Support Services Research Articles

A Descriptive Study to Assess the Level of Knowledge Regarding National Geriatric Health Care Policies Among Elderly People in a Selected Area of Haridwar

This descriptive study aimed to assess the level of knowledge regarding national geriatric health care policies among elderly people in a selected rural area of Haridwar. Geriatric health care is an important aspect of ensuring the well-being and quality of life for the elderly, a population that is often dependent on external support due to the aging process. The study was conducted among 80 participants aged 60 years and above using a non-probability purposive sampling technique. Data was collected through a self-structured questionnaire designed to evaluate knowledge of national policies such as the Indira Gandhi National Old Age Pension Scheme, Atal Pension Yojana, Ayushman Bharat Yojana, and others. The results indicated that the majority (65%) of the elderly had average knowledge, while 35% had poor knowledge of these policies, and no participant demonstrated a high level of knowledge. Further analysis revealed no significant association between the level of knowledge and demographic factors such as age, gender, education, and income. This lack of awareness suggests a pressing need for greater dissemination of information regarding geriatric health care policies in rural communities, where elderly people may be particularly vulnerable to poor health outcomes due to limited access to healthcare and support services. The study concludes that improving awareness and access to these policies can empower the elderly to better utilize available resources, ultimately improving their health and well-being. The findings highlight the need for targeted health education programs and policy-level interventions to bridge the knowledge gap in rural areas. Future research should explore larger populations and examine strategies to effectively increase policy awareness among the elderly.

Self-Report of Changes in Cognitive-Communication Function and Social Engagement Among Adults With Cancer-Related Cognitive Impairment.

This study aimed to examine the prevalence of cognitive-communication deficits in adult cancer survivors who reported experiencing cancer-related cognitive impairment (CRCI). The study also aimed to determine how these problems impact their ability to engage socially and find satisfaction in their social roles. This study employed a cross-sectional survey to collect data from adult cancer survivors. The survey included questions on demographic characteristics, self-perceived cognitive-communication abilities, social engagement, and satisfaction with social participation. Data analysis included descriptive statistics, Spearman rank-order correlation, Mann-Whitney U tests, and Kruskal-Wallis H tests. Of 172 participants, 78% completed the survey, with 109 self-reporting CRCI. The participants predominantly had breast cancer, and most were diagnosed with Stage II cancers. The results indicated self-perceived impairment in various cognitive-communication domains, with functional daily communication being the most affected. Participants reported more difficulty participating in social roles and activities than their overall satisfaction with social participation. This study explored the relationships between cognitive-communication scores and social engagement, considering variables such as education, cancer type, stage, age, and treatment. This study underscores the multidimensional nature of CRCI, emphasizing the importance of addressing both cognitive-communication and social aspects in interventions and support services. It highlights the clinical implications for speech-language pathology, suggesting a potential role in identifying and addressing cognitive-communication deficits. Future research needs are discussed.

A new high-resolution Coastal Ice-Ocean Prediction System for the East Coast of Canada

The Coastal Ice Ocean Prediction System for the East Coast of Canada (CIOPS-E) was developed and implemented operationally at Environment and Climate Change Canada (ECCC) to support a variety of critical marine applications. These include support for ice services, search and rescue, environmental emergency response and maritime safety. CIOPS-E uses a 1/36° horizontal grid (~ 2 km) to simulate sea ice and ocean conditions over the northwest Atlantic Ocean and the Gulf of St. Lawrence (GSL). Forcing at lateral open boundaries is taken from ECCC’s data assimilative Regional Ice-Ocean Prediction System (RIOPS). A spectral nudging method is applied offshore to keep mesoscale features consistent with RIOPS. Over the continental shelf and GSL, the CIOPS-E solution is free to evolve according to the model dynamics. Overall, CIOPS-E significantly improves the representation of tidal and sub-tidal water levels compared to ECCC’s lower resolution systems: RIOPS (~ 6 km) and the Regional Marine Prediction System – GSL (RMPS-GSL, 5 km). Improvements in the GSL are due to the higher resolution and a better representation of bathymetry, boundary forcing and dynamics in the upper St. Lawrence Estuary. Sea surface temperatures show persistent summertime cold bias, larger in CIOPS-E than in RIOPS, as the latter is constrained by observations. The seasonal cycle of sea ice extent and volume, unconstrained in CIOPS-E, compares well with observational estimates, RIOPS and RMPS-GSL. A greater number of fine-scale features are found in CIOPS-E with narrow leads and more intense ice convergence zones, compared to both RIOPS and RMPS-GSL.

