<p>I read with great interest the article by Malapela et al., titled “Exploring Stakeholder Roles and Strategies for Preventing Teenage Pregnancy: A Comprehensive Analysis in Lepelle-Nkumpi District, South Africa” (2025) [<span>1</span>]. The authors make a very valuable contribution by foregrounding the voices of non-governmental organizations (NGOs) working closely with teenagers in rural communities. Their thematic analysis, highlighting multi-stakeholder collaboration, economic empowerment, nurturing family bonds, information sharing, and extramural activities offers a rich and pragmatic framework for community-level action.</p><p>As an obstetrician working in teenager and maternal health, I would like to offer a complementary perspective relevant to this era. The study deliberately focused on NGO workers; however, obstetricians, midwives, and nurses are also central actors in both the prevention and clinical management of teenage pregnancy. These professionals are often the first to see pregnant teenagers, manage complications, and provide post-pregnancy contraception. Their perspectives can offer valuable guidance for policymakers, communities, and stakeholders.</p><p>In my daily practice as an obstetrician, I have encountered teenagers presenting with complications of early pregnancy or with a second pregnancy within a short interval, despite having previously interacted with health services. Many of these young patients shared that no one had ever discussed effective contraception with them in a clear, nonjudgmental manner after their first pregnancy or abortion. This represents a missed opportunity for prevention. These experiences suggest that hospital- and clinic-based providers are not only treating the consequences of teenage pregnancy but are also uniquely positioned to intervene and prevent repeat pregnancies through timely counselling.</p><p>In a study conducted in socioeconomically deprived neighborhoods with high immigrant populations, a culturally adapted community-based contraceptive counselling program was implemented. Following the intervention, fertility rates among girls aged 15–19 years declined by approximately 40%. The authors concluded that brief, community-based counselling initiatives can significantly reduce adolescent fertility rates [<span>2</span>]. It is likely that if midwives and nurses were assigned community-based roles and supported to conduct such initiatives, similar reductions could be achieved.</p><p>Obstetricians can also allocate additional time within hospital settings to actively focus on preventing repeat pregnancies. The review by Sedlecky and Stanković emphasized that the most effective strategy to prevent repeated unintended adolescent pregnancies is to initiate an effective contraceptive method immediately after abortion. This timing is critical, as motivation for contraception is highest at that moment. Ovulation typically resumes within 3 weeks, and more than half of adolescents resume sexual
{"title":"Integrating Clinical Perspectives in the Prevention of Teenage Pregnancy","authors":"Erhan Muluk","doi":"10.1111/hex.70570","DOIUrl":"10.1111/hex.70570","url":null,"abstract":"<p>I read with great interest the article by Malapela et al., titled “Exploring Stakeholder Roles and Strategies for Preventing Teenage Pregnancy: A Comprehensive Analysis in Lepelle-Nkumpi District, South Africa” (2025) [<span>1</span>]. The authors make a very valuable contribution by foregrounding the voices of non-governmental organizations (NGOs) working closely with teenagers in rural communities. Their thematic analysis, highlighting multi-stakeholder collaboration, economic empowerment, nurturing family bonds, information sharing, and extramural activities offers a rich and pragmatic framework for community-level action.</p><p>As an obstetrician working in teenager and maternal health, I would like to offer a complementary perspective relevant to this era. The study deliberately focused on NGO workers; however, obstetricians, midwives, and nurses are also central actors in both the prevention and clinical management of teenage pregnancy. These professionals are often the first to see pregnant teenagers, manage complications, and provide post-pregnancy contraception. Their perspectives can offer valuable guidance for policymakers, communities, and stakeholders.</p><p>In my daily practice as an obstetrician, I have encountered teenagers presenting with complications of early pregnancy or with a second pregnancy within a short interval, despite having previously interacted with health services. Many of these young patients shared that no one had ever discussed effective contraception with them in a clear, nonjudgmental manner after their first pregnancy or abortion. This represents a missed opportunity for prevention. These experiences suggest that hospital- and clinic-based providers are not only treating the consequences of teenage pregnancy but are also uniquely positioned to intervene and prevent repeat pregnancies through timely counselling.</p><p>In a study conducted in socioeconomically deprived neighborhoods with high immigrant populations, a culturally adapted community-based contraceptive counselling program was implemented. Following the intervention, fertility rates among girls aged 15–19 years declined by approximately 40%. The authors concluded that brief, community-based counselling initiatives can significantly reduce adolescent fertility rates [<span>2</span>]. It is likely that if midwives and nurses were assigned community-based roles and supported to conduct such initiatives, similar reductions could be achieved.</p><p>Obstetricians can also allocate additional time within hospital settings to actively focus on preventing repeat pregnancies. The review by Sedlecky and Stanković emphasized that the most effective strategy to prevent repeated unintended adolescent pregnancies is to initiate an effective contraceptive method immediately after abortion. This timing is critical, as motivation for contraception is highest at that moment. Ovulation typically resumes within 3 weeks, and more than half of adolescents resume sexual","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12804142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa D. Hawke, Katie Upham, Hajar Seiyad, Mary Rose van Kesteren
