bluuebunny/crossref_metadata_2025_split huggingface dataset:
Persuasive design principle of social support in digital interventions targeting mental health symptoms: a systematic review and meta-analysis
Authors: Mutter Agnes , Bücheler Mara , Idrees Abdul Rahman , Domhardt Matthias , Baumeister Harald 
Published: November 2024

ObjectiveThis systematic review and meta-analysis evaluates the available evidence on efficacy of social support strategies, as defined by the persuasive system design framework, in internet-based and mobile-based interventions (IMI) targeting mental health.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, PsycINFO and the Cochrane Central Register of Controlled Trials.Eligibility criteria for selecting studiesRandomised controlled trials comparing IMI implementing a social support strategy for mental health symptoms to various control conditions. Publications up to June 2023 (date of search 6 June 2023) were considered.Data extraction and synthesisTwo independent reviewers screened and extracted data in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk of bias was assessed with the Risk of Bias Tool V.2.0. Data were pooled based on a random-effects model.ResultsAfter screening 6484 records, a total of 45 studies met our inclusion criteria. At 96%, social support was predominantly implemented through the strategy of social facilitation, by which users recognising others using the intervention (eg, discussion forum). IMI implementing social support strategies showed moderate effect sizes of Hedges’g=−0.34 (95% CI −0.47 to −0.21, p<0.001) in comparison to different control conditions. Heterogeneity was considerable (I2=73.6%; 95% CI 64.8 to 80.3). Subgroup analyses revealed a significant influence of targeted psychological condition (p<0.001), type of social support (p<0.001) and control condition (p<0.001). Ink=11 component studies (ie, comparison to a disentangled version of the same intervention), IMI with social support strategies were not significantly more effective in comparison to the same IMI without social support (Hedges’g=−0.08 (95% CI −0.22 to 0.05, p=0.19, I2=0%). 64% (k=7) of component studies reported higher adherence rates in IMI with social support.ConclusionsBased on a small number of component studies, implementing social support strategies in IMI that target mental health symptoms has no significant incremental benefit on effectiveness. To draw more robust conclusions, the potential of other social support strategies besides social facilitation should be exploited in future component studies.PROSPERO registration numberCRD42020222810.
Mothers’ health-seeking practices and associated factors towards neonatal danger signs in Ethiopia: a systematic review and meta-analysis
Authors: Ferede Wassie Yazie , Yimer Tigist Seid , Gelaw Tiruset , Mekie Maru , Zewude Shimeles Biru , Mekete Getachew , Alemayehu Habtam Desse , Sisay Fillorenes Ayalew , Ayalew Abeba Belay , Mitiku Assefa Kebie , Yehuala Enyew Dagnew , Erega Besfat Berihun 
Published: November 2024

BackgroundA decrease in obtaining quality healthcare is a major cause of maternal and newborn deaths in low-income and middle-income countries. Ethiopia has one of the highest neonatal mortality rates. Increasing mothers’ health-seeking practices related to neonatal danger signs is an essential strategy for reducing the death rate of newborns. However, the pooled prevalence of mothers’ health-seeking practices related to neonatal danger signs is not well known in Ethiopia.ObjectiveThe main aim of this systematic review and meta-analysis is to assess the mothers’ health-seeking practices and associated factors towards neonatal danger signs in Ethiopia.DesignSystematic review and meta-analysis.Primary and secondary outcomesThe primary outcome was to assess the mothers’ health-seeking practices towards neonatal danger signs and the secondary outcome was to identify factors associated with health-seeking practices.MethodsIn total, comprehensive literature was searched in the PubMed, Google Scholar, HINARI, Embase and CINAHL databases published up to 30 December 2023. A random effect model was used to estimate the pooled prevalence and adjusted OR (AOR). Stata (V.17.0) was used to analyse the data. I2statistics were computed to assess heterogeneity among studies. To minimise the underlying heterogeneity, a subgroup analysis was conducted based on the study region and year of publication. To assess publication bias, Egger’s test and funnel plots were used.ResultsOverall, 1011 articles were retrieved, and 11 cross-sectional studies, with a total of 5066 study participants, were included in this systematic review. The overall pooled prevalence of mothers’ health-seeking practices for neonatal danger signs in Ethiopia was 52.15%. Postnatal care follow-up (AOR 2.72; 95% CI 1.62 to 4.56), good maternal knowledge (AOR 3.20, 95% CI 2.24 to 4.56), educational status of secondary school and above (AOR 4.17, 95% CI 2.04 to 8.55), women’s decision-making autonomy (AOR 3.59, 95% CI 1.60 to 8.06) and place of delivery (AOR 2.71, 95% CI 1.21 to 6.04) were significantly associated with mothers’ health-seeking practices for neonatal danger signs.ConclusionThe maternal health-seeking practices of women towards neonatal danger signs were found to be low in Ethiopia. When barriers to seeking care for newborn danger signs are successfully removed, women’s practices for seeking care for neonatal danger signs could decrease perinatal mortality.
Weight control efforts and practices and health professional advice: a cross-sectional national survey in England
Authors: Jackson Sarah E , Warr William , Brown Jamie , Hartmann-Boyce Jamie , Jebb Susan A , Tudor Kate , Shahab Lion , Aveyard Paul 
Published: November 2024

