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Abstract Introduction Patient‐reported measures that assess satisfaction and experience are increasingly utilised in healthcare sectors, including the alcohol and other drug (AOD) sector. This scoping review identifies how and to what extent people accessing AOD services have been involved in the development of satisfaction and experience measures to date. Methods PubMed, EMBASE, CINAHL, Scopus, ProQuest, Google and Google Scholar were searched. Included papers described the development and/or implementation of a multiple‐item measure of patient‐reported experience or satisfaction specifically for people accessing AOD treatment and/or harm reduction programmes. If there was more than one paper, key papers were chosen that described each measure. The method of development, including service user involvement, was assessed against a framework generated for this review. Two reviewers were involved at each stage. Results Thirty measures—23 satisfaction and 7 experience—were identified. Sixteen measures reported some level of involvement by people accessing AOD services in their development, although, for most measures, at a relatively low level. This involvement increased over the time span of the review becoming more frequent in later years. Only four measures were developed for use in harm reduction‐specific settings, and fewer than half reported undertaking analysis of underlying scale structure and constructs. Conclusion Several gaps could be addressed to enhance the measurement of patient‐centred care in the AOD sector, including: developing experience measures for use in harm reduction settings and across various AOD settings in a service system; improved reporting of psychometric properties of these measures and increasing commitment to the meaningful involvement of AOD service users in measure development. Patient or Public Contribution This scoping review is part of a broader codesign project that involves a partnership between the peak organisation for AOD services and the peer‐based AOD consumer organisation in the Australian Capital Territory, Australia. These organisations are working closely together to engage with AOD service users, service providers and policy makers in this codesign project. As such, the Executive Director of the peer‐based AOD consumer organisation is involved as a co‐author of this scoping review.

The recent outpouring of testimonies about teenage sexual assault has reinvigorated calls for improved education on sexual consent. Better understanding of the approach, content and delivery of these programmes is key to informing best practice. In this paper, we systematically searched for peer-reviewed articles on programmes in education settings for young people aged 15-29 that purport to teach sexual consent, with 18 meeting the inclusion criteria. Nearly all reviewed programmes were implemented in the USA (n = 16) in university settings (n = 15), with short-term duration (1-2-hour sessions), with varied facilitators and interactive teaching strategies. Thematic analysis identified four main approaches to sexual consent education, some of which were interwoven within programmes: risky behaviour, sex-positive, life skills, and socioculturally adapted. In line with existing research into best practice sex and relationship education, we recommend that consent education programmes take a sex-positive and whole-school approach, are interactive and inclusive, and facilitate critical analysis of how experiences of consensual and non-consensual sexual activity are connected to socio-structural forces within socio-cultural contexts. Future research should evaluate a larger number of programmes and ensure consistent measurement of programme outcomes, whilst taking account of complex social systems and their shifting influence on consent.

High-quality teaching is central to the higher education sector. Its pursuit has become heightened with increasing competition across institutions and opportunities to study globally through various modes. This systematic meta-review provides a synthesis of evidence relating to the methods used to assess and enhance the quality of teaching practice within higher education. Key words, synonyms and subject headings were used to search six electronic databases between January 2009 and August 2019. Titles and abstracts of publications were screened and full text articles assessed against the eligibility criteria. Findings were extracted and integrated in a narrative synthesis. Thirteen review articles, revealed that the use of teaching quality: student feedback data, self-assessment tools, peer review of teaching (formative and summative) and the use of teaching portfolios. We report evidence related to the effectiveness of each of these approaches and that a multi-modal approach may be most effective but requires consideration of resourcing.

Plain English summary High proportion of married women do not use an effective contraceptive method and is a public health concern that is associated with unintended pregnancies, unwanted births, and unsafe abortions. This is also associated with increased risks of pregnancy and childbirth-related maternal morbidity. The decision to initiate use and continue the use of contraceptives is influenced by a number of factors. A greater understanding of these factors will inform policymakers, programmers, and other stakeholders to strengthen family planning and other health intervention programs to achieve the SDGs targeted maternal and under-5 child mortality reduction. Thus, the main objective of this study was to understand the social influences in initiating and continuing use of an LARC methods for contraception in a rural setting in Pakistan, using qualitative research. The analysis was done from a total of 27 women, aged 15–49 years, who started the use of long acting reversible contraceptive in the year preceding the study. The findings have an implication for policymakers, programmers, health care providers, and other stakeholders to evaluate and strengthen the provision of different contraceptive methods and improve support provided to women through the family planning programs. The findings of this study strongly recommended the provision of quality counseling on side effects and availability of contraceptive methods, peer support, and support for decision-making regarding long acting reversible contraceptive use.