<p>Engaging people with lived/living experience and caregivers in research (also known as ‘patient engagement’ or ‘patient and public involvement’) has many benefits to research, to the community, and to the people involved in the process [<span>1</span>]. Engagement is increasingly valued by many funding bodies [<span>2, 3</span>] as being best practice when possible. However, funding barriers have been described as getting in the way of authentic engagement [<span>4</span>]. It is therefore important that grant writers optimise their descriptions of the engagement components of their protocols, making engagement a strength of their applications. Researchers have many grant writing recommendations, courses, and professional development materials available to them to support them in their grant-writing endeavours [<span>5, 6</span>]. Yet, there is minimal concrete, specific guidance on how to embed lived/living experience and caregiver engagement into grant applications effectively [<span>7</span>]. With this editorial, we aim to address this gap.</p><p>The engagement description in a grant application serves to clarify the applicants' engagement methods for their own purposes and sets them out to be judged by a team of peer reviewers, who are the gatekeepers to funding. Although rare, some funders include people with lived/living experience and caregivers as peer reviewers [<span>8</span>], who are well positioned to evaluate proposed engagement strategies. Whether lived/living experience peer reviewers are included or not, the way engagement is described in the protocol can influence the funding decision. If the engagement is poorly described and peer reviewers fear tokenistic engagement approaches, the application may be less likely to be funded. Regardless of page limits and tight application requirements, engagement can be well described in any protocol, and should be described together with lived/living experience and caregiver co-applicants or collaborators when possible.</p><p>Through our experience in writing and reviewing grant applications, we have come to recognise when engagement is well described, making it a strength of the application, versus when it is poorly described, raising fears of tokenistic, performative engagement. Based on this experience, we propose a number of recommendations to guide grant writers in effectively describing engagement in their grant applications (see Box 1). These recommendations can be generally followed regardless of the format of the funding call, to the extent possible within the limits of the application guidelines. Below, we describe an overview of how engagement might be described poorly in a grant application, which we contrast with the description of a robustly described engagement plan. In doing so, our goal is to equip researchers to optimise the engagement components of their grant applications to maximise the chances of funding, thereby increasing the amount of patient-engaged research bei
参与过程可能被视为仅仅是一个象征性的复选框，旨在满足资助者的需求，而不是反映申请人团队的合法利益和承诺。在这种情况下，无论资助人的初衷如何，参与都不太可能被评估为支持积极资助决策的应用程序的优势。相比之下，一些拨款申请表达了引人注目和令人兴奋的参与计划。他们强调参与是研究的核心价值，其方式与资助机构的授权、指示和价值观相一致，并使同行审稿人相信参与计划的真实性。参与是前沿和中心，同行评议者可以确信，研究人员有承诺和技能，以一种充实的方式吸引有生活经验的人和照顾者，体现包容、尊重、真诚和有意义的参与。一份写得好的参与计划的拨款申请有很多特点。值得注意的是，参与度贯穿于整个应用程序，并作为核心价值嵌入其中。申请人团队参考并引用参与中的模型、框架或最佳实践，包括资助者提供的任何模型、框架或最佳实践，并承诺遵循这些模型、框架或最佳实践。提供具体的业务结构，包括会议的次数、频率和长度；将参与的有生活经验的人员和护理人员的数量；以及他们将在整个项目过程中完成的具体任务，从开始到结束。该计划在整个项目中是可行的、可信的和一致的。“共同”的语言在整个拨款中使用，拨款作者表明研究工具或产品将共同生产，共同选择或共同创造。参与甚至可以直接嵌入到目标声明中，例如“与有生活经验的人和护理人员直接合作，我们的目标是……”。这延续到影响和相关性陈述以及应用程序的结论。如果赠款包括研究实施阶段，则会聘请相同的生活经历和护理伙伴来帮助将研究结果转化为现实世界的实践。相关的预算表明，承诺为所有会议、演讲和异步工作时间支付有生活经验的人和照顾者的生活工资或更高的工资，加上旅行费用，以鼓励公平，并为计划外的紧急贡献留出一些空间。描述了可访问性和多样性考虑因素。不止一个有生活经验的人可能被包括为知识使用者或合作者，或者提供了支持信，他们反映了资助申请的重点人群。他们的专业知识得到强调和重视。理想情况下，一些最初的参与将已经发生，以完善研究问题，并且生活/生活和护理经验反馈有助于形成资助申请的描述。申请人已经证明他们在参与方面具有专业知识，真正关心确保公平合作，并且真正理解参与过程，或者已经引入了具有这种互补专业知识的可靠团队成员。在同行评审看来，遵循这些建议的资助申请会显得更真诚，展示出一个充实而有意义的参与计划。参与成为应用程序的关键优势，也是促使同行审稿人决定推荐资助的一个因素。我们致力于支持在整个研究过程中嵌入生活/生活经验的研究，从创意产生到知识动员。我们相信，在整个研究部门中嵌入有意义的参与将创造更多相关的研究，为参与人员和研究人员创造更有意义的经验，建立更严格的证据基础，最终建立更强大的医疗保健系统，更能反映他们所服务的人的需求，同时为所有研究团队成员建立能力。然而，为了让参与式研究在健康研究中占据主导地位，它需要得到资助机构的鼓励，并得到成功的资助。我们希望这些建议能帮助申请基金的人强调参与是他们申请的优势。我们进一步希望，这将提高积极参与的研究团队的资助成功率，帮助提高研究标准，使强有力的参与计划成为黄金标准，并最终使卫生系统受益。Lisa D. Hawke：概念化，写作-原稿，资金获取。Katie Upham, Hajar Seiyad， Mary Rose van Kesteren：概念化，写作-评论和编辑。作者没有什么可报告的。
{"title":"Writing Patient Engagement Effectively Into Grant Applications: Practical Tips for Grant Writers","authors":"Lisa D. Hawke, Katie Upham, Hajar Seiyad, Mary Rose van Kesteren","doi":"10.1111/hex.70547","DOIUrl":"10.1111/hex.70547","url":null,"abstract":"<p>Engaging people with lived/living experience and caregivers in research (also known as ‘patient engagement’ or ‘patient and public involvement’) has many benefits to research, to the community, and to the people involved in the process [<span>1</span>]. Engagement is increasingly valued by many funding bodies [<span>2, 3</span>] as being best practice when possible. However, funding barriers have been described as getting in the way of authentic engagement [<span>4</span>]. It is therefore important that grant writers optimise their descriptions of the engagement components of their protocols, making engagement a strength of their applications. Researchers have many grant writing recommendations, courses, and professional development materials available to them to support them in their grant-writing endeavours [<span>5, 6</span>]. Yet, there is minimal concrete, specific guidance on how to embed lived/living experience and caregiver engagement into grant applications effectively [<span>7</span>]. With this editorial, we aim to address this gap.</p><p>The engagement description in a grant application serves to clarify the applicants' engagement methods for their own purposes and sets them out to be judged by a team of peer reviewers, who are the gatekeepers to funding. Although rare, some funders include people with lived/living experience and caregivers as peer reviewers [<span>8</span>], who are well positioned to evaluate proposed engagement strategies. Whether lived/living experience peer reviewers are included or not, the way engagement is described in the protocol can influence the funding decision. If the engagement is poorly described and peer reviewers fear tokenistic engagement approaches, the application may be less likely to be funded. Regardless of page limits and tight application requirements, engagement can be well described in any protocol, and should be described together with lived/living experience and caregiver co-applicants or collaborators when possible.</p><p>Through our experience in writing and reviewing grant applications, we have come to recognise when engagement is well described, making it a strength of the application, versus when it is poorly described, raising fears of tokenistic, performative engagement. Based on this experience, we propose a number of recommendations to guide grant writers in effectively describing engagement in their grant applications (see Box 1). These recommendations can be generally followed regardless of the format of the funding call, to the extent possible within the limits of the application guidelines. Below, we describe an overview of how engagement might be described poorly in a grant application, which we contrast with the description of a robustly described engagement plan. In doing so, our goal is to equip researchers to optimise the engagement components of their grant applications to maximise the chances of funding, thereby increasing the amount of patient-engaged research bei","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12802554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evgenia Stepanova, Matthew Cooper, Anna Robinson-Barella, Vicki Harris, Abbie Rance, Abbie Husband, David Wright, Fabi Lorencatto, Clare Tolley, Wade Tovey, Geoff Wong, Daniel Cowie, Kerry Parker, Elise Crayton, Hamde Nazar
