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Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review. 糖尿病、高血压和血脂异常药物获取的障碍和促进因素:范围综述。
IF 5.5 Q1 Nursing Pub Date : 2022-09-02 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604796
Carla Castillo-Laborde, Macarena Hirmas-Adauy, Isabel Matute, Anita Jasmen, Oscar Urrejola, Xaviera Molina, Camila Awad, Catalina Frey-Moreno, Sofia Pumarino-Lira, Fernando Descalzi-Rojas, Tomás José Ruiz, Barbara Plass

Objective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives. Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed. Results: The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients' education. Conclusion: Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers' role bringing medicines closer; and patients' health education and disease management.

目的:从患者、卫生服务提供者和卫生系统的角度出发,确定糖尿病、高血压和血脂异常药物获取的障碍和促进因素。方法:基于Joanna Briggs方法的范围审查。检索考虑了PubMed、Cochrane Library、CINAHL、Academic search Ultimate、Web of Science、SciELO引文索引和灰色文献。两名研究人员进行了筛选和资格阶段。对数据进行主题分析。结果:共纳入219篇文献。糖尿病是研究最多的疾病;大多数证据来自患者和美国。药品的可负担性和可获得性分别是报告最多的方面和具体障碍,两者都是交叉关注的问题。在高收入和中等收入国家,确定的障碍是药品费用、专业人员陪同、距离设施很远以及文化方面;交通成本出现在低收入环境中。据报告,促进因素包括经济可及性、训练有素的卫生工作者、离社区更近的药品以及患者的教育。结论:障碍和促进因素是由社会经济和文化条件决定的,突出了卫生系统在监管和政策背景下的作用(确保财政覆盖和免费药品);提供者拉近药品距离的作用;以及患者健康教育和疾病管理。
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引用次数: 1
Industrial Air Pollution Leads to Adverse Birth Outcomes: A Systematized Review of Different Exposure Metrics and Health Effects in Newborns. 工业空气污染导致不良的出生结果:不同暴露指标和新生儿健康影响的系统综述。
IF 5.5 Q1 Nursing Pub Date : 2022-08-10 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604775
Triin Veber, Usha Dahal, Katrin Lang, Kati Orru, Hans Orru

Objectives: To review the evidence of associations between adverse birth outcomes (ABO) and industrial air pollution. Methods: Searches were conducted in PubMed, and Scopus databases, and additional articles were found from snowball search techniques. The included studies feature a study population of mothers with live-born babies exposed to industrial air pollutants, and they examine the effects of industrial pollutants on adverse birth outcomes-namely, low birth weight, term low birth weight, preterm birth, and small for gestational age. Results: Altogether, 45 studies were included in this review. Exposure to PM2.5, PAHs, benzene, cadmium, and mixtures of industrial air pollutants and living near an industrial area affect birth outcomes. Conclusion: This study concludes that industrial air pollution is an important risk factor for ABO, especially low birth weight and preterm birth. The strongest evidence is associations between ABO and air pollution from power plants and petrochemical industries. Understanding of specific chemicals that are critical to birth outcomes is still vague. However, the evidence is strongest for more specific air pollutants from the industry, such as PAH, benzene, BTEX, and cadmium.

