interventions

干预措施
  • 文章类型: Journal Article
    背景:经过数十年的吡喹酮大规模给药(MDA),几个国家接近消除血吸虫病。在大部分未感染的人群中继续使用MDA似乎不再合理。需要采取替代干预措施来维持增益或加速传输中断。我们报告结果,优势,以及奔巴血吸虫低流行地区新型测试-治疗-追踪-测试-治疗(5T)干预措施的缺点,坦桑尼亚。
    方法:在2021年和2022年进行了基于学校和家庭的调查,以监测血链球菌和微血尿的患病率,并评估干预措施的影响。2021年,在15个低流行地区实施了5T干预措施,包括:(i)对小学和伊斯兰学校的学童进行微血尿测试,以代替血吸虫,(ii)治疗积极的儿童,(iii)将他们追踪到他们经常光顾的家庭和水体,(iv)在家庭和水体中测试个人,和(V)治疗阳性个体。此外,试验和治疗干预措施在研究区域的22个医疗机构实施.
    结果:在以学校为基础的15个低患病率实施单位的调查中,2021年和2022年分别为0.5%(7/1560)和0.4%(6/1645)。在以家庭为基础的调查中,在2021年和2022年,分别有0.5%(14/2975)和0.7%(19/2920)的参与者感染了S。微血尿患病率,不包括跟踪结果,在以学校为基础的调查中,2021年为1.4%(21/1560),2022年为1.5%(24/1645)。在以家庭为基础的调查中,2021年为3.3%(98/2975),2022年为5.4%(159/2920)。在5T干预期间,在小学和伊斯兰学校的儿童中,微血尿患病率分别为3.8%(140/3700)和5.8%(34/594),分别,家庭成员占17.1%(44/258),水体中的人占16.7%(10/60)。在卫生设施中,19.8%(70/354)的患者检测微血尿阳性。
    结论:有针对性的5T干预措施维持了极低的血吸虫流行率,并且被证明可以直接和可行地识别和治疗少数血吸虫感染的个体。未来的研究将显示5T干预措施是否可以长期维持收益并加快消除。
    背景:ISRCTN,ISCRCTN91431493。2020年2月11日注册,https://www。isrctn.com/ISRCTN91431493.
    BACKGROUND: After decades of praziquantel mass drug administration (MDA), several countries approach schistosomiasis elimination. Continuing MDA in largely uninfected populations no longer seems justified. Alternative interventions to maintain the gains or accelerate interruption of transmission are needed. We report results, strengths, and shortcomings of novel test-treat-track-test-treat (5T) interventions in low Schistosoma haematobium prevalence areas on Pemba, Tanzania.
    METHODS: School- and household-based surveys were conducted in 2021 and 2022 to monitor the S. haematobium and microhematuria prevalence and assess the impact of interventions. In 2021, 5T interventions were implemented in 15 low-prevalence areas and included: (i) testing schoolchildren in primary and Islamic schools for microhematuria as a proxy for S. haematobium, (ii) treating positive children, (iii) tracking them to their households and to water bodies they frequented, (iv) testing individuals at households and water bodies, and (v) treating positive individuals. Additionally, test-and-treat interventions were implemented in the 22 health facilities of the study area.
    RESULTS: The S. haematobium prevalence in the school-based survey in 15 low-prevalence implementation units was 0.5% (7/1560) in 2021 and 0.4% (6/1645) in 2022. In the household-based survey, 0.5% (14/2975) and 0.7% (19/2920) of participants were infected with S. haematobium in 2021 and 2022, respectively. The microhematuria prevalence, excluding trace results, in the school-based survey was 1.4% (21/1560) in 2021 and 1.5% (24/1645) in 2022. In the household-based survey, it was 3.3% (98/2975) in 2021 and 5.4% (159/2920) in 2022. During the 5T interventions, the microhaematuria prevalence was 3.8% (140/3700) and 5.8% (34/594) in children in primary and Islamic schools, respectively, 17.1% (44/258) in household members, and 16.7% (10/60) in people at water bodies. In health facilities, 19.8% (70/354) of patients tested microhematuria-positive.