<div> <section> <h3> Background</h3> <p>As researchers strive to conduct culturally competent and equitable research, there remains a lack of actionable guidance across the research lifecycle. Increasingly, funding bodies require evidence of such approaches, yet a clear, practical direction for effective research practice is often lacking.</p> </section> <section> <h3> Aim</h3> <p>To develop a practical framework, grounded in Meleis' cultural competence criteria, to guide all stages of the research lifecycle.</p> </section> <section> <h3> Methods</h3> <p>Databases PsycINFO, ERIC, PubMed, Web of Science Core Collection and Google Scholar were searched (August–October 2025) for English-language publications applying Meleis' framework in research contexts. Narrative and thematic analysis synthesised identified applications into draft recommendations and measures across five research stages. A modified Delphi process with 31 experts (community leads, researchers, policymakers and translators) in two survey rounds and a consensus workshop was then used to refine and finalise items, producing a co-developed framework of actionable, measurable recommendations for culturally competent research with minoritised and/or diverse groups.</p> </section> <section> <h3> Results</h3> <p>The review identified eight studies, yielding 41 applications of Meleis' criteria. These were distilled into 29 draft recommendations and measures, which were further refined through Delphi consensus to 25 recommendations and 25 measures, offering practice-ready guidance across research focus, recruitment, measurement, analysis and dissemination. Contextuality was rated critical in four stages, highlighting how cultural identities shape engagement. Language was strongly prioritised in focus, recruitment and measurement, with emphasis on diverse, well-funded interpretation and transcription strategies. Empowerment and reciprocation were noted as underused but essential for legitimacy and impact, particularly in focus and dissemination. Continuous cultural humility training was endorsed, reinforcing critiques of competence as a static skill. During consensus discussions, recommendations initially framed as optional (‘could’) were reframed as compulsory (‘should’). The final framework is available as an accessible online resource.</p> </section> <section> <h3> Conclusions</h3> <p>Using consensus, an evidence-based, culturally competent research framework was co-designed; it comprised 2
背景：随着研究人员努力进行文化胜任和公平的研究，在整个研究生命周期中仍然缺乏可操作的指导。越来越多的资助机构需要这些方法的证据，然而有效的研究实践往往缺乏一个明确的、实用的方向。目的：开发一个实用的框架，以Meleis的文化能力标准为基础，指导研究生命周期的所有阶段。方法：检索PsycINFO、ERIC、PubMed、Web of Science Core Collection和谷歌Scholar数据库（2025年8 - 10月）中应用Meleis框架进行研究的英文出版物。叙述和专题分析将确定的应用程序综合为五个研究阶段的建议和措施草案。经过修改的德尔菲过程由31位专家（社区领导、研究人员、政策制定者和翻译人员）参与两轮调查和共识研讨会，然后用于完善和最终确定项目，为少数族裔和/或不同群体的文化主管研究提供可操作的、可衡量的建议。结果：本综述确定了8项研究，产生了41项Meleis标准的应用。这些被提炼成29项建议和措施草案，并通过德尔菲共识进一步细化为25项建议和25项措施，为研究重点、招募、测量、分析和传播提供了实践就绪的指导。情境性在四个阶段中被评为关键，突出了文化身份如何塑造参与。语言在重点、招聘和衡量方面被高度重视，并强调多样化、资金充足的口译和转录策略。有人指出，授权和相互作用没有得到充分利用，但对合法性和影响，特别是在重点和传播方面，却是必不可少的。持续的文化谦逊训练得到认可，强化了对能力是一种静态技能的批评。在协商一致的讨论中，最初作为可选（“可能”）的建议被重新定义为强制性（“应该”）。最后的框架作为可访问的在线资源提供。结论：采用共识，共同设计了一个以证据为基础、具有文化竞争力的研究框架；它包括25项建议，可供研究人员、政策制定者、社区领导和其他人采取行动、衡量和适应。这个框架是朝着促进公平和有影响力的研究实践迈出的关键一步。患者或公众贡献：由三名来自少数族裔背景的患者和两名保健专业人员组成的患者和公众参与小组举行了两次会议，审查调查结果，改进组成部分，并就语言、可及性和可用性提供反馈。
{"title":"Cultural Competency in Research: A Practical Framework for Use by Researchers, Policymakers, Community Leads and Others When Working With People From Diverse Groups","authors":"Evgenia Stepanova, Matthew Cooper, Anna Robinson-Barella, Vicki Harris, Abbie Rance, Abbie Husband, David Wright, Fabi Lorencatto, Clare Tolley, Wade Tovey, Geoff Wong, Daniel Cowie, Kerry Parker, Elise Crayton, Hamde Nazar","doi":"10.1111/hex.70544","DOIUrl":"10.1111/hex.70544","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As researchers strive to conduct culturally competent and equitable research, there remains a lack of actionable guidance across the research lifecycle. Increasingly, funding bodies require evidence of such approaches, yet a clear, practical direction for effective research practice is often lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To develop a practical framework, grounded in Meleis' cultural competence criteria, to guide all stages of the research lifecycle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Databases PsycINFO, ERIC, PubMed, Web of Science Core Collection and Google Scholar were searched (August–October 2025) for English-language publications applying Meleis' framework in research contexts. Narrative and thematic analysis synthesised identified applications into draft recommendations and measures across five research stages. A modified Delphi process with 31 experts (community leads, researchers, policymakers and translators) in two survey rounds and a consensus workshop was then used to refine and finalise items, producing a co-developed framework of actionable, measurable recommendations for culturally competent research with minoritised and/or diverse groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review identified eight studies, yielding 41 applications of Meleis' criteria. These were distilled into 29 draft recommendations and measures, which were further refined through Delphi consensus to 25 recommendations and 25 measures, offering practice-ready guidance across research focus, recruitment, measurement, analysis and dissemination. Contextuality was rated critical in four stages, highlighting how cultural identities shape engagement. Language was strongly prioritised in focus, recruitment and measurement, with emphasis on diverse, well-funded interpretation and transcription strategies. Empowerment and reciprocation were noted as underused but essential for legitimacy and impact, particularly in focus and dissemination. Continuous cultural humility training was endorsed, reinforcing critiques of competence as a static skill. During consensus discussions, recommendations initially framed as optional (‘could’) were reframed as compulsory (‘should’). The final framework is available as an accessible online resource.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Using consensus, an evidence-based, culturally competent research framework was co-designed; it comprised 2","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susanna Nordin, Aaron Davis, France Légaré, Allyson Jones, Louise Meijering, Marie Elf
<div> <section> <h3> Background</h3> <p>Co-design is increasingly used to involve older adults in the development of digital tools, yet less attention has been given to how to engage them effectively in these processes. Older adults represent a highly diverse population, but co-design practices often overlook this heterogeneity and rely on limited representation. Similarly, co-design approaches vary widely in structure and degree of user involvement. While evaluations often focus on outcomes such as usability and technical performance, fewer studies explore the value of participation itself.</p> </section> <section> <h3> Aim</h3> <p>This study evaluates the process of a 5-day online design sprint where participants, including older adults, healthcare and technology professionals, researchers, facilitators and business representatives, collaborated to develop housing-related digital support tools.</p> </section> <section> <h3> Methods</h3> <p>A hybrid thematic analysis process links process documentation and participant reflections with value-based frameworks to examine how different elements of the process created or inhibited value for participants.</p> </section> <section> <h3> Results</h3> <p>The findings highlight how the structure of the design sprint, together with specific facilitation practices, fostered respectful dialogue, trust, autonomy and a sense of ownership among participants. The evaluation describes how the process satisfied participants' collectively prioritised values, and their individual needs.</p> </section> <section> <h3> Conclusions</h3> <p>The study highlights that co-design is not a neutral method, but a practice with social, ethical and emotional consequences. Effective facilitation is essential to support agency, ensure psychological safety and promote authentic collaboration. Recognising the heterogeneity of older adults and aligning facilitation strategies with participants' values and needs can enhance both the relevance of digital innovations and the meaningfulness of the co-design experience itself.</p> </section> <section> <h3> Patient and Public Contribution</h3> <p>The project was supported by a reference group that was actively involved throughout. The group included, for instance, representatives from the municipality, regional authorities and a pensioners' organisation.</p> </section>