Sport-for-social-change programs focusing on enhancing young people’s personal and social development emerged in the early to mid-2000s. Children and adolescents who participated in early programs are now adults, providing an opportunity to examine whether these programs have had any influence on their life trajectories. The Football United program has been operating in Sydney, Australia, since 2006 and is used as a case study in this article. This qualitative study draws on 20 interviews conducted in 2018 with a diverse sample of past participants of the program. Key findings were that participants perceived that the relationships they formed at Football United have had a substantial impact on their life trajectories, including influencing education and career decisions. These relationships were found to increase participants’ social capital, creating diverse connections with people and institutions within and external to their geographical communities. This study also found participants embraced a long-term commitment to ‘give back’ to their local geographical, cultural, and ethnic communities, which they attributed to their participation in the program.

Abstract Background Couples HIV Testing & Counselling (CHTC) service is an approach that may enable more people to be reached and tested for HIV. However, little is known about how couples may use this service and what they think about CHTC as an approach to finding out their HIV status. This study aimed to understand how individuals who had ever been in an ongoing heterosexual relationship for 6 months or more intended to use CHTC in Ethiopia and their beliefs about its benefits and potential harms. Methods Qualitative in-depth interviews were conducted in Addis Ababa, the capital city of Ethiopia, in 2017. Semi-structured interviews were undertaken with individuals who had ever been in an ongoing heterosexual relationship (n = 21) and key-informants (n = 11) including religious leaders, health care providers, and case managers. The interviews were transcribed verbatim, and an inductive thematic analysis was conducted. The data were coded to look for concepts and patterns across the interviews and relevant themes identified which captured key aspects related to the individual’s views on undertaking HIV testing with a sexual partner. Results Most participants regarded CHTC as an important HIV testing approach for people who are in an ongoing heterosexual relationship and expressed the view that there was “nothing like testing together”. However, many of the individual participants revealed they would prefer first to get tested alone to find out their own HIV status. They feared the consequences if they were HIV-positive, including accusations of infidelity, relationship break-up, and being exposed in the community. Many also reported being pressured to undertake CHTC before marriage by a third party, including religious institutions. Key informant interviews also discussed the requirements for CHTC before marriage. Conclusion The findings of this study suggest that people may be concerned about undertaking couples HIV testing without prior individual HIV testing. The intention of many to first test alone has policy and cost implications and underscores the possible harms of the implementation of CHTC in Ethiopia. Future research should examine whether the views identified in this qualitative study are reflected more broadly among couples in the community.

Abstract Background Complex interacting social, economic and historical factors influence the availability and uptake of alcohol and drugs, including among Indigenous communities. Self-harm and suicide as well as homelessness and incarceration, can both precede and result from drug and alcohol use. Rates of self-harm, suicide and incarceration among Aboriginal and Torres Strait Islander people in Australia are among the highest in the world and drug and alcohol treatment programs need to address these underlying complexities. This study examines whether an ‘holistic’ residential drug and alcohol treatment program for adolescents, with over 30% of clients identifying as Aboriginal and Torres Strait Islander, can improve outcomes post-discharge, including reducing self-harm, suicide attempts, arrests and alcohol and drug use. The program addresses substance use, mental health, employment, accommodation, social/community and family life. Program admission and 3 months’ post-discharge data from 2007 to 2016 were analysed. Results From 2007 to 2016, 619 Aboriginal and Torres Strait Islander young people were admitted to the program; 247 stayed in the program for 30 days or more; 89 were successfully followed up three months post-discharge to determine whether there was a significant improvement from baseline using the McNemar’s Test and the Wilcoxon Signed Ranks Test. On admission, 18 people (20%) of the study population reported attempting suicide in the last 3 months and 23 people (30%) reported self-harm. Most had been engaged in the criminal justice system, with 67 people (75%) having been to court and 62 people (70%) arrested one or more times in the past 3 months, with 35 people (41%) in unstable housing, reporting having lived in three or more places in the previous 6 months. At 3 months post-treatment, all (n = 18) who reported suicide attempts in the 3 months prior to admission reported no attempts in the prior 3 months at follow-up. There was also a significant reduction in self-harm with 23 young people out of the 27 who reported self-harm at baseline not reporting self-harm at follow up (85%) and in the proportion of adolescents who reported using cannabis, amphetamines and alcohol, as well as a reduction in the proportion who reported being arrested. Conclusions The findings provide support for an ‘holistic’ residential treatment program as an approach to improve health and related outcomes for Aboriginal and Torres Strait Islander young people. In addition to a focus on multiple aspects of a young person’s life in treatment, culturally relevant modes of treatment and support should be a future focus to further strengthen programs when Aboriginal and Torres Strait Islander young people are over-represented in the client group.