目的:回顾不良出生结局(ABO)与工业空气污染之间关系的证据。方法:在PubMed和Scopus数据库中进行检索,并通过滚雪球搜索技术找到额外的文章。纳入的研究以活产婴儿暴露于工业空气污染物的母亲为研究对象,研究了工业污染物对不良出生结果的影响,即低出生体重、足月低出生体重、早产和胎龄小。结果:本综述共纳入45项研究。暴露在PM2.5、多环芳烃、苯、镉和工业空气污染物的混合物中,并居住在工业区附近,都会影响出生结果。结论:工业空气污染是ABO发病的重要危险因素,尤其是低出生体重和早产。最有力的证据是ABO与发电厂和石化工业产生的空气污染之间的联系。对对出生结果至关重要的特定化学物质的了解仍然模糊不清。然而,来自工业的更具体的空气污染物,如多环芳烃、苯、苯醚和镉,证据是最有力的。
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引用次数: 2
Moving Forward With Integrated Care: The Use of Realist Approaches to Understand What Works, How, for Whom and Under Which Circumstances. 以综合护理向前迈进:使用现实主义方法来了解什么有效,如何有效,为谁有效以及在何种情况下有效。
IF 5.5 Q1 Nursing Pub Date : 2022-08-05 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1605082
Isabelle Peytremann-Bridevaux, Maura MacPhee
The purpose of our commentary is to raise the pro fi le of alternate methodological approaches, speci fi cally realist approaches, for advancing knowledge of and practice in healthcare innovations for diverse patient populations. We will use the example of literature reviews on integrated care for patients with chronic obstructive pulmonary disease (COPD). Chronic diseases, such as COPD, have created signi fi cant burdens on healthcare systems. One evidence-informed approach to chronic disease management is integrated care. Implemented by healthcare systems to overcome care fragmentation, it has been shown to bring bene fi ts to patients, at least in some healthcare dimensions. rmed precision: integrated care results in previous rigorously conducted and reliable of
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引用次数: 2
Drawing on Adolescent Psychology to Achieve Tobacco-Free Generations. 利用青少年心理实现无烟世代。
IF 5.5 Q1 Nursing Pub Date : 2022-08-04 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604321
Jon Berrick

Background: In 2021, the European Union called for creation of a "tobacco-free generation." We consider the means to this end. The persistence of youthful noncompliance with current minimum age laws (leading to widespread subsequent addiction, morbidity and mortality) raises questions whether such laws are truly aligned with adolescent psychology. Evidence: The ubiquity of minimum-age laws limits direct evidence of their effectiveness, so we seek indirect evidence. Qualitative findings originally intended for tobacco manufacturers indicate counterproductive aspects of minimum-age laws. Further evidence about adolescent reactions is provided by a recent review and meta-analysis of greater youth defiance of under-age laws than whole-of-life laws in the domain of motorcycle helmets. Policy Options and Recommendations: As an alternative to minimum-age laws, we consider the Tobacco-Free Generation proposal (TFG), which phases out sales on an age cohort basis and has recently gained prominence. Conclusion: The Tobacco-Free Generation proposal (TFG) seems well aligned with adolescent psychology, and is therefore especially worthy of attention. It has recently been introduced or endorsed by a number of jurisdictions, both local and national.

背景:2021年,欧盟呼吁创造“无烟一代”。我们考虑实现这一目的的手段。年轻人一直不遵守现行的最低年龄法律(导致随后广泛的成瘾、发病率和死亡率),这引发了这样的问题:这些法律是否真正符合青少年的心理。证据:普遍存在的最低年龄法律限制了证明其有效性的直接证据,因此我们寻求间接证据。最初为烟草制造商准备的定性调查结果表明,最低年龄法律有适得其反的方面。最近的一项综述和荟萃分析提供了关于青少年反应的进一步证据,该综述和荟萃分析表明,在摩托车头盔领域,青少年对未成年人法律的蔑视程度高于终身法律。政策选择和建议:作为最低年龄法律的替代方案,我们考虑了无烟一代提案(TFG),该提案以年龄队列为基础逐步停止销售,最近得到了重视。结论:无烟一代提案(TFG)似乎与青少年心理非常一致,因此特别值得关注。最近,一些地方和国家的司法管辖区已经采用或核准了这项规定。
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引用次数: 3
Flipped Classroom Formats in a Problem-Based Learning Course: Experiences of First-Year Bachelor European Public Health Students. 基于问题的学习课程中的翻转课堂模式:欧洲公共卫生本科一年级学生的经验。
IF 5.5 Q1 Nursing Pub Date : 2022-08-04 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604795
Nynke de Jong, Peter van Rosmalen, Maria Teresa Brancaccio, Michel H C Bleijlevens, Hilde Verbeek, Inge G P Peeters

