BACKGROUND: The mental health of young people (aged 16-25 years) is a growing public health concern in the United Kingdom due to the increasing numbers of young people experiencing mental health difficulties, with many not in contact with mental health services. To design services that meet the needs of all young people, a diversity of young people must be involved in mental health research, beyond being participants. This Delphi study aimed to identify different types of \'involvement\' and to define and describe \'under-representation\' in young people\'s involvement in mental health research.
METHODS: Twenty-seven experts in young people\'s mental health research completed a series of online questionnaires. The experts were academic researchers, patient and public involvement (PPI) professionals and young \'experts by experience\'. Round 1 generated panellists\' views on \'involvement\' and \'under-representation\'. Round 2 summarised panellists\' responses from Round 1 and sought consensus (minimum 70% agreement) in nine question areas. Round 3 validated the findings of the previous rounds.
RESULTS: Consensus was achieved in eight out of nine areas, resulting in a matrix (with definitions) of the different types of young people\'s involvement in mental health research, from being advisors to involvement ambassadors. The findings generated an agreed-upon definition of under-representation, an identification of when in the research process there is under-representation and the characteristics of the young people who are under-represented. Experts further agreed on demographic data that should be collected to improve reporting on involvement.
CONCLUSIONS: This study adds to our understanding of involvement and under-representation in the context of young people\'s mental health research through expert consensus. It provides a practical resource for researchers considering involving young people in the research process and suggests the data that should be collected to improve reporting on the diversity of the young people involved.
UNASSIGNED: A research oversight group of five young people advised on this study. They contributed throughout the project-from endorsing the research question to commenting on the findings and dissemination. Two of the group reviewed all participant materials and piloted the initial questionnaire.

BACKGROUND: Recent research within the context of Obstetrics shows the added value of patient participation in in-hospital patient safety. Notwithstanding these benefits, recent research within an Obstetrics department shows that four different negative effects of patient participation in patient safety have emerged. However, the approach to addressing these negative effects within the perspective of patient participation in patient safety is currently lacking. For this reason, the aim of this study is to generate an overview of actions that could be taken to mitigate the negative effects of patient participation in patient safety within an Obstetrics department.
METHODS: This study was conducted in the Obstetrics Department of a tertiary academic center. An explorative qualitative interview study included sixteen interviews with professionals (N = 8) and patients (N = 8). The actions to mitigate the negative effects of patient participation in patient safety, were analyzed and classified using a deductive approach.
RESULTS: Eighteen actions were identified that mitigated the negative effects of patient participation in patient safety within an Obstetrics department. These actions were categorized into five themes: \'structure\', \'culture\', \'education\', \'emotional\', and \'physical and technology\'. These five categories reflect the current approach to improving patient safety which is primarily viewed from the perspective of professionals rather than of patients.
CONCLUSIONS: Most of the identified actions are linked to changing the culture to generate more patient-centered care and change the current reality, which looks predominantly from the perspective of the professionals and too little from that of the patients. Furthermore, none of the suggested actions fit within a sixth anticipated category, namely, \'politics\'. Future research should explore ways to implement a patient-centered care approach based on these actions. By doing so, space, money and time have to be created to elaborate on these actions and integrate them into the organizations\' structure, culture and practices.

