Health & Social Care in the Community最新文献

Recent work outlines definitions of social prescribing, but the role of a social prescribing link worker (SPLW) remains ill defined. Core components of the role must be clarified to enable the study of its impact in connecting people to community-based support and subsequent outcomes. This review compiles and summarises published information on the SPLW role. A scoping review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Review. Suitable online databases were searched using identified terms, a review of the reference lists of identified papers was completed and relevant grey literature was identified through Google Scholar. Relevant reports from UK-based social prescribing networks and government organisations were gathered. Eligibility of each paper was determined based on the specified criteria. Inclusion criteria were identified using the PCC (Population; Concept; Context) framework. Of the 251 search results originally identified, 15 peer-reviewed papers met the criteria for inclusion. Five additional published reports from government and community organisations and networks were identified. Data were extracted and collated in tabular form. Thematic data analysis highlighted four common themes clarifying the role of the SPLW and identifying improvements required to advance social prescribing referral processes. (1) SPLW works in collaboration with the participant, to identify personal needs and goals, and monitors progress over time. (2) SPLW connects service users to community/statutory support. (3) SPLW views health in a holistic manner. (4) The importance of training for SPLWs, and those referring into the system, to improve the referral process. Disparity in language and roles is evident, making it difficult to describe and compare the role across social prescribing services. The importance of training is outlined, and training recommendations are made. Additional effort is needed to clarify the role, impact and training requirements within social prescribing, to strengthen the evidence base, and allow applicability and transferability across services.

Background: The potential association and underlying mechanisms between instrumental activities of daily living (IADL) and depressive symptoms in middle- and older-aged adults remain unclear. This study explores the bidirectional relationship between IADL disability and depressive symptoms among Chinese middle-aged and older adults and examines the mediating or moderating effects of self-rated health (SRH) and age on this relationship.

Methods: We used data from five waves (2011, 2013, 2015, 2018, and 2020) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. A total of 4830 participants aged 45 and older were included in the analysis. Longitudinal associations between IADL disability, SRH, and depressive symptoms were tested using cross-lagged models to simultaneously evaluate the bidirectional association and the strength of the temporal association.

Results: Among middle-aged and older adults, there was a significant bidirectional longitudinal relationship between IADL disabilities and depressive symptoms. Higher levels of IADL disability predicted an increased risk of depressive symptoms and vice versa. SRH mediated the bidirectional relationship between IADL disabilities and depressive symptoms. Higher levels of IADL disability led to lower SRH, which further increased the risk of depressive symptoms and vice versa. Age moderated the cross-lagged models, indicating that the effect of SRH on the bidirectional relationship between IADL disability and depressive symptoms was stronger in the middle-aged group than that in the older group.

Conclusion: The study results clarified the bidirectional relationship between IADL disability and depressive symptoms in middle-aged and older adults. Healthcare providers can use the findings to design targeted interventions to address the decline in IADL function and potentially benefit mental health. Helping middle-aged and older adults improve their SRH may interrupt the vicious cycle linking IADL disability and depressive symptoms, particularly in middle-aged adults transitioning to old age.

Social prescribing is a health and social model of care which is emerging globally. It is a multifaceted intervention shaped by various contextual factors that can affect its implementation. Our aim was to describe community connectors’ (link workers or navigators) perceptions and experiences delivering social prescribing programs, with a particular interest in identifying implementation factors or themes. We conducted 11 online semi-structured interviews with community connectors who delivered social prescribing in British Columbia (BC), Canada. We used directed content analysis, and two authors explored interviews using an implementation perspective. We sorted findings using a deductive approach based on previously published guidance to consider program acceptability, adoption, reach, dose, fidelity, feasibility, and sustainability, and community connectors’ self-efficacy in delivering the program. We identified factors or themes which could impact on social prescribing implementation, specifically: variability in people’s unmet social needs, identification of community resources, team relationships, and communication. Participants also shared their experiences and perspectives on community connectors’ training, support, and their roles and scope within the continuum of care. At the client level, participants noted some challenges for people to access services because of low income and/or digital literacy. They further provided suggestions for shaping the future of social prescribing. Overall, participants provided valuable insights into social prescribing implementation opportunities and challenges which contribute to understanding community connectors’ role within the wider scope of this quickly emerging health and social model of care.

Introduction: Despite a growing social prescribing (SP) movement, the concept itself remains ambiguous, resulting in considerable variation in practice across different contexts. As discussions of SP emerge at the policy level, this ambiguity may influence program and policy spread. This research explores current literature and practices of SP to understand the different conceptual elements (i.e., goals and motivations) and core components (i.e., structures and behaviors) of SP.

