Pub Date : 2024-07-29DOI: 10.1101/2024.07.28.24311109
Margaret Fischer, Jennifer Swint, Wei Zhang, Xi Zhang
Background: Mental health disparities persist as a significant public health concern in the United States, with certain populations experiencing disproportionate burdens of mental illness and barriers to care. This systematic review aims to synthesize current evidence on mental health disparities across various demographic groups and identify key factors contributing to these inequities. Methods: We conducted a comprehensive search of peer-reviewed literature published between 2010 and 2024 using PubMed, PsycINFO, and Scopus databases. Studies examining mental health outcomes, access to care, and treatment efficacy across racial/ethnic, socioeconomic, gender, sexual orientation, and geographic groups in the US were included. Two independent reviewers screened articles, extracted data, and assessed study quality. Results: Of 2,345 initially identified studies, 127 met inclusion criteria. Consistent disparities were observed across multiple domains, with racial/ethnic minorities, low-income individuals, LGBTQ+ populations, and rural residents experiencing higher rates of mental health disorders, lower access to quality care, and poorer treatment outcomes. Key contributing factors included systemic racism, socioeconomic barriers, stigma, lack of culturally competent care, and inadequate insurance coverage. Conclusion: This review highlights persistent and multifaceted mental health disparities in the US. Addressing these inequities requires comprehensive policy interventions, increased funding for community-based mental health services, improved cultural competence in healthcare delivery, and targeted research to develop effective, culturally-tailored interventions for underserved populations.
{"title":"Mind the Gap: Unraveling Mental Health Disparities in America's Diverse Landscape","authors":"Margaret Fischer, Jennifer Swint, Wei Zhang, Xi Zhang","doi":"10.1101/2024.07.28.24311109","DOIUrl":"https://doi.org/10.1101/2024.07.28.24311109","url":null,"abstract":"Background: Mental health disparities persist as a significant public health concern in the United States, with certain populations experiencing disproportionate burdens of mental illness and barriers to care. This systematic review aims to synthesize current evidence on mental health disparities across various demographic groups and identify key factors contributing to these inequities.\u0000Methods: We conducted a comprehensive search of peer-reviewed literature published between 2010 and 2024 using PubMed, PsycINFO, and Scopus databases. Studies examining mental health outcomes, access to care, and treatment efficacy across racial/ethnic, socioeconomic, gender, sexual orientation, and geographic groups in the US were included. Two independent reviewers screened articles, extracted data, and assessed study quality.\u0000Results: Of 2,345 initially identified studies, 127 met inclusion criteria. Consistent disparities were observed across multiple domains, with racial/ethnic minorities, low-income individuals, LGBTQ+ populations, and rural residents experiencing higher rates of mental health disorders, lower access to quality care, and poorer treatment outcomes. Key contributing factors included systemic racism, socioeconomic barriers, stigma, lack of culturally competent care, and inadequate insurance coverage.\u0000Conclusion: This review highlights persistent and multifaceted mental health disparities in the US. Addressing these inequities requires comprehensive policy interventions, increased funding for community-based mental health services, improved cultural competence in healthcare delivery, and targeted research to develop effective, culturally-tailored interventions for underserved populations.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141871059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1101/2024.07.25.24310981
Justin Chapman, Aaron Miatke, Dorothea Dumuid, Jairo Migueles, Shuichi Suetani, Nicole Korman, Mike Trott, Jacqueline Byrne, Dan Siskind, Donni Johnston, Jeanette Sewell, Michael Breakspear, Sue Patterson
Background and aims: Adults with severe mental illness (SMI) have lower physical activity (PA) than the general population. Supervised exercise interventions provide high support but may not effectively promote motivation, which is important for behaviour change. Motivational strategies such as PA counselling may target motivation more directly; however, the effectiveness in people with SMI is unclear. Methods: This was a randomised controlled trial of interventions designed to promote PA in adults with SMI. Participants were randomised to either: (1) supervised exercise (GYM), or (2) motivational counselling and self-monitoring using fitness trackers (MOT). Group sessions were once/week over 8-weeks. The primary outcome was time spent in moderate-to-vigorous PA (MVPA) assessed using GENEActiv accelerometers worn continuously. Change in MVPA was assessed using the cumulative change from baseline, and as a composition of light activity, sedentary behaviour, and sleep. Results: Sixty-four participants were allocated (63% male, 82% overweight/obese, 59% psychotic disorder). Accelerometer-derived MVPA increased for the MOT group between baseline and post-intervention, and the cumulative sum of change in MVPA from baseline in the MOT group was higher than the GYM group. Compositional analyses showed stable weekly activity profiles, with no significant changes attributable to group allocation. Conclusions: The cumulative change in MVPA was higher for MOT than GYM; however, compositional analyses that considers MVPA as a composition of other daily behaviours showed no change in composition over the intervention period. Exercise interventions should incorporate motivational strategies and supervised exercise; future research should investigate behaviour change interventions with longer durations and more frequent sessions. Registration details: The trial is registered under the Australian and New Zealand Clinical Trial Registry (ACTRN12617001017314).