Objectives: Students would like to see more creativity and flexibility in the performance of problem-based learning (PBL). Therefore, we applied flipped classroom formats in a course of the Bachelor European Public Health at Maastricht University to investigate the experiences of the students. The main objective was to stimulate interaction between students mutual, and between students and teachers. Methods: 304 first-year students following the course on "Ageing in Europe" in three academic years, were asked to fill out questions focussing on prior knowledge, preparation work, and group session parameters, e.g., duration, content, extent of interaction and format group session. Results: In-class activities, such as debate, making a mind map, giving a pitch, role-play e.g., were highly appreciated by students, especially the interactivity and discussions with the experts during these sessions. Students felt they applied knowledge. Conclusion: Flipped classroom formats can be used to extend the Maastricht University PBL design and students do recommend this. It can be a relevant and challenging answer on the articulated request for more creativity and flexibility in the regular PBL format.

目的:学生希望在基于问题的学习(PBL)的表现中看到更多的创造力和灵活性。因此,我们在马斯特里赫特大学的欧洲公共卫生学士课程中应用翻转课堂模式来调查学生的体验。主要目的是激发学生之间的互动,以及学生和老师之间的互动。方法:对304名一年级学生进行为期三个学年的“老龄化在欧洲”课程的调查,问卷内容包括前期知识、准备工作和小组会议参数,如小组会议的持续时间、内容、互动程度和形式。结果:课堂上的辩论、思维导图、演讲、角色扮演等活动,尤其是与专家的互动和讨论,受到了同学们的高度评价。学生们觉得他们应用了知识。结论:翻转课堂模式可以用来扩展马斯特里赫特大学PBL的设计,学生们也推荐这样做。对于要求在常规PBL格式中增加创造性和灵活性的明确要求,它可能是一个相关的和具有挑战性的答案。
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引用次数: 0
Determinants of Voluntary Counseling and Testing Service Uptake Among Adult Sub-Saharan Africans: A Systematic Review and Meta-Analysis. 撒哈拉以南非洲成年人接受自愿咨询和检测服务的决定因素:系统回顾和荟萃分析。
IF 5.5 Q1 Nursing Pub Date : 2022-08-03 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604065
Muhammed Lamin Sambou, Juncheng Dai, Xiaoyu Zhao, Tongtong Hong, Til Bahadur Basnet, Gifty Marley, Alima Sambou, El Hafa Fadoua, Muhammad Naveed

Objective: To examine the major determinants of VCT service uptake among adults in SSA. Methods: Electronic databases were searched to identify eligible English language publications. Reporting of the study selection procedure was done according to PRISMA and the selected articles were also critically appraised. Results: We found 8 significant determinants of VCT uptake among adults in SSA, such as less physical access [OR (Odds ratio): 0.77 (95% CI (Confidence interval): 0.62-0.96), p < 0.01], older age [OR: 1.36 (95% CI: 1.08-1.73), p < 0.01], higher education level [OR: 1.60 (95% CI: 1.24-2.05), p < 0.01], high knowledge of HIV and VCT awareness [OR: 1.40 (95% CI: 1.03-1.90), p < 0.01], unprotected sexual practices [OR: 1.75 (95% CI: 1.18-2.58), p < 0.01], discussion on HIV among partners and others [OR: 1.76 (95% CI: 1.10-2.81), p < 0.01], other STIs [OR: 1.40 (95% CI: 1.00-1.98), p < 0.01], and divorced/separated [OR: 1.39 (95% CI: 1.12-1.72), p < 0.01]. Conclusion: This study showed that 8 determinants were significantly associated with VCT service uptake in SSA. Thus, HIV interventions and policy initiatives should be tailored to these determinants to ensure scale-up of VCT service uptake in SSA.