    CONCLUSIONS: The targeted 5T interventions maintained the very low S. haematobium prevalence and proved straightforward and feasible to identify and treat many of the few S. haematobium-infected individuals. Future research will show whether 5T interventions can maintain gains in the longer-term and expedite elimination.
    BACKGROUND: ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493 .
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  • 文章类型: Journal Article
    目的:我们进行了系统评价,以评估2006年至2021年在非洲改善人乳头瘤病毒(HPV)疫苗接种的干预措施的范围和有效性。
    方法:系统评价。
    方法:四个数据库(Medline,Embase,搜索了CINAHL和PsycINFO)在2006年至2021年之间发表的文章。使用DistillerSR(2.35版)基于资格标准筛选并纳入文章。使用叙述性综合提取并报告数据。还使用经过验证的质量评估工具对每个研究进行质量评估。
    结果:在通过系统搜索确定的7603篇文章中,18条符合纳入标准。纳入的研究包括2012年至2021年发表的影响评估和横断面研究,在八个非洲国家进行,即:尼日利亚,喀麦隆,南非,肯尼亚,坦桑尼亚,赞比亚,马里,和马拉维。研究质量从高到低质量不等。干预措施包括15项教育干预措施和3项多组分干预措施。在13项影响评估研究(所有教育干预措施)中,12项研究有效增加HPV疫苗的摄取和/或提高参与者的知识,态度,以及对疫苗的看法。在五项横断面研究(两项教育和三项多成分干预)中,HPV疫苗的摄取率从34%到93.3%不等,67.9%-90.3%的参与者在干预后对安全性和有效性达成共识。
    结论:已经在非洲实施了教育和多组分干预措施以改善HPV疫苗接种。虽然教育干预已被证明可有效提高HPV疫苗的摄取,我们需要更多样化的干预措施以及稳健的影响评估研究设计,以加强现有证据并提高疫苗的接种.
    OBJECTIVE: We conducted a systematic review to assess the scope and effectiveness of interventions to improve human papilloma virus (HPV) vaccination in Africa from 2006 to 2021.
    METHODS: Systematic review.
    METHODS: Four databases (Medline, Embase, CINAHL and PsycINFO) were searched for articles published between 2006 and 2021. Articles were screened and included based on eligibility criteria using DistillerSR (Version 2.35). Data were extracted and reported using a narrative synthesis. A quality assessment was also conducted for each study using validated quality appraisal tools.
    RESULTS: Out of 7603 articles identified by a systematic search, 18 articles met the inclusion criteria. Included studies comprised impact evaluation and cross-sectional studies published between 2012 and 2021 and conducted in eight African countries namely: Nigeria, Cameroon, South Africa, Kenya, Tanzania, Zambia, Mali, and Malawi. Study quality ranged from high to low quality. Interventions comprised fifteen educational and three multicomponent interventions. Out of thirteen impact evaluation studies (all educational interventions), twelve studies were effective in increasing HPV vaccine uptake and/or improving participants\' knowledge, attitudes, and perceptions about the vaccine. Across five cross-sectional studies (two educational and three multicomponent interventions), HPV vaccine uptake rates ranged from 34% to 93.3%, with a consensus on safety and effectiveness in 67.9%-90.3% of participants post-intervention.
    CONCLUSIONS: Educational and multicomponent interventions have been implemented to improve HPV vaccination in Africa. While educational interventions have proven effective at improving HPV vaccine uptake, a more diverse range of interventions with robust impact evaluation study designs are needed to strengthen the available evidence and improve vaccine uptake.
