Mixed Methods Assessment Tool Research Articles

Interventions for left-behind children in Mainland China: A scoping review

BackgroundAs the discussion of Chinese left-behind children (LBC) continues, intervention programs dedicated to this population increase and diversify. While reviews have summarized intervention programs promoting LBC’s health and psychological wellbeing, there is no synthesis depicting a comprehensive picture. This scoping review systematically examines interventions tackling LBC’s various issues and identifies their design and foci. MethodWe performed a systematic literature search to extract intervention studies from four English (i.e., Web of Science, Scopus, Embase, & PsycINFO) and one Chinese (i.e., CNKI) database. The quality of the studies was assessed using the Mixed Methods Assessment Tool (MMAT). Two main rounds of deductive coding were performed on Nvivo 12 plus to identify the design and foci of the interventions. ResultsThirty-three articles were identified for our final review. Twenty-six were published in Chinese and seven in English. Existing interventions have tackled multiple psychological, social, physical, developmental, and sexual problems or needs of Chinese rural left-behind children. Among them, LBC’s psychological wellbeing has drawn the most attention. The majority of the reviewed studies performed a randomized controlled trial (N=20). Quantitative evaluation is prevalent, with only one study applying a purely qualitative evaluation. In addition, only two studies adopted validated interventions, while the others are self-designed. ConclusionsThe review results indicate several gaps in intervention studies for LBC. First, many existing interventions have considered LBC’s psychological and social wellbeing, while little effort has been paid to address their educational and intellectual development. Further, while existing interventions are concerned with LBC’s temporary needs, their long-term life planning, as well as their current self-efficacy and self-concept driving their actions towards future self, were neglected. As for the intervention design, empirically validated interventions are recommended for future studies for their verified efficacy and evidence-based standardized practice. In addition, a qualitative evaluation should be considered because it might be more powerful in eliciting realistic and viable solutions to improve the effectiveness and reliability of the interventions from the participants.

Teachers’ experiences of enacting pedagogical models and models-based practice: a systematic mixed study review

ABSTRACT Background The shift from traditional, teacher-led methods towards more student-centred approaches in many countries has positioned pedagogical models and Models-based Practice (MbP) as a potential future for physical education pedagogy. Over the last 10–15 years there has been a surge in publications reporting on teachers’ experiences of enacting models. These studies have not, until now, been synthesised. Such a synthesis would allow a richer, more nuanced and holistic understanding of teachers’ experiences of enacting pedagogical models in physical education. This understanding helps to provide a robust evidence base from which to consider the usefulness of pedagogical models and MbP as a future physical education pedagogy. Purpose The purpose of this review is to explore and synthesise teachers’ experiences of enacting pedagogical models in literature from 2010 to 2022. In doing this we set out to answer the question: What are teachers’ reported experiences of enacting pedagogical models and/or models-based practice? Methods This study employed a systematic mixed study approach to analyse empirical examples of qualitative, quantitative, and mixed methods research published between 1st January 2010 and 31st October 2022. The selection process involved a comprehensive search strategy across four databases (SportDiscus, ERIC, Web of Science, Scopus), title and abstract screening, full-text evaluation, the use of the mixed methods assessment tool and a synthesis of the findings from the 91 included studies. Results The findings highlighted five themes related to teachers’ experiences of enacting pedagogical models: (1) developing democratic classrooms through pedagogical models, (2) enacting pedagogical models for professional growth, (3) strengthening student learning within and beyond the physical domain, (4) aligning curricula through pedagogical models, and (5) challenging the current state of physical education through pedagogical models. Results reveal teachers’ efforts to democratise the classroom environment where students, regardless of their ability, were given equal opportunities. This democratisation occurred alongside teachers’ pedagogical growth but was not without its challenges. The review underscores the multifaceted challenges of integrating pedagogical models into diverse educational contexts. Teachers report on the need for investment in professional development and the garnering of other professional support to be able to negotiate and adapt pedagogical models to the curricular aspirations in local contexts. Importantly, the review highlights how many teachers reported that their use of pedagogical models allowed them to extend student learning beyond the physical domain. Discussion The review makes an important, original and innovative contribution to understanding and knowledge in the field by highlighting the potential of pedagogical models to enrich physical education pedagogy by fostering more inclusive, reflective, and dynamic learning environments. It critically examines the barriers in the enactment of pedagogical models, ranging from infrastructural limitations to the intricacies of using pedagogical models in practice. The paper, therefore, highlights the need for supportive frameworks for teachers implementing pedagogical models that emphasises continuous learning and collaboration. In conclusion, we ask if pedagogical models are destined to remain a lofty ideal, or if there is a need to recalibrate our scholarly compass, broadening our research horizons to envisage a more inclusive and diverse future for physical education?

