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This study explores the usability, usefulness and user experience of the Forward with Dementia website for people with dementia and family carers, and identifies strategies to improve web design for this population. The website was iteratively user-tested by 12 participants (five people with dementia, seven carers) using the Zoom platform. Data collection involved observations, semi-structured interviews and questionnaires. Integrative mixed-method data analysis was used, informed by inductive thematic qualitative analysis. Users of Version 1 of the website experienced web functionality, navigation and legibility issues. Strategies for desirable web design were identified as simplifying functions, streamlining navigation and decluttering page layouts. Implementation of strategies produced improvements in usability, user experience and usefulness in Version 2, with mean System Usability Scale scores improving from 15 to 84, and mean task completion improving from 55% to 89%. The user journey for people with dementia and carers overlapped, but each group had their own unique needs in the context of web design. The interplay between a website's content, functionality, navigation and legibility can profoundly influence user perceptions of a website. Dementia-related websites play an important role in informing audiences of management strategies, service availability and planning for the progression of dementia. Findings of this study may assist in guiding future web development targeting this population. People with cognitive impairment can provide useful feedback on design and accessibility of websites, and their input should be obtained when developing digital applications for this group. This paper provides practical suggestions for website design features to improve function, legibility and navigation of websites for older people and people living with dementia. [ABSTRACT FROM AUTHOR]

The government of India introduced the Accredited Social Health Activist (ASHA) programme in 2006 to connect marginalised communities to the health system. ASHAs are mandated to increase the uptake of modern contraception through the doorstep provision of services. There is currently no evidence on the impact of ASHAs on the uptake of contraception at the national level. This paper examines the impact of ASHAs on the uptake of modern contraception using nationally representative National and Family Health Survey data collected in 2019– 21 in India. A multilevel logistic regression analysis was performed to determine the effect of contact with ASHAs on the uptake of modern contraception, controlling for regional variability and socio-demographic variables. The data provide strong evidence that ASHAs have succeeded in increasing modern contraceptive use. Women exposed to ASHAs had twice the odds of being current users of modern contraception compared to those with no contact, even after controlling for household and individual characteristics. However, only 28.1% of women nationally reported recent contact with ASHA workers. The ASHA programme should remain central to the strategy of the government of India and should be strengthened to achieve universal access to modern contraception and meet sustainable development goals by 2030. [ABSTRACT FROM AUTHOR]

During health crisis, individuals need information to comprehend their circumstances. Channel complementarity theory posits that in meeting their informational needs, people will use different sources in a complementary fashion. This paper puts to test the main tenet of channel complementarity theory by focusing on information scanning (i.e. routine health information exposure) in the context of the COVID-19 pandemic in Chile. A survey was conducted among a sample of Chilean adults (N = 2,805). The questionnaire addressed information scanning across six sources (television, radio, internet, social media, family, and friends or coworkers) and explores how socioeconomic and demographic variables, as well as COVID-19 perceived risk related to scanning. Latent class analysis was employed to identify patterns of complementarity across channels. The analysis yielded a solution of five classes, namely 'high complementarity and high frequency' (21%), 'high complementarity and low frequency' (34%), 'high frequency on television and digital media' (19%), 'mass media predominant' (11%), and 'no scanning' (15%). Educational attainment, age, and COVID-19 perceived risk were associated with scanning. Television was a central channel for information scanning during the pandemic in Chile and more than half of participants scanned COVID-19 information complementarily. Our findings expand channel complementarity theory to information scanning in a non-US context and provide guidelines for designing communication interventions aiming at informing individuals during a global health crisis. [ABSTRACT FROM AUTHOR]

Spanish legislation obliges the public administration to ensure equal opportunities and support for access to higher education for people with disabilities. This work has one central goal: to analyse and understand the causes for the potential inequality for people with disabilities in accessing higher education in Spain and the barriers they encounter during their academic life. This paper focuses on the differences in inclusive education between people with disabilities and people without disabilities by sex, age, and type of university. A mixed research design is used: qualitative research of two focus groups and fourteen interviews to sixteen students with disabilities; and statistical analysis of the Social Integration and Health Survey 2012, using two-way and multi-way cross-tables. There are significant differences between presence of disability and learning variables. Controlling by sex and age, almost every age-group is significant. Using sex as independent variable, and controlling by disability, there is no relationship with the variables relating to barriers to accessing education; therefore, the larger differences by sex are in the group of people without disabilities. [ABSTRACT FROM AUTHOR]