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  • 文章类型: Journal Article
    背景:家庭暴力是导致孕期和产后健康状况不佳的主要原因。因此,在生殖保健环境中需要综合的家庭暴力干预措施。印度是孕产妇和儿童死亡率最高的国家之一。这项审查旨在确定印度现有的循证综合家庭暴力和生殖保健干预措施的特征,以确定证明有效解决家庭暴力的干预措施的差距和组成部分。
    方法:使用系统评价和荟萃分析的首选报告项目对干预研究进行系统评价。三名研究小组成员进行了独立的标题筛选,摘要和全文。
    结果:搜索产生了633篇文章,其中13篇文章符合全文筛选和分析的纳入标准。有效解决家庭暴力的综合暴力和生殖健康干预措施的共同组成部分包括:心理教育/教育(n=5),技能建设(n=5),咨询(n=5),让利益相关者使用训练有素的外行同伴主持人(n=3),和男性配偶(n=3)。
    结论:在印度,将家庭暴力与生殖保健相结合的干预措施仍然很少,家庭暴力的有效结果较少。在那些有有效结果的人中,所有的干预措施都利用了心理教育/教育,技能建设,和咨询作为干预的一部分。
    家庭暴力是怀孕期间和怀孕后健康状况不佳的主要原因。因此,在生殖保健环境中需要综合的家庭暴力干预措施。印度是孕产妇和儿童死亡率最高的国家之一。这项审查旨在确定印度现有的循证综合家庭暴力和生殖保健干预措施的特征,以确定干预措施的差距和组成部分,这些差距和组成部分证明了解决生殖保健环境中妇女家庭暴力问题的有效性。对干预研究进行了系统评价。搜索产生了633篇文章,其中13篇文章符合本次审查的标准。有效的综合家庭暴力和生殖健康干预措施的共同组成部分包括:心理教育/教育(n=5),技能建设(n=5),咨询(n=5),让利益相关者使用训练有素的外行同伴主持人(n=3),和男性配偶(n=3)。主要的收获是,在印度,与生殖保健相结合的家庭暴力干预措施仍然很少,家庭暴力的有效结果较少。心理教育/教育,技能建设,和咨询是有效解决家庭暴力的干预措施中常用的策略。
    BACKGROUND: Domestic violence is a leading cause of poor health outcomes during pregnancy and the postpartum period. Therefore, there is a need for integrated domestic violence interventions in reproductive health care settings. India has one of the highest maternal and child mortality rates. This review aimed to identify characteristics of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing domestic violence.
    METHODS: A systematic review of intervention studies was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Three research team members performed independent screening of title, abstracts and full-texts.
    RESULTS: The search resulted in 633 articles, of which 13 articles met inclusion criteria for full text screening and analysis. Common components of integrated violence and reproductive health interventions that were effective in addressing domestic violence included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3).
    CONCLUSIONS: Interventions in India for domestic violence that are integrated with reproductive health care remain few, and there are fewer with effective outcomes for domestic violence. Of those with effective outcomes, all of the interventions utilized psychoeducation/education, skill building, and counseling as part of the intervention.
    Domestic violence is a leading cause of poor health outcomes during pregnancy and the time after pregnancy. Thus, there is a need for integrated domestic violence interventions in reproductive healthcare settings. India has one of the highest maternal and child death rates. This review aimed to identify features of existing evidence-based integrated domestic violence and reproductive healthcare interventions in India to identify gaps and components of interventions that demonstrate effectiveness for addressing the problem of domestic violence among women in reproductive healthcare settings. A systematic review of intervention studies was conducted. The search resulted in 633 articles, of which 13 articles met the criteria to be included in this review. Common components of effective integrated domestic violence and reproductive health interventions included: psychoeducation/education (n = 5), skill building (n = 5), counseling (n = 5), engaging stakeholders with use of trained lay peer facilitators (n = 3), and engaging male spouses (n = 3). The key takeaways are that interventions in India for domestic violence that are integrated with reproductive healthcare remain few, and there are fewer with effective outcomes for domestic violence. Psychoeducation/education, skill building, and counseling were commonly used strategies in interventions that were effective in addressing domestic violence.
