Health Policy Stakeholders Research Articles

Adaptation and Validation of the Psychological Consequences of Screening Questionnaire (PCQ) for Cognitive Screening in Primary Care.

Context-specific measures with adequate external validity are needed to appropriately determine psychosocial effects related to screening for cognitive impairment. Two-hundred adults aged ≥65 y recently completing routine, standardized cognitive screening as part of their Medicare annual wellness visit were administered an adapted version of the Psychological Consequences of Screening Questionnaire (PCQ), composed of negative (PCQ-Neg) and positive (PCQ-Pos) scales. Measure distribution, acceptability, internal consistency, factor structure, and external validity (construct, discriminative, criterion) were analyzed. Participants had a mean age of 73.3 y and were primarily female and socioeconomically advantaged. Most had a normal cognitive screening result (99.5%, n = 199). Overall PCQ scores were low (PCQ-Neg: = 1.27, possible range 0-36; PCQ-Pos: = 7.63, possible range 0-30). Both scales demonstrated floor effects. Acceptability was satisfactory, although the PCQ-Pos had slightly more item missingness. Both scales had Cronbach alphas >0.80 and a single-factor structure. Spearman correlations between the PCQ-Neg with general measures of psychological distress (Impacts of Events Scale-Revised, Perceived Stress Scale, Kessler Distress Scale) ranged from 0.26 to 0.37 (P's < 0.001); the correlation with the World Health Organization-Five Well-Being Index was -0.19 (P < 0.01). The PCQ-Neg discriminated between those with and without a self-reported subjective cognitive complaint ( = 2.73 v. 0.89, P < 0.001) and was associated with medical visit satisfaction (r = -0.24, P < 0.001) on the Patient Satisfaction Questionnaire. The PCQ-Pos predicted self-reported willingness to engage in future screening ( = 8.00 v. 3.00, P = 0.03). The adapted PCQ-Neg is an overall valid measure of negative psychological consequences of cognitive screening; findings for the PCQ-Pos were more variable. Future studies should address measure performance among diverse samples and those with abnormal screening results. The PCQ scale is an overall valid measure of psychological dysfunction related to cognitive screening in older adults receiving normal screen results.PCQ scale performance should be further validated in diverse populations and those with abnormal cognitive screening results.The adapted PCQ may be useful to both health research and policy stakeholders seeking improved assessment of psychological impacts of cognitive screening.

Promoting successful health care transitions for young people aging out of foster care.

Improving adolescent to adult health care transitions (HCTs) would benefit all young people in the United States but has particular importance for the more than 120,000 adolescents and young adults (AYA) placed in foster care. Leveraging clinical guidelines and evidence-based interventions, HCT efforts inclusive of and specific to AYA placed in foster care can be strengthened through greater collaboration between child welfare, health care, and other AYA-serving systems. This Health Policy Brief advances the importance of structured Health Care Transition services for adolescents and young adults placed in foster care. Additionally, it highlights opportunities for health care providers, youth-serving systems, and health policy stakeholders to collaborate with child-welfare involved young people in order to prioritize evidence-based health care transition interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Contextual awareness, response and evaluation (CARE) of diabetes in poor urban communities in Ghana: the CARE diabetes project qualitative study protocol

ABSTRACT Diabetes remains a major, global clinical and public health threat with consistent rises in prevalence around the world over the past four decades. Two-thirds of the projected increases in global diabetes prevalence to 2045 are expected to come from low- and middle-income countries, including those in sub-Saharan Africa. Ghana is typical of this trend. However, there are gaps in evidence regarding the appropriate development of interventions and well-targeted policies for diabetes prevention and treatment that pay due attention to relevant local conditions and influences. Due consideration to community perspectives of environmental influences on the causes of diabetes, access to appropriate health services and care seeking for diabetes prevention and management is warranted, especially in urban settings. The ‘Contextual Awareness, Response and Evaluation (CARE): Diabetes in Ghana’ project is a mixed methods study in Ga Mashie, Accra. An epidemiological survey is described elsewhere. Six qualitative studies utilising a range of methodologies are proposed in this protocol to generate a contextual understanding of type 2 diabetes mellitus in an urban poor population. They focus on community, care provider, and policy stakeholder perspectives with a focus on food markets and environmental influences, the demand and supply of health services, and the history of the Ga Mashie community and its inhabitants. The results will be shared with the community in Ga Mashie and with health policy stakeholders in Ghana and other settings where the findings may be usefully transferable for the development of community-based interventions for diabetes prevention and control.

