Program Stakeholders Research Articles

Training for the future of the genetic counseling profession: Exploring the assessment and adaptation of graduate programs' didactic curriculum.

Since the first genetic counseling program (GCP) was established in 1969, there has been a proliferation of growth and demand for genetic counselors. Advances in technology, affordable access to genetic testing, public genomic health initiatives, and diversifying clinical and non-clinical roles comprise a dynamic environment that GCPs must respond to. While there is extensive literature regarding how other health professions adapt their curricula to changing environments, this has yet to be documented and explored for genetic counseling. This study aimed to understand how GCPs evolve their didactic curricula to keep up with the rapidly changing professional landscape. An online survey was used to recruit program leadership of fully accredited GCPs for semi-structured interviews. These interviews explored four critical factors of didactic curricular change, including drivers, implementation, barriers, and mechanisms for evaluation after a change has been made. Interview transcripts were analyzed using reflexive thematic analysis based on iterative discussions with prioritization of excerpts from the codes that had been most commonly applied across multiple transcripts. Multiple factors were identified that program leadership must appropriately weigh when making curricular change decisions. The factors that were considered major influences by all participants included national accreditation standards, program stakeholders, sponsoring institutions and local genetic counseling communities, and the genetic counseling profession as a whole. Our data also demonstrated the extensive role program leadership plays in the adaptation of didactic curricula. With GCP leadership constantly identifying, implementing, and evaluating complex didactic curricular change, there is a need for further exploration of this topic and development of genetic counseling specific resources and tools.

How Does Transitioning to Primary Human Papillomavirus Screening Impact Colposcopy Services? Lessons From an Australian National Program.

In 2017, Australian's National Cervical Screening Program changed from 2-yearly cytology to 5-yearly primary human papillomavirus (HPV) testing. The Stakeholder Opinions of Renewal Implementation and Experiences Study (STORIES) aimed to capture stakeholder perspectives during implementation of the renewed National Cervical Screening Program. Qualitative semistructured interviews were conducted with key National Cervical Screening Program stakeholders 11-20 months following the change, either face-to-face, online, or via phone. Data related to colposcopy services were thematically analyzed using Proctor's conceptual framework for implementation outcomes. The authors identified 4 overarching themes: non-adherence to guidelines, lack of preparedness, unintended consequences, and mitigation strategies. While an initial increase in colposcopy referral was expected following transition, many stakeholders found increased referrals to be inequitably spread across services and exacerbated by confusion about, or overuse of testing for, symptoms. The study provides the first assessment of stakeholder perceptions and experiences relating to colposcopy services during a transition from cytology to HPV screening. Significant preparation is required to ensure equitable and timely access to colposcopy when transitioning cervical screening programs, including wide stakeholder communication to build confidence; clear guidelines, especially around symptoms; and adequate resourcing for colposcopy services to meet projected referral rates.

Stakeholder Synergy Analysis in the Reksa Village Program in Sleman Regency

Social change in all fields can have the potential for social conflicts. The diverse conditions of Sleman Regency certainly have a very positive influence on the acceleration of development in Sleman Regency The potential for social conflicts must be managed properly through the Village Mutual Program (Village Movement for Early Detection and Prevention towards Safe Villages). This movement is based on the independence of community members together with the village government to create immunity in their environment from all forms of problems that have the potential for social conflicts. The purpose of this study is to analyze the level of synergy of stakeholders in the Village Mutual Program in Sleman Regency. This research uses a descriptive qualitative method. The results of this study show that the synergy between stakeholders in the Village Mutual Program is found in 5 (five) indicators (communication network structure, reciprocal/response relationships, standard measures and activity procedures, cooperation/coordination and trust between parties) which are tested on 4 (four) stakeholders obtained an average score of 75%, meaning that the level of stakeholder synergy in the Village Mutual Program in Sleman Regency is already good.

Common intestinal parasitic infections in an improved water access, sanitation, and hygiene profile setting in North Jakarta, Indonesia.