Remote Exercise Engagement Among Individuals With Cardiovascular Disease

Purpose: To systematically review the literature regarding barriers and facilitators to remote exercise among individuals with cardiovascular diseases (CVD). Review Methods: Six databases were searched (inception—December 2023). Studies including barriers and facilitators for remote exercise reported by individuals living with CVD were considered. Quality was rated using the Mixed Methods Assessment Tool (MMAT). Results were synthesized following a thematic analysis approach. Characteristics of interventions were reported using the Template for Intervention Description and Replication (TIDieR). Summary: From an initial pool of 8543 records, 18 studies met the inclusion criteria. Among these, 13 were qualitative studies, with individual interviews being the most frequent data extraction method. Nine studies received 5/5 MMAT scores (ie, high quality). Twelve studies reported remote exercise interventions, mostly delivered within cardiac rehabilitation, by physiotherapists, nurses, and dietitians, predominantly via telephone calls or videoconferences, with only one study incorporating text messages. Five key themes influencing remote exercise interventions were identified: technology (encompassing access and literacy, self-monitoring/motivation, and security concerns), individual health considerations (health/personal aspects and coronavirus disease-2019), social factors (support from health care team and family/social support), environment (facilities), and logistical factors (time and displacement). Several themes served as both facilitators and barriers. Key insights for remote exercise interventions included mobile accessibility, interactive chat sessions, minimal click interactions, short sessions, personalized feedback, and flexible timing. Results emphasize the importance of promoting social interaction and support between participants and health care teams to mitigate barriers and enhance facilitators in remote exercise interventions for individuals with CVD.

Clinical decision support systems for maternity care: a systematic review and meta-analysis

The use of Clinical Decision Support Systems (CDSS) is increasing throughout healthcare and may be able to improve safety and outcomes in maternity care, but maternity care has key differences to other disciplines that complicate the use of CDSS. We aimed to identify evaluated CDSS and synthesise evidence of their impact on maternity care. We conducted a systematic review for articles published before 24th May 2024 that described i) CDSS that ii) investigated the impact of their use iii) in maternity settings. Medline, CINAHL, CENTRAL and HMIC were searched for articles relating to evaluations of CDSS in maternity settings, with forward- and backward-citation tracing conducted for included articles. Risk of bias was assessed using the Mixed Methods Assessment Tool, and CDSS were described according to the clinical problem, purpose, design, and technical environment. Quantitative results from articles reporting appropriate data were meta-analysed to estimate odds of a CDSS achieving its desired outcome using a multi-level random effects model, first by individual CDSS and then across all CDSS. PROSPERO ID: CRD42022348157. We screened 12,039 papers and included 87 articles describing 47 unique CDSS. 24 articles (28%) described randomised controlled trials, 30 (34%) described non-randomised interventional studies, 10 (11%) described mixed methods studies, 10 (11%) described qualitative studies, 7 (8%) described quantitative descriptive studies, and 7 (8%) described economic evaluations. 49 (56%) were in High-Income Countries and 38 (44%) in Low- and Middle-Income countries, with no CDSS trialled in both income categories. Meta-analysis of 35 included studies found an odds ratio for improved outcomes of 1.69 (95% confidence interval 1.24-2.30). There was substantial variation in effects, aims, CDSS types, context, study designs, and outcomes. Most CDSS evaluations showed improvements in outcomes, but there was heterogeneity in all aspects of design and evaluation of systems. CDSS are increasingly important in delivering healthcare, and Electronic Health Records and mHealth will increase their availability, but traditional epidemiological methods may be limited in guiding design and demonstrating effectiveness due to rapid CDSS development lifecycles and the complex systems in which they are embedded. Development methods that are attentive to context, such as Human Centred Design, will help to meet this need. None.

Rural healthcare workers' well-being: A systematic review of support interventions.

