OBJECTIVE: This study explores and understands community members\' resilience in outpatient clinics, considering various dimensions and types of resilience.
METHODS: A cross-sectional study.
METHODS: This study was conducted in Saudi outpatient clinics from September to December 2023 and included 384 individuals chosen through systematic random sampling. Various tools were used, such as Social Cohesion and Trust Scale, Community Resilience Assessment Tool, Community Assessment of Psychic Experiences, Environmental Resilience Assessment, Economic Resilience Index, Connor-Davidson Resilience Scale, Brief Resilience Scale, Resilience Scale for Adults and Healthcare Resilience Index.
RESULTS: Participants displayed a robust overall resilience level, as indicated by Total Connor-Davidson Resilience Scale score of 63.0 ± 9.0. Additionally, they demonstrated commendable levels of resilience in Total Brief Resilience Scale (56.04 ± 8.6), Resilience Scale for Adults (82.5 ± 7.2) and Healthcare Resilience Index (45.8 ± 5.5). These findings offer significant insights into psychological and emotional well-being of the study population, highlighting their adaptive capacities and coping mechanisms across various life domains.
CONCLUSIONS: This study provides valuable insights into the multidimensional nature of resilience in outpatient settings. The cross-sectional design sets the groundwork for future longitudinal investigations, highlighting the need for a holistic approach to understanding and promoting resilience.
CONCLUSIONS: This study holds immediate implications for participants and their communities. It underscores the adaptive capacities and coping mechanisms prevalent in the outpatient population by revealing commendable resilience levels. This insight enhances individuals\' psychological and emotional well-being, contributing positively to the overall resilience and communal strength. Additionally, this study sheds light on how resilience among community members in Saudi Arabia relates to international advanced nursing communities, providing insight into their work.
UNASSIGNED: Patients who have received outpatient services in the past 6 months were purposively chosen to ensure a diverse representation across age, gender and socio-economic backgrounds in this study.

BACKGROUND: Community health workers (CHWs) bridge the primary health care (PHC) system and communities by providing care in the household. In Malawi, few studies have examined the perspective of users of household-level CHW services, in remote areas, to understand CHW\'s role in community-based PHC.
OBJECTIVE: To explore perspectives of community and facility stakeholders on the enablers and challenges of the CHW role in community-based PHC in Neno District.
METHODS: The study was conducted in the Neno District health facilities, namely, Ligowe, Dambe, Chifunga, and Zalewa.
METHODS: We conducted eight focus group discussions (FGDs) with purposively sampled community members and conveniently sampled facility stakeholders. Data were transcribed and analysed thematically through an adapted COM-B model of behaviour change.
RESULTS: Three main themes of perceived behaviour change within the CHW role were identified: (1) capacity - the CHW programme aids health education and promotion within the community; (2) opportunity - the CHW programme facilitates community-based PHC and linkage to the facility; and (3) motivation - the CHW programme enablers and challenges in providing community-based PHC.
CONCLUSIONS: Community health workers enrich community-based PHC delivery through health education, timely access to care, and linking communities to the facility. Optimising workload and programme support is critical for the help of CHWs. Further studies are required to address programme and cultural challenges to enhance positive health-seeking behaviours.Contribution: This study provides contextual knowledge for further research on bringing together spiritual and formal health practices and considering the cultural background when planning for health interventions in remote areas.

BACKGROUND: COVID-19 is still a disease of global public health importance which requires long term application of control measures as millions of new infections or re-infections and thousands of related deaths still occur worldwide and the risk of an upsurge from new strains of the virus continues to be a threat. The decrease in the use of and non-use of preventive public health measures are among the factors fuelling the disease. The (previous) experiences and perceptions of people regarding the COVID-19 pandemic, COVID-19 vaccination, and the vaccination process are factors that will influence subsequent use of preventive/control measures. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the community members in Ebonyi state, Nigeria.
METHODS: We conducted an analytical cross-sectional study between March 12 and May 9, 2022 among all consenting/assenting community members aged 15 years and above in 28 randomly selected geographical clusters. A structured interviewer-administered electronic questionnaire in KoBoCollect installed in android devices was used to collect data which was analysed using descriptive statistics and bivariate and multivariate generalized estimating equations.
RESULTS: Of the 10,825 community members surveyed: only 31.6% had strong COVID-19 experience and perception, 72.2% had good COVID-19 vaccination expectation and perception, and only 54.2% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent/level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of attitude towards COVID-19 and COVID-19 vaccination and level of knowledge about COVID-19. Other important predictors were marital status, educational level, and main occupation.
CONCLUSIONS: This study\'s evidence, including the identified predictors, will inform subsequent policy actions regarding COVID-19 in the strategies to improve the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of community members (and their use of preventive/control measures) in Ebonyi state and Nigeria, and other similar contexts. It will also inform future policy actions/strategies regarding similar diseases.