Factors Influencing the impact of nurse practitioners' clinical autonomy: a self determining perspective.

To explore factors that influence the impact of nurse practitioners' clinical autonomy with a self-determining perspective. Worldwide, there is a significant demand for healthcare professionals such as the nurse practitioner in meeting some healthcare needs across patients' lifespans. Factors influencing nurse practitioners clinical autonomy can impact the full utilisation of the role in practice. Limited evidence exists that describes or researches nurse practitioner clinical autonomy. Instead, there is a focus in the literature on strategic debates, role confusion and nurse practitioners reporting the straddling between nursing, allied heath professionals and medicine in the provision of healthcare services. A cross-sectional study design was used in a purposive sample in a national sample of nurse practitioners in Ireland across a full range of healthcare settings. Additionally, the survey included open comments sections to capture qualitative comments by the nurse practitioners themselves. Self-determination theory is rooted in an organismic dialectical stance. This study used a convenience sample of n = 148 from a total sample of n = 448 (33%) of the population. The Dempster Practice Behavioural Scale and an initially validated advanced nursing practice clinical autonomy scale were used. Open comments were analysed by thematic analysis. STROBE Standards guidelines for cross-sectional studies were followed, and COREQ guidelines were followed for writing qualitative research. The study findings demonstrated that the more clinical experience the nurse practitioner had, the higher their levels of clinical autonomy. The previous length of nursing experience did not impact nurse practitioner clinical autonomy levels. However, average experience of nurse practitioner' in this study was 3-10 years. No significant differences existed between the reported gender, nurse practitioners' clinical autonomy and decision-making. 1:40 female and 1:9 male nurse practitioners undertook a doctorate or PhD-level education. No advanced nurse practitioner identified as non-binary. Gender and organisational culture considerations can influence nurse practitioners clinical autonomy. This study highlights intrinsic motivators that support nurse practitioners in providing innovative healthcare: competence, relatedness and clinical autonomy. Countries credentialing, regulations professional standards and healthcare policy positively influence nurse practitioner clinical autonomy. Nurse practitioners' clinical autonomy is championed when health policy and organisational stakeholders intrinsically collaborate. A disconnect between health policy organisational culture extrinsically influences lower levels of nurse practitioners' clinical autonomy. The findings underline the positive impact of nurse practitioner clinical autonomy. A recommendation of this study is to continue to measure impact of clinical autonomy anddevelop nurse practitioners' self-determination strategies around the role and integrity of their levels of intrinsic clinical autonomy.

Lived experience of critical care nurses serving in awar zone: A phenomenological study.

War has always been a part of human life, and nurses are among the first people to attend to the battlefield alongside the soldiers. Nurses' experiences of being in war zones have long been of interest to researchers. In the conflicts in Syria, Iranian nurses have played a crucial role in saving the lives of many people. This qualitative study aims to explore the lived experience of Iranian critical care nurses deployed to battlefields in Syria between 2014 and 2020. This qualitative study adopted a hermeneutic phenomenology approach using Van Manen's methodology. The data was obtained through semi-structured in-depth interviews with 15 nurses who experienced war zones. Purposive sampling was used and interviews with the participants were conducted at the agreed place. Interviews were recorded, wrote verbatim and analysed with MAXQDA10 software. COREQ, a 32-item checklist, guided method selection, data analysis and the findings' presentation. The four main themes that emerged include 'blossoming of talents on the battlefield', 'capable nurses at war', 'nursing jihad' and 'mental preoccupations'. These themes include 12 subthemes and 32 primary subthemes that explain the meaning of Iranian nurses being in war zones in Syria. Nurses in the war zones of Syria gained valuable experiences of the blossoming of talents in themselves and others. The lived experiences of the nurses revealed that working in the war zones of Syria is a concept of nurses' capabilities. They considered being in the war zones of Syria as a form of nursing jihad. In spite of the many positive aspects of their experience, the nurses expressed their mental preoccupations during their deployment. Nursing care in a war zone for the critically wounded is a unique experience. The experience and ongoing impact of those experiences offer invaluable information for nursing and health policy stakeholders who are planning future deployments.