Although there is increased awareness about healthcare workers' (HCWs') stress and burnout after the COVID-19 pandemic, support interventions should be tailored according to the needs of HCWs. Given the unique challenges rural HCWs face, we sought to systematically identify the types of interventions specifically designed and utilized to support the well-being of HCWs practicing in rural settings. We conducted a comprehensive search of the existing literature through electronic databases to identify quantitative, qualitative, and mixed-methods studies describing supportive interventions for rural HCWs with well-being-related outcomes between January 1, 2023 and March 31, 2023. We used the Effective Public Health Practice Project, Mixed Methods Assessment Tool, and Joanna Briggs Institute Critical Appraisal Checklist to evaluate the study quality. Out of 1,583 identified records, 25 studies were included in the analysis. The studies described a wide range of supportive interventions and outcomes. The overall quality of the studies was weak to moderate. None of the studies were randomized and only six included controls. Included interventions were generally well- accepted. Quantitative and qualitative themes identified shared decision making, effective supervision, and proactive cultural change as promising interventions that warrant further exploration. Financial interventions alone were not effective. Most of the studies were either unfunded or were funded internally by the institutions. There is limited research in support interventions for rural HCWs. Larger, well-designed studies are needed to explore promising interventions to promote well-being of rural healthcare workforce. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effect of pre-operative exercise training on post-operative cognitive function: a systematic review.

With population aging and advances in surgical and anesthetic procedures, the incidence of surgery in patients over the age of 65 years is increasing. One post-operative complication often encountered by older surgical patients is post-operative cognitive dysfunction (POCD). Preoperative exercise training can improve the overall physiological resilience of older surgical patients, yet its impact on post-operative cognition is less well-established. Six databases (Medline (OVID); EMBASE (OVID); EMCARE (OVID); CINAHL (EBSCOHost), the Cochrane Library, and PubMed) were searched for studies reporting the effect of pre-operative physical training on post-operative cognition. The quality of evidence was assessed using the Mixed Methods Assessment Tool. A total of 3983 studies were initially identified, three of which met the inclusion criteria for this review. Two studies were pilot randomized trials, and one was a prospective randomized trial. Two of the studies were high-quality. Each study used a different type of physical exercise and cognition assessment tool. Across the studies, post-operative cognition (p = 0.005) and attention (p = 0.04) were found to be better in the intervention groups compared to control, with one study reporting no difference between the groups. Preoperative physical training may improve post-operative cognitive function, although more research with a consistent endpoint is required. Future studies should focus on patients at high risk of POCD, such as older adults, and explore the impact of different exercise regimes, including frequency, intensity, time, and type.

Lack of autonomy and professional recognition as major factors for burnout in midwives: A systematic mixed-method review.

The aim of this study was to review the existing evidence on burnout levels in midwives and the main related factors. Mixed studies systematic review. PubMed, Scopus and Web of Science were sourced from 2018 and 2023. Inclusion criteria: quantitative cross-sectional or qualitative articles published in English within the last 5 years. studies with undergraduate or trainee midwives, studies examining the factors in a pandemic setting and those not answering the research question. Potential risk of bias was assessed using the Mixed Methods Assessment Tool (MMAT). A convergent synthesis design was followed through a thematic synthesis using Thomas and Harden's three-step method: inductive coding of the text, development of descriptive themes and generation of analytical themes. Qualitative approaches adopted exploratory descriptive studies and participatory action research. Thirty-six studies were included, with a total of 17,364 participants. There were higher levels of burnout in midwives who were single, under 35-40 years of age, with less than 10 years of experience and those with young children. Stress, anxiety and depression, as well as the emotional impact of traumatic events, have been described as related psychological factors. Although extrinsic work factors such as shifts, workload, pay and interpersonal relationships increase burnout, intrinsic factors such as lack of autonomy and recognition are the main factors related to it. What problem did the study address? Burnout among healthcare workers has been recognized as a global crisis requiring urgent attention, specifically in midwives. What were the main findings? There is a persistent shortage of midwives that is attributed in part to chronic retention difficulties related to job burnout expressed by these professionals. Where and on whom will the research have an impact? We seek to address the paucity of research on burnout in midwives in the current crisis in the profession. Work factors such as lack of autonomy or recognition in the profession carry an associated risk of burnout and job attrition. Understanding the factors that contribute to burnout will enable healthcare organizations to reduce the current problem. PREFERRED: Reporting items for systematic review and meta-analyses (PRISMA). No patient or public contribution.