目的:探讨影响SSA成人VCT服务接受程度的主要因素。方法:检索电子数据库,确定符合条件的英文出版物。根据PRISMA报告研究选择程序,并对选定的文章进行严格评价。结果:我们发现SSA成人中VCT摄入的8个重要决定因素,如身体接触较少[OR(优势比):0.77 (95% CI: 0.62-0.96), p < 0.01],年龄较大[OR: 1.36 (95% CI: 1.08-1.73), p < 0.01],高等教育程度[OR: 1.60 (95% CI: 1.24-2.05), p < 0.01],对艾滋病毒和VCT的认识较高[OR: 1.40 (95% CI: 1.03-1.90), p < 0.01],无保护的性行为[OR: 1.75 (95% CI: 1.03-1.90), p < 0.01];(1.18-2.58), p < 0.01),伴侣及其他人对HIV的讨论[OR: 1.76 (95% CI: 1.10-2.81), p < 0.01],其他性传播感染[OR: 1.40 (95% CI: 1.00-1.98), p < 0.01],离婚/分居[OR: 1.39 (95% CI: 1.12-1.72), p < 0.01]。结论:本研究显示8个决定因素与SSA的VCT服务摄取显著相关。因此,艾滋病毒干预措施和政策举措应根据这些决定因素进行调整,以确保在SSA扩大VCT服务的吸收。
{"title":"Determinants of Voluntary Counseling and Testing Service Uptake Among Adult Sub-Saharan Africans: A Systematic Review and Meta-Analysis.","authors":"Muhammed Lamin Sambou,&nbsp;Juncheng Dai,&nbsp;Xiaoyu Zhao,&nbsp;Tongtong Hong,&nbsp;Til Bahadur Basnet,&nbsp;Gifty Marley,&nbsp;Alima Sambou,&nbsp;El Hafa Fadoua,&nbsp;Muhammad Naveed","doi":"10.3389/phrs.2022.1604065","DOIUrl":"https://doi.org/10.3389/phrs.2022.1604065","url":null,"abstract":"<p><p><b>Objective:</b> To examine the major determinants of VCT service uptake among adults in SSA. <b>Methods:</b> Electronic databases were searched to identify eligible English language publications. Reporting of the study selection procedure was done according to PRISMA and the selected articles were also critically appraised. <b>Results:</b> We found 8 significant determinants of VCT uptake among adults in SSA, such as less physical access [OR (Odds ratio): 0.77 (95% CI (Confidence interval): 0.62-0.96), <i>p</i> < 0.01], older age [OR: 1.36 (95% CI: 1.08-1.73), <i>p</i> < 0.01], higher education level [OR: 1.60 (95% CI: 1.24-2.05), <i>p</i> < 0.01], high knowledge of HIV and VCT awareness [OR: 1.40 (95% CI: 1.03-1.90), <i>p</i> < 0.01], unprotected sexual practices [OR: 1.75 (95% CI: 1.18-2.58), <i>p</i> < 0.01], discussion on HIV among partners and others [OR: 1.76 (95% CI: 1.10-2.81), <i>p</i> < 0.01], other STIs [OR: 1.40 (95% CI: 1.00-1.98), <i>p</i> < 0.01], and divorced/separated [OR: 1.39 (95% CI: 1.12-1.72), <i>p</i> < 0.01]. <b>Conclusion:</b> This study showed that 8 determinants were significantly associated with VCT service uptake in SSA. Thus, HIV interventions and policy initiatives should be tailored to these determinants to ensure scale-up of VCT service uptake in SSA.</p>","PeriodicalId":35944,"journal":{"name":"PUBLIC HEALTH REVIEWS","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40433667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond the Individual -A Scoping Review and Bibliometric Mapping of Ecological Determinants of Eating Behavior in Older Adults. 超越个体——老年人饮食行为生态决定因素的范围回顾和文献计量制图。
IF 5.5 Q1 Nursing Pub Date : 2022-08-03 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604967
Íris Rafaela Montez De Sousa, Ina Bergheim, Christine Brombach

