Bo Yan, Zhenke He, Ran Zhang, Bin Shao, Shuai Zheng, Xiaomin Wang, Xudong Zhou
Background
Encouraging healthy behaviours among rural residents in China is crucial to promote health and well-being. Although financial incentives are known to be effective in promoting single healthy behaviours, their efficacy in simultaneously encouraging multiple healthy behaviours remains unclear. This study aimed to test the feasibility and acceptability of an incentive-based intervention to encourage multiple healthy behaviours.
Methods
‘Health Bank’, a digital platform established by the Changxing County Center for Disease Control and Prevention, was employed financial incentives to engage villagers in promoting healthy behaviours. The intervention, conducted from January to October 2022, was followed by a mixed-methods evaluation in November 2022 to assess its feasibility and acceptability as the primary outcomes. Feasibility was assessed based on quantitative data from self-administered questionnaires and routine data, while acceptability was assessed by conducting semi-structured interviews.
Results
Routine data indicated that 1164 out of 3137 (37.1%) villagers participated in ‘Health Bank’, with the majority completing the required three daily healthy behaviours, despite their low participation rates in other behaviours. Among the 140 surveyed villagers, 68 respondents were not willing to participate in ‘Health Bank’, with only 19% refraining due to a lack of interest or need. The qualitative results suggested that financial incentives were a compelling factor for most participants, though challenges remained regarding the programme's elderly-friendliness, gift redemption process and the range of activities covered.
Conclusions
Although the incentive-based behaviour change intervention exhibited promising feasibility and acceptability, participant feedback necessitates further modifications. To comprehensively assess the efficacy of this intervention, larger-scale, randomised controlled trials were encouraged.
Patient or Public Contribution
A team-based approach was taken for developing the incentive-based intervention model for this study. This included experienced staff from local Centers for Disease Control and Prevention, as well as community workers and community residents.
{"title":"Feasibility and Acceptability of an Incentive-Based Intervention for Health Behaviour Change Among Rural Residents in China: A Mixed-Methods Evaluation","authors":"Bo Yan, Zhenke He, Ran Zhang, Bin Shao, Shuai Zheng, Xiaomin Wang, Xudong Zhou","doi":"10.1111/hex.70518","DOIUrl":"https://doi.org/10.1111/hex.70518","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Encouraging healthy behaviours among rural residents in China is crucial to promote health and well-being. Although financial incentives are known to be effective in promoting single healthy behaviours, their efficacy in simultaneously encouraging multiple healthy behaviours remains unclear. This study aimed to test the feasibility and acceptability of an incentive-based intervention to encourage multiple healthy behaviours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>‘Health Bank’, a digital platform established by the Changxing County Center for Disease Control and Prevention, was employed financial incentives to engage villagers in promoting healthy behaviours. The intervention, conducted from January to October 2022, was followed by a mixed-methods evaluation in November 2022 to assess its feasibility and acceptability as the primary outcomes. Feasibility was assessed based on quantitative data from self-administered questionnaires and routine data, while acceptability was assessed by conducting semi-structured interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Routine data indicated that 1164 out of 3137 (37.1%) villagers participated in ‘Health Bank’, with the majority completing the required three daily healthy behaviours, despite their low participation rates in other behaviours. Among the 140 surveyed villagers, 68 respondents were not willing to participate in ‘Health Bank’, with only 19% refraining due to a lack of interest or need. The qualitative results suggested that financial incentives were a compelling factor for most participants, though challenges remained regarding the programme's elderly-friendliness, gift redemption process and the range of activities covered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the incentive-based behaviour change intervention exhibited promising feasibility and acceptability, participant feedback necessitates further modifications. To comprehensively assess the efficacy of this intervention, larger-scale, randomised controlled trials were encouraged.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>A team-based approach was taken for developing the incentive-based intervention model for this study. This included experienced staff from local Centers for Disease Control and Prevention, as well as community workers and community residents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70518","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739891","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}
Christina Lange Ferreira, Hellena Habte-Asres, Angus Forbes, Kirsty Winkley
Aim
To explore the experiences and perspectives of older adults living with diabetes, in relation to insulin management during a surgical hospital admission and identify factors that appear to be associated with insulin safety in these older people. To identify key messages that address people with diabetes priorities, to be used in staff education.
Methods
Qualitative study, conducted in a single, rural NHS hospital. Ten semi-structured phone interviews were held with older adults with diabetes, with or without frailty, treated with insulin while undergoing surgical hospital admission. Framework analysis was employed in data analysis.
