Causal theoretical frameworks that explain veteran mental health help-seeking behavior: a scoping review protocol.

OBJECTIVE: This scoping review will determine what causal theoretical frameworks have been used to examine veteran mental health help-seeking behavior. The review will also examine the causal factors proposed by these theoretical frameworks, and whether they account for the complex cultural, social, and affective experiences of veterans, which may drive both uptake or avoidance of mental health help-seeking. INTRODUCTION: Some military veterans delay mental health help-seeking, preventing early intervention, creating poor long-term quality of life and functional outcomes, and increasing the likelihood of reaching crisis point before seeking help. There is a distinct lack of research utilizing causal motivational frameworks to explain veteran mental health help-seeking behavior (both engagement and avoidance). To date, no review has been conducted on motivational frameworks used to explain veteran help-seeking behavior. This scoping review will be the first to identify the motivational models that have been used to explain veteran mental health help-seeking, as well as table the proposed causal factors, and determine whether the models account for the cultural, social, and affective experiences of veterans. INCLUSION CRITERIA: This scoping review will only consider studies on veteran cohorts. Studies in English that utilize or create an explanatory theory, model, or framework for veteran mental health help-seeking behavior will be included. Literature that focuses solely on intentions rather than behavior will be excluded. METHODS: Published and unpublished studies and gray literature will be included. Titles and abstracts will be screened, followed by full-text screening. Factors, theories, models, and frameworks used to explain veteran help-seeking behavior will be extracted, charted, and narratively summarized. The JBI methodology for scoping reviews will be used.

A meta-synthesis of how parents of children with autism describe their experience of accessing and using routine healthcare services for their children.

In order to present a greater understanding to parental experiences of supporting their child with autism to access healthcare services, a systematic review of qualitative research was undertaken, addressing the review question: 'How do parents of children with autism describe their experiences of utilising routine healthcare services?'. After a systematic search and selection process, 12 studies were identified and appraised independently by paired reviewers using an adapted version of the Critical Appraisal Skills Programme (CASP) tool. Data were synthesised by two reviewers in line with the Joanna Briggs Approach for meta-aggregation. The 12 studies included in this review (spanning 2012-2020), represented the voices of 240 parents. The synthesis resulted in the following synthesised finding (based on four categories that emerged from the original studies' themes): parents report challenges in accessing and use of mainstream health services, for their child with autism, due to not having a voice, inadequate communication and lack of understanding from health service providers. This review raises our awareness of parents' experiences of healthcare services and will assist healthcare practitioners to reconsider their own communication style, understanding and approach with children with autism and their families. From these findings, we recommend that healthcare practitioners more readily incorporate parents' contributory expertise into healthcare visits. These recommendations will help facilitate effective, supportive and positive healthcare experiences for all involved.