Exploring the Potentials of Digital Economy for Accelerated Economic Growth and Sustainable GDP in Nigeria’s Agricultural Sector

Purpose: The study investigated the potentials of the digital economy for accelerated economic growth in Nigeria. Specifically, the study was guided by the following objectives; potential of the digital economy for accelerated economic growth and sustainable GPD, constraints to attaining the utilization of the digital economy for accelerated economic growth and sustainable GDP and ways of improving the implementation of digital economy for accelerated economic growth and sustainable GDP. Theoretical Reference: Diffusion of Innovation (DOI) Theory, developed by E.M. Rogers in 1962, formed the theoretical foundation of this study. It originated to explain how, over time, an idea or product gains momentum and diffuses (or spreads) through a specific population or social system. The result of this diffusion is that people, as part of a social system, adopt a new idea, behavior, or product. Method: The descriptive survey design was adopted using 130 farmers selected through a convenience sampling approach in the four North Central States of Nasarawa, Benue, Plateau and Niger including the FCT Abuja. Data was gathered using closed-ended questionnaires and measured using modified three-point Likert Scale of Agree = 3, Uncertain = 2 and Disagree = 1. The Lawshe’s formula yielded a content validity ratio (CVR) of 0.99, which confirmed the representativeness and clarity of the questionnaire. A reliability coefficient alpha (r - coefficient) of 0.84 was reported by Cronbach Alpha to determine the internal consistency of the questionnaire. The data was collected on the spot and analyzed using frequency counts (f) and percentages (%), and presented in tables and graphs. Results/Conclusion: The findings showed that the farmers understood clearly the potential of the digital economy in creating jobs and accelerating their economic status and contributing significantly to a sustainable GDP in Nigeria if properly utilized. However, the attainment of these enormous benefits to farmers is affected by the reduction in access to the Internet, affordability and quality of service, training and government support. Digital economy could boost agricultural production with wide project margin if infrastructure for implementation are available and utilization is effective. The study recommended the provision of broadband sufficient to provide extensive access to the Internet in order to accelerate utilization and improve productivity, especially among rural dwellers. Implication: Understanding the potential offered by embracing and utilizing the digital economy, as well as the difficulties and strong tactics farmers must employ to successfully capitalize on these advances in order to boost GDP and economic growth in Nigeria's agriculture sector Originality/Value: The originality of this investigation lay in its empirical evidence regarding the potentials, challenges, and strategies for enhancing farmers' utilization to support economic growth and GDP in the agricultural sector, which helped to expand the body of literature on digital economy in the agricultural sector, particularly in Nigeria.

Analysis of Rural Producers' Performance Indicators: a Case Study of Cooperative Members of the Southern Bahia Cocoa Indication of Origin

Objective: The aim of this study is to investigate performance indicators for cocoa in the southern region of Bahia for the period 2021-2023. Theoretical Framework: Through a literature review, this study aims to understand the concepts and connections between Geographical Indication and its impacts on socio-economic development as a basis for analyzing qualitative data collected from the Cacau Sul da Bahia Association and the Brazilian Micro and Small Business Support Service to evaluate and compare the impacts over time. Method: An applied and exploratory approach was used, using secondary data, which was analyzed according to Bardin's (1997) proposal. Results and Discussion: The research shows the seasonality of cocoa production in the south of Bahia, with production peaks in July, the peak harvest season. Production stability is suggested for the 2021-2023 period. The geographical distribution of producers showed a concentration of production in a few municipalities, as well as the fact that only five maintained regularities over the three years. Research Implications: The research implies the need for management and planning strategies to ensure the sustainability of the sector and promote greater participation by municipalities in cocoa production in the region. Originality/Value: This study proposes a comprehensive assessment of the socio-economic and environmental impacts in a region with a product protected by Geographical Indication.

