Value chain interventions for improving women's economic empowerment: A mixed-methods systematic review and meta-analysis: A systematic review.

Background: Value chain interventions have become widespread throughout the international development sector over the last 20 years, and there is a need to evaluate their effectiveness in improving women's welfare across multiple dimensions. Agricultural value chains are influenced by socio-cultural norms and gender dynamics that have an impact on the distribution of resources, benefits, and access to opportunities. While women play a critical role in agriculture, they are generally confined to the least-valued parts of the value chain with the lowest economic returns, depending on the local, social and institutional contexts. Objectives: The review assesses the effectiveness of approaches, strategies and interventions focused on women's engagement in agricultural value chains that lead to women's economic empowerment in low- and middle-income countries. It explores the contextual barriers and facilitators that determine women's participation in value chains and ultimately impact their effectiveness. Search Methods: We searched completed and on-going studies from Scopus, Web of Science Core Collection (Social Sciences Citation Index [SSCI], Science Citation Index Expanded [SCI-EXPANDED], Conference Proceedings Citation Index - Science [CPCI-S], Conference Proceedings Citation Index - Social Science & Humanities [CPCI-SSH], and Emerging Sources Citation Index [ESCI]), International Bibliography of the Social Sciences, EconLit, Business Source Premier, APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane, Database of Systematic Reviews, CAB Abstracts and Sociological Abstracts. We also searched relevant websites such as Consortium of International Agricultural Research Centers (CGIAR); the International Fund for Agricultural Development (IFAD); AgriProFocus; the Bill & Melinda Gates Foundation (BMGF); Donor Committee for Enterprise Development; the UN Food and Agriculture Organisation (FAO); the International Labour Organisation (ILO); the Netherlands Development Organisation; USAID; the Swiss Agency for Development and Cooperation; the International Food Policy Research Institute; World Agroforestry; the International Livestock Research Institute; the Foreign, Commonwealth & Development Office; the British Library for Development Studies (BLDS); AGRIS; the IMMANA grant database; the 3ie impact evaluation database; Innovations for Poverty Action (IPA); The Abdul Latif Jameel Poverty Action Lab (J-PAL); the World Bank IEG evaluations; the USAID Development Data Library; Experience Clearinghouse; the proceedings of the Agriculture, Nutrition and Health Academy conference; the proceedings of the Centre for the Study of African Economies (CSAE) Conference; the proceedings of the North East Universities Development Consortium (NEUDC) Conference; and the World Bank Economic Review. The database search was conducted in March 2022, and the website search was completed in August 2022. Selection Criteria: The review includes value chain interventions evaluating the economic empowerment outcomes. The review includes effectiveness studies (experimental and non-experimental studies with a comparison group) and process evaluations. Data Collection and Analysis: Two review authors independently assessed studies for inclusion, extracted data, critically appraised the studies, and synthesised findings. Results: We found that value chain interventions are successful in improving the economic conditions of their intended beneficiaries. The interventions were found to improve women's economic outcomes such as income, assets holdings, productivity, and savings, but these effects were small in size and limited by low confidence in methodological quality. The meta-analysis suggests that this occurs more via the acquisition of skills and improved inputs, rather than through improvement in access to profitable markets. The qualitative evidence on interventions points to the persistence of cultural barriers and other constraints. Those interventions implemented in Sub-Saharan Africa and South Asia are consistently more successful for all outcomes considered, although there are few studies conducted in other areas of the world. Conclusions: The review concludes that value chain interventions empower women, but perhaps to a lesser extent than expected. Economic empowerment does not immediately translate into empowerment within families and communities. Interventions should either moderate their expectations of empowerment goals, or they should be implemented in a way that ensures higher rates of participation among women and the acquisition of greater decision-making power.

Parental Grief After the Unexpected Death of a Child: A Scoping Review About the Impact on Parent's Social Networks and the Function of Self-Help Groups.