Objectives: The objective of this scoping review was to summarize and provide a visual overview of the present-day knowledge on ecological determinants of eating behavior in community-dwelling elderly persons in relation with nutrition communication, considering the evolution of the field. The second objective was to integrate results in recommendations for the development of nutrition communication strategies. Methods: A literature review was performed on Medline, PubMed and Google Scholar, according with the PRISMA protocol for scoping reviews. An a-priori analysis was executed by categorizing determinants from the literature according with the different levels represented in the ecological framework and an a-posteriori analysis by using VosViewer for a chronological bibliometric mapping analysis. Results: Of 4029 articles retrieved, 77 were selected for analysis. Initial publications focused more on individual determinants of eating behavior. Over time, there was a shift towards a holistic view of eating behavior considering the "food environment", including social networks, physical settings and public policy. Conclusion: Beyond the individual, all ecological levels are relevant when targeting eating behavior in the elderly. Nutrition communication strategies should be structured considering these influences.

目的:这一范围审查的目的是总结和提供一个视觉概述目前的知识,在社区居住的老年人饮食行为的生态决定因素与营养沟通,考虑到该领域的发展。第二个目标是将结果纳入制定营养宣传战略的建议。方法:在Medline, PubMed和Google Scholar上进行文献综述,按照PRISMA协议进行范围综述。根据生态框架中所代表的不同层次对文献中的决定因素进行分类,进行先验分析,并使用VosViewer进行时间顺序文献计量制图分析,进行后验分析。结果:在检索到的4029篇文献中,选择77篇进行分析。最初的出版物更多地关注饮食行为的个体决定因素。随着时间的推移,考虑到“食物环境”,包括社交网络、物理环境和公共政策,人们开始转向对饮食行为的整体看法。结论:在针对老年人饮食行为时,除个体外,所有生态水平都是相关的。营养沟通策略应考虑到这些影响。
{"title":"Beyond the Individual -A Scoping Review and Bibliometric Mapping of Ecological Determinants of Eating Behavior in Older Adults.","authors":"Íris Rafaela Montez De Sousa,&nbsp;Ina Bergheim,&nbsp;Christine Brombach","doi":"10.3389/phrs.2022.1604967","DOIUrl":"https://doi.org/10.3389/phrs.2022.1604967","url":null,"abstract":"<p><p><b>Objectives:</b> The objective of this scoping review was to summarize and provide a visual overview of the present-day knowledge on ecological determinants of eating behavior in community-dwelling elderly persons in relation with nutrition communication, considering the evolution of the field. The second objective was to integrate results in recommendations for the development of nutrition communication strategies. <b>Methods:</b> A literature review was performed on Medline, PubMed and Google Scholar, according with the PRISMA protocol for scoping reviews. An <i>a-priori</i> analysis was executed by categorizing determinants from the literature according with the different levels represented in the ecological framework and an <i>a-posteriori</i> analysis by using VosViewer for a chronological bibliometric mapping analysis. <b>Results:</b> Of 4029 articles retrieved, 77 were selected for analysis. Initial publications focused more on individual determinants of eating behavior. Over time, there was a shift towards a holistic view of eating behavior considering the \"food environment\", including social networks, physical settings and public policy. <b>Conclusion:</b> Beyond the individual, all ecological levels are relevant when targeting eating behavior in the elderly. Nutrition communication strategies should be structured considering these influences.</p>","PeriodicalId":35944,"journal":{"name":"PUBLIC HEALTH REVIEWS","volume":null,"pages":null},"PeriodicalIF":5.5,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9381692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40628767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Addressing the Evidence Gap in the Economic and Social Benefits of Civil Registration and Vital Statistics Systems: A Systematic Review. 解决民事登记和人口统计系统在经济和社会效益方面的证据差距:系统回顾。
IF 5.5 Q1 Nursing Pub Date : 2022-07-08 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604560
Rebeca Revenga Becedas, Carmen Sant Fruchtman, Irina Dincu, Donald De Savigny, Daniel Cobos Muñoz