{"title":"Designing Meaningful Engagement for Older Adults: An Evaluation of Participation in a Five-Day Co-Design Sprint","authors":"Susanna Nordin, Aaron Davis, France Légaré, Allyson Jones, Louise Meijering, Marie Elf","doi":"10.1111/hex.70555","DOIUrl":"10.1111/hex.70555","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Co-design is increasingly used to involve older adults in the development of digital tools, yet less attention has been given to how to engage them effectively in these processes. Older adults represent a highly diverse population, but co-design practices often overlook this heterogeneity and rely on limited representation. Similarly, co-design approaches vary widely in structure and degree of user involvement. While evaluations often focus on outcomes such as usability and technical performance, fewer studies explore the value of participation itself.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study evaluates the process of a 5-day online design sprint where participants, including older adults, healthcare and technology professionals, researchers, facilitators and business representatives, collaborated to develop housing-related digital support tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A hybrid thematic analysis process links process documentation and participant reflections with value-based frameworks to examine how different elements of the process created or inhibited value for participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings highlight how the structure of the design sprint, together with specific facilitation practices, fostered respectful dialogue, trust, autonomy and a sense of ownership among participants. The evaluation describes how the process satisfied participants' collectively prioritised values, and their individual needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study highlights that co-design is not a neutral method, but a practice with social, ethical and emotional consequences. Effective facilitation is essential to support agency, ensure psychological safety and promote authentic collaboration. Recognising the heterogeneity of older adults and aligning facilitation strategies with participants' values and needs can enhance both the relevance of digital innovations and the meaningfulness of the co-design experience itself.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and Public Contribution</h3>\u0000 \u0000 <p>The project was supported by a reference group that was actively involved throughout. The group included, for instance, representatives from the municipality, regional authorities and a pensioners' organisation.</p>\u0000 </section>\u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Gamillscheg-Müllner, Agata Łaszewska, Sophie Diexer, Kathryn Hoffmann, Judit Simon, Susanne Mayer
<div> <section> <h3> Background</h3> <p>Long Covid-19 (LC) patients have substantial treatment and care needs, yet research has shown that the majority of them experience healthcare access barriers. While qualitative studies indicate socio-economic and demographic access inequalities among LC patients, quantitative evidence remains limited. This study aims to assess socio-economic inequalities in healthcare access among LC patients in Austria, focusing on self-perceived barriers, facilitators and unmet healthcare needs.</p> </section> <section> <h3> Methods</h3> <p>Retrospective cross-sectional data were collected from adult LC patients through online and paper-based surveys (10-12/2024), following a prior qualitative study. The survey assessed 47 barriers and 10 facilitators based on Levesque's ‘access to care’ framework, along with unmet healthcare needs overall and related to general practitioner (GP), specialist and hospital care. Overall barrier and facilitator scores were calculated. Inequalities related to gender, age, urbanicity, health-related background through training/employment, complementary private health insurance, and economic situation were examined in linear, logistic and ordered logistic regressions, controlling for clinical and demographic variables.</p> </section> <section> <h3> Results</h3> <p>Overall, 433 LC patients completed the survey. Participants living in urban areas, with complementary private health insurance, or in a good economic situation reported fewer barriers, reflected in statistically significantly lower overall barrier scores. Income-related inequalities emerged particularly in relation to barriers in GP care, including not being taken seriously, attribution of symptoms to mental health conditions, burdensome costs, short consultation times, and limited availability of telemedicine or home visits. Facilitator scores, in contrast, did not differ by socio-economic factors. Living in a rural area was associated with a higher probability of unmet healthcare needs related to GP and specialist care. A poor economic situation was associated with a higher probability of reporting unmet needs related to specialist and hospital care. No evidence of gender-based inequalities was found.</p> </section> <section> <h3> Conclusions</h3> <p>Our findings reveal enhanced inequalities in LC healthcare access in an otherwise universal healthcare system. Contrary to prior research, we find income-related inequalities in GP access. Future policy efforts in Austria should consider that central case management through GP care may no
