bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-experiences of osteoporosis care through an Integrated, People-Centred Health Services (IPCHS)-framework lens: an international perspective
Authors: Verdonck Caroline , Van Daele Ellis , Willems Ruben , Borgermans Liesbeth , Boeckxstaens Pauline 
Published: January 2024

Introduction: Aligning healthcare systems worldwide to meet the challenge of caring for the world’s rapidly growing older population is among the most important goals of the World Health Organization (WHO) Decade of Healthy Ageing (2021-2030). This entails ensuring people have broad access to the most effective diagnostic and prevention strategies, treatments and care for diseases that disproportionately impact the aging, such as osteoporosis. Currently, health systems do not succeed in meeting the needs of osteoporosis patients. Previous studies have demonstrated unmet needs in terms of accessibility, affordability, patient-centredness and comprehensiveness. In order to reorient health care systems towards a more integrated approach supporting these rightful demands, the WHO has developed the framework on Integrated, People-Centred Health Services (IPCHS), encompassing five interdependent strategies and 20 substrategies that support health care delivery integration. Whilst these strategies are often implemented by stakeholders, the patient perspective with regard to these strategies is poorly understood. The study aims to analyse the gaps in osteoporosis care as experienced by patients and relate them to IPCHS-strategies.
Methods: Individual interviews were performed by two researchers, using a semi-structured interview guide. Interviews were held in English, Dutch, Spanish and French, recorded using screen recording, and transcribed at verbatim. Interviews were first analyzed deductively based on the IPCSH framework, assigning patient responses to one or more substrategies of the five IPCHS strategies. Afterwards, inductive analyses per sub-strategy were performed.
Results: Thirty-five (33 women, 2 men) patients from 14 countries were interviewed. From the 20 IPCHS substrategies, patients mostly reported difficulties and shortcomings they experienced in relation to “empowering and engaging individuals and families” such as patient education and shared decision making, and “coordinating care for individuals” with an emphasis on multidisciplinary care pathways, respectively. They also inclined a larger focus is needed on preventive services. High out-of-pocket payments were considered an important barrier in accessing services and comprehensive care. Patients advocated for stronger primary care-based services in which more continuity and follow-up is provided by a dedicated physician.
Conclusion: Improvements in integrated, people-centred osteoporosis care should focus on patient-reported experiences with care.
Ethical approval: Approval for the study has been provided by the Ethics Committee (EC) of Ghent University Hospital (BC-10951). All participants signed an informed consent form after receiving written and verbal information. This study has been made possible through a value-based partnership between Ghent University and Amgen.
Scoping literature review and focus groups with healthcare professionals on psychosocial and lifestyle assessments for childhood obesity care.
Authors: Koetsier Leandra 
Published: January 2024

Background: Childhood obesity is a complex disease resulting from the interaction of multiple factors. The effective management of childhood obesity requires assessing the psychosocial and lifestyle factors that may play a role in the development and maintenance of obesity. This study centers on available scientific literature on psychosocial and lifestyle assessments for childhood obesity, and experiences and views of healthcare professionals with regard to assessing psychosocial and lifestyle factors within Dutch integrated care.
Methods: Two methods were used. First, a scoping review (in PubMed, Embase, PsycInfo, IBSS, Scopus and Web of Science) was performed by systematically searching for scientific literature on psychosocial and lifestyle assessments for childhood obesity. Data were analysed by extracting data in Microsoft Excel. Second, focus group discussions were held with healthcare professionals from a variety of disciplines and domains to explore their experiences and views about assessing psychosocial and lifestyle factors within Dutch integrated care. Data were analysed using template analysis, complemented with open coding in MAXQDA.
Results: The results provide an overview of relevant psychosocial and lifestyle factors that should be assessed and were classified as child, family, parental and lifestyle (e.g. nutrition, physical activity and sleep factors) and structured into psychological and social aspects.
Insights into how to assess psychosocial and lifestyle factors were identified as well, including talking about psychosocial factors, lifestyle and weight; the professional-patient relationship; and attitudes of healthcare professionals.
Conclusions: This study provides an overview of psychosocial and lifestyle factors that should be identified within the context of childhood obesity care, as they may contribute to the development and maintenance of obesity. The results highlight the importance of both what is assessed and how it is assessed. The results of this study can be used to develop practical tools for facilitating healthcare professionals in conducting a psychosocial and lifestyle assessment.
Development, piloting, and dissemination of a suicide prevention brief online course for non-health professionals
Authors: Belarra Begoña , López Puy , Portuondo Janire , Gómez-Alcalde Jose Luis , Gabilondo Andrea , Martin Susana 
Published: January 2024