The unexpected death of a child, whether due to accident, sudden death syndrome, suicide, or homicide, causes profound parental grief that endures for years. Often, this grief is not fully understood by the social environment, leading parents to feel increasingly misunderstood and isolated. While initial support may be provided, it can become insufficient over time. Therefore, many parents turn to support groups, finding multiple benefits such as validation of their feelings, a safe space to discuss their children and express emotions, strengthening of their social identity, and a platform for reconstructing meaning in their lives. A scoping review was carried on to review the state of knowledge regarding the role that self-help groups can play in case of bereavement due to the unexpected death of a child and regarding the impact on social relationships referred to in these contexts. The search was conducted on 11 databases and grey literature and provided 22 final results. Reviewed studies confirm the impact of this loss, particularly on mothers, and suggest that self-help groups contribute to a more favorable development of the grieving process. Despite the scarcity of research, future studies could leverage newer theoretical models and measurement tools to confirm protective, predictive, and risk factors.

Contribuições dos grupos operativos da atenção básica a partir da visão dos usuários / Aportes de los grupos operativos de atención primaria desde la visión de los usuarios / Contributions of primary care operating groups from user perception

Os grupos em saúde nascem para fomentar práticas coletivas de saúde, tendo se expandido para a atenção básica, encontrando ressonância na promoção da saúde e da qualidade de vida. Baseados nas teorias de Pichon-Rivière e de Yalom e Leszcz, esses grupos são capazes de contribuir para mudanças significativas na qualidade de vida de seus usuários participantes. Este artigo tem como objetivo analisar as contribuições dos grupos operativos da atenção primária à saúde a partir da visão de seus usuários e compreender a operacionalização desses grupos. Trata-se de pesquisa descritiva e analítica de caráter qualitativo, realizada em quatro grupos operativos em saúde da atenção básica de um município do Rio Grande do Norte, no interior do semiárido nordeste brasileiro. Os dados foram coletados por questionário socioeconômico e grupos focais entre março e agosto de 2023, sendo utilizada estatística descritiva para os questionários e análise temática de conteúdo para os grupos focais. Os questionários revelaram um predomínio de participantes do sexo feminino, com faixa etária acima dos 60 anos e situação socioeconômica de baixa renda. A análise de conteúdo demonstrou a efetividade dos grupos em produzir vetores grupais e fatores terapêuticos, além de seu potencial, como campo para a educação popular em saúde, em fomentar as redes sociais, o apoio, o acolhimento e o bem-estar biopsicossocial. Os grupos em saúde são estratégias eficazes na promoção da saúde e na qualidade de vida. Entretanto, ressalta-se a necessidade de pesquisas que avaliem a eficácia global dos grupos nos processos de morbimortalidade.

Health care groups were created to promote collective health practices and were expanded into Primary Care, helping to promote health and quality of life. Based on the theories of Pichon-Rivière and Yalom and Lezscz, these groups can contribute to significant changes in the quality of life of their participating users. Thus, this article analyzes the contributions of Primary Health Care operating groups from users' perspective and understands their operationalization. A descriptive analytical qualitative research was conducted with four health operating groups in Primary Care from a municipality in Rio Grande do Norte, in the semi-arid northeastern Brazil. Data were collected by means of a socioeconomic questionnaire and focus groups between March and August 2023, and investigated using descriptive statistics (questionnaires) and thematic content analysis (focus groups). The questionnaires revealed a predominance of female participants over 60 years old and with low-income socioeconomic status. Content analysis showed the groups' effectiveness in producing group vectors and therapeutic factors, as well as their potential as a field for popular health education in fostering social networks, support, user embracement, and biopsychosocial well-being. Health groups are effective strategies for promoting health and quality of life, future research should evaluate their global effectiveness in morbidity and mortality.

Los grupos de salud se crearon para promover prácticas de salud colectiva y se expandieron a la atención primaria, repercutiendo en la promoción de la salud y la calidad de vida. Basados en las teorías de Pichon-Rivière y Yalom y Lezscz, los grupos son capaces de contribuir a cambios significativos en la calidad de vida de sus usuarios participantes. Este artículo tuvo por objetivo analizar las contribuciones de los grupos operativos de atención primaria de la salud desde la perspectiva de sus usuarios, así como comprender la operacionalización de estos grupos. Se trata de una investigación cualitativa, descriptiva y analítica, realizada en cuatro grupos operativos de salud en atención primaria de un municipio de Rio Grande do Norte (Brasil), en el interior de la región semiárida del Nordeste de Brasil. Los datos se recogieron de un cuestionario socioeconómico y de grupos focales en el período entre marzo y agosto de 2023, utilizando estadística descriptiva para los cuestionarios y análisis de contenido temático para los grupos focales. Los cuestionarios revelaron un predominio de los participantes del sexo femenino, mayores de 60 años y con nivel socioeconómico de bajos ingresos. El análisis de contenido demostró la eficacia de los grupos en la producción de vectores grupales y factores terapéuticos, además de su potencial como campo de educación popular en salud para fomentar redes sociales, apoyo, acogida y bienestar biopsicosocial. Los grupos de salud son estrategias efectivas para promover la salud y la calidad de vida. Sin embargo, se destaca la necesidad de investigaciones que evalúen la efectividad global de los grupos en los procesos de morbimortalidad.