{"title":"Theoretically Universal, Practically Unequal: Socio-Economic Inequalities in Healthcare Access for Long Covid-19 Patients in Austria","authors":"Peter Gamillscheg-Müllner, Agata Łaszewska, Sophie Diexer, Kathryn Hoffmann, Judit Simon, Susanne Mayer","doi":"10.1111/hex.70553","DOIUrl":"10.1111/hex.70553","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Long Covid-19 (LC) patients have substantial treatment and care needs, yet research has shown that the majority of them experience healthcare access barriers. While qualitative studies indicate socio-economic and demographic access inequalities among LC patients, quantitative evidence remains limited. This study aims to assess socio-economic inequalities in healthcare access among LC patients in Austria, focusing on self-perceived barriers, facilitators and unmet healthcare needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective cross-sectional data were collected from adult LC patients through online and paper-based surveys (10-12/2024), following a prior qualitative study. The survey assessed 47 barriers and 10 facilitators based on Levesque's ‘access to care’ framework, along with unmet healthcare needs overall and related to general practitioner (GP), specialist and hospital care. Overall barrier and facilitator scores were calculated. Inequalities related to gender, age, urbanicity, health-related background through training/employment, complementary private health insurance, and economic situation were examined in linear, logistic and ordered logistic regressions, controlling for clinical and demographic variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 433 LC patients completed the survey. Participants living in urban areas, with complementary private health insurance, or in a good economic situation reported fewer barriers, reflected in statistically significantly lower overall barrier scores. Income-related inequalities emerged particularly in relation to barriers in GP care, including not being taken seriously, attribution of symptoms to mental health conditions, burdensome costs, short consultation times, and limited availability of telemedicine or home visits. Facilitator scores, in contrast, did not differ by socio-economic factors. Living in a rural area was associated with a higher probability of unmet healthcare needs related to GP and specialist care. A poor economic situation was associated with a higher probability of reporting unmet needs related to specialist and hospital care. No evidence of gender-based inequalities was found.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings reveal enhanced inequalities in LC healthcare access in an otherwise universal healthcare system. Contrary to prior research, we find income-related inequalities in GP access. Future policy efforts in Austria should consider that central case management through GP care may no","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heather Block, Candice Oster, Suzanne Dawson, Claire Gough, Gregory B. Crawford, Adelaide Boylan, Jan Angelo, Matthew Freeman, Rachel Milte, Helen Exley, Stacey George
Background
Older people are living longer with unmet social needs that impact their health and wellbeing. Social prescribing programs connect individuals with nonclinical services to address these needs. While international programs have shown benefits for quality of life, health and healthcare utilisation, social prescribing research in Australia is limited.
Objective
This study aims to design, implement and evaluate a social prescribing program to address the unmet social needs of older adults in Adelaide, South Australia.
Research Design and Methods
This observational feasibility study will use a multiphase mixed methods process and outcomes evaluation. Prescriptions for Connection, a social prescribing program, will be co-designed and implemented in six primary care practices and three council areas. Implementation outcomes will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance Framework. Qualitative data collection, via focus groups for health and social care providers and interviews for older people, will be based on the Consolidated Framework for Implementation Research to explore barriers and facilitators, and explain outcomes.
Conclusion
This study will provide novel evidence on the process, outcomes and feasibility of the Prescriptions for Connection program. Scalability, sustainability and modifications to the program will be explored for testing in a larger hybrid effectiveness-implementation trial.
Patient or Public Contribution
Older adults will participate in codesign workshops and provide feedback on the Prescriptions for Connection program. Community members will be recruited as volunteer community connectors to link older people to social activities. The national peak body for older Australians will be represented on the steering group.
{"title":"Prescriptions for Connection—Social Prescribing for Older People in Australia: Protocol for a Feasibility Study","authors":"Heather Block, Candice Oster, Suzanne Dawson, Claire Gough, Gregory B. Crawford, Adelaide Boylan, Jan Angelo, Matthew Freeman, Rachel Milte, Helen Exley, Stacey George","doi":"10.1111/hex.70506","DOIUrl":"10.1111/hex.70506","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older people are living longer with unmet social needs that impact their health and wellbeing. Social prescribing programs connect individuals with nonclinical services to address these needs. While international programs have shown benefits for quality of life, health and healthcare utilisation, social prescribing research in Australia is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to design, implement and evaluate a social prescribing program to address the unmet social needs of older adults in Adelaide, South Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Research Design and Methods</h3>\u0000 \u0000 <p>This observational feasibility study will use a multiphase mixed methods process and outcomes evaluation. <i>Prescriptions for Connection</i>, a social prescribing program, will be co-designed and implemented in six primary care practices and three council areas. Implementation outcomes will be evaluated using the Reach, Effectiveness, Adoption, Implementation and Maintenance Framework. Qualitative data collection, via focus groups for health and social care providers and interviews for older people, will be based on the Consolidated Framework for Implementation Research to explore barriers and facilitators, and explain outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study will provide novel evidence on the process, outcomes and feasibility of the <i>Prescriptions for Connection</i> program. Scalability, sustainability and modifications to the program will be explored for testing in a larger hybrid effectiveness-implementation trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>Older adults will participate in codesign workshops and provide feedback on the <i>Prescriptions for Connection</i> program. Community members will be recruited as volunteer community connectors to link older people to social activities. The national peak body for older Australians will be represented on the steering group.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ACTRN12625000664448.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12778934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Toni Martinford, Dennis P. Watson, Sarah Messmer, Leyla Rashid, Monte Staton, Michael L. Dennis, Christine E. Grella, Abigail Elmes-Patel