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  • 文章类型: Journal Article
    目的:孤独和社会隔离与不良健康结局相关,特别是在老年人群中,强调需要有效的干预措施。本系统综述和荟萃分析旨在总结有关孤独感和社会隔离干预措施有效性的所有可用证据。来规划他们的工作机制,并对政策和实践产生影响。
    方法:系统文献综述和荟萃分析。
    方法:老年人(≥65岁)。
    方法:在MEDLINE中进行了系统搜索,PsycINFO,和CINAHL用于定量或定性评估老年人孤独感和社会隔离干预措施的影响的研究,遵循预定义的选择标准。评估了偏倚风险和微小的研究效果,在适当的地方,有关使用随机效应荟萃分析汇总的单个研究的效应大小的信息。研究间异质性的来源使用meta回归进行了探索。
    结果:在n=2223个确定的文章中,n=67最终被纳入叙事合成。在一定比例的研究中报告了显着的干预效果(孤独和社会孤立分别为55.9%和50.0%,分别)和包括随访措施(n=29)在内的57.6%的研究报告了持续的干预效果。n=27项研究的荟萃分析,代表n=1756名参与者,表明孤独感干预的总体效果中等(d=-0.47;95%CI,-0.62至-0.32)。研究之间的异质性很大,不能用研究设计的差异来解释,出版年份,结果衡量标准,干预长度,参与者人口统计,设置,孤独的基线水平,或地理位置。然而,非基于技术的干预报告平均效应大小较大(Δd=-0.35;95%CI,-0.66~-0.04;P=0.029),且通常更显著.对潜在干预机制的定性评估导致了3组有效组成部分:“促进社会接触,\"\"转移知识和技能,\"和\"解决社会认知\"。
    结论:对孤独和社会隔离的干预通常是有效的,尽管研究之间仍然存在一些无法解释的异质性。需要进一步研究干预措施在不同环境和国家的适用性,还考虑到它们的成本效益。
    OBJECTIVE: Loneliness and social isolation are associated with adverse health outcomes, especially within the elderly population, underlining the need for effective interventions. This systematic review and meta-analysis aims to summarize all available evidence regarding the effectiveness of interventions for loneliness and social isolation, to map out their working mechanisms, and to give implications for policy and practice.
    METHODS: Systematic literature review and meta-analysis.
    METHODS: Older adults (≥65 years).
    METHODS: A systematic search was conducted in MEDLINE, PsycINFO, and CINAHL for studies quantitively or qualitatively assessing effects of interventions for loneliness and social isolation in older adults, following predefined selection criteria. Risk of bias as well as small study effects were assessed and, wherever appropriate, information about effect sizes of individual studies pooled using random-effects meta-analyses. Sources for between-study heterogeneity were explored using meta-regression.
    RESULTS: Of n = 2223 identified articles, n = 67 were eventually included for narrative synthesis. Significant intervention effects were reported for a proportion of studies (55.9% and 50.0% for loneliness and social isolation, respectively) and 57.6% of studies including a follow-up measure (n = 29) reported sustained intervention effects. Meta-analysis of n = 27 studies, representing n = 1756 participants, suggested a medium overall effect of loneliness interventions (d = -0.47; 95% CI, -0.62 to -0.32). Between-study heterogeneity was substantial and could not be explained by differences in study design, year of publication, outcome measures, intervention length, participant demographics, setting, baseline level of loneliness, or geographic location. However, non-technology-based interventions reported larger effect sizes on average (Δd = -0.35; 95% CI, -0.66 to -0.04; P = .029) and were more often significant. Qualitative assessment of potential intervention mechanisms resulted in 3 clusters of effective components: \"promoting social contact,\" \"transferring knowledge and skills,\" and \"addressing social cognition\".