The Relationship Of Clean Water And Environmental Sanitation To The Incident Of Diarrhea: Systematic Review

Indonesia is one of the developing countries that experiences diarrhea problems. This is because of its high morbidity and mortality. Diarrhea is an endemic disease that has the potential to cause Extraordinary Events (KLB) which are often accompanied by death in Indonesia. Most diarrheal diseases can be prevented through safe drinking water and adequate sanitation and hygiene. This study aims to determine the relationship between environmental sanitation and the incidence of diarrhea in toddlers. This research uses a systematic review method (Systematic Review) which is a research method for identifying, evaluating, and interpreting research results that are relevant to a particular research topic, or phenomenon that is the focus of the research. The results of this research show that there is a relationship between environmental sanitation such as the physical quality of water, ownership of a toilet, type of floor in the house, and the incidence of diarrhea. It is hoped that after this research is carried out, mothers and health policy stakeholders such as the health department and community health centers can improve residential environmental health programs to have physically clean water quality and good environmental sanitation. Keywords: Environmental Sanitation, Diarrhea, Toddlers, Systematic Review

The Covid-19 Pandemic Public Policies: The United Nations, The European Union and Türkiye

This study delves into the public policies implemented by the United Nations (UN), the European Union (EU), and Türkiye in their endeavors to combat the Covid-19 pandemic, which was initially reported to have emerged from the city of Wuhan in the Hubei province of the People's Republic of China in late 2019. Specifically, the study aims to examine and analyze the effectiveness of these actors in managing the Covid-19 and its impact on public health, the economy, and social well-being. Through a comparative lens, the study seeks to shed light on the national and global efforts undertaken by these actors to protect public health and mitigate the socio-economic consequences of the pandemic. To achieve its objectives, the study begins with providing a comprehensive understanding of the concept of public policy and its relevance in the context of managing public health crises. Furthermore, by providing a historical analysis of past pandemics, it engages in discussions on drawing lessons from previous experiences for the current pandemic's management and policymaking. Subsequently, the strategies that pursued by UN, the EU and Türkiye in tackling the Covid-19 outbreak are critically examined and evaluated. In order to make a comparison between different political organizational levels (international organization, regional cooperation, and nation-state) in combating the pandemic, these actors have been selected. The study assesses the efficacy, effectiveness, adaptability, problem-solving capacity, and establishment of global solidarity through an evaluation framework, which encompasses various criteria by using qualitative analysis methods. Subsequently, the study seeks to offer nuanced insights into the strengths, limitations, and lessons learned from the public policies formulated and implemented by these actors during the Covid-19 pandemic. By undertaking this academic inquiry, the study would contribute to the scholarly surrounding pandemic management and public policy formulation. It also contributes to the understanding of the effectiveness and impact of public policies in the context of a global health crisis and provides a background for public health policy makers and stakeholders. The analyzed public policies show that the actors basically pursue similar policies, but there are differences in terms of timing.

The fertility care gap in the Global South: lessons from The Gambia, West Africa, and ways forward to establish fertility care for all

Infertility is a neglected global public health issue affecting an estimated 56–72 million couples worldwide. The prevention and management of infertility was recognized as a basic component of sexual and reproductive health at the landmark 1994 International Conference on Population and Development, yet progress in this area remains limited. Interdisciplinary research has been conducted in The Gambia, West Africa, since 2016, with communities, women’s organizations, clinicians, and health policy and systems stakeholders, to identify key gaps in fertility care, and to better understand the delivery of infertility services. A partnership between the Ministry of Health, Safe Haven Foundation, and international researchers helped create The Gambia’s National Infertility Awareness Campaign and gave birth to the Fertility Care Policy Dialogue supporting the inclusion of infertility in The Gambia’s new 10-year National Health Policy. It also helped to establish the White Rose Interdisciplinary Network on Fertility Care in the Global South. To date, the network has more than 60 members globally, including researchers, health workers, policy makers, and activists who work together on infertility awareness raising, policy change, and system strengthening, with the aim of improving equitable access to fertility care for all. Here, we introduce the network and draw on key lessons from ongoing infertility-related research in The Gambia.

