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Background Premarital screening is a preventive public health measure to identify genetic, infectious, and chronic conditions affecting the health of couples and their future offspring. It plays a crucial role in reducing the prevalence of common hereditary disorders, particularly in regions with high consanguinity rates, like the Middle East. In the United Arab Emirates, where approximately half of the marriages are consanguineous, premarital screening has become a cornerstone of genetic healthcare, helping to mitigate the increased risk of genetic disorders. Despite its importance, gaps remain in healthcare professionals’ awareness and training regarding the implementation of premarital genetic screening, highlighting the need for educational interventions to ensure its effective integration into routine practice. This study evaluates the knowledge enhancement and attitude shift among physicians participating in health education workshops on expanded premarital screening, addressing gaps in their awareness, training, and perspectives on its implementation and ethical considerations. Results A cross-sectional study was conducted between May 2023 and June 2024 among physicians participating in three premarital genetic screening workshops. Differences in knowledge scores before and after the training were assessed using paired t-tests. The study surveyed 60 physicians, predominantly females (85%) and Emiratis (67%). Only 25% received formal training or education on premarital genetic screening. The study observed a significant increase in knowledge scores after the workshop, with overall scores rising from a mean of 45% (SD = 15) to 77% (SD = 12), showing a mean difference of 32% ( p  < 0.001). This improvement was significant across different age groups, genders, and regardless of prior formal training. While the belief that expanded premarital screening should be obligatory decreased (90% to 76%), the proportion of physicians who strongly disagreed that it breaks personal privacy increased significantly (10% to 42%). Conclusion These findings suggest that targeted educational interventions can significantly enhance healthcare professionals’ knowledge and attitudes regarding genetic screening practices. To maximize impact, these interventions should be sustainable and reinforced through regular refresher courses. Continuous education ensures that physicians remain updated on the latest guidelines, advancements in genetic screening, and best practices, ultimately improving the quality of patient care and counseling services.

Postpartum depression (PPD) affects up to one in five mothers and birthing parents, yet as few as 10% access evidence-based treatment. One-day cognitive behavioral therapy (CBT)-based workshops for PPD have the potential to reach large numbers of sufferers and be integrated into stepped models of care. This randomized controlled trial of 461 mothers and birthing parents in Ontario, Canada with Edinburgh Postnatal Depression Scale (EPDS) scores ⩾10, age ⩾18 years, and an infant <12 months of age compared the effects of a 1-day CBT-based workshop plus treatment as usual (TAU; i.e. care from any provider(s) they wished) to TAU alone at 12-weeks post-intervention on PPD, anxiety, the mother-infant relationship, offspring behavior, health-related quality of life, and cost-effectiveness. Data were collected via REDCap. Workshops led to meaningful reductions in EPDS scores ( = 15.77 to 11.22; = -4.6, < 0.01) and were associated with three times higher odds of a clinically significant decrease in PPD [odds ratio (OR) 3.00, 95% confidence interval (CI) 1.93-4.67]. Anxiety also decreased and participants had three times the odds of clinically significant improvement (OR 3.20, 95% CI 2.03-5.04). Participants reported improvements in mother-infant bonding, infant-focused rejection and anger, and effortful control in their toddlers. The workshop plus TAU achieved similar quality-adjusted life-years at lower costs than TAU alone. One-day CBT-based workshops for PPD can lead to improvements in depression, anxiety, and the mother-infant relationship and are cost-saving. This intervention could represent a perinatal-specific option that can treat larger numbers of individuals and be integrated into stepped care approaches at reasonable cost.