Results
Six people with type 2 diabetes and four people with type 1 diabetes, aged 68 to 91 years old (mean age 77.2 years [SD = 6.2]) participated in the study. Four themes identified specific to hospital insulin management and safety: (1) preparedness for hospital admission; (2) feeling disempowered in hospital; (3) staff knowledge, confidence, attitudes and behaviours; (4) diabetes and insulin management as a balancing act. In addition, participants co-designed an infographic to help hospital staff understand what matters most to older adults in terms of managing their insulin safely in the hospital.
Conclusion
Lack of joined-up care, staff knowledge gaps and lack of empowerment ethos hinder hospital insulin safety. This study identified that having a self-management policy in a hospital does not necessarily mean it is implemented for older adults with diabetes. Using a co-design approach to engage with older adults helped to identify components critical to hospital insulin safety interventions.
Patient or Public Contribution
Patients and members of the public are involved in study design and interpretation of findings. Before the study, a diabetes peer-support group reviewed and contributed to the interview topic guide and study recruitment documentation. Study participants co-designed the infographic developed.
{"title":"‘Why, Can I Not Have Control of My Own Insulin?’: Qualitative Exploration Amongst Older Adults With Diabetes With Lived Experience of Surgical Hospital Admission","authors":"Christina Lange Ferreira, Hellena Habte-Asres, Angus Forbes, Kirsty Winkley","doi":"10.1111/hex.70509","DOIUrl":"10.1111/hex.70509","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore the experiences and perspectives of older adults living with diabetes, in relation to insulin management during a surgical hospital admission and identify factors that appear to be associated with insulin safety in these older people. To identify key messages that address people with diabetes priorities, to be used in staff education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Qualitative study, conducted in a single, rural NHS hospital. Ten semi-structured phone interviews were held with older adults with diabetes, with or without frailty, treated with insulin while undergoing surgical hospital admission. Framework analysis was employed in data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six people with type 2 diabetes and four people with type 1 diabetes, aged 68 to 91 years old (mean age 77.2 years [SD = 6.2]) participated in the study. Four themes identified specific to hospital insulin management and safety: (1) preparedness for hospital admission; (2) feeling disempowered in hospital; (3) staff knowledge, confidence, attitudes and behaviours; (4) diabetes and insulin management as a balancing act. In addition, participants co-designed an infographic to help hospital staff understand what matters most to older adults in terms of managing their insulin safely in the hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lack of joined-up care, staff knowledge gaps and lack of empowerment ethos hinder hospital insulin safety. This study identified that having a self-management policy in a hospital does not necessarily mean it is implemented for older adults with diabetes. Using a co-design approach to engage with older adults helped to identify components critical to hospital insulin safety interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>Patients and members of the public are involved in study design and interpretation of findings. Before the study, a diabetes peer-support group reviewed and contributed to the interview topic guide and study recruitment documentation. Study participants co-designed the infographic developed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702942","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}
Jinxin Li, Yue Zhang, Nan Zhao, Jianxiao Zheng, Yang Wang, Jiajia Dong, Jianwen Zhu, Jie Fu, Hong Fan
<div> <section> <h3> Background</h3> <p>Effective self-management is essential for improving the health outcomes of patients with type 2 diabetes mellitus (T2DM). However, many patients fail to achieve ideal self-management. This qualitative study, grounded in the theory of planned behaviour (TPB), aims to explore the mechanisms underlying self-management behaviours of patients with T2DM in the community, to provide insights for improve patients' self-management and reduce the disease burden.</p> </section> <section> <h3> Methods</h3> <p>Within the framework of the TPB, a semi-structured interview guide was developed based on a literature review and expert consensus. Qualitative data were obtained from in-depth interviews with 21 patients with T2DM from a community health service centre in Nanjing, Jiangsu Province. All interviews were conducted by the same interviewer to ensure consistency. Content analysis was used to identify the key factors influencing patients' self-management behaviours and the underlying mechanism.</p> </section> <section> <h3> Results</h3> <p>This study systematically explained the underlying mechanisms of self-management behaviours among patients with T2DM based on Ajzen's TPB, including three key levels: (1) Attitudes towards self-management: shaped by both internal (e.g., self-perception, perceived importance and understanding of the disease) and external factors (e.g., perceived benefits and degree of acceptance). (2) Subjective norms: influenced by both intrinsic (e.g., personal motivations) and extrinsic pressures (e.g., surrounding individuals and social groups). (3) Perceived behavioural control: determined by both inner (e.g., personal characteristics, physical and mental experience, economic resources and time management) and outer factors (e.g., environmental suitability, policy support and technical availability).</p> </section> <section> <h3> Conclusion</h3> <p>This study provides a valuable theoretical basis and practical implications for designing effective interventions to improve self-management behaviours of patients with T2DM in the community. To optimize self-management behaviours of this population, a multifaceted approach is recommended, focusing on the following six key areas: improving T2DM knowledge, strengthening follow-up management system, empowering patients to take an active role in their care, fostering social support network, developing their own coping skills and expanding policy support for T2DM care.</p> </section> <section>