The Policy to Prevention Services Tuberculosis Using Standardized and Directed Services

The Probolinggo Government's efforts to support the accelerated program to eradicate tuberculosis in 2030, followed by Permenkes Number 64 of 2016 concerning Tuberculosis Control, experienced obstacles in Probolinggo Regency. The number of tuberculosis case findings in Probolinggo Regency in 2021 is only 1,193 or 46.41% compared to the target of 2,572. However, tuberculosis patients are worried they will be diagnosed with the Covid-19 virus because of similar symptoms, so they are reluctant to go to the Puskesmas. This study aimed to describe and analyze the implementation of health centre service policies for tuberculosis patients based on Permenkes Number 67 of 2016, along with the supporting and inhibiting factors at the Kraksaan Health Center, Probolinggo Regency. The location of research was carried out at the Kraksaan Health Center in Probolinggo Regency with the consideration that it has a conducive situation and condition because it is located near the Probolinggo Regency government centre and is a reference for tuberculosis services that the East Java Provincial Health Office has appointed. The research method used is qualitative descriptive research using a case study technique. The research analysis results show that the implementation of tuberculosis patient service policies at the Kraksaan Probolinggo Health Center has complied with Permenkes Number 67 of 2016. This is driven by several factors, such as standardized and targeted services supported by certified health workers and integration and collaboration between health policy stakeholders in Probolinggo Regency. On the other hand, several obstacles become inhibiting factors, including the lack of socialization of the provision of health service facilities for tuberculosis patients, inadequate facilities and infrastructure, and the reluctance of the public to check themselves.

An intersectional approach to exploring lived realities and harnessing the creativity of ethnic minority youth for health gains: protocol for a multiphase mixed method study

BackgroundUnderstanding the diversity and multiplicity of identities experienced by youth in Aotearoa (Te reo Māori name of the country) New Zealand (NZ) is vital to promoting their wellbeing. Ethnic minority youth (EMY) in NZ (defined as those identifying with Asian, Middle Eastern, Latin American and African ethnic origins) have been historically under-studied and under-counted, despite reporting high levels of discrimination, a major determinant of mental health and wellbeing and potentially a proxy for other inequities. In this paper, we describe the protocol for a multi-year study that examines, using an intersectional approach, how multiple marginalised identities impact mental and emotional wellbeing of EMY.MethodsThis is a multiphase, multi-method study designed to capture the diversity of lived realities of EMY who self-identify with one or more additional marginalised intersecting identity (the population referred here as EMYi). Phase 1 (Descriptive study) will involve secondary analyses of national surveys to examine the prevalence and relationships between discrimination and wellbeing of EMYi. Phase 2 (Study on public discourse) will analyse data from media narratives, complemented by interviews with stakeholders to explore discourses around EMYi. Phase 3 (Study on lived experience) will examine lived experiences of EMYi to discuss challenges and sources of resilience, and how these are influenced by public discourse. Phase 4 (Co-design phase) will use a creative approach that is youth-centered and participatory, and will involve EMYi, creative mentors and health service, policy and community stakeholders as research partners and advisors. It will employ participatory generative creative methods to explore strengths-based solutions to discriminatory experiences.DiscussionThis study will explore the implications of public discourse, racism and multiple forms of marginalisation on the wellbeing of EMYi. It is expected to provide evidence on the impacts of marginalisation on their mental and emotional wellbeing and inform responsive health practice and policy. Using established research tools and innovative creative means, it will enable EMYi to propose their own strength-based solutions. Further, population-based empirical research on intersectionality and health is still nascent, and even more scarce in relation to youth. This study will present the possibility of expanding its applicability in public health research focused on under-served communities.

Concept and study protocol of the process evaluation of a pragmatic randomized controlled trial to promote physical activity in outpatients with heterogeneous mental disorders—the ImPuls study