{"title":"A randomised controlled trial of interventions to promote adoption of physical activity in adults with severe mental illness","authors":"Justin Chapman, Aaron Miatke, Dorothea Dumuid, Jairo Migueles, Shuichi Suetani, Nicole Korman, Mike Trott, Jacqueline Byrne, Dan Siskind, Donni Johnston, Jeanette Sewell, Michael Breakspear, Sue Patterson","doi":"10.1101/2024.07.25.24310981","DOIUrl":"https://doi.org/10.1101/2024.07.25.24310981","url":null,"abstract":"Background and aims: Adults with severe mental illness (SMI) have lower physical activity (PA) than the general population. Supervised exercise interventions provide high support but may not effectively promote motivation, which is important for behaviour change. Motivational strategies such as PA counselling may target motivation more directly; however, the effectiveness in people with SMI is unclear. Methods: This was a randomised controlled trial of interventions designed to promote PA in adults with SMI. Participants were randomised to either: (1) supervised exercise (GYM), or (2) motivational counselling and self-monitoring using fitness trackers (MOT). Group sessions were once/week over 8-weeks. The primary outcome was time spent in moderate-to-vigorous PA (MVPA) assessed using GENEActiv accelerometers worn continuously. Change in MVPA was assessed using the cumulative change from baseline, and as a composition of light activity, sedentary behaviour, and sleep. Results: Sixty-four participants were allocated (63% male, 82% overweight/obese, 59% psychotic disorder). Accelerometer-derived MVPA increased for the MOT group between baseline and post-intervention, and the cumulative sum of change in MVPA from baseline in the MOT group was higher than the GYM group. Compositional analyses showed stable weekly activity profiles, with no significant changes attributable to group allocation. Conclusions: The cumulative change in MVPA was higher for MOT than GYM; however, compositional analyses that considers MVPA as a composition of other daily behaviours showed no change in composition over the intervention period. Exercise interventions should incorporate motivational strategies and supervised exercise; future research should investigate behaviour change interventions with longer durations and more frequent sessions. Registration details: The trial is registered under the Australian and New Zealand Clinical Trial Registry (ACTRN12617001017314).","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-24DOI: 10.1101/2024.07.23.24310901
Jeremy Y Ng, Mehvish Masood, Sivany Kathir, Holger Cramer
Background: Complementary, alternative, and integrative medicine (CAIM) has been increasing in popularity for patients with cardiovascular illnesses. However, little is known about perceptions of CAIM among cardiology researchers and clinicians. In response, this study aimed to assess the practices, perceptions, and attitudes towards CAIM among cardiology researchers and clinicians. Methods: An anonymous, digital cross-sectional survey was administered to researchers and clinicians who have published articles in cardiology journals indexed in OVID MEDLINE. The survey was sent to 37,915 researchers and clinicians and included 5-point Likert scales, multiple-choice questions, and open-ended questions. Basic descriptive statistics were drawn from quantitative data, and a thematic content analysis was conducted to analyze open-ended responses. Results: Among the 309 respondents, the majority (n=173, 55.99%) identified themselves as both researchers and clinicians in the field of cardiology. While 45.78% (n=114) of participants expressed agreement regarding the safety of CAIM therapies, 44.40% (n=111) disagreed on their efficacy. Most respondents believed in the value of conducting research on CAIM therapies (79.2%, n=198). Respondents perceived mind-body therapies (57.61%, n=159) and biologically based practices (47.46%, n=131) as the most promising interventions for the prevention and treatment of cardiovascular conditions. Biofield therapies were the least favoured for integration into mainstream medical practices (11.93%, n=29). Conclusions: While cardiology researchers and clinicians perceive CAIM therapies to have potential, many are hesitant about integrating such interventions into the current medical system due to a perceived lack of scientific evidence and standardized products. Insights from this study may help establish educational resources for healthcare practitioners.
