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Introduction: There is a lack of community-based rehabilitation for stroke in the Philippines, and research on this topic is limited. Different challenges may be encountered in urban and rural settings. The aim of the Tulong, Ugnayan ng Lingap At gabaY (TULAY) project is to develop a context-appropriate, community-based stroke support programme, consisting of self-management and training resources to augment the rehabilitation and recovery process. An important stage in the development of this programme is to qualitatively explore the experiences and needs of all stakeholders. Materials and methods: Using co-designed and evidence-based topic guides, in-depth semi-structured interviews will be conducted with people living with stroke, household carers and care providers. We will aim to gain a representation of different regions (within Luzon, Visayas, and Northern Mindanao), socioeconomic levels, and urban and rural locations. For people with stroke and household carers, interviews will be supplemented by auto-photography and visual elicitation to widen access for those that prefer to share their experiences visually or have communication problems. An interpretivist paradigm will be applied across all interview data and the consolidated criteria for reporting qualitative research (COREQ) will be followed. Thematic analysis will be undertaken using guidance by Braun and Clarke. Discussion: To our knowledge, this study is the first of its kind in the Philippines. It has several methodological strengths, including the capture of perspectives from multiple stakeholders in diverse settings, the inclusion of people with communication difficulties, use of visual methods, and analysis in the native language. The findings will have various applications, including the potential to influence policy, practice and guidelines, and to inform the development of the TULAY stroke support programme. [ABSTRACT FROM AUTHOR]

Background: Four out of five people living with osteoarthritis (OA) also suffer with at least one other long-term health condition. The complex interaction between OA and multiple long-term conditions (MLTCs) can result in difficulties with self-care, restricted mobility, pain, anxiety, depression and reduced quality of life. The aim of the MulTI-domain Self-management in Older People wiTh OstEoarthritis and Multi-Morbidities (TIPTOE) trial is to evaluate the clinical and cost-effectiveness of the Living Well self-management support intervention, co-designed with people living with OA, integrated into usual care, in comparison to usual care alone. Methods: TIPTOE is a multi-centre, two-arm, individually randomised controlled trial where 824 individuals over 65 years old with knee and/or hip joint pain from their OA affected joint and at least one other long-term health condition will be randomised to receive either the Living Well Self-Management support intervention or usual care. Eligible participants can self-refer onto the trial via a website or be referred via NHS services across Wales and England. Those randomised to receive the Living Well support intervention will be offered up to six one-to-one coaching sessions with a TIPTOE-trained healthcare practitioner and a co-designed book. Participants will be encouraged to nominate a support person to assist them throughout the study. All participants will complete a series of self-reported outcome measures at baseline and 6- and 12-month follow-up. The primary outcome is symptoms and quality of life as assessed by the Musculoskeletal Health Questionnaire (MSK-HQ). Routine data will be used to evaluate health resource use. A mixed methods process evaluation will be conducted alongside the trial to inform future implementation should the TIPTOE intervention be found both clinically and cost-effective. An embedded 'Study Within A Project' (SWAP) will explore and address barriers to the inclusion of under-served patient groups (e.g. oldest old, low socioeconomic groups, ethnic groups). Discussion: TIPTOE will evaluate the clinical and cost-effectiveness of a co-designed, living well personalised self-management support intervention for older individuals with knee and/or hip OA and MLTCs. The trial has been designed to maximise inclusivity and access. Trial registration: ISRCTN 16024745. Registered on October 16, 2023. [ABSTRACT FROM AUTHOR]