Methods: A scoping review of academic literature was conducted. Search terms included “social prescr ^∗,” “social medicine,” “link worker,” “social refer ^∗,” and “community refer ^∗.” From this data, a typology of models based on descriptions of conceptual elements and core components was developed. Following the development of the typology, we applied our findings to existing SP programs, which were found through reference-checking academic sources and a community consultation conducted by our partner organization.

Results: 29 articles informed the scoping review, and 24 program descriptions were compared to the typology. Four models of SP are proposed. The clinical model follows a biomedical approach where the physician refers patients to SP services primarily geared to lifestyle factors. The holistic model addresses social determinants of health, referring to food security, housing, or income programs. The empowerment model considers well-being through relationship-building and a deep understanding of the client context. The healthy community’s model focuses on community development, where community members gain the capacity to better support one another.

Conclusion: The proposed typology will help implementers design programs that best suit their goals and contexts. At the policy level, this research demonstrates how a “bounded ambiguity” approach may allow SP to demonstrate its fullest potential. For researchers, this work provides a foundation for future exploration of how SP is implemented despite its ambiguity.

Grandparents have a long history of assuming caregiving responsibilities, particularly in Indigenous communities, where the concepts of “kin” and “care” are expansive. In Australia, there has been a rise in grandparents becoming custodial carers for their grandchildren who cannot live with their parents, biological or otherwise. Placement with relatives or family friends is known as kinship care, with most of these families headed by grandparents raising grandchildren. Children being raised by kin are widely considered the preferred option compared to nonrelative institutional or foster care, as kinship care provides a connection to family, community, and culture and fosters a sense of belonging and identity, while also offering the potential for stable living arrangements. This paper reports on an Australian study involving 428 grandparent carers sharing their experiences of caring for their grandchildren as survey respondents, with nine of those carers participating in an individual in-depth interview. Findings suggest that the pleasure of watching their grandchildren grow was a privilege for many. Alongside this privilege, many experienced multiple and complex levels of stress, distress and trauma, exacerbated by a service system that did not appear to want to hear or understand. Implications for policy, practice and further research are highlighted.

Singapore is experiencing both an ageing population and a decreasing birth rate, with fewer adults to care for older adults. Caregiving for older adults can be taxing, and hence, caregivers need support. Using previous literature and the study team’s interactions with caregivers, a multicomponent intervention, consisting of a mobile application, fall detection and response service, and peer support program, was conceptualized. To better understand the needs and challenges of caregivers and to determine the potential usefulness of the multicomponent intervention, the study team engaged ward nurses and Community Health Team (CHT) members, two groups of stakeholders that regularly interact with caregivers in their work, using a modified Delphi technique. Ward nurses and CHT members each formed one Delphi panel and answered statements specific to their panel over two rounds. Nineteen ward nurses and 15 CHT members participated. The final participation rate for both rounds was 100% (19/19) for ward nurses and 93% (14/15) for CHT members. A total of 17/30 statements (57%) and 10/32 statements (31%) reached consensus for ward nurses and CHT members, respectively. Ward nurses agreed that (a) caregivers will benefit from a one-stop digital resource library (84%), (b) the importance of having a wide array of localized information for this digital resource (79%–89%) and (c) several challenges associated with caregiver training (74%–79%). The CHT members agreed that (a) caregivers do not receive adequate support outside their immediate family (86%), (b) caregivers struggle to manage care recipients’ behaviours and emotions (80%), and (c) there is a lack of relevant community resources for caregivers (71%–93%). The agreements indicated the feasibility of certain components of the intervention. Refinements to the multicomponent intervention were also made based on the findings.

Background: Pedestrian visibility is a critical factor in reducing the number of pedestrian accidents on roads. A review of pedestrian visibility literature may reveal different types of interventions that are feasible for promoting pedestrian visibility. Therefore, this study aimed to identify the interventions to increase pedestrian visibility.

Methods: A systematic search was conducted on electronic databases including PubMed, Scopus, and Google Scholar for full-text articles published from 2003 to December 17, 2023. All interventions used for pedestrians to increase their visibility were considered for the review.

Results: Our systematic search identified 13,472 records, of which 5749 duplicated articles were removed. The remaining 7723 records were initially screened on the basis of title and abstract. After full reading of 804 articles, finally, 14 articles were eligible to be included in the review. The strategies for the visibility of pedestrians were categorized based on the nature of strategies intervened on pedestrians, components, and benefits. The categorizations highlight a diverse range of strategies employed to enhance pedestrian visibility, including technological solutions, wearable, nonverbal communication, detection-based warnings, and educational interventions.