{"title":"An International, Cross-Sectional Survey of Cardiology Researchers and Clinicians: Perceptions of Complementary, Alternative, and Integrative Medicine","authors":"Jeremy Y Ng, Mehvish Masood, Sivany Kathir, Holger Cramer","doi":"10.1101/2024.07.23.24310901","DOIUrl":"https://doi.org/10.1101/2024.07.23.24310901","url":null,"abstract":"Background: Complementary, alternative, and integrative medicine (CAIM) has been increasing in popularity for patients with cardiovascular illnesses. However, little is known about perceptions of CAIM among cardiology researchers and clinicians. In response, this study aimed to assess the practices, perceptions, and attitudes towards CAIM among cardiology researchers and clinicians. Methods: An anonymous, digital cross-sectional survey was administered to researchers and clinicians who have published articles in cardiology journals indexed in OVID MEDLINE. The survey was sent to 37,915 researchers and clinicians and included 5-point Likert scales, multiple-choice questions, and open-ended questions. Basic descriptive statistics were drawn from quantitative data, and a thematic content analysis was conducted to analyze open-ended responses. Results: Among the 309 respondents, the majority (n=173, 55.99%) identified themselves as both researchers and clinicians in the field of cardiology. While 45.78% (n=114) of participants expressed agreement regarding the safety of CAIM therapies, 44.40% (n=111) disagreed on their efficacy. Most respondents believed in the value of conducting research on CAIM therapies (79.2%, n=198). Respondents perceived mind-body therapies (57.61%, n=159) and biologically based practices (47.46%, n=131) as the most promising interventions for the prevention and treatment of cardiovascular conditions. Biofield therapies were the least favoured for integration into mainstream medical practices (11.93%, n=29).\u0000Conclusions: While cardiology researchers and clinicians perceive CAIM therapies to have potential, many are hesitant about integrating such interventions into the current medical system due to a perceived lack of scientific evidence and standardized products. Insights from this study may help establish educational resources for healthcare practitioners.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-23DOI: 10.1101/2024.07.22.24309820
Oliver Groene, Keriin Katsaros, Antonio Chiarenza, Sally Fawkes, Margareta Kristenson
The need to reorient health services towards health promotion is greater than ever. Health systems are overburdened by treating an ever-growing number of chronic patients, many of which seek care for problems that could partly be avoided or postponed through better health promotion implementation. Since its establishment, the International Network of Health Promoting Hospitals and Health Services has explicitly addressed this issue by developing specific standards on evidence-based health promotion approaches and interventions that should be implemented in health services organizations. These approaches and interventions not only address the health of patients, but also of staff and the wider community. Since the development of the standards in 2006, health systems and legitimate patient demands have evolved considerably. At the same time, topics emerged that are strongly associated with health promotion strategies, such as the climate impact of health services. An update of the 2006 standards was therefore overdue. The purpose of this paper is, firstly, to describe the methodology used to develop and outline the 2020 Standards for Health Promoting Hospitals and Health Services. Secondly, we present a self-assessment tool, which was developed to operationalize and provide concrete measurable elements for each standard against which performance and progress towards implementation can be measured and tracked. The 2020 standards are health-oriented, continue to uphold the strategies defined in the Ottawa Charter for Health Promotion, and respond to recent international declarations and charters
{"title":"Standards for Health Promoting Hospitals and Health Services: Development and tools for implementation and measurement","authors":"Oliver Groene, Keriin Katsaros, Antonio Chiarenza, Sally Fawkes, Margareta Kristenson","doi":"10.1101/2024.07.22.24309820","DOIUrl":"https://doi.org/10.1101/2024.07.22.24309820","url":null,"abstract":"The need to reorient health services towards health promotion is greater than ever. Health systems are overburdened by treating an ever-growing number of chronic patients, many of which seek care for problems that could partly be avoided or postponed through better health promotion implementation. Since its establishment, the International Network of Health Promoting Hospitals and Health Services has explicitly addressed this issue by developing specific standards on evidence-based health promotion approaches and interventions that should be implemented in health services organizations. These approaches and interventions not only address the health of patients, but also of staff and the wider community. Since the development of the standards in 2006, health systems and legitimate patient demands have evolved considerably. At the same time, topics emerged that