Mental health concerns are increasing for postsecondary students and often exceed supportive capacity. Research highlights the importance of mental health literacy (MHL) training for educators; few studies have evaluated a program designed to improve it. The purpose was to assess the impact of a two-session, virtual workshop offered 10 weeks apart for postsecondary educators on MHL and self-efficacy to recommend mental health resources to students. Content was co-created and delivered in collaboration with the university’s Student Health and Wellness department. Validated questionnaires were used to assess MHL, self-efficacy, and psychological well-being before and after each session. Open-ended questions were posed following the second session to explore experiences. Educators at the host institution who did not enrol were invited to complete the same quantitative measures to serve as comparative data. Seven participants attended both workshops and were included in the analysis. Scores for MHL and self-efficacy increased following each session and were highest following the second, revealing medium and large effect sizes, respectively. Post-workshop MHL and self-efficacy scores were higher for workshop attendees compared to their institutional counterparts (n = 28). Positive experiences (e.g. group camaraderie, improved empathy and understanding, workshop utility) were noted qualitatively. Findings suggest that this type of virtual workshop may be valuable for equipping educators with knowledge and self-efficacy to enhance student mental health. Postsecondary wellness centre partnerships should be considered to facilitate reach of mental health education and resources. Involving educators who have direct contact with students can foster a whole campus approach to mental health.

Background Midwifery plays a vital role in the quality of care as well as rapid and sustained reductions in maternal and newborn mortality. Like most other sub-Saharan African countries, the Democratic Republic of Congo experiences shortages and inequitable distribution of health workers, particularly in rural areas and fragile settings. The aim of this study was to identify strategies that can help to attract, support and retain midwives in the fragile and rural Ituri province. Methods A qualitative participatory research design, through a workshop methodology, was used in this study. Participatory workshops were held in Bunia, Aru and Adja health districts in Ituri Province with provincial, district and facility managers, midwives and nurses, and non-governmental organisation, church medical coordination and nursing school representatives. In these workshops, data on the availability and distribution of midwives as well as their experiences in providing midwifery services were presented and discussed, followed by the development of strategies to attract, retain and support midwives. The workshops were digitally recorded, transcribed and thematically analysed using NVivo 12. Results The study revealed that participants acknowledged that most of the policies in relation to rural attraction and retention of health workers were not implemented, whilst a few have been partially put in place. Key strategies embedded in the realities of the rural fragile Ituri province were proposed, including organising midwifery training in nursing schools located in rural areas; recruiting students from rural areas; encouraging communities to use health services and thus generate more income; lobbying non-governmental organisations and churches to support the improvement of midwives’ living and working conditions; and integrating traditional birth attendants in health facilities. Contextual solutions were proposed to overcome challenges. Conclusion Midwives are key skilled birth attendants managing maternal and newborn healthcare in rural areas. Ensuring their availability through effective attraction and retention strategies is essential in fragile and rural settings. This participatory approach through a workshop methodology that engages different stakeholders and builds on available data, can promote learning health systems and develop pragmatic strategies for the attraction and retention of health workers in fragile remote and rural settings.

Background/Aim With the pharmaceutical innovation and clinical knowledge updating, the continuing education and on-the-job training are extremely important for improving community pharmacists’ professional competence. Previous training often adopted traditional lecture-based teaching, and the efficacy was limited. The aim of this study is to develop a new strategy for community pharmacist training. Methods Based on the BOPPPS (Bridge-in, Objective, Pre-assessment, Participatory Learning, Post-assessment and Summary) teaching model and workshop method, a continuing on-the-job training program was constructed. Participates were randomly and evenly divided into two groups by random number table method. Twenty-four community pharmacists in total completed all training contents and evaluation components in this study. Twelve pharmacists in experimental group were trained via this new BOPPPS-based workshop, while others still adopted traditional didactic lecture-based approaches. Results After training, quantitative examination combined with clinical pharmacy practice tests were carried out to evaluate the effectiveness and outcomes of two training groups. For written exam, the total scores from the BOPPPS-based workshop group (82.67 ± 4.70) was higher than that of traditional lectured-base group (73.75 ± 6.15) ( P  < 0.001). Encouragingly, compared with the results of practical ability assessment from traditional training group (71.75 ± 4.75), the pharmacists receiving BOPPPS-based workshop training presented more excellent performance (78.25 ± 5.03), which displayed statistically significant differences ( P  < 0.01). In addition, an anonymous questionnaire was used to survey trainees’ feelings after completing this continuing education program. The results revealed that the BOPPPS-based workshop can bring a better learning experience than traditional lecture-based training, and the percentages of positive response to each item were more than 91.7%. Conclusions Through multi-dimensional evaluation, it was suggested that our BOPPPS-based workshop achieved desired training effects. Moreover, our research also demonstrated that this strategy had advantages of stimulating inspiration, autonomous learning, team-work spirit and pharmacy practice improvement. It may provide a reference of innovative training method for community pharmacists.

