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Assess knowledge, attitudes, and practices (KAPs) of a diverse population. Identify barriers and facilitators that inform routine vitamin D supplementation and self-care in the community setting. Cross-sectional online voluntary survey. Electronic survey link published on college Qualtrics platform and advertised widely. Study information provided with Participant Information Sheet. 556 community dwelling adults across the UK. The overarching study included two phases, incorporating quantitative and qualitative methodologies. This paper reports findings from the first phase of the FABCOM-D (Facilitators and Barriers to Community (Healthy) Vitamin D status) study. Online survey questions were iteratively developed after background literature searches and piloted to ensure clarity and ease of understanding. Survey responses summarised using frequencies and percentages, and univariable and multivariable logistic regression models explored for any association. A p-value less than 0.05 was considered statistically significant. The Checklist for Reporting Results of Internet E-Surveys guided reporting. Statistical analysis performed using IBM SPSS software. Awareness of vitamin D information sources, health benefits and testing. Attitudes to supplementation, sun exposure and fortification. Three quarters of the community had some awareness of vitamin D and around half were taking supplements. The two most trusted sources of information included health professionals and the NHS website. Participants were willing to pay for supplements, supporting a self-care agenda. With increasing age, there was significant reduced intake of vitamin D supplements. This aspect needs to be explored further as this could be a concern in deficiency status in the elderly. There was acceptance of food fortification but uncertainty on how to balance food intake with supplementation. We were successful in eliciting views on KAPs around vitamin D from a community population including a large proportion of Black and Minority Ethnic individuals. The community wanted information and guidance to help manage individual vitamin D status, especially for high-risk groups, and on balancing supplementation, food fortification and sun exposure.

[This corrects the article DOI: 10.1371/journal.pone.0281172.].

The COVID-19 pandemic fundamentally changed the way services are delivered. Self-care, including good hygiene practices and avoidance of risk was emphasised as the key measure to tackle the pandemic in the early stages. To understand how self-reported professional attitudes, perceptions and practices of self-care have changed as a result of the COVID-19 pandemic. Cross-sectional online survey and semi-structured qualitative interview. Health care. 304 healthcare professionals (HCPs). A wide range of HCPs, including pharmacists, nurses, doctors, social prescribers and other designations took part in a 27-item anonymous online survey. Semi-structured qualitative interviews with nine healthcare professionals explored attitudes to and practices of self-care before and during the pandemic. Views were sought on the permanence and implications of changes. Data were analysed using routine statistics and thematic analysis to identify major themes. A total of 304 HCPs responded to the survey fully. Nine participated in a semi-structured interview. There was agreement that the importance of self-care has increased markedly during the pandemic. The percentage of respondents who felt that self-care was 'very' important to their clients increased from 54.3% to 86.6% since the pandemic. Personal empowerment and capacity of service users to self-care increased significantly during the pandemic. Willingness of patients to engage (74%) and poor understanding of self-care (71%) were cited as the two main barriers to self-care. A close third was digital exclusion (71%), though 86% of respondents recommended online resources and 77% the use of smartphone apps. Survey respondents believed the changes to be permanent and positive. Interviewees reported a major, and positive move to self-care with the pandemic seen as an opportunity to be grasped, but professional education would have to be aligned to make the most of it. They raised concerns as to whether the shift to self-care was perceived by users as 'abandonment' rather than 'empowerment' and whether problems had been stored rather than dealt with through self-care and therefore whether the positive changes would continue after the pandemic. Reporting their views before the pandemic, barely more than half of the professionals surveyed saw self-care as fundamentally important to the individuals they served. This changed to 86% as a result of the pandemic. Patient/client engagement with and understanding of self-care were reported as major barriers, as was digital exclusion, though increased technological solutions were used by all respondents. Concerns were raised that the permanence of the changes depended upon continued encouragement and empowerment of individuals to self-care and on its inclusion in professional education as a substantive subject.