are strongly associated with health promotion strategies, such as the climate impact of health services. An update of the 2006 standards was therefore overdue. The purpose of this paper is, firstly, to describe the methodology used to develop and outline the 2020 Standards for Health Promoting Hospitals and Health Services. Secondly, we present a self-assessment tool, which was developed to operationalize and provide concrete measurable elements for each standard against which performance and progress towards implementation can be measured and tracked. The 2020 standards are health-oriented, continue to uphold the strategies defined in the Ottawa Charter for Health Promotion, and respond to recent international declarations and charters","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141777899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-19DOI: 10.1101/2024.07.19.24310586
Eva Aalbers, Miriam de Kleijn, Marja van Vliet, Marieke Spreeuwenberg
Objectives: The Alternative Dialogue (PHD), a dialogue technique which is based on Positive Health, is considered a potential method to improve patient-centred care within the Netherlands. This study aims to provide clarity on the core elements of the PHD and aims to assess to what extent the practical application of the PHD aligns with these core elements. Design: An exploratory qualitative study using semi-structured interviews. Setting: The study was conducted among health professionals working in primary and secondary care in the Netherlands. Participants: Thirteen experts were purposely sampled and included based on their involvement in the development, implementation or research of the PHD. Additionally, seven users, who applied the PHD in patient consultations and worked as a primary or secondary health professional participated, both self-selected and purposively sampled. They were included if they participated in a Positive Health training. Results: The analysis revealed consensus among experts and users about prioritizing the patient's perspective, adopting a holistic health view, and promoting self-management and empowerment as main guiding principles. Consensus was also found regarding professional attitude, goals and outcomes and implementation conditions. Variability was observed in the role of behaviour change support as a guiding principle. Further, the PHD as intended by its developers seems more structured and comprehensive than often applied in practice. Discrepancies also emerged regarding target patient groups and applicable settings, highlighting the need for customization and tailored guidance within diverse contexts. Conclusions: While there is alignment on the main guiding principles of PHD, there are varying opinions regarding its specific tools and techniques. Clarity in terminology and delineation of the PHD, along with customization for diverse contexts, is crucial to address these challenges and to determine its effectiveness. This study provides initial insights to inform future research and practice in PHD implementation.
{"title":"Core elements of the Positive Health dialogue during patient consultations: a qualitative study exploring expert and user opinions in the Netherlands","authors":"Eva Aalbers, Miriam de Kleijn, Marja van Vliet, Marieke Spreeuwenberg","doi":"10.1101/2024.07.19.24310586","DOIUrl":"https://doi.org/10.1101/2024.07.19.24310586","url":null,"abstract":"Objectives: The Alternative Dialogue (PHD), a dialogue technique which is based on Positive Health, is considered a potential method to improve patient-centred care within the Netherlands. This study aims to provide clarity on the core elements of the PHD and aims to assess to what extent the practical application of the PHD aligns with these core elements. Design: An exploratory qualitative study using semi-structured interviews. Setting: The study was conducted among health professionals working in primary and secondary care in the Netherlands. Participants: Thirteen experts were purposely sampled and included based on their involvement in the development, implementation or research of the PHD. Additionally, seven users, who applied the PHD in patient consultations and worked as a primary or secondary health professional participated, both self-selected and purposively sampled. They were included if they participated in a Positive Health training. Results: The analysis revealed consensus among experts and users about prioritizing the patient's perspective, adopting a holistic health view, and promoting self-management and empowerment as main guiding principles. Consensus was also found regarding professional attitude, goals and outcomes and implementation conditions. Variability was observed in the role of behaviour change support as a guiding principle. Further, the PHD as intended by its developers seems more structured and comprehensive than often applied in practice. Discrepancies also emerged regarding target patient groups and applicable settings, highlighting the need for customization and tailored guidance within diverse contexts. Conclusions: While there is alignment on the main guiding principles of PHD, there are varying opinions regarding its specific tools and techniques. Clarity in terminology and delineation of the PHD, along with customization for diverse contexts, is crucial to address these challenges and to determine its effectiveness. This study provides initial insights to inform future research and practice in PHD implementation.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141740921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.1101/2024.07.10.24310251
