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The death of a child may be the most traumatic event a family can experience. Bereavement care for parents is essential for their physical and mental well-being and is a psychosocial standard of care. Childhood mortality is higher in low- or middle-income countries (LMICs); however, little is known regarding bereavement support or interventions for parents in LMICs. To identify programs, services, initiatives, or interventions offered to bereaved parents in LMICs in hospital settings. A systematic search was executed following the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles from LMICs describing interventions, programs, or resources provided to parents after the death of a child (0–18 years old) from any cause were included. Extracted data was categorized by demographics, study design, outcomes, and quality assessment using the McGill Mixed Methods Appraisal Tool (MMAT). We retrieved 4428 papers and screened their titles and abstracts, 36 articles were selected for full-text assessment, resulting in nine articles included in the final analysis. Most interventions described support for parents whose child died during the prenatal or neonatal period. The primary interventions included psychological counseling, creating mementos (such as photographs or footprints), and bereavement workshops. Only one paper described a fully established bereavement program for parents. Eight of the papers met high-quality criteria. Although bereavement care is crucial for parents whose child has died, only a few studies have documented bereavement interventions in LMICs. More research may help with bereavement program implementation and improved care for bereaved parents in LMICs. [ABSTRACT FROM AUTHOR]

Adolescents' health behaviors and experiences contribute to many outcomes, including risks for HIV, other sexually transmitted diseases, and unintended pregnancy. Public health interventions and approaches addressing risk behaviors or experiences in adolescence have the potential for wide-reaching impacts on sexual health and other related outcomes across the lifespan, and schools are a critical venue for such interventions. This paper describes a school-based program model developed by the Centers for Disease Control and Prevention's Division of Adolescent and School Health for preventing HIV/sexually transmitted diseases, unintended pregnancy, and related health risk behaviors and experiences among middle and high school students. This includes a summary of the theoretical and evidence base that inform the model, and a description of the model's activities, organized into three key strategies (sexual health education, sexual health services, and safe and supportive environments) and across three cross-cutting domains (strengthening staff capacity, increasing student access to programs and services, and engaging parent and community partners). The paper also outlines implications for adolescent health professionals and organizations working across schools, clinics, and communities, to address and promote adolescent sexual health and well-being. [ABSTRACT FROM AUTHOR]

To integrate existing literature on barriers and facilitators to implementing interventions for Medically Unexplained Symptoms (MUS) in primary and secondary care. Systematic review following PRISMA guidelines. A search of PsychINFO/Pubmed/Web of Science was performed to select studies focusing on MUS-interventions and implementation. All included papers were checked for quality and bias. A narrative synthesis approach was used to describe the included papers by implementation level, ranging from the specific intervention to the broader economic/political context. 20 (quantitative/qualitative/mixed design) papers were included, but the quantitative studies especially, lacked methodological quality, with possible publication bias as a result. Results showed that the intervention needs to be acceptable and in line with daily practice routines. The professional 's attitude and skills are important for implementation success, as well as for overcoming problems in the professional-patient interaction. If patients stick to finding a somatic cause, this hampers implementation. A lack of time is a frequently mentioned barrier at the organizational level. Barriers/facilitators at the social context level and at the economic/political level were barely reported on in the included papers. Results were integrated into an existing implementation model, as an example of how MUS-interventions can be successfully implemented in practice. [ABSTRACT FROM AUTHOR]

This study evaluated the implementation and outcomes of a multisite initiative to identify and intervene in adolescent substance use across the many settings where youth interact. This paper focuses on the implementation and intermediate outcomes of the initiative, while others in the supplement address impact and ultimate outcomes. A mixed-methods cross-grantee evaluation was conducted from 2014 to 2019 among 56 recipients of funding from the Conrad N. Hilton Foundation to implement screening, brief intervention, and referral to treatment (SBIRT) across more than 1,266 youth-facing settings. Qualitative and quantitative data were collected from grantees on a quarterly basis, as well as from grantee proposals, progress reports, monthly grantee monitoring calls, and survey findings. Grantees reported increased capacity to provide SBIRT to youth across various settings: pediatric and primary care practices, community behavioral health organizations, juvenile justice programs, schools, and community-based organizations. Collectively, grantees screened 141,230 youth for substance use, 12,272 received a brief intervention, and 2,212 were referred to treatment. As part of the initiative, grantees provided SBIRT training to over 37,000 nursing and social work students, medical residents, addiction medicine fellows, and others. Implementation challenges included fitting screening into the workflow of primary care settings, confidentiality and consent in schools, reimbursement, and lack of specialist providers to refer to for substance use disorder treatment. Intermediate outcomes collected include total numbers of youth screened, received a brief intervention, and/or referred to more intensive treatment based on their screening scores. Research on SBIRT in adolescents has been limited to date despite positive outcomes reported in adults. This mixed-methods evaluation of an initiative to expand SBIRT implementation demonstrates feasibility of expanding access to substance use screening and intervention for youth across multiple settings and identifies challenges of implementation that differ somewhat based on settings. [ABSTRACT FROM AUTHOR]

This paper presents results of a research priority setting process focused on trans women living with and affected by HIV across Canada. It features data from semi-structured interviews and focus groups conducted with a diverse group of 76 trans women in five urban centers across the country on how they have navigated health and social service programming within their geographic context. The results focus on the structure and types of services. Respondents offered simple, yet creative ways to address barriers to vital services based on their individual and collective experiences. Notably, participants stressed the need for 1) trans-friendly and trans-specific services, 2) integrated health services, and aid in navigating complex, overlapping systems, and 3) comprehensive community-based services. They also suggest employing trans women as care coordinators or case managers in order to foster more trans-friendly environments and empower community members. We identify concrete ways to improve health and social services at the level of service delivery and program design, as well as recommendations for future participatory research. We close with an interrogation of trans people, and trans women living with and affected by HIV in particular, as 'hard to reach' populations. • Research with trans women yields richer insights if trans-identified experts lead. • Trans-friendly and trans-specific modes of service design and provision differ. • Integrated services are vital, but must address nuance of transgender women's needs. • Trans women are not hard to reach; rather, it is services that are hard to access. • Our trans-led community-based participatory approach can and should be reproduced. [ABSTRACT FROM AUTHOR]