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Background: The increasing burden of epidemics of communicable and noncommunicable diseases in low- and middle-income countries underscores the importance of strengthening health systems to deliver effective and efficient care. Unfortunately, we know little about the contribution of interventions to an effective functioning of the health systems in Africa. Thus, we seek to identify existing effective interventions which could be implemented or scaled up to strengthen the functionality of health systems in Africa. Methods: We will conduct a scoping review following the methodology recommended in the Joanna Briggs Institute Reviewers Manual. We will use the following eligibility criteria: 1) study design: any empirical research; 2) participants: any individual, organizations, or systems involved in the delivery or receipt of health care or services; 3) intervention: any practice, procedure, method, strategy, or product covering at least one of the 13 elements of health systems (health workforce, health products, health infrastructure, service delivery processes, health governance processes, health information systems, financial management systems, values and norms, beliefs, practices, organizational culture, interests and networks, and relationships and power); 4) comparator: no restrictions; 5) outcomes: any metrics or indicators related to the four capacities of health systems (access to essential services, quality of care, demand for essential services, and resilience of health systems); and 5) setting: any country in the African continent or any low-income or lower-middle-income countries in other regions according to the 2022 World Bank classifications. We will search electronic databases (e.g., Web of Science, MEDLINE, Embase, and Cochrane Library) from inception onwards and hand search the World Health Organization (WHO) Library, Hinari, Google, and Google Scholar. We will select eligible reports, extract relevant information, and synthesize data based on the WHO Framework of Actions for Africa. We will report results using the PRISMA extension for Scoping Reviews Checklist. Discussion: Our findings will allow us to harmonize the evidence-based interventions that contribute to the functionality of health systems in Africa. This will also contribute to the achievement of universal health coverage and health related sustainable development goals targets.We will disseminate our findings to knowledge users through a publication in a peer-reviewed journal and organization of workshops.

Metabolic health issues have a high and increasing prevalence among Indigenous populations of Canada, the United States, New Zealand, and Australia. While including a consideration for the cultural safety of health interventions targeting these issues has proven to be relevant, little is known about the optimal way to proceed in this regard. We aim to systematically map the evidence for culturally safe interventions targeting health issues related to metabolic syndrome in Indigenous populations.

Health systems face increasingly complex challenges, such as the growing burden of chronic diseases and new epidemics. We are constantly developing and testing innovations, but we fail to implement those shown to be successful. Because of our failure to scale up our successes, we are not helping as many people as we could and our health systems are not as effective as they could be. CubecXpert seeks to tackle this problem. Our primary mission is to develop, connect, and mobilize knowledge and skills in implementation science, knowledge translation, epidemiology, and statistics to catalyze the scaling up of innovations in health and social services. We created the Living Scalability Assessment Platform (LiSAP) to help organizations, health agencies, research centres, researchers, clinicians, and students design and implement their projects using a variety of epidemiological, statistical, implementation science, and knowledge translation techniques. Thus, we will create a world-class knowledge base about scalability assessment that will be accessible and usable by patients and other knowledge users for scaling up evidence-based health innovations the world over.

Supplemental material, sj-docx-2-mpp-10.1177_23814683221124090 for Difficult Decisions for Older Canadians Receiving Home Care, and Why They Are So Difficult: A Web-Based Decisional Needs Assessment by Alfred Kodjo Toi, Ali Ben Charif, Claudia Lai, Gérard Ngueta, Karine V. Plourde, Dawn Stacey and France Légaré in MDM Policy & Practice

Additional file 1. List of experts participating in the 2-hour workshop.

Supplemental material, sj-pdf-1-mpp-10.1177_23814683221124090 for Difficult Decisions for Older Canadians Receiving Home Care, and Why They Are So Difficult: A Web-Based Decisional Needs Assessment by Alfred Kodjo Toi, Ali Ben Charif, Claudia Lai, Gérard Ngueta, Karine V. Plourde, Dawn Stacey and France Légaré in MDM Policy & Practice

Additional file 3. Email sent to experts to identify potential eligible records.

Additional file 7. Interpretability criteria for selecting items.

Additional file 5. List of excluded reports with reason for exclusion.

Additional file 1. Search strategy.

Additional file 2. List of relevant websites used to identify potential eligible records.

