Connecting Health and Technology: A Comprehensive Review of Social Media and Online Communities in Healthcare.

This review provides an in-depth analysis of the intersection between health and technology, focusing specifically on social media's and online communities' role in healthcare. It explores the significance of these digital platforms in patient education, empowerment, and support, highlighting their potential to improve healthcare delivery and patient outcomes. Key findings are synthesized by examining existing literature, including the wide-reaching impact of social media on health information dissemination and the value of online communities in facilitating peer support. However, privacy concerns and misinformation are also addressed, emphasizing the need for careful consideration and strategic implementation of these technologies. The implications for healthcare practice and research are discussed, with recommendations for future actions and priorities outlined. Overall, this review underscores the transformative potential of social media and online communities in reshaping the healthcare landscape. It also highlights the importance of ethical and responsible use to maximize benefits.

The book is just being written: The enduring journey of parents of children with emerging- ultrarare disorders.

Ultra rare disorders are being diagnosed at an unprecedented rate, due to genomic sequencing. These diagnoses are often a new gene association, for which little is known, and few share the diagnosis. For these diagnoses, we use the term emerging-ultrarare disorder (E-URD), defined as <100 diagnosed individuals. We contacted 20 parents of children diagnosed with an E-URD through the Duke University Research Sequencing Clinic. Seventeen completed semi-structured interviews exploring parental perspectives (7/17 had children in publications describing the phenotype; 4/17 had children in the first publication establishing a new disorder). Data were analyzed using a directed content approach informed by an empowerment framework. Parents reported a range of responses, including benefits of a diagnosis and challenges of facing the unknown, some described feeling lost and confused, while others expressed empowerment. Empowerment characteristics were hope for the future, positive emotions, engagement, and confidence/self-efficacy to connect with similar others, partner with healthcare providers, and seek new knowledge. We identified a subset of parents who proactively engaged researchers, supported research and publications, and created patient advocacy and support organizations to connect with and bolster similarly diagnosed families. Other parents reported challenges of low social support, low tolerance for uncertainty, limited knowledge about their child's disorder, as well as difficulty partnering with HCPs and connecting to an E-URD community. An overarching classification was developed to describe parental actions taken after an E-URD diagnosis: adjusting, managing, and pioneering. These classifications may help genetic counselors identify and facilitate positive steps with parents of a child with an E-URD.

Empowerment of individuals in Iranian health systems: a qualitative study using the Z-cognitive map approach.

The empowerment of people is considered as one of the most effective approaches in national healthcare systems. Identifying the effective criteria for this empowerment approach can be useful for planning enhancements. Therefore, studying and researching different aspects of people empowerment, and identifying the various relationships among related factors are of great importance. In this study - after identifying and extracting the effective factors in empowering individuals/insured persons, and interviewing health insurance and healthcare experts through content analysis - a causal model examining variables and their impact intensity through cognitive mapping is designed and drawn up. In modeling the concept of empowerment, to cover the ambiguity of expert comments, a combination of the Z-number approach with cognitive mapping has been used. Results demonstrate how various factors relate to insured empowerment. According to the results of empowerment strategies, the insurance participation strategy with the highest central index was determined as the most effective strategy, and the appropriate component for individuals gained the highest score in the centrality index. The results of this article help a lot to policy making in medical insurance.

Intrahousehold empowerment gaps and dietary diversity in China.

Objective: This article analyzes the relationship between intrahousehold empowerment gaps and food and nutrition security using quantitative data collected through a household survey organized by the Agricultural Information Institute, Chinese Academy of Agricultural Sciences (CAAS-AII), in 2023. Methods: Based on empowerment theory, this study measured the relative empowerment of spouses from the Abbreviated Women's Empowerment in Agriculture Index (A-WEAI). Results: From the micro-level evidence of 468 rural households, this study found that intrahousehold empowerment gaps harm the diversity of household diets. In particular, reducing gender gaps in access to resources, leadership, and income can help diversify household diets. However, data on the impact of shortening the difference in working hours between wives and husbands for the benefit of food safety are yet to be conclusive. Additionally, gender gaps in the group of non-coresident mothers-in-law and non-migrants hurt household food security. Conclusion: The paper also provides further justification for policies and interventions that aim to improve women's bargaining position in the household.