Bingjun Chen, Xiaoying Lyu, Koryna Lottenbach, Chantal Zeier, Dominic Jaminet, Sarangoo Solongo, Hummel Timo, Wicker Talia, Ahmet Sevik, Xiaying Wang, Michael Hammes, Yiming Li, Saroj K. Pradhan, Michael Furian
Importance Traditional Chinese Medicine (TCM) becomes popular in Switzerland, however, Swiss TCM research activity and scientific output have not been investigated. Objective To describe the Swiss TCM research activities and main health conditions studied. Data Source A systematic literature search of PubMed and Embase was performed from database inception to December 31st, 2023. Study Selection Articles describing a TCM-related therapy modality in humans with at least one author affiliated with a Swiss institution. Data Extraction Primary and secondary outcomes, as well as study and author characteristics were extracted from included articles. Main Outcomes and Measures The main outcome was the main health condition studied. Secondary outcomes are the total number of articles published over time, the TCM therapies used, and the Swiss institutions involved. Results Of the 223 articles included, 68.2% of published articles originated from the top 3 of 73 (4.1%) Swiss institutions, namely the University of Zurich (32.3%), University of Bern (30.0%) and University of Basel (7.6%). Overall, 116 (52.0%) articles described original studies including 36 (31.0%) articles reporting findings from randomized clinical trials, 29 (25.0%) from cross-sectional studies, 20 (17.2%) from prospective cohort studies, 19 (16.4%) from case reports and 12 (10.3%) from retrospective studies. The top health categories studied were Pain Management (16.4%), Psychology and Behaviour (8.6%), Neurology (6.9%), and Oncology (6.9%). The most used TCM therapies were acupuncture or moxibustion (61.2%), combination of several treatments (15.5%), herbal medicine (10.3%), and Qi Gong or martial arts (9.5%). Conclusion and Relevance Until 2023, the total number of scientific TCM output by Swiss authors is steadily increasing but remains small. More effort to conducted TCM research and to elucidate the TCM therapy effects in Switzerland is warranted.
{"title":"Traditional Chinese Medicine Research Activity in Switzerland. A Systematic Review and Bibliometric Analysis","authors":"Bingjun Chen, Xiaoying Lyu, Koryna Lottenbach, Chantal Zeier, Dominic Jaminet, Sarangoo Solongo, Hummel Timo, Wicker Talia, Ahmet Sevik, Xiaying Wang, Michael Hammes, Yiming Li, Saroj K. Pradhan, Michael Furian","doi":"10.1101/2024.07.10.24310251","DOIUrl":"https://doi.org/10.1101/2024.07.10.24310251","url":null,"abstract":"Importance Traditional Chinese Medicine (TCM) becomes popular in Switzerland, however, Swiss TCM research activity and scientific output have not been investigated. Objective To describe the Swiss TCM research activities and main health conditions studied. Data Source A systematic literature search of PubMed and Embase was performed from database inception to December 31st, 2023. Study Selection Articles describing a TCM-related therapy modality in humans with at least one author affiliated with a Swiss institution. Data Extraction Primary and secondary outcomes, as well as study and author characteristics were extracted from included articles. Main Outcomes and Measures The main outcome was the main health condition studied. Secondary outcomes are the total number of articles published over time, the TCM therapies used, and the Swiss institutions involved. Results Of the 223 articles included, 68.2% of published articles originated from the top 3 of 73 (4.1%) Swiss institutions, namely the University of Zurich (32.3%), University of Bern (30.0%) and University of Basel (7.6%). Overall, 116 (52.0%) articles described original studies including 36 (31.0%) articles reporting findings from randomized clinical trials, 29 (25.0%) from cross-sectional studies, 20 (17.2%) from prospective cohort studies, 19 (16.4%) from case reports and 12 (10.3%) from retrospective studies. The top health categories studied were Pain Management (16.4%), Psychology and Behaviour (8.6%), Neurology (6.9%), and Oncology (6.9%). The most used TCM therapies were acupuncture or moxibustion (61.2%), combination of several treatments (15.5%), herbal medicine (10.3%), and Qi Gong or martial arts (9.5%). Conclusion and Relevance Until 2023, the total number of scientific TCM output by Swiss authors is steadily increasing but remains small. More effort to conducted TCM research and to elucidate the TCM therapy effects in Switzerland is warranted.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141615063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-11DOI: 10.1101/2024.07.11.24310222
Hwayeon Danielle Shin, Jessica Kemp, Samantha Groves, Laura Bennett-Poynter, Charlotte Pape, Karen Lascelles, Gillian Strudwick