    CONCLUSIONS: Interventions for loneliness and social isolation can generally be effective, although some unexplained between-study heterogeneity remains. Further research is needed regarding the applicability of interventions across different settings and countries, also considering their cost-effectiveness.
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  • 文章类型: Journal Article
    在许多欧洲国家,旨在最大程度地减少药物使用对健康和社会的影响的措施是国家毒品战略的组成部分。在经济发达国家大麻使用率高的背景下,以及对治疗大麻相关问题的需求不断增加,同行实施了一系列减少伤害的措施,法定机构和第三部门组织。在对文献进行系统回顾的基础上,作者描述了这些不同形式的干预,确定创新战略,并提出一种简单的类型学,可以在探索现有措施或寻求制定新政策时使用。这种类型涵盖了不同类型的法律,社会组织和健康相关干预措施。所有研究设计均符合纳入条件,除了病例报告,非系统评价,社论和新闻故事。研究必须在2011年至2022年之间以英文发表,他们不得不提到欧洲,美洲,澳大利亚或新西兰。使用Embase.com和许多其他数据库实现了两个概念的搜索,结合引文搜索和手动网站搜索,以提高研究报告和宣传文件的覆盖率。共有35份文件被视为符合资格,其中许多依赖于定性研究方法。
    Measures that seek to minimise the health and social consequences of substance use are an integral part of national drug strategies in many European countries. Against the backdrop of a high prevalence of cannabis use in the economically advanced countries, and increasing demand for treatment for cannabis-related problems, a range of harm reduction measures have been implemented by peers, statutory bodies and third-sector organisations. Based on a systematic review of the literature, the author describes these different forms of intervention, identifies innovative strategies and presents a simple typology that can be used when exploring existing measures or seeking to develop new policies. This typology covers different kinds of legal, socio-organisational and health-related interventions. All study designs were eligible for inclusion, with the exception of case reports, non-systematic reviews, editorials and news stories. Studies had to be published between 2011 and 2022, in English, and they had to refer to Europe, the Americas, Australia or New Zealand. A two-concept search was implemented using Embase.com and a number of other databases, combined with citation searches and manual website searching to improve coverage of research reports and advocacy documents. A total of 35 documents were deemed eligible, many of which rely on qualitative research methods.
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  • 文章类型: Journal Article
    大学生使用大麻代表了一个持续的公共卫生问题。目的是评估违反大学药物使用政策的学生使用大麻的风险因素和原因,以及风险因素是否影响大麻使用量。
    这项横断面调查研究包括在美国一所大型公立大学注册的99名大学生。计算了描述性统计数据,并进行了普通最小二乘回归分析。
    学生报告说,过去一个月平均使用大麻7.4天(SD=10.2天),8%的人报告每天使用。平均而言,学生每天消耗略高于0.25(SD=0.25)克,40%的人报告每天超过1克。大麻使用的平均年龄为16.8岁(SD=1.8)。使用大麻的主要原因是:放松或缓解紧张情绪(75.8%),感觉良好或变高(62.6%),与朋友相处愉快(60.6%)。学生认为平均有47%的同龄人参与了过去一个月的大麻使用,并且只有轻微的风险与经常使用有关。学生们认为他们的亲人大多会赞成减少大麻的使用。回归结果表明,过去一个月的大麻频率(p=0.002)和种族/族裔少数族裔血统(p=0.05)与每天的大麻数量呈正相关,而正常使用大麻的感知风险(β=-0.21)呈负相关。
    对违反大学药物使用政策的学生进行基于证据的大麻干预是迫切需要的,旨在减少大麻使用并减轻其相关的负面影响。
    UNASSIGNED: Cannabis use among college students represents a continued public health issue. The objective was to assess risk factors and reasons for cannabis use among students who violated their university\'s drug use policy, and whether risk factors influenced cannabis use quantity.