Conclusion: The diverse range of strategies explored in the reviewed studies underscores the multidimensional approach required to enhance pedestrian visibility and safety. It highlights the need for effective interventions to improve detection and recognition of pedestrians by drivers, which is crucial for reducing accidents. The findings suggest that a combination of technological advancements, wearables, nonverbal communication, detection-based warnings, and educational interventions can contribute to a safer pedestrian environment. However, further research is needed to assess the long-term effectiveness and real-world applicability of these strategies.

Adversities during childhood such as experiences of neglect, parental mental illness, substance use, financial stress, unstable housing and racism/discrimination have cumulative and harmful lifelong impacts. Early identification, intervention and support for parents, families and communities experiencing adversity can enhance their capacity to provide environments where children can thrive and reach their full potential. However, parents experience many barriers to seeking support including experiences of judgement, blame and discrimination when accessing services. This systematic review of qualitative evidence aimed to explore parents’ experiences of interactions with health, welfare and educational professionals when accessing support for adversities that impact parental capacity and children’s health, development or wellbeing in the early years (0–5 years). In doing so, we specifically aimed to explore elements of professionals’ interactions that parents viewed either positively or negatively to inform future policy, practice, education and research. After the screening process, 16 studies were included in the synthesis. Key findings highlighted that although health and welfare services should be promoting parental capacity to raise thriving children, parents frequently experienced professionals who were unwilling to listen, disrespectful and restricted parents’ participation. Furthermore, parents felt the complexity of their lives was not acknowledged and felt blamed for broader socioeconomic circumstances and intergenerational patterns of marginalisation. Conversely, positive experiences came from professionals who engaged in genuine relationships that provided emotional and practical supports that empowered parents to change. These findings highlight the need for change across all levels of service delivery, inclusive of individual professionals through to the systems and policies underpinning the structure and provision of services for parents and families. Further work is needed to explore how to implement and sustain effective change across multiple sectors to inform consistent, empathetic and therapeutic approaches to supporting parents, so children can grow and thrive within their own families and communities.

Introduction: In 2017, a provincial Liberal government launched the Ontario Basic Income Pilot (OBIP) to assess a promising approach to poverty reduction in Ontario, Canada. It was prematurely canceled by a subsequent Conservative government, despite election promises assuring that it would continue. The cancelation affected 4000 OBIP recipients.

Objective: This study explored how participants’ lives were on the OBIP compared to their lives before and after the pilot project using the social determinants of mental health (SDoMH) as a key lens.

Study Design and Data Collection: Semistructured interview data, gathered in 2019, were collected from a sample of 46 OBIP participants from three study sites, viewed through the lenses of structural violence and the SDoMH, and analyzed using reflexive thematic analysis.

Findings: We identified eight themes from the data, all of which pointed to the positive impacts of the OBIP on the SDoMH of participants. These included expanded opportunities for education and employment, improved housing stability, enhanced social inclusion (including an escape from the denigrations of receiving charity), improved sense of security and mental health, the wherewithal to eschew “crappy foods” in favor of healthier options, and the freedom to live one’s life as one chooses. All these positive impacts were threatened or reversed by the Pilot’s cancelation.

Conclusions and Implications: The discontinuation of the OBIP, a benefit that appeared to be improving the mental health and well-being of OBIP participants, can be viewed as an act of structural violence by government leaders. This study contributes to the growing evidence showing that cash transfer programs, such as a basic income, can alleviate psychological distress and improve mental well-being for people living in poverty. A groundswell of mobilized citizens, and public health and mental health practitioners specifically, must hold governments accountable for acts of structural violence that can readily be addressed through policies that eradicate poverty.

With the gradual promotion of the human papillomavirus (HPV) vaccine in mainland China, social media has been suggested as an important channel for disseminating HPV-related information and promoting vaccination behaviors. This study explored the mechanism that health information communication based on social media usage affects HPV vaccination intention, i.e., examining the mediating effects of external factors (information credibility and information satisfaction) and internal factors (personal health beliefs) between social media use and HPV vaccination intention, and examining the potential moderating effect of subjective norms and health literacy on the key independent variables and the outcome variables. A total of 2552 cross-sectional sample data (through random sampling and based on the 95% confidence level with population size > 100,000) were collected through an online questionnaire in April 2022. The results based on mediating analyses indicated that information credibility, information satisfaction, and health belief all positively mediated the relationship between social media use and HPV vaccination intentions (p < 0.001). In addition, subjective norms and health literacy separately moderated the relationship between social media use and information credibility and between social media use and information satisfaction. This study provides insights for the community to promote HPV vaccination intention by utilizing social media information communication. Specifically, we identify that information satisfaction, information credibility, and health beliefs are positively associated with social media use, thereby contributing to healthy behaviors.