ObjectivesThere is evidence that general practitioners (GPs) can increase the uptake of weight management programmes that enhance weight loss compared with self-directed efforts, but the rate at which they do so is unclear. This study examined the prevalence of weight control efforts and practices, the reported frequency and impact of receipt of GP advice on weight loss attempts and perceptions of the appropriateness of health professionals delivering weight loss advice.DesignA nationally representative cross-sectional survey.SettingEngland.Participants1722 adults (≥16 years) surveyed in October 2018 (mean (SD) age=47.4 (19.2), 51.1% women).Main outcome measuresWeight control efforts and practices, whether a GP gave advice or a specific referral/prescription medication, perception of the appropriateness of GP weight loss advice.ResultsTwo-thirds (64.7% (95% CI 58.1% to 71.3%)) of people with obesity reported trying to lose weight. Of people with obesity who visited their GP in the past year, 40% (95% CI 32.2% to 47.7%) recalled receiving any advice on weight loss: 30.8% (95% CI 23.5% to 38.2%) general advice and 9.2% (95% CI 4.6% to 13.7%) a referral to a weight loss service or prescription medication for weight loss. Having received weight loss advice from a GP was strongly associated with a greater likelihood of trying to lose weight (general advice: ORadj=4.49, 95% CI 2.52 to 8.00; referral/medication: ORadj=9.25, 95% CI 2.65 to 32.3). Views on whether health professionals should deliver weight loss advice were mixed, with a substantial minority (19.4% (95% CI 17.5% to 21.4%)) finding it unacceptable. People with a BMI outside of the healthy weight range (underweight/overweight/obesity), women and those from more disadvantaged social grades were less likely to find it acceptable.ConclusionsMost people with obesity reported trying to lose weight but less than half recalled receiving advice on weight loss from their GP in the past year and few were referred to community weight-loss programmes. Those who recalled receiving GP advice on weight loss were substantially more likely to report taking action to lose weight. One in five people thought GP advice on weight loss was inappropriate.
High-flow weaning strategies for infants with bronchiolitis: protocol for a pilot randomised controlled trial in the UK
Authors: Towriss Christopher , Dafydd Carwyn , Edwards Martin 
Published: November 2024

IntroductionWard-based high-flow nasal cannula (HFNC) is an effective therapy for children with bronchiolitis who have failed standard oxygen therapy. However, HFNC can increase hospital length of stay perhaps because there is a lack of evidence to guide weaning strategies.We aim to conduct a pilot study to identify the most effective weaning strategy for infants, up to 12 months, supported on HFNC for bronchiolitis. This may lead to reduced time on respiratory support and shorter length of stay. If this pilot study is deemed feasible, it will inform a larger multicentre trial.Methods and analysisThis open label, non-blinded, randomised controlled trial will be conducted over 24 months at the Noah’s Ark Children’s Hospital for Wales, Cardiff, and will aim to recruit 20 patients. It will compare high-flow only weaning (high-flow discontinued at FiO2of 21%) to HFNC and low-flow weaning (HFNC discontinued at 30% and replaced by low-flow up to 2 L/min). HFNC therapy will be delivered at 2 L/kg/min (maximum 20 L/min). The primary outcome is to examine the feasibility of different weaning strategies for infants with bronchiolitis requiring HFNC. Secondary outcomes include the time from decision to wean HFNC to the patient no longer requiring respiratory support and a safety assessment of the weaning strategies.Ethics and disseminationHealth Research Authority and Health and Care Research Wales approval was granted on 8 September 2020 following review by the NHS research ethics committee.The sponsor is Cardiff and Vale University Health Board. We will publish the results in a peer-reviewed medical journal, via websites and newsletters.Trial registration numberNCT04287959.
Exploring how to widen the acceptability of public health interventions: a systematic review protocol
Authors: Conway-Moore Kaitlin , Graham Fiona , McKinlay Alison R , Birch Jack , Oliver Emily , Bambra Clare , Kelly Michael P , Bonell Chris 
Published: November 2024