BackgroundEvidence suggests that patients suffering from different mental disorders benefit from exercise programs combined with behavior change techniques. Based on this evidence, we have developed an exercise program (ImPuls) specifically designed to provide an additional treatment option in the outpatient mental health care system. The implementation of such complex programs into the outpatient context requires research that goes beyond the evaluation of effectiveness, and includes process evaluation. So far, process evaluation related to exercise interventions has rarely been conducted. As part of a current pragmatic randomized controlled trial evaluating ImPuls treatment effects, we are therefore carrying out comprehensive process evaluation according to the Medical Research Council (MRC) framework. The central aim of our process evaluation is to support the findings of the ongoing randomized controlled trial.MethodsThe process evaluation follows a mixed-methods approach. We collect quantitative data via online-questionnaires from patients, exercise therapists, referring healthcare professionals and managers of outpatient rehabilitative and medical care facilities before, during, and after the intervention. In addition, documentation data as well as data from the ImPuls smartphone application are collected. Quantitative data is complemented by qualitative interviews with exercise therapists as well as a focus-group interview with managers. Treatment fidelity will be assessed through the rating of video-recorded sessions. Quantitative data analysis includes descriptive as well as mediation and moderation analyses. Qualitative data will be analyzed via qualitative content analysis.DiscussionThe results of our process evaluation will complement the evaluation of effectiveness and cost-effectiveness and will, for example, provide important information about mechanisms of impact, structural prerequisites, or provider qualification that may support the decision-making process of health policy stakeholders. It might contribute to paving the way for exercise programs like ImPuls to be made successively available for patients with heterogeneous mental disorders in the German outpatient mental health care system.Trial registrationThe parent clinical study was registered in the German Clinical Trials Register (ID: DRKS00024152, registered 05/02/2021, https://drks.de/search/en/trial/DRKS00024152).

Prevalence of congenital heart disease according to the echocardiography findings in 8145 neonates, multicenter study in southern Iran.

Congenital heart disease (CHD), the lethal congenital anomaly in newborns, is multifactorial, with environmental and genetic factors contributing to its occurrence. Although some studies on the prevalence of CHD have been conducted throughout the country, this large-scale study aims to provide information on the prevalence of various types of CHDs in newborns according to the echocardiography findings. Over 3 years, 8145 neonates with suspected CHD who underwent echocardiography by a trained pediatric cardiologist were included in this multicenter, cross-sectional observational study. CHD was categorized into two major groups; cyanotic and acyanotic heart disease. The SPSS version 22 software was used to analyze the data with a significance level set at 0.05. Of 8145 neonates who were referred to our centers with CHD symptoms, 6307 were indicated for echocardiography. The mean age of the studied population was 8.5 ± 9.3 days and the male-to-female ratio was 2.6, especially in the arterial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) groups. 77.2% of patients had acyanotic heart disease (100 in 1000 neonates) with ASD as the most common one and 9% were diagnosed with cyanotic heart disease (11 in 1000 neonates) with transposition of the great arteriesas the most common form and the aortopulmonary window was the rarest form. This large prospective, multicenter screening study reported arterial septal defect (85%) and patents with ductus arteriosus (32%) as the most frequent type of CHD. Moreover, the prevalence of male patients was significantly higher. This information would be helpful for health policy makers, stakeholders, and general practitioners in regions where there are no trained pediatric cardiologist fellowships and limited access to echocardiography devices for better management of CHD.

Co-producing agricultural policy with beekeepers: Obstacles and opportunities

Dominant agricultural practices are widely recognised as one of many factors leading to severe declines in honey bees and other pollinators. Improving the agri-environment for pollinators and other species is an urgent ecological priority. Beekeepers have long been at the forefront of recognising agricultural and environmental challenges to their bees; many of these also impact other pollinators. As the UK moves towards a post-Brexit agricultural policy, this should be an excellent time for beekeepers’ observations and concerns to be recognised, and contribute to a system where farmers and land managers ensure the delivery of ‘public goods’. However, evidence suggests significant obstacles to effectively co-producing agricultural policy that ensures pollinator wellbeing. This paper is based on archival and interview data on long-term beekeepers throughout the UK. Beekeepers’ past experience of engaging with agricultural, and pollinator health policy stakeholders highlights significant obstacles to effective co-production of policy. Beekeepers’ experiential observations are commonly dismissed as anecdotal, and subsequently irrelevant knowledge, according to scientifically and politically acknowledged epistemological categories. Multiple stakeholders in agriculture and land management have opposing priorities, and unequal access to power. This presents significant challenges to government efforts to overcome boundaries and co-produce actionable policy. Internationally, significant steps have been made to incorporate hybrid knowledge, and its associated value systems into environmental governance. Developing agricultural policy which acknowledges and incorporates multiple forms of evidence and pro-environmental values is necessary for a successful post-Brexit agricultural system focused on Environmental Land Management, public goods, and multiple values of nature.