Intestinal parasitic infections (IPIs), caused by helminths and/or protozoa, continue to be a significant public health concern in Indonesia. Water access, sanitation, and hygiene practices (WASH) are influential factors for IPIs, especially among children. The aim of this study was to investigate the association between WASH and IPIs among school-aged children. A cross-sectional study involving 338 school-age children in an urban slum area in North Jakarta, Indonesia, was conducted using stool specimens subjected to microscopic and real-time polymerase chain reaction (rt-PCR) examination. The children underwent a finger-prick blood test and anthropometric measurements to determine anemia and nutritional status. Parents whose children participated in stool and blood examinations were interviewed using a modified WASH questionnaire. Helminth infections were not found in this study, whereas the overall prevalence of intestinal protozoa parasitic infection (IPPI) was 18.3% and 52.4% by microscopy and rt-PCR, respectively. Blastocystis spp. was found to have the highest prevalence (microscopy: 12%; rt-PCR: 48.6%), followed by Giardia intestinalis (microscopy: 0.6%; rt-PCR: 6.7%), Cryptosporidium spp. (microscopy: 5.1%; rt-PCR: 1.6%), and Entamoeba histolytica/dispar (microscopy: 0.6%; rt-PCR: 3.2%). Additionally, Dientamoeba fragilis was detected by rt-PCR at 4.1%. Furthermore, the discrepancies between microscopy and rt-PCR were observed in 8.9% (n = 28) of the examined specimens. The majority of the respondents had a low-risk category of WASH profile. School children aged 5-10 years old (OR = 2.06; 95%CI = 1.27-3.33) and those who drank unprocessed cooking water (OR = 1.95; 95%CI = 1.07-3.57) were significantly associated with IPPI. The present study demonstrated that rt-PCR provides a better understanding of IPI epidemiology and has potential as a monitoring strategy for managing IPIs. Even though this population exhibits an adequate WASH profile and is not directly associated with IPIs, conducting a more in- depth observation of WASH facilities and practices is recommended to ensure a comprehensive assessment of the WASH profile. Additionally, engaging stakeholders in health promotion programs to ensure the sustainability of a good WASH profile and awareness of parasitic infections will be advantageous in achieving optimal urban health.

Exploring System Context Contributing to Emerging REDD+ Collaborative Governance Regime in Ghana: Stakeholders Perceptions at the National Level.

Since its emergence in 2007, the global mechanism for Reducing Emissions from Deforestation and Degradation in developing countries (REDD+) has raised hopes of providing cost-effective solutions to climate change. However, the design and implementation of REDD+ projects in many developing countries, including Ghana, have faced complex governance challenges. In recent years, a collaborative governance approach has been increasingly recommended for effective REDD+ implementation, but the impact of the dynamics of developing countries' context on collaboration success remains unclear. Using Ghana's Cocoa Forest REDD+ Programme (GCFRP) as a case study, this paper aims to increase our understanding of how the dynamics of developing countries' context affect the drivers shaping the initiation of REDD+ collaborative regimes for transforming cocoa forest landscapes. Through qualitative content analysis of document reviews and semi-structured interviews with national program stakeholder groups, the results indicate that Ghana's dynamic context facilitates collaboration on REDD+ implementation when stakeholders feel uncertain about the future availability of forest resources and recognize their interdependence in responding to such issues. Additionally, the findings of the study indicate that strong political will for change, along with strategic windows of opportunity created by REDD+ funding mechanisms, play a vital role in shaping consequential incentives essential for aligning stakeholder interests and fostering cross-sector leadership for initiating the REDD+ collaborative governance regime. While the applicability and limitations of the IFCG framework are discussed, further in-depth studies at project levels are crucial to understanding local stakeholders' perspectives on the key elements necessary for successful collaboration.

Russian Business and the Authoritarian Welfare State

Authoritarian regimes widely involve non-state actors in social welfare to increase output legitimacy and regime stability. Despite the volume of corporate social investments, the role of private companies in authoritarian welfare is still poorly understood. This study analyzes the functioning of corporate social programs in the Russian authoritarian welfare state by focusing on corporate grant competitions and corporate volunteering as means of engaging both the local population and the companies’ employees in the regions. Drawing on stakeholder theory, it investigates how companies position themselves as welfare providers and how they legitimize their role with regard to key stakeholders, including state officials, employees, and the local population. The analysis is based on in-depth interviews with company representatives and key stakeholders in four Russian regions: Kemerovo, Khanty-Mansi Autonomous Region, Tiumen′, and Volgograd. In addition, corporate social reports from 2018 and information for beneficiaries were evaluated to identify program guidelines, motivations, and stakeholder assessments. The study argues that companies play an important role as welfare providers through the financial support of social organizations and employee initiatives at the regional and the local level. By providing social investments in geographically defined “territories of presence,” Russian companies pursue a double legitimation strategy, both demonstrating their social responsibility and loyalty toward the regime and strengthening authoritarian welfare provision through private social investments. With a detailed analysis of corporate social programs, this study contributes to our understanding of the specific conditions and mechanisms of social policy in authoritarian regimes and the place that companies occupy within it.