Family carers as service producers – insights into psychological contracts

ABSTRACT Family carers and caregiving have a role in the service system but family carers are often invisible and go unnoticed in society. In this article we are interested in family carers as service producers in health and social care. We analyze family care using the concept of a psychological contract. A psychological contract is an unspoken, unconfirmed and unwritten agreement where an exchange is based on perception rather than what is explicitly written and agreed. A psychological contract shapes family carers’ expectations and obligations, while providing a concept for understanding their work. The data were analyzed via theory-driven content analysis. Research question is: what are the features of a psychological contract in a family carer´s work? Data were collected from Finland in 2015. Ten family carers, aged between 64–78 years, who take care of their spouses were interviewed. A psychological contract involves the normative and mental schema of the carers, which direct what kind of care they feel they should provide as a spouse and carer. The psychological contract also guides what kind of support the carers may be willing to accept. The psychological contract clearly shows that family carers are primarily spouses rather than service providers. The concept of the psychological contract provides a workable frame to describe the relationship between family carers and the service system. This study enables the development of family care support services for the needs of family carers.

Screening for STIs among criminal legal system involved youth of color in community settings

BackgroundSexually transmitted infections are a significant, and growing, public health problem in this country – particularly among youth. Innovative strategies are needed to reduce the community burden of infection. Preliminary studies indicate that individuals involved in the criminal legal system have high rates of infection. While gaps exist in providing screening for incarcerated individuals, there are minimal efforts that have been initiated to screen individuals diverted from incarceration. In this study, we examined the STI risk profile and feasibility of screening for sexually transmitted infections for youth who were attending an alternative sentencing program after arrest for a minor offense. Youth were screened for chlamydia and gonorrhea using urine-based nucleic acid amplification tests.ResultsOf the 307 participants engaged in a program providing supportive services for criminal legal system involved youth at the Brooklyn Court House in New York City, 186 agreed to screening for sexually transmitted infections, and 8% were positive for chlamydia, gonorrhea, or both.ConclusionsScreening programs within carceral settings have proven effective in identifying individuals with STIs. However, with policy changes diverting more young people away from incarceration and into community-based programs, innovative programs are needed to identify STIs among youth in these settings. Our findings indicate that it is feasible to conduct venue-based screening in these settings, and, doing so may identify youth in need of treatment and further evaluation.

Multilevel factors associated with HIV-related stigma among women living with HIV in Guangdong Province, China: a social-ecological model-informed study

BackgroundHIV-related stigma continues to hinder optimal HIV care, and its determinants should be understood at multiple levels. Based on the social-ecological model, this study aimed to explore factors associated with HIV-related stigma among women living with HIV in Guangdong Province, China.MethodsA cross-sectional study was conducted from July to August 2022 to recruit newly reported women living with HIV with a history of pregnancy or current pregnancy in 2021 in 21 cities in Guangdong Province. HIV-related stigma was assessed using an abbreviated Chinese version of Berger's HIV Stigma Scale. Univariate and multivariable hierarchical regression analyses based on the social-ecological model were conducted to explore factors associated with HIV-related stigma and its four dimensions (personalized stigma, disclosure concerns, negative self-image and concerns about public attitudes) at the community/hospital, interpersonal, and individual levels.ResultsA moderate level of HIV-related stigma was found among the 360 participants included, with a mean score of 45.26. Multivariable hierarchical regression analysis showed that at the community/hospital-level, individuals were more likely to experience high levels of HIV-related stigma if they had experienced the discriminatory behaviors from health care workers (aOR = 2.34, 95%CI: 1.48–3.70) and if they rated serostatus disclosure services as less helpful (aOR = 0.69, 95%CI: 0.48–0.98). At the interpersonal-level, individuals with an HIV-positive partner (aOR = 1.71, 95%CI: 1.01–2.90) were more likely to experience high levels of HIV-related stigma than those with an HIV-negative or unknown partner. Individuals with high resilience (aOR = 0.22, 95%CI: 0.13–0.35) had lower levels of HIV-related stigma at the individual-level. In addition, ever experiencing discriminatory behaviors from health care workers, thinking serostatus disclosure services helpful, having ever seen publicity about personal interest protection services and complaint channels for people living with HIV(PLHIV), knowing about care and support services for PLHIV from social organizations at the community/hospital-level, partner notification and support at the interpersonal-level, and violations of personal interests, resilience at the individual-level were also associated with different dimensions of HIV-related stigma.ConclusionsHIV-related stigma was moderate among women living with HIV. The social-ecological model can facilitate a better understanding of factors associated with HIV-related stigma. Multilevel intervention strategies need to be tailored to reduce HIV-related stigma.