In the context of a deepening global shortage of health workers and, in particular, the COVID-19 pandemic, there is growing international interest in, and use of, online symptom checkers (OSCs). However, the evidence surrounding the triage and diagnostic accuracy of these tools remains inconclusive. This systematic review aimed to summarize the existing peer-reviewed literature evaluating the triage accuracy (directing users to appropriate services based on their presenting symptoms) and diagnostic accuracy of OSCs aimed at lay users for general health concerns. Searches were conducted in MEDLINE, Embase, CINAHL, Health Management Information Consortium (HMIC), and Web of Science, as well as the citations of the studies selected for full-text screening. We included peer-reviewed studies published in English between January 1, 2010, and February 16, 2022, with a controlled and quantitative assessment of either or both triage and diagnostic accuracy of OSCs directed at lay users. We excluded tools supporting health care professionals, as well as disease- or specialty-specific OSCs. Screening and data extraction were carried out independently by 2 reviewers for each study. We performed a descriptive narrative synthesis. A total of 21,296 studies were identified, of which 14 (0.07%) were included. The included studies used clinical vignettes, medical records, or direct input by patients. Of the 14 studies, 6 (43%) reported on triage and diagnostic accuracy, 7 (50%) focused on triage accuracy, and 1 (7%) focused on diagnostic accuracy. These outcomes were assessed based on the diagnostic and triage recommendations attached to the vignette in the case of vignette studies or on those provided by nurses or general practitioners, including through face-to-face and telephone consultations. Both diagnostic accuracy and triage accuracy varied greatly among OSCs. Overall diagnostic accuracy was deemed to be low and was almost always lower than that of the comparator. Similarly, most of the studies (9/13, 69 %) showed suboptimal triage accuracy overall, with a few exceptions (4/13, 31%). The main variables affecting the levels of diagnostic and triage accuracy were the severity and urgency of the condition, the use of artificial intelligence algorithms, and demographic questions. However, the impact of each variable differed across tools and studies, making it difficult to draw any solid conclusions. All included studies had at least one area with unclear risk of bias according to the revised Quality Assessment of Diagnostic Accuracy Studies-2 tool. Although OSCs have potential to provide accessible and accurate health advice and triage recommendations to users, more research is needed to validate their triage and diagnostic accuracy before widescale adoption in community and health care settings. Future studies should aim to use a common methodology and agreed standard for evaluation to facilitate objective benchmarking and validation. PROSPERO CRD42020215210; https://tinyurl.com/3949zw83.

Background Reported cases of Domestic Violence and Abuse (DVA) have increased since the advent of the COVID-19 pandemic and ensuing lockdowns. Understanding the general public’s view about DVA is vital, as it would help develop targeted interventions and effective public policies to tackle this rising problem in society. Our qualitative study investigated the public awareness, attitudes and perceptions towards DVA, and explored mechanisms to tackle DVA in the community setting in the UK. Methods The research team conducted personal interviews with 29 community dwelling adults who responded to study invitations and adverts on social media. We used a topic guide to ensure consistency across the interviews, which were audio-recorded, transcribed and analysed thematically to detect emergent themes concerning DVA. Results All respondents were aware of the concept of abuse. Thirty-eight percent declared either having experienced DVA directly or that they knew someone close to being abused. More than half of the respondents were not aware of existing DVA supportive services in the UK. Overarching themes generated from the contextual analysis included contributing factors for DVA, challenges and barriers facing victims and proposals for future interventions. Conclusions Community dwelling adults have a good understanding of the impacts of DVA, but many fail to recognise specific instances or events in their daily lives contributing to DVA. Raising public awareness, particularly in children through the school curriculum, highlighting existing support services and introducing the routine use of short screening tools for DVA in health and social care settings can increase awareness, early identification and signposting to effective interventions. Sustained, multi-level community facing interventions are recommended to reduce stigma and fear associated with DVA.

