Literature Collection

The unmet need for mental health care continues to rise across the world. This article synthesizes the evidence supporting the components of a hypothetical model of integrated digital mental health care to meet population-wide mental health needs. This proposed model integrates two approaches to broadening timely access to effective care: integrated, primary care-based mental health services and digital mental health tools. The model solves for several of the key challenges historically faced by digital health, through promoting digital literacy and access, the curation of evidence-based digital tools, integration into clinical practice, and electronic medical record integration. This model builds upon momentum toward the integration of mental health services within primary care and aligns with the principles of the Collaborative Care Model. Finally, the authors present the major next steps toward implementation of integrated digital mental health care at scale.

AIMS: To examine the effects of integrated health education programmes with physical activity among community-dwelling older adults at risk of atherosclerotic cardiovascular disease (ASCVD). DESIGN: Integrative review. DATA SOURCES: A systematic search of experimental studies was conducted in six electronic databases and one registry from inception to December 2022. METHODS: Two researchers independently conducted the eligibility screening, quality appraisal and data extraction. A total of 11 studies, which were published between 1996 and 2021, were included in the review and were analysed by narrative synthesis. RESULTS: The 11 included studies involved 1973 participants. The findings indicate that integrated health education programmes with physical activity have potential benefit in short-term weight management among community-dwelling older adults at risk of ASCVD. Nevertheless, the programmes appear ineffective on body mass index, short-term lipid profiles, diastolic blood pressure (BP) and blood glucose. Further investigation is recommended to confirm the programme effects on physical activity level, exercise self-efficacy, systolic BP, waist circumference, long-term lipid profiles, long-term weight management and cardiac endurance. The findings suggest that body mass index may not be a sensitive indicator of obesity in the elderly population and should be measured along with waist circumference to better predict the risk of ASCVD. The available evidence is restricted in its robustness and generalisability. As most included studies were conducted in the United States, more studies should be implemented in other countries to enhance study generalisability. CONCLUSIONS: The effects of integrated health education programmes with physical activity among community-dwelling older adults at risk of ASCVD remain inconclusive. Further research with adequate statistical power and good methodology is warranted. IMPACT: The findings provide insights into whether health education programmes with physical activity effectively improve various outcomes, and suggest that researchers should include exercise self-efficacy and cardiac endurance in future studies. REPORTING METHOD: Adhered to PRISMA reporting guidelines. NO PATIENT OR PUBLIC CONTRIBUTION: This review was conducted without patient or public participation.

BACKGROUND AND OBJECTIVES: Migrant families have reduced access to universal child and family health (CFH) services, including CFH nursing visits, wherein infant and maternal surveillance offers a key opportunity to identify maternal health and child developmental concerns. Evidence is emerging on the effectiveness of integrated health and social care hubs (Hubs) to improve access to CFH services. Our aim was to evaluate the impact of Hubs at 2 sites in Sydney, Australia for migrant women and their infants on attendance to CFH nursing visits until 12 months postpartum for infant and maternal surveillance. METHODS: We conducted a nonrandomized trial to compare Hubs (intervention) with routine CFH nursing services (control). Pregnant and/or recently birthed migrant women were allocated to Hubs (n = 119) or routine care (n = 120), with allocation based on residential proximity to the Hubs. Mothers and their infants were followed until the child was aged 12 months. RESULTS: Compared with routine care, the Hub group demonstrated a more than 4-fold higher rate of attendance at CFH nursing visits (12-month visit: adjusted relative risk, 4.68; 95% CI, 2.48-8.84) and a 2-fold increase in completion of maternal postnatal depression and psychosocial surveillance at visits. There was no difference in completion of infant surveillance between Hubs and routine care at visits. CONCLUSIONS: There was a significant improvement in attendance of CFH nursing visits for migrant women and their infants attending Hubs compared with routine CFH nursing services. Completion of maternal surveillance was higher in Hubs. Hubs are important service models to be considered when addressing disparities in access to CFH nursing services for migrant communities.

Integrated healthcare models combining behavioral and primary care provide solutions for vulnerable pediatric populations, especially youth in foster care, facing disproportionately high rates of chronic conditions and mental health issues. This review synthesizes current literature to assess the impact of integrated care on health outcomes for youth in foster care. Findings suggest integrated care can reduce healthcare barriers, improve coordination, and improve health outcomes for these youth. However, literature gaps indicate a need for more research. Clinical practice implications include adopting coordinated, multidisciplinary care. Future research should standardize definitions and approaches to support the sustainability of these care models.