Taboo subject of miscarriage? - Anchoring through mechanisms at the medical, social, and organisational level "It broke my heart and that's just the way it is ..."

Miscarriage is the most common complication of pregnancy. In this work, the experiences associated with miscarriage and their relevance for the women are analysed on different levels. In May 2023, 14 guided interviews were conducted with women. The text material obtained will be brought to a higher level of abstraction using Mayring's content analysis approach and then interpreted. The results of the study underpin the significance of a miscarriage as a dramatic experience and the assumption of a broad taboo experienced as stressful. The deliberately chosen exchange among like-minded people, the concealment of the pregnancy and subsequently the miscarriage for reasons of shame, self-protection from professional disadvantages, and the assumption of overburdening the partner do not weigh as heavily as those mechanisms that operate in the health sector: at this level, mistrust, trivialisation and organisational and spatial inadequacies contribute to tabooing. The stressful circumstance of miscarriage is cushioned by people who recognise the grief and offer support. Based on the results of the study, improvements can be derived primarily in the area of care: Recognition of miscarriage, needs-based support services, improvement of communicative elements and organisational and spatial framework conditions.

What are the barriers and facilitators for health and social care professionals accessing organizational wellbeing support services? A mixed-methods study

Recent years have seen increases in workers’ stress levels and sickness absence rates. Organizations have increased the number of wellbeing support services they offer employees, but uptake has been poor. This study investigated barriers and facilitators to accessing organizational wellbeing support services. A two-study, mixed-methods design in health and social care employees was used. Study 1 conducted a directed content analysis of qualitative interview data based on the Theoretical Domains Framework (TDF) to identify barriers and facilitators. These were translated into survey items. Study 2 conducted a quantitative cross-sectional survey to assess whether the number of barriers and facilitators was associated with the likelihood of service use. Study 1 (n = 20) created a survey list of 23 barriers and 23 facilitators. Study 2 (n = 162) found that a greater number of facilitators was associated with a greater likelihood of service access, but number of barriers was not. We concluded that increasing facilitators may increase employee uptake of wellbeing support services. Facilitators include making access routes to services simple and efficient and circulating regular information to staff about available services.

Az Europol-együttműködés tapasztalatai

Aim: The aim of the article is to present the practical experience of cooperation between Europol, which plays a key role in international criminal cooperation, and Hungary. Methodology: The author collected knowledge about the operation of Europol and its investigative support services by studying the available EU legislation, and by working as the Head of the Hungarian Liaison Bureau at Europol, as well as by carrying out the tasks of the former expert in the cyber-attacks priority and the deputy national EMPACT coordinator. Findings: Europol’s system of cooperation with the Member States and operational and strategic partners provides the law enforcement agencies of the countries concerned with an opportunity that no other agency, institution or organisation can offer. In addition to supporting specific investigations, the institutional system also provides countries with IT, strategic and financial support. Value: The article aims to provide a practical and comprehensive overview of the state of cooperation with Europol, to give a deeper insight into the day-to-day work of the law enforcement and judicial authorities and to provide the interested reader with contextualized insights into the steps and processes involved.

The Impact of Medical Education Quality on Career Adaptability for International Students in China: The Mediating Role of Proactive Career Planning Behavior

Background: The quality of medical education plays a significant role in shaping the career outcomes of international students. As they navigate the challenges of their studies and career paths in a foreign country, understanding the elements that influence their career adaptability is essential. Objective: This study aims to examine the impact of medical education quality on career adaptability among international students in China and to emphasize the mediating role of proactive career planning behavior. It also investigates challenges related to cultural adjustment. Methodology: A quantitative technique is employed in a cross-sectional survey of international medical students in China. Information was collected from 575 valid responses through structured questionnaires. The research utilizes regression analysis and Structural Equation Modeling (SEM) to assess the relationships between medical education quality, career adaptability, proactive career planning behavior, and cultural adjustment challenges. Result: The evaluation revealed that medical education quality positively influences career adaptability (p < 0.001, β = 0.45). Proactive career planning behavior was found to positively influence career adaptability (p < 0.001, β = 0.38). Medical education quality positively influences proactive career planning behavior (p < 0.001, β = 0.50), and proactive career planning behavior mediated the connection between medical education quality and career adaptability (p = 0.013, β = 0.20). Cultural adjustment challenges moderated the relationship between medical education quality and career adaptability, with a significant interaction effect (p = 0.032, β = -0.15). Conclusion: The research emphasizes the significance of high-quality medical education in promoting career adaptability among international students, highlighting proactive career planning and examining cultural adjustment challenges for optimal career outcomes. These insights can inform educational practices and support services for international medical students, aiming to enhance their career readiness and adaptability in a global context.