Examining Asian Parents' Perspectives and Challenges in Sexual and Reproductive Health Education with Implications for Public Health: A Systematic Review.

In Asian cultures, discussing sexual matters with adolescents is often considered taboo and culturally or religiously sensitive. Due to a lack of knowledge and skills, many parents find approaching such a topic with their children challenging, fearing that raising such an issue will bring concerns about encouraging promiscuity. This systematic review aims to assess evidence on Asian parents' perspectives and practices regarding delivering sexuality information to adolescents. It also seeks to identify the factors that facilitate or hinder the effective delivery of such knowledge. The electronic databases EBSCO-CINAHL, Scopus, and Science Direct were searched using keywords and synonyms such as "sexuality information," "sexuality education," "parent-child," "communication," and "Asian." The studies' quality was assessed using the Mixed-Method Assessment Tool. A comprehensive database search identified 1392 potentially relevant literature sources for this review. Following the application of inclusion criteria, a final set of 16 eligible full-text research articles was selected for inclusion in the review. In most quantitative literature, parents were found to have a good level of knowledge, whereas most qualitative studies reported the opposite, indicating inadequate knowledge. Seven studies highlighted the cultural denial of delivering regarding sexuality, whereas six studies emphasized the need for parental support. Negative experiences, including discomfort, shyness, embarrassment, fear of intimidation, and fearful encounters, were reported in the literature. In conclusion, this review aims to pinpoint gaps and challenges in the delivery of sexuality education among Asian parents, offering valuable insights for public health practitioners and policymakers.

Leadership conceptions of nurses and physicians in emergency care: A scoping review

BackgroundThe Emergency Department (ED) is a setting where teamwork and leadership is imperative, however, the literature to date is mostly discipline (nursing or medical) specific. This scoping review aimed to map what is known about nurses’ and physicians’ conceptions of leadership in the ED to understand similarities, differences, and opportunities for leadership development and research. MethodGuided by the Joanna Briggs Institute approach, and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Guidelines, a systematic search of three electronic databases was performed. The Mixed Methods Assessment Tool was used for quality appraisal of included articles. ResultsIn total, 37 articles were included. Four key findings emerged: 1) leadership was rarely explicitly defined; 2) nurse leaders tended to be characterised as agents of continuity whilst physician leaders tended to be characterised as agents of change and continuity; 3) the clarification of expectations from nurse leaders was more evident than expectations from physician leaders; and 4) leadership discourse tended to be traditional rather than contemporary. ConclusionDespite the proliferation of studies into ED nurse, physician and interprofessional leadership, opportunities exist to integrate learnings from other sectors to strengthen the development of current and next generation of ED leaders.

Self-management of chronic, non-communicable diseases in South Asian settings: A systematic mixed-studies review.

Self-management is crucial in mitigating the impacts of a growing non-communicable disease (NCD) burden, particularly in Low and Middle-Income countries. What influences self-management in these settings, however, is poorly understood. We aimed to identify the determinants of self-management in the high NCD region of South Asia and explore how they influence self-management. A systematic mixed-studies review was conducted. Key electronic databases [MEDLINE (1946+), Embase (1974+), PsycInfo (1967+) and CINAHL (EBSCOhost)] in March 2022 (and updated in April 2023) were searched for studies on the self-management of four high-burden NCD groups: cardiovascular diseases, type 2 diabetes, chronic respiratory diseases and depression. Study characteristics and quantitative data were extracted using a structured template, and qualitative information was extracted using NVivo. Quality appraisal was done using the Mixed Methods Assessment Tool (MMAT). Quantitative findings were organised using the Commission on Social Determinants of Health (CSDH) framework and synthesised narratively, supported by effect direction plots. Qualitative findings were thematically synthesised. Both were integrated in a mixed synthesis. Forty-four studies (26 quantitative, 16 qualitative and 2 mixed-methods studies) were included, the majority of which were conducted in urban settings and among individuals with diabetes and cardiovascular diseases. Higher age, education, and income (structural determinants), health-related knowledge, social support and self-efficacy (psychosocial determinants), longer illness duration and physical comorbidity (biologic determinants), and the affordability of medicine (health-system determinants) were key determinants of self-management. Qualitative themes highlighted the role of financial adversity and the social and physical environment in shaping self-management.A complex interplay of structural and intermediary social determinants shapes self-management in South Asian settings. Multi-component, whole-systems approaches could boost self-management in these settings. Key areas include empowerment and education of patients and wider community, design and delivery of bespoke behavioural interventions and a stronger emphasis on supporting self-management in healthcare settings.