Making the invisible visible: Using a qualitative system dynamics model to map disparities in cumulative environmental stressors and children's neurodevelopment

BackgroundThe combined effects of multiple environmental toxicants and social stressor exposures are widely recognized as important public health problems, likely contributing to health inequities. However, US policy makers at state and federal levels typically focus on one stressor exposure at a time and have failed to develop comprehensive strategies to reduce multiple co-occurring exposures, mitigate cumulative risks and prevent harm. This research aimed to move from considering disparate environmental stressors in isolation to mapping the links between environmental, economic, social and health outcomes as a dynamic complex system using children's exposure to neurodevelopmental toxicants as an illustrative example. Such a model can be used to support a broad range of child developmental and environmental health policy stakeholders in improving their understanding of cumulative effects of multiple chemical, physical, biological and social environmental stressors as a complex system through a collaborative learning process. MethodsWe used system dynamics (SD) group model building to develop a qualitative causal theory linking multiple interacting streams of social stressors and environmental neurotoxicants impacting children's neurodevelopment. A 2 1/2-day interactive system dynamics workshop involving experts across multiple disciplines was convened to develop the model followed by qualitative survey on system insights. ResultsThe SD causal map covered seven interconnected themes: environmental exposures, social environment, health status, education, employment, housing and advocacy. Potential high leverage intervention points for reducing disparities in children's cumulative neurotoxicant exposures and effects were identified. Workshop participants developed deeper level of understanding about the complexity of cumulative environmental health risks, increased their agreement about underlying causes, and enhanced their capabilities for integrating diverse forms of knowledge about the complex multi-level problem of cumulative chemical and non-chemical exposures. ConclusionGroup model building using SD can lead to important insights to into the sociological, policy, and institutional mechanisms through which disparities in cumulative impacts are transmitted, resisted, and understood.

Stakeholder perceptions and public health system performance evaluation: Evidence from Greece during the COVID-19 pandemic

The COVID-19 pandemic has been challenging and testing of public health systems across the globe, engaging them in a prolonged scrutinization of their functions, capacity and resources. While in theory, this process can yield invaluable insights for future policy design and mitigate future adversity, it demands a suitable mode of evaluation. Often, innovative and ambitious legislative frames are a far cry from policymaking realities plagued with institutional and operational deficiencies. As a result, we decide to move past assessments of the de jure status quo and examine the de facto modus operandi through the eyes of the systems' participating agents. We focus on the case of Greece, a country which boasts a modern public health systemic design, aligned with contemporary public health thought and international trends. We develop a new framework iteration for public health system performance evaluation, founded on prominent templates. We rely on elite surveying insights from 261 public health policy stakeholders in Greece, collected between 15.07.2020 and 13.12.2020. We capture the effect of the COVID-19 pandemic both in a latent fashion, through the timing of our survey, and in a direct one, through explicit inquiry. Our results show that the functions of the Greek Public Health System are disproportionally developed, relevant resources come to be narrow in scope and outcomes are suboptimal, failing to fulfill identified aims. Moreover, high centralization, the absence of public health expertise and undeveloped evaluative channels prevent failures from instigating adjustments. The COVID-19 pandemic has brought the system's deficiencies to light forcefully and highlighted the essentiality of scientific inputs. Our conclusions point to an ill-alignment between the system's mission and the ideational orientation of its stakeholders, which is likely to contain structural change if it remains unaddressed. We identify future research agendas and present policy directions for the Greek public health system.

Learning from critical care nurses' wartime experiences and their long-term impacts.

The history of critical care nursing is intertwined with that of battlefield nursing, where for almost 200 years, nurses worked to save injured soldiers' lives, risking their own physical and emotional injuries. Today, with nurses increasingly deployed to provide critical care during natural, man-made and public health crises that can resemble battlefield situations, there is much to learn from battlefield nurses. This qualitative study aims to explore the lessons of the experiences of civilian nurses deployed to Israeli battlefields in three wars between 1967 and 1982. Qualitative, semi-structured, in-depth interviews were conducted with twenty-two former military nurses who were deployed in three wars between 1967 and 1982. We analysed interview transcripts using a content analysis approach. COREQ, a 32-item checklist, guided method selection, data analysis and the findings' presentation. Data analysis revealed three main themes, with ten related subthemes: Field Service Challenges, Coping with Challenges, and Nurses' Need for Recognition. The findings identify mental, emotional, and organizational issues resulting from nurses' wartime experiences, revealing numerous opportunities for better preparing and supporting critical care nurses before, during, and after crises. Critical care nursing during crises, such as wartime, is unique but increasingly common. The memories and ongoing impact of those experiences offer invaluable information for nursing and health policy stakeholders planning for future deployments during wartime or other disasters such as the COVID-19 pandemic and the Russo-Ukrainian war.

