent in interventions designed to be carried out in a group format and where keepsakes were created. However, the value of these interventions was in reducing parents' feelings of isolation through increased social support and providing a starting point for conversations with wider family and friends about the family's neonatal experience. Participant demographics were poorly reported, with only two studies taking into consideration the ethicality of the intervention. Poor reporting of participant demographics, and a focus on mothers as participants, means findings are not transferrable to the wider population of parents in neonatal units. Future studies should consider how to ensure that research and interventions are accessible to multicultural populations to improve the understanding of the acceptability of interventions. Better knowledge of neonates and the NNU setting amongst intervention providers could increase the accessibility of psychotherapeutic support for parents. Training for providers on how to manage sensitive conversations may also be beneficial to support parents during interventions. The impact of neonatal admission on parental mental health is increasingly recognized and reported. Interventions have been developed to reduce the negative impact on the mental health of parents. There continue to be significant health inequalities as a result of many services not taking into account the acceptability and accessibility of interventions in this setting for their multicultural populations. This review highlights the need for better reporting of participant demographics in research and the inclusion of those seldom heard to ensure interventions are culturally, religiously and linguistically appropriate for multicultural populations.

Mixed-methods systematic review of shared decision-making tools for cancer screening

Abstract Shared decision-making (SDM) tools hold promise for guiding informed choices in cancer screening. However, their effectiveness among underserved people, as well as the specific characteristics of these tools preferred by this group and clinicians, remains unclear. This review aimed to synthesize evidence on the effectiveness of SDM tools for cancer screening and explored the preferences of underserved people and clinicians regarding the specific characteristics of the SDM tools. A mixed-method convergent segregated approach was employed, which involved an independent synthesis of quantitative and qualitative data. Articles were systematically selected and screened, resulting in the inclusion and critical appraisal of 55 studies. Results from the meta-analyses showed that SDM tools for cancer screening are effective in reducing decisional conflict for both the general population and the underserved, and in increasing cancer screening knowledge and intention for underserved people only. Subgroup analyses showed minimal heterogeneity for decisional conflict outcomes, measured over a six-month period. Insights from the qualitative findings revealed that underserved people highly preferred SDM tools with relevant information about cancer risk, culturally tailored content, and high accessibility, both during clinical encounters and beyond. Meanwhile, clinicians highly preferred tools that can be easily integrated into medical systems, and can effectively guide SDM, while considering their patients’ values and the limited time for consultation. There is strong evidence on the effectiveness of SDM tools in facilitating informed choice in cancer screening, especially among underserved people. However, evidence on long-term outcomes remains insufficient. Additionally, considering the difference in preferences of key stakeholders in terms of tool characteristics, fostering collaboration with them during the creation of an SDM tool for cancer screening is essential. Key messages • Shared decision-making tools are effective in increasing screening knowledge and intention among underserved people. • Considering the difference in preferences of key stakeholders in terms of tool characteristics, fostering collaboration with them during the creation of an SDM tool for cancer screening is essential.

Understanding barriers and facilitators to lifestyle management in people with polycystic ovary syndrome: A mixed method systematic review.

Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10-13% of reproductive-aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed-methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed-methods studies were narratively synthesized and all studies were thematically analyzed. Sixty-eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS-specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self-perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight-centric care are necessary for long-term sustainable changes and improvements in health outcomes in people with PCOS.

"I didn't really fit into any boxes": understanding the experiences of women affected by cancer in pregnancy and up to one-year postpartum-a mixed-method systematic review.