{"title":"A Qualitative Study Exploring the Mechanisms Underlying Self-Management Behaviours Among Community-Dwelling Type 2 Diabetes Mellitus Patients in Nanjing, China","authors":"Jinxin Li, Yue Zhang, Nan Zhao, Jianxiao Zheng, Yang Wang, Jiajia Dong, Jianwen Zhu, Jie Fu, Hong Fan","doi":"10.1111/hex.70522","DOIUrl":"10.1111/hex.70522","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective self-management is essential for improving the health outcomes of patients with type 2 diabetes mellitus (T2DM). However, many patients fail to achieve ideal self-management. This qualitative study, grounded in the theory of planned behaviour (TPB), aims to explore the mechanisms underlying self-management behaviours of patients with T2DM in the community, to provide insights for improve patients' self-management and reduce the disease burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Within the framework of the TPB, a semi-structured interview guide was developed based on a literature review and expert consensus. Qualitative data were obtained from in-depth interviews with 21 patients with T2DM from a community health service centre in Nanjing, Jiangsu Province. All interviews were conducted by the same interviewer to ensure consistency. Content analysis was used to identify the key factors influencing patients' self-management behaviours and the underlying mechanism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study systematically explained the underlying mechanisms of self-management behaviours among patients with T2DM based on Ajzen's TPB, including three key levels: (1) Attitudes towards self-management: shaped by both internal (e.g., self-perception, perceived importance and understanding of the disease) and external factors (e.g., perceived benefits and degree of acceptance). (2) Subjective norms: influenced by both intrinsic (e.g., personal motivations) and extrinsic pressures (e.g., surrounding individuals and social groups). (3) Perceived behavioural control: determined by both inner (e.g., personal characteristics, physical and mental experience, economic resources and time management) and outer factors (e.g., environmental suitability, policy support and technical availability).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides a valuable theoretical basis and practical implications for designing effective interventions to improve self-management behaviours of patients with T2DM in the community. To optimize self-management behaviours of this population, a multifaceted approach is recommended, focusing on the following six key areas: improving T2DM knowledge, strengthening follow-up management system, empowering patients to take an active role in their care, fostering social support network, developing their own coping skills and expanding policy support for T2DM care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12683677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702948","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}
Julia Frost, Widening Engagement Patient Advisory Group, Jessica Mandizha, Chantal van den Dungen, Lauren Asare, Catherine Pope
<div> <section> <h3> Background</h3> <p>Drug development practices for rare diseases promote a <i>promissory</i> notion that the drug pipeline will succeed (with the next new drug/drug trial) and an <i>imaginary</i> of widening patient engagement (often desired but yet to be enacted). Contemporary industry practices of patient engagement are shaped by this promissory, and engagement often includes limited patient perspectives, typically relying on patients from established Patient Organisations or identified by Contract Research Organisations.</p> </section> <section> <h3> Objective</h3> <p>We sought to explore whether more deliberative methods might enable wider, more diverse patient engagement for orphan drug trials.</p> </section> <section> <h3> Design</h3> <p>Citizen's Jury co-designed with patient advisors.</p> </section> <section> <h3> Setting and Participants</h3> <p>Results of an earlier ethnography of a biotech company's patient engagement practices, along with findings from clinical trials for patients with idiopathic pulmonary fibrosis, clinical practice and patient testimony, were presented to the Citizens' Jury made up of patients and carers.</p> </section> <section> <h3> Results</h3> <p>Jurors discussed and offered a ‘verdict’ on trial materials and processes that would optimise the engagement of more diverse patients for drug trials for rare diseases, suggesting that more could be done at an organisational level to ensure that potential trial participants were able to ‘engage’. They asserted that the industry could do more to understand the unmet needs and wishes of a wider group of patients and should seek input from more diverse groups.</p> </section> <section> <h3> Discussion</h3> <p>The Citizens' Jury called for practices to enable wider engagement—for both drug trials and drug trial design—and more transparency about the risks associated with engagement, for individual patients and currently marginalised groups.</p> </section> <section> <h3> Conclusions</h3> <p>Current drug development practices reify expert patient perspectives and often ignore the views of the wider group of patients who may participate in trials and/or use new medicines developed. More deliberative methods of engagement have the potential to democratise drug