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: Early detection and prevention of diseases can reduce morbidity, mortality, and economic burden. There is need to assess the utilization of preventive services for common chronic diseases, cancers, and vaccinations. This study aimed to estimate the prevalence and sequence of utilization of preventive services for common chronic diseases, cancers, and vaccinations in addition to exploring community perspectives on these services.
UNASSIGNED: This study was a cross-sectional survey, which was conducted at primary healthcare centers in Prince Sultan Military Medical City covering Riyadh region from October 2022 to January 2023. The study used a self-administered questionnaire to collect data from attendees aged 18 years and older, focusing on the utilization of eight preventive services (blood glucose testing, blood pressure measurement, cholesterol testing, screening for breast cancer, screening for cervical cancer, screening for colorectal cancer, screening for prostate cancer, and flu and pneumococcal vaccines). Descriptive statistics of the study were reported in frequencies and percentages. Chi-square test was used to assess association between outcome variables.
UNASSIGNED: Participants were mostly married and had a higher educational degree. However, a considerable number is not accessing primary healthcare services regularly. The results showed that the rate of utilizing preventive services was as follows: blood pressure screening (91%), blood glucose testing (72%), cholesterol testing (65.8%), vaccination utilization (39.5%), breast cancer screening (8%), prostate cancer screening (4.6%), colon cancer screening (4.2%), and least utilized was cervical cancer screening with frequency of (3%).
UNASSIGNED: The results underscore the importance of increasing awareness and accessibility of primary healthcare services to promote better health outcomes in the region.

Substance use is a major public health issue in South Africa. Cocktails, containing two or more low-quality substances, have been reported. Nyaope is one of the most popular and is widely available. It has a significant impact on users and communities. The aim of this study was to explore community members\' perceptions of the potential contributors to Nyaope use and dependency.
This was an exploratory descriptive qualitative study that conducted three focus group interviews with 29 community members. A maximum variation sample was used. Data were analysed using the framework method, assisted by Atlas-ti.
Seven main themes were identified, namely unfavourable home environments, distrust between community members and the local police, easy access to Nyaope at school, inadequate social services, lack of religious or spiritual drive, unfavourable community environments and the effects of Nyaope on users.
The factors identified, were used to construct an emerging model of how Nyaope use is driven in Tshwane. It is clear that a multisectoral response is required involving health and social services, basic education, policing and community leadership. Further research will explore the views of family members and users and quantify the importance of the factors identified.Contribution: This study showed that rather than a simple linear chain of events, Nyaope use is enabled by a complex system of interconnected elements. According to the respondents, variables in the community at large, the school, the home and the specific user all have a role in Nyaope usage and dependency.

Objectives were (a) to understand a community-informed narrative, as told by community members (CMs) and community partners (CPs), about the strengths, experiences, and perspectives of public housing communities; and (b) to analyze similarities and differences between CMs\' and CPs\' experiences and perspectives. Qualitative interviews were conducted with 22 CMs of public housing (ages 26-58, 100% female caregivers, 96% Black, 4% multiethnic) and 43 CPs (ages 28-78, 67.4% female, 81.4% Black and African American). Four themes were derived from the CM and CP interviews: (1) counters to public narratives, (2) disinvestment begets disinvestment, (3) community conditions should be better, and (4) community cohesion and connection. Findings from this study present community-centered narratives and experiences that were counter to stereotyped public narratives and could influence public perceptions and behavior to inform policy changes related to improving living conditions and supporting CMs in public and low-income housing communities.

