UNASSIGNED: There is a known lack of diversity in research participant populations. This impacts on the generalisability of findings and affects clinician prescribing. In the United Kingdom the research community defines those who are underrepresented as under-served. They are commonly those affected by health inequality and disparity. The notion of under-served is complex, with numerous papers identifying multiple factors that contribute to being under-served and in turn suggesting many strategies to improve engagement.
UNASSIGNED: Research professionals in the UK were invited to complete an online survey. The broad aim was to explore their views on under-served groups. The findings were analysed using statistical and qualitative methods to identify enablers and barriers to engaging the under-served. Descriptive statistics were utilised with associations compared univariately by chi-square test and logistic regression for multivariable analysis.
UNASSIGNED: A total of 945 completed responses were received. Those identified as under-served in this study reflected the previous body of works with a broader descriptor of ethnic and cultural minorities and the addition of adolescents and young adults. Language and literacy skills had the most impact on being under-served. Only 13% of respondents said they felt equipped to meet the needs of the under-served. The main strategy to increase diversity was community engagement and movement of research delivery into the community. The barriers were funding and time. Training needs identified were linked to community engagement, cultural competence and consent processes.
UNASSIGNED: The UK findings from research professionals reflected the previous literature. Adolescents and young people were added to those identified as under-served. Enablers included community outreach and improvement to communication. Barriers were time, funding, organisational processes and lack of focus. Issues were identified with translation and interpretation services. Training requirements focus on methodologies and methods to engage and the consent processes of those from under-served groups.
Research study participants do not reflect the general population. This means that findings from research cannot be reliably transferred to the general population. The people missing are termed under-served or underrepresented. These people come from groups who have unequal access to health care and have poorer health. There are different reasons why people may not take part in research and many ways to support them to take part. This project asked the people who work in research who they thought were missing from research studies. It asked, what would make it easier for people to take part and what got in the way. Those who work in research were invited to write their thoughts in an online survey. Answers were then looked at using tests to find out the number of people who said the same or different things. Other answers were looked at to find out their views and opinions. A total of 945 people filled in the questionnaire. Those who responded thought the biggest group of people who were missing from research populations were from minority social and cultural groups. They also thought teenagers and young adults were missing from research. When asked why people didn’t take part the biggest problem was with making research easy to understand. Only 13% of the people who filled in the survey thought they were able to help those who were missing. It was suggested the best way to improve the number of different people taking part in research was to move research from hospitals to the places where the under-served live. The biggest thing that stopped those working in research helping was funding and time. They also wanted to find out how to carry out research in the community, how to help different cultural groups and aid those with certain medical conditions.

Research indicates widespread unhealthy eating habits among college students, posing long-term health risks. This study at a Historically Black College and University (HBCU) aimed to explore the perceived obstacles and facilitators to healthy eating among college students, using the social ecological model (SEM). Through focus group discussions and key informant interviews, the study identified several barriers to healthy eating, including challenges in accessing federal food assistance resources, gaps in nutrition knowledge, cost concerns, limited food variety on campus, difficulty accessing grocery stores, and a lack of cooking skills. To address these barriers, participants suggested various solutions, such as implementing cooking demonstrations, providing nutrition education, increasing food variety on campus, offering gardening opportunities, adjusting cafeteria hours for more flexibility, making fresh produce more available on campus, assisting students in accessing federal food assistance programs, and providing transportation to nearby grocery stores. The findings highlight the need for targeted interventions to promote healthier dietary behaviors among college students, particularly those attending HBCUs. By addressing the identified barriers and implementing the suggested solutions, initiatives can be developed to support students in making healthier food choices, ultimately reducing long-term health risks associated with unhealthy eating habits.

UNASSIGNED: Despite well-documented benefits of physical activity (PA), people with brain injury face numerous PA barriers. This mixed methods systematic review aimed to summarize barriers and enablers that individuals with traumatic brain injury (TBI) experience when participating in PA.
UNASSIGNED: Primary studies investigating barriers and/or enablers to PA in adults living with TBI were included. Literature search in MEDLINE, EmCare, Embase, PsychINFO, PEDro, and OTSeeker was initially conducted in December 2021 and January 2022, and updated in June 2022. Methodological quality of the included studies was assessed using Joanna Briggs Institute critical appraisal tools. A customized data extraction form was utilized. Descriptive synthesis was used to summarize the findings.
UNASSIGNED: Twelve studies of various methodological qualities were identified. Barriers to PA included personal issues, changing health status, external factors, lack of support, and lack of knowledge. Identified enablers included personal drivers, social support, professional support, accessibility, and education.
UNASSIGNED: The shared similarities between barriers and enablers across several themes suggest that multiple barriers may be amenable to change. Given the diverse barriers to PA, health professionals should use person-centered, holistic approach with ongoing review and monitoring, when engaging with individuals with TBI.