Children's experience of harm and abuse has a profound impact on their health and well-being. In response, school-based prevention programmes have been developed and delivered by external organisations with the aim of improving children's awareness and understanding of forms of harm and abuse which may affect them, encouraging them to seek help if needed. In September 2020, Relationships Education became statutory within the primary school curriculum in England and this ratification is likely to increase demand for externally delivered classroom-based programmes, which address the broad range of topics to be covered within this field. However, evidence is required to understand the impact and acceptability of such programmes. This paper presents qualitative findings from a larger mixed-methods study. Focus group discussions with 29 children explored their responses to one Healthy Relationships programme delivered to primary school children aged 10 and 11 in England. Analysis focuses specifically on responses to the topics of sexual abuse prevention and help-seeking. Children's widespread support for the programme indicates that topics are relevant and the opportunity to explore these issues is valued. However, for effective programme implementation, schools and parents need to be prepared, and prevention messages should continue to be embedded throughout children's school lives. [ABSTRACT FROM AUTHOR]

Adult adoptees and adoption professionals encourage transracial adoptive parents to provide cultural socialization (CS)—learning about and facilitating a sense of connectedness to children's birth culture. Research showed that CS is related to positive developmental outcomes. However, recent studies suggested that there were varying degrees of cultural depth in CS (Quiroz, 2012; Zhang & Pinderhughes, 2019). This qualitative study examined how transracial adoptive parents addressed cultural depth in CS. Thirty transracial adoptive parents participated in semi-structured phone interviews. Five themes related to cultural depth were identified using phenomenological analysis. Findings revealed that parents' cognitions about culture (understanding of adoptees' birth culture, acknowledgment of limited cultural knowledge, and the belief that "culture is not everything"), and actions that facilitate cultural connections (providing role models, creating diverse context) all varied in depth. This paper discussed variations in CS depth and suggested that a deep cultural connection may provide a foundation for adoptees to pursue their identity development journeys as adolescents and young adults. Social workers can use the findings of this study to guide their self-examination of cultural understanding, as well as to help adoptive parents to provide deeper CS to their children. [ABSTRACT FROM AUTHOR]

This paper examines the process and outcomes from a five-year, community-based participatory research (CBPR) study of a community building initiative to strengthen two neighborhoods in a mid-size, Mid-Atlantic city. In addition to supporting over 50 resident-led projects during the five-year initiative, outcomes included positive changes in resident perceptions about some aspects of neighborhood safety, cleanliness, greening, and vibrancy, and in both neighborhoods respondents who were most involved with the lead community-based organizations (CBOs) reported significantly higher social capital compared to those least involved. Nevertheless, analysis of the evaluation process revealed certain data were more meaningful to stakeholders during and at the end of the initiative, and other data were less worth the effort and cost to collect. This study offers insights for how foundations and nonprofit organizations can best use their evaluation resources in small-scale community-building efforts. [ABSTRACT FROM AUTHOR]

Climate change is an important driver of migration, but little research exists on whether migrant communities in the U.S. identify climate change-related factors as reasons for migrating. In 2021, we conducted a multidisciplinary, collaborative project to better understand the nexus of climate change and immigrant health in the Atlanta area. This paper presents one arm of this collaboration that explored both the role of climate change in decisions to immigrate to Georgia and the ways that climate change intersects with other possible drivers of migration. First generation migrants from Latin America were recruited primarily through CPACS Cosmo Health Center and were invited to participate in an intake survey and an in-depth interview. Results were analyzed using descriptive statistics and thematic analysis. Findings suggest that while participants may not have explicitly identified climate change as a primary reason for migration, in both surveys and in-depth interviews, participants reported multiple and intersecting social, economic, political, and environmental factors that are directly or indirectly influenced by climate change and that are involved in their decisions to migrate. The narratives that emerged from in-depth interviews further contextualised survey data and elucidated the complex nexus of climate change, migration, and health. [ABSTRACT FROM AUTHOR]

Thailand's antimicrobial stewardship strategy has focussed on promoting 'rational drug use' in the public sector, to reduce the threat of drug resistance and control healthcare expenditure. The strategy's next ambition is to attend to the private sector, where antibiotics are widely available over the counter without prescription. Using ethnographic and survey data, this paper follows antibiotics through community pharmacies, to explore drug distribution and access, and identify potential challenges for stewardship. We extend the analytical frame beyond 'irrational' dispenser-customer transactions, to explore the logics of practice of a multiplicity of actors in the context of a highly competitive pharmaceutical market. Highlighting the role of the pharmaceutical industry in mystifying medicines, we show how antibiotics are collapsed into a category of 'strong medicines' and requested by customers using 'prescriptions by proxy'. We further examine how Thailand's drug regulation and classificatory systems, historically orientated around access to medicines, enable the proliferation of antibiotics in the context of contemporary efforts to control distribution. Recognising the negotiations involved in dispensing antibiotics in a pluralistic health system, we attempt to reconfigure allocations of responsibility, advocating for stewardship approaches that take into account local ecologies of care, as well as implications for access, equity, and accountability. [ABSTRACT FROM AUTHOR]

In this paper, we share some personal reflections of straddling different research roles in a doctoral study entitled Queering Sex Work and Mobility in South Africa. We highlight the importance of using a Feminist Participatory Action Research (FPAR) methodology when conducting studies with migrant and mobile sex workers as it offers participants an opportunity to express their lived realities and embodied knowledge(s) beyond linguistic barriers. Through our reflections, we demonstrate that marginalised communities can become co-creators in knowledge production processes, not just the givers of stories (aka 'poverty porn') but integral members of the research team who actively contribute towards the conceptualisation, data collection, analysis, publishing and distribution of scholarship. [ABSTRACT FROM AUTHOR]

Changing business models in scholarly publishing means that researchers have increased choices as to where to submit their articles. Choices are made on the basis of perceived quality of the journal, the speed of publishing, and how close a match there is between the journal scope and the article topic. Additionally, there is an increasing concern as to whether the journals are predatory. This paper reports on a study which sought to understand how health researchers go about selecting where to publish and the support that they receive in this regard from librarians and related staff. The research confirms that knowledge of a specific journal is still the predominant factor for researchers and that they prefer to rely on their own judgment. Librarians are providing the tools such as databases and whitelists by which better choices can be made whilst exploring new roles in advising and training researchers. Predatory journals are being selected by some, chiefly as a consequence of a lack of awareness amongst researchers and the need for some to publish swiftly and at low cost. [ABSTRACT FROM AUTHOR]

While mobile phones promise to be an important tool for bridging the healthcare gaps in resource-poor areas in developing countries, scalability and sustainability of mobile phones for health (mhealth) interventions still remain a major challenge. Meanwhile, health workers are already using their own mobile phones (referred to as 'informal mhealth') to facilitate healthcare delivery in diverse ways. Therefore, this paper explores some strategies for integrating 'informal mHealth' in the healthcare delivery of Ghana, by highlighting some opportunities and challenges. The study mainly employed a combination of literature review, focus group discussions and key informant interviews with community health nurses (CHNs) and other stakeholders, who were purposively selected from the three ecological zones in Ghana. The study found that, while scale-up of 'formal mhealth' remains challenging in Ghana, almost all CHNs in our study are using their personal mobile phones 'informally' to bridge healthcare gaps, thereby promoting universal health coverage. This provides opportunities for promoting (or formalising) 'informal' mhealth in Ghana, in spite of some practical challenges in the use of personal mobile phones that need to be addressed to ensure sustainable healthcare delivery in the country. [ABSTRACT FROM AUTHOR]

Amendments to various state laws have made it easier for cisgendered lesbian, bisexual and queer (LBQ) women to access Australian fertility clinics. When women conceive through clinics, they generally use intrauterine insemination (IUI) or in vitro fertilisation (IVF). IUI is cheaper and requires less invasive medical intervention than IVF. A recent survey found that almost 60% of Australian cisgendered LBQ women who conceived with clinical assistance did so using IVF, despite most presenting to clinics without a diagnosis of infertility and seeking donor sperm only. In this paper, based on 20 interviews with Australian clinicians who treat LBQ patients seeking pregnancy, we explore potential explanations for why over half of LBQ women using Australian fertility clinics to conceive used IVF rather than IUI. A 'perfect storm' of factors appears to converge in this tendency. Although some LBQ women are purposefully choosing IVF to achieve biological relatedness for two mothers, other pressures toward high intervention conceptions include the distinction between 'social' and 'clinical' infertility by Medicare (the Australian national health insurance scheme), the relative profitability of IVF procedures and issues with the supply and quality of donor sperm. Accessing sperm from clinics appears to set some Australian women without male partners on a potentially unnecessary path to a high intervention and costly conception. [ABSTRACT FROM AUTHOR]

Adolescents experience significant barriers, including stigma and discrimination, to accessing voluntary family planning and reproductive health (FP/RH) services in Rwanda. Self-care interventions have been shown to reduce social barriers to FP/RH care, but little is known about the effectiveness of digital self-care for adolescents, particularly in low-resource settings. This paper presents findings from a pilot study of CyberRwanda, a digital self-care intervention providing comprehensive sexuality education and confidential online ordering of contraceptives for school-aged youth in Rwanda through a rights-based approach. A mixed-methods pilot study was conducted from November 2019 to February 2020 to assess feasibility, acceptability, and engagement and to inform a future impact evaluation. Surveys were administered to a random sample of 158 students aged 12–19 years in three secondary schools. In-depth interviews were conducted with students, parents, teachers, pharmacists, district-level administrators, and youth centre staff. Descriptive statistics were calculated and qualitative data were analyzed using a thematic coding approach. One hundred and fifty-eight surveys and 28 interviews were conducted. Results revealed high demand for CyberRwanda in schools. Students were interested in engaging with the program and found the FP/RH content relevant to their needs. However, few purchased contraceptive products through the online ordering system. There are preliminary indications that CyberRwanda may improve access to FP/RH information. An extended implementation period and further research are needed to measure the long-term impacts of the program and evaluate whether this digital self-care intervention can increase uptake of contraceptive methods and reduce adolescent pregnancy among school-aged youth. [ABSTRACT FROM AUTHOR]