White privilege, ethnic disadvantage, and stigmatized linguistic capital: COVID-19 infection rates and lockdown law enforcement in Hong Kong

The COVID-19 pandemic has exposed and exacerbated existing disparities in various societies. This study investigates disparities among racial, ethnic, and linguistic groups in Hong Kong's society in COVID-19 infection rates and lockdown enforcement practices that was imposed 545 times from January 2021 to September 2022 and affected 9% of the population. It is found that neighborhoods with more white individuals had lower infection rates than the overall population, while those with more ethnically minoritized groups had higher infection rates. Furthermore, hit rate tests reveal that the government targeted more neighborhoods with a higher share of individuals from linguistically minoritized groups. This novel finding suggests that not only race, but linguistic difference of the same ethnicity can cause bias. The study highlights the positive impact of providing ethnic support services on health outcomes in neighborhoods with a higher share of individuals from ethnically minoritized groups.

Adaptive Scenario Planning Development for Indonesian Digital Health Industry: Case Study of Export Support Services (ESS) in Promoting UK Companies Entering Indonesia

The COVID-19 pandemic, once an unpredictable yet plausible future event, has proven to be a reality, highlighting the urgent need for adaptation. Factors such as varying Universal Health Coverage (UHC) maturity, limitations in healthcare infrastructure, and unpredictable private sector moves, including venture capital investments, add to the uncertainty. Like the COVID-19 pandemic, Brexit was another unpredictable yet plausible event that has become a reality. Export Support Service (ESS), a UK Department for Business and Trade (DBT) initiative, assists UK SMEs in expanding beyond the EU post-Brexit, including Indonesia’s digital health sector. The study refines its strategy to navigate the market’s complexities through adaptive scenario planning. This study identified 25 key factors shaping Indonesia’s digital health future and developed three scenarios: “Cherry Blossom Park,” “Volcano Eruptions Amidst a Forest,” and “High-Tech Greenhouse in a Desert.” Each scenario explores implications and opportunities, providing strategic guidance for ESS.

County-Level Enrollment in Medicare Advantage Plans Offering Expanded Supplemental Benefits