People with rare neurological conditions (RNCs) struggle to achieve regular physical activity (PA). This study explored experiences of people with RNC engaging in PA, their carers, and health care professionals (HCPs) working with them. We developed three surveys: for individuals living with RNCs, their carers, and HCPs working with them. Themes from interviews with RNC charity representatives were used to co-design questions, together with people living with RNCs, their representatives, and an expert panel. Surveys were disseminated via charity mailing lists, social media accounts, and professional networks (HCPs). We received 436 responses (225 people with RNC, 94 carers, 117 HCPs). Most respondents with RNC achieved some level of regular PA but needed motivation to maintain it. Many felt they lacked knowledge on starting and staying active, with scarce resources and support. Most HCP respondents worked in specialist services, and overwhelmingly agreed that people with RNC should be physically active, while acknowledging lack of evidence and resources. We identified key barriers at environmental/organisational, interpersonal, and intrapersonal levels, highlighting a critical lack of support for people with RNC across UK health services. These factors can be targeted to increase engagement in PA. People living with rare neurological conditions experience barriers to engaging in physical activity, with some common to more prevalent neurological diseases, e.g. access and facilities, but some notable differences due to the rarity of the condition For people living with rare neurological conditions, and their carers, there is a lack of knowledge on safe and appropriate engagement in physical activity Increasing the knowledge of health and exercise professionals may improve how they support people with rare neurological disease to engage with physical activity. Evidence based resources and recommendations for people living with rare neurological conditions, and professionals working with them, may facilitate engagement in physical activity [ABSTRACT FROM AUTHOR]

Performance arts can benefit people with acquired brain injury (ABI). This study explored the online delivery during COVID-19 restrictions, of a performance art intervention through the experiences of participants, artists and facilitators. Two community-based programmes were delivered. Online ethnographic observations and semi-structured interviews with participants, artists and facilitators were completed. The programmes benefited participants by addressing loneliness and isolation; building confidence through peer support; improving physical limitations through movement; improving communication through music and vocal work; and using poetry, visual arts, metaphor and performance to make sense of participants' experiences. Participants had mixed experiences of participation, but it was an acceptable alternative to in-person arts interventions for those who overcame digital challenges. ABI survivors can engage in online performance art programmes and find participation valuable for their health, well-being, and recovery. More work is needed to explore the generalisability of these findings, especially given digital poverty. [ABSTRACT FROM AUTHOR]

Objective To explore how primary care organizations assess and subsequently act upon the social determinants of noncommunicable diseases in their local populations. Methods For this systematic review we searched the online databases of PubMed[R], MEDLINE[R], Embase[R] and the Health Management Information Consortium from inception to 28 June 2019, along with hand-searching of references. Studies of any design that examined a primary care organization assessing social determinants of noncommunicable diseases were included. For quality assessment we used Cochrane's tool for assessing risk of bias in non-randomized studies of interventions. We used narrative data synthesis to appraise the extent to which the assessments gathered data on the domains of the World Health Organization social determinants of health framework. Findings We identified 666 studies of which 17 were included in the review. All studies used descriptive study designs. Clinic-based and household surveys and interviews were more commonly used to assess local social determinants than population-level data. We found no examples of organizations that assessed sociopolitical drivers of noncommunicable diseases; all focused on sociodemographic factors or circumstances of daily living. Nevertheless, the resulting actions to address social determinants ranged from individual-level interventions to population-wide measures and introducing representation of primary care organizations on system-level policy and planning committees. Conclusion Our findings may help policy-makers to consider suitable approaches for assessing and addressing social determinants of health in their domestic context. More rigorous observational and experimental evidence is needed to ascertain whether measuring social determinants leads to interventions which mitigate unmet social needs and reduce health disparities. [phrase omitted] [phrase omitted] Objectif Etudier la fagon dont les organlsmes de soins primaires evaluent et ensuite agissent sur les determinants sociaux des maladies non transmissibles au sein de leur population locale. Methodes Pour cette