Factors associated with empowerment after participating in a supported osteoarthritis self-management program: An explorative study.

Objective: To explore factors associated with change in empowerment in patients that have participated in a 3-month Supported Osteoarthritis Self-Management Program (SOASP). Further, to evaluate empowerment in the longer term. Design: An explorative analysis including patients from a cohort study conducted in primary healthcare in Sweden was performed. Univariable linear regression models were performed to assess associations between demographics and patient-reported outcome measures (explanatory factors), respectively, and change in empowerment from baseline to 3-month follow-up (outcome variable). Long-term follow-up of empowerment was at 9 months. Results: Self-reported increase in enablement at the 3-month follow-up was associated with a greater improvement in empowerment (B â€‹= â€‹0.041, 95% CI (0.011, 0.07), p â€‹= â€‹0.008). Living alone was associated with less improvement in empowerment (B â€‹= â€‹-0.278, 95% CI (-0.469, -0.086), p â€‹= â€‹0.005) compared to living together. Physical exercise >120 â€‹min per week at baseline was associated with less improvement in empowerment (B â€‹= â€‹-0.293, 95% CI (-0.583, -0.004), p â€‹= â€‹0.047) compared to reporting no exercise at baseline. No other associations were observed (p â€‹> â€‹0.05). Empowerment improved from baseline to the 3-month follow-up (mean 0.20 (SD 0.5), p â€‹< â€‹0.001) but there was no change from baseline to the 9-month follow-up (mean 0.02 (SD 0.6), p â€‹= â€‹0.641). Conclusions: Self-reported increased enablement may lead to greater improvement in empowerment after SOASP. Greater efforts may be needed to support those that live alone, are physically active, and to sustain empowerment in the longer term after SOASP. More research is needed on empowerment to provide personalized support for patients with OA after SOASP.

Empowering Chinese university health service providers to become mental health champions: insights from the ACE-LYNX intervention.

Background: Evidence shows that there is a high prevalence of mental health challenges including depression and anxiety, among Chinese university students. Providing mental health care providers with professional training is crucial to implementing effective mental health promotion initiatives in university settings. Globally, the focus of the mental health system is shifting to recovery and the importance of empowerment is increasingly being emphasized. There is a call to integrate empowerment education into professional training programs for health service providers with the goal of mobilizing them to become mental health champions capable of advancing mental health care. Method: The ACE-LYNX (Acceptance and Commitment to Empowerment-Linking Youth and Xin i.e., "heart(s)" in Chinese) intervention took place at six universities in Jinan, Shandong Province, China. It aimed to promote mental health literacy and build capacity among mental health service providers (MHSPs) to enable them to become mental health champions at their universities and beyond. A total of 139 university MHSPs participated. We collected pre-, immediate post- and three-month-post-surveys. In addition, we recruited forty-five participants to take part in three-month- post-intervention focus group interviews to explore their experiences taking part in ACE-LYNX and applying the knowledge, skills, and insights they gained from the intervention. Result: This paper reports on the effects of empowerment education, which is a key component of ACE-LYNX, on the MHSPs. Four themes were identified: 1) conscious awareness and behavioral change through psychological empowerment users; 2) professional insights and motivation for organizational empowerment; 3) non-self in the continuum of collective empowerment; and 4) interdisciplinary challenges and divergences in empowerment action. Discussion: We found that it is critical to integrate empowerment education into professional training. The process of MHSPs developing their empowerment practice is characterized by their moving from individual to collective empowerment along a continuum, with organizational and collective empowerment taking place in a longer time frame. Experiential learning, empathy education, and critical reflection accelerated the continuous iterative transformative process of empowerment practices. To advance the integration of empowerment into mental health care, the engagement of organizational decision-makers and policy makers in empowerment training is critical to ensure alignment of empowerment values and competence at all levels of service provision.

Validation of the Psychological Empowerment Scale and Client-Centered Care Questionnaire in budget holders with disabilities.