Introduction: Prior mental health care utilization presents an important window of opportunity for providing suicide prevention interventions. To date, no reviews have consolidated the help-seeking needs of individuals in contact with mental health services. This warrants further attention given this group may have different needs for interventions compared to the general population who have not sought help previously. Aim: The purpose of this rapid scoping review was to summarize the available literature on help-seeking needs related to suicide prevention among individuals in contact with mental health services from healthcare settings. Method: Cochrane rapid review and Joanna Briggs Institute scoping review methodologies were adapted, and databases, including MEDLINE, Scopus, CINAHL, PsycInfo, and EMBASE, were searched. Results: A total of 42 primary studies were included in analysis. Reported barriers and facilitators to help-seeking behaviors identified within studies were mapped onto the socio-ecological model. Barriers and facilitators identified included knowledge and attitudes toward healthcare utilization, family and peer support, interactions with healthcare professionals, provision of holistic care, and the creation of a supportive atmosphere and safe space to promote open discussions of suicide-related concerns. Discussion: The findings of this review offer valuable insights into areas for improvement in addressing help-seeking needs for individuals who are in contact with health services related to suicide prevention. Implication for Research: The findings serve as a foundation for shaping mental health initiatives informing approaches and care delivery tailored towards individuals who are in contact with health services. The reported barriers and facilitators offer insights to inform the development of mental health support tools to enhance care and considerations for evaluations.
{"title":"Help-seeking needs related to suicide prevention for individuals in contact with mental health services: A rapid scoping review","authors":"Hwayeon Danielle Shin, Jessica Kemp, Samantha Groves, Laura Bennett-Poynter, Charlotte Pape, Karen Lascelles, Gillian Strudwick","doi":"10.1101/2024.07.11.24310222","DOIUrl":"https://doi.org/10.1101/2024.07.11.24310222","url":null,"abstract":"Introduction: Prior mental health care utilization presents an important window of opportunity for providing suicide prevention interventions. To date, no reviews have consolidated the help-seeking needs of individuals in contact with mental health services. This warrants further attention given this group may have different needs for interventions compared to the general population who have not sought help previously. Aim: The purpose of this rapid scoping review was to summarize the available literature on help-seeking needs related to suicide prevention among individuals in contact with mental health services from healthcare settings. Method: Cochrane rapid review and Joanna Briggs Institute scoping review methodologies were adapted, and databases, including MEDLINE, Scopus, CINAHL, PsycInfo, and EMBASE, were searched. Results: A total of 42 primary studies were included in analysis. Reported barriers and facilitators to help-seeking behaviors identified within studies were mapped onto the socio-ecological model. Barriers and facilitators identified included knowledge and attitudes toward healthcare utilization, family and peer support, interactions with healthcare professionals, provision of holistic care, and the creation of a supportive atmosphere and safe space to promote open discussions of suicide-related concerns. Discussion: The findings of this review offer valuable insights into areas for improvement in addressing help-seeking needs for individuals who are in contact with health services related to suicide prevention.\u0000Implication for Research: The findings serve as a foundation for shaping mental health initiatives informing approaches and care delivery tailored towards individuals who are in contact with health services. The reported barriers and facilitators offer insights to inform the development of mental health support tools to enhance care and considerations for evaluations.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141614460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-09DOI: 10.1101/2024.07.09.24310132
Simon C Cork, Keith Hopcroft
Communication with patients in language they understand leads to greater comprehension of treatment and diagnoses but can be time consuming for clinicians. Here we sought to investigate the utility of ChatGPT to translate clinic letters into language patients understood, without loss of clinical information. Twenty-three letters from a range of specialities were translated, resulting in no loss of clinical information. Subjective analysis from patient representatives revealed significantly increased understanding of treatment and diagnoses, increased satisfaction, and a significant decrease in the requirement to seek medical assistance in understanding their content when compared to original letters written to clinicians. Overall, we conclude that ChatGPT can be used to translate clinic letters into patient friendly language, and that these letters are preferred by patients.