Introduction: The use of online gatekeeper training resources facilitates the dissemination of useful knowledge and skills for suicide prevention with an integrated care perspective and a focus in the community, especially in a context of a pandemic and of limited human and economic resources.
Aim: To develop and evaluate the impact of a short online gatekeeper training course in Spanish for non-health professionals in the community. To disseminate the course among this group of professionals as a free and easy to access online resource.
Methods: An expert panel developed the training after the review of the evidence and available programs. Evaluation was carried out in two phases (Pilot 1&2). In the 2nd pilot a greater variety of professional fields was included and the evaluation questionnaire was shortened. In both cases, a single group design of repeated measures (before, immediate post and 3 months post) was used as well as a one-factor analysis of variance with repeated measures. Participants responded to an ad-hoc online questionnaire which evaluated satisfaction, knowledge, self-confidence (pilot 1&2), and attitudes (pilot 2). We consecutively recruited all interested professionals in the community who responded to an invitation email sent by the public health coordinators in the counties. A dissemination plan in 4 stages has been developed in coordination with Public Health coordinators.
Results: Sample for the pilot was made up of 272 (53+219) professionals. Improvements in self-confidence, knowledge about suicide and attitudes were found, with statistically significant differences. Overall satisfaction with the training was 8.5 out of a maximum of 10. The dissemination phase is now starting. The aim is to reach as many professionals working with vulnerable groups as possible. Results of this phase will be available by May 2023.
Conclusions: Results of the evaluation pilot are promising and suggest the usefulness of this training to improve professionals' self-confidence and knowledge about suicide prevention. The challenge is to make this training available to the greatest possible number of community professionals.
Uncovering the black box: the potential of Realist Evaluation
Authors: Van Den Bulck Anne , Smeets Rowan , Tichler Anna , Geurten Rose , Hertroijs Dorijn , Elissen Arianne 
Published: January 2024

Background and aim: Complex programs, with multiple components and many stakeholders involved, are rather the norm than the exception in the field of integrated care. Experimental designs, with a focus on íf programs work, often disappointingly fail to open the black box about ‘why and how’ complex programs work. With a focus on ‘what works, for whom, why, and under what circumstances’, Realist Evaluation (RE) offers a promising research paradigm to evaluate such programs in a transferable way. Furthermore, RE is highly participative: active involvement of all program stakeholders is key to unearth their perceptions about program functioning. The use of RE is growing steadily in social sciences. However, successful adoption of RE in practice may be challenging, as research in general is still largely dominated by ‘experimental thinking’ and it requires the active participation of a range of stakeholders. Therefore, we have designed a workshop called ‘Uncovering the black box: the potential of Realist Evaluation’. In this workshop, we not only aim to create awareness amongst fellow researchers of the potential of RE, but also gather insights into how these adoption challenges can be overcome to successfully use RE in research.
Who is it for? Our workshop is for everyone interested in thinking beyond the traditional golden standard of randomized controlled trials, and broaden their knowledge of research design. Both researchers conducting studies and those participating in studies (e.g. all kinds of stakeholders) can find and make this workshop valuable.
Workshop program: We will start with a short general introduction about RE, combined with an online question to the audience to gather their first impressions of RE (15 minutes). Then we will provide some example projects that use an RE approach (10 minutes). Next, a world-café method will be followed. This means that the audience will be divided into three groups, where each group discusses a different topic at a roundtable, being: advantages and opportunities (i.e. how RE could help you in your research), barriers (to apply RE to your research projects), and solutions to overcome the barriers. Each group has 15 minutes to discuss the topic in question at their table and write down their findings. Discussions are guided by the workshop organizers, who function as moderators. When time is up, all groups move on to the next roundtable with one of the other topics where they can add up their findings to those that were already put on paper. After 45 minutes, all groups discussed three topics. Finally, each moderator will give a plenary presentation of the findings of each topic, and the audience can share some final thoughts (15 minutes). We will end with a 5 minutes closing, asking the audience about what they found most striking during the workshop and if they think they would apply RE (more) in future.
Integration of processes related to the implementation of the mediGOAT platform in diabetic patient care.
Authors: Zwiefka Antoni , Wyrzykowski Andrzej , Waszkiewicz Krzysztof 
Published: January 2024