Autistic youth and adults are more likely to experience psychiatric symptoms (e.g. depression, anxiety) and to use psychiatric services than non-autistic people, yet research on evidence-based approaches to enhance psychiatric care for autistic people is limited. Measurement-based care is an evidence-based approach to psychotherapy that improves outcomes for clients, clinicians, and organizations by routinely administering and evaluating measures to clients. Despite this, research on measurement-based care systems for autistic clients is sparse. To address this gap, we developed an autism-adapted measurement-based care (MBC-AUT) system for and with autistic people and pilot tested the system in an outpatient psychiatry clinic to investigate the preliminary feasibility, acceptability, benefits, and barriers to this system for clients and clinicians. Findings suggested that the MBC-AUT system was a feasible and acceptable system for the first 18 autistic youth, their caregivers, and autistic adults to use the system. In semi-structured interviews, clients and clinicians discussed the benefits of the MBC-AUT system to various therapeutic processes, as well as several important barriers to the use of the system. We offer potential solutions to address these barriers and to reduce client and clinician burden, and propose future directions for this line of research to increase access to more autistic people. As autistic clients continue to seek psychological services amid social landscapes of increasing complexity (e.g. COVID-19 pandemic), efforts to enhance the delivery of psychotherapy for this population are critical.

In this evaluation of COVID-19 preventative response programs in South Kivu, Democratic Republic of the Congo (DRC), we aimed to explore community understandings of COVID-19, assess operational successes and challenges of COVID response activities, and identify barriers to practicing COVID-19 preventative behaviors.
Thirty-one semi-structured interviews were conducted from April to September 2021 in South Kivu, DRC, with community members (n = 16) and programmatic stakeholders (n = 15) (healthcare providers, government officials, and developmental and NGO staff engaged in COVID-19 response).
Most community members were aware of COVID-19 and its global burden, but few were aware of local transmission in their area. Some community members attributed COVID-19 to actions of malevolent neighbors, miasma (\"bad air\"), or spirits. Awareness of COVID-19 preventative measures was widespread, largely because of radio and TV health promotion programs. Community members and programmatic stakeholders both said community-level non-compliance to COVID-19 preventative measures was high despite high awareness of preventative methods. Community members expressed concern that face masks distributed as part of preventative programs contained the COVID-19 virus. Programmatic stakeholders emphasized the need for broader health system strengthening with improved coordination, provision of resources to health facilities at the provincial level, and prioritization of research. Lessons learned from addressing Ebola were leveraged for COVID-19 health promotion, rapid training of healthcare personnel, and surveillance.
Community-informed approaches are needed for effective COVID-19 preventative response programs in South Kivu, DRC. Our study identified successes and challenges in COVID-19 response activities. Future research should assess the effectiveness of integrating preventive programs with COVID-19 vaccination efforts.

(a) Objective: To build an evidence base on effective water, sanitation, and hygiene interventions to reduce diarrheal diseases in cholera hotspots, we developed the CHoBI7 Cholera Rapid Response Program. (b) Methods: Once a cholera patient (confirmed by bacterial culture) is identified at a health facility, a health promoter delivers a targeted WASH intervention to the cholera hotspot (households within 20 m of a cholera patient) through both in-person visits during the first week and bi-weekly WASH mobile messages for the 3-month program period. A randomized controlled trial of the CHoBI7 Cholera Rapid Response Program was conducted with 284 participants in 15 cholera hotspots around cholera patients in urban Dhaka, Bangladesh. This program was compared to the standard message in Bangladesh on the use of oral rehydration solution for dehydration. Five-hour structured observation of handwashing with soap and diarrhea surveillance was conducted monthly. (c) Findings: Handwashing with soap at food- and stool-related events was significantly higher in the CHoBI7 Cholera Rapid Response Program arm compared to the standard message arm at all timepoints (overall 54% in the CHoBI7 arm vs. 23% in the standard arm, p < 0.05). Furthermore, there was a significant reduction in diarrheal prevalence for all participants (adults and children) (Prevalence Ratio (PR) 0.35, 95% CI: 0.14-0.85) and for children under 5 years of age (PR: 0.27, 95% CI: 0.085-0.87) during the 3-month program. (d) Conclusions: These findings demonstrate that the CHoBI7 Cholera Rapid Response Program is effective in lowering diarrhea prevalence and increasing handwashing with soap for a population at high risk of cholera.