{"title":"Evaluating the utility of ChatGPT to convert clinic letters into patient friendly language","authors":"Simon C Cork, Keith Hopcroft","doi":"10.1101/2024.07.09.24310132","DOIUrl":"https://doi.org/10.1101/2024.07.09.24310132","url":null,"abstract":"Communication with patients in language they understand leads to greater comprehension of treatment and diagnoses but can be time consuming for clinicians. Here we sought to investigate the utility of ChatGPT to translate clinic letters into language patients understood, without loss of clinical information. Twenty-three letters from a range of specialities were translated, resulting in no loss of clinical information. Subjective analysis from patient representatives revealed significantly increased understanding of treatment and diagnoses, increased satisfaction, and a significant decrease in the requirement to seek medical assistance in understanding their content when compared to original letters written to clinicians. Overall, we conclude that ChatGPT can be used to translate clinic letters into patient friendly language, and that these letters are preferred by patients.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-08DOI: 10.1101/2024.07.06.24310027
Mel Ramasawmy, David Sunkersing, Lydia Poole, Ann Blandford, Paramjit Gill, Kamlesh Khunti, Shivali Modha, Kiran Patel, Henry W W Potts, Madiha Sajid, Nushrat Khan, Amitava Banerjee
Background: Use of Digital Health Interventions (DHIs) for the management of cardiometabolic diseases has increased, but may exacerbate existing health inequalities. Healthcare professionals (HCPs) play a vital role in recommending and supporting patients to use these tools. There is a need to understand the role of HCPs in managing the implementation of digital health in communities at risk of health inequalities. Objective: To explore the views of health care professionals about digital health and its impact on health inequalities, focusing on cardiometabolic diseases and the South Asian population in the UK. Methods: Online interviews and focus-groups with HCPs (n=18), exploring participants' experiences and attitudes towards digital health, perceptions of patients' barriers and facilitators to use, whether they perceived any populations to be particularly at risk of digital inequalities, and the impact of the COVID-19 pandemic on their practice in relation to digital health. After informed consent, transcription and coding, a reflexive thematic approach was taken to analysis. Results: HCPs recognised the potential benefits of DHIs to improve access and delivery of care and patient outcomes, but described several barriers to successful implementation. HCPs demonstrated a good understanding of the challenges their patients face in relation to wider inequalities, barriers to health behaviours and healthcare access, and digital health. Of particular concern was the impact of increasing reliance of digital interventions in health care on the exclusion of some patient groups. Participants recommended improvement of the design and implementation of DHIs offered to patients through working with at-risk populations throughout the process. Finally, participants emphasised the importance of ensuring non-digital services remained available to ensure equitable access to health and social care. Conclusions: HCPs described the complexities of delivering care to underserved communities. DHIs were identified as a potential way to improve health outcomes for some, while over-reliance risked exacerbating inequalities. Participant recommendations related to design, implementation, and engaging target populations providing practical examples to address digital health inequalities, such as working with other sectors to take a community approach.
{"title":"Healthcare professionals' attitudes towards digital health interventions and perspectives on digital health inequalities: a qualitative study","authors":"Mel Ramasawmy, David Sunkersing, Lydia Poole, Ann Blandford, Paramjit Gill, Kamlesh Khunti, Shivali Modha, Kiran Patel, Henry W W Potts, Madiha Sajid, Nushrat Khan, Amitava Banerjee","doi":"10.1101/2024.07.06.24310027","DOIUrl":"https://doi.org/10.1101/2024.07.06.24310027","url":null,"abstract":"Background: Use of Digital Health Interventions (DHIs) for the management of cardiometabolic diseases has increased, but may exacerbate existing health inequalities. Healthcare professionals (HCPs) play a vital role in recommending and supporting patients to use these tools. There is a need to understand the role of HCPs in managing the implementation of digital health in communities at risk of health inequalities. Objective: To explore the views of health care professionals about digital health and its impact on health inequalities, focusing on cardiometabolic diseases and the South Asian population in the UK. Methods: Online interviews and focus-groups with HCPs (n=18), exploring participants' experiences and attitudes towards digital health, perceptions of patients' barriers and facilitators to use, whether they perceived any populations to be particularly at risk of digital inequalities, and the impact of the COVID-19 pandemic on their practice in relation to digital health. After informed consent, transcription and coding, a reflexive thematic approach was taken to analysis. Results: HCPs recognised the potential benefits of DHIs to improve access and delivery of care and patient outcomes, but described several barriers to successful implementation. HCPs demonstrated a good understanding of the challenges their patients face in relation to wider inequalities, barriers to health behaviours and healthcare access, and digital health. Of particular concern was the impact of increasing reliance of digital interventions in health care on the exclusion of some patient groups. Participants recommended improvement of the design and implementation of DHIs offered to patients through working with at-risk populations throughout the process. Finally, participants emphasised the importance of ensuring non-digital services remained available to ensure equitable access to health and social care. Conclusions: HCPs described the complexities of delivering care to underserved communities. DHIs were identified as a potential way to improve health outcomes for some, while over-reliance risked exacerbating inequalities. Participant recommendations related to design, implementation, and engaging target populations providing practical examples to address digital health inequalities, such as working with other sectors to take a community approach.