Little is known about women's experiences of cancer during pregnancy and up to one-year postpartum. As the incidence of gestational cancer rises parallel to increasing rates of early onset cancers there is an imperative need to understand their experiences. The aim of this research is to understand women's experiences of gestational cancer during pregnancy and up to one-year postpartum. This systematic integrative review followed the JBI methodology for mixed method systematic reviews (MMSR) which integrates empirical data from qualitative and quantitative primary studies. The search strategy included electronic databases, APA PsycINFO, CINHAL, Medline, Scopus, and the Web of Science Core Collection. The review has been reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive methodological quality assessment was undertaken using the Mixed Methods Appraisal Tool (MMAT). Thirteen studies were included, reporting on the experiences of 266 women. The findings represented the women's insight on the psychological impact of their gestational cancer, the impact on women's identity as a mother and a patient, and women's experiences of complex care. Gestational cancer reflects an emerging focus of clinical practice and an opportunity for much needed new research to explore woman-centered care exploring supportive care needs and models of maternity care. Women's experiences indicate that services are under-resourced to address the holistic and integrated supportive care needs of women affected by cancer across both maternity and cancer care teams.

Reading Comprehension Instruction: Evaluating Our Progress Since Durkin’s Seminal Study

ABSTRACT Purpose: Nearly 50 years ago, Durkin (1978–1979) conducted a seminal observation study on reading comprehension teaching in Grades 3 through 6. She reported that teachers rarely taught reading comprehension (less than 1% of instructional time). Since then, we have gained substantial knowledge about teaching reading comprehension. We aimed to comprehensively review direct observation studies of reading instruction to understand the extent to which recommended comprehension practices are implemented in schools. Method: A systematic search of the extant literature identified 66 observation studies of reading comprehension instruction for children in K–12 schools, including a total of 1,784 teachers. We employed a mixed-method systematic review to address the research questions. Results: Integrated analyses revealed that reading comprehension instruction infrequently aligned with research-based practices. Findings revealed that, on average, 23% of instructional time during reading/language arts instruction was dedicated to reading comprehension. Like Durkin’s study (1978–1979), the results indicated that teachers spent much of this time engaging in initiation-response-evaluation conversation patterns rather engaging students in extensive discussion of text or teaching knowledge or practices (e.g. text structure, reading comprehension strategies) that support reading comprehension. However, analyses suggested that studies conducted after 2000 reported more research-based reading comprehension practices than earlier studies. Conclusions: These findings suggest a substantial gap persists between the reading comprehension practices identified as research-based and those observed in typical practice. There is a need for renewed efforts to prioritize reading comprehension instruction in policy and practice.

The effectiveness and acceptability of physical activity interventions amongst older adults with lower socioeconomic status: a mixed methods systematic review.

Older adults with lower socioeconomic status are less likely to be physically active than those with higher socioeconomic status. To inform future intervention development, this review explored: [i] how effective are physical activity interventions at increasing levels of physical activity amongst older adults with lower socioeconomic status?; [ii] what factors are associated with the acceptability of physical activity interventions amongst older adults with lower socioeconomic status?; [iii] what are the implications for developing physical activity interventions for older adults with lower socioeconomic status? This mixed methods systematic review followed PRISMA guidelines. MEDLINE, CENTRAL, Embase, Scopus, Web of Science, PsycINFO, CINAHL, ASSIA and Sports Medicine and Education Index were searched up to May 2023, to identify quantitative, qualitative and mixed methods primary research studies measuring the effectiveness of and/or experiences of physical activity interventions for older adults (aged ≥ 65 years) with lower socioeconomic status. No limits on country were applied. Included studies were assessed for methodological quality using the Mixed Methods Appraisal Tool. Results were synthesised using a results-based convergent synthesis approach with narrative synthesis of quantitative findings and thematic synthesis of qualitative findings. Thirty studies were included. Mixed effects were found for the effectiveness of physical activity interventions, with positive effects for increases in utilitarian walking (i.e. for transport) but not for leisure, mixed effects for objectively measured physical activity and no effects for self-reported total physical activity or muscle strengthening and flexibility activities. Engaging in physical activity interventions was perceived as offering many benefits, social familiarity was important to intervention acceptability and interventions were seen as more acceptable when they were compatible with the lifestyles of older adults with lower socioeconomic status. Future development of physical activity interventions for older adults with lower socioeconomic status should foster social connections, emphasise health benefits of physical activity, hold interventions in locations that are accessible and familiar to older adults with lower socioeconomic status, minimise costs to participants, employ individuals who share participant characteristics to lead interventions, and combine physical activity with other activities older adults with lower socioeconomic status already do to make more efficient use of time. PROSPERO CRD42023417312; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=417312 .