IntroductionHealth interventions that require significant change to individual lifestyles or social norms can pose a challenge for widespread public acceptability and uptake. At the same time, over the last two decades, there has been increasing attention paid to the rise of populist movements globally, defined by ‘the people’ pushing against ‘an elite’ viewed as depriving the people of their sovereignty. To understand potential overlap in these two areas, this study aims to synthesise existing international evidence on linkages between populist attitudes and reduced uptake, acceptability, adherence and/or effectiveness of public health interventions. The goal of this work is to create a conceptual framework that can be used to inform policy strategies aimed at widening the impact of public health interventions.Methods and analysisA systematic review will be performed via searches across databases and websites relevant to public health and social science research, informed by preliminary searches on the topic. There will be no language restrictions, but included studies will be limited to those produced since 2008, the year of the global financial crisis, from which most current literature on populism dates. Risk of bias will be assessed using validated tools according to study design. Due to expected heterogeneity across included studies, this will be a systematic review without meta-analysis. Findings will be synthesised narratively, and the strength of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The review will be reported according to the Systematic Reviews without Meta-Analysis reporting guidelines.Ethics and disseminationEthical review is not required for this study. Public dissemination will be informed via consultation with our Patient and Public Involvement and Engagement Strategy Group, along with reporting via peer-reviewed publication, relevant international conferences, a policy brief and a workshop with public health and communications experts.PROSPERO registration numberCRD42024513124.
A service evaluation of the uptake and effectiveness of a digital delivery of the NHS health check service
Authors: Salway Ruth , Sillero-Rejon Carlos , Forte Chloe , Grey Elisabeth , Jessiman Patricia , McLeod Hugh , Harkes Rebecca , Stokes Paul , De Vocht Frank , Campbell Rona , Jago Russell 
Published: November 2024

ObjectivesTo compare the uptake, effectiveness and costs of a digital version of the National Health Service (NHS) Health Check (DHC) to the standard face-to-face NHS Health Check (F2F).Participants and settingA random sample of 9000 patients aged 40–74 eligible for an NHS Health Check in Southwark, England, between January and April 2023.Intervention and designThe DHC was an online tool with a health assessment section, an advice and support section, and a section on how to obtain and update follow-up physical measures (blood pressure, cholesterol, glycated haemoglobin (HbA1c)). 6000 patients from GP records were randomly allocated to receive a DHC invitation and 3000 to receive an F2F invitation. Those invited to DHC were able to choose F2F if they preferred.OutcomesThe primary outcome was the uptake of any type of health check, either a completed F2F appointment or completion of the DHC health assessment section, along with demographics and data on appointments, medications and referrals within the study period. QRISK3 and QDiabetes risk scores were calculated. Management and operation costs were estimated for F2F and DHC pathways.ResultsExcluding participants who moved away or died, the DHC uptake to the health assessment section was 21% (1189/5705), with a further 3% (198/5705) choosing F2F, compared with 11% (305/2900) for F2F completion (p<0.001). The DHC uptake was lower among those from Black (14%) and Mixed (13%) compared with White (29%) ethnicities (p<0.001), and there was no evidence of higher DHC uptake among groups less likely to engage in NHS Health Checks. Of those who completed the health assessment, 60% (714) completed the support section, and 7% (84) completed the provision and updating of physical measures. Appointments, medications and referrals were lower among DHC service users than among F2F users (p<0.001). The estimated total management and operation costs for F2F were £154.80 per user, compared with total management and operation costs for DHC of £68.48 per user for health assessment only, £134.46 including the support section and £1479.01 per user with completed physical measures.ConclusionsThe study suggests that a choice of Health Check pathways may potentially reduce pressures on the NHS. Cholesterol and HbA1c were not generally known, and the options to obtain and update these measures require further development for the DHC to be considered a viable comparable alternative to the F2F service for estimating cardiovascular disease and diabetes risk. Strategies are still needed to reach those groups not currently engaging with NHS Health Checks.RegistrationThis study was registered on the Open Science Framework:https://osf.io/y87zt.
Perinatal health in a cohort of children conceived after assisted reproduction in the UK: a population-based record-linkage study
Authors: Purkayastha Mitana , Sutcliffe Alastair , Brison Daniel R , Nelson Scott M , Lawlor Deborah , Roberts Stephen A 
Published: November 2024