{"title":"Can the Development of Orphan Drugs Include Wider Patient Engagement? A Citizens' Jury to Explore a Promissory Notion","authors":"Julia Frost, Widening Engagement Patient Advisory Group, Jessica Mandizha, Chantal van den Dungen, Lauren Asare, Catherine Pope","doi":"10.1111/hex.70524","DOIUrl":"10.1111/hex.70524","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Drug development practices for rare diseases promote a <i>promissory</i> notion that the drug pipeline will succeed (with the next new drug/drug trial) and an <i>imaginary</i> of widening patient engagement (often desired but yet to be enacted). Contemporary industry practices of patient engagement are shaped by this promissory, and engagement often includes limited patient perspectives, typically relying on patients from established Patient Organisations or identified by Contract Research Organisations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We sought to explore whether more deliberative methods might enable wider, more diverse patient engagement for orphan drug trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Citizen's Jury co-designed with patient advisors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting and Participants</h3>\u0000 \u0000 <p>Results of an earlier ethnography of a biotech company's patient engagement practices, along with findings from clinical trials for patients with idiopathic pulmonary fibrosis, clinical practice and patient testimony, were presented to the Citizens' Jury made up of patients and carers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Jurors discussed and offered a ‘verdict’ on trial materials and processes that would optimise the engagement of more diverse patients for drug trials for rare diseases, suggesting that more could be done at an organisational level to ensure that potential trial participants were able to ‘engage’. They asserted that the industry could do more to understand the unmet needs and wishes of a wider group of patients and should seek input from more diverse groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The Citizens' Jury called for practices to enable wider engagement—for both drug trials and drug trial design—and more transparency about the risks associated with engagement, for individual patients and currently marginalised groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Current drug development practices reify expert patient perspectives and often ignore the views of the wider group of patients who may participate in trials and/or use new medicines developed. More deliberative methods of engagement have the potential to democratise drug ","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70524","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679626","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}
Hennessy, M., Dennehy, R., O'Leary, H., O'Donoghue, K., and RE:CURRENT Research Advisory Group (2024), “Involving Knowledge Users in Health Services Research: Collective Reflections and Learning From a National Evaluation of Recurrent Miscarriage Services,” Health Expectations, 27: e70125. https://doi.org/10.1111/hex.70125.
Please refer to the corrected text in the revised Table 1 below.
{"title":"Correction to “Involving Knowledge Users in Health Services Research: Collective Reflections and Learning From a National Evaluation of Recurrent Miscarriage Services”","authors":"","doi":"10.1111/hex.70525","DOIUrl":"10.1111/hex.70525","url":null,"abstract":"<p>Hennessy, M., Dennehy, R., O'Leary, H., O'Donoghue, K., and RE:CURRENT Research Advisory Group (2024), “Involving Knowledge Users in Health Services Research: Collective Reflections and Learning From a National Evaluation of Recurrent Miscarriage Services,” <i>Health Expectations,</i> 27: e70125. https://doi.org/10.1111/hex.70125.</p><p>Please refer to the corrected text in the revised Table 1 below.</p><p>We apologise for these errors.</p>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70525","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679693","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}
Ian Litchfield, Gayathri Delanerolle, Lorraine Harper, Sian Dunning
Background
Effective communication is central to safe, high-quality primary care. For Bangladeshi communities in the United Kingdom (UK), linguistic barriers continue to impede access to timely and culturally sensitive healthcare. This study describes an early phase of the co-production pathway of the tool seeking to understand the contextual acceptability of an AI-enabled translation tool designed for general practice, with functionality to capture symptoms, clinical problems, across diverse Bangladeshi dialects and provide guidance on next steps.
Methods
We conducted a series of semi-structured interviews with a sample of Bangladeshi patients from South Birmingham, UK to understand their attitudes towards using the AmarDoctor translation tool. The data were analysed using a directed content analysis to populate Sekhon's theoretical framework of acceptability.
Results
Seven participants, all native Bengali speakers, were recruited. AmarDoctor was viewed positively for supporting appointment booking, guiding appropriate next steps, and offering a safe, anonymous means of discussing sensitive concerns. Noted strengths were its ability to capture symptoms in multiple Bengali dialects and its ease of use by those with limited digital literacy. The most frequently shared concern centred on the potential for translation inaccuracies and the subsequent risks.
Conclusions
Participants expressed optimism about the role of AmarDoctor and similar AI-enabled translation tools in improving access to primary care. To gain wider acceptance, AmarDoctor must maximise the next steps of the co-production process that includes staff and commissioners to ensure translation accuracy meets the needs of all users and that credible pathways for implementation at scale are developed.
Patient or Public Contribution
Patients and the public have been involved from the beginning of the AmarDoctor initiative, contributing to the design and content of patient facing materials, and informing the content of our topic guide.