Interventions Targeting the Mental Health and Well-being of Care-Experienced Children and Young People: Mixed-Methods Systematic Review with Stakeholder Consultation to Inform Transportability and Adaptability to UK Context

Interventions Targeting the Mental Health and Well-being of Care-Experienced Children and Young People: Mixed-Methods Systematic Review with Stakeholder Consultation to Inform Transportability and Adaptability to UK Context

Acceptability and use of HIV self-testing among young people in sub-Saharan Africa: a mixed methods systematic review

BackgroundYoung people (YP) are disproportionately affected by the HIV pandemic in sub-Saharan Africa (SSA), but testing rates remain low despite global targets of testing 95% of people with HIV infection by 2030. HIV self-testing (HIVST) has been recently introduced to reach high-risk population groups such as these. Thus, synthesis of emerging evidence on the acceptability and use of HIVST among YP in SSA is needed so that comprehensive information can be generated to inform policy and practice.MethodsWe employed a mixed methods systematic review of quantitative and qualitative literature reporting on HIVST among YP involving any design and published in English by 31st of October 2023. The review synthesized quantitative evidence on acceptability and use of HIVST, and qualitative evidence on perspectives of YP about HIVST. We searched databases of published articles (e.g. MEDLINE, CINAHL) and Gray literature sources (e.g. Google, Google Scholar). The concepts for the search included self-testing, HIV/AIDS, and countries in SSA. Two authors independently screened, retrieved full-text, and assessed quality of the studies.ResultsA total of 4150 studies were retrieved and 32 studies were finally included in the review. Acceptability of HIVST computed from a single item asking YP on their preference or willingness or demand for HIVST was moderate (34–67%) to high (≥ 67%) among YP in SSA. Nine of the fourteen studies that reported on acceptability found high acceptability of HIVST. Use of HIVST ranged from 0.8 to 100% while in most studies the use rate was below 50%. Key barriers to HIVST use were coping with a positive test in the absence of counselling and support, physical discomfort, and cost of kits. Perceived enablers included perceptions of HIVST as promoting personal empowerment and autonomy; privacy and confidentiality; and convenience in location, time, and skill.ConclusionsHIVST was highly accepted but not well utilized among YP in SSA. YP showed diversified needs with mixed preferences for location, and modalities of service provision. Overall, the review identified heterogeneous evidence in terms of methods, population, outcome measures, and results. The review was registered in the International Prospective Registry of Systematic Reviews (PROSPERO: ID = CRD42021278919).

Urban public space initiatives and health in Africa: A mixed-methods systematic review.

Public space initiatives (PSIs) in African cities can significantly promote health and social well-being, yet their implementation and impact are unknown across the continent. There is a substantial gap in literature on PSIs in African countries, with most studies concentrated in wealthier cities and lacking comprehensive assessments of long-term health impacts. The objective of this study was to synthesise evidence on the typology, location, features, and outcomes of these initiatives as well as the guiding principles that underlie their design and implementation. Employing a mixed-methods model, the study systematically reviews peer-reviewed and grey literature articles, focusing on the types, settings, and outcomes of PSIs. Data is analyzed using the CASP appraisal tool and thematic analysis. We analysed 47 studies, 15 of which were mixed methods, 22 qualitative and 10 quantitative. Sports accounted for 50% of initiatives. 30 of the 47 papers originated from South Africa. Communities viewed initiatives' wellbeing impacts through social, economic, and ecological lenses, with health being but one dimension. The sustainability of initiatives was often limited by funding, historical marginalization, and competing land uses. Findings underscore the need for more comprehensive, long-term evaluations and cross-sector collaborations to sustain and enhance health-promoting public spaces in African cities.