revue systematique, nous avons mene nos recherches dans les bases de donnees en ligne de PubMed[R], MEDLINE[R], Embase[R] ainsi que du Health Management Information Consortium, depuis sa creation jusqu'au 28 juin 2019, mais aussi cherche manuellement plusieurs references. Quel que soit leur modele, toutes les etudes qui portaient sur des organismes de soins primaires evaluant les determinants sociaux des maladies non transmissibles ont ete incluses. Afin de mesurer la qualite, nous avons employe l'outil Cochrane destine a determiner le risque de biais dans les etudes non randomisees sur les interventions. Nous avons egalement etabli une synthese narrative de donnees, pour definir dans quelle mesure les evaluations recoltaient des donnees dans les domaines couverts par les determinants sociaux de la sante caracterises par l'Organisation mondiale de la Sante. Resultats Nous avons identifie 666 etudes, dont 17 figurent dans cette revue. Toutes avaient eu recours a des modeles descriptifs. Les enquetes et entretiens realises dans les cliniques et aupres des menages etaient plus frequemment utilises que les donnees sur l'ensemble de la population pour reperer les determinants sociaux a l'echelle locale. Nous n'avons trouve aucun exemple d'organisme tenant compte des moteurs sociopolitiques en lien avec les maladies non transmissibles; tous se concentraient sur des facteurs sociodemographiques ou des conditions de vie specifiques. Neanmoins, les actions visant a avoir un impact sur les determinants sociaux etaient multiples: des interventions au niveau individuel jusqu'aux mesures applicables a l'integralite de la population, en passant par une representation inedite des organismes de soins primaires dans les strategies de systeme et les comites de planification. Conclusion Nos decouvertes pourraient aider les legislateurs a envisager des approches plus adaptees pour evaluer et aborder les determinants sociaux de la sante dans leur contexte national. Des observations et preuves experimentales supplementaires sont necessaires, afin de verifier si le fait d'identifier les determinants sociaux engendre des actions concretes qui repondent partiellement aux besoins sociaux non satisfaits et reduit les inegalites sanitaires. [phrase omitted] Objetivo Estudiar como las organizaciones de atencion primaria evaluan y aplican posteriormente los determinantes sociales de las enfermedades no transmisibles en sus poblaciones locales. Metodos Para esta revision sistematica se realizaron busquedas en las bases de datos en linea de PubMed[R], MEDLINE[R], Embase[R] y el Health Management Information Consortium desde su inicio hasta el 28 de junio de 2019, junto con una busqueda manual de referencias. Se incluyeron estudios de todos los disenos que analizaron a una organizacion de atencion primaria en la que se evaluaban los determinantes sociales de las enfermedades no transmisibles. Para la evaluacion de la calidad se utilizo la herramienta de Cochrane para evaluar el riesgo de sesgo en los estudios no aleatorizados de las intervenciones. Se utilizo la sintesis narrativa de datos para evaluar el alcance de las evaluaciones para recopilar datos sobre los dominios del marco de los determinantes sociales de la salud de la Organizacion Mundial de la Salud. Resultados Se identificaron 666 estudios, de los cuales 17 se incluyeron en la revision. Todos los estudios utilizaron disenos de estudio descriptivos. Se utilizaron las encuestas y las entrevistas en los consultorios y en los hogares con mayor frecuencia que los datos a nivel de la poblacion para evaluar los determinantes sociales locales. No se encontraron ejemplos de organizaciones que evaluaran los factores sociopoliticos determinantes de las enfermedades no transmisibles, ya que todas se centraban en los factores sociodemograficos o en las circunstancias de la vida cotidiana. No obstante, las medidas que se adoptaron para abordar los determinantes sociales fueron desde intervenciones a nivel individual hasta medidas a nivel de la poblacion y la integracion de la representacion de las organizaciones de atencion primaria en los comites de planificacion y de politicas a nivel del sistema. Conclusion Los resultados obtenidos pueden ayudar a los responsables de formular las politicas a considerar los enfoques adecuados para evaluar y abordar los determinantes sociales de la salud en su contexto nacional. Se necesitan evidencias observacionales y experimentales mas rigurosas para determinar si la medicion de los determinantes sociales conduce a las intervenciones que mitigan las necesidades sociales que no se atienden y que reducen las desigualdades en la salud., Introduction Primary health care is a whole-of-society approach to health that depends on integrated primary care and essential public health functions; empowered people and communities; and multisectoral policy and action. [...]