Self-help groups and opioid use disorder treatment: An investigation using a machine learning-assisted robust causal inference framework.

OBJECTIVES: This study investigates the impact of participation in self-help groups on treatment completion among individuals undergoing medication for opioid use disorder (MOUD) treatment. Given the suboptimal adherence and retention rates for MOUD, this research seeks to examine the association between treatment completion and patient-level factors. Specifically, we evaluated the causal relationship between self-help group participation and treatment completion for patients undergoing MOUD. METHODS: We used the Substance Abuse and Mental Health Services Administration's (SAMHSA) Treatment Episode Data Set: Discharges (TEDS-D) from 2015 to 2019. The data are filtered by the patient's opioid use history, demographics, treatment modality, and other relevant information. In this observational study, machine learning models (Lasso Regression, Decision Trees, Random Forest, and XGBoost) were developed to predict treatment completion. Outcome Adaptive Elastic Net (OAENet) was used to select confounders and outcome predictors, and the robust McNemars test was used to evaluate the causal relationship between self-help group participation and MOUD treatment completion. RESULTS: The machine-learning models showed a strong association between participation in self-help groups and treatment completion. Our causal analysis demonstrated an average treatment effect on treated (ATT) of 0.260 and a p-value < 0.0001 for the robust McNemars test. CONCLUSIONS: Our study demonstrates the importance of participation in self-help groups for MOUD treatment recipients. We found that participation in MOUD along with self-help groups caused higher chances of treatment completion than MOUD alone. This suggests that policymakers should consider further integrating self-help groups into the treatment for OUD to improve the adherence and completion rate.

Impact of COVID-19 among small-scale industry fishermen - A mixed methods study from the coastal area of Karnataka.

BACKGROUND: COVID-19 pandemic resulted in widespread and devastating physical, emotional, societal, and economic repercussions among workers in India. OBJECTIVES: To evaluate the impact of COVID-19 and to understand the challenges faced and coping mechanism adopted among fishermen community from the coastal area of Karnataka. METHODOLOGY: This community-based mixed-methods study included participants from a coastal Karnataka fishermen's community. Questionnaire based personal interviews collected information on sociodemographics, COVID-19 diagnosis, treatment, and related costs, COVID-19-appropriate behavior and were screened using DASS-21. Focus group discussions and key informant interviews were conducted to acquire qualitative data. RESULTS: Quantitative data collection involved 107 participants, predominantly males [70.1%], aged between 46-60 years [37.4%] and low socioeconomic status [79.4%]. Among 107, 51 participants reported to have probable COVID-19 symptoms. Around 11% had tested for COVID-19 and two were admitted in hospital with mean hospital stay of seven days. According to DASS-21, 20.6%, 15.9% and 9.3% of participants screened positive for depression, anxiety and stress respectively. Nearly one third of the participants were found to have significant socioeconomic impact.Major challenges faced included loss of livelihood, inaccessibility to health care, repayment of loans, stigma related to COVID-19 and meeting educational expenses of children with one dropping out of college. Activities of local self-help groups in the community and grass root level marketing strategies to sell fish were highly successful in mitigating the impact as a community. CONCLUSION: COVID-19 had a significant impact on fishermen community and implies a need for better pandemic and disaster preparedness strategies in the community.

An online, two-day educational seminar had no impact on disease-specific knowledge in patients with systemic sclerosis.

