BACKGROUND: In 2018, the Dutch government initiated the Solid Start program to provide each child with the best start in life. Key program elements are a biopsychosocial perspective on pregnancy and children\'s development and stimulating local collaborations between social and health domains, with a specific focus on (future) families in vulnerable situations. Two programs for interprofessional collaboration between maternity and social care professionals to optimize care for pregnant women in vulnerable situations were developed and implemented, in Groningen in 2017 and in South Limburg in 2021. This paper describes the extent of implementation of these programs and the perceptions of involved professionals about determinants that influence program implementation.
METHODS: We conducted a mixed-methods study in 2021 and 2022 in two Dutch regions, Groningen and South Limburg. Questionnaires were sent to primary care midwives, hospital-based midwives, obstetricians (i.e. maternity care professionals), (coordinating) youth health care nurses and social workers (i.e. social care professionals), involved in the execution of the programs. Semi-structured interviews were held with involved professionals to enrich the quantitative data. Quantitative and qualitative data were collected and analyzed using Fleuren\'s implementation model.
RESULTS: The findings of the questionnaire (n = 60) and interviews (n = 28) indicate that professionals in both regions are generally positive about the implemented programs. However, there was limited knowledge and use of the program in Groningen. Promoting factors for implementation were mentioned on the determinants for the innovation and the user. Maternity care professionals prefer a general, conversational way to identify vulnerabilities that connects to midwives\' daily practice. Low-threshold, personal contact with clear agreements for referral and consultation between professionals contributes to implementation. Professionals agree that properly identifying vulnerabilities and referring women to appropriate care is an important task and contributes to better care. On the determinants of the organization, professionals indicate some preconditions for successful implementation, such as clearly described roles and responsibilities, interprofessional training, time and financial resources.
CONCLUSIONS: Areas for improvement for the implementation of interprofessional collaboration between maternity care and social care focus mainly on determinants of the organization, which should be addressed both regionally and nationally. In addition, sustainable implementation requires continuous awareness of influencing factors and a process of evaluation, adaptation and support of the target group.

UNASSIGNED: The population health burden of adverse childhood experiences (ACEs) reflects a critical need for evidence-based provider training. Rural children are also more likely than urban children to have any ACEs. A large proportion of providers are unaware of the detrimental effects of ACEs. There is a significant documented need for training providers about ACEs and trauma-informed care, in addition to a demand for that training.
UNASSIGNED: The objective was to develop, implement, and evaluate an online ACEs training curriculum tailored to Missouri providers, particularly those in rural areas given the higher prevalence of ACEs.
UNASSIGNED: From July 2021 to June 2022, we conducted literature reviews and environmental scans of training videos, partner organizations, clinical practice guidelines, and community-based resources to curate appropriate and tailored content for the course. We developed the ACEs training course in the Canvas learning platform (Instructure) with the assistance of an instructional designer and media designer. The course was certified for continuing medical education, as well as continuing education for licensed professional counselors, psychologists, and social workers. Recruitment occurred via key stakeholder email invitations and snowball recruitment.
UNASSIGNED: Overall, 135 providers across Missouri requested enrollment, with 72.6% (n=98) enrolling and accessing the training. Of the latter, 49% (n=48) completed course requirements, with 100% of respondents agreeing that the content was relevant to their work, life, or practice; they intend to apply the content to their work, life, or practice; they feel confident to do so; and they would recommend the course to others. Qualitative responses supported active intent to translate knowledge into practice.
UNASSIGNED: This study demonstrated the feasibility, acceptability, and effectiveness of interprofessional workforce ACEs training. Robust interest statewide reflects recognition of the topic\'s importance and intention to translate knowledge into practice.

BACKGROUND: The use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices.
OBJECTIVE: This study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device.
METHODS: We used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data.
RESULTS: A total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses.
CONCLUSIONS: Ongoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.

UNASSIGNED: With the rapid development of China\'s social work sector, the increasing job pressures, and risks of professional burnout among social workers have become more prevalent. This study examined the relationship between Chinese social workers\' attitudes toward evidence-based practice (EBP) and burnout, exploring the mediating mechanisms of evidence-based knowledge (EBK) and service quality perception (SQP).
UNASSIGNED: We applied PROCESS 4.2 macro in SPSS to analyze the data from 5,931 social workers, testing the sequential mediation effects of EBK and SQP between their attitudes toward EBP and burnout.
UNASSIGNED: The findings revealed: (1) Attitudes toward EBP had significant indirect positive effects on burnout; (2) EBK partially mediated the relationship between EBP attitude and burnout; (3) SQP partially mediated the relationship between attitudes toward EBP and burnout; (4) Attitudes toward EBP had a sequential mediated effect on burnout through EBK and SQP.
UNASSIGNED: The findings emphasize the need to implement targeted interventions and training programs to foster positive attitudes toward EBP, promote continuous professional development, and provide access to EBP resources. Moreover, nurturing EBK and SQP could help alleviate burnout by improving social workers\' ability to address client issues and enhance their sense of confidence and accomplishment.
UNASSIGNED: This study fills a research gap by providing empirical evidence on the negative correlation between Chinese social workers\' attitudes toward EBP and burnout, while demonstrating the mediating roles of EBK and SQP.

BACKGROUND: Previous studies have explored facilitators and barriers to research conducted by allied health professionals in general medical settings. Since the mental health system is acknowledged to be significantly under-funded and more poorly functioning than general medical services, it is unclear whether the published facilitators and barriers also apply to mental health settings. This study sought to explore the research-related knowledge, understanding and practices of allied mental health clinicians based in a large public mental health service.
METHODS: A mixed methods study recruited 59 occupational therapists and social workers working in a dedicated metropolitan public mental health service in Melbourne, Australia. Quantitative survey results are reported elsewhere. Semi-structured interviews were conducted with 16 survey responder volunteers. Thematic analysis was conducted on the qualitative survey and interview data.
RESULTS: Four main themes were identified: research must connect with clinical practice; fragments of knowledge; research in practice; and research is not part of my professional identity. The third theme, research in practice, comprised four subthemes: no time for research in clinical roles, missing communication, lack of ownership, and what I need to do research.
CONCLUSIONS: This study found that research and research-related activities were not considered part of the mental health social workers and occupational therapists\' professional identities. Dealing with this issue may be instrumental to the realization of these clinicians\' professional peak-body associations\' code of practice and to government mandated practice standards. We provided several strategies to encourage both clinicians and services to view research-related activities as an everyday part of clinical roles. This is especially important if we think of allied health evidence-based practice requiring a reasonable level of research-related skills and/or competencies to appraise, practice, evaluate and adapt their evidence-based practice.

BACKGROUND: The underlying mechanisms of post-COVID syndrome (PCS) are still not fully understood. While pre-existing conditions have been described as a risk factor for severe PCS in the general population, data specific to different occupational groups in this context is lacking. This study aimed to investigate the impact of pre-existing conditions on severe post-COVID syndrome among the occupational group of healthcare and social services employees.
METHODS: Baseline data from a longitudinal, observational study were analysed. In February 2021, health workers who had a COVID-19 infection in 2020 were surveyed about sequelae of the infection. Factors influencing severe PCS with at least one persistent symptom categorised as severe were subjected to a multivariate logistic regression analysis.
RESULTS: Of a total of 2,053 participants, 21.5% had severe PCS. Underlying respiratory (OR 1.94; CI 1.44-2.61), cardiovascular (OR 1.35; CI 1.04-1.77) and urogenital (OR 1.79; CI 1.10-2.91) disease were risk factors for severe PCS overall. Respiratory and mental illnesses had a statistically significant impact on persistent fatigue/exhaustion, concentration/memory difficulties and shortness of breath categorised as severe. Urogenital disease was associated with severe fatigue/exhaustion. Other significant risk factors for severe PCS were female sex, smoking, physical exercise and hospitalisation due to COVID-19 infection.
CONCLUSIONS: Workers in healthcare and social services with pre-existing conditions may face a higher risk of developing severe PCS. Additional analyses performed as part of the longitudinal study will show if and how this result changes over time.

UNASSIGNED: Every child deserves the right to life. In Nigeria like other African countries, a high burden of child mortality prevails. Attaining a low-mortality rate of children entails that mothers who are the primary caregivers are in the best position to provide quality healthcare management.
UNASSIGNED: With the phenomenological approach in qualitative research, the researchers sourced data using Focus Group Discussions (FGDs) and In-Depth Interviews (IDI) from 38 mothers of various categories. The participants were purposively selected from four government and mission health institutions in a semi-urban Nsukka town, Enugu State. Data were analyzed thematically.
UNASSIGNED: Results revealed that mothers utilize health institutions including government, mission, private, pharmacies and patent medicine vendors when seeking healthcare for their children. Their inability to recognize potential life-threatening conditions is the leading factor in increasing child mortality. Findings show that because participants were concerned about financial challenges; they were ready to adopt traditional medicine as an alternative to modern medicine. The study showed evidence of unsafe strategies mothers adopt for the health management of their under-five children with common illnesses. Participants indicated little knowledge of social workers\' engagement in health institutions.
UNASSIGNED: Healthy living is essential in the protection from illnesses. Since under-five children are vulnerable to illnesses, their mothers should provide them with quality healthcare management. The study recommends that social workers\' engagement with health providers and users in semi-urban societies could help propagate healthcare awareness and strategies in mothers\' choice of health management for under-five children in Nigeria. Overall, adequate health policy consideration should be given to all under-five children in Nigeria.

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BACKGROUND: Unaccompanied refugee children are one of the most vulnerable categories within the refugee population. They face inexhaustible risks from the start of their journey until its conclusion; being exposed to various forms of violence, assault, and exploitation during the transit phase.
OBJECTIVE: This study was aimed to discern the challenges faced by unaccompanied refugee children in Jordan, as perceived by social workers. Additionally, to uncover the role of the social work profession in helping these children in confronting and alleviating these challenges.
METHODS: Ten social workers working with unaccompanied refugee children in the International Medical Corps in Jordan were selected to take part in the study.
METHODS: The study adopted a qualitative research approach to achieve its aims. Semi-structured interviews served as the primary method for data collection. Data analysis used inductive thematic analysis, and ethical considerations were consistently observed throughout the study process.
RESULTS: The study revealed significant social challenges, including strained alternative familial relationships and difficulties in social integration. Psychological struggles were clear in enduring loss, separation, and suicidal thoughts. Economic hardships manifested in meeting basic needs and child labor. School dropouts appeared as a prominent educational issue. Social workers are primarily engaged in case management, providing psychosocial support, and easing referrals.
CONCLUSIONS: Adverse living conditions profoundly affect children, affecting their psychological, physical, and social development. This leads to the emergence of deep psychological traits such as sadness, hostility, anxiety, and behavioral disintegration. Consequently, many children experience social disconnection and struggle to adapt to their environment effectively.

OBJECTIVE: At some point in their career, many healthcare workers will experience psychological distress associated with being unable to take morally or ethically correct action, as it aligns with their own values; a phenomenon known as moral distress. Similarly, there are increasing reports of healthcare workers experiencing long-term mental and psychological pain, alongside internal dissonance, known as moral injury. This review examined the triggers and factors associated with moral distress and injury in Health and Social Care Workers (HSCW) employed across a range of clinical settings with the aim of understanding how to mitigate the effects of moral distress and identify potential preventative interventions.
METHODS: A systematic review was conducted and reported according to recommendations from Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Searches were conducted and updated regularly until January 2024 on 2 main databases (CENTRAL, PubMed) and three specialist databases (Scopus, CINAHL, PsycArticles), alongside hand searches of study registration databases and other systematic reviews reference lists. Eligible studies included a HSCW sample, explored moral distress/injury as a main aim, and were written in English or Italian. Verbatim quotes were extracted, and article quality was assessed via the CASP toolkit. Thematic analysis was conducted to identify patterns and arrange codes into themes. Specific factors like culture and diversity were explored, and the effects of exceptional circumstances like the pandemic.
RESULTS: Fifty-one reports of 49 studies were included in the review. Causes and triggers were categorised under three domains: individual, social, and organisational. At the individual level, patients\' care options, professionals\' beliefs, locus of control, task planning, and the ability to make decisions based on experience, were indicated as elements that can cause or trigger moral distress. In addition, and relevant to the CoVID-19 pandemic, was use/access to personal protection resources. The social or relational factors were linked to the responsibility for advocating for and communication with patients and families, and professionals own support network. At organisational levels, hierarchy, regulations, support, workload, culture, and resources (staff and equipment) were identified as elements that can affect professionals\' moral comfort. Patients\' care, morals/beliefs/standards, advocacy role and culture of context were the most referenced elements. Data on cultural differences and diversity were not sufficient to make assumptions. Lack of resources and rapid policy changes have emerged as key triggers related to the pandemic. This suggests that those responsible for policy decisions should be mindful of the potential impact on staff of sudden and top-down change.
CONCLUSIONS: This review indicates that causes and triggers of moral injury are multifactorial and largely influenced by the context and constraints within which professionals work. Moral distress is linked to the duty and responsibility of care, and professionals\' disposition to prioritise the wellbeing of patients. If the organisational values and regulations are in contrast with individuals\' beliefs, repercussions on professionals\' wellbeing and retention are to be expected. Organisational strategies to mitigate against moral distress, or the longer-term sequalae of moral injury, should address the individual, social, and organisational elements identified in this review.