Since 2019 and 2020, Medicare Advantage (MA) plans have been able to offer supplemental benefits that address long-term services and supports (LTSS) and social determinants of health (SDOH). To examine the temporal trends and geographic variation in enrollment in MA plans offering LTSS and SDOH benefits. This cross-sectional study used publicly available data to examine changes in beneficiary enrollment and plan offerings of LTSS and SDOH benefits from the benefits data from the second quarter of each year and other data from April of each year except 2024, for which the first quarter was the latest for benefits data and January the latest for other data at the time of analysis. Multivariable linear regression models for each type of benefit were used to investigate associations between county characteristics and enrollment in 2024. Analyses were stratified for (1) Dual Eligible Special Needs Plans (D-SNPs) that exclusively enroll dual-eligible beneficiaries and (2) non-D-SNPs. The percentage of MA enrollees in plans offering LTSS or SDOH benefits at the county level. This study included 2 631 697 D-SNP and 20 114 506 non-D-SNP enrollees in 2020, which increased to 5 494 426 and 25 561 455, respectively, in 2024. From 2020 to 2024, the percentage of D-SNP enrollees in plans offering SDOH benefits increased from 9% to 46%, whereas the percentage fluctuated between 23% and 39% for LTSS benefits. There was an increase in non-D-SNP enrollees with LTSS (from 9% to 22%) and SDOH (from 4% to 20%) benefits from 2020 to 2023, which decreased in 2024. In 2024, the most offered LTSS benefit was in-home support services, and the most offered SDOH benefit was food and produce. The percentage of enrollees with these benefits varied across counties in 2024. In multivariable linear regression models, among D-SNPs, enrollment in plans offering any SDOH benefits was higher in counties with greater MA penetration (coefficient, 5.0 percentage points [pp] per 10-pp change; 95% CI, 2.1-7.9 pp), in urban counties (coefficient, 7.2 pp vs rural counties; 95% CI, 3.8-10.6 pp), in counties with greater enrollment in fully integrated D-SNPs (coefficient, 3.0 pp per 10-pp change; 95% CI, 2.2-3.9 pp), and in counties in states with approved Medicaid home- and community-based services waivers for individuals 65 years or older or those with disabilities (coefficient, 10.8 pp; 95% CI, 4.0-17.6 pp). Enrollment in D-SNPs offering LTSS benefits was also higher in counties with greater MA penetration (coefficient, 5.9 pp per 10-pp change; 95% CI, 2.4-9.5 pp), urban vs rural counties (coefficient, 4.6 pp; 95% CI, 1.1-8.1 pp), and counties with greater enrollment in fully integrated D-SNPs (coefficient, 3.0 pp per 10-pp change; 95% CI, 2.1-3.9 pp) in addition to counties with greater social vulnerability scores (coefficient, 1.4 pp per 10-pp change; 95% CI, 0.3-2.5 pp). In this cross-sectional study of MA plans and enrollees, an increase in enrollment was most consistent in D-SNPs offering SDOH benefits compared with LTSS benefits and in D-SNPs compared with non-D-SNPs. Geographic variation in enrollment patterns highlights potential gaps in access to LTSS and SDOH benefits for rural MA beneficiaries and dual-eligible enrollees living in counties with lower enrollment in fully integrated D-SNPs and states with more limited Medicaid home- and community-based services coverage.

Experience of the Europol cooperation

Aim: The aim of the article is to present the practical experience of cooperation between Europol, which plays a key role in international criminal cooperation, and Hungary. Methodology: The author collected knowledge about the operation of Europol and its investigative support services by studying the available EU legislation, and by working as the Head of the Hungarian Liaison Bureau at Europol, as well as by carrying out the tasks of the former expert in the cyber-attacks priority and the deputy national EMPACT coordinator. Findings: Europol’s system of cooperation with the Member States and operational and strategic partners provides the law enforcement agencies of the countries concerned with an opportunity that no other agency, institution or organisation can offer. In addition to supporting specific investigations, the institutional system also provides countries with IT, strategic and financial support. Value: The article aims to provide a practical and comprehensive overview of the state of cooperation with Europol, to give a deeper insight into the day-to-day work of the law enforcement and judicial authorities and to provide the interested reader with contextualised insights into the steps and processes involved.

Chronically ill patients’ perspectives on support services and activities of patient organizations

BackgroundPatient Organizations (POs) are an important support factor in helping chronically ill patients cope with their illness. Patient involvement in the management of their disease helps to achieve the best possible care for the patient, streamline the work of healthcare providers, shape healthcare policy, and even influence the structures of healthcare systems. The perspective of chronically ill patients on the activities and services provided by patient organizations has not been evaluated yet. This study aimed to identify and map the services and activities of all types of non-profit patient organizations from the perspective of chronically ill patients so that they can be integrated as an integral part of the healthcare system.MethodsNineteen services and activities of patient organizations were sampled from Israeli patient organizations and scientific literature. These services and activities were evaluated by chronically ill patients in Israel. Patient-Oriented Questionnaires (POQ) were distributed among patients with chronic diseases (N = 1395) using snowball sampling.ResultsExploratory factor analysis (EFA) was performed, followed by confirmatory factor analysis (CFA) for convergent and discriminant validity. Findings showed that twelve services and activities suggested by patient organizations were found to represent chronically ill patients’ needs and categorized into three groups: Interpersonal support (five items), patients’ rights (four items), and medical information (three items). CFA showed a good fit for the observed data. CFI = 0.98, NFI = 0.97, TLI = 0.96, RMSEA = 0.058.ConclusionsWell-organized patient organizations are an important pillar in reformed healthcare systems. They can serve as the social arm of the healthcare system and as an intermediary between patients and healthcare institutions. We narrowed down twelve services and activities given by patient organizations that were important to chronically ill patients in Israel. patient organizations can utilize patient needs or preferences into clinical practice and influence health policy planning, patient-caregiver relationships, research and even healthcare costs. patient organizations recognition by the healthcare system, and establishment of a national patient council will help to realize these processes.

Tailored text-messaging versus standard Quitline telephone counselling for smoking cessation among people who smoke from a low-socio-economic status background in Australia: A study protocol for a non-inferiority randomized controlled trial (The Quit By Phone Study).

Signficant inequalities in tobacco smoking exist, with higher smoking rates among people from low-socio-economic status (low-SES) populations. Tailored technology-based programs for low-SES smoking populations have the potential for high reach, but require effectiveness data from large-scale trials. This trial among Australians who smoke from a low-SES background will determine the effectiveness and cost-effectiveness of tailored text-message (TTM) support compared with standard Quitline (SQL) telephone support service. This is a two-arm, parallel group, randomized, non-inferiority trial with allocation concealment and blinded outcome assessment in an Australian population within the greater Sydney region in New South Wales. Participants are adults who smoke daily (n = 1246), are interested in quitting and currently receiving a government pension or allowance, and will be recruited via advertisements. Participants will be randomized (1:1 ratio) to receive either 12 months of TTM quit support or enrolment in SQL telephone support. Assessments will be completed at baseline (telephone interview), within 1 month (check-in call), at 3months (on-line questionnaire) and 12 months (telephone interview) post-randomization. The primary outcome will be 6-month continuous abstinence verified by carbon monoxide breath test at 12-month follow-up. The study will test whether TTM is non-inferior to SQL by a non-inferiority margin of 2%, i.e. the quit rate in the TTM group will be no worse than 2% less than the quit rate in the SQL group. Secondary outcomes will include self-reported continuous and point prevalence abstinence and acceptability and cost-effectiveness of TTM versus SQL. Should the tailored text-message support prove non-inferior and more cost-effective than Quitline for this population, this will provide an opportunity for the upscaling of an effective, inexpensive and tailored quit support service. The trial findings will inform cessation treatment policy for priority populations in Australia and globally.

Supporting older adults’ mental health: a Delphi survey identifying audiology best practices

Objective This study aimed to gather opinions and establish consensus among audiologists and patients on supporting individuals with mental health concerns in audiology settings. Design Utilising a modified electronic Delphi survey, a panel of 25 experts engaged in three rounds of data collection over 12 weeks. Participants provided open-text responses in Round 1 describing “clinical practices that can be employed to support to patients presenting with mental health concerns”, and the research team combined these with relevant clinical practices from literature searches. In subsequent rounds, panellists then rated their level of agreement with the combined list of statements; individually (Round 2) and again after seeing the panel’s collated responses (Round 3). Study Sample Panel experts included 11 patients (adults with hearing loss; Mage 73.8 years) and 14 audiologists (with M 11.8 years of experience working in audiology). Results Consensus was met for 123 items categorised into: Detection, Education, Effective Communication, Provision of Emotional Support, Personal Qualities and Attitudes of the Audiologist, Interventions, Connecting the Patient to Additional Support Services, Normal Processes that are Especially Important in these Cases, and Organisational Considerations. Conclusions The study highlights the diversity of approaches audiologists can employ to support patients with mental health concerns.

Differences in LGBTQ young people’s mental health, wellbeing, and community involvement by residential location

ABSTRACT Residential location can significantly impact the mental health, wellbeing, and community involvement of lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) young people. While research has explored geographical differences in LGBTQ adult wellbeing, limited knowledge exists regarding LGBTQ young people’s experiences. Using a large Australian cross-sectional survey of 6,620 LGBTQ individuals aged 14–21, this study examined the associations between residential location and wellbeing outcomes. Findings revealed that LGBTQ young people in rural and remote areas reported higher levels of psychological distress. Cisgender young people in rural areas experienced more verbal and physical harassment, while those in inner-suburban areas faced increased sexual harassment. Participants were also particularly vulnerable to experiencing homelessness when living in regional towns and rural and remote areas. Trans young people were more likely to attend LGBTQ events in inner-suburban areas. These results emphasize the need for policy changes to foster diversity and inclusion in rural areas, along with targeted support services to enhance the mental health and wellbeing of LGBTQ young people. Understanding the unique experiences of LGBTQ young people across different residential locations is vital, calling for tailored interventions and support in all settings.