Systemic sclerosis (SSc) is a multifaceted disease, and its diagnosis triggers substantial anxiety and uncertainty for those affected. Currently, there are no valid data describing the impact of disease-specific patient education on the disease knowledge available. We created a two-day, online educational seminar to provide SSc patients with disease-specific information. The primary objective of the study was to observe the change in the disease-specific knowledge of the patients. A total of 118 patients were randomized into an intervention group and a waiting list control group. The change in knowledge was assessed using a multiple-choice test. The intervention group completed the questionnaire before, directly after, and 3 months after the seminar, while the waiting list control group also took the test 3 months before the seminar to rule out nonspecific learning. The primary outcome measure was the score difference between baseline and 3 months after baseline. The study was registered in the German Clinical Trials Register (protocol code DRKS00024915). The educational seminar resulted in a small, but measurable, increase in knowledge. While the two tests in the waiting list control group prior to the seminar did not show a nonspecific increase in disease knowledge, the intervention led to a numerical increase in knowledge (mean ± sd score difference 0.34 ± 1.31, 95% CI (- 0.23; 0.86), p = 0.26) that did not reach statistical significance. Multiple linear regression analysis showed that being a member of a self-help group (ß = 1.12; p = 0.03) is a positive predictor of a higher disease knowledge. Although highly appreciated by participants, a two-day online seminar may not be the most appropriate format to generate measurable disease-specific knowledge. Self-help group membership was a positive predictor of a higher level of disease-specific knowledge prior to the educational seminar and should be recommended to every affected person.

Perceived benefits of patient support groups and their format for people with an implantable cardioverter defibrillator.

BACKGROUND: Support groups for people with Implantable Cardioverter Defibrillators (ICDs) are widely used, however, it is not clear what people with ICDs gain from a support group or what format they should take. OBJECTIVES: The aim of the present study is to define the perceived benefit of ICD support groups and develop practical recommendations for group format. METHODS: 14 individuals with ICDs were interviewed using a semi-structured interview guide. Reflexive thematic analysis methods were utilised to code and analyse the transcripts before generating themes. RESULTS: Four themes were defined: confronting mortality, coping through sharing, coping through learning, and providing space. Making connections with other people with ICDs, reassurance, access to information, and advice from health care professionals were important perceived benefits of the support group. CONCLUSION: People with ICDs may have to confront their own mortality and adapt to considerable life changes after implant. The findings from the present study have improved understanding of how support groups are perceived and how ICD indication and group format influence the experience. A blended format of in-person community meetings, online forums, HCP-led education and space for person-person interaction is recommended. Importantly, provision of support should not be time-limited to allow people to access it when it most likely to be of benefit to them.

'No matter what time of day': The value of joining Facebook groups supporting women's self-management of gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) affects a significant and growing proportion of pregnant women each year. The condition entails additional monitoring, self-management and healthcare use during pregnancy, and some women also join GDM support groups on Facebook. Little is known about the practices inside these groups, but examining them may elucidate support needs, women's experience of healthcare and improve overall outcomes. The aims of this study were to explore motivations for joining GDM Facebook groups and the perceived value and benefits of such spaces. DESIGN: A cross-sectional design using a web-based survey collected data from two peer-led GDM Facebook groups; relevant quantitative and qualitative data were extracted from open and closed questions, and analysed using descriptive statistics and content analysis. RESULTS: A total of 340 women responded to the survey, with 306 (90%) tendering their motivations to join a GDM Facebook group. Their answers were classified into six categories: peer support; information and practical advice; lived experiences; community; a safe place to ask questions and being recommended. The most commonly reported benefits of membership were 'reading about food ideas' and 'finding helpful information and tips'. Respondents reported finding their group strongly sympathetic, sincere, compassionate, heart-felt, tolerant, sensitive, warm and supportive. DISCUSSION AND CONCLUSIONS: GDM Facebook groups are valuable for informational and emotional support, and the sharing and perusal of lived experiences; another key benefit for women is feeling belonging to a community. GDM Facebook groups provide women with access to more tailored and readily available support, filling gaps not addressed by healthcare providers. PATIENT CONTRIBUTION: This study was led by a person with lived experience of GDM, and the survey was pilot tested with women who had also experienced GDM, which contributed to its development.

Group Cohesion and Necessary Adaptations in Online Hearing Voices Peer Support Groups: Qualitative Study With Group Facilitators.