    UNASSIGNED: This cross-sectional survey study included 99 college students enrolled at a large U.S. public university. Descriptive statistics were calculated, and an ordinary least squares regression analysis was conducted.
    UNASSIGNED: Students reported using cannabis an average of 7.4 (SD = 10.2) days in the past month, with 8% reporting daily use. On average, students consumed slightly over 0.25 (SD = 0.25) grams per day, with 40% reporting greater than one gram per day. The average age of onset of cannabis use was 16.8 (SD = 1.8) years old. The top reasons for cannabis use were to: relax or relieve tension (75.8%), feel good or get high (62.6%), and have a good time with friends (60.6%). Students perceived an average of 47% of their peers engaged in past-month cannabis use and only slight risk was associated with regular use. Students perceived their loved ones would mostly approve of a reduction in their cannabis use. Regression results indicated past-month cannabis frequency (p = .002) and being of racial/ethnic minority descent (p = .05) were positively associated with quantity of cannabis per day, while perceived risk of regular cannabis use (β = -0.21) was negatively associated.
    UNASSIGNED: Evidence-based cannabis interventions for students who violate their university\'s drug use policies are critically needed that aim to reduce cannabis use and mitigate its associated negative consequences.
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  • 文章类型: Journal Article
    背景:潜在的不适当的多重用药(PIP)是导致药物不良反应的主要因素之一。医疗费用增加,降低药物依从性,恶化了病人的状况.这项研究旨在确定在意大利环境中实施的现有干预措施,以监测和管理多重药房。方法:根据PRISMA声明指南进行系统的文献综述(PROSPERO:CRD42023457049)。PubMed,Embase,ProQuest,和WebofScience在没有时间限制的情况下被查询,涵盖所有发表的论文,直到2023年10月。纳入标准遵循PICO模型:多重用药患者;监测/管理多重用药方案的干预措施与无/任何干预措施;干预效果和成本变化方面的结果。结果:重复删除后,提取了153份潜在相关出版物。经过摘要和全文筛选,九篇文章符合纳入标准。总的来说,78%(n=7)是观察性研究,11%(n=1)是实验研究,11%(n=1)为两阶段研究。总共44%(n=4)的研究涉及年龄≥65岁的患者。而56%(n=5)是疾病特异性的。监测是最普遍的干预选择(67%;n=6)。结果主要与多重用药水平(29%;n=6)和合并症(29%;n=6)有关,有效率(14%;n=3),和可避免成本(9%;n=2)。结论:这篇综述概述了意大利仍然缺乏监测/管理PIP的干预措施,解决在制定针对患者的策略以减少卫生系统负担方面未满足的需求。
    Background: Potentially inappropriate polypharmacy (PIP) is among the major factors leading to adverse drug reactions, increased healthcare costs, reduced medication adherence, and worsened patient conditions. This study aims to identify existing interventions implemented to monitor and manage polypharmacy in the Italian setting. Methods: A systematic literature review (PROSPERO: CRD42023457049) was carried out according to the PRISMA statement guidelines. PubMed, Embase, ProQuest, and Web of Science were queried without temporal constraints, encompassing all published papers until October 2023. Inclusion criteria followed the PICO model: patients with polypharmacy; interventions to monitor/manage polypharmacy regimen versus no/any intervention; outcomes in terms of intervention effectiveness and cost variation. Results: After duplicate deletion, 153 potentially relevant publications were extracted. Following abstract and full-text screenings, nine articles met the inclusion criteria. Overall, 78% (n = 7) were observational studies, 11% (n = 1) were experimental studies, and 11% (n = 1) were two-phase studies. A total of 44% (n = 4) of the studies involved patients aged ≥ 65 years, while 56% (n = 5) were disease-specific. Monitoring was the most prevalent choice of intervention (67%; n = 6). Outcomes were mainly related to levels of polypharmacy (29%; n = 6) and comorbidities (29%; n = 6), effectiveness rates (14%; n = 3), and avoidable costs (9%; n = 2). Conclusions: This review outlines that Italy is still lacking in interventions to monitor/manage PIP, addressing an unmet need in developing patient-tailored strategies for reducing health-system burden.