The study investigated barriers and enablers of nurse\'s adoption of digital health technology to facilitate the delivery of healthcare in resource-limited settings. Using a self-administered questionnaire, data were collected from ninety-three nurses. Descriptive statistics were conducted to analyse and summarise the data. The study found that barriers to digital technology use included workload, time constraints, limited access to computers and a lack of skills in searching for information, while positive attitudes and confidence were enabling factors. Providing access to technology and skills training will improve the adoption of technology in healthcare delivery by nurses.

BACKGROUND: National health and social care standards are complex, quality improvement interventions. Standards typically describe a process and/or outcome of safe, quality, person-centred care according to best evidence. Currently, there are 11 national standards that apply to diverse services in Ireland including residential centres, acute hospitals and rehabilitation and community inpatient healthcare services. A better understanding of contextual factors influencing implementation will inform decision-making when selecting implementation strategies to enhance the implementation of standards.
OBJECTIVE: To explore experiences of implementing national health and social care standards and secondly, to identify enablers and barriers to implementation with stakeholders from across multiple levels of the health system.
METHODS: A qualitative descriptive study.
METHODS: We conducted six focus groups and eight individual interviews from October to November 2021 with stakeholders at system level (n = 14), organizational level (n = 14) and individual level (n = 10). Focus groups and interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis.
RESULTS: Six themes were generated; (1) Top-down, bottom-up, a team approach: everybody together, we are all involved, we are all responsible, (2) Support tools: accessible tools and bite-size material pertaining to standards will support us to implement standards, (3) Empower with knowledge: increase awareness and understanding of standards, make them relatable in practice so we can make sense of them, (4) A system-wide malaise: we do not have the bandwidth to implement standards, (5) Follow the leader: we need a lead person at every level to inspire implementation, (6) A bi-directional influence: we know inspections drive quality improvements but we still feel trepidation around inspection outcomes.
CONCLUSIONS: Key enablers identified related to teamwork, support tools, leadership and inspections. Key barriers related to workforce issues, a lack of awareness of standards and fear of inspection outcomes. Our findings can be incorporated into strategies to support implementation of standards, ultimately for the benefit of service-users.
CONCLUSIONS: The enablers and barriers described in this study reflect the importance of organizational factors in the implementation of standards. Interdisciplinary teams can infer from these findings, which enablers and barriers apply to their own context. These findings can inform decision-making when selecting strategies that can be effective in supporting the implementation of standards.
UNASSIGNED: We have adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.
UNASSIGNED: No patient or public contribution.

UNASSIGNED: Implementation of evidence-based practice (EBP) for chronic low back pain (CLBP) is poor. This study aimed to investigate the factors that influence exercise-based clinicians\' implementation of EBP for people with CLBP.
UNASSIGNED: Semi-structured interviews were conducted with 40 clinicians (20 physiotherapists and 20 accredited exercise physiologists). Interviews explored clinicians\' definition of EBP, understanding of EBP in CLBP management, barriers and enablers to EBP, and the impact of these factors on EBP implementation. Interviews were analysed using reflexive thematic analysis.
UNASSIGNED: A complex interplay among clinician factors, systemic factors, and patient interactions was identified. Clinicians encountered challenges stemming from their misconceptions about EBP, which influenced their perspective(s) on its implementation. Clinicians expressed the challenges of implementing EBP when navigating patient expectations and beliefs, experiencing external pressures from funders and business models, and the subsequent impacts on their well-being. Continuing professional development, support from community, and workplaces that prioritised EBP enhanced clinicians\' ability to make decisions that accommodate for the complexities of CLBP and better align with EBP.
UNASSIGNED: A variety of factors impact exercise-based clinicians\' implementation of EBP. The interaction between these factors greatly influences clinicians\' ability to engage in and implement EBP in clinical practice.
The interplay among clinician, patient, and health system/structural level factors affects exercise-based clinicians’ implementation of evidence-based practice for chronic low back pain.Clinicians are well positioned to identify issues in clinical practice and initiate appropriate changes that could improve evidence-based practice.Clinicians could provide feedback on continuing professional development to ensure it is accessible and applicable to clinical practice.Clinicians could encourage workplaces to prioritise time and/or funding for sufficient engagement in evidence-based practice.