BACKGROUND: Face-to-face hearing voices peer support groups (HVGs), a survivor-led initiative that enables individuals who hear voices to engage with the support of peers, have a long-standing history in community settings. HVGs are premised on the notion that forming authentic, mutual relationships enables the exploration of one's voice hearing experiences and, in turn, reduces subjective distress. As such, group cohesion is assumed to be a central mechanism of change in HVGs. The rise of digital mental health support, coupled with the COVID-19 pandemic, has resulted in many HVGs adapting to online delivery. However, to date no studies have examined the implementation of these online groups and the adaptations necessary to foster cohesion. OBJECTIVE: This study aims to understand the experience of group cohesion among HVG facilitators in online groups compared with face-to-face groups. Specifically, we examined the ways in which the medium through which groups run (online or face-to-face) impacts group cohesion and how facilitators adapted HVGs to foster group cohesion online. METHODS: Semistructured qualitative interviews were conducted with 11 facilitators with varied experience of facilitating online and face-to-face HVGs. Data were analyzed using reflexive thematic analysis. RESULTS: The findings are organized into 3 themes and associated subthemes: nonverbal challenges to cohesion (lack of differentiation, transitional space, inability to see the whole picture, and expressions of empathy); discursive challenges to cohesion (topic-based conversation and depth of disclosure); and necessary adaptations for online groups (fostering shared experience and using the unique context to demonstrate investment in others). Despite challenges in both the setting and content of online groups, facilitators felt that group cohesion was still possible to achieve online but that it had to be facilitated intentionally. CONCLUSIONS: This study is the first to specifically investigate group cohesion in online HVGs. Participants noted numerous challenges to group cohesion when adapting groups to run online, including the unnaturally linear narrative flow of dialogue in online settings; lack of transitional spaces, and associated small talk before and after the session; ease of disengagement online; inhibited sharing; and absence of shared physical presence online. Although these challenges were significant, facilitators nevertheless emphasized that the benefits provided by the accessibility of online groups outweighed these challenges. Necessary adaptations for cultivating group cohesion online are outlined and include capitalizing on moments of humor and spontaneity, using group activities, encouraging information sharing between participants using the chat and screen-sharing features, and using objects from participants' environments to gain deeper insight into their subjective worlds.

Family Fellowship Society for Psychosocial Rehabilitation Services (1993-2019): A Self-help Movement.

Family Fellowship Society for Psychosocial Rehabilitation Services is an initiative of families of persons with mental illness and with psychiatric disabilities. It has been advocating self-help movement on the part of the families who have been on the lookout for alternative care services. This venture has been technically supported by the mental health professionals at National Institute of Mental Health and Neurosciences, Bangalore. It is a collaborative effort of families and professionals to address the needs that have been felt by the consumers and the professionals. It is the first of its kind in India. Over a period of 26 years, 150 + families have availed the alternative care for psychosocial rehabilitation services for their wards. In this context, an attempt was made to enlighten the psychosocial rehabilitation services at family fellowship society.

[Quality of life, disease burden and healthcare need of patients with vitiligo]. / Lebensqualität, Krankheitslast und Versorgungsbedarf von Patienten mit Vitiligo.

BACKGROUND: With a prevalence of 0.5-2%, vitiligo is one of the most common skin disorders worldwide with loss of pigment. The skin disease has a disfiguring, often stigmatising character and is often associated with psychosocial distress. OBJECTIVE: To provide an overview of the psychosocial impairment, disease burden and resulting health care needs of patients with vitiligo. MATERIALS AND METHODS: Narrative review based on a literature search in PubMed for the years 1996-2022 on disease burden, quality of life and stigmatization is provided. RESULTS: The search yielded 175 relevant original papers including clinical studies, meta-analyses and systematic reviews (n = 65) for the search period. A large number of studies document that vitiligo is associated with considerable psychosocial stress and relevant losses in quality of life. Problem areas particularly concern stigmatisation, sexual dysfunction, anxiety, reduced self-esteem and problems at work. The observed increased levels of anxiety and depression correlate with the severity and activity of vitiligo. Often, comorbidity also contributes to reduced self-esteem and social isolation. These factors determine a high need for care in a relevant proportion of those affected. CONCLUSION: Vitiligo is not primarily a cosmetic problem, but a disease requiring treatment according to the World Health Organisation's definition of health as physical, mental and social well-being. The benefits of treatment options are to be measured by their effects on patient-reported outcomes.