The impact of telemedicine enabled pre-hospital triage in acute stroke - a protocol for a mixed methods systematic review.

Increasing access to thrombolysis and thrombectomy through improved pathway organisation remains a health service challenge that requires contextualisation to the geographic, demographic and resourcing status of any regional stroke service. Pre-hospital delays or delays during inter-hospital transfers can result in patients being outside the window for one or both interventions. Pre-hospital triage using technology-enabled interdisciplinary communication networks may facilitate rapid individualized care decisions, permitting streamlined care pathways to hospital sites most appropriate to their clinical presentation and history in the first instance. Understanding the experience of those involved in efforts to improve or reorganise care may help to explain the impact observed. 1. To review the impact of pre-hospital telemedicine enabled workflow intervention strategies on patient outcomes and on service process metrics in hyper-acute stroke care2. To examine how the experience of those involved in providing or receiving such interventions might identify key characteristics of effective interventions. Quantitative, qualitative and primary mixed methods studies will be included. Quantitative studies will assess effectiveness of telemedicine-enabled interventions that facilitate pre-hospital acute stroke triage. Intervention effects on functional outcomes of patients, on intervention rates and on key time metrics in hyperacute stroke care will be assessed. Qualitative studies will explore the experiences of people involved in or impacted by these interventions. A convergent segregated mixed methods systematic review will synthesise and integrate primary qualitative, quantitative and mixed methods studies using the Joanna Briggs Institute methodology. Database searches will include OVID (MEDLINE), EMBASE, The Cochrane Library, CINAHL and Web of Science. Critical appraisal will include the Mixed Methods Assessment Tool. Results of quantitative studies and findings of qualitative studies will be integrated and configured to explore and contextualize each single method synthesis. This protocol has been submitted for registration with PROSPERO.

Unpacking older adults’ experiences using mobile telepresence robots: A systematic mixed-studies review

This review aimed to explore the experiences of mobile telepresence robots (MTRs) among older adults (OAs) using a systematic mixed-studies approach. Ten electronic databases were searched for published and unpublished studies from inception to January 2022. The mixed methods assessment tool was used to assess the quality of the studies. A results-based convergent synthesis was employed to integrate quantitative and qualitative results. A total of 3,816 records were retrieved, and 43 studies were included, involving 1,568 participants across 19 countries. More than half of the selected studies had high methodological quality. After integrating findings from seven qualitative subthemes and eight quantitative categories, four themes emerged: (1) enjoyable experience, (2) willingness and acceptance, (3) promoting social connectedness, and (4) improved psychosocial and physiological well-being. The MTRs show promising benefits for OAs and their families. Future research should improve the design and functionalities of MTRs to customize different OAs.

Prevalence and factors affecting cancer medication nonadherence among patients on chemotherapy

Introduction: Adherence to cancer medication varies universally with compliance ranging from 70% to 80%. One of the main reasons cited is the cost of anticancer drugs which many may not be able to bear, and yet the cancer with extensive need of aggressive treatment affects the economic condition of people. Inequitable distribution of disease and service utilization poses the threat of an increase in cancer-related deaths due to poor treatment adherence. The suggested systematic review will assess the cancer medication nonadherence prevalence in cancer patients and identify cost-related, sociodemographic, comorbid conditions, and disease-specific aspects of medication nonadherence. Methodology: Eligibility criteria include any cancer patient on oral or intravenous chemotherapy with or without radiotherapy or surgical intervention. Electronic databases will be searched using predefined search terms to identify relevant studies. Observational, experimental, and qualitative studies (if available) will be included. Methodological quality of included studies will be assessed using the Mixed Methods Assessment Tool by Pace et al. Data synthesis will be done following a predesigned data extraction template, answering the research question. Quality of evidence for an association will be evaluated as per the GRADE system. Meta-analysis will be performed to quantify the association between multiple characteristics and nonadherence, if there is no data heterogeneity (tested using I 2 test of heterogeneity). If applicable, meta-regression will be performed to address confounders. Conclusion: The authors have clearly described the methodology and intended outcomes. The findings will help in understanding the potential barriers to successful chemotherapy compliance among cancer patients.