International audience; Background: Harm reduction (HR) interventions are essential to reduce human immunodeficiency virus (HIV) and hepatitis C virus (HCV) transmission in people who inject drugs (PWID). Preliminary testing of the Individually Tailored Support and Education for Safer Injection (ITSESI) evidence-based educational intervention for PWID was performed in France in 2011. We created the Eurosider project to implement and evaluate ITSESI at a wider European level, with a view to its future pan-European diffusion.Methods: We performed a mixed-methods study involving quantitative (a 6-month before-after study with PWID) and qualitative (focus groups with field workers) components. The study was conducted in 2018-2019 with 307 eligible PWID participating in four existing HR programmes in Bulgaria, Greece, Portugal, and Romania. ITSESI consists in trained field workers observing PWID injection practices and providing an educational exchange. For the present study, PWID participants were allocated to either the control group (i.e., they continued receiving only the current HR services) or the intervention group (i.e., current HR services plus ITSESI). We used the RE-AIM QuEST framework to assess the effectiveness of ITSESI and its acceptability by field workers. Effectiveness was defined as a reduction in both syringe sharing - the highest HIV/HCV transmission risk practice - and in cutaneous abscesses. We used a multivariable mixed logit model to analyse both effectiveness outcomes and to provide adjusted odds ratios (aOR) and 95% confidence intervals (CI). Field workers' acceptability of the intervention was described using a thematic analysis of the qualitative data.Results: Of the 307 PWID, 55% received ITSESI. Syringe sharing and cutaneous abscesses decreased during follow-up in the intervention group (from 25 to 16% and from 27 to 14%, respectively). Reductions were smaller in the control group (from 29 to 24% and from 23 to 18%, respectively). The multivariable analyses confirmed the effect of the intervention on both of these outcomes (aOR [95% CI]: 0.38 [0.17, 0.85]) and (aOR [95% CI]: 0.38 [0.16, 0.90], respectively). Our qualitative data on acceptability showed the feasibility of involving field workers as proactive research partners in making ITSESI more accessible and acceptable across Europe.Conclusions: We demonstrated both the effectiveness of ITSESI in reducing syringe sharing and cutaneous abscesses in four European countries, and a high level of intervention acceptability by field workers. Our findings provide important insights into how ITSESI can be adapted for pan-European implementation.

Background Young breast cancer survivors are often dissatisfied with the information provided on fertility and sexuality. Our aim was to discuss possible contributing factors and to propose strategies to increase patient satisfaction with such information. Methods Using the French National Health Insurance System database, we constituted the ELIPPSE40 regional cohort of 623 women, aged 18–40, diagnosed with breast cancer between 2005 and 2011. As of January 2014, 319 women had taken part in the 10-, 16-, 28 and 48-month telephone interviews. Satisfaction with the information provided about the potential impact of cancer and its treatment on fertility and sexuality was assessed at 48 months after diagnosis on 5-point Likert scales. Results Four years after diagnosis, only 53.0 and 42.6 % of women were satisfied with fertility- and sexuality-related information, respectively, without any significant change over the 2009–2014 period (P = 0.585 and P = 0.676 respectively). The two issues were moderately correlated (ρ = 0.60; P

International audience; BACKGROUNDAntiretroviral preexposure prophylaxis has been shown to reduce the risk of humanimmunodeficiency virus type 1 (HIV-1) infection in some studies, but conflictingresults have been reported among studies, probably due to challenges ofadherence to a daily regimen.METHODSWe conducted a double-blind, randomized trial of antiretroviral therapy for preexposureHIV-1 prophylaxis among men who have unprotected anal sex with men.Participants were randomly assigned to take a combination of tenofovir disoproxilfumarate (TDF) and emtricitabine (FTC) or placebo before and after sexualactivity. All participants received risk-reduction counseling and condoms and wereregularly tested for HIV-1 and HIV-2 and other sexually transmitted infections.RESULTSOf the 414 participants who underwent randomization, 400 who did not have HIVinfection were enrolled (199 in the TDF-FTC group and 201 in the placebo group).All participants were followed for a median of 9.3 months (interquartile range, 4.9 to20.6). A total of 16 HIV-1 infections occurred during follow-up, 2 in the TDF-FTCgroup (incidence, 0.91 per 100 person-years) and 14 in the placebo group (incidence,6.60 per 100 person-years), a relative reduction in the TDF-FTC group of 86% (95%confidence interval, 40 to 98; P = 0.002). Participants took a median of 15 pills ofTDF-FTC or placebo per month (P = 0.57). The rates of serious adverse events weresimilar in the two study groups. In the TDF-FTC group, as compared with theplacebo group, there were higher rates of gastrointestinal adverse events (14% vs. 5%,P = 0.002) and renal adverse events (18% vs. 10%, P = 0.03).CONCLUSIONSThe use of TDF-FTC before and after sexual activity provided protection againstHIV-1 infection in men who have sex with men. The treatment was associated withincreased rates of gastrointestinal and renal adverse events. (Funded by the NationalAgency of Research on AIDS and Viral Hepatitis [ANRS] and others;ClinicalTrials.gov number, NCT01473472.)