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  • 文章类型: Journal Article
    男性对性健康和生殖健康(SRH)服务的利用不足仍然是全球公共卫生挑战。SRH问题构成了主要的健康挑战,因为它们几乎占疾病负担的七分之一,并导致男性发病率更高,更早。我们,因此,邀请主题专家合作共同制定干预策略,以提高男性对SRH服务的利用率。我们采用名义分组技术(NGT)进行数据收集。NGT是一种结构化的方法,涉及聚集一群人来讨论问题,以达成群体共识并为所选问题计划行动。有目的地采样的参与者包括研究人员,科学家,学者,临床医生,和政策制定者。参与者建议需要提高男性的知识,提供医疗资源,如设备,医疗用品,和受过SRH培训的男性医护人员,通过培训和能力培养处理医护人员的消极态度,并贬低社会建构的性别规范,阻止男性寻求医疗帮助。可以实施这些重要的干预策略来鼓励男性使用SRH服务。男性目前对SRH服务的利用不足,需要紧急实施循证干预措施。与SRH专家合作确定适当的干预策略可以帮助项目经理和决策者设计适合男性性健康需求的SRH服务。
    Sexual and reproductive health (SRH) services\' underutilization by men remains a global public health challenge. SRH problems constitute major health challenges in that they form almost one-seventh of the disease burden and contribute to higher and earlier morbidity among men. We, therefore, invited subject matter experts to collaborate in co-creating intervention strategies to enhance men\'s utilization of SRH services. We employed the nominal group technique (NGT) for data collection. The NGT is a structured method that involves gathering a group of people to discuss a problem for the purpose of achieving a group consensus and planning actions for the selected problem. The participants who were purposively sampled included researchers, scientists, academics, clinicians, and policymakers. The participants suggested the need to improve men\'s knowledge, provide healthcare resources such as equipment, medical supplies, and SRH-trained male healthcare workers, deal with healthcare workers\' negative attitudes through training and capacitation, and destigmatize socially constructed gender norms that deter men from seeking medical help. These important intervention strategies can be implemented to encourage men\'s use of SRH services. Men\'s current underutilization of SRH services requires the urgent implementation of evidence-based interventions. Collaborating with SRH experts in identifying appropriate intervention strategies can assist program managers and policymakers in designing SRH services tailored to men\'s sexual health needs.
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  • 文章类型: Journal Article
    许多中年和老年人(MAOAs)不从事足够的体力活动(PA),尽管它有据可查的健康衰老的好处。现有的巴勒斯坦权力机构干预措施往往无法有效地覆盖或吸引目标人群。本研究调查了MAOAs对招募策略的偏好,以优化PA干预措施的覆盖范围和吸收,从而增强它们对健康老龄化和公共卫生的影响。对39名MAOA参与者进行了定性访谈(69%为女性,平均年龄=69.46,标准差=7.07),以麦奎尔的说服沟通理论为指导。与来源有关的因素,消息内容,通道,分析了招聘策略的接收者特征和目标行为。我们的研究结果表明,人们更喜欢可信的来源(例如,医疗保健专业人员而不是商业实体)和积极的,非年龄信息。MAOA的渠道偏好各不相同,但强调个性化的重要性。尽管存在异质性,MAOA通常认为自己足够活跃,表明需要改进关于什么构成足够的PA的知识,以及轻松注册或尝试干预措施。根据年龄为不同的MAOA细分市场量身定制招聘策略对于有效参与至关重要。未来的研究可以探索定量研究,以了解沟通因素与各种目标人群特征的关系。
    Many middle-aged and older adults (MAOAs) do not engage in sufficient physical activity (PA), despite its well-documented benefits for healthy aging. Existing PA interventions often fail to reach or engage the target population effectively. This study investigates MAOAs\' preferences for recruitment strategies to optimize the reach and uptake of PA interventions, thereby enhancing their impact on healthy aging and public health. Qualitative interviews were conducted with 39 MAOA participants (69% female, mean age = 69.46, SD = 7.07), guided by McGuire\'s Theory on Persuasive Communication. Factors related to the source, message content, channel, receiver characteristics and target behavior of recruitment strategies were analyzed. Our findings suggest a preference for trustworthy sources (e.g., healthcare professionals over commercial entities) and positive, non-ageist messaging. MAOAs vary in their channel preferences but emphasize the importance of personalization. Despite heterogeneity, MAOAs commonly perceive themselves as sufficiently active, indicating a need for improved knowledge on what constitutes sufficient PA, as well as easy enrollment or trying out interventions. Tailoring recruitment strategies to diverse MAOA segments based on age seems crucial for effective engagement. Future research could explore quantitative research into how communication factors relate to various target population characteristics.