UNASSIGNED: Education for the lay public in basic life support (BLS) is critical for increasing bystander cardiopulmonary resuscitation (CPR) rates and improving survival from out-of-hospital cardiac arrest (OHCA). Despite years of implementation, the BLS training rate in China has remained modest. The aim of this study was to investigate the factors influencing the implementation of BLS training programs in emergency medical service (EMS) centers in China and to identify specific barriers and enablers.
UNASSIGNED: Qualitative interviews were conducted with key informants from 40 EMS centers in Chinese cities. The participants included 11 directors/deputy directors, 24 training department leaders, and 5 senior trainers. The interview guide was based on the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. Thematic content analysis was used to identify themes and patterns across the interviews.
UNASSIGNED: We identified 16 factors influencing the implementation of BLS training programs encompassing the outer content, inner context, innovation and bridging factors. Some factors acted as either barriers or enablers at different EPIS stages. The main implementation barriers included limited external leadership, insufficient government investment, low public awareness, a shortage of trainers, an absence of incentives, an absence of authoritative courses and guidelines, a lack of qualification to issue certificates, limited academic involvement, and insufficient publicity. The main enablers were found to be supportive government leaders, strong public demand, adequate resources, program champions, available high-quality courses of high fitness within the local context, the involvement of diverse institutions, and effective publicity and promotion.
UNASSIGNED: Our findings emphasize the diversity of stakeholders, the complexity of implementation, and the need for localization and co-construction when conducting BLS training for lay public in city EMS centers. Improvements can be made at the national level, city level, and EMS institutional level to boost priority and awareness, promote legislation and policies, raise sustainable resources, and enhance the technology of BLS courses.

暂无摘要。

BACKGROUND: With an increasing number of grandparents providing care to their grandchildren, calls have been made for these caregivers to be considered important stakeholders in encouraging children\'s engagement in health-promoting behaviors, such as physical activity. Understanding the perspectives of grandparents who provide care is crucial to informing efforts that aim to increase children\'s physical activity, yet little is understood about their perceptions of specific barriers and enablers to promoting children\'s physical activity and reducing screen time. The present study sought to explore these perceptions.
METHODS: Semi-structured focus groups and individual interviews were conducted with grandparents who reported providing care to a grandchild aged 3 to 14 years. A total of 20 grandparents were sampled (mean age = 67.8 years). Data were subjected to reflexive thematic analysis.
RESULTS: Key reported barriers to physical activity included (i) the effort (physical and logistical) and financial cost associated with organizing physical activities, (ii) grandparents\' age and mobility issues (e.g., due to injury or illness), (iii) caring for children of different ages (e.g., older children having different physical activity interests than younger children), and (iv) a local environment that is not conducive to physical activity (e.g., lack of appropriate facilities). Barriers to reducing screen time included (i) parents sending children to care with electronic devices and (ii) children\'s fear of missing out on social connection that occurs electronically. Strategies and enablers of physical activity included (i) integrating activity into caregiving routines (e.g., walking the dog), (ii) involving grandchildren in decision making (e.g., asking them in which physical activities they wish to engage), (iii) encouraging grandchildren to engage in activity with other children, and (iv) creating a physical and social environment that supports activity (e.g., owning play equipment). A common strategy for reducing screen time was the creation of a home environment that is not conducive to this activity (e.g., removing electronic devices from view).
CONCLUSIONS: Findings suggest that grandparents may benefit from resources that assist them to identify activities that are inexpensive and require minimal effort to organize. Activities that account for grandparents\' age and health status, as well as any environmental barriers, are likely to be well-received.

UNASSIGNED: The growing use of telerehabilitation within the healthcare community has garnered substantial attention. In congruence with other healthcare fields, examining perceptions, barriers, and facilitators assumed paramount significance in the continuation and fortification of telerehabilitation practices among physiotherapists.
UNASSIGNED: In this scoping review, we aimed to systematically map the literature on the perceptions of physiotherapists as well as the barriers and enablers of telerehabilitation in their daily practice.
UNASSIGNED: The five-stage methodological framework recommended by Arksey and O\'Malley (2005) was used for this scoping review. In the framework, eight databases were searched using key search terms such as \"telerehabilitation\", \"physiotherapists\", \"readiness\", \"enablers\" and \"barriers\" All findings were organised into perceptions and readiness, enablers, and barriers.
UNASSIGNED: Fourteen articles met the inclusion criteria and were categorized as: (1) perception and readiness, (2) enablers, and (3) barriers. In the perception and readiness category, new trends in healthcare, advancement in physiotherapy practices and the benefits to clients were identified. The enablers identified included prior training, personal experience, familiarity with technology, functional equipment and space, and client selection. The barriers to the adoption of telerehabilitation in physiotherapy practice are pinpointed to poor technology, communication hurdles, limited availability, lack of familiarity, and client-related concerns.
UNASSIGNED: While initial evidence suggests a generally positive perceptions it is important to consider both facilitators and barriers when understanding adoption. This review\'s findings revealed a wide research gap, with unequal weightage towards barriers compared to enablers, and highlights the need for further research. Developing telerehabilitation guidelines that cater to both physiotherapists and clients is necessary.