{"title":"Understanding Acceptability of AI Triage Tools Amongst Underserved Populations: Lessons From the Early Phases of Co-Production With Bangladeshi Communities in Birmingham, UK","authors":"Ian Litchfield, Gayathri Delanerolle, Lorraine Harper, Sian Dunning","doi":"10.1111/hex.70523","DOIUrl":"10.1111/hex.70523","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective communication is central to safe, high-quality primary care. For Bangladeshi communities in the United Kingdom (UK), linguistic barriers continue to impede access to timely and culturally sensitive healthcare. This study describes an early phase of the co-production pathway of the tool seeking to understand the contextual acceptability of an AI-enabled translation tool designed for general practice, with functionality to capture symptoms, clinical problems, across diverse Bangladeshi dialects and provide guidance on next steps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a series of semi-structured interviews with a sample of Bangladeshi patients from South Birmingham, UK to understand their attitudes towards using the AmarDoctor translation tool. The data were analysed using a directed content analysis to populate Sekhon's theoretical framework of acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven participants, all native Bengali speakers, were recruited. AmarDoctor was viewed positively for supporting appointment booking, guiding appropriate next steps, and offering a safe, anonymous means of discussing sensitive concerns. Noted strengths were its ability to capture symptoms in multiple Bengali dialects and its ease of use by those with limited digital literacy. The most frequently shared concern centred on the potential for translation inaccuracies and the subsequent risks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participants expressed optimism about the role of AmarDoctor and similar AI-enabled translation tools in improving access to primary care. To gain wider acceptance, AmarDoctor must maximise the next steps of the co-production process that includes staff and commissioners to ensure translation accuracy meets the needs of all users and that credible pathways for implementation at scale are developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>Patients and the public have been involved from the beginning of the AmarDoctor initiative, contributing to the design and content of patient facing materials, and informing the content of our topic guide.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70523","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670939","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}
Marisha E. Palm, Callie A. Gu, Ingrid V. Bassett, Bruce D. Levy, Li Qing Chen, Janice John, Cheralyn Johnson, Jacqui Lindsay, Rebecca Lobb, Netia McCray, Bisola Ojikutu, Linda Sprague Martinez, Jacqueline Rodriguez-Louis, Alice Rushforth, Robert Torres, Danielle L. Zionts, Cheryl R. Clark
<div> <section> <h3> Background</h3> <p>In 2021, the National Institutes of Health launched a multi-centre observational study on long Covid: Researching COVID to Enhance Recovery (RECOVER). Six Boston academic medical centres joined community partners to become the Boston COVID Recovery Cohort (BCRC), a consortium of RECOVER sites. Our consortium developed a community engagement model, and this manuscript shares lessons and recommendations.</p> </section> <section> <h3> Design and Participants</h3> <p>The BCRC Community Partnership Table, which included community partners, senior equity leaders, academic researchers and health system collaborators, co-developed a charter to advance research, community education, clinical care, social support and institutional and policy change goals. BCRC engaged patients, providers, caregivers and legislators via multiple communication channels.</p> </section> <section> <h3> Findings</h3> <p>The BCRC Community Partnership Table faced several challenges: working within a novel, evolving pandemic; structural barriers to successful community engagement; perspectives on trustworthiness of research; and working across multiple organisations with distinct structures, resources and goals. There were also successes: leaders who were invested in community engagement; a focus on inclusive network building; co-production; flexible communication channels; a shift to centring communities and patients; and connection with the legislature to support broader policy impacts.</p> </section> <section> <h3> Discussion</h3> <p>To inform future community engagement models, we recommend the following: (1) healthcare research funders should build in time and resources for community engagement; (2) study consortia should include community engagement specialists in decision-making positions from the outset; and (3) community members should have prominent roles leading research engagement efforts.</p> </section> <section> <h3> Conclusions</h3> <p>Engagement models can enhance the equity impact of long Covid research. Reflections and recommendations in this paper can inform future efforts.</p> </section> <section> <h3> Patient or Public Contribution</h3> <p>The project included community leaders, community-based organisations, people with long Covid, and those caring for people with long Covid. Community leaders, community-based organisatio