Diabetes has always been viewed through the prism of the fact that any expenditure in this area is a threat to the budget of the entire health care system. Most often it is the progress of science that forces integration activities. An example may be the integration processes related to the implementation and creation of the mediGOAT platform, which are focused on its multi-functionality, i.e. the ability to connect many different measuring devices (Glucometer, CGM, SmartPen, Insulin Pump, GlucoActive) from many manufacturers. They are made up of smaller particles with their own rules and goals, such as engaging and evaluating activities. We meet with this, among others by implementing good practices.
As a result, such activities give the user more choice and independence from many native applications (manufacturers), and it enables cooperation with Google Health and iHealth (Apple). This makes it possible to use additional information provided by External Applications (meals, exercise, pressure, weight, ...) in the treatment process. In addition, it allows you to collect and store your medical records (including the results of medical tests). The indicated/selected medical/health data (in the future on-line measurements) can be provided to the doctor via the Portal, ensuring security (login via Apple and Google, Backup) and ease of use.
Additional knowledge is written at various levels of detail, scattered in different places, its origin is sometimes uncertain, which makes it unreliable. It is often oversized where it is not necessary, and various sources can contradict each other. Therefore, it is important to use trusted sources. Controlling blood glucose levels is important, as are the circumstances surrounding such a measurement, what you do and where you are. Mobile Continuous Glucose Monitoring, using CGM, enables up to 288 readings per day, giving you insight into information that fingerstick tests cannot match. CGM provides real-time glucose readings every five minutes throughout the day and night, notifying you of high and low values. The sensor continuously measures the glucose level just below the skin and transmits the data wirelessly to the display device via the transmitter. This enables an immediate reaction. A discreet sensor placed just under the skin (the automatic applicator introduces the sensor just under the skin with one press) measures the glucose level for the time specified by the manufacturer. Glucose data is sent wirelessly to the analysing and smart device via Bluetooth® or NFC technology. Such a device can be a compatible smartphone or other optional receiver that displays and archives glucose data in real time.
Design, implementation, and evaluation of a training on culturally sensitive care for nursing students: A pilot study
Authors: Claeys Ann , Berdai-Chaouni Saloua , Tricas-Sauras Sandra , De Donder Liesbeth 
Published: January 2024

There is a need for culturally sensitive care for people with a migration background because of the increasing ethnocultural diversity in Western countries. Consequently, more and more training programs for health care providers are starting to implement these topics in curricula. However, while the content of culturally competent care is widely debated in nursing literature, a description of how students are and should be taught is lacking. Even more, studies have shown that merely increasing knowledge on ethnicity, culture or migration does not help to increase culturally sensitive behaviour of (future) healthcare providers. On the contrary it even leads to more stereotypical thinking. More critical self-awareness is needed among caregivers to overcome barriers such as othering (i.e., micro-racism by defining the other in an inferior way).

In response to abovementioned shortcomings, we developed, implemented and evaluated a course on culturally sensitive care in the curriculum of nursing students. Nursing students and caregivers were involved in the development of the course. This program (4h) aimed to increase self-awareness among caregivers about othering, racism and exclusion in society and in healthcare. The paper will describe the content of the program (building on the Johari Window model developed to increase awareness in interpersonal relations (Luft & Ingham, 1961), the pilot implementation and evaluation among 34 students. The program was well received by the participants. Success factors (i.e. profile of the teacher, self-awareness positionality) and working points (i.e. ethnic/minority-matching) were detected. This program will be adapted and further implemented in the curriculum based on the feedback.
Training for coordinating professionals as part of Dutch integrated care for childhood overweight and obesity – a mixed-methods evaluation
Authors: Koetsier Leandra , Boutalab Lamyae , Seidell Jaap , Baan Caroline , Halberstadt Jutka 
Published: January 2024

Introduction: Healthcare professionals (HCPs) play an important role in childhood overweight and obesity care, yet they often feel ill-equipped to manage this complex and sensitive health problem. As part of Dutch integrated care for childhood overweight and obesity, a training for coordinating professionals (CPs) was designed and carried out. This study evaluates the training based on the four levels of Kirkpatrick’s model of training evaluation: (1) reaction, (2) learning, (3) behaviour, and (4) results.
Method: Eleven CPs who completed the training participated in this mixed-methods study. First, completed questionnaires on the four levels were analysed with Qualtrics. Next, the transcripts of semi-structured interviews on levels 1, 3 and 4 were analysed in MAXQDA using thematic analysis.
Results: On level 1, participants were satisfied with the training as it stimulated their professional and personal development, for instance awareness of prejudices about people with overweight and obesity. Barriers, improvements and needs from the training varied between participants based on their background. On level 2, CPs improved perceived knowledge about integrated care and its practice, skills for providing overweight and obesity care, coaching attitudes, and trust and commitment towards local integrated care. On level 3, the extent to which the learnings were practised depended on the experience and local context of the CP. Last, on level 4 CPs mentioned noticing post-training practical results for themselves, the child and the family, integrated care partners, and the participants’ organisation.
Conclusion: This study evaluated a training for CPs for the support and care they provide to children with overweight and obesity and their families as part of Dutch integrated care. The training contributed to improve perceived knowledge, skills and attitudes of CPs. This study recommends sufficient implementation of local integrated care, to optimally practise what was learned during the training. More on-time evaluations of the training and taking the perspective of the organisation into account is needed. This would improve the training and give CPs confidence to adequately provide support and care to children with overweight and obesity and their families.
Keywords: Pediatric obesity, education, health care providers, primary health care, mixed-methods appraisal
Smoking cessation encouragement by community pharmacists.
Authors: Vauterin Delphine , Tommelein Eline , Lahousse Lies 
Published: January 2024