Perceptions, attitudes, awareness and perspectives towards sustainability practices and climate change among nurses: a systematic review protocol

IntroductionClimate change has been described as the most significant threat to humanity and human health to have emerged this century. It is widely accepted that contemporary human activities are the...

An Integrative Review of the Influence on Human Papillomavirus Vaccination Adherence among Adolescents.

To enhance the vaccination rate of adolescents against HPV, understanding their current vaccination intentions and identifying the factors that influence their decision to vaccinate are imperative. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to search for relative literature. Five electronic databases (CINAHL, PubMed, Web of science, Research Information Sharing Service (RISS) and Korea Citation Index (KCI)) were searched from 2007 to 2022, and 19 studies were selected for final review. The Mixed Methods Assessment Tool (MMAT) was used as a critical appraisal tool to evaluate the quality for various types of research designs. This integrative review revealed three themes, including facilitators (personal characteristics and environmental factors), barriers (lack of awareness and knowledge about HPV, concerns about side effects, and the burden of costs), and ways to increase vaccination uptake (knowledge promotion and HPV vaccines coverage by public insurance). To encourage HPV vaccine uptake, it is essential to enhance public knowledge, create compelling advertisements, and ensure that the vaccines are covered by public insurance. Moreover, providing educational programs that emphasize the effectiveness and significance of HPV vaccines to adults who can influence the vaccination decisions of adolescents is vital.

Primary health care capacity assessment in Qatar: the primary health care progression model as an assessment method

Background: The Primary Health Care Performance Initiative (PHCPI) was developed as a measurement of Primary Health Care (PHC) to evaluate the PHC systems, improve services, and maximize health outcomes. With the limitation of data sources and metrics of PHC capacity, PHCPI designed the PHC Progression Model, as a rubric-based mixed-methods assessment tool for capacity measurement through a participatory process. This paper uses the PHC progression model to assess the system capacity of primary health care in Qatar. Methods: The PHC Progression Model consists of a set of 33 quantitative and qualitative measures, each of which is assessed using a rubric that classifies the level of performance into 4 levels, ranging from Level 1 (low capacity) to Level 4 (high capacity). The assessment measured both quantitative and qualitative information. Results: The assessment showed that PHC in Qatar has a strong capacity with an overall score of the key measures of capacity governance (3.6), inputs (4.0), and population health management (4.0). Conclusion: The main strength of the system was in the key inputs such as facility, workforce, fund, information system, and drugs and supply. Also, the assessment showed strong population health and facility management including standardized team organization, measuring performance, community engagement, and use of the information system data. Keywords: Primary health care, progression model, health system evaluation, health care capacity, Qatar

Understanding nurse suicide using an ideation-to-action framework: An integrative review.

The purpose of this integrative review was to explore, appraise and synthesize the current literature on correlates of suicide risk in nurses. Integrative literature review. Cumulative Index to Nursing and Allied Health Literature (CINAHL), Joanna Briggs Institute, PubMed, PsycInfo and Scopus electronic databases were searched for abstracts published between 2005 and 2020. Reference lists were hand searched. The integrative review was based on the Whittemore and Knafl review methodology. Primary qualitative and quantitative studies about suicidal behaviour in nurses published in peer-reviewed journals were included. The methodological quality of included articles was assessed using the Mixed Methods Assessment Tool. Separate correlates of risk and protective factors were identified for suicidal ideation, suicide attempt and death by suicide in nurses. Due to a number of factors at the individual, interpersonal and work levels, nurses are uniquely positioned to be at risk of dying by suicide. The ideation-to-action framework provides a theoretical guide to understand the interplay between correlates and the effect it has on increasing a nurses' capability for suicide. This review integrates the empirical literature to elucidate the concept of suicidal behaviour as it applies to nurses.

Systematic review: Psychological/psychosocial interventions for the families of gender diverse youth under 18 years old.