{"title":"Community Engagement in Long Covid: Insights From the Boston COVID Recovery Cohort","authors":"Marisha E. Palm, Callie A. Gu, Ingrid V. Bassett, Bruce D. Levy, Li Qing Chen, Janice John, Cheralyn Johnson, Jacqui Lindsay, Rebecca Lobb, Netia McCray, Bisola Ojikutu, Linda Sprague Martinez, Jacqueline Rodriguez-Louis, Alice Rushforth, Robert Torres, Danielle L. Zionts, Cheryl R. Clark","doi":"10.1111/hex.70493","DOIUrl":"10.1111/hex.70493","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In 2021, the National Institutes of Health launched a multi-centre observational study on long Covid: Researching COVID to Enhance Recovery (RECOVER). Six Boston academic medical centres joined community partners to become the Boston COVID Recovery Cohort (BCRC), a consortium of RECOVER sites. Our consortium developed a community engagement model, and this manuscript shares lessons and recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design and Participants</h3>\u0000 \u0000 <p>The BCRC Community Partnership Table, which included community partners, senior equity leaders, academic researchers and health system collaborators, co-developed a charter to advance research, community education, clinical care, social support and institutional and policy change goals. BCRC engaged patients, providers, caregivers and legislators via multiple communication channels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The BCRC Community Partnership Table faced several challenges: working within a novel, evolving pandemic; structural barriers to successful community engagement; perspectives on trustworthiness of research; and working across multiple organisations with distinct structures, resources and goals. There were also successes: leaders who were invested in community engagement; a focus on inclusive network building; co-production; flexible communication channels; a shift to centring communities and patients; and connection with the legislature to support broader policy impacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>To inform future community engagement models, we recommend the following: (1) healthcare research funders should build in time and resources for community engagement; (2) study consortia should include community engagement specialists in decision-making positions from the outset; and (3) community members should have prominent roles leading research engagement efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Engagement models can enhance the equity impact of long Covid research. Reflections and recommendations in this paper can inform future efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>The project included community leaders, community-based organisations, people with long Covid, and those caring for people with long Covid. Community leaders, community-based organisatio","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662783","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}
Anu Mohan, Teddy Andrews Jaihind Jothikaran, Lena Ashok
<div> <section> <h3> Background</h3> <p>Decline of intergenerational co-residence, risk of functional and emotional deprivations in old age, and the diminishing capacity of families to care in-person for their older parents have intensified the demand for formal care provisions among left-behind older adults in migrant households of Kerala. While several attempts have been made to quantify the accessibility and utilisation of geriatric care, there is a dearth of evidence on the realities of alternative care in Kerala. The present study aims to explore the perception of older adults (65+) and service providers (government and non-governmental) on the systemic enablers and barriers of alternative care in migrant households of Kerala.</p> </section> <section> <h3> Materials and Methods</h3> <p>A qualitative approach using IDIs were employed among 20 left-behind older adults (65+) and 8 service providers across three districts of Kerala (Pathanamthitta, Thrissur and Kannur), using purpose sampling, and thematic analysis was followed using a deductive approach.</p> </section> <section> <h3> Results</h3> <p>Analysis using the Rainbow Model of Integrated Care revealed that the high cost of care at a micro level limits access and utilisation, while the inactivity of day care homes and their failure to upgrade as resource centres challenge the alternative care at a meso level of operation. The absence of need assessments, top-down implementation, inappropriate fund allocation, lack of measures to sustain the programme and rigid eligibility norms for inclusion pose challenges in the care avenues, while pain and palliative care community-based associations and doorstep delivery of essential services facilitate seamless delivery of alternative care.</p> </section> <section> <h3> Conclusion</h3> <p>Alternative care efforts should integrate regional, state and central levels of planning, concrete implementation guidelines, participation of older adults in planning and implementation, and efforts to upgrade day care homes into regional resource centres, along with systematic monitoring and evaluation and multi-stakeholder governance to realise alternative care for older adults.</p> </section> <section> <h3> Patient and/or Public Contribution</h3> <p>Informal discussions with community-dwelling older adults and service providers helped in refining research questions and in-depth interview guides to explore their lived experiences. Participants shared insights on t
{"title":"Enablers and Barriers to Alternative Care: Perspectives of Community-Dwelling Older Adults and Service Providers in Kerala","authors":"Anu Mohan, Teddy Andrews Jaihind Jothikaran, Lena Ashok","doi":"10.1111/hex.70507","DOIUrl":"10.1111/hex.70507","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Decline of intergenerational co-residence, risk of functional and emotional deprivations in old age, and the diminishing capacity of families to care in-person for their older parents have intensified the demand for formal care provisions among left-behind older adults in migrant households of Kerala. While several attempts have been made to quantify the accessibility and utilisation of geriatric care, there is a dearth of evidence on the realities of alternative care in Kerala. The present study aims to explore the perception of older adults (65+) and service providers (government and non-governmental) on the systemic enablers and barriers of alternative care in migrant households of Kerala.