Psycho-Oncological Self-Help Groups in Bavaria: The Current Situation and Suggestions for Improvement.

BACKGROUND: Self-help groups (SHGs) are an important cornerstone of the German health care system. Especially collaborations of SHGs with cancer centers enable active patient involvement in cancer care. We investigated the current situation and unmet needs of Bavarian SHGs in order to point out possible options of action. METHODS: We conducted a cross-sectional study with Bavarian psycho-oncological SHGs. Via e-mail, an online survey was sent to 150 SHGs registered at the BZKF (Bavarian Cancer Research Center). We assessed activities and needs of the SHGs as well as the nature of collaborations with cancer centers. We focused on adaptations during the COVID-19 pandemic and the inclusion of migrants. RESULTS: 46 (33.66%) SHGs participated, while 39 (84.78%) completed the questionnaire. During the COVID-19 pandemic, 50% of the SHGs reported less meetings. 22.7% changed to online meetings or other formats (43.2%). 20.9% of the SHGs had regular meetings with the cancer center, and 23.1% with the psycho-oncology. 51.2% evaluated the psycho-oncological services as neutral to dissatisfying due to lack of information, availability, and long waiting times. The SHGs indicated needs concerning interventions (coping strategies, digital applications, etc.), information, and better communication. Efforts for overcoming inequalities seemed rare: only 13.6% of the SHGs and 16.2% of the cancer centers had services for migrants. CONCLUSIONS: This study gave an overview of current activities and needs of Bavarian SHGs. The implementation of patient guides, comprehensive information material, and low-threshold psycho-oncological services should be objectives in future care to increase patient satisfaction. The needs for services for migrants should be investigated in more detail.

Equity and empowerment effects: Multiple styles of 'voluntarism' in community-based health projects.

Community health workers (CHW) are individuals with no formal health training who perform various roles to address health disparities. There are long-sustained debates over how different forms of incentives shape CHW programs, which are often staffed with volunteer or minimally remunerated women. These debates are complicated by the diversity of CHW roles and contexts in which they work. Evidence is particularly scant around "change-agent" style CHWs, who shape health knowledge and norms within their community. This paper addresses this gap through an analysis of a change agent-staffed program that provided nutrition participatory education through women's groups in three eastern Indian sites. We examine how contextual factors across sites shaped change-agent management, and analyze the implications of each approach for efficacy, empowerment, and equity. Analyzing 68 interviews and 10 focus groups this study advances a typology of 'varieties' of voluntarism that we name laissez faire, active-cultivation, and honorarium-accountability, and uses comparative analysis to examine the equity and empowerment effects within selection, management, and payment. First, we find tensions in the community-based selection of volunteers because rather than selecting highly motivated women, groups selected women in the most favorable socioeconomic position to volunteer. Second, there is a tension around responsibility and expectations in that greater training and responsibility leads women to see more psychosocial empowerment (e.g., knowledge, confidence), but also may create more 'costs' to participation and leads to wider economic inequities in change-agent ranks. Third, we observe a misplaced focus on payments as central to change-agent motivation. While the two volunteer-only sites see payment as 'the answer' to motivation problems, the honorarium site sees payments as 'the problem' because they attract less intrinsically motivated individuals. We conclude that while payments may not make an unmotivated volunteer into a motivated one, this analysis suggests payments would potentially allow more marginalized women to participate, which may be key to making more equitable and efficacious impacts.

Criação e desenvolvimento de grupos de apoio para o autocuidado em hanseníase em um estado do Nordeste brasileiro / Creation and development of support groups for leprosy self-care in a state in the northeast of Brazil

Resumo Objetivo Compreender a criação e desenvolvimento de grupos de apoio para o autocuidado em hanseníase em um estado do Nordeste brasileiro. Métodos Estudo qualitativo realizado em três grupos no Nordeste do Brasil, entre fevereiro e dezembro de 2019. A coleta de dados englobou entrevistas, observação participante e análise documental. Os dados foram analisados segundo a técnica de análise de conteúdo a partir dos temas preestabelecidos: implantação, organização e continuidade dos grupos. Resultados A implantação dos grupos apresentou como motivos comuns a necessidade de ampliação dos cuidados, e de otimização do tempo de trabalho. O estigma e questões da organização dos serviços foram obstáculos para a implantação. O fator mais relevante para a continuidade dos grupos foi o envolvimento dos coordenadores nas atividades. O apoio de atores externos como ONG e universidades foram relevantes para a implantação e continuidade. Considerações finais As similaridades e diferenças dos grupos relacionam-se aos participantes, à indução e apoio da política de saúde e às interferências de atores externos. Grupos de apoio para o autocuidado em hanseníase são espaços que potencializam a prática de cuidado. O estudo contribui com a implantação ou reorganização de grupos de apoio ao autocuidado.