Background Globally, radon is the leading risk factor for lung cancer in never-smokers (LCINS). In this study, we systematically reviewed and meta-analysed the evidence of the risk of LCINS associated with residential radon exposure. Methods Medline and Embase databases were searched using predefined inclusion and exclusion criteria to identify relevant studies published from 1 January 1990 to 5 March 2020 focused on never-smokers. We identified four pooled collaborative studies (incorporating data from 24 case–control studies), one case–control study and one cohort study for systematic review. Meta-analysis was performed on the results of the four pooled studies due to different measures of effect and outcome reported in the cohort study and insufficient information reported for the case–control study. In a post hoc analysis, the corresponding risk for ever-smokers was also examined. Results Risk estimates of lung cancer from residential radon exposure were pooled in the meta-analysis for 2341 never-smoker cases, 8967 never-smoker controls, 9937 ever-smoker cases and 12 463 ever-smoker controls. Adjusted excess relative risks (aERRs) per 100 Bq·m−3 of radon level were 0.15 (95% CI 0.06–0.25) for never-smokers and 0.09 (95% CI 0.03–0.16) for ever-smokers, and the difference between them was statistically insignificant (p=0.32). The aERR per 100 Bq·m−3was higher for men (0.46; 95% CI 0.15–0.76) than for women (0.09; 95% CI −0.02–0.20) among never-smokers (p=0.027). Conclusion This study provided quantified risk estimates for lung cancer from residential radon exposure among both never-smokers and ever-smokers. Among never-smokers in radon-prone areas, men were at higher risk of lung cancer than women.

Introduction In a majority of low- and middle-income countries (LMICs), levels of child growth failure (CGF) have steadily declined since 2000. However, some countries show a different trend. Despite continued investment from the government of Ethiopia as well as donors, CGF levels are still high in Ethiopia. This study aimed to assess trends in CGF and associated sociodemographic, economic and water, sanitation, and hygiene (WASH) factors from 2000 to 2016 in Ethiopia. Methods Data were taken from four rounds of the Ethiopia Demographic and Health Survey (EDHS). Children aged between 0 to 59 months were included. CGF indicators were categorised based on height-for-age z-score (HAZ) < -2 Standard deviation (SD), weight-for-age z-score (WAZ) < -2 SD and weight-for-height z-score (WHZ) < -2 SD. CGF trends were estimated for predicted probabilities and odds ratios (ORs) between 2000 and 2016. Results A total sample size of 31978 for HAZ, 32045 for WAZ and 32246 for WHZ were included in the current study. Stunting decreased from an adjusted odds ratio (AOR) = 0.77 (95% CI: 0.67 to 0.88) in 2005 to an AOR = 0.45 (95% CI: 0.39 to 0.53) in 2016 compared with the year 2000. Compared with data in 2000, underweight decreased from an AOR of 0.70 (95% CI: 0.61 to 0.80) in 2005 to an AOR of 0.43 (95% CI: 0.36 to 0.50) in 2016. Wasting declined from an AOR of 0.91 (95% CI: 0.75 to 1.10) in 2005 to an AOR of 0.76 (95% CI: 0.61 to 0.94) in 2016, compared with data in 2000. Conclusions Between 2000 to 2016, there was a decline in CGF levels albeit the levels are still relatively high compared with the World Health Organization (WHO) cut-off levels for public health concern. Observed rates of change varied across sociodemographic, economic and WASH factors which suggest that interventions tailored towards addressing the imbalances across those factors are required.

