Literature Collection

AIM: This research aimed to explore the perspectives of primary and community care providers on the challenges that hinder the delivery and uptake of personalized type 2 diabetes (T2D) care, with a focus on the integration of mental health support and care. BACKGROUND: The day-to-day burden and demand of self-managing T2D can negatively impact quality of life and take a toll on mental health and psychological well-being. As a result, there is a need for personalized T2D self-management education and support that integrates mental health care. Despite the need for this personalized care, existing systems remain siloed, hindering access and uptake. In response, innovative, comprehensive, and collaborative models of care have been developed to address fragmentations in care. As individuals living with T2D often receive their care in primary care settings, linking mental health care to existing teams and networks in primary care settings is required. However, there is a need to understand how best to support access, adoption, and engagement with these models in these unique contexts. METHODS: A cross-sectional survey was distributed to primary and community providers of an Ontario-based smoking cessation network. Survey data were analyzed descriptively with free text responses thematically reported. FINDINGS: Survey respondents (n = 85) represented a broad mix of health professions across primary and community care settings. Addressing challenges to the delivery and uptake of personalized T2D care requires comprehensive strategies to address patient-, practice-, and system-level challenges. Findings from this survey identify the need to tailor these models of care to individual needs, clearly addressing mental health needs, and building strong partnership as means of enhancing accessibility and sustainability of integrated care delivery in primary care settings.

Culture, tradition, structural violence, and mental health-related stigma play a major role in global mental health for refugees. Our aim was to understand what factors determine the success or failure of community-based psychotherapy for trauma-affected refugees and discuss implications for primary health care programs. Using a systematic realist-informed approach, we searched five databases from 2000 to 2018. Two reviewers independently selected RCTs for inclusion, and we contacted authors to obtain therapy training manuals. Fifteen articles and 11 training manuals met our inclusion criteria. Factors that improved symptoms of depression, anxiety, and PTSD included providing culturally adapted care in a migrant-sensitive setting, giving a role to other clinical staff (task-shifting), and intervention intensity. Precarious asylum status, constraining program monitoring requirements, and diverse socio-cultural and gender needs within a setting may reduce the effectiveness of the program. Primary care programs may enable community based mental health care and may reduce mental health-related stigma for refugees and other migrants. More research is needed on the cultural constructs of distress, programs delivered in primary care, and the role of cultural and language interpretation services in mental health care.

BACKGROUND: The postpartum period represents a critical period for both birthing and nonbirthing parents due to mental health concerns and new caregiving demands. Collaborative care models aim to address these needs, but postpartum care remains fragmented, lacking continuity and holistic support. Baby2Home (B2H) is a digital intervention rooted in the collaborative care model, specifically designed to support parents through their transition into parenthood by addressing their physical, emotional, and psychosocial needs. This intervention seeks to close the gaps left by traditional care models by providing continuous, organized, and accessible support throughout the postpartum period. In our qualitative study of the B2H intervention, we reference the parallel journeys framework and use it as a part of our analysis to evaluate whether mobile health (mHealth) technology addresses the holistic needs (postpartum and psychosocial) of new parents. OBJECTIVE: We aimed to assess how the B2H app supports the holistic needs of new parents and addresses care gaps identified in traditional postpartum services. METHODS: We conducted semistructured interviews with 20 birthing and nonbirthing parents selected through purposive sampling based on their app use. Data were analyzed using the postpartum parallel journeys framework and inductive coding. RESULTS: Our findings demonstrate the comprehensive impact of the B2H intervention in addressing both the physical and psychosocial needs of new parents. B2H supported postpartum care by helping parents navigate uncertainties, enhancing health care provider-parent communication, promoting self-care, and increasing parental self-efficacy. Psychosocial support included symptom identification, timely care manager assessments, coordinated treatment, and transition resources. The app also addressed care gaps by promoting inclusivity for nonbirthing parents, bridging screening and treatment, supporting real-time treatment navigation, and ensuring continuity of care. CONCLUSIONS: We demonstrate that the use of mHealth technology such as the B2H app can effectively support the multifaceted needs of new parents during their postpartum care period. By applying the parallel journeys framework, the research also identifies gaps in care that are addressed by the B2H app, presenting unique opportunities for future development and research.

BACKGROUND: The Sparkbrook Children's Zone is an example of a place-based integrated health and social care service developed to support children and young people living in marginalized populations in the United Kingdom. This model of care is expected to address both clinical need and the social determinants of health but evidence of the practical support needed is lacking. OBJECTIVE: To understand the infrastructural challenges of providing a service combining clinical and non-clinical staff from a range of organisations and settings. METHODS: A qualitative exploration of the experiences of staff delivering the service and used a directed content analysis to present the results within the Sustainable integrated chronic care model for multi-morbidity: delivery, financing, and performance (SELFIE) framework. RESULTS: A total of 14 staff were interviewed including clinicians, social care providers, local voluntary groups, and school-based family mentors. Participants described the gap between system-level integration and the lack of practical support for delivering a unified service on the ground; the training opportunities afforded by collocation; the complexity of securing staff from multiple employers using various funding sources; and the need for lengthier evaluations that extend beyond early instability. CONCLUSIONS: Despite decades of structural reform aimed at integrating the health and social care system in the UK, there was a surprising lack of practicable support for delivering a place-based integrated health and social care service. Their delivery is also hindered by short-term funding cycles limiting the reliability of evidence gathered from complex and evolving services.

BACKGROUND: The UK's National Health Service has provided funds for developing localized services integrating health and social care intended to address the health inequities prevalent in children and young people living in marginalized communities. However, little is understood of the factors that influence their design and delivery, nor which combined health and social care models are most effective. OBJECTIVE: To use evidence drawn from staff delivering a collocated integrated health and social support service for children, also known as the Sparkbrook Children's Zone, to inform similar care offers. METHODS: A qualitative exploration of staff experience using a directed content analysis to populate and present the results within the Sustainable integrated chronic care model for multi-morbidity: delivery, financing, and performance (SELFIE) framework. The analysis presented here focusses on the domain of Service delivery, predominantly relating to the content and access of care. RESULTS: A total of 14 staff were interviewed: clinicians from primary and secondary care, social care providers, local voluntary groups, and school-based family mentors. Participants described at the Micro- level how the service increased engagement of families and facilitated referral to social support and preventive care; at a Meso- level the benefits of collocation, collaborative working, and community outreach and at the Macro level, improvements to the access and availability of appropriate care. CONCLUSIONS: The pilot appeared to deliver multiple benefits for both patients and staff particularly through collocating health care and social support. However, sustainable integrated health and social care requires greater institutional commitment and leadership.

BACKGROUND: The Social Prescribing Link Worker (SPLW) approach is a means for supporting individuals and communities with diverse needs, with its reach and impact widely recognised in health and community systems. However, SPLW support for people with long-term physical and mental health conditions (P + MH LTCs) has been variable and there are knowledge gaps such as unheard voices of those with a varied engagement in SPLW support. We undertook a study to better understand the potential relevance of SPLW support for addressing the needs of individuals with P + MH LTCs. Its aim was to explore a range of health and psychosocial needs of people living with P + MH LTCs and to examine perspectives on how the SPLW role supports the complex needs of this group. METHODS: A qualitative study utilising one-to-one semi-structured interviews with community dwelling adults (aged ≥ 18 years old) living with P + MH LTCs with diverse socio-demographic and clinical characteristics. Research was informed by a Patient and Public Involvement and Engagement (PPIE) group for meaningful and inclusive research activities, and qualitative data were analysed using a Framework Method. RESULTS: Analysis revealed five themes and sixteen sub-themes that collectively demonstrate the complex and shifting experience of living with P + MH LTCs. This population dealt with competing multi-layered needs, and felt that the potential role of SPLW support to mitigate some of the unmet demands of this group was not effectively carried out in practice. This meant that potential benefits were often missed. CONCLUSIONS: Our findings demonstrate that this population is experiencing a substantial impact on health and wellbeing, and that there is an urgent need for integrated health and care systems that are complemented by consistent, coordinated and skilled SPLW support. Lessons learnt in this research provide new evidence and suggest directions for further research. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-025-02990-z.

Craniofacial conditions often require extensive medical care and surgeries throughout childhood and adolescence. However, there is limited research investigating the psychological effects of craniofacial care, including risks for medical traumatic stress. This cross-sectional study investigated the medical care experiences of adults with craniofacial conditions, including the frequency of potentially traumatic medical events, post-traumatic stress disorder (PTSD) symptoms, and resilience. Participants (N=34; mean age 35.2 ± 12.2 y; 71% female) were recruited at 3 US pediatric hospitals and craniofacial support organizations. Participants completed the PTSD Checklist (PCL-5), Connor-Davidson Resilience Scale, the Craniofacial Experiences Questionnaire, and open-ended questions about their medical care experiences. Most participants reported experiencing potentially traumatic medical experiences, such as prolonged and/or painful dental (79%) and medical treatments (73%) and hospitalization in the intensive care unit (70%). On the PCL-5, 21% met the criteria for PTSD, which is similar to other medical populations and higher than the 6% rate of PTSD in the general US population. Participants reported both stressors and positive aspects related to living with a craniofacial condition; however, resilience scores were lower relative to a US community sample. Qualitative analysis of open-ended responses identified themes including interactions with providers, medical treatment experiences, and psychosocial impacts. Adults with craniofacial conditions appear to be vulnerable to post-traumatic stress symptoms related to their medical care experiences, and report reduced resilience relative to community samples. Implications for clinical care and research include the integration of trauma-informed care approaches and strategies to support coping and resilience across the lifespan.

INTRODUCTION: The COVID-19 pandemic has instigated the development of telemedicine-mediated provision of medications for opioid use disorder such as buprenorphine and methadone, referred to as TMOUD in this study. As services start to return to pre-pandemic norms, there is a debate around the role of TMOUD as addition to or replacement of the conventional cascade of care for people with opioid use disorder (PWOUD). This scoping review is designed to characterize existing TMOUD services and provide insights to enable a more nuanced discussion on the role of telemedicine in the care of PWOUD. METHODS: The literature search was conducted in OVID Medline, CINAHL, and PsycINFO, from inception up to and including April 2023, using the Joanna Briggs Institute methodology for scoping reviews. The review considered any study design that detailed sufficient descriptive information on a given TMOUD service. A data extraction form was developed to collect and categorize a range of descriptive characteristics of each discrete TMOUD model identified from the obtained articles. RESULTS: A total of 45 articles met the inclusion criteria, and from this, 40 discrete TMOUD services were identified. In total, 33 services were US-based, three from Canada, and one each from India, Ireland, the UK, and Norway. Through a detailed analysis of TMOUD service characteristics, four models of care were identified. These were TMOUD to facilitate inclusion health, to facilitate transitions in care, to meet complex healthcare needs, and to maintain opioid use disorder (OUD) service resilience. CONCLUSIONS: Characterizing TMOUD according to its functional benefits to PWOUD and OUD services will help support evidence-based policy and practice. Additionally, particular attention is given to how digital exclusion of PWOUD can be mitigated against.