<div> <section> <h3> Background</h3> <p>This study aimed to explore the experiences of people diagnosed with opioid use disorder (OUD) and recently involved with the criminal-legal system (CLS) as they received addiction treatment services from a Mobile Medications for Opioid Use Disorder (MOUD) programme in Chicago. By assessing perceptions and satisfaction with receiving addiction treatment and additional wraparound services, including factors influencing care-seeking decisions, this research provides insight to tailor care and services to this population of people who have involvement with the CLS. Insights from this population are critical to increasing their access to MOUD and other services, given that people with CLS involvement are at disproportionately higher risk of overdose than people without such involvement.</p> </section> <section> <h3> Methods</h3> <p>Semi-structured interviews were conducted with people with OUD engaged in mobile MOUD services who had CLS involvement in the past 90 days (arrested, booked, or charged; released from prison, jail, or electronic monitoring; or currently on probation, parole, or supervised release). Eligibility for participation was determined by an outreach specialist with knowledge of past service utilisation and access to the medical record. Questions were based on Consolidated Framework for Implementation Research (CFIR) domains. Interviews were recorded, transcribed, deidentified, and inductively analyzed using Dedoose qualitative analysis software. The primary phenomenon of interest was a description of perceived benefits, barriers, and facilitators to accessing mobile MOUD services by CLS-involved individuals.</p> </section> <section> <h3> Results</h3> <p>A total of 13 interviews were conducted. The mean age of the participants was 48.5 years (SD 11.4). Over half of participants identified as Black or African American (61.5%) and male (61.5%). In the 30 days prior to interview, seven (53.8%) participants reported stable housing, five (38.5%) were living outdoors, and one (7.7%) had been incarcerated. Five themes and eight sub-themes were identified. Participants viewed the mobile unit services as essential to their communities, citing proximity to an open-air drug market and limited services in the area. Participants overwhelmingly praised the non-judgmental, approachable, and trustworthy environment compared to other healthcare settings. Law enforcement interactions ranged from positive to neutral, with some noting CLS referrals to mobile medical unit care. Key facilitators included onsite MOUD dispensing, walk-in appointments, and comprehensive medical services. Word-of-mouth, co-utilisation of
{"title":"“Convenience, Quickness, and Compassion”: Experiences of People Involved in the Criminal-Legal System Accessing Medications for Opioid Use Disorder Services From a Mobile Unit in Chicago","authors":"Toni Martinford, Dennis P. Watson, Sarah Messmer, Leyla Rashid, Monte Staton, Michael L. Dennis, Christine E. Grella, Abigail Elmes-Patel","doi":"10.1111/hex.70552","DOIUrl":"10.1111/hex.70552","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to explore the experiences of people diagnosed with opioid use disorder (OUD) and recently involved with the criminal-legal system (CLS) as they received addiction treatment services from a Mobile Medications for Opioid Use Disorder (MOUD) programme in Chicago. By assessing perceptions and satisfaction with receiving addiction treatment and additional wraparound services, including factors influencing care-seeking decisions, this research provides insight to tailor care and services to this population of people who have involvement with the CLS. Insights from this population are critical to increasing their access to MOUD and other services, given that people with CLS involvement are at disproportionately higher risk of overdose than people without such involvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with people with OUD engaged in mobile MOUD services who had CLS involvement in the past 90 days (arrested, booked, or charged; released from prison, jail, or electronic monitoring; or currently on probation, parole, or supervised release). Eligibility for participation was determined by an outreach specialist with knowledge of past service utilisation and access to the medical record. Questions were based on Consolidated Framework for Implementation Research (CFIR) domains. Interviews were recorded, transcribed, deidentified, and inductively analyzed using Dedoose qualitative analysis software. The primary phenomenon of interest was a description of perceived benefits, barriers, and facilitators to accessing mobile MOUD services by CLS-involved individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13 interviews were conducted. The mean age of the participants was 48.5 years (SD 11.4). Over half of participants identified as Black or African American (61.5%) and male (61.5%). In the 30 days prior to interview, seven (53.8%) participants reported stable housing, five (38.5%) were living outdoors, and one (7.7%) had been incarcerated. Five themes and eight sub-themes were identified. Participants viewed the mobile unit services as essential to their communities, citing proximity to an open-air drug market and limited services in the area. Participants overwhelmingly praised the non-judgmental, approachable, and trustworthy environment compared to other healthcare settings. Law enforcement interactions ranged from positive to neutral, with some noting CLS referrals to mobile medical unit care. Key facilitators included onsite MOUD dispensing, walk-in appointments, and comprehensive medical services. Word-of-mouth, co-utilisation of","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by brief vertigo episodes. It often leads to functional limitations, psychological distress, and fear of recurrence.</p> </section> <section> <h3> Objective</h3> <p>The purpose of this phenomenological study was to gain a deep understanding of the lived experiences of patients with BPPV.</p> </section> <section> <h3> Methods</h3> <p>Participants were initially recruited through convenience sampling at a BPPV specialist clinic, with additional participants identified via snowball sampling. Data were gathered through individual, in-depth interviews.</p> </section> <section> <h3> Findings</h3> <p>A central theme, “Reconstructing meaning in the face of an unpredictable illness,” captured patients' transformative journey from shock and confusion to adaptation and renewed self-awareness. Six themes emerged from data: “Shock and confusion from unexpected illness,” “Unbearable symptoms affecting daily life,” “Persistent anxiety about recurrence leading to emotional fatigue,” “Heightened health awareness following the illness experience,” “Disappointment with treatment support and efforts to seek alternatives independently,” and “Empathy from others and support from family as emotional anchors.”</p> </section> <section> <h3> Conclusion</h3> <p>Patients with BPPV experienced fear and dread of recurrence, while simultaneously struggling to develop their own coping strategies to address unresolved questions and concerns. Recognizing this need can help identify areas requiring professional intervention. Although the symptoms and fears associated with BPPV may be underestimated due to the perceived mildness of the condition, the impact of BPPV on patients' overall well-being is significant.</p> </section> <section> <h3> Patient and Public Contribution</h3> <p>Patients and the public were not directly involved in the design or conduct of this study. However, the research was grounded in the lived experiences of individuals with BPPV, whose narratives were central to shaping the research questions and analysis. Their perspectives provided valuable insights into the physical, emotional, and social impacts of BPPV, ensuring that the findings reflect issues most relevant to those affected and guiding potential directions for future patient
{"title":"Living With the Fear of Recurrence in Benign Paroxysmal Positional Vertigo","authors":"Seo-Jin Lee, Yujin Hur","doi":"10.1111/hex.70551","DOIUrl":"10.1111/hex.70551","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder characterized by brief vertigo episodes. It often leads to functional limitations, psychological distress, and fear of recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this phenomenological study was to gain a deep understanding of the lived experiences of patients with BPPV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were initially recruited through convenience sampling at a BPPV specialist clinic, with additional participants identified via snowball sampling. Data were gathered through individual, in-depth interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A central theme, “Reconstructing meaning in the face of an unpredictable illness,” captured patients' transformative journey from shock and confusion to adaptation and renewed self-awareness. Six themes emerged from data: “Shock and confusion from unexpected illness,” “Unbearable symptoms affecting daily life,” “Persistent anxiety about recurrence leading to emotional fatigue,” “Heightened health awareness following the illness experience,” “Disappointment with treatment support and efforts to seek alternatives independently,” and “Empathy from others and support from family as emotional anchors.”</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with BPPV experienced fear and dread of recurrence, while simultaneously struggling to develop their own coping strategies to address unresolved questions and concerns. Recognizing this need can help identify areas requiring professional intervention. Although the symptoms and fears associated with BPPV may be underestimated due to the perceived mildness of the condition, the impact of BPPV on patients' overall well-being is significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and Public Contribution</h3>\u0000 \u0000 <p>Patients and the public were not directly involved in the design or conduct of this study. However, the research was grounded in the lived experiences of individuals with BPPV, whose narratives were central to shaping the research questions and analysis. Their perspectives provided valuable insights into the physical, emotional, and social impacts of BPPV, ensuring that the findings reflect issues most relevant to those affected and guiding potential directions for future patient","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Introduction</h3> <p>Pregnancy is a unique time that can be affected by environmental events. This study was conducted to explain mothers' understanding of pregnancy during the Covid-19 pandemic.</p> </section> <section> <h3> Methods</h3> <p>This study was conducted with a qualitative content analysis approach. Data were obtained through in-depth virtual semi-structured interviews with 16 pregnant and postpartum mothers before access to the Covid-19 vaccine in Iran, between January and May 2021. Participants were selected from an online announcement in Tehran, Iran. Data were analyzed by conventional qualitative content analysis introduced by Graneheim and Lundman (2004).</p> </section> <section> <h3> Results</h3> <p>Data analysis showed that mothers who became pregnant during the outbreak of Covid-19, despite the lack of access to the vaccine, fulfilled their previous decision to get pregnant. They had motivations for pregnancy and made a conscious decision for this purpose. Prenatal care during the Covid-19 pandemic has had unique features. Prenatal care was a necessity; mothers adjusted themselves to prenatal care. The continuous midwifery model of care using telehealth helped pregnant women overcome the difficulties of the Covid-19 pandemic. Covid-19 made a special experience for expectant mothers, which included everything from disturbance of mental condition to adopting solutions.</p> </section> <section> <h3> Conclusion</h3> <p>Pregnancy and prenatal care during the Covid-19 pandemic were a unique experience. Psychological disturbances, the impact of the pandemic on the experience of pregnancy, and the effectiveness of prenatal care under the conditions governing the pandemic were some of the features of women's experience. In future possible pandemics, the experiences gained from the Covid-19 pandemic, such as telehealth and continued care, could be used.</p> </section> <section> <h3> Patient or Public Contribution</h3> <p>This study was informed by the need to understand the firsthand experiences of pregnant and postpartum mothers during a public health crisis. While patients or the public were not involved in the initial design of this study, their central and invaluable contribution lies in their participation as the key study subjects. The research is fundamentally built upon their lived experiences, which were shared through in-depth interviews. The analysis and interpretation of the data are directly derived from
{"title":"Pregnancy in the Shadow of Covid-19: A Qualitative Study","authors":"Giti Ozgoli, Sedigheh Sedigh Mobarakabadi","doi":"10.1111/hex.70558","DOIUrl":"10.1111/hex.70558","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pregnancy is a unique time that can be affected by environmental events. This study was conducted to explain mothers' understanding of pregnancy during the Covid-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted with a qualitative content analysis approach. Data were obtained through in-depth virtual semi-structured interviews with 16 pregnant and postpartum mothers before access to the Covid-19 vaccine in Iran, between January and May 2021. Participants were selected from an online announcement in Tehran, Iran. Data were analyzed by conventional qualitative content analysis introduced by Graneheim and Lundman (2004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data analysis showed that mothers who became pregnant during the outbreak of Covid-19, despite the lack of access to the vaccine, fulfilled their previous decision to get pregnant. They had motivations for pregnancy and made a conscious decision for this purpose. Prenatal care during the Covid-19 pandemic has had unique features. Prenatal care was a necessity; mothers adjusted themselves to prenatal care. The continuous midwifery model of care using telehealth helped pregnant women overcome the difficulties of the Covid-19 pandemic. Covid-19 made a special experience for expectant mothers, which included everything from disturbance of mental condition to adopting solutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pregnancy and prenatal care during the Covid-19 pandemic were a unique experience. Psychological disturbances, the impact of the pandemic on the experience of pregnancy, and the effectiveness of prenatal care under the conditions governing the pandemic were some of the features of women's experience. In future possible pandemics, the experiences gained from the Covid-19 pandemic, such as telehealth and continued care, could be used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>This study was informed by the need to understand the firsthand experiences of pregnant and postpartum mothers during a public health crisis. While patients or the public were not involved in the initial design of this study, their central and invaluable contribution lies in their participation as the key study subjects. The research is fundamentally built upon their lived experiences, which were shared through in-depth interviews. The analysis and interpretation of the data are directly derived from ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12771590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reema Harrison, Bronwyn Newman, Ashfaq Chauhan, Kellie Holland, Clarel Philibert, Juliana Emerick, Kirsten Oataway, Elizabeth Manias, Carlene Wilson