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A qualitative approach using IDIs were employed among 20 left-behind older adults (65+) and 8 service providers across three districts of Kerala (Pathanamthitta, Thrissur and Kannur), using purpose sampling, and thematic analysis was followed using a deductive approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis using the Rainbow Model of Integrated Care revealed that the high cost of care at a micro level limits access and utilisation, while the inactivity of day care homes and their failure to upgrade as resource centres challenge the alternative care at a meso level of operation. The absence of need assessments, top-down implementation, inappropriate fund allocation, lack of measures to sustain the programme and rigid eligibility norms for inclusion pose challenges in the care avenues, while pain and palliative care community-based associations and doorstep delivery of essential services facilitate seamless delivery of alternative care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Alternative care efforts should integrate regional, state and central levels of planning, concrete implementation guidelines, participation of older adults in planning and implementation, and efforts to upgrade day care homes into regional resource centres, along with systematic monitoring and evaluation and multi-stakeholder governance to realise alternative care for older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient and/or Public Contribution</h3>\u0000 \u0000 <p>Informal discussions with community-dwelling older adults and service providers helped in refining research questions and in-depth interview guides to explore their lived experiences. Participants shared insights on t","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642753","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}
Nicoleta-Monica Pașca, Diana Tăut, Rachel Greenley, Pia Kirkegaard, Rikke Buus Bøje, Martin McKee, Marc Bardou, Adriana-Smaranda Băban, and the CBIG-SCREEN Consortium
Introduction
This study aimed to explore the emotional and cognitive perceptions of cervical cancer screening (CCS), with a focus on self-sampling for human papillomavirus (HPV) by vulnerable Romanian women.
Methodology
Eighteen semi-structured individual interviews were conducted with vulnerable women, defined by their low socioeconomic status (SES), residence in rural areas and membership in ethnic minorities. Participants were recruited using snowball sampling. Interviews followed a guide designed to assess constructs from the Health Belief Model (knowledge, barriers, evaluation of vulnerability) as they relate to women's views of prevention, the healthcare system and CCS. A Think Aloud protocol was used with a subsample of six women to identify potential barriers, opportunities and attitudes related to the use of self-sampling kits. A reflexive thematic analysis was conducted to identify the primary themes related to with women's perceptions of CCS and self-sampling.
Results
Four major themes emerged: (a) risk, fear and other emotional experiences; (b) women's perception of barriers; (c) knowledge, personal control and cues to action; and (d) women's perception of self-sampling. Participants unravelled emotional and logistical barriers to CCS and self-sampling. Limited health literacy, fear and shame influenced risk perceptions, hindering CCS participation. Logistical challenges and financial constraints further impeded access, while women often prioritized the needs of their families over their own health. The Think Aloud protocol revealed that initial concerns regarding self-sampling could be alleviated by having clear instructions, highlighting the importance of support during the decision-making process.
Conclusion
This study identified diverse barriers preventing vulnerable Romanian women from engaging in CCS, including logistical challenges, financial constraints and emotional factors.
Patient or Public Contribution
Patients or the public were not involved in the design, conduct, analysis or interpretation of the study.
{"title":"Exploring Emotional and Cognitive Perceptions of Cervical Cancer Screening and Self-Sampling Among Vulnerable Romanian Women: A Qualitative Study","authors":"Nicoleta-Monica Pașca, Diana Tăut, Rachel Greenley, Pia Kirkegaard, Rikke Buus Bøje, Martin McKee, Marc Bardou, Adriana-Smaranda Băban, and the CBIG-SCREEN Consortium","doi":"10.1111/hex.70485","DOIUrl":"10.1111/hex.70485","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to explore the emotional and cognitive perceptions of cervical cancer screening (CCS), with a focus on self-sampling for human papillomavirus (HPV) by vulnerable Romanian women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Eighteen semi-structured individual interviews were conducted with vulnerable women, defined by their low socioeconomic status (SES), residence in rural areas and membership in ethnic minorities. Participants were recruited using snowball sampling. Interviews followed a guide designed to assess constructs from the Health Belief Model (knowledge, barriers, evaluation of vulnerability) as they relate to women's views of prevention, the healthcare system and CCS. A Think Aloud protocol was used with a subsample of six women to identify potential barriers, opportunities and attitudes related to the use of self-sampling kits. A reflexive thematic analysis was conducted to identify the primary themes related to with women's perceptions of CCS and self-sampling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four major themes emerged: (a) risk, fear and other emotional experiences; (b) women's perception of barriers; (c) knowledge, personal control and cues to action; and (d) women's perception of self-sampling. Participants unravelled emotional and logistical barriers to CCS and self-sampling. Limited health literacy, fear and shame influenced risk perceptions, hindering CCS participation. Logistical challenges and financial constraints further impeded access, while women often prioritized the needs of their families over their own health. The Think Aloud protocol revealed that initial concerns regarding self-sampling could be alleviated by having clear instructions, highlighting the importance of support during the decision-making process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified diverse barriers preventing vulnerable Romanian women from engaging in CCS, including logistical challenges, financial constraints and emotional factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>Patients or the public were not involved in the design, conduct, analysis or interpretation of the study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650192","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}