The Impact of Youth Leadership Program on Perceived Employability Skills: Evidence from Brunei Darussalam

Youth leadership programs foster skills development in youth which are pivotal for gaining successful careers and being more employable throughout their career. Given the concerning youth unemployment issues in Brunei, the study aims to highlight the importance of youth leadership programs and examine their influence on perceived employability skills. By utilising structural equation modelling to analyse the survey data gathered from 229 samples of participants from youth leadership programs, it was revealed that the impact of learning involving skills-based and attitudinal outcomes has significant positive relationships with perceived employability skills. The results further confirmed the role of behavioural outcomes as a mediating variable in the relationship between learning and perceived employability skills. Findings from this study can be valuable for program designers, practitioners, and stakeholders in contributing to the process of structuring and making ongoing improvements to these programs to align with the essential employability skills. It also offers youth the foundation to be employable in the 21st-century job market, by highlighting the importance of youth leadership programs as a channel through which youth acquire desirable capabilities necessary for attaining a set of attributes that reflect the employability skills sought by employees in the current competitive job market. Therefore, the study can be a starting point in moving forward to mitigate the unemployment issues in Brunei through improving programs to meet the demand of employers concerning employability skills. The study provides notable contributions to the existing body of literature on youth leadership development in Brunei as well as contributing to a few other studies in the Asian region to demonstrate the impact of youth leadership programs on employability skills perceptions.

A program evaluation of the new choices workforce development program: An appreciative inquiry approach

A significant amount of money ($1.76B annually in the United States) is spent on workforce development programs, while there is limited research on the effectiveness of workforce development programs in meeting their program objectives and assisting program participants in attaining employment. This study evaluated the New Choices Program, a workforce development program offered by PA Women Work, to help its clients obtain employment and overcome personal and professional barriers. The program has historically been offered in a 30-hour in person format but was forced to be modified to a 10-hour virtual program when the COVID-19 pandemic restrictions began. This program evaluation included a comparative analysis of the perceptions of participants in the 30-hour in person program and the 10-hour virtual program. It was found that participants in both the 30-hour in person program and 10-hour virtual program perceived the program positively, experienced an increase in self-confidence and belonging, which led to either obtaining employment or being better prepared for the job search process. The data will help inform the New Choices program stakeholders on programmatic improvements and how best to structure the program in the post-pandemic employment world.

Improving discharge times for patients admitted for allogeneic stem cell transplantation.