What are the barriers to the diagnosis and management of chronic respiratory disease in sub-Saharan Africa? A qualitative study with healthcare workers, national and regional policy stakeholders in five countries

ObjectivesChronic respiratory diseases (CRD) are among the top four non-communicable diseases globally. They are associated with poor health and approximately 4 million deaths every year. The rising burden of CRD...

Recognising Sepsis as a Health Priority in Sub-Saharan African Country: Learning Lessons from Engagement with Gabon's Health Policy Stakeholders.

Sepsis has been recognised as a global health priority by the United Nations World Health Assembly, which adopted a resolution in 2017 to improve sepsis prevention, diagnosis, and management globally. This study investigated how sepsis is prioritised in Gabon. From May to November 2021, we conducted a qualitative study in healthcare stakeholders at the local, regional, and national levels. Stakeholders included the Ministry of Health (MOH), ethics/regulatory bodies, research institutions, academic institutions, referral hospitals, international funders, and the media. Twenty-three multisectoral stakeholders were interviewed. Respondents indicated that sepsis is not yet prioritised in Gabon due to the lack of evidence of its burden. They also suggest that the researchers should focus on linkages between sepsis and the countries’ existing health sector priorities to accelerate sepsis prioritisation in health policy. Stakeholder awareness and engagement might be accelerated by involving the media in the generation of communication strategies around sepsis awareness and prioritisation. There is a need for local, regional and national evidence to be generated by researchers and taken up by policymakers, focusing on linkages between sepsis and a country’s existing health sector priorities. The MOH should set sepsis reporting structures and develop appropriate sepsis guidelines for identification, management, and prevention.

Analyzing the Difficulties of Continuing Physical Activity during the COVID-19 Crisis in France.

Physical activity (PA) and limiting sedentary behavior have been recognized as health-promoting behaviors for many years. Since the COVID-19 pandemic, changes in lifestyle habits have occurred, causing disparities in PA practice. This article aimed to examine the characteristics of French adults who self-reported having difficulties in continuing their exercise practices during the pandemic. Multivariate logistic regressions were used to test whether certain demographic, morphologic, behavioral (sleep, sedentary lifestyle, extent of household chores), and exercise-related variables were significant predictors of experiencing such difficulties, based on data from an online survey of insurance company members. Difficulties in PA practice were found in 57% of the population surveyed. Several factors were identified as predictors of experiencing difficulties, including a high BMI, the type and number of physical activities usually practiced before lockdown, as well as the number of times per week dedicated to PA. For the employed population, specific factors were additionally decisive: sex, time spent in front of screens, and sleeping. Our results will allow public health policy makers and stakeholders in PA and prevention to better target populations in difficulty during periods of disruption, such as that of the pandemic; thus, allowing them to propose structural or organizational solutions for the continuity of PA practice.

Access to mental health for Black youths in Alberta

Introduction The objective of this study was to examine the barriers that influence access to and use of mental health services by Black youths in Alberta. Methods We used a youth-led participatory action research (PAR) methodology within a youth empowerment model situated within intersectionality theory to understand access to health care for both Canadian-born and immigrant Black youth in Alberta. The research project was co-led by an advisory committee consisting of 10 youths who provided advice and tangible support to the research. Seven members of the advisory committee also collected data, co-facilitated conversation cafés, analyzed data and helped in the dissemination activities. We conducted in-depth individual interviews and held four conversation café-style focus groups with a total of 129 youth. During the conversation cafés, the youths took the lead in identifying issues of concern and in explaining the impact of these issues on their lives. Through rigorous data coding and thematic analysis as well as reflexivity and member checking we ensured our empirical findings were trustworthy. Results Our findings highlight key barriers that can limit access to and utilization of mental health services by Black youth, including a lack of cultural inclusion and safety, a lack of knowledge/information on mental health services, the cost of mental health services, geographical barriers, stigma and judgmentalism, and limits of resilience. Conclusion Findings confirm diverse/intersecting barriers that collectively perpetuate disproportional access to and uptake of mental health services by Black youths. The results of this study suggest health policy and practice stakeholders should consider the following recommendations to break down barriers: diversify the mental health service workforce; increase the availability and quality of mental health services in Black-dominated neighbourhoods; and embed anti-racist practices and intercultural competencies in mental health service delivery.