Background The United Kingdom’s (UK) integration of Pre-exposure Prophylaxis (PrEP) into community pharmacies presents an alternative avenue for supporting Human Immunodeficiency Virus (HIV) prevention. Despite its effectiveness, PrEP's accessibility remains hindered by various barriers within community settings. The aim of this study was to explore the perspectives of pharmacy team members regarding the barriers and facilitators to the routine provision of PrEP in community pharmacies in the UK, as well as any recommendations for mitigating these challenges. Methods Exploratory mixed-method cross-sectional study utilising an online survey and semi-structured interviews with community pharmacists and non-pharmacist team members across the North Thames area of London, England. A convenience sample of 110 pharmacy team members participated in the study, including both pharmacists and non-pharmacists. Two pharmacy technicians and eight pharmacists took part in semi-structured interviews. Data collection involved a cross-sectional online survey and semi-structured interviews. The survey collected data such as demographic characteristics, knowledge, and attitudes towards PrEP provision, while interviews explored in-depth perceptions, experiences and recommendations. Results A significant proportion of respondents expressed a lack of confidence and knowledge regarding PrEP, with training identified as a critical need for facilitating PrEP provision. Additionally, the study highlighted the potential of community pharmacies to increase accessibility of PrEP due to their geographical reach and the trust placed in pharmacists. Conclusion The study demonstrates an interest from community pharmacies in London in providing a commissioned PrEP supply service. However, this would need to be in conjunction with training programmes and public health campaigns to equip community pharmacies for effective PrEP provision. Enhancing pharmacists' competencies and raising public awareness could significantly support the current HIV prevention strategies in the UK.

Background Despite advancements in HIV prevention, barriers and disparities in accessing Pre-exposure Prophylaxis (PrEP) from specialist services persist. Community pharmacies, with their extensive reach, offer an opportunity to reduce these disparities and help end new HIV infections. Objective This study aims to investigate the accessibility of HIV PrEP through community pharmacies and sexual health clinics (SHCs) across two London Integrated Care Systems (ICS) in the United Kingdom (UK). We also sought to assess the potential for community pharmacies to enhance access to PrEP and to address existing gaps in PrEP provision in the UK to gauge the potential for community pharmacies to facilitate easier access to PrEP. Methods We mapped the distribution of pharmacies, PrEP clinics, and SHCs across 11 local authority areas in London, covering North West London ICS and three catchment areas from North Central London ICS using publicly available data, including postcode data. Our selection process for sources of evidence was guided by a set of predefined criteria aimed at identifying community pharmacies and SHCs within the targeted ICSs for their relevance to HIV PrEP accessibility. Two reviewers systematically charted data from each included source. Information extracted included the name of the pharmacy or clinic, address, contact details and operating hours. Results Our data collection, spanning from April to July 2022, included 692 community pharmacies. The study revealed that 543 (78.5%) of these pharmacies offered sexual health services, with a significant proportion categorised at Tier 2 according to the Umbrella Sexual Health Model, indicating they are well-positioned to offer PrEP services. The mapping showed an uneven distribution of PrEP and sexual health clinics, with community pharmacies widely accessible and offering longer service hours. Conclusion The findings highlight the critical role community pharmacies could play in providing PrEP, addressing gaps in accessibility, and reducing HIV transmission risks, thus potentially facilitating easier access to PrEP. This study supports the need for policy adjustments to enable community pharmacies to dispense PrEP, aligning with public health goals for broader access to HIV preventative measures.