Background: Pharmaceutical care interventions have shown to improve health outcomes in specific patient populations. However, which smokers could be reached by community pharmacists in Belgium is unknown. Moreover, the impact of behavioural interventions for smoking cessation (such as brief motivational interviewing) on short term health outcomes remains unclear. Therefore, we aimed to describe the population reached and potential impact on health outcomes among persons who received a brief motivational interview by their community pharmacist.
Methods: Demographics of approached smokers in Flemish community pharmacies during the months May-June 2021, and objectifiable outcomes of a brief motivational interview were retrieved from the pharmacy database. Smoking cessation aids use as well as the impact on cough, inhaler or exacerbation medication use was evaluated 90 and 180 days after the encouragement. Data were analysed using the Mann-Whitney U test, ꭕ² test and binary logistic regression analysis.
Results: Community pharmacists provided a brief motivational interview to a broad population of smokers of both sexes, including young persons and persons without chronic medication use. Two out of three smokers were motivated to quit (67.7%) and a third of the included population (33.0%) purchased a smoking cessation aid on the index date (36.7% after 90 and 39.3% after 180 days). Smokers motivated to quit who purchased a smoking cessation aid on the index date had a significantly lower use of cough (OR = 0.37; p = 0.032) and inhaler medication (OR = 0.37; p = 0.009) after 90 days than those not motivated to quit. Effects were less pronounced after 180 days but still statistically significant for lower inhaler use (OR = 0.46; p = 0.031).
Conclusions: By implementing a brief pharmaceutical counselling in Belgian community pharmacies, a broad range of smokers can be reached and triggered to start smoking cessation aids with suggestive short-term health benefits.
Acknowledgements
The authors want to thank the Flemish Pharmacists Network (VAN) for training the pharmacists and Farmaflux and the Association of Pharmacists Belgium (APB) for providing the data with special acknowledgements to Karel Verlinde, An Vanthienen, Corine De Winter and Marc Buckens.
Identifying and providing management support for people at risk of frailty in general practice.
Authors: Nicholson Caroline , Job Jenny , Clark Debra , Arapova Julia 
Published: January 2024

Background: Frailty, associated with increasing age and characterised by diminished strength and function, often remains undetected. Presentations of frailty often occur when a seemingly minor event results in a significant health crisis and unnecessary hospital admission, with substantial associated health care costs. Evidence suggests that targeted therapies may decrease the negative outcomes associated with being frail. In Australia frailty affects up to 25% of people aged ≥70 yet a standardised assessment of frailty amongst patients attending general practice is not routine. The FRAIL Scale, developed and validated internationally as a screening tool, requires five simple questions relating to fatigue, resistance, ambulation, illnesses, and weight loss to be answered to identify risk of frailty.
Method: Audit of 282 patients aged ≥75 years who had completed annual health assessments in ten Australian general practices, found only 2% had been assessed for all five FRAIL Scale components.
Outcome: To facilitate use of the FRAIL scale a FRAIL Scale App has been developed which can be built into the General Practice clinical support system. Our pilot study is investigating the 1) feasibility and adoption of the App by general practices recruited from two Australian regions (North Sydney/Brisbane South); 2) access to resources/referral options in the community to support identified need; 3) acceptability to providers/patients/carers of the risk of frailty assessment and management approach. The App has been adopted by 17 general practices recruited from the two regions and is an efficient and effective method to identify risk of frailty and provide management suggestions.
Implications: This study is providing an understanding of the services required in the community to support those who are pre-frail/at risk of frailty. A reduced burden to the hospital system, improved health outcomes and quality of life for older people who are at risk or living with frailty are potential benefits of an effective tool used routinely in general practice.

Key messages:
1.Risk of frailty is not being routinely assessed in general practice
2.The Frail scale tool can be easily incorporated into the practice workflow.
3.Risk of frailty management resources and services are required to support the implementation.