Literature Collection

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.

OBJECTIVE: To examine the associations between unhealthy alcohol use and risk of coronary heart disease (CHD) among women and men aged 18-65 years. METHODS: An observational study in an integrated healthcare system with systematic alcohol screening. We identified 432,265 primary care patients aged 18-65 years who, in 2014-2015, reported weekly alcohol intake levels. Weekly alcohol intake, categorized into below (≤14/week men; ≤7/week women) and above limits (≥15/week men; ≥ 8/week women) per U.S. guidelines, and heavy episodic drinking (HED, ≥5/≥4 drinks any day in past 3 months for men/women, respectively). Main outcome was CHD during 4-year follow-up, based on inpatient ICD diagnoses of myocardial infarction and CHD. Cox proportional hazards models adjusted for age, sex, race/ethnicity, body mass index, physical activity, smoking, hypertension, diabetes, and hyperlipidemia. RESULTS: The cohort comprised 44 % women, mean age (standard deviation) of 43.5 years (±13.1). Weekly alcohol intake above limits was associated with higher prevalence of cardiovascular risk factors, and a 26 %, 19 % and 43 % higher risk on the overall, men- and women-specific risk of CHD after adjusting for these risk factors (hazard ratio [95 % confidence interval] = 1.26[1.13 -1.40], 1.19[1.04-1.35] and 1.43[1.20-1.71], respectively). CONCLUSIONS: In a large, real-world, diverse population with a systematic alcohol screening program, having weekly alcohol intake above limits was associated with increased risk of CHD among young and middle-aged men and women. Increased CHD risk due to alcohol intake above limits warrants particular awareness and interventions.