The aim of this paper is the systematic review of psychological/psychosocial interventions for gender diverse youth under 18years of age and their families, based on the published protocol: PROSPERO 2020 CRD42020163995. A search strategy was developed using key terms. An electronic literature search was completed using the following data bases (OVID MEDLINE; EBSCO CINAHL; ProQuest MEDLINE; OVID PsycINFO). Only studies published in English between 2001-2021 were included. This review is based on PRISMA guidance. Studies meeting inclusion criteria were quality appraised using the Mixed Methods Assessment Tool (MMAT). 8405 studies were independently screened. Four studies met the inclusion criteria for the study. Parents of transgender youth attended between one and 11 psychological/psychosocial group interventions. Parents reported reduced isolation and increased knowledge, which enabled them to advocate for their young person`s needs. Psychological/psychosocial group interventions were creating challenges in terms of group processes, with some parents dominating interactions. Psychological/psychosocial group interventions were positive for parents, but no outcomes were collected for transgender young people. More research is required to understand the role of group facilitators, the optimal group size and the number of psychological/psychosocial intervention sessions required.

Promotors and barriers to the implementation and adoption of assistive technology and telecare for people with dementia and their caregivers: a systematic review of the literature

BackgroundOne of the most pressing issues in our society is the provision of proper care and treatment for the growing global health challenge of ageing. Assistive Technology and Telecare (ATT) is a key component in facilitation of safer, longer, and independent living for people with dementia (PwD) and has the potential to extend valuable care and support for caregivers globally. The objective of this study was to identify promotors and barriers to implementation and adoption of ATT for PwD and their informal (family and friends) and formal (healthcare professionals) caregivers.MethodsFive databases Medline (Ovid), CINAHL, Web of Science, APA PsycINFO and EMBASE were searched. PRISMA guidelines have been used to guide all processes and results. Retrieved studies were qualitative, mixed-method and quantitative, screened using Rayyan and overall quality assessed using Critical Appraisal Skills Programme (CASP) and Mixed Methods Assessment Tool (MMAT). Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria and assigned within categories of high, moderate, or low. NVivo was used for synthesis and analysis of article content. A narrative synthesis combines the study findings.ResultsThirty studies (7 quantitative, 19 qualitative and 4 mixed methods) met the inclusion criteria. Identified primary promotors for the implementation and adoption of ATT were: personalized training and co-designed solutions, safety for the PwD, involvement of all relevant stakeholders, ease of use and support, and cultural relevance. Main barriers for the implementation and adoption of ATT included: unintended adverse consequences, timing and disease progress, technology anxiety, system failures, digital divide, and lack of access to or knowledge of available ATT.ConclusionThe most crucial elements for the adoption of ATT in the future will be a focus on co-design, improved involvement of relevant stakeholders, and the adaptability (tailoring related to context) of ATT solutions over time (disease process).

Mixed-Methods Systematic Review to Identify Facilitators and Barriers for Parents/Carers to Engage Pre-School Children in Community-Based Opportunities to Be Physically Active.

Background: Low physical activity levels in young children is a major concern. For children aged 0-5 years, engagement with opportunities to be physically active are often driven by the adults responsible for the child's care. This systematic review explores the barriers and facilitators to parents/caregivers engaging pre-school children in community-based opportunities for physical activity, within real-world settings, or as part of an intervention study. Methods: EBSCOhost Medline, CINHAL plus, EBSCOhost SPORTDiscus, Web of Science, ProQuest, and ASSIA were systematically searched for quantitative and qualitative studies published in English between 2015 and 16 May 2022. Data extracted from 16 articles (485 parents/carers; four countries) were quality-assessed using the Mixed Methods Assessment Tool and coded and themed via thematic analysis. Results: Nine themes (eight core, one minor) were identified and conceptualised into a socio-ecological model, illustrating factors over four levels: Individual-beliefs and knowledge (and parental parameters); Interpersonal-social benefits, social network, and family dynamic; Community-organisational factors and affordability; and Built and Physical Environment-infrastructure. Discussion: The findings provide valuable insights for practitioners and policy makers who commission, design, and deliver community-based physical activity opportunities for pre-school children. Developing strategies and opportunities that seek to address the barriers identified, as well as build on the facilitators highlighted by parents, particularly factors related to infrastructure and affordability, are imperative for physical activity promotion in pre-school children. The perspectives of fathers, socioeconomic and geographical differences, and the importance parents place on physical activity promotion all need to be explored further.