Abstract Objective To understand the creation and development of support groups for leprosy in a state in the northeast of Brazil. Methods Qualitative study conducted with three groups in northeast Brazil, from February to December 2019. Data collection included interviews, participant observation, and document analysis. Data were analyzed using the content analysis technique, considering preestablished topics: implementation, organization, and continuity of the groups. Results The most common reasons presented by the groups for the implementation were the needs to expand care and optimize working time. The stigma and service organization issues were obstacles to implementation. The most relevant factor for the continuity of groups was the involvement of the coordinators in the activities. Support from external actors, such NGOs and universities, was relevant to implementation and continuity. Final considerations Similarities and differences among groups are related to participants, actions to foster the groups, health policy support, and interference from external actors. Support groups for leprosy self-care are spaces that strengthen the practice of care. This study contributed to implement or reorganize self-care support groups.

Ethnicity, information and cooperation: Evidence from a group-based nutrition intervention.

Development programs often rely on locally hired agents for service delivery, especially for interventions promoting agricultural practices, health, and nutrition. These agents are key to reaching underserved communities, especially women, with information and services around recommended practices. However, where societies are socially stratified, differences in ethnic identities between agents and beneficiaries may impact the effectiveness of information and service delivery and the uptake of recommended behaviors. We explore the salience of shared ethnic identity between agents and beneficiaries in promoting collective action using a field experiment with women's self-help groups (SHGs) in India. We cross-randomize an information treatment and a group-agent shared ethnicity treatment at the SHG level. We measure impacts on individual group member information retention and willingness to contribute to a group-owned kitchen garden that could improve access to a diverse and nutritious diet. We find information retention is better when the group is matched with an agent lower in the ethnic hierarchy, but that agents higher in the hierarchy elicit greater individual contributions to the group-owned kitchen garden. We suggest some hypotheses for these seemingly contradictory results. Other characteristics like education, group cohesion and perceived agent ability also matter in changing knowledge and contribution. Our findings have important implications for effective program design and implementation, suggesting that implementers need to consider factors beyond the information content, target group and pedagogical mode of delivery for their strategies to be transformative.

Amyotrophic Lateral Sclerosis and Its Management during the COVID-19 Pandemic: A Qualitative Study with Thematic Analysis of Patients and Caregivers Who Participated in Self-Help Groups.

This study employs a qualitative methodology to explore the effects of the pandemic on the lives of ALS patients and their caregivers. It aims to understand whether and how online self-help groups have assisted families dealing with amyotrophic lateral sclerosis (ALS) patients. ALS is a neurodegenerative disease with both physical and psychosocial implications. Consequently, it significantly affects the lives of patients' caregivers. In 2020, the COVID-19 pandemic exacerbated this situation. The results show that the pandemic has had a negative impact on the well-being of ALS caregivers and patients. Furthermore, bereavement and death were dealt with in different ways by the families involved. The pandemic aggravated the health of ALS patients and increased the workload of their caregivers; however, online psychological support was appreciated for its role in providing emotional help and diminishing social isolation.

[Nonpharmacological treatment measures, rehabilitation services and membership in patient support groups in axial spondylarthritis (The ATTENTUS axSpA study)]. / Nichtmedikamentöse Therapiemaßnahmen, Rehabilitationsleistungen und Mitgliedschaft in Selbsthilfeorganisationen bei axialer Spondyloarthritis (Die ATTENTUS axSpA-Studie).