The NORDeHEALTH project studies patient-accessible electronic health records (PAEHRs) in Estonia, Finland, Norway, and Sweden. Such country comparisons require an analysis of the sociotechnical context of these services. Although sociotechnical analyses of PAEHR services have been carried out in the past, a framework specifically tailored to in-depth cross-country analysis has not been developed. This study aims to develop and evaluate a method for a sociotechnical analysis of PAEHRs that advances a framework for sociotechnical analysis of eHealth solutions first presented by Sittig and Singh. This first article in a series presents the development of the method and a cross-country comparison of the contextual factors that enable PAEHR access and use. The dimensions of the framework for sociotechnical analysis were thoroughly discussed and extended in a series of workshops with international stakeholders, all being eHealth researchers focusing on PAEHRs. All countries were represented in the working group to make sure that important national perspectives were covered. A spreadsheet with relevant questions related to the studied services and the various dimensions of the sociotechnical framework was constructed and distributed to the 4 participating countries, and the project participants researched various national sources to provide the relevant data for the comparisons in the 10 sociotechnical dimensions. In total, 3 dimensions were added to the methodology of Sittig and Singh to separate clinical content from features and functions of PAEHRs and demonstrate basic characteristics of the different countries regarding national and regional steering of health care and information and communications technology developments. The final framework contained the following dimensions: metadata; hardware and software computing infrastructure; features and functions; clinical content shared with patients; human-computer interface; people; workflow and communication; the health care organization's internal policies, procedures, and culture; national rules, regulations, and incentives; system measurement and monitoring; and health care system context. The dimensions added during the study mostly concerned background information needed for cross-country comparisons in particular. Several similarities were identified among the compared countries, especially regarding hardware and software computing infrastructure. All countries had, for example, one national access point, and patients are provided a PAEHR automatically. Most of the differences could be identified in the health care system context dimension. One important difference concerned the governing of information and communications technology development, where different levels (state, region, and municipality) were responsible in different countries. This is the first large-scale international sociotechnical analysis of services for patients to access their electronic health records; this study compared services in Estonia, Finland, Norway, and Sweden. A methodology for such an analysis was developed and is presented to enable comparison studies in other national contexts to enable future implementations and evaluations of PAEHRs.

Background Health literacy is the single best predictor of an individual’s health status. It is important to customize health-related education material to the individual patient’s level of reading skills. Readability of a given text is the objective measurement of the reading skills one should possess to understand the written material. Questions/purposes In this article, some of the commonly used readability assessment tools are discussed and guidelines to improve the comprehension of patient education handouts are provided. Where are we now? Several healthcare organizations have recommended the readability of patient education materials be no higher than sixth- to eighth-grade level. However, most of the patient education materials currently available on major orthopaedic Web sites are written at a reading level that may be too advanced for comprehension by a substantial proportion of the population. Where do we need to go? There are several readily available and validated tools for assessing the readability of written materials. While use of audiovisual aids such as video clips, line drawings, models, and charts can enhance the comprehension of a health-related topic, standard readability tools cannot construe such enhancements. How do we get there? Given the variability in the capacity to comprehend health-related materials among individuals seeking orthopaedic care, stratifying the contents of patient education materials at different levels of complexity will likely improve health literacy and enhance patient-centered communication.

Despite the high health and mental health care needs, resettled refugees often face cultural and linguistic challenges that hinder the access to appropriate and timely interventions and services. Additionally, such concepts as preventive health or mental health treatment are foreign to this population, which creates additional burdens to the refugee community that already have difficulty navigating a complex health care system in the U.S. To address multiple and complex gaps in health and mental health support for the refugee community, requested is an innovative approach that can convey culturally responsive and effective interventions for health promotion, such as peerbased health education. Few studies have been conducted on the effectiveness of peer-led community health interventions with refugee populations in the U.S. resettlement context. However, peer-led interventions have been shown to be effective when working with cultural minorities and interventions in an international context. Adopting a social capital framework, the current study conducted qualitative evaluation on the impact of a pilot peer-led community health workshop (CHW) in the Bhutanese refugee community. A hybrid thematic analysis of focus group discussion data revealed the improvement in health promotion outcomes and health practice, as well as perceived emotional health. The results also showed that the peer-led CHW provided a platform of community building and participation, while increasing a sense of community, sense of belonging and unity. The findings posit that a peer-led intervention model provides culturally responsive and effective tools for building social capital and promoting community health in the refugee community.

Background Health systems face complex and multifaceted challenges that require health professionals (including clinicians, nurses and other health workers) to be equipped with entrepreneurship and innovation (E&I) competencies. However, the integration of E&I training within health university curricula remains largely underexplored across different countries and educational contexts. This study aimed to identify core E&I competencies and aligned training needs for future health professionals through a structured, multi-stakeholder approach. Methods Shaped within a value-focused thinking framework (systematically linking competencies as end goals with educational topics as means to achieve competencies), the study comprised three stages: (1) a scoping review (ScR) combined with qualitative content analysis (QCA) to identify and categorise E&I competencies and course topics documented in literature, alongside a value-driven competencies-topics relevance matrix; (2) a 3-round web-Delphi process involving a diverse panel of health stakeholders who validated and refined competencies and course topics lists (presented as pre-built thematic maps within the web-Delphi platform), and assessed course topics’ relevance for developing specific E&I competencies; (3) a facilitated virtual workshop to discuss Delphi results and implications for higher education. Results The ScR included twenty-nine studies. QCA of these studies produced initial lists of 28 competencies (grouped into five E&I domains of competency) and 34 course topics, organized into thematic maps. Through the responses of 29 Delphi participants, these lists were expanded to a final set of 51 competencies and 55 competency-aligned course topics. Participants rated 91% of topics as at least strongly relevant for developing the respective E&I domain of competency. The workshop provided insights on implementing formal E&I training within health education curricula, with specific reference to the Portuguese context. Conclusions Results provide educational institutions with a practical starting point for reflecting on and designing profession-specific E&I courses and enhancing existing graduate programs through targeted E&I competency integration. Findings have significant implications for health workforce education and planning, particularly in promoting competency-driven E&I curricula to enhance professionals’ readiness for current and future healthcare system challenges. This study presents an innovative multi-stakeholder collaborative approach for mapping E&I competencies and aligned topics for training health professionals.

Coronavirus Disease 2019 (COVID-19) and the social justice movement in early 2020 awakened many Americans to the health disparities and health care inequities affecting Black communities. This heightened awareness has strengthened the call to address social determinants of health, like racism. Physicians can play an important role in dismantling racism through knowledge of implicit biases and understanding of historical trauma resulting in medical distrust as a crucial step to help advance the health of minority communities. The purpose of this project was to develop an anti-racism workshop for Graduate Medical Education. Two discussants led 1.5-hour interactive workshops. Content covered microagressions, colorblindness, tokenism, stereotypes, levels of racism, the impact of racism on health, and anti-racism concepts. Facilitated breakout sessions allowed participants to provide examples of witnessed racism and discuss application of anti-racism tools in those settings. Following the workshops, participants were asked to complete a 16-item survey to evaluate workshop effectiveness. Between July and August 2020, four workshops were delivered to 131 attendees. Fifty-nine completed post workshop surveys. Most respondents were White (75%), female (63%), and aged 31-40 (29%). Over half were faculty; 24% were residents, 8% fellows. The majority agreed they could apply knowledge to their work (95%) and found the workshop useful (95%). Over two-thirds reported being able to better identify disparities and better identify and communicate about racism. In open-ended questions, many participants requested an interactive longitudinal curriculum. Developing an antiracism workshop for an academic medical center located in the Deep South provided more insight into tangible next steps to foster an institutional culture centered on antiracism.