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-05DOI: 10.1101/2024.07.04.24309946
Kochr Ali Mahmood, Govand Saadadin Sadraldeen, Samir M Othman, Nazar Pols Shabila, Abubakir Majeed Saleh, Kameran Hassan Ismail
Background Premarital screening programs are essential for identifying and providing counseling to couples at risk of transmitting genetic diseases or sexually transmitted infections. Despite their importance, university students' awareness and knowledge of premarital screening programs remain inadequate. This study aimed to evaluate the knowledge, perceptions, and attitudes of university students in the Kurdistan Region of Iraq regarding premarital screening programs. Methods A cross-sectional survey involving 960 students was conducted from December 2023 to February 2024. The survey assessed participants' demographics, knowledge, perception, and attitudes toward PMSP using a structured questionnaire. Results Findings revealed that a significant portion of participants (39.4%) had poor knowledge of premarital screening programs, 35.9% had fair knowledge, and only 24.7% had good knowledge. Despite limited knowledge, there was strong support for premarital screening programs, with 83.1% agreeing on its importance and 78.8% recognizing the need for premarital awareness. Most participants (65.8%) believed premarital screening programs could reduce genetic diseases, and 65.6% thought it could lower sexually transmitted diseases' prevalence. Cultural acceptance of marrying relatives was notable, with 59.7% disagreeing with the preference for not marrying relatives. Married participants showed significantly higher knowledge and attitude scores compared to single participants. Gender differences were observed, with males having higher knowledge scores. There were no significant differences in perception and attitude scores based on gender or residential area. Conclusion The study underscores the need for enhanced educational campaigns to improve premarital screening programs awareness and positively influence attitudes, especially targeting cultural aspects like accepting relative marriages. Comprehensive education and fostering positive attitudes toward premarital screening programs are vital for their broader acceptance and implementation.
{"title":"Knowledge, perception, and attitude toward premarital screening among university students in Kurdistan region- Iraq.","authors":"Kochr Ali Mahmood, Govand Saadadin Sadraldeen, Samir M Othman, Nazar Pols Shabila, Abubakir Majeed Saleh, Kameran Hassan Ismail","doi":"10.1101/2024.07.04.24309946","DOIUrl":"https://doi.org/10.1101/2024.07.04.24309946","url":null,"abstract":"Background Premarital screening programs are essential for identifying and providing counseling to couples at risk of transmitting genetic diseases or sexually transmitted infections. Despite their importance, university students' awareness and knowledge of premarital screening programs remain inadequate. This study aimed to evaluate the knowledge, perceptions, and attitudes of university students in the Kurdistan Region of Iraq regarding premarital screening programs. Methods A cross-sectional survey involving 960 students was conducted from December 2023 to February 2024. The survey assessed participants' demographics, knowledge, perception, and attitudes toward PMSP using a structured questionnaire. Results Findings revealed that a significant portion of participants (39.4%) had poor knowledge of premarital screening programs, 35.9% had fair knowledge, and only 24.7% had good knowledge. Despite limited knowledge, there was strong support for premarital screening programs, with 83.1% agreeing on its importance and 78.8% recognizing the need for premarital awareness. Most participants (65.8%) believed premarital screening programs could reduce genetic diseases, and 65.6% thought it could lower sexually transmitted diseases' prevalence. Cultural acceptance of marrying relatives was notable, with 59.7% disagreeing with the preference for not marrying relatives. Married participants showed significantly higher knowledge and attitude scores compared to single participants. Gender differences were observed, with males having higher knowledge scores. There were no significant differences in perception and attitude scores based on gender or residential area. Conclusion The study underscores the need for enhanced educational campaigns to improve premarital screening programs awareness and positively influence attitudes, especially targeting cultural aspects like accepting relative marriages. Comprehensive education and fostering positive attitudes toward premarital screening programs are vital for their broader acceptance and implementation.","PeriodicalId":501556,"journal":{"name":"medRxiv - Health Systems and Quality Improvement","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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