Background Almost all women will experience menopause, and the symptoms can have a severely detrimental impact on their quality of life. However, there is limited research exploring health-seeking behaviours and alternative service design or consultation formats. Group consultations have been successfully deployed in perinatal and diabetic care, improving accessibility and outcomes. This cross-sectional online survey was conducted to explore women’s personal experiences of menopause, including perspectives on group consultations. Methods An online survey investigated the experiences of individuals at all stages of menopause and their receptiveness towards group consultations for menopause. Respondents were categorised by menopause stage according to the STRAW + 10 staging system. Associations between menopause stage, acceptability of group consultations and participant demographics were assessed using logistic regression. Results Respondents experienced an average of 10.7 menopausal symptoms, but only 47% of respondents felt they had the knowledge and tools to manage their symptoms. Advice on menopause was sought from a healthcare professional (HCP) by 61% of respondents, the largest trigger for this being severity of symptoms and the main barrier for this was the perception that menopause wasn’t a valid enough reason to seek help. Of the respondents seeking advice from HCPs, 32% were prescribed transdermal HRT, 29% received oral HRT, 19% were offered antidepressants, 18% received local oestrogen and 6% were prescribed testosterone. Over three quarters (77%) of respondents indicated that they would join a group consultation for menopause and would be comfortable sharing their experiences with others (75%). Logistic regression indicated premenopausal respondents were 2.84 times more likely than postmenopausal women to be interested in a group consultation where they can meet or learn from others’ experiences. Conclusions This study highlighted a strong willingness of women aged 35–70 to participate in group consultations for menopause, with motivation being strongest amongst premenopausal women. Low awareness of self-management and lifestyle interventions to manage the symptoms of menopause highlight the need for greater outreach, research and interventions to build knowledge and confidence in the general population at scale. Future studies should focus on investigating the effectiveness and economic impact of menopause group consultations and the lived experience of individuals participating in group consultations.

ObjectiveInvestigate the impact of the COVID-19 lockdown on feelings of loneliness and social isolation in parents of school-age children.DesignCross-sectional online survey of parents of primary and secondary school-age children.SettingCommunity setting.Participants1214 parents of school-age children in the UK.MethodsAn online survey explored the impact of lockdown on the mental health of parents with school-age children, and in particular about feelings of social isolation and loneliness. Associations between the UCLA Three-Item Loneliness Scale (UCLATILS), the Direct Measure of Loneliness (DMOL) and the characteristics of the study participants were assessed using ordinal logistic regression models.Main outcome measuresSelf-reported measures of social isolation and loneliness using UCLATILS and DMOL.ResultsHalf of respondents felt they lacked companionship, 45% had feelings of being left out, 58% felt isolated and 46% felt lonely during the first 100 days of lockdown. The factors that were associated with higher levels of loneliness on UCLATILS were female gender, parenting a child with special needs, lack of a dedicated space for distance learning, disruption of sleep patterns and low levels of physical activity during the lockdown. Factors associated with a higher DMOL were female gender, single parenting, parenting a child with special needs, unemployment, low physical activity, lack of a dedicated study space and disruption of sleep patterns during the lockdown.ConclusionsThe COVID-19 lockdown has increased feelings of social isolation and loneliness among parents of school-age children. The sustained adoption of two modifiable health-seeking lifestyle behaviours (increased levels of physical activity and the maintenance of good sleep hygiene practices) wmay help reduce feelings of social isolation and loneliness during lockdown.

Background Workplace settings are linked to staff health and wellbeing, affecting sickness absence, presenteeism and productivity. With the growing prevalence of health issues among employees in the UK, including stress and long-term conditions, effective workplace health and wellbeing support by local government can play a crucial role in keeping people economically active and well. Objective Identify and characterise workplace health and wellbeing programmes offered by local authorities within the United Kingdom. Methods A scoping review involved a comprehensive search of Local Authority Districts (LADs) and county councils' websites followed by direct communications between 1 January 2024 and 30 April 2024. Initiatives were included if they were designed to enhance workplace health and wellbeing, actively ongoing and offered at no cost to workplaces. Data were extracted on the initiative name, provider, deprivation level, health focus, workplace eligibility and accreditation processes. Results The review identified 61 active local government workplace health programmes across the UK in March 2024, reflecting a 21% provision among local authorities. These initiatives were homogenous in focus, scope of coverage and implementation methods, with all focusing on general health. Geographical mapping highlighted regional disparities in the provision of workplace health and wellbeing initiatives that are free at the point of access (WHISPAs). England had a higher number (Central, Southern, and Southeastern regions specifically) while the rest of England, Wales, Scotland and North Ireland had a lower number or no WHISPAs. Conclusion There is a need for more coordinated efforts to increase the visibility and accessibility of local government workplace health initiatives that are free at the point of access. National workplace health accreditation could further encourage employers to adopt health and wellbeing programmes.