BACKGROUND: The treatment of axial spondylarthritis (axSpA) includes pharmacological treatment measures (PTM) and nonpharmacological treatment measures (NPTM) as well as supporting resources, such as rehabilitation services (RS) and membership in patient support groups (PSG). Nevertheless, there are significant participation restrictions in patients with axSpA in Germany. OBJECTIVE: Investigation of functional deficits, participation restrictions and utilization of PTM, NPTM, RS and PSG membership in patients with axSpA. MATERIAL AND METHODS: Multicentric, observational study of 770 axSpA patients in Germany (ATTENTUS-axSpA). RESULTS: Substantial functional deficits and participation restrictions were observed in axSpA patients. Of the patients 39% did not receive treatment with biological disease-modifying antirheumatic drugs (bDMARD). In the NPTM 54% received physiotherapy less than once per week and 29% once per week. Physical activities were regularly performed by 86% of patients, mainly in the form of home exercises. Training in a gym (14%) or sports club (7%) was carried out much less frequently. Of the patients 54% received RS, one third had the last rehabilitation more than 5 years ago and 13% of the patients were members in a PSG. A significantly higher utilization of NPTM and rehabilitation was found in this group. CONCLUSION: Treatment options and resources were often utilized to a small extent and/or in low intensity by axSpA patients, which could be a possible explanation for persisting restrictions of participation. Membership in a PSG was associated with an increased utilization of NPTM and RS.

Experiences of peer support activities and the need for a metaverse-based program in young women with breast cancer: A qualitative study.

Objective: This study aimed to explore young breast cancer survivors' experiences of peer support activities and their need for a metaverse-based peer support program. Methods: This qualitative content analysis study involved 15 young women with breast cancer under the age of 40. Participants with diverse experiences in peer support activities were purposefully selected. Data were collected in March 2023 through three focus group interviews and three additional individual interviews. Saturation was reached when no new themes emerged from the interviews. The interviews were transcribed verbatim and analyzed using conventional content analysis. This study ensured the trustworthiness of the data based on criteria including truth value, applicability, consistency, and neutrality. Results: Four categories emerged: advantages, disadvantages, preferences for peer support activities, and the need for metaverse-based peer support programs. Participants valued peer support activities for exchanging information, nurturing empathy, and encouraging healthy behaviors. Challenges included information confusion, peer conflict, isolation, and stigma. Preferences for group composition, size, and medium varied; however, all participants agreed on the importance of operational guidelines. Participants expected a metaverse-based peer support program to provide safe and enjoyable experiences despite concerns about unfamiliar platforms. Conclusions: This study highlights the unique needs and preferences of young breast cancer survivors regarding peer support activities. Well-organized and tailored peer support can significantly enhance their quality of life. These findings provide valuable insights for developing effective metaverse-based peer support programs to meet the needs of young women with breast cancer.

Grupo de apoio diante das necessidades da família do dependente químico / Support group for the needs of the chemical dependent's family

Objetivou-se identificar as necessidades dos participantes de um Grupo de Apoio à Família no tocante à convivência com o familiar dependente químico. Tratou-se de um estudo qualitativo, desenvolvido com seis familiares que frequentam o Grupo de Apoio à Família em um Centro de Atenção Psicossocial para usuários de Álcool e outras Drogas, em uma cidade do Sul do Brasil. Os dados foram coletados em junho de 2020, mediante entrevista semiestruturada; e, posteriormente, foram analisados por meio de análise temática de conteúdo. Após a observação, emergiram três categorias: Necessidades dos familiares em relação às perspectivas do Grupo de Apoio à Família; Vivência dos familiares em relação ao suporte do Grupo de Apoio à Família e Aspectos a serem reconsiderados no Grupo de Apoio à Família. Nesse contexto, o estudo possibilitou reflexões sobre a elaboração de estratégias mais efetivas a fim de proporcionar um processo terapêutico mais eficaz e resultados mais positivos.

The objective was to identify the needs of participants of a Family Support Group regarding coexistence with the family member who is chemically dependent. This was a qualitative study, developed with six family members who attend the Family Support Group in a Psychosocial Care Center for users of Alcohol and other Drugs in a city in southern Brazil. The data were collected in June 2020 in a semi-structured interview and subsequently analyzed through thematic content analysis. After observation, three categories emerged: Needs of family members in relation to the perspectives of the Family Support Group; Experience of family members in relation to the support of the Family Support Group; and Aspects to be reconsidered in the Family Support Group. In this context, the study enabled reflections on the development of more effective strategies in order to provide a more effective therapeutic process and more positive results.