Objective This study aimed to provide clarification on the benefits of water, sanitation and hygiene (WASH) alone separately and combined with nutrition in improving child growth outcomes.Design Systematic review and meta-analysis.Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. PubMed, MEDLINE, EMBASE, Scopus, Cochrane Library, Web of Science and Science Direct were searched in May 2018 and last updated in April 2019. We included studies that reported WASH interventions alone separately or combined with nutrition. Fixed and random-effects models were used to estimate pooled effect in mean difference (MD). Heterogeneity and publication bias statistics were performed.Results A total of 18 studies were included: 13 cluster randomised controlled trials (RCTs) and 5 non-randomised controlled trials (non-RCTs). Non-RCTs showed effect of WASH interventions alone on height-for-age z-score (HAZ) (MD=0.14; 95% CI 0.08 to 0.21) but RCTs did not. WASH alone of non-RCTs and RCTs that were delivered over 18–60 months indicated an effect on HAZ (MD=0.04; 95% CI 0.01 to 0.08). RCTs showed an effect for children

IntroductionPoor access to water, sanitation, and handwashing (WASH) facilities frequently contribute to child growth failure. The role of access to WASH facilities on child growth outcomes in Ethiopia is largely unknown. The aim of this study was to determine individual and combined effects of access to WASH facilities on child growth outcomes.MethodsData for this analysis was sourced from the recent Ethiopia Demographic and Health Survey (EDHS) 2016. A multivariable logistic regression model was applied to identify the separate and combined association of access to WASH facilities with child growth outcomes. Odds ratio (OR) and 95% confidence interval (CI) were estimated. Statistical significance was declared at p < 0.05.ResultsIncluded in the analyses were data for children 0-59 months of age, which amounted to valid data for 9588 children with a height-for-age z-score (HAZ), 9752 children with a weight-for-age z-score (WAZ) and 9607 children with a weight-for-height z-score (WHZ). Children with access to improved combined sanitation with handwashing facilities had 29% lower odds of linear growth failure (stunting) (adjusted odds ratio (AOR) = 0.71; 95% CI: 0.51-0.99) compared with those with unimproved. Children with access to combined improved WASH facilities were 33% less likely to have linear growth failure (AOR = 0.67; 95% CI: 0.45-0.98). Access to improved handwashing alone reduced the odds of being underweight by 17% (AOR = 0.83; 95% CI: 0.71-0.98) compared with unimproved. Improved water and sanitation separately as well as combined WASH were not associated with decreased odds of underweight and wasting.ConclusionsCombined access to improved water, sanitation and handwashing was associated with reduced child linear growth failure. Further research with robust methods is needed to examine whether combined WASH practices have synergistic effect on child growth outcomes.

Abstract Objective: To explore the knowledge and attitudes underlying contraceptive use and non‐use among Tongan adults and investigate the potential acceptability of contraceptive implants. Methods: A mixed methods study was conducted that used two focus groups and a short self‐completed survey (n=109). Participants were recruited from a Tongan non‐governmental sexual and reproductive health clinic. Results: Contraceptive method discontinuation was high among the study group, with reasons for discontinuation often relating to misconceptions circulating in the community about the side effects of contraceptives. A high proportion (38%) reported using ‘natural’ contraceptive methods. A total of 47% of survey participants reported having heard of implants and 37% indicated they would be willing to try them. Conclusion: Current Tongan contraceptive uptake and continuation is hampered by misconceptions about side effects of methods and their risks, particularly among long‐acting and reversible methods. Contraceptive implants may be acceptable to Tongans given their arm placement, reversibility and long‐lasting effect. Implications: Efforts to improve contraceptive continuation in Tonga should focus on improving counselling on potential side effects for all methods. The introduction of contraceptive implants as an additional long‐acting reversible method should be considered.

Describes a study that defined and provided initial empirical support for differentiating the concepts of computer attitude, subjective computer experience, and objective computer experience. Discusses results of a principal component factor analysis and presents a conceptual analysis of the relation between subjective computer experience and computer attitude. (Contains 50 references.) (Author/LRW)

Issues examined concerns the methods and definitions used to study computer experience, or people's attitudes towards computers and information technology. Topics addressed include the influence of computer experience on computer attitudes, how knowledge and beliefs about computers are formed, and the psychological processes involved in the rejection or acceptance of technology.