Sexual and reproductive health rights (SRHRs) are integral elements of the rights of everyone to the highest attainable standard of physical and mental health, but they are the most underdeveloped and least understood sphere of rights, especially in Africa, including the country of Ethiopia. The implementation of women\'s SRHRs is essential for achieving gender equality and promoting women\'s rights. Husbands\' knowledge and involvement play a significant role in improving women\'s practice of their SRHRs. However, there is limited information/data about the level of husbands\' knowledge and involvement in Northwest Ethiopia, including Bahir Dar City. Therefore, this study aimed to assess husbands\' knowledge, involvement, and factors influencing their involvement in women\'s SRHRs.
Community-based cross-sectional study design was conducted from March 20 to April 5, 2023, in Bahir Dar City, Northwest Ethiopia, among 391 husbands. Multi-stage sampling and simple random sampling technique were applied to select kebeles and study participants, respectively. Participants were interviewed face-to-face using structured and pretested questionnaire. Binary logistic regression was applied to identify associated factors, and a p-value of <0.05 was a cutoff point to declare statistical significance.
In this study, 50.6% (198/391) of the husbands had good knowledge about their wives\' SRHRs and 44.2% (173/391) (95% CI, 39.3-49.1%) of the husbands were involved when their wives practiced their SRHRs. Access training/education about sexual health [AOR = 5.99; 95% CI (2.7-13.2)], husbands\' advance educational level [AOR = 8.81; 95% CI (2.04-38)], good knowledge about SRHRs [AOR = 7.94; 95% CI (4.3-14.4)], low monthly income (<4,600 birr) [AOR = 9.25; 95% CI (4.2-20.5)], and had open discussion with family members and friends about SRHRs [AOR = 1.92; 95% CI (1.01-3.6)] were found to have significant association with husbands\' involvement.
Husbands\' level of knowledge on SRHRs of women and their involvement remain low. Therefore, responsible concerned bodies need to work on the strategies that help to improve men involvement and knowledge, and tackle the above-mentioned factors influencing their involvement.

BACKGROUND: Low back pain is still the leading cause of disability and societal burden, with 619 million prevalent cases worldwide in 2020. Most countries produce clinical guidelines to support healthcare professionals in evidence-based care regarding low back pain. However, several studies have identified relatively poor uptake of guidelines. Tailored strategies to facilitate the implementation of guidelines have been argued to increase uptake. This study aimed to develop a contextually tailored implementation programme to enhance evidence-based low back pain care among Danish physiotherapists and chiropractors in primary care.
METHODS: A theory-driven implementation programme development study was conducted using the Behaviour Change Wheel, with high healthcare professional involvement. Data collection included four workshops with seven physiotherapists and six chiropractors from primary care clinics. The development process consisted of [1] establishing a theoretical frame, [2] involving participants, [3] understanding the behaviour, [4] designing the implementation programme, and [5] final implementation programme.
RESULTS: The target behaviours selected (guideline recommendations) for the implementation programme were (i) screening of psychosocial risk factors and (ii) offering patient education. The barriers and facilitators for the selected behaviours were described and linked to intervention functions and behavioural techniques. Finally, the implementation programme comprised five strategies: webinars, e-learning videos, communication exercises, peer learning, and group dialogue meetings. In addition, the programme consisted of implementation support: champions, a physical material folder, a weekly email reminder, a specially designed website and a visit from an implementation consultant. An essential element of the overall programme was that it was designed as a step-by-step implementation process consisting of 16 h of education and training distributed over 16 weeks.
CONCLUSIONS: A programme for implementing low back pain guideline recommendations was developed based on behaviour change theory and four co-design workshops involving healthcare professionals to overcome the contextually identified barriers. A theory-driven approach involving healthcare professionals was useful in identifying relevant target behaviours and tailoring the programme to consider contextual barriers and facilitators for implementation. The effectiveness of the final implementation programme will be evaluated in the project\'s next phase.
BACKGROUND: Central Denmark Region, Registered November 11, 2021, act no. 1-16-02-93-19.

UNASSIGNED: Involvement of male partners in antenatal care (ANC) is an effective approach to improve maternal and child health outcomes. It also enhances maternal healthcare utilization as males prevails decision-making regarding healthcare utilization in most developing countries including Ethiopia. Despite the acknowledged importance of male partners involvement, there is no research data in the study area. Therefore, the purpose of this study is to assess the status of male partners\' involvement in antenatal care and associated factors in Chencha town, which is found in southern region of Ethiopia.
UNASSIGNED: The study adopted a community-based cross-sectional design from April 1-30, 2022, among 560 male partners in Chencha Town. To collect data, we use a structured, pretested and interviewer-administered questionnaire. The study participants were selected using a simple random sampling method. Analysis of data was performed using the statistical package for social sciences (SPSS) version 25. Descriptive statistics including mean, frequency, and percentage were used to summarize pertinent characteristics of study participants. Both bivariable and multivariable logistic regression analyses were carried out to detect the association between the independent and outcome variables. The statistical significance was set at P < 0.05 in the final model.
UNASSIGNED: The study found that 57% (95% CI: 53%-61%) of male partners were involved in antenatal care. Age 20 to 29 (AOR = 2.60, 95%CI:1.26, 5.37), more than secondary educational level (AOR = 2.04, 95%CI:1.08, 3.88), being government workers (AOR = 2.03, 95%CI:1.12, 3.67), exposure to information on male involvement during antenatal care (AOR = 4.37, 95%CI: 2.77, 6.91), and males\' knowledge about pregnancy danger sign (AOR = 2.55, 95%CI: 1.62, 4.02) were factors positively associated with male partner involvement in antenatal care.
UNASSIGNED: The prevalence of male partner involvement in antenatal care was relatively high, but it still needs to be improved to reach acceptable level. The involvement thrives among those aged 20-29 years, who have been exposed to information on male involvement in antenatal care, have higher education levels, government employees, and are aware of pregnancy danger signs. These factors can be used to target interventions that aim to increase male involvement in antenatal care, which helps to improve the health of both mothers and children.

UNASSIGNED: The purpose of this mixed-methods study is to examine the role of caregiver strategies to support community participation among children and youth with disabilities and those at risk, from the caregiver perspective. For the quantitative phase, we tested the hypothesized positive effect of participation-focused caregiver strategies on the relationship(s) between participation-related constructs and community participation attendance and involvement. For the qualitative phase, we solicited caregiver perspectives to explain the quantitative findings.
UNASSIGNED: An explanatory sequential mixed-methods design (QUAN > qual) was used. For the quantitative phase, we conducted secondary analyses of data collected during a second follow-up phase of a longitudinal cohort study, including 260 families of children and youth (mean age: 13.5 years) with disabilities and those at risk [i.e., 120 families of children and youth with craniofacial microsomia (CFM); 140 families of children and youth with other types of childhood-onset disabilities]. Data were collected through the Participation and Environment Measure-Children and Youth, the Pediatric Quality of Life Inventory, and the Child Behavior Checklist and analyzed using structural equation modeling. For the qualitative phase, we conducted semi-structured interviews with eight caregivers of children and youth with disabilities and those at risk (i.e., three caregivers of children and youth with CFM; five caregivers of children and youth with other childhood-onset disabilities). Interviews were transcribed verbatim and inductively content-analyzed.
UNASSIGNED: Our model reached acceptable to close model fit [CFI = 0.952; RMSEA = 0.068 (90% CI = 0.054-0.082); SRMR = 0.055; TLI = 0.936], revealing no significant effect of the number of participation-focused caregiver strategies on the relationships between participation-related constructs (e.g., activity competence, environment/context) and community participation in terms of attendance and involvement. The qualitative findings revealed three main categories for how caregivers explained these quantitative results: (1) caregiver workload and supports needed for implementing strategies; (2) caregivers careful strategy quality appraisal; and (3) community setting characteristics hindering successful strategy implementation.
UNASSIGNED: The findings suggest that the insignificant effect of the number of caregiver strategies may be explained by the intensified need for caregiver effort and support to develop and implement quality strategies that are responsive to community setting characteristics.

We investigated the involvement of community members in response to the Ebola Virus Disease (EVD) epidemic in the North Kivu and Ituri provinces of the Democratic Republic of Congo. This cross-sectional study, conducted using mixed methods of data collection, included a uniformly structured questionnaire survey, which was administered to 800 randomly selected adults (aged ≥ 18 years). Further, we used qualitative tools of inquiry-focus group discussions (FGD) and in-depth interviews (IDI)-to guide the context of the information collected in the survey. Community leaders, religious leaders, and Ebola survivors were interviewed using the IDI guide, while young men (≤ 30 years), young women (≤30 years), adult community males (<30 years), and adult community females (<30 years) were in separate FGD sessions. The results revealed that the urban area was the most affected by the epidemic (79.2%) compared to 20.8% in rural areas. The χ2 calculated was 18.183 (P<0.001). Community members exhibited varying degrees of involvement in response to the EVD epidemic in the two provinces. Community members were mostly engaged in information dissemination. However, they believe they could have contributed more if they had been fully engaged. These findings were derived from the qualitative data. The study contributes to evidence on how community involvement could help response to public health events globally, hence this study provides valuable insights for future public health interventions and response.

UNASSIGNED: To meet the needs of people with mild stroke, multidisciplinary, person-centred, cross-sectoral rehabilitation is internationally recommended. However, there seem to be gaps in the rehabilitation process. The aim of this study was to investigate how occupational therapists and physiotherapists experience working in cross-sectoral rehabilitation for people with mild stroke.
UNASSIGNED: Data were generated through interviews with occupational therapists and physiotherapists working in four different Danish rehabilitation settings. Four group interviews and two individual interviews with a total of 19 participants were conducted. Ricoeur\'s theory of interpretation was used to interpret and discuss the data.
UNASSIGNED: Four themes were identified: the risk of overlooking symptoms: better safe than sorry; varying degrees of involvement of people with mild stroke; spontaneous involvement of relatives; and contextual challenges for coherence in the rehabilitation process.
UNASSIGNED: The therapists experienced challenges in coordinating rehabilitation across sectors due to the timing of the needs assessment and contextual challenges. They used a preventive strategy of sending a plan or referral for later re-assessment. The therapists involved people with mild stroke to varying degrees. They involved relatives spontaneously. For successful rehabilitation, ongoing assessment, recognition of collaboration factors and relative involvement are essential.
It is crucial to continuously evaluate needs and establish goals throughout the entirety of the rehabilitation process.Recognizing that the capacity and resources of people with mild strokes to collaborate with professionals are contextually, relationally, and individually determined is important.Involvement of relatives should be strengthened on many levels from the institutional level to the personal level.

BACKGROUND: Patient involvement in healthcare decisions is key to patient-centred care, and it is an area subject to continuous political focus. However, patient-centred care and patient involvement are challenging to implement in an emergency department (ED) setting, as EDs tend to focus on structures, processes, and outcomes. This study explored nurses\' perspectives on patient involvement in an ED setting.
METHODS: This study applied an explorative design and conducted focus group interviews to generate data; abductive reasoning was chosen as the analytical method. Two focus groups were held in February 2021, each including six ED nurses.
RESULTS: Four themes were generated: notions of patient involvement, significant factors, ED culture, and management. Nurses considered patient involvement an optional add-on and, to some extent, a matter of tokenism carried forward by managers who are afraid of complaints and bad media coverage. Patient involvement in the form of providing information to patients was considered important yet less critical than life-saving and technical tasks.
CONCLUSIONS: ED nurses\' perspectives on patient involvement are particularly influenced by the technical and life-saving culture in an ED. Information provision is considered patient involvement and is decided and administered by nurses.

OBJECTIVE: To investigate the decisional needs in Denmark of people with kidney failure, relatives, and health professionals when planning end-of-life care.
METHODS: A qualitative interview study.
METHODS: Individual semi-structured interviews were carried out with people with kidney failure, relatives and health professionals from November 2021 to June 2022. Malterud\'s systematic text condensation was used to analyse transcripts.
RESULTS: A total of 13 patients, 10 relatives, and 12 health professionals were interviewed. Overall, four concepts were agreed on: (1) Talking about end of life is difficult, (2) Patients and relatives need more knowledge and information, (3) Health professionals need more tools and training, and (4) Experiencing busyness as a barrier to conversations about end of life.
CONCLUSIONS: People with kidney failure, relatives, and health professionals shared certain decisional needs while also having some different decisional needs about end-of-life care. To meet these various needs, end-of-life conversations should be systematic and organized according to the patients\' needs and wishes.
CONCLUSIONS: Non-systematic end-of-life care decision-making processes limit patients\' involvement. Patients and relatives need more knowledge about end-of-life care, and health professionals need more competences and time to discuss decisional needs. A shared decision-making intervention for people with kidney failure when making end-of-life care decisions will be developed.
UNASSIGNED: This empirical qualitative research is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
UNASSIGNED: Patients, relatives, and health professionals have been involved throughout the research process as part of the research team and advisory board. The patients are people with kidney failure and the relatives are relatives of a person with kidney failure. For this study, the advisory board has particularly contributed to the validation of the invitation letter for participation, the interview guides and the preparation of the manuscript.