290 Background: Among patients admitted for allogeneic stem cell transplant (SCT) at University of Virginia (UVA) Health from 01/2022 through 12/2022, 0% were discharged by noon, even when discharge was anticipated. The discharge of SCT recipients is dynamic, impacted by events occurring throughout admission. Delays in discharge can result in patient/provider dissatisfaction, postponed admissions, additional costs, and poor utilization of healthcare resources. Methods: A multidisciplinary team of licensed providers, pharmacists, nurses and key stakeholders in the SCT program attended ASCO’s Quality Training Program in 2023, with the aim of increasing the percentage of patients discharged by noon to 20%. After review of baseline data and development of current and ideal process maps, the team distributed a survey to the department to identify perceived sources of delay. Results were corroborated with baseline data and arranged into a pareto chart and priority matrix to synthesize an action plan. The most commonly identified causes for discharge delay included: medication delivery time, complex medication issues, and delay in placing the discharge order. Results: From 10/2023 through 12/2023, the first PDSA cycle focused on anticipation of discharge and prompt placement of the discharge order, which was identified as a process measure. A discharge checklist was created via EPIC smartphrase and incorporated into daily progress notes. Data analysis demonstrated no change in the percentage of patients discharged by noon, but did show numerical improvement in the average time of discharge order placement and discharge time. The second PDSA cycle from 01/2024 through 05/2024 involved standardization of the team responsible for discharging SCT patients, with continued use of the smartphrase. Subsequently, the percentage of patients discharged by noon increased to 14.3%, with significant improvement in the time of discharge order placement and discharge time from baseline (see Table). Conclusions: Through implementation of quality improvement concepts, our team was able to improve our process measure of discharge order placement time. While we have made strides in regards to our outcome measure of percentage of patients discharged by noon, we have not met our goal yet. With continued progress and consistent auditing, we may see improvements in length of stay, bed availability, and financial burden. Future PDSA cycles are planned with an emphasis on medication delivery time. Key times during discharge for patients admitted for allogeneic stem cell transplantation. Mean Baseline PDSA 1 PDSA 2 p-value (PDSA 1 and PDSA 2) Discharge Order Time 11:46 AM 11:09 AM (p ≤ 0.304) 9:32 AM (p ≤ 0.0001) p ≤ 0.023 Discharge Time 4:20 PM 4:03 PM (p ≤ 0.559) 3:08 PM (p ≤ 0.022) p ≤ 0.239 Length of Stay (days) 26.8 25.9 (p ≤ 0.647) 26.6 (p ≤ 0.898) p ≤ 0.663 Medication Delivery Time 2:18 PM 1:00 PM (p ≤ 0.054) 12:18 PM (p ≤ 0.002) P ≤ 0.402

The Educational Experience Improvement Collective for Inpatient Medicine Healthcare Professional Trainees at a University-Affiliated Veterans Affairs Medical Center

Background: Rotation evaluations reflect the resident-perceived value of clinical experiences in graduate medical education. In this study, we sought to improve the quality of education for internal medicine residents during their inpatient medicine rotation. Methods: Program stakeholders critically appraised a core medicine rotation at a university-affiliated U.S. Veterans Affairs Medical Center utilizing end-of-rotation evaluations by residents. Thematic analysis identified three areas for improvement: culture, communication, and workload. Solutions were developed to address each theme: (1) site-specific orientation was provided to new trainees, (2) real-time notification of admissions occurred via secure messaging platform, and (3) an assistive rounding tool was integrated into the electronic medical record. Outcome measures of education were obtained via end-of-rotation evaluations by residents. Results: This study included 198 pre-intervention and 58 post-intervention evaluations by trainees from October 2022 through December 2023. Using a 5-point Likert scale, the quality of education improved from good to very good (3.26 to 4.02, +15%, p < 0.001) over the course of one year. All four subcategories also improved: diversity/quality of pathology (0.33; +7%), supervision (0.50; +10%), workload (0.42; +8%), and learning value (0.51; +10%). When the five categories are compared immediately pre-intervention (fourth quarter of 2022-2023 academic year) to full post-intervention (second quarter of 2023-2024 academic year) using a paired t-test, the change was statistically significant (p = 0.007). Conclusions: Significant educational enhancements were achieved over time for a core rotation in a residency program using solutions developed from interconnected themes found in learner evaluations.

Enhancing the quality of educators for excellence in secondary education in Pariaman city: Policy analysis and quality feasibility

Along with decentralization and regional autonomy, the government encourages regions to develop sensitivity as stakeholders in education development. The government must strengthen its functions in education services, including setting national education policies, standards, performance-based quality control, and fostering coordination across government levels, education units, and society. This study aims to gather data on the policy direction for education implementation and the quality of educators in Pariaman City. Programs like teacher certification and improving education qualifications aim to enhance teacher quality, competence, and prestige, contributing to the improvement of Indonesia's education system. Teachers are encouraged to improve professionalism, teaching quality, and commitment to their profession, ensuring they feel valued and proud in their roles. As a result, there is a need for continuous program development and stakeholder support in Pariaman City, as well as in districts and municipalities, to enhance the quality of basic education, including systematic management of educators.