Khadijeh Khademi, Mohammad Hossein Kaveh, Mahin Nazari, Abdolrahim Asadollahi
<div> <section> <h3> Background</h3> <p>Menopause is a natural biological transition in a woman's life, often accompanied by various physical and emotional challenges. Enhancing postmenopausal women's health and quality of life requires empowerment, particularly through self-care strategies. The present study aimed to evaluate the effectiveness of a training programme based on Longwe's Empowerment Framework and a Community-Based Participatory Research approach.</p> </section> <section> <h3> Methods</h3> <p>A randomised controlled trial was conducted involving 140 postmenopausal Iranian women, with 70 women in each control and intervention group. The intervention group received a 6-week training programme, with weekly 120-min sessions, designed using Longwe's framework in combination with the PRECEDE-PROCEED model. Data were collected at three time points: baseline, 2 weeks post-intervention and 4 months post-intervention, using validated questionnaires. Statistical analyses were performed using SPSS version 27, with significance set at <i>p</i> < 0.05.</p> </section> <section> <h3> Results</h3> <p>The training intervention significantly improved participants' quality of life (η² = 0.23, <i>p</i> < 0.001) and overall health (η² = 0.12, <i>p</i> < 0.001), with large and moderate effect sizes, respectively. Notably, the programme had a large effect on menopausal self-care behaviours (η² = 0.42, <i>p</i> < 0.001) and a small but significant effect on internal health locus of control (η² = 0.05, <i>p</i> < 0.001).</p> </section> <section> <h3> Conclusion</h3> <p>This study demonstrates that a structured self-care training programme, based on empowerment theory and community engagement, can effectively enhance the health outcomes and quality of life of postmenopausal women. The findings indicate that integrating participatory and empowerment-based educational interventions into public health initiatives for midlife women is advantageous.</p> </section> <section> <h3> Patient or Public Contribution</h3> <p>This study employed a community-based participatory research approach, actively engaging postmenopausal women as collaborators throughout the intervention process. Participants were involved in the initial needs assessment, where they shared their self-care priorities and preferences. They also provided input on the structure, scheduling, and delivery format of the educational sessions. Furthermore, they collaborated to develop and partic
{"title":"Effect of Health Model-Based Menopausal Self-Care Training on Quality of Life and Health: A Randomised Controlled Trial","authors":"Khadijeh Khademi, Mohammad Hossein Kaveh, Mahin Nazari, Abdolrahim Asadollahi","doi":"10.1111/hex.70511","DOIUrl":"https://doi.org/10.1111/hex.70511","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Menopause is a natural biological transition in a woman's life, often accompanied by various physical and emotional challenges. Enhancing postmenopausal women's health and quality of life requires empowerment, particularly through self-care strategies. The present study aimed to evaluate the effectiveness of a training programme based on Longwe's Empowerment Framework and a Community-Based Participatory Research approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A randomised controlled trial was conducted involving 140 postmenopausal Iranian women, with 70 women in each control and intervention group. The intervention group received a 6-week training programme, with weekly 120-min sessions, designed using Longwe's framework in combination with the PRECEDE-PROCEED model. Data were collected at three time points: baseline, 2 weeks post-intervention and 4 months post-intervention, using validated questionnaires. Statistical analyses were performed using SPSS version 27, with significance set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The training intervention significantly improved participants' quality of life (η² = 0.23, <i>p</i> < 0.001) and overall health (η² = 0.12, <i>p</i> < 0.001), with large and moderate effect sizes, respectively. Notably, the programme had a large effect on menopausal self-care behaviours (η² = 0.42, <i>p</i> < 0.001) and a small but significant effect on internal health locus of control (η² = 0.05, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates that a structured self-care training programme, based on empowerment theory and community engagement, can effectively enhance the health outcomes and quality of life of postmenopausal women. The findings indicate that integrating participatory and empowerment-based educational interventions into public health initiatives for midlife women is advantageous.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient or Public Contribution</h3>\u0000 \u0000 <p>This study employed a community-based participatory research approach, actively engaging postmenopausal women as collaborators throughout the intervention process. Participants were involved in the initial needs assessment, where they shared their self-care priorities and preferences. They also provided input on the structure, scheduling, and delivery format of the educational sessions. Furthermore, they collaborated to develop and partic","PeriodicalId":55070,"journal":{"name":"Health Expectations","volume":"28 6","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.70511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626863","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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