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  • 文章类型: Journal Article
    实施和采用质量改进干预措施已被证明是困难的,即使在所有参与者都认识到干预的相关性和益处的情况下。描述实施新质量改进干预措施的困难的一种方法是探索不同类型的知识边界,更具体地说是句法,语义和语用边界,影响实施过程。因此,这项研究旨在确定和理解养老院和家庭护理服务实施过程的知识界限。
    本研究采用探索性定性方法。经验数据,包括与领导者和发展护士的个人访谈(n=10)和焦点小组访谈(n=10),源于外部驱动的领导干预和需要内部驱动干预的补充示踪剂项目。这两项实施都在挪威的疗养院和家庭护理服务中进行。根据扎根理论对经验数据进行了归纳分析。
    研究结果表明,句法边界包括诸如缺乏会议场所之类的边界,缺乏知识转移和学习的连续性。此外,句法界限主要与整个组织工作人员的传播和培训有关。语义边界由歧义等边界组成,缺乏对实践的感知影响,也缺乏适当的知识。这个边界主要与推动者角色的不确定性有关。务实的边界包括与缺乏所有权有关的边界,阻力,感到不安全,工作量,不同的观点,缺乏支持和关注,反映了实践的变化。
    本研究为遍历不同的知识边界提供了潜在的解决方案,并为理解与实施质量干预措施有关的知识边界提供了框架。
    UNASSIGNED: Implementation and adoption of quality improvement interventions have proved difficult, even in situations where all participants recognise the relevance and benefits of the intervention. One way to describe difficulties in implementing new quality improvement interventions is to explore different types of knowledge boundaries, more specifically the syntactic, semantic and pragmatic boundaries, influencing the implementation process. As such, this study aims to identify and understand knowledge boundaries for implementation processes in nursing homes and homecare services.
    UNASSIGNED: An exploratory qualitative methodology was used for this study. The empirical data, including individual interviews (n = 10) and focus group interviews (n = 10) with leaders and development nurses, stem from an externally driven leadership intervention and a supplementary tracer project entailing an internally driven intervention. Both implementations took place in Norwegian nursing homes and homecare services. The empirical data was inductively analysed in accordance with grounded theory.
    UNASSIGNED: The findings showed that the syntactic boundary included boundaries like the lack of meeting arenas, and lack of knowledge transfer and continuity in learning. Furthermore, the syntactic boundary was mostly related to the dissemination and training of staff across the organisation. The semantic boundary consisted of boundaries such as ambiguity, lack of perceived impact for practice and lack of appropriate knowledge. This boundary mostly related to uncertainty of the facilitator role. The pragmatic boundary included boundaries related to a lack of ownership, resistance, feeling unsecure, workload, different perspectives and a lack of support and focus, reflecting a change of practices.
    UNASSIGNED: This study provides potential solutions for traversing different knowledge boundaries and a framework for understanding knowledge boundaries related to the implementation of quality interventions.
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