Policy analysis of the triple burden of malnutrition in children below 5 years of age in Oman

Background: Oman faces the triple burden of malnutrition (TBM) among children under 5 years of age, characterized by stunting, overweight, and wasting. This critical issue impacts children’s healthy development and the country’s progress toward the UN Sustainable Development Goal three addressing good health and well-being. Methods: This study employs secondary data analysis to investigate the prevalence and trends of stunting, overweight, and wasting among children under 5 years of age in Oman, compared with selected Gulf Cooperation Council countries and the Organization for Economic Co-operation and Development (OECD) countries. Data sources include the United Nations International Children’s Emergency Fund, the World Health Organization, and the World Bank Group. Kingdon’s Multiple Streams Framework (MSF) and Howlett’s Policy Implementation Theory are used to critically analyze Oman’s strategies for improving child malnutrition. Results: The prevalence of stunting in Oman decreased from 12.3% in 2012 to 11.6% in 2022. The percentage of children who are overweight increased significantly from 2.9% in 2012 to 6.5% in 2022, surpassing trends in OECD countries. The incidence of wasting was 9.3% in 2017. Conclusion: The three critical aspects to address TBM in Oman are (1) policy gaps (the need for regular follow-up of children under the age of 5 years), (2) implementation barriers (need for regular program review and stakeholder engagement), and (3) the need for tailored interventions. These challenges can be rectified by (1) implementing an expansion of nutrition programs through early education in childcare facilities, (2) increasing parental awareness, and (3) increasing collaboration with healthcare providers (through childcare health programs) for continuous monitoring and support.

A stakeholder perspective on the necessary conditions for successfully implementing parenting interventions in Botswana.

Encouraging positive parenting practices through evidence-based interventions is vital for the achievement of SDG target 16.2, which aims to eradicate all forms of violence against children while promoting their safety and mental wellbeing. As low- and middle- income countries increasingly adopt parenting programs, policymakers and implementers face the challenge of efficiently transporting, adapting, and implementing them across multiple settings. This study seeks to evaluate the real-world experiences, challenges, and best practices in implementing parent support programs in Botswana. A series of interviews with program implementers and stakeholders from governmental and non-governmental organizations were conducted. Key informants from governmental and non-governmental institutions were recruited through purposive and snowball sampling and 17 practitioners participated in the study. Data collection was carried out through online Zoom video conferencing at a convenient time and location for participants. The findings indicate several factors that contribute to the successful implementation of parenting programs in Botswana, including (a) enabling factors such as supportive policies, regulations and guidelines, (b) innovative factors such as capacity building, program adaptation and mixed method program delivery, (c) bridging factors through collaborations with skilled organizations, and (d) intra-organizational factors such as organizational resources, program sustainability, and support for program staff. No single organization or strategy can sustainably foster positive parenting support in Botswana. Instead, a collective and collaborative learning approach is necessary to develop lasting and scalable solutions.

Charting the Course: A Policy Perspective on the Evolution of Kebbi State's Health Sector Annual Operational Planning

<i>Aim</i>: This study aims to provide a comprehensive overview of the Annual Operational Planning (AOP) process, a key health sector planning and harmonization approach, in Kebbi State, Nigeria, from 2020 to 2024, focusing on nine optimal planning parameters: state ownership, stakeholder participation, sector harmonization, evidence-based, timeliness, executive sign-off, quarterly tracking, dissemination, and sustainability. <i>Methods</i>: Review of AOP program reports, state-relevant reports, and stakeholders’ interviews. Employing a mixed-methods research design, the study integrates quantitative data derived from secondary sources like annual reports and policy documents with qualitative data from semi-structured interviews with key stakeholders. Descriptive statistics and time-series analysis are used for quantitative data to study progress and trends in each milestone, while thematic analysis of interview transcripts helps to elucidate factors influencing implementation and outcomes. <i>Results:</i> Findings highlight a progressive improvement in the annual operational planning across several of the planning parameters over the years from the baseline in 2020, including in participatory engagement of the lower levels of the health sector (bottom-up approach), using evidence to inform planning; timely development of the AOP to inform health budget; and regular tracking of the plan. However, challenges persist in the government funding of stakeholders’ engagement, particularly the bottom-up approach at the Local Government Health Authorities (LGAs) level, which may affect the inclusiveness of the process in the future. <i>Conclusion</i>: The study concludes that the annual operational planning in Kebbi State has seen notable improvement across multiple planning parameters, assuring the effectiveness and sustainability of the process as a key planning tool. However, allocating adequate resources, including budget and human resources, to facilitate a participatory approach in the AOP development process is critical for continuous success. This study contributes to the broader discourse on health sector planning in developing contexts, offering valuable insights for policymakers, health managers, and stakeholders in designing and implementing effective and harmonized health plans.

