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Background Digital Health technologies (DHT) have potential to deliver intensive, novel and engaging rehabilitation for people with neurological conditions, yet health services lack a strong track record in embedding DHT into practice. The aim of this review was to synthesise factors that have been shown to influence implementation of DHT into neurological rehabilitation. Method An integrative review was undertaken. An extensive search of MEDLINE, CINAHL, AMED, EMBASE was undertaken. The title and abstract of all retrieved sources were screened against pre-defined criteria. Retained sources underwent full text review. The quality of all included sources was assessed. A meta-ethnographic synthesis explored commonalities and contradictions of the included studies. Results Fourteen studies (one quantitative, eight qualitative and five mixed methods) were included. Eleven implementation theories/models/frameworks were used across the 14 studies. Five themes were identified: (i) individual factors; (ii) user experience of the technology; (iii) the content of the intervention; (iv) access to the technology and (v) supporting use. Conclusions Key factors which appear to influence the implementation of DHT into clinical settings are highlighted. Implementation theories, models and frameworks are under-utilised in DHT rehabilitation research. This needs to be addressed if DHT are to realise their potential in neurological rehabilitation. Registration The protocol was registered and is available from PROSPERO (CRD42021268984).

Aims: To discover whether dental visiting behavior can be understood as a dichotomy of planned versus problem based, or whether there were a range of different types of understanding and patient behavior, recognizable as patterns of dental visiting behavior. Methods: Secondary analysis drawing on 2 qualitative studies of patients’ accounts of dental attendance and oral health, with 1) opportunistic interviews with people attending urgent dental care services ( n = 43; including 19 with follow-up) and 2) home-based, in-depth interviews with people attending a dental practice with a mixture of improved or deteriorated/poor periodontal health ( n = 25). Results: Four distinguishable patterns of dental visiting were identified in patients’ accounts: Accepting and Active Monitoring, as well as Ambivalent and Active Problem-based dental visiting behavior. Individuals’ patterns were relatively stable over time but could shift at turning points. Accepting Monitors were characterized as accepting dentists’ recommendations and dental practice policies relating to oral health and visits, whereas Active Monitors were more independent in judging how often to attend for preventive appointments, while still valuing anticipatory care. Ambivalent Problem–based visitors placed a relatively low value on anticipatory care for oral health maintenance and drifted into lapsed attendance, in part because of service-related factors. This contrasted with Active Problem–based visitors, for whom using services only in an emergency was a conscious decision, with low value placed on anticipatory care. Conclusion: This article demonstrates the dynamic nature of patterns of dental visiting where the dental system itself is partly instrumental in shaping patterns of utilization in an ecological way. Thus, service-related factors tend to combine with patients’ behavior in expanding inequalities. This illuminates the reasons why risk-based recalls are challenging to implement as a dental policy. Know

The key to empowering and supporting children and young people (CYP) with vision impairment (VI) to achieve their potential lies in the delivery of habilitation training. Evidence has revealed that provision of habilitation services across the United Kingdom was inconsistent, with CYP with VI not receiving services in some areas. This research explored the accessibility and quality of habilitation provision for CYP with VI via two studies: (1) 12 qualitative case studies of habilitation practice and (2) surveys of habilitation training experiences, with CYP with VI (n = 43) and with parents of CYP with VI (n = 68). Five themes were identified highlighting inconsistencies and variability in the delivery of habilitation training in recent years, a lack of focus on independent living skills training, on social inclusion and emotional well-being, a lack of support for parents and a lack of clarity with regard to the definition of habilitation, and who is responsible for providing training.

The systems of support for people with a visual impairment in the United Kingdom are complex and can be difficult to access, involving input from a range of health and social care services. In this article, we report qualitative findings from research looking at people’s experiences of accessing health and social care services. These highlight the inconsistencies and variability in existing systems of support for people with a visual impairment, and show that access to services is largely dependent on the agency and initiative of individual service users in establishing networks of support for themselves. This means that those who are less able to do this may find themselves without the support necessary to maintain or improve their quality of life. We argue that health and social care agencies need to be more proactive in addressing the support needs of people with a visual impairment beyond the point of initial diagnosis or registration.

The impact of sight loss on everyday life changes over time, through further deterioration of vision, as well as a result of other physical changes and key events in people’s lives. As such, even the support needs of people with relatively stable visual impairment are likely to change throughout their life course. This article explores the long-term support needs of people with sight loss and the barriers they face when accessing services over time and at the time of need. Data from biographical interviews with 36 participants with sight loss is presented, with particular focus upon three illustrative case studies. The study reveals that many participants experienced problems gaining information about, and access to, services in the short and longer term. There is a need for systematic referral from clinical services to social and voluntary services and for regular follow-up to identify and respond to people’s changing needs.