PURPOSE: Several high-income countries install Cash-for-Care Schemes (CCSs) by granting budgets to care users. However, little quantitative evidence exist on empowerment and client-centered care levels, due to a lack of validated scales. This research aimed to validate the Psychological Empowerment Scale (PE scale) and Client-Centered Care Questionnaire (CCCQ) in budget holders with disabilities. METHODS: A survey was developed based on a literature review and experts and budget holders input. Principal Axis Factoring with direct oblimin rotation, Cronbach's Alpha, and hypotheses testing with socio-demographic and budget characteristics as independent variables, and PE scale and CCCQ as dependent, were undertaken to assess both scales' internal consistency and validity. RESULTS: A convenience sample of 224 Flemish (proxy) budget holders completed the survey. Our analysis showed a two-factor solution for both scales; for the PE scale consisting of "meaning" and "competence," and "self-determination" and "impact," for CCCQ consisting of items 1-7 (conduct by caregiver) and items 8-15 (autonomy). Cronbach's Alpha of both scales was 0.94. The majority of our hypotheses were confirmed. CONCLUSIONS: The findings show that both scales are valid and internally consistent, meaning that they can be further tested in a respondent sample of people with disabilities and in other care contexts.

In light of the current trends in the (health)care sector to stimulate empowerment and client-centered care in care users, the monitoring of this experience is important.The Psychological Empowerment Scale (PE scale) measures empowerment by means of four cognitions (meaning, competence, impact, and self-determination), while the Client-Centered Care Questionnaire (CCCQ) measures the level of client-centered care.The PE scale and CCCQ are valid and internally consistent in our sample of (proxy) budget holders with disabilities.

Study protocol for the implementation of Centering Patients with Fibroids, a novel group education and empowerment program for patients with symptomatic uterine fibroids.

BACKGROUND: Black women and people with uteri have utilized collectivistic and relational practices to improve health outcomes in the face of medical racism and discrimination for decades. However, there remains a need for interventions to improve outcomes of uterine fibroids, a condition that disproportionately impacts Black people with uteri. Leveraging personalized approaches alongside evidence that demonstrates the positive impact of social and peer support on health outcomes, we adapted from CenteringPregnancy, an evidence based group prenatal care intervention, for the education and empowerment of patients with uterine fibroids. METHODS: The present report provides  an overview of the study design and planned implementation of CPWF in cohorts at Boston Medical Center and Emory University / Grady Memorial Hospital. After receiving training from the Centering Healthcare Institute (CHI), we adapted the 10-session CenteringPregnancy curriculum to an 8-session hybrid group intervention called Centering Patients with Fibroids (CPWF). The study began in 2022 with planned recruitment of six cohorts of 10-12 participants at each institution. We will conduct a mixed methods evaluation of the program using validated survey tools and qualitative methods, including focus groups and 1:1 interviews. DISCUSSION: To date, we have successfully recruited 4 cohorts at Boston Medical Center and are actively implementing BMC Cohort 5 and the first cohort at Emory University / Grady Memorial Hospital. Evaluation of the program is forthcoming.

Fibroids are non-cancerous smooth muscle tumors that disproportionate impact black women and gender expansive people. Our team adapted CenteringPregnancy, a group based model of prenatal care, to an education and empowerment program for peple with fibroids called Centering Patients with Fibroids (CPWF). This paper describes the development and implemation of the program at two academic hospitals serving diverse patients in Boston, Massachusetts and Atlanta, Georgia. To evaluate the successes and challenges of the program, we ask participants to complete surveys to learn more about their experience with having fibroids and also invite them to group feedback sessions or focus groups. We also interview other healthcare providers, team members, and hospital leadership on their knowledge and thoughts about the program. We hope to use the feedback to improve the program and make it available to more people across the country.

A survey examining the relationship between burnout, professional empowerment, and personality traits of midwives of an inner London NHS Trust.