Evaluating Experiences in a Digital Nutrition Education Program for People With Multiple Sclerosis: A Qualitative Study.

Multiple sclerosis (MS) is a complex immune-mediated disease with no currently known cure. There is growing evidence to support the role of diet in reducing some of the symptoms and disease progression in MS, and we previously developed and tested the feasibility of a digital nutrition education program for people with MS. The aim of this study was to explore factors that influenced engagement in the digital nutrition education program, including features influencing capability, opportunity and motivation to change their dietary behaviours. Semi-structured interviews were conducted with people who had MS, and who completed some or all of the program until data saturation was reached. Interviews were analysed inductively using thematic analysis. Themes were deductively mapped against the COM-B (Capability, Opportunity, Motivation, Behaviour) behaviour change model. Sixteen interviews were conducted with participants who completed all (n = 10) or some of the program (n = 6). Four themes emerged: (1) acquiring and validating nutrition knowledge; (2) influence of time and social support; (3) getting in early to improve health and (4) accounting for food literacy experiences. This is the first online nutrition program with suitable behavioural supports for people with MS. It highlights the importance of disease-specific and evidence-based nutrition education to support people with MS to make dietary changes. Acquiring nutrition knowledge, coupled with practical support mechanisms, such as recipe booklets and goal setting, emerged as crucial for facilitating engagement with the program. When designing education programs for people with MS and other neurological conditions, healthcare professionals and program designers should consider flexible delivery and building peer support to address the needs and challenges faced by participants. Members of the MS Nutrition Research Program Stakeholder Reference Group, which includes people with MS and MS health professionals, provided input during the development of the nutrition education program and study design stages.

Comprehensive evaluation of malaria reactive surveillance and response strategies in Lao People’s Democratic Republic: a mixed-methods study

ObjectivesTo achieve malaria elimination by 2030, the Lao People’s Democratic Republic (PDR) adopted a reactive surveillance and response (RASR) strategy of malaria case notification within 1 day, case investigation and...

Addressing mental illness stigma in German higher education: study protocol for a mixed-methods evaluation of a psychosocial setting-based intervention

IntroductionMental illness stigma is associated with a range of negative consequences, such as reduced help-seeking for mental health problems. Since stigma affects individual, social, and structural aspects, multilevel interventions such...

Physical activity policies in Saudi Arabia and Oman: a qualitative study using stakeholder interviews

BackgroundCountries in the Middle East have some of the lowest rates of physical activity and some of the highest rates of obesity in the world. Policies can influence population levels of physical activity. However, there is a dearth of research on physical activity policies in the Gulf region. This qualitative study analyses cross-sectoral barriers and facilitators for the development, implementation and evaluation of physical activity policies in Saudi Arabia and Oman, two of the largest countries in the region.MethodsSemi-structured interviews were conducted with 19 senior policymakers from the Ministries of Health, Education, and Sport in Saudi Arabia and Oman, and were examined using thematic analysis.ResultsWe identified seven themes related to physical activity policies in Saudi Arabia and Oman: leadership; existing policies; physical activity programs related to policies; private sector policies; challenges; data/monitoring; and future opportunities. Both countries have a central document that guides policy-makers in promoting physical activity, and the available policies in both countries are implemented via multiple programs and initiatives to increase physical activity. Compared with Oman, in Saudi Arabia, programs from the non-profit sector, represented by community groups, play a more significant role in promoting physical activity outside the government framework. The private sector has contributed to promoting physical activity in both countries, but interviewees stated that more financial support is required. Policy limitations differ between Saudi Arabia and Oman: intersectoral collaboration in Oman is limited and mainly based on individuals’ own initiative, while the health transformation in Saudi Arabia tends to slow down policy implementation in relevant areas. Physical education in Saudi Arabia and Oman is similar; however, increased support and collaboration between government agencies and the private sector for out-of-school sports academies are needed.ConclusionsThis study addresses key gaps in analysing physical activity policies in Gulf Cooperation Council countries. Our study highlights the importance of increasing financial support, improving collaboration between governmental agencies and between them and the private sector and consolidating efforts to back physical activity policies and dismantle cross-sectoral barriers in Saudi Arabia and Oman. Educational institutions in Saudi Arabia and Oman play a crucial role in promoting physical activity from early childhood to young adults. Our insights assist policy-makers, public health officials and stakeholders in shaping effective physical activity-promoting policies, programs and interventions to prevent non-communicable diseases. Challenges identified in Saudi Arabia and Oman's policies will inform their future development.