<div> <section> <h3> Background</h3> <p>For many individuals, living with cancer means having a chronic and complex health condition that requires well-coordinated care between primary and specialist settings. Continuity of care is often compromised by lack of shared information between providers about a person's circumstances, communication support needs, health information or cultural requirements. This project aimed to use co-design with people from culturally and linguistically diverse backgrounds who have lived experience of cancer and their care providers to create a resource to enhance continuity of care when accessing multiple health providers.</p> </section> <section> <h3> Methods</h3> <p>A co-design group (<i>n</i> = 9) was formed comprising of people from different cultural and linguistic backgrounds with lived experience of cancer (<i>n</i> = 4) as survivors or carers, alongside healthcare providers (<i>n</i> = 5) working in primary care or as specialists. Co-design group members were recruited from cancer support organisations, consumer organisations, primary health networks, hospital oncology services and professional networks nationally in Australia to provide diverse lived experience of cancer and professional expertise in the provision of cancer care. A series of four co-design workshops were held, supported by asynchronous communication facilitated by an external agency to create and refine the final prototype resource.</p> </section> <section> <h3> Results</h3> <p>The co-design group created a person-held tool called Care My Way for individuals with cancer to share socio-cultural information with health providers. This resource was developed in response to an identified gap in person-held resources that for people with cancer to communicate their socio-cultural information beyond interpreter requirements, language spoken and country of birth so that health providers can understand how this may influence care. Care My Way comprises of four components through which people living with cancer can share information about (1) themselves, (2) their communication approach and support needs, (3) their cancer journey and care, and (4) their care requirements based on cultural and faith backgrounds. Using Care My Way seeks to promote relational and informational continuity of care between multiple health professionals for people with cancer whose care spans primary and specialist settings.</p> </section> <section> <h3> Conclusions</h3> <p>Person-held tools such as Care My Way provide an opportunity for people affected by cancer to identify
背景：对于许多人来说，患有癌症意味着患有慢性和复杂的健康状况，需要在初级和专科机构之间进行良好协调的护理。由于提供者之间缺乏关于个人情况、沟通支持需求、健康信息或文化要求的共享信息，护理的连续性往往受到影响。该项目旨在与具有不同文化和语言背景的人进行共同设计，这些人有过癌症的生活经历，他们的护理提供者创建了一种资源，以增强在访问多个保健提供者时护理的连续性。方法：组成一个共同设计组（n = 9），包括来自不同文化和语言背景的癌症幸存者或护理人员（n = 4），以及从事初级保健或作为专家的医疗保健提供者（n = 5）。共同设计小组的成员是从澳大利亚全国的癌症支持组织、消费者组织、初级卫生网络、医院肿瘤服务和专业网络中招募的，以提供癌症护理方面的多样化生活经验和专业知识。在外部机构的异步交流支持下，举办了一系列四次共同设计研讨会，以创建和完善最终的原型资源。结果：共同设计小组创建了一个名为Care My Way的个人工具，用于癌症患者与医疗服务提供者分享社会文化信息。开发这一资源是为了应对已确定的个人资源方面的差距，这些资源可供癌症患者交流其社会文化信息，超出口译要求、使用的语言和出生国家，以便保健提供者能够了解这可能如何影响护理。Care My Way由四个部分组成，癌症患者可以通过这些部分分享以下信息：(1)他们自己，(2)他们的沟通方式和支持需求，(3)他们的癌症旅程和护理，以及(4)他们基于文化和信仰背景的护理需求。“以我的方式护理”旨在促进多名卫生专业人员之间对癌症患者的关系和信息连续性护理，这些癌症患者的护理跨越初级和专科环境。结论：个人持有的工具，如Care My Way，为受癌症影响的人提供了一个机会，以确定关于他们自己和他们的护理的关键信息，包括与他们的护理相关的社会文化信息。“按我的方式护理”将个人置于他们希望分享的信息的决策核心，并可能为个人在初级和专业环境之间分享关于他们自己、他们的文化和他们的健康的信息提供一种低成本、可获得和灵活的方法，以提高护理质量。现在需要进行评价研究，以确定这一工具在改善护理连续性方面的有效性。患者或公众贡献：本研究是一个为期4年的项目的一部分，该项目是由来自澳大利亚不同文化和语言背景的有癌症生活经历的患者或护理者设计的。该项目包括消费者调查员和消费者咨询小组，贯穿整个生命周期。这份手稿的共同作者包括消费者（c.p.， J.E.），他们是共同设计组的成员，希望以作者的身份贡献。
{"title":"Care My Way: Co-Designing a Patient-Held Resource to Improve Information Sharing Between Primary and Specialist Care for People With Cancer","authors":"Reema Harrison, Bronwyn Newman, Ashfaq Chauhan, Kellie Holland, Clarel Philibert, Juliana Emerick, Kirsten Oataway, Elizabeth Manias, Carlene Wilson","doi":"10.1111/hex.70498","DOIUrl":"10.1111/hex.70498","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For many individuals, living with cancer means having a chronic and complex health condition that requires well-coordinated care between primary and specialist settings. Continuity of care is often compromised by lack of shared information between providers about a person's circumstances, communication support needs, health information or cultural requirements. This project aimed to use co-design with people from culturally and linguistically diverse backgrounds who have lived experience of cancer and their care providers to create a resource to enhance continuity of care when accessing multiple health providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A co-design group (<i>n</i> = 9) was formed comprising of people from different cultural and linguistic backgrounds with lived experience of cancer (<i>n</i> = 4) as survivors or carers, alongside healthcare providers (<i>n</i> = 5) working in primary care or as specialists. Co-design group members were recruited from cancer support organisations, consumer organisations, primary health networks, hospital oncology services and professional networks nationally in Australia to provide diverse lived experience of cancer and professional expertise in the provision of cancer care. A series of four co-design workshops were held, supported by asynchronous communication facilitated by an external agency to create and refine the final prototype resource.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The co-design group created a person-held tool called Care My Way for individuals with cancer to share socio-cultural information with health providers. This resource was developed in response to an identified gap in person-held resources that for people with cancer to communicate their socio-cultural information beyond interpreter requirements, language spoken and country of birth so that health providers can understand how this may influence care. Care My Way comprises of four components through which people living with cancer can share information about (1) themselves, (2) their communication approach and support needs, (3) their cancer journey and care, and (4) their care requirements based on cultural and faith backgrounds. Using Care My Way seeks to promote relational and informational continuity of care between multiple health professionals for people with cancer whose care spans primary and specialist settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Person-held tools such as Care My Way provide an opportunity for people affected by cancer to identify ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"29 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70498","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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