ObjectiveTo compare the risk of hospitalisation for conditions originating in the perinatal period between children conceived via assisted reproductive technology and those that are naturally conceived, differentiating by treatment type.Study design, setting and participantsPopulation-based record-linkage study of children born after assisted reproduction in the UK between 2002 and 2009 (n=44 618), their naturally conceived siblings (n=8462) and matched naturally conceived population (n=89 072) controls linked to their hospital inpatient records up to 31 March 2016.Primary and secondary outcome measuresRobust estimates of the overall and cause-specific risk of hospital admission for adverse perinatal events and the comparison of outcomes by type of treatment.ResultsOver the study period, 17 132 (38.40%) children conceived via assisted reproduction and 30 306 (34.02%) and 1738 (20.54%) naturally conceived population and sibling controls, respectively, were admitted to the hospital for severe perinatal events. Compared with the population controls, singletons (Risk ratio (95% CI 1.30 (1.26, 1.34))) and twins (1.01 (0.99, 1.03)) conceived via assisted reproduction exhibited a higher risk of hospitalisation for any adverse perinatal event. However, no such increase was observed in the within-sibling analysis (0.97 (0.84, 1.12)). Similar patterns were seen for diagnoses related to length of gestation and fetal growth (vs population controls: 1.37 (1.29, 1.46); vs siblings: 1.17 (0.86, 1.60)); birth trauma (vs population controls: 1.23 (1.04, 1.44); vs siblings: 0.78 (0.47, 1.30)); respiratory and cardiovascular disorders (vs population controls: 1.28 (1.20, 1.38); vs siblings: 0.72 (0.53, 0.98)); infections (vs population controls: 1.30 (1.06, 1.59); vs siblings: 0,68 (0.24, 1.90)) and several other conditions. Associations were similar when comparing in vitro fertilisation to intracytoplasmic sperm injection and were higher when comparing fresh to frozen embryo transfers.ConclusionChildren conceived via assisted reproduction showed modest increases in the risk of hospitalisations for severe perinatal events when compared with population controls, although these findings were attenuated in the sibling analyses. The imprecision of within-sibling analyses highlights the need for larger studies to explore potential causal effects.
Insights on health policies from a political philosophy perspective
Authors: Abiétar Daniel G , Martí-González Mariacarla , Aguiló Elena , Sánchez-Valdivia Nacho 
Published: November 2024

Health policies play a crucial role in shaping people’s well-being. While public health often relies on evidence-based policy to improve health outcomes, many non-scientific factors determine the health policy-making process. This article explores how public health advocacy can be strengthened by examining the relationship between political philosophy and the scientistic aspirations of public health.We begin by critically assessing the deliberative decision-making model, offering insights on policy processes that could inspire new directions in health policy research. To enhance these efforts, we delve into the philosophical critique of scientism, aiming to liberate public health from its technocratic inclinations. Our analysis draws on political philosophy from two angles: first, we revisit Renaissance utopias to highlight the risks of a science-driven society devoid of ethics; second, we introduce modern perspectives on democratic justice, advocating for health policies that resist domination.Ultimately, we argue for a new model of health policy science that positions public health as a key political actor. By focusing on the everyday realities of policy-making, public health can tackle two fundamental questions: How are citizens’ interests considered in health policy? And how do we deliberate the goals and means of health policy? By addressing these questions, our proposals aim to enhance public health advocacy, promoting research and actions that lead to more just and inclusive health policies, ensuring the protection of everyone’s health.
Within-person relationship between employment insecurity and mental health: a longitudinal analysis of the Understanding America Study
Authors: Jin Haomiao , Lee Woo Jung , Maupin Daniel , Lee Jungeun Olivia 
Published: November 2024