Characterization of the typology of producers in the “sembrando vida” program in Oaxaca, Mexico

In Mexico, research work documented at plot in the field or producer level is uncommon and with limited information, due to the fact that it is expensive and requires specialized personnel. This research work carried out by the National Institute of Forestry, Agriculture and Livestock Research (INIFAP) and financed by the National Council of Humanities, Science and Technology (CONAHCYT) was based on a field diagnosis to determine the description of the typology of the participating "sowers'' producers enrolled in the Sembrando Vida Program (PSV), of the Federal Goverment of Mexico belonging to the state of Oaxaca, and thus, be able to implement strategies for training and follow-up attention on a massive scale. A total of 383 sample surveys were analyzed from a population of 37,719 small producers representing an estimated crop area of 56,578 hectares distributed in two regions of the state of Oaxaca. It is concluded that the diagnosis continues to be a fundamental information tool to identify and address more precisely and timely the problems at the farmer's plot level and with any type of crop. Another fundamental activity was the visit or technical visits to the territories that are representative of the regions in order to validate the information obtained. With the results obtained in this research, it was possible to address the main problems through personalized and directed technical assistance under the scheme of field schools (learning-by-doing) throughout the development of annual and fruit crops that the planters have in the MIAF within their PUPs (Small Production Units). Likewise, insert the main training needs at the express and consensual request of all program stakeholders: researchers-trainers, PSV technicians and sowers.

Community-based health programme for nurses and midwives: A mixed methods evaluation.

To evaluate a community-based psychological health and well-being programme for nurses and midwives. Mixed methods programme evaluation. Four studies were included: observational descriptive study (cross-sectional survey) of the health, well-being and experiences of previous programme participants (Study 1); observational exploratory prospective cohort study (longitudinal survey) of health, well-being and experiences of participants who engaged in the programme from 2020 to 2023 (Study 2); qualitative descriptive study (interviews) of experiences and perceptions of nurses and midwives who have engaged with the programme as participants or clinicians (Study 3); observational descriptive study (cross-sectional survey) of experiences and perceptions of programme stakeholders (Study 4). Surveys included validated measures. Data were collected online. Descriptive, repeated measures and thematic analyses were conducted. One-hundred and fifteen participants completed Study 1: 20% (n = 23) reported stress in the severe-to-extremely severe category; 22% (n = 25) reported psychological distress in the moderate-to-severe category. Thirty-one programme participants were followed in Study 2: the effect of the programme on participant well-being over time was not significant. Sixteen programme participants and eight programme clinicians were interviewed (Study 3). Experiences of nurses and midwives engaging with the programme were highly positive and strong attributes of the programme included (1) shared professional experience of clinicians and participants which supported a common language and facilitated understanding, and (2) effective programme leadership, and autonomy and flexibility in the clinicians' role which enabled and supported a positive working experience. Thirty-nine broader stakeholders participated in a cross-sectional survey (Study 4). All stakeholders reported high satisfaction with the programme. Participants considered the programme being 'by nurses and midwives, for nurses and midwives' critical to the programme's success and value. The community-based psychological health and well-being programme developed, led and delivered by nurses and midwives, for nurses and midwives, was a highly valued resource. Levels of stress and burnout in the health workforce are high. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives. A programme delivered by nurses and midwives, for nurses and midwives, was considered critical to programme success. Programme leadership, and autonomy and flexibility in the programme clinicians' roles, facilitated and supported a positive working experience for programme clinicians. Quality and safety in patient care is directly impacted by the well-being of nurse and midwives. A community-based psychological health and well-being programme for nurses and midwives was found to be an important and highly valued resource for nurses and midwives. Survey findings were reported according to STROBE (von Elm etal. in Lancet, 370:1453-1457, 2007) and qualitative findings according to COREQ (Tong etal. in International Journal for Quality in Health Care, 19(6):349-357, 2007). No patient or public contribution.