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Abstract Introduction Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation.

Big data refers to extremely large data generated at high volume, velocity, variety, and veracity. The nurse scientist is uniquely positioned to leverage big data to suggest novel hypotheses on patient care and the healthcare system. The purpose of this paper is to provide an introductory guide to understanding the use and capability of big data for nurse scientists. Herein, we discuss the practical, ethical, social, and educational implications of using big data in nursing research. Some practical challenges with the use of big data include data accessibility, data quality, missing data, variable data standards, fragmentation of health data, and software considerations. Opposing ethical positions arise with the use of big data, and arguments for and against the use of big data are underpinned by concerns about confidentiality, anonymity, and autonomy. The use of big data has health equity dimensions and addressing equity in data is an ethical imperative. There is a need to incorporate competencies needed to leverage big data for nursing research into advanced nursing educational curricula. Nursing science has a great opportunity to evolve and embrace the potential of big data. Nurse scientists should not be spectators but collaborators and drivers of policy change to better leverage and harness the potential of big data. [ABSTRACT FROM AUTHOR]

Introduction: Poor communication is a leading root cause of preventable maternal mortality in the United States. Communication challenges are compounded with the presence of biases, including racism. Hospital administrators and clinicians are often aware that communication is a problem, but understanding where to intervene can be difficult to determine. While clinical leadership routinely reviews incident reports and acts on them to improve care, we hypothesized that reviewing incident reports in a systematic way might reveal thematic patterns, providing targeted opportunities to improve communication in direct interaction with patients and within the healthcare team itself. Methods: We abstracted incident reports from the Women's Health service and linked them with patient charts to join patient's race/ethnicity, birth outcome, and presence of maternal morbidity and mortality to the incident report. We conducted a qualitative content analysis of incident reports using an inductive and deductive approach to categorizing communication challenges. We then described the intersection of different types of communication challenges with patient race/ethnicity and morbidity outcomes. Results: The use of incident reports to conduct research on communication was new for the health system. Conversations with health system‐level stakeholders were important to determine the best way to manage data. We developed a thematic codebook based on prior research in healthcare communication. We found that we needed to add codes that were equity focused, as this was missing from the existing codebook. We also found that clinical and contextual expertise was necessary for conducting the analysis—requiring more resources to conduct coding than initially estimated. We shared our findings back with leadership iteratively during the work. Conclusions: Incident reports represent a promising source of health system data for rapid improvement to transform organizational practice around communication. There are barriers to conducting this work in a rapid manner, however, that require further iteration and innovation. [ABSTRACT FROM AUTHOR]

As the United States' population grows via migration and immigration, with this rise in diverse identities, there has been increasing concern regarding disparities for undocumented immigrants living in the U.S. with limited access to the health system. Given the various constraints involving communication and social structures that undocumented immigrants face, a culture-centered approach is drawn on to investigating how this group goes about navigating a dominant health system given their restricted access. I explore co-constructed themes that emerged through conversations with undocumented immigrants, (people without papers as I call them in this work) living in the United States to gain an understanding as to the structural and cultural limitations faced by this group. By doing qualitative semi-structured interviews with local participants living in the South Florida region, I describe the various features of a complex U.S. health system that undocumented immigrants (people without papers) deemed as important obstacles that limit their willingness to interact with official medical spaces. This work draws on narratives and accounts to shed light on the intersection of disparities this group has to overcome in order to consider entering a medical space to receive the treatment they might need. The findings of this article highlighted the structural violence that certain subaltern groups, such as people without papers experience due to their limited access to foundational systems in their environment. [ABSTRACT FROM AUTHOR]

The article discusses an article by M. R. Larochelle and colleagues about disparities in overdose deaths. Topics include reason that the opioid overdose crisis most heavily affected non-Hispanic White people, major events that could not have been predicted at the time the article by Larochelle and colleagues was written, and lessons learned about the need for timely data on drug use patterns and overdoses to guide interventions.

• Representatives of five expert panels came together to establish conceptual clarity and consensus for what social determinants of health mean for nursing. • We define the social determinants of health as having six key dimensions: economic stability, education access and quality (including health literacy), health care access and quality, neighborhood and the built environment, social and community context, and planetary conditions. • We provide a specific health policy example for each of the six key areas of the social determinants of health to illustrate how nurses can act to improve population health. • We underscore the crucial need to eliminate systematic and structural racism if equity in planetary health-related quality of life is to be attained. • Our conceptual framework addresses the particular importance of nursing actions at the individual, family, and population levels to promote health policies that advance health equity, anti-racism, and planetary health-related quality of life. The 2019-2020 American Academy of Nursing (Academy, 2019) policy priorities document states that "they have a clear and distinct focus on social determinants of health and uses this lens to advance policies and solutions within each of the three overarching priorities" This consensus paper seeks to establish conceptual clarity and consensus for what social determinants of health mean for nursing, with emphasis on examples of health policies that advance planetary health equity and improve planetary health-related quality of life. Volunteers from five Expert Panels of the Academy met via videoconference to determine roles and refine the focus of the paper. After the initial discussion, the first draft of the conceptual framework was written by the first three authors of the paper and, after discussion via videoconference with all the co-authors, successive drafts were developed and circulated for feedback. Consensus was reached when all authors indicated acceptance of what became the final version of the conceptual framework. A conceptual framework was developed that describes how the social determinants of health can be addressed through nursing roles and actions at the individual, family, and population levels with a particular focus on the role of health policy. The paper provides a specific health policy example for each of the six key areas of the social determinants of health to illustrate how nurses can act to improve population health. Nursing actions can support timely health policy changes that focus on upstream factors in the six key areas of the social determinants of health and thus improve population health. The urgent need to eliminate systematic and structural racism must be central to such policy change if equity in planetary health-related quality of life is to be attained. [ABSTRACT FROM AUTHOR]

The American College of Physicians (ACP) has a long-standing commitment to improving the health of all Americans and opposes any form of discrimination in the delivery of health care services. ACP is committed to working toward fully understanding and supporting the unique needs of the incarcerated population and eliminating health disparities for these persons. In this position paper, ACP offers recommendations to policymakers and administrators to improve the health and well-being of persons incarcerated in adult correctional facilities. [ABSTRACT FROM AUTHOR]

Racial and ethnic disparities have been clearly documented in schizophrenia studies, but it is unclear how much research attention they receive among US-based studies published in high-impact journals. The current paper updates Lewine and Caudle's (1999) and Chakraborty and Steinhauer's (2010) works, which quantified how frequently schizophrenia studies included information on race and ethnicity in their analyses. We examined all US-based papers on schizophrenia-spectrum, first-episode psychosis, and clinical high-risk groups, published between 2014 to 2016 in four major psychiatric journals: American Journal of Psychiatry, Journal of the American Medical Association – Psychiatry, Schizophrenia Bulletin, and Schizophrenia Research. Of 474 US-based studies, 62% (n = 295) reported analyses by race or ethnicity as compared to 20% in Lewine and Caudle's (1999) study. The majority of papers (59%) reported sample descriptions, a 42% increase from Lewine and Caudle's (1999) study. Additionally, 47% matched or compared the racial/ethnic composition of primary study groups and 12% adjusted for race (e.g., as a covariate). However, only 9% directly analyzed racial and/or ethnic identity in relation to the primary topic of the paper. While schizophrenia studies report analyses by race and ethnicity more frequently than 20 years ago, there remains a strong need for systematic, nuanced research on this topic. The authors offer recommendations for how to conceptualize and report upon race and ethnicity in schizophrenia research. [ABSTRACT FROM AUTHOR]

While we have the tools to achieve this goal, the persistent barriers to healthcare services experienced by too many individuals will need to be addressed to make significant progress and improve the health and quality of life of all people with human immunodeficiency virus (HIV). The necessary structural changes require actions by federal, state, and local policymakers and range from ensuring universal access to healthcare services to optimizing care delivery to ensuring a robust and diverse infectious diseases and HIV workforce. In this article, we outlines 10 key principles for policy reforms that, if advanced, would make ending the HIV epidemic in the United States possible and could have much more far-reaching effects in improving the health of our nation. [ABSTRACT FROM AUTHOR]

Introduction: As part of its mission to advance Transcultural Nursing worldwide, the Transcultural Nursing Society Scholars upholds the central role of the discipline and cultural competence in advocacy, empowerment, and transformation of the life conditions of disadvantaged populations. This White Paper affirms the Scholars' core belief in the value of Transcultural Nursing and culturally competent care in addressing social determinants to promote health equity. Methods: The Scholars Education Interest Group proposes recommendations for changes in education, practice, and research undergirding the discipline and expand cultural competence to directly address social structural and historical forces that perpetuate health vulnerability in diverse populations. Results: Collaborative leadership between the TCNS Scholars, Board of Trustess and members should develop initiatives to foster implementation of the recommendations and promote global dissemination of exemplars in education, research and practice. Discussion: Collaborative implementation of recommendations will generate evidence of health equity outcomes through TCN and culturally competent care. [ABSTRACT FROM AUTHOR]

Question: Most adolescents live in low- and middle-income countries (LMIC), and about 10% of them face mental problems. The mental health provision gap in low- and middle-income countries could be addressed by evidence-based practices, however costs are implementational barriers. Digitalization can improve the accessibility of these tools and constitutes a chance for LMIC to use them more easily at a low cost. We reviewed free and brief evidence-based mental health assessment tools available for digital use to assess psychopathology across different domains in youth. Methods: For the current study, instruments from a recent review on paper-based instruments were re-used. Additionally, a systematic search was conducted to add instruments for the personality disorder domain. We searched and classified the copyright and license terms available from the internet in terms of free usage and deliverability in a digital format. In the case that this information was insufficient, we contacted the authors. Results: In total, we evaluated 109 instruments. Of these instruments, 53 were free and digitally usable covering 11 mental health domains. However, retrieving information on copyright and license terms was very difficult. Conclusions: Free and digitally adaptable instruments are available, supporting the strategy of using instruments digitally to increase access. The instrument's authors support this initiative, however, the lack of copyright information and the difficulties in contacting the authors and licence holders are barriers to using this strategy in LMIC. A comprehensive, online instrument repository for clinical practice would be an appropriate next step to make the instruments more accessible and reduce implementation barriers. [ABSTRACT FROM AUTHOR]

• Latino adults are disproportionately impacted by dementia due to high exposure to adverse social determinants of health (SDOH). • "Brain health literacy" in middle adulthood may be a modifiable factor that could help mitigate later life risk of cognitive decline. • The proposed Brain Health Literacy framework can guide health promotion efforts, with the ultimate goal of increasing brain health equity. [ABSTRACT FROM AUTHOR]

The article informs about the call for papers for a special issue on Culturally Responsive Qualitative Health Research, aiming to address important contemporary issues in qualitative health research. Topics include the aim and purpose of the special edition, the methodology of culturally responsive qualitative research, and the significance of disrupting harmful research practices in health-related disciplines.

Background: There is an often-held assumption that the engagement of clinicians and healthcare organizations in research improves healthcare performance at various levels. Previous reviews found up to 28 studies suggesting a positive association between the engagement of individuals and healthcare organizations in research and improvements in healthcare performance. The current study sought to provide an update. Methods: We updated our existing published systematic review by again addressing the question: Does research engagement (by clinicians and organizations) improve healthcare performance? The search covered the period 1 January 2012 to March 2024, in two phases. First, the formal updated search ran from 1 January 2012 to 31 May 2020, in any healthcare setting or country and focussed on English language publications. In this phase two searches identified 66 901 records. Later, a further check of key journals and citations to identified papers ran from May 2020 to March 2024. In total, 168 papers progressed to full-text appraisal; 62 were identified for inclusion in the update. Then we combined papers from our original and updated reviews. Results: In the combined review, the literature is dominated by papers from the United States (50/95) and mostly drawn from the Global North. Papers cover various clinical fields, with more on cancer than any other field; 86 of the 95 papers report positive results, of which 70 are purely positive and 16 positive/mixed, meaning there are some negative elements (i.e. aspects where there is a lack of healthcare improvement) in their findings. Conclusions: The updated review collates a substantial pool of studies, especially when combined with our original review, which are largely positive in terms of the impact of research engagement on processes of care and patient outcomes. Of the potential engagement mechanisms, the review highlights the important role played by research networks. The review also identifies various papers which consider how far there is a "dose effect" from differing amounts of research engagement. Additional lessons come from analyses of equity issues and negative papers. This review provides further evidence of contributions played by systems level research investments such as research networks on processes of care and patient outcomes. [ABSTRACT FROM AUTHOR]

The use of Artificial Intelligence (AI) medical devices is rapidly growing. Although AI may benefit the quality and safety of healthcare for older adults, it simultaneously introduces new ethical and legal issues. Many AI medical devices exhibit age-related biases. The first part of this paper explains how 'digital ageism' is produced throughout the entire lifecycle of medical AI and may lead to health inequity for older people: systemic, avoidable differences in the health status of different population groups. This paper takes digital ageism as a use case to show the potential inequitable effects of AI, conceptualized as the 'AI cycle of health inequity'. The second part of this paper explores how the European Union (EU) regulatory framework addresses the issue of digital ageism. It argues that the negative effects of age-related bias in AI medical devices are insufficiently recognized within the regulatory framework of the EU Medical Devices Regulation and the new AI Act. It concludes that while the EU framework does address some of the key issues related to technical biases in AI medical devices by stipulating rules for performance and data quality, it does not account for contextual biases, therefore neglecting part of the AI cycle of health inequity. [ABSTRACT FROM AUTHOR]

The disparity in health outcomes between Indigenous and non-indigenous Australians continues to increase. Barriers to accessing health care, particularly surgical treatment, contribute to health inequalities among Indigenous Australians. Despite a positive correlation between improved patient experiences and health outcomes, there is little research available on nursing interventions to improve Indigenous patients' perioperative health care treatment. This discussion paper investigates culturally appropriate and evidence- based nursing interventions that can be applied in the perioperative setting to improve the surgical experience of Indigenous patients. It was shown that establishing trust among Aboriginal and Torres Strait Islander patients through anaesthetic nurse practices and advocating for family involvement is critical in providing culturally safe care and enhancing patient experiences. Indigenous health liaison officers were also identified as a valuable resource in bridging cultural and communication gaps between health care providers and Indigenous patients. These findings demonstrate that using tailored nursing strategies while providing perioperative care to Indigenous Australians can enhance their perioperative health care experience and contribute to improving health outcomes of Indigenous Australians. It is therefore recommended that perioperative nurses adopt these strategies; however, further research is needed to investigate implementation of an enhanced role for anaesthetic nurses, advocating for family involvement and referral to Indigenous health liaison officers. Such research should evaluate the impact of these new holistic and patient-centred approaches on the health outcomes and experiencecs of Indigenous patients. [ABSTRACT FROM AUTHOR]

Background: The social determinants of health (SDOH) are the focus of an exponentially increasing number of publications, including evidence syntheses. However, there is not an established standard for searching for SDOH literature. This study seeks to identify published evidence syntheses pertaining to the SDOH, analyzing the search strategies used and the studies included within these reviews. The primary objectives are to compare search strategies and create a test set of SDOH publications. Methods: We searched PubMed, Embase, and Scopus for evidence syntheses that mentioned the SDOH in their research questions and included an SDOH search strategy. Relevant data extracted from each review included databases searched; search terms used for the SDOH; conceptual frameworks referenced; and the citations of primary studies included in the reviews, which were compiled to form a test set of cited papers. The relative recall of the respective search strategies was tested by documenting the total number of MEDLINE results each retrieved and the number of test set papers retrieved. Results: Sixty-four evidence syntheses were identified and included in the analysis, and 2750 cited papers were extracted. Findings indicate few commonalities across search strategies in search terms used, the total number of results retrieved, and the number of test set cited papers retrieved. One hundred and ninety-three unique MeSH terms and 1385 unique keywords and phrases were noted among the various search strategies. The number of total results retrieved by the SDOH search strategies ranged from 21,793 to over 16 million. The percentage of cited papers retrieved by the search strategies ranged from 2.46 to 97.9%. Less than 3% of the cited papers were indexed with the Social Determinants of Health MeSH. Conclusions: There has been little consistency across evidence syntheses in approaches to searching for SDOH literature. Differences in these strategies could have a significant impact on what literature is retrieved, included in reviews, and, consequently, incorporated into evidence-based practice. By documenting these differences and creating a set of papers relevant to SDOH, this research provides a snapshot of the current challenges in searching for SDOH content and lays the groundwork for the creation of a standardized search approach for SDOH literature. [ABSTRACT FROM AUTHOR]

Epigenetic clocks are increasingly being used as a tool to assess the impact of a wide variety of phenotypes and exposures on healthy ageing, with a recent focus on social determinants of health. However, little attention has been paid to the sociodemographic characteristics of participants on whom these clocks have been based. Participant characteristics are important because sociodemographic and socioeconomic factors are known to be associated with both DNA methylation variation and healthy ageing. It is also well known that machine learning algorithms have the potential to exacerbate health inequities through the use of unrepresentative samples – prediction models may underperform in social groups that were poorly represented in the training data used to construct the model. To address this gap in the literature, we conducted a review of the sociodemographic characteristics of the participants whose data were used to construct 13 commonly used epigenetic clocks. We found that although some of the epigenetic clocks were created utilizing data provided by individuals from different ages, sexes/genders, and racialized groups, sociodemographic characteristics are generally poorly reported. Reported information is limited by inadequate conceptualization of the social dimensions and exposure implications of gender and racialized inequality, and socioeconomic data are infrequently reported. It is important for future work to ensure clear reporting of tangible data on the sociodemographic and socioeconomic characteristics of all the participants in the study to ensure that other researchers can make informed judgements about the appropriateness of the model for their study population. [ABSTRACT FROM AUTHOR]

Objective: Publication science is the scholarly study of various aspects of the academic publishing process. Its applications to COVID-19 literature have been limited. Here, we describe COVID-19 submissions to, and resulting articles published by, the journal Public Health Reports (PHR), an important resource for US public health practice. Methods: We reviewed PHR 's COVID-19 submissions and articles published between March 27, 2020, and March 27, 2023. We coded each article for article type, author affiliation, the categories listed in PHR 's call for COVID-19 papers, and the public health emergency preparedness and response capabilities from the Centers for Disease Control and Prevention (CDC). Results: During the study period, PHR received 1545 COVID-19 submissions and published 190 of those articles in a collection, COVID-19 Response. The COVID-19 Response collection included 102 research articles, 29 case study/practice articles, and 24 commentaries. The corresponding author of more than half (52.1%; n = 99) of the articles was affiliated with academia. By the categories listed in PHR 's call for COVID-19 papers, 51 articles addressed health disparities, 38 addressed public health surveillance, and 34 addressed COVID-19 vaccination. By the CDC public health emergency preparedness and response capabilities, 87 articles addressed public health surveillance and epidemiologic investigation, 38 addressed community preparedness, and 32 addressed community recovery. The percentage of articles focused on policy/law was higher early in the pandemic (2020-2021) than later (2022-2023) (9.5% vs <3.0%). During the latter period, articles largely focused on vaccination (12.8%) and contact tracing (10.6%). Conclusions: Articles published in PHR 's COVID-19 Response collection covered a broad range of topics and were authored by contributors from diverse organizations. Our characterization of the COVID-19 output of a representative US public health practice journal can help academic publishing better address informational needs of public health responders. [ABSTRACT FROM AUTHOR]

An introduction to three papers from the 2021 Research Symposium is presented which includes topics like literature on disability health and health care disparities experienced by persons with communication disabilities, health and health care disparities experienced by adults with hearing loss, and intervention for Deaf and Hard of Hearing (DHH) children to improve their behavioral health outcomes.

Objectives: In 2008, an analysis investigating health impact assessment (HIA) practice found that only 6% of HIA-related peer-reviewed publications had a focus on low- and medium-developed countries, whereas 94% were conducted in countries with a high or very high development state. We aimed to update and deepen these observations. Methods: We conducted a systematic review, searching PubMed and Web of Science for HIA-related papers published in the scientific literature from June 2007 to January 2023. Only applied HIA and papers with HIA as a subject were included. Results: The search yielded 3,036 publications and the final selection consisted of 1,019 publications. The annual number of total publications increased considerably over the past 15 years. Whereas research-driven HIA (n = 460) showed a steep increase, step-by-step HIA (n = 71) did not show a clear trend. Conclusion: The gap between the number of HIA-related peer-reviewed publications focusing on low/medium and high/very high developed countries has diminished from 6/ 94 to 11/89. There is a growing tendency to apply the terminology HIA for health impact modelling studies and quantitative health risk assessments. [ABSTRACT FROM AUTHOR]

The complex interconnections between climate change policies and health equity are well established, and policy research to understand the health impacts of climate change in multiple domains is growing. Policy analysis theories/frameworks are an important aspect of policy analysis. Many frameworks exist to understand the health equity considerations in policies across various disciplines and the health impacts of climate change-related policies in the health and climate change sectors. However, a closer examination is required to understand whether there is explicit attention to health equity issues in relation to climate change policies in an integrated way. This systematic review attempted to identify existing health equity-focused policy analysis frameworks for understanding health equity considerations in climate change and public health policies. Eight papers were identified through five database searches. Policy analysis frameworks exploring the integration of health equity and climate change are fragmented, and frameworks encompassing several aspects of the policy-making process could not be found. Problem framing and policy-focused solutions were common approaches to understanding health equity in climate change policies. Concepts of social determinants of health and social justice were central to the intersection of climate change and health equity. [ABSTRACT FROM AUTHOR]

Background: Patients with disabilities often require healthcare accommodations in order to access high-quality, equitable healthcare services. While attention has been paid to accommodation needs in specific disability populations, limited research to date has explored healthcare accommodations that cross-cut diverse disability populations.Objective: To identify a deeper understanding regarding accommodations in healthcare settings that could apply across disability populations and promote equitable healthcare.Design: We conducted qualitative focus groups with patients with disabilities and caregivers to understand their experiences and preferences for healthcare accommodations.Participants: We recruited patients and caregivers across all major disability categories to participate in focus groups. Participants were recruited through advocacy organizations and healthcare settings in Southeastern Minnesota.Approach: A total of eight focus groups were conducted with 56 participants. Participants described their healthcare experiences and desires for healthcare accommodations. The multidisciplinary research team recorded, transcribed verbatim, and coded all focus groups. The team thematically coded transcripts using content analysis within and across focus groups to identify major themes.Key Results: Patients identified four challenges and corresponding steps healthcare team could take to promote equitable care: (1) consistent documentation of disabilities and needed accommodations in the medical record; (2) allowance for accommodations to the environment, including adapting physical space, physical structures, and scheduling and rooming processes; (3) provide accommodations for administrative tasks, such as completing paper or electronic forms; and (4) adapt communication during interactions, such as speaking slower or using terms that patients can easily understand.Conclusion: These identified themes represent specific opportunities for healthcare teams to effectively provide accessible care to patients with disabilities. Many of the accommodations require minimal financial investment, but did require behavioral changes by the healthcare team to ensure equitable healthcare. [ABSTRACT FROM AUTHOR]

Background: Residents of rural areas have poorer health status, less healthy behaviours and higher mortality than urban dwellers, issues which are commonly addressed in primary care. Strengthening primary care may be an important tool to improve the health status of rural populations. Objective: Synthesize and categorize studies that examine interventions to improve rural primary care. Eligibility criteria: Experimental or observational studies published between January 1, 1996 and December 2022 that include an historical or concurrent control comparison. Sources of evidence: Pubmed, CINAHL, Cochrane Library, Embase. Charting methods: We extracted and charted data by broad category (quality, access and efficiency), study design, country of origin, publication year, aim, health condition and type of intervention studied. We assigned multiple categories to a study where relevant. Results: 372 papers met our inclusion criteria, divided among quality (82%), access (20%) and efficiency (13%) categories. A majority of papers were completed in the USA (40%), Australia (15%), China (7%) or Canada (6%). 35 (9%) papers came from countries in Africa. The most common study design was an uncontrolled before-and-after comparison (32%) and only 24% of studies used randomized designs. The number of publications each year has increased markedly over the study period from 1-2/year in 1997–99 to a peak of 49 papers in 2017. Conclusions: Despite substantial inequity in health outcomes associated with rural living, very little attention is paid to rural primary care in the scientific literature. Very few studies of rural primary care use randomized designs. [ABSTRACT FROM AUTHOR]

Background: Many areas of healthcare are impacted by a paucity of research that is translatable to clinical practice. Research utilising real-world data, such as routinely collected patient data, may be one option to efficiently create evidence to inform practice and service delivery. Such studies are also valuable for exploring (in)equity of services and outcomes, and benefit from using non-selected samples representing the diversity of the populations served in the 'real world'. This scoping review aims to identify and map the published research which utilises routinely collected clinical healthcare data. A secondary aim is to explore the extent to which this literature supports the pursuit of social justice in health, including health inequities and intersectional approaches. Method: This review utilises Arksey and O'Malley's methodological framework for scoping reviews and draws on the recommended enhancements of this framework to promote a team-based and mixed methods approach. This includes searching electronic databases and screening papers based on a pre-specified inclusion and exclusion criteria. Data relevant to the research aims will be extracted from included papers, including the clinical/professional area of the topic, the source of data that was used, and whether it addresses elements of social justice. All screening and reviewing will be collaborative and iterative, drawing on strengths of the research team and responsive changes to challenges will be made. Quantitative data will be analysed descriptively, and conceptual content analysis will be utilised to understand qualitative data. These will be collectively synthesised in alignment to the research aims. Conclusion: Our findings will highlight the extent to which such research is being conducted and published, including gaps and make recommendations for future endeavours for real-world data studies. The findings from this scoping review will be relevant for practitioners and researchers, as well as health service managers, commissioners, and research funders. [ABSTRACT FROM AUTHOR]

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This paper examines the challenges posed by the COVID-19 pandemic on the existing health inequalities disproportionately affecting vulnerable populations. It explores the impact of COVID-19 pandemic response measures to "curb the spread" on informal sector workers in Ghana. In Ghana, like many other developing countries, the informal sector was impacted by a higher risk of exposure to the COVID-19 infection and the slew of pandemic response measures, for example, lockdowns and stay-at-home orders, as well as guidelines around social distancing implemented by their governments. Given the high level of precarity that undergirds work in the informal sector and the intersectional forces that contribute to and maintain their marginality—class, race, ethnicity, gender, religion, and geographic location—this paper creates a space for dialogue about the unintended consequences of pandemic response measures on the livelihood security of informal sector workers. [ABSTRACT FROM AUTHOR]

The World Health Organization has designated vaccine hesitancy and vaccine confidence among the most pressing issues in global health. The COVID-19 pandemic has made vaccine hesitancy and vaccine confidence particularly salient and urgent. The purpose of this special issue is to highlight a broad range of perspectives on these critical issues. We have included a total of 30 papers that address issues related to vaccine hesitancy and vaccine confidence across multiple levels of the Socio-Ecological Model. We have organized the empirical papers into the following sections: individual-level beliefs, minority health and health disparities, social media and conspiracy beliefs, and interventions. In addition to the empirical papers, three commentaries are included in this special issue. [ABSTRACT FROM AUTHOR]

Background: For the professions of audiology and speech-language therapy (A/SLT), there continues be a dire need for more equitable services. Therefore there is a need to develop emerging practices which have a specific focus on equity as a driving force in shifting practices. This scoping review aimed to synthesise the characteristics of emerging practices in A/SLT clinical practice in relation to equity with an emphasis on communication professions. Methods: This scoping review followed the Joanna Briggs Institute guidelines and aimed to map the emerging practices in A/SLT to identify the ways in which the professions are developing equitable practices. Papers were included if they addressed equity, focused on clinical practice and were situated within A/SLT literature. There were no time or language restrictions. The review included all sources of evidence across PubMed, Scopus, EbscoHost, The Cochrane Library and Dissertation Abstracts International, Education Resource Information Centre from their inception. The review uses PRISMA Extension for scoping reviews and PRISMA-Equity Extension reporting guidelines. Results: The 20 included studies ranged from 1997–2020, spanning over 20 years. There were a variety of papers including empirical studies, commentaries, reviews and research. The results demonstrated that the professions were increasingly considering addressing equity through their practice. However, there was a prominent focus around culturally and linguistically diverse populations, with limited engagement around other intersections of marginalisation. The results also showed that while the majority of contributions to theorising equity are from the Global North with a small cluster from the Global South offering critical contributions considering social categories such as race and class. Collectively the contributions from the Global South remain a very small minority of the professional discourse which have a focus on equity. Conclusion: Over the last eight years, the A/SLT professions are increasingly developing emerging practices to advance equity by engaging with marginalised communities. However, the professions have a long way to go to achieve equitable practice. The decolonial lens acknowledges the impact and influence of colonisation and coloniality in shaping inequity. Using this lens, we argue for the need to consider communication as a key aspect of health necessary to achieve health equity. [ABSTRACT FROM AUTHOR]

Objectives: Unwarranted clinical variations in radical prostatectomy (RP) procedures are frequently reported, yet less attention is given to the variations in associated costs. This issue can further widen disparities in access to care and provoke questions about the overall value of the procedure. The present paper aimed to delve into the disparities in hospital, medical provider and out-of-pocket costs for RP procedures in Australia, discussing plausible causes and potential policy opportunities. Methods: A retrospective cohort study using Medibank Private claims data for RP procedures conducted in Australian hospitals between 1 January 2015 and 31 December 2020 was undertaken. Results: Considerable variations in both medical provider and out-of-pocket costs were observed across the country, with variations evident between different states or territories. Particularly striking were the discrepancies in the costs charged by medical providers, with a notable contrast between the 10th and 90th percentiles revealing a substantial difference of A$9925. Hospitals in Australia exhibited relatively comparable charges for RP procedures. Conclusions: Initiatives such as enhancing transparency regarding individual medical provider costs and implementing fee regulations with healthcare providers may be useful in curbing the variations in RP procedure costs. What is known about the topic? Unwarranted clinical variations in radical prostatectomy procedures are well documented in the literature; however, variations in cost are less widely reported. What does this paper add? This paper aims to highlight the cost variations in radical prostatectomy procedures in Australia, discussing their plausible causes, implications and proposing potential policy opportunities. What are the implications for practitioners? Excessive fees imposed by medical providers may contribute to inequalities in healthcare access. Enhancing transparency of individual medical provider costs and implementing fee regulations may be useful in controlling unwarranted variations in procedure costs. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents results from a participatory action research study with 46 LGBTQIA+ community leaders and 60 library workers who participated in four community forums at public libraries across the US. The forums identified barriers to LGBTQIA+ communities addressing their health questions and concerns and explored strategies for public libraries to tackle them. Design/methodology/approach: Forums followed the World Café format to facilitate collaborative knowledge development and promote participant-led change. Data sources included collaborative notes taken by participants and observational researcher notes. Data analysis consisted of emic/etic qualitative coding. Findings: Results revealed that barriers experienced by LGBTQIA+ communities are structurally and socially entrenched and require systematic changes. Public libraries must expand their strategies beyond collection development and one-off programming to meet these requirements. Suggested strategies include outreach and community engagement and mutual aid initiatives characterized by explicit advocacy for LGBTQIA+ communities and community organizing approaches. Research limitations/implications: Limitations include the sample's lack of racial diversity and the gap in the data collection period between forums due to COVID-19. Public libraries can readily adopt strategies overviewed in this paper for LGBTQIA+ health promotion. Originality/value: This research used a unique methodology within the Library and Information Science (LIS) field to engage LGBTQIA+ community leaders and library workers in conversations about how public libraries can contribute to LGBTQIA+ health promotion. Prior research has often captured these perspectives separately. Uniting the groups facilitated understanding of each other's strengths and challenges, identifying strategies more relevant than asking either group alone. [ABSTRACT FROM AUTHOR]

Dalal convincingly argues that these 'positivist methodologies are unable, even in principle, to capture the intricacies of human exchange' which are fundamental to process-led therapies. Using psychology, psychiatry, and psychotherapy, Dalal shows how "regulatory and legislative capture" have been a consequence of our profession attempting to fit into a model of scientific practice unsuited to a subjective, relational, and process-led undertaking. The study questions whether there is an element of mental health care inequality in community-based psychotherapy provision and concludes that patients who are "better equipped to seek help" are favoured, thereby 'discriminating against patients with severe mental health conditions'. [Extracted from the article]

Cervical cancer screening is a critical public health measure, especially vital for underserved communities where disparities in access and outcomes are pronounced. Despite the life-saving potential of regular screening, numerous barriers--including geographical isolation, cultural and linguistic challenges, and socioeconomic factors--severely hinder accessibility for these populations. Multicancer early detection (MCED) tests emerge as a potentially effective intervention, offering a less invasive, more accessible approach that could transform how screenings are conducted. This paper explores the existing challenges in traditional cervical cancer screening methods, the potential of MCED tests to address these barriers, and the implications of these technologies for global health equity. Through a comprehensive review, we highlight the need for culturally sensitive, tailored interventions and the importance of effectively overcoming logistical and financial difficulties to implement MCED tests. Despite the promise shown by MCED tests, the paper acknowledges significant implementation challenges, including cost, logistical obstacles, and the need for cultural acceptance and validation studies. This study emphasizes the necessity for equitable MCED test implementation strategies, highlighting the potential of these innovative technologies to advance global health equity in cervical cancer prevention. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate Ghana's National Health Insurance Scheme (NHIS) on healthcare utilisation by exploring its heterogeneous effects based on residential status and wealth. Design/methodology/approach: The study used the Ghana Socioeconomic Panel Survey (GSPS) datasets. An instrumental variable strategy, specifically the two-stage residual inclusion (2SRI), was employed to control endogenous NHIS membership. Findings: Generally, the results show that NHIS improves healthcare utilisation (i.e. visits to a health facility and formal care). Concerning the heterogeneous effects of health insurance on healthcare utilisation, the results revealed that NHIS members are more likely to seek care, irrespective of their residence status. The results further indicate that the probability of visiting a health facility and utilising formal care increases for the poorest NHIS participants. Based on these, the authors conclude that NHIS provides equitable healthcare access and utilisation for its vulnerable populations, who are beneficiaries. Originality/value: To the best of the authors' knowledge, this paper is the first to explore the heterogeneous effects of NHIS on healthcare utilisation across residential and income subpopulations. Splitting the dataset by residential status to examine healthcare utilisation inequality is worthwhile. In addition, analysing utilisation in terms of health care type would show whether Ghana's NHIS may be viewed as welfare-enhancing through increased formal health care utilisation. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-05-2023-0330 [ABSTRACT FROM AUTHOR]

Purpose: During the COVID-19 pandemic, the NZ COVID Tracer App (NZCTA) was released as a digital intervention to support contact tracing processes in Aotearoa New Zealand. This paper examines whether NZCTA met the data governance requirements of the Indigenous Māori people. Māori are an interesting case study as they have unique Treaty and data sovereignty rights, and a higher risk of COVID-related mortality. Methods: The NZCTA was assessed against 24 criteria drawn from the Māori Data Governance Model. The assessment drew on documentary sources and the authors' knowledge of NZCTA and contact tracing process. Each criteria was assessed as 'met', 'partially met' or 'not met'. Results: Our retrospective assessment showed a mixed performance against the Māori Data Governance Model, with NZCTA only fulfilling seven of the 24 model criteria and failing to meet nine. Conclusion: There is significant room for improvement in future digital health interventions for Māori. Much work remains to be done in the Aotearoa public sector to uphold Māori data sovereignty and address systemic barriers to genuine partnership with Māori. [ABSTRACT FROM AUTHOR]

Population Health Management – often abbreviated to PHM – is a relatively new approach for healthcare planning, requiring the application of analytical techniques to linked patient level data. Despite expectations for greater uptake of PHM, there is a deficit of available solutions to help health services embed it into routine use. This paper concerns the development, application and use of an interactive tool which can be linked to a healthcare system's data warehouse and employed to readily perform key PHM tasks such as population segmentation, risk stratification, and deriving various performance metrics and descriptive summaries. Developed through open-source code in a large healthcare system in South West England, and used by others around the country, this paper demonstrates the importance of a scalable, purpose-built solution for improving the uptake of PHM in health services. [ABSTRACT FROM AUTHOR]

Introduction: "Programme science" deploys scientific methods to address questions that are a priority to support the impact of public health programmes. As such, programme science responds to the challenges of making such studies: (1) feasible to undertake, (2) useful, (3) rigorous, (4) real‐world‐relevant, (5) informative, and undertaken by (6) equitable partnerships. The acronym "FURRIE" is proposed to describe this set of six challenges. This paper discusses selected HIV/STI (sexually transmitted infection) programme science case studies to illustrate how programme science rises to the FURRIE challenges. Discussion: One way in which programme science is made more feasible is through the analysis and interpretation of data collected through service delivery. For some questions, these data can be augmented through methods that reach potential clients of services who have not accessed services or been lost to follow‐up. Process evaluation can enhance the usefulness of programme science by studying implementation processes, programme−client interactions and contextual factors. Ensuring rigour by limiting bias and confounding in the real‐world context of programme science studies requires methodological innovation. Striving for scientific rigour can also have the unintended consequence of creating a gap between what happens in a study, and what happens in the "real‐world." Community‐led monitoring is one approach to grounding data collection in the real‐world experience of clients. Evaluating complex, context‐specific strategies to strengthen health outcomes in a way that is informative for other settings requires clear specification of the intervention packages that are planned and delivered in practice. Programme science provides a model for equitable partnership through co‐leadership between programmes, researchers and the communities they serve. Conclusions: Programme science addresses the FURRIE challenges, thereby improving programme impact and ultimately health outcomes and health equity. The adoption and adaptation of the types of novel programme science approaches showcased here should be promoted within and beyond the HIV/STI field. [ABSTRACT FROM AUTHOR]

Oral health is high on the global agenda following the adoption of the 2022 global strategy on oral health at the 75th World Health Assembly. Given the global burden of oral disease, workforce development to achieve universal health coverage [UHC] is crucial to respond to population needs within the non-communicable disease agenda. The aim of this paper is to present an overview of the oral health workforce [OHWF] globally in relation to key contextual factors. Data from the National Health Workforce Accounts and a survey of World Health Organization [WHO] member states were integrated for analysis, together with country-level data on population and income status. Data are presented using the WHO categorisation of global regions and income status categories established by the World Bank. Workforce densities for key OHWF categories were examined. Multiple regression was used to model workforce density and contextual influences. Challenges and possible solutions were examined by country income status. There are approximately 3.30 dentists per 10,000 population globally, and a combined OHWF [dentists, dental assistants/therapists and dental prosthetic technicians] of 5.31 per 10,000. Marked regional inequalities are evident, most notably between WHO European and African regions; yet both make greater use of skill mix than other regions. When adjusted by region, 'country income status' and 'population urbanization' are strong predictors of the workforce density of dentists and even more so for the combined OHWF. Maldistribution of the workforce [urban/rural] was considered a particular workforce challenge globally and especially for lower-income countries. Strengthening oral health policy was considered most important for the future. The global distribution of dentists, and the OHWF generally, is inequitable, with variable and limited use of skill mix. Creative workforce development is required to achieve the global oral health agenda and work towards equity using innovative models of care, supported by effective governance and integrated policies. [ABSTRACT FROM AUTHOR]

In the US, the COVID-19 pandemic devastated minoritized communities, laying bare centuries of health disparities. In response, government agencies, foundations, nonprofit organizations, and corporations allocated funding for innovative solutions to combat inequality throughout the healthcare landscape. However, this article argues that to achieve sustainable and impactful innovation that helps the US progress toward a more fair, equitable, and effective healthcare system, we must diversify the range of professionals involved in innovation ecosystems, utilize paradigms that allows underserved communities to effectively engage in research to support their health and wellbeing, infuse health equity into innovation ecosystems, and make long-term investments in underserved communities. This article chronicles health disparities in the US., especially during the COVID-19 pandemic, while also discussing the current barriers to inclusive innovation in health equity. Using these barriers as a springboard for a conversation on realizing positive change in the healthcare system, the paper ends by highlighting examples of collaborative, inclusive and potentially impactful initiatives that could address and alleviate the concerns presented at the beginning of the paper. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to provide new insights into and offer potential solutions to the challenges encountered by mental health services working with remote, rural or underserved communities in the UK. Design/methodology/approach: In this paper, the authors reflect on the utility of integrating conventional clinical approaches, with preventive care and empowering work within the community, to provide culturally sensitive and accessible mental health services. The authors describe an example of community intervention from a mental health service in Ghana designed to enhance reach within remote and rural communities and identify potential lessons for practice in the UK. Findings: The partnership between community mental health services and the rural communities, including families and existing social frameworks, applies collaborative care to overcome the lack of resources and facilitate the acceptability of mental health services to the local population. There are a series of important lessons from this experience including the importance of understanding the culture of a community to optimise reach and the importance of working IN the community and WITH the community. Originality/value: This paper is novel because it provides learning from a model of care applied in the global south that has potential for implementation with underserved populations in the UK. The authors suggest a reframing of the notion of community care to encompass existing frameworks of community, not merely a biomedical conceptualisation. [ABSTRACT FROM AUTHOR]

Objective: The objective of this scoping review is to map the available evidence on strategies that nurses can use to facilitate genomics-informed healthcare to address health disparities. Introduction: Advancements in genomics over the last two decades have led to an increase in the delivery of genomics-informed health care. Although the integration of genomics into health care services continues to enhance patient outcomes, access to genomic technologies is not equitable, exacerbating existing health disparities amongst certain populations. As the largest portion of the health workforce, nurses play a critical role in the delivery of equitable genomics-informed care. However, little is known about how nurses can help address health disparities within the context of genomics-informed health care. A review of the literature will provide the necessary foundation to identify promising practices, policy, and knowledge gaps for further areas of inquiry. Inclusion criteria: We will include papers that explore strategies that nurses can undertake to facilitate genomics-informed care to address health disparities. Methods: This review will be conducted using JBI methodology for scoping reviews. We will search electronic databases including MEDLINE (OVID), EMBASE, Cochrane Library, PsychInfo, and CINAHL for quantitative and qualitative studies, systematic reviews and grey literature. Theses, books, and unavailable full-text papers will be excluded. The search will be limited to papers from 2013 and beyond. Two reviewers will screen titles and abstracts followed by full-text and disagreements will be resolved by a third reviewer. We will use a data extraction tool using Microsoft Excel and analyse data using descriptive statistics and conventional content analysis. Findings will be presented in the form of evidence tables and a narrative summary. We will report findings using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Discussion: Genomics will continue to transform all aspects of health care across the wellness continuum from prevention, assessment, diagnosis, management, treatment, and palliative care. The identification of nursing strategies to address health disparities will build the foundation for policy and practice to ensure that the integration of genomic technologies benefits everyone. [ABSTRACT FROM AUTHOR]

Background: The American Association of Medical Colleges has called for incorporation of the health humanities into medical education, and many medical schools now offer formal programs or content in this field. However, there is growing recognition among educators that we must expand beyond empathy and wellness and apply the health humanities to questions of social justice – that is, critical health humanities. In this paper we demonstrate how this burgeoning field offers us tools for integrating social justice into medical education, utilizing the frameworks of critical consciousness and structural competency. Practice of health humanities: Critical health humanities can be applied at multiple levels of learners, and in a variety of contexts. We are two physician-writers who have developed several educational programs that demonstrate this. We taught a seminar that introduced first-year and second-year undergraduates to concepts such as social determinants of health, intergenerational trauma, intersectionality, resilience, and cross-cultural care through works of fiction, poetry, film, podcasts, stand-up comedy, and more. Through creative projects and empathic reflection, students engaged with the complexities of structural forces that create and maintain health disparities. Medical students in their clinical years can engage in critical health humanities learning experiences as well. We teach several multidisciplinary electives that address social (in)justice in medicine, as well as mentor fourth-year students engaged in independent electives that foster critical awareness around health equity and ethics. Beyond the classroom, we have actively engaged in critical health humanities practices through story slams, literary journal clubs, conference presentations, and Grand Rounds. Through these activities we have included learners at GME and CME levels. These examples also demonstrate how community engagement and multidisciplinary partnerships can contribute to the practice of critical health humanities. Conclusion: In this paper, we explore the growing field of critical health humanities and its potential for teaching health equity through narrative practices. We provide concrete examples of educational activities that incorporate critical consciousness and structural competency – frameworks we have found useful for conceptualizing critical health humanities as a pedagogical practice. We also discuss the strengths and challenges of this work and suggest future directions. [ABSTRACT FROM AUTHOR]

Accessible summary: After the consultation with people with learning disabilities, the topic of health inequalities was chosen for the 2024 special issue.The lives of people with learning disabilities around the world was also of interest to people so we have made this the theme of this issue. There are papers from the Czech Republic, Hong Kong, Belgium, Chile and Iceland.We also have papers about life in the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]