BackgroundEmployment insecurity is a socioeconomic factor influencing mental health, yet the empirical evidence supporting this claim has important limitations. The fluctuations in employment insecurity throughout the COVID-19 pandemic offered a distinctive opportunity to delve deeper into this issue. By viewing employment as a dynamic process, this study explores the within-person relationship between shifts in employment status and corresponding changes in mental health.Methods24 waves of data between April 2020 and March 2021 from the Understanding America Study (N=3824) were analysed using a within-person multilevel model. Employment security was modelled as a dynamic process involving transitions between secure employment, underemployment and unemployment with or without benefits. Mental health was measured by questionnaires on core symptoms of depression and anxiety.ResultsDownward transitions in employment security, from secure employment to underemployment or unemployment without benefits, were associated with worse mental health. Persisting in unemployment without benefits was also associated with poorer mental health, and regaining job security did not immediately improve it. Timely provision of unemployment benefits mitigated the adverse mental health impacts. Significant cross-level moderation effects were observed for prepandemic mental health status, Hispanic ethnicity and education level.ConclusionDownward transitions in employment security compromise mental health, and certain segments of the population experience worse consequences. Regaining job security is not associated with immediate improvement in mental health. Timely provision of unemployment benefits, providing support for both unemployment and underemployment and targeting vulnerable groups are vital for alleviating adverse mental health impacts from losing job security.
High long-term mortality in ischaemic heart disease accentuated among ethnic minorities in Eastern Europe: findings from a prospective all-comers percutaneous coronary intervention registry in Romania
Authors: Călburean Paul-Adrian , Grebenișan Paul , Nistor Ioana-Andreea , Șulea Ioana Paula , Scurtu Anda-Cristina , Brinzaniuc Klara , Suciu Horatiu , Harpa Marius , Dobreanu Dan , Hadadi Laszlo 
Published: November 2024

BackgroundLong-term outcomes in cardiovascular diseases are historically under-reported in Eastern Europe. Our aim was to report long-term survival and to identify survival predictors in a prospective Romanian percutaneous coronary intervention (PCI) registry, with an emphasis on important under-resourced minorities, such as Hungarian and Roma ethnicities.MethodsAn all-comers patient population treated by PCI in a tertiary cardiovascular centre that has been included prospectively in the local registry since January 2016 was analysed. Cardiovascular cause and all-cause mortality data were available as of December 2023.ResultsA total of 6867 patients with 8442 PCI procedures were included. Romanian group consisted of 5095 (74.2%) patients, the Hungarian group consisted of 1417 (20.6%) patients and the Roma group consisted of 355 (5.1%) patients. During a median follow-up of 3.60 (1.35–5.75) years, a total of 1064 cardiovascular-cause and 1374 all-cause events occurred. Romanian, Hungarian and Roma patients suffered 5.12, 5.89 and 7.71 all-cause deaths per 100 patient-years, respectively. Romanian, Hungarian and Roma patients suffered 3.94, 4.63 and 6.22 cardiovascular-cause deaths per 100 patient-years, respectively. Both Hungarian and Roma patients presented significantly higher all-cause mortality than Romanian patients (adjusted HR (aHR)=1.20 (1.05–1.36), p=0.005 and aHR=1.51 (1.21–1.88), p=0.0001). Similarly, Hungarian and Roma patients presented significantly higher cardiovascular cause mortality than Romanian patients (aHR=1.22 (1.05–1.41), p=0.006 and aHR=1.51 (1.18–1.92), p=0.0008).ConclusionsHigh long-term cardiovascular and all-cause mortality was observed for the entire included population. Long-term survival was significantly lower in ethnic minorities, such as the Hungarian and Roma minority than in the Romanian population.