To understand young women’s views of cervical screening, what obstacles they face, and what encourages them when considering attending their cervical screening.

Cervical screening figures have been steadily decreasing in the United Kingdom (UK). There is limited research on this trend, especially around views and knowledge of young women, aged 20–24 years, have before they are eligible for cervical screening.

This qualitative study conducted 15 semi-structured Zoom in-depth interviews to discuss young women’s knowledge and perceptions of cervical screening in 2022. Participants were based in the UK. Thematic analysis was used to systematically manage, analyse, and identify themes including cervical screening knowledge; perceptions of cervical screening; barriers to cervical screening; and facilitators of cervical screening.

The findings demonstrate significant gaps in knowledge and negative perceptions of cervical screening. Barriers to attending cervical screening were perceived pain and embarrassment. Facilitators suggested to promote attendance were ensuring access to appointments, creating pop-up clinics, and utilising incentives. The level of knowledge demonstrated by the participants, their negatively framed perceptions; and the vast number of barriers identified present substantial factors that could affect future attendance to cervical screening. Overall, action needs to be taken to prevent decreasing cervical screening attendance rates and eradicate any barriers women may experience.

Legume and pulse consumption is currently recommended for health and sustainability purposes, but barriers to consumption can include low enjoyment and poor sensory properties. This work aimed to investigate the relative importance of a number of barriers and facilitators towards legume, including pulse, consumption with a specific focus on enjoyment, sensory properties and a possible role for perceived cooking abilities in these relationships.

A cross-sectional questionnaire study assessed legume and pulse consumption, agreement and disagreement with statements relating to enjoyment, sensory properties, cooking abilities, practical aspects, healthiness, upbringing, social influences and quality issues, and four demographic characteristics. Complete responses were gained from 633 respondents with a mix of genders, ages, usual cooking responsibilities and usual eating habits.

UK, March 2021 – September 2022.

General UK adult population.

Using multiple regression analyses, enjoyment and cooking abilities were found to be important for both legume and pulse consumption (smallest beta = 0·165, P < 0·01), and the sensory properties of these foods were also important for the consumption of pulses (beta = 0·099, P = 0·04). Perceived cooking abilities also reduced the importance of enjoyment and sensory properties for consumption, mitigated effects due to upbringing and practical aspects and increased the value of perceived health benefits (smallest beta = 0·094, P = 0·04).

These findings demonstrate a clear role for enjoyment, sensory properties and perceived cooking abilities in legume and pulse consumption and suggest benefits for increasing cooking abilities for improved legume and pulse consumption, as result of both direct and indirect effects.

Around 95% of Chinese with dementia in Australia and China reside at home and are cared for by family members. The World Health Organization (WHO) iSupport program has been translated into simplified and traditional Chinese and culturally adapted to the Chinese populations in Australia, Mainland China, Taiwan, Hong Kong and Macau. The objective of this study was to explore family caregivers’ experience in a 6-month randomized controlled trial of a facilitator-enabled iSupport intervention program that includes the utilization of the online iSupport and peer support activities.

A qualitative descriptive design was applied to address the study objective. Caregivers’ interactions with peers and program facilitators in monthly online meetings were audio-recorded and transcribed verbatim for data analysis. Facilitators were required to document their support for caregivers in their monthly portfolios and submit for data analysis. Thematic analysis was used to analyse data collected from online caregiver meetings and facilitator portfolios.

Five main themes were identified from data. First, caregivers were able to follow the group learning goal to complete their monthly learning activities using the online iSupport. They were also capable of selecting additional learning units from iSupport to meet their individual learning needs. Second, caregivers perceived that iSupport enabled them to change their responses to changed behaviours their care recipients had by which they reduced the sources of stressor in their daily care. Third, caregivers were willing and felt safe to share their stressors and seek help from peers and facilitators in group meetings. Fourth, caregivers demonstrated their enthusiasm to help their peers reduce their stressors and social isolation by searching and sharing various electronic resources via Wechat or Whatsapp platform throughout the trial. In addition, facilitators were able to assess caregivers’ learning needs and link them with relevant care services and resources accordingly.

Facilitator-enabled iSupport intervention in our study demonstrated advantages of engaging caregivers in learning iSupport, applying knowledge into daily care activities, sharing experiences with and supporting other caregivers.

The duration of untreated psychosis (DUP) continues to be a global priority. Early intervention services were established to reduce treatment delays but have had limited impact. This systematic review examines barriers and facilitators to seeking access to these services, to identify targets for service level change.

We conducted a systematic review of relevant databases (PsychINFO, MEDLINE, CINAHL, and PsychARTICLES) using pre-defined search terms for psychosis, early intervention, and barriers and facilitators. Given the majority of qualitative studies, a thematic synthesis rather than meta-analysis was indicated.

The search yielded 10 studies. Mental health stigma and discrimination predict DUP, compounded by structural barriers which limit the impact of early intervention services on timely access to recommended treatments. Synthesis of the qualitative studies generated three themes: knowledge, relationships, and stigma. Lack of knowledge, absence of supportive relationships (social and professional), and self-stigma constitute significant barriers to seeking access to early intervention services.

This is the first review of the barriers and facilitators to seeking access to early intervention services. The findings highlight public health and secondary care service targets to expedite access to recommended treatments and thereby reduce the DUP.

Children and young people with CHD benefit from regular physical activity. Parents are reported as facilitators and barriers to their children’s physical activity. The aim of this study was to explore parental factors, child factors, and their clinical experience on physical activity participation in young people with CHD.

An online questionnaire was co-developed with parents (n = 3) who have children with CHD. The survey was then distributed in the United Kingdom by social media and CHD networks, between October 2021 and February 2022. Data were analysed using mixed methods.

Eighty-three parents/guardians responded (94% mothers). Young people with CHD were 7.3 ± 5.0 years old (range 0–20 years; 53% female) and 84% performed activity. Parental participation in activity (X2(1) = 6.9, P < 0.05) and perceiving activity as important for their child were positively associated with activity (Fisher’s Exact, P < 0.05). Some parents (∼15%) were unsure of the safety of activity, and most (∼70%) were unsure where to access further information about activity. Fifty-two parents (72%) had never received activity advice in clinic, and of the 20 who received advice, 10 said it was inconsistent. Qualitative analysis produced the theme “Knowledge is power and comfort.” Parents described not knowing what activity was appropriate or the impact of it on their child.

Parental participation and attitudes towards activity potentially influence their child’s activity. A large proportion of young people performed activity despite a lack and inconsistency of activity advice offered by CHD clinics. Young people with CHD would benefit from activity advice with their families in clinics.

Little is known about strategies to implement new critical care practices in response to COVID-19. Moreover, the association between differing implementation climates and COVID-19 clinical outcomes has not been examined. The purpose of this study was to evaluate the relationship between implementation determinants and COVID-19 mortality rates.

We used mixed methods guided by the Consolidated Framework for Implementation Research (CFIR). Semi-structured qualitative interviews were conducted with critical care leaders and analyzed to rate the influence of CFIR constructs on the implementation of new care practices. Qualitative and quantitative comparisons of CFIR construct ratings were performed between hospital groups with low- versus high-mortality rates.

We found associations between various implementation factors and clinical outcomes of critically ill COVID-19 patients. Three CFIR constructs (implementation climate, leadership engagement, and engaging staff) had both qualitative and statistically significant quantitative correlations with mortality outcomes. An implementation climate governed by a trial-and-error approach was correlated with high COVID-19 mortality, while leadership engagement and engaging staff were correlated with low mortality. Another three constructs (needs of patient; organizational incentives and rewards; and engaging implementation leaders) were qualitatively different across mortality outcome groups, but these differences were not statistically significant.

Improving clinical outcomes during future public health emergencies will require reducing identified barriers associated with high mortality and harnessing salient facilitators associated with low mortality. Our findings suggest that collaborative and engaged leadership styles that promote the integration of new yet evidence-based critical care practices best support COVID-19 patients and contribute to lower mortality.

Practising compassion has shown to increase well-being and reduce distress in people across cultures. However, very little research has explored cultural differences in different facets of compassion with a dearth of research evident especially in the Asian context. Several inhibitors and facilitators of compassion have been identified although the nuances of cultural differences of these remain unexploited. This study aimed to discover cross-cultural similarities and differences of the levels of compassion, facilitators and inhibitors of compassion between Sri Lankan and UK people.

A cross-sectional, questionnaire-based quantitative research was conducted among 149 Sri Lankan and 300 UK participants. Individual predictors (such as fears of compassion, self-reassurance, external shame, social safeness and pleasure, depression and anxiety) were also explored in relation to compassion, compassion to others, and compassion from others in each group.

The results indicated that Sri Lankan participants were more self-reassured and self-compassionate and self-identifying as a Buddhist predicted higher self-compassion, when compared to UK participants. However, Sri Lankan participants reported higher levels of external shame and fear of compassion not just towards themselves, but also towards and from others, indicating difficulty in engaging compassionately with others. In contrast, UK participants reported higher social safeness, indicating that they were more likely to feel safe and soothed by the society than the Sri Lankan participants.

Society plays a pivotal role in shaping one's experiences of compassion. This study suggests that specific cultural and social factors should be considered when implementing Western compassionate approaches to non-Western settings.

Early intervention in psychosis (EIP) services target the early manifestation of psychosis and provide multidisciplinary care. They demonstrate effectiveness and cost-effectiveness. Implementation of EIP services is inconsistent and piecemeal. This systematic review and narrative synthesis aims to identify barriers and facilitators to EIP service implementation.

We conducted an electronic search of databases (EMBASE, Medline, Web of Science, and PsychINFO) to detect papers reporting EIP service implementation findings and associated barriers and facilitators. The search occurred between June to August 2020, and again in January 2021. Articles meeting inclusion criteria were extracted and narratively synthesized. A quality assessment was conducted using the Mixed Methods Appraisal Tool.

Twenty-three studies were selected. The most common study design was descriptive accounts of implementation. Patient age ranged varied from 14 to 35 years. We identified three barrier and facilitator domains: (a) system; (b) services; and (c) staff, and a range of subdomains. The most frequent subdomains were “funding” and “strength of collaboration and communication between EIP and outside groups and services”. Associations between domains and subdomains were evident, particularly between systems and services.

A range of barriers and facilitators to EIP implementation exist. Some of these are generic factors germane across health systems and services, while others are specific to EIP services. A thorough prior understanding of these challenges and enablers are necessary before implementation is attempted. Accounting for these issues within local and national contexts may help predict and increase the likelihood of services’ success, stability, and longevity.

Hispanic/Latinos living in rural areas have limited healthcare resources, including palliative and hospice care. Moreover, little is known about advance care planning (ACP) among Hispanic/Latino cancer patients in rural areas. This study explores facilitators and barriers for ACP. It elicits suggestions to promote ACP among rural Hispanic/Latino cancer patients in a US/Mexico border region.

Hispanic/Latino cancer patients (n = 30) were recruited from a nonprofit cancer organization. Data were collected via in-person interviews. Interviews were transcribed and translated from Spanish to English. Data were uploaded into NVivo 12 and analyzed using thematic analysis.

A common theme for facilitators and barriers for ACP was safeguarding family. Additional facilitators included (1) Desire for honoring end-of-life (EoL) care wishes and (2) experience with EoL care decision making. Additional barriers include (1) Family's reluctance to participate in EoL communication and (2) Patient–clinicians’ lack of EoL communication. Practice suggestions include (1) Death education and support for family, (2) ACP education, and (3) Dialogue vs. documentation.

ACP functions not only as a decisional tool; its utility reflects complex dynamics in personal, social, and cultural domains. ACP approaches with this underserved population must consider family relationships as well as cultural implications, including language barriers.

The number of people growing older with severe mental illness (SMI) is rising, reflecting societal trends towards an ageing population. Evidence suggests that older people are less likely to seek help, be referred for and receive psychological therapy compared with younger people, but past research has focused on those with mild to moderate mental health needs.

This research aims to identify the specific barriers faced by older people with SMI.

We interviewed 53 participants (22 service users with SMI aged over 50 years, 11 carers of people with SMI, and 20 health care professionals) about their views and experiences of accessing therapy for SMI in later life.

Thematic analysis revealed five themes: organizational and resource issues; myths about therapy and attitudinal barriers; stigma; encouraging access to therapy; and meeting age-specific needs.

Barriers faced by older people with SMI are not only age-related, but also reflect specific issues associated with having a SMI over many years. Improving awareness of the benefits of psychological therapies is important not only for older people with SMI themselves, but also for their carers and staff who work with them.

Multiple factors such as socioeconomic status (SES), education, race, and ethnicity can affect colorectal cancer screening (CRCS) rates. However, few studies have addressed CRCS disparities among Arab Americans. Our aim was to understand how Arab Americans view CRCS.

Employing thematic analysis, we collected and analyzed the dialogue of Arab American focus groups and interviews to better understand participants’ perceptions of CRCS. Themes were generated and categorized into barriers and facilitators.

Eleven Arab American males participated in two focus groups and two interviews. Three barriers included disbelief in modern medicine, concerns about the procedure, and lack of communication with the physician. Three facilitators were also identified: compliance and priority of health, access to healthcare, and awareness.

Disparities in CRCS cannot solely be explained by SES and access but cultural differences also contribute. Specific interventions accounting for these cultural differences are needed to reduce disparities in CRCS among Arab Americans.

Translating Emergency Knowledge for Kids (TREKK) is a national network aimed at improving emergency care for children by increasing collaborations and knowledge sharing between general and pediatric emergency departments (EDs). This study aimed to determine patterns of knowledge sharing within the network and to identify connections, barriers, and opportunities to obtaining pediatric information and training.

We conducted 22 semi-structured interviews with health care professionals working in general EDs, purposefully sampled to represent connected and disconnected sites, based on two previous internal quantitative social network analyses (SNA). Data were analyzed by two independent reviewers.

Participants included physicians (59%) and nurses (41%) from 18 general EDs in urban (68%) and rural/remote (32%) Canada. Health care professionals sought information both formally and informally, by using guidelines, talking to colleagues, and attending pediatric related training sessions. Network structure and processes were found to increase connections, support practice change, and promote standards of care. Participants identified personal, organizational and system level barriers to information and skill acquisition, including resources and personal costs, geography, dissemination, and time. Providing easy access to information at the point of care was promoted through enhancing content visibility and by embedding resources into local systems. There remains a need to share successful methods of local dissemination and implementation across the network, and to leverage local professional champions such as clinical nurse liaisons.

These findings reinforce the critical role of ongoing network evaluation to improve the design and delivery of knowledge mobilization initiatives.

Despite considerable evidence supporting the health benefits of regular nut consumption, nut intakes remain lower than recommended among many populations. Understanding how the general population perceives nuts could inform strategies to promote regular nut consumption and increase intakes among the general public.

Cross-sectional study. Participants were invited to complete a questionnaire which included information on nut consumption and knowledge and perceptions of nuts.

The study was set in New Zealand (NZ).

Participants (n 1600), aged 18 years or over, were randomly selected from the NZ electoral roll.

A total of 710 participants completed the questionnaire (response rate 44 %). More than half of the respondents believed that nuts are healthy, filling, high in protein and high in fat. The most common reason cited by consumers for eating nuts was taste (86 % for nuts, 85 % for nut butters), while dental issues was the most frequent reason for avoidance. About 40 % of respondents were not aware of the effects of nut consumption on lowering blood cholesterol and CVD risk.

Despite overall basic knowledge of the nutritional value of nuts, a substantial proportion of the general population was unaware of the cardioprotective effects of nuts. The present study identified common motivations for eating and avoiding nuts, as well as perceptions of nuts which could affect intake. These should guide the content and direction of public health messages to increase regular nut consumption. The public’s knowledge gaps should also be addressed.

To identify facilitators and barriers that Health Canada’s (HC) cross-sector partners experienced while implementing the Eat Well Campaign: Food Skills (EWC; 2013–2014) and describe how these experiences might differ according to distinct partner types.

A qualitative study using hour-long semi-structured telephone interviews conducted with HC partners that were transcribed verbatim. Facilitators and barriers were identified inductively and analysed according partner types.

Implementation of a national mass-media health education campaign.

Twenty-one of HC’s cross-sector partners (food retailers, media and health organizations) engaged in the EWC.

Facilitators and barriers were grouped into seven major themes: operational elements, intervention factors, resources, collaborator traits, developer traits, partnership factors and target population factors. Four of these themes had dual roles as both facilitators and barriers (intervention factors, resources, collaborator traits and developer traits). Sub-themes identified as both facilitators and barriers illustrate the extent to which a facilitator can easily become a barrier. Partnership factors were unique facilitators, while operational and target population factors were unique barriers. Time was a barrier that was common to almost all partners regardless of partnership type. There appeared to be a greater degree of uniformity among facilitators, whereas barriers were more diverse and unique to the realities of specific types of partner.

Collaborative planning will help public health organizations anticipate barriers unique to the realities of specific types of organizations. It will also prevent facilitators from becoming barriers. Advanced planning will help organizations manage time constraints and integrate activities, facilitating implementation.