Objectives: Considering the aspiration embedded in the Sustainable Development Goals to Leave No One Behind by 2030, civil registration and vital statistics systems have an essential role in providing reliable, up-to-date information to monitor the progress. Thus, the aim of this systematic review is to compile empirical evidence on the benefits of a functioning civil registration and vital statistics system. Methods: Selected databases were systematically searched until 2019. Key experts were also contacted for relevant literature. The review process was managed with the software EPPI-Reviewer and followed standard methods for systematic reviews. Results: A total of 18 studies were included. The findings revealed that having birth, death, and/or marriage registration, and vital statistics were associated with access to rights and protection, positive impact on economic and health outcomes, and increased access to education. Conclusion: The present review supports the idea that systemic approaches strengthen civil registration and vital statistics systems due to the cumulative effects of vital events' registration. Ensuring appropriate systems for civil registration will have an impact not only on the individuals but also on the generations to come.

目标:考虑到到2030年不让任何一个人掉队的可持续发展目标所包含的愿望,民事登记和人口动态统计系统在提供可靠的最新信息以监测进展方面发挥着至关重要的作用。因此,本系统审查的目的是汇编关于有效的民事登记和生命统计系统的好处的经验证据。方法:系统检索所选数据库至2019年。还联系了主要专家以获取相关文献。评审过程由软件EPPI-Reviewer管理,并遵循系统评审的标准方法。结果:共纳入18项研究。调查结果显示,进行出生、死亡和/或婚姻登记以及生命统计与获得权利和保护、对经济和健康成果产生积极影响以及增加受教育机会有关。结论:由于生命事件登记的累积效应,本综述支持系统方法加强民事登记和生命统计系统的观点。确保适当的民事登记制度不仅会对个人产生影响,也会对后代产生影响。
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引用次数: 1
Prevalence of Access to Prenatal Care in the First Trimester of Pregnancy Among Black Women Compared to Other Races/Ethnicities: A Systematic Review and Meta-Analysis. 与其他种族/民族相比,黑人妇女妊娠前三个月获得产前护理的患病率:一项系统回顾和荟萃分析
IF 5.5 Q1 Nursing Pub Date : 2022-07-04 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604400
Pedro Henrique Alcântara da Silva, Kezauyn Miranda Aiquoc, Aryelly Dayane da Silva Nunes, Wilton Rodrigues Medeiros, Talita Araujo de Souza, Javier Jerez-Roig, Isabelle Ribeiro Barbosa

Objective: To analyze the prevalence of access to prenatal care in the first trimester of pregnancy among black women compared to other races/ethnicities through a systematic review and meta-analysis. Methods: Searches were carried out at PUBMED, LILACS, Web of Science, Scopus, CINAHL, and in the grey literature. The quality of the studies and the risk of bias were analyzed using the Joanna Briggs Critical Appraisal Checklist for Analytical Cross-Sectional Studies instrument. The extracted data were tabulatesd and analyzed qualitatively and quantitatively through meta-analysis. Results: Black women had the lowest prevalence of access to prenatal services in the first trimester, with prevalence ranging from 8.1% to 74.81%, while among white women it varied from 44.9 to 94.0%; 60.7% of black women started prenatal care in the first trimester, while 72.9% of white women did so. Conclusion: Black women compared to other racial groups had lower prevalence of access to prenatal care, with less chance of access in the first trimester, and it can be inferred that the issue of race/skin color is an important determinant in obtaining obstetric care. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020159968_, PROSPERO CRD42020159968.

目的:通过系统回顾和荟萃分析,分析与其他种族/民族相比,黑人妇女妊娠前三个月获得产前护理的流行程度。方法:检索PUBMED、LILACS、Web of Science、Scopus、CINAHL和灰色文献。研究的质量和偏倚风险使用乔安娜布里格斯关键评估清单分析横断面研究工具进行分析。将提取的资料制成表格,通过meta分析进行定性和定量分析。结果:黑人妇女妊娠前三个月获得产前服务的比例最低,为8.1% ~ 74.81%,白人妇女为44.9% ~ 94.0%;60.7%的黑人妇女在妊娠前三个月开始产前护理,而白人妇女的这一比例为72.9%。结论:与其他种族妇女相比,黑人妇女获得产前护理的患病率较低,在妊娠早期获得产前护理的机会较少,可以推断种族/肤色问题是获得产科护理的重要决定因素。系统评价注册号:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020159968_, PROSPERO CRD42020159968。
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引用次数: 4
Factors Influencing the Implementation of Remote Delivery Strategies for Non-Communicable Disease Care in Low- and Middle-Income Countries: A Narrative Review. 影响中低收入国家实施非传染性疾病远程医疗策略的因素:叙述性综述》。
IF 3.5 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2022-06-27 eCollection Date: 2022-01-01 DOI: 10.3389/phrs.2022.1604583
Caroline Favas, Éimhín Ansbro, Evette Eweka, Gina Agarwal, Maria Lazo Porras, Ioanna Tsiligianni, Rajesh Vedanthan, Ruth Webster, Pablo Perel, Adrianna Murphy

Objectives: The COVID-19 pandemic has disrupted health care for non-communicable diseases (NCDs) and necessitated strategies to minimize contact with facilities. We aimed to examine factors influencing implementation of remote (non-facility-based) delivery approaches for people with hypertension and/or diabetes in low- and middle-income countries (LMICs), to inform NCD care delivery during health service disruption, including humanitarian crises. Methods: Our narrative review used a hermeneutic and purposive approach, including primary studies conducted in LMICs, which assessed implementation factors influencing remote NCD care delivery. Results were analyzed using the Consolidated Framework for Implementation Research. Results: Twenty-eight included studies revealed the strong influence of both internal organizational and broader contextual factors, such as community health worker policies or technological environment. Addressing patients' specific characteristics, needs and resources was important for implementation success. Conclusion: This review highlighted the multiple, complex, interdependent factors influencing implementation of remote NCD care in LMICs. Our findings may inform actors designing NCD care delivery in contexts where facility-based access is challenging. Implementation research is needed to evaluate context-adapted e-Health, community-based, and simplified clinical management strategies to facilitate remote NCD care.

目标:COVID-19 大流行扰乱了非传染性疾病 (NCD) 的医疗保健,因此有必要采取策略尽量减少与医疗机构的接触。我们旨在研究影响在中低收入国家(LMICs)为高血压和/或糖尿病患者实施远程(非设施)医疗方法的因素,从而为在医疗服务中断(包括人道主义危机)期间提供非传染性疾病医疗服务提供参考。方法:我们的叙述性综述采用了诠释学和目的性方法,包括在低收入和中等收入国家开展的主要研究,这些研究评估了影响远程非传染性疾病医疗服务的实施因素。我们使用实施研究综合框架对结果进行了分析。结果:纳入的 28 项研究显示,组织内部因素和更广泛的背景因素(如社区医疗工作者政策或技术环境)都有很大影响。针对患者的具体特点、需求和资源对实施的成功非常重要。结论本综述强调了影响低收入和中等收入国家远程非传染性疾病护理实施的多重、复杂和相互依存的因素。我们的研究结果可为设计非传染性疾病医疗服务的参与者提供参考,因为在这种情况下,以医疗机构为基础的医疗服务具有挑战性。需要开展实施研究,以评估适合具体情况的电子健康、社区和简化临床管理策略,从而促进远程非传染性疾病护理。
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引用次数: 0
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