INTRODUCTION: Besides the well-known negative effects on physical and psychological well-being, burnout has been associated with high attrition and absenteeism in the midwifery profession. This study explores whether burnout in midwifery can be explained by the midwives' type of personality and the sense of empowerment they experience at work. Moreover, the study identifies areas of improvement in relation to these topics and elements that can be conducive to strengthening the midwifery workforce. METHODS: A cross-sectional exploratory study design was used, including an online survey completed by 120 midwives working for an NHS Trust in London. The response rate was 24%. Three validated questionnaires were used: the Copenhagen Burnout Inventory (CBI), the Perception of Empowerment in Midwifery Scale (PEMS), and the Big Five Personality Trait Short Questionnaire (BFPTSQ). RESULTS: A multiple linear regression analysis indicated empowerment and personality traits are significant predictors of levels of burnout. Furthermore, emotional stability was shown to partially mediate the relationship between empowerment and burnout. The study also examined the midwifery burnout levels of this NHS Trust, which were found to be significantly high and similar to a previous study conducted by the Royal College of Midwives. CONCLUSIONS: The empowerment experienced by midwives and their personality traits significantly predict the levels of burnout in the midwifery workforce. Only empowerment and emotional stability were significant contributors to the regression model. Multiple strategies can be implemented to support midwives in these two areas. These interventions could also be of great help to reinforce the role of the midwife, making it more appealing to society and, in particular, younger generations with an interest in human-orientated professions.

Economic well-being induced Women's empowerment: Evidence from coastal fishing communities of Bangladesh.

Women's empowerment is an important policy agenda that is critical for developing countries like Bangladesh to achieve sustainable development goals (SDGs). The prime objective of this paper was to examine whether community savings groups can truly improve the economic conditions of women which turns into women's empowerment in fishing communities or not. The propensity score matching (PSM) and logistic regression technique were incorporated, and required data were collected from Community Savings Groups (CSG) interventions and non-CSG villages of coastal Bangladesh. Quantitative data were collected from 615 women comprising 306 CSG participants (treatment group) and 309 non-participants (control group). The results affirm CSG group members were economically more solvent and less dependent on borrowed money than non-CSG group members. Improved economic indicators (savings, income and expenditure) of CSG households make the foundation of attaining women's empowerment for the intervened group. The findings revealed that CSG women performed better in various dimensions of leadership capacity than non-CSG women. Econometric analysis confirmed positive impacts of CSG interventions on savings, gross household income, earning from catching fish, alternative income-generating activities (AIGAs), expenditure, and women's empowerment. The initiatives of CSG not only generate economic well-being but also contribute to women's empowerment. Financial access, improved literacy and an enabling environment for the productive engagement of women reduce gender inequality in fishing communities. To sustain the benefits of CSG, establishing institutional linkages (advisory and financial), legality/registration of CSGs from the government authority, and facilitation of alternative IGAs are crucial.

Empowering School Staff to Support Pupil Mental Health Through a Brief, Interactive Web-Based Training Program: Mixed Methods Study.

BACKGROUND: Schools in the United Kingdom and elsewhere are expected to protect and promote pupil mental health. However, many school staff members do not feel confident in identifying and responding to pupil mental health difficulties and report wanting additional training in this area. OBJECTIVE: We aimed to explore the feasibility of Kognito's At-Risk for Elementary School Educators, a brief, interactive web-based training program that uses a simulation-based approach to improve school staff's knowledge and skills in supporting pupil mental health. METHODS: We conducted a mixed methods, nonrandomized feasibility study of At-Risk for Elementary School Educators in 6 UK primary schools. Our outcomes were (1) school staff's self-efficacy and preparedness to identify and respond to pupil mental health difficulties, (2) school staff's identification of mental health difficulties and increased risk of mental health difficulties, (3) mental health support for identified pupils (including conversations about concerns, documentation of concerns, in-class and in-school support, and referral and access to specialist mental health services), and (4) the acceptability and practicality of the training. We assessed these outcomes using a series of questionnaires completed at baseline (T1), 1 week after the training (T2), and 3 months after the training (T3), as well as semistructured qualitative interviews. Following guidance for feasibility studies, we assessed quantitative outcomes across time points by comparing medians and IQRs and analyzed qualitative data using reflexive thematic analysis. RESULTS: A total of 108 teachers and teaching assistants (TAs) completed T1 questionnaires, 89 (82.4%) completed T2 questionnaires, and 70 (64.8%) completed T3 questionnaires; 54 (50%) completed all 3. Eight school staff members, including teachers, TAs, mental health leads, and senior leaders, participated in the interviews. School staff reported greater confidence and preparedness in identifying and responding to mental health difficulties after completing the training. The proportion of pupils whom they identified as having mental health difficulties or increased risk declined slightly over time (medianT1=10%; medianT2=10%; medianT3=7.4%), but findings suggested a slight increase in accuracy compared with a validated screening measure (the Strengths and Difficulties Questionnaire). In-school mental health support outcomes for identified pupils improved after the training, with increases in formal documentation and communication of concerns as well as provision of in-class and in-school support. Referrals and access to external mental health services remained constant. The qualitative findings indicated that school staff perceived the training as useful, practical, and acceptable. CONCLUSIONS: The findings suggest that brief, interactive web-based training programs such as At-Risk for Elementary School Educators are a feasible means to improve the identification of and response to mental health difficulties in UK primary schools. Such training may help address the high prevalence of mental health difficulties in this age group by helping facilitate access to care and support.

Fruit and Vegetable Intake, Food Security, Barriers to Healthy Eating, and Empowerment among Dietetic Interns and Physician Assistant Interns: A Cross-Sectional Pilot Study.

Students are required to complete supervised practice hours prior to becoming Registered Dietitians and Physician Assistants. Research suggests that environmental and social factors affect dietetic interns' diets during their internship, although these factors have not been studied among physician assistant interns. This cross-sectional study utilized an online survey to compare dietetic interns' (n = 81) and physician assistant interns' (n = 79) fruit and vegetable intake, food security, barriers to healthy eating, and empowerment for making healthy dietary choices during an internship. Differences were assessed via independent t-tests and chi-square distributions. The significance was set at p < 0.05. Dietetic interns had a higher vegetable intake (p = 0.002) while physician assistant interns had higher rates of food insecurity (p = 0.040). Dietetic interns reported a greater impact on their dietary choices due to mental fatigue (p = 0.006), while physician assistant interns' dietary choices were more heavily impacted by peer influence, interactions with patients, and interactions with preceptors (p < 0.05). There was not a group difference in overall empowerment (p = 0.157), although both groups rated empowerment for asking for help with food and nutrition challenges the lowest of the empowerment sub-items. Addressing interns' unique needs may support students' educational success and wellbeing once they are professionals, promote a diverse workforce, and ensure optimal care for patients.

"Being an informal caregiver - strengthening resources": mixed methods evaluation of a psychoeducational intervention supporting informal caregivers in palliative care.

BACKGROUND: Informal caregivers are key support for patients with progressive incurable diseases. However, their own needs often remain unmet. Therefore, we developed, manualised and implemented the intervention "Being an informal caregiver - strengthening resources" aiming to support and empower informal caregivers by addressing relevant information-related, physical, psychological and social needs. METHODS: In this pilot study, we evaluated the acceptance and experiences with this psychoeducational intervention. The study was conducted over two years (2019-2021). Informal caregivers were recruited from the University Medical Centre Hamburg-Eppendorf and the metropolitan region of Hamburg, Germany. The intervention was aimed at adult persons who identified themselves as an informal caregiver to an adult patient with a progressive incurable cancer and non-cancer disease. For the evaluation we used a mixed methods approach, combining a longitudinal questionnaire survey (pre-intervention, after each module, 3-months follow-up) and semi-structured interviews post-intervention. Quantitative data were analysed using descriptive statistics and a paired t-Test, interviews were analysed based on the qualitative content analysis according to Mayring. Results were triangulated using a convergent triangulation design. RESULTS: Of 31 informal caregivers who received the intervention, 25 returned the follow-up questionnaire and 20 informal caregivers were interviewed. Triangulated results showed a high satisfaction with the implementation of the intervention. Of a broad range of subjective benefits, gaining knowledge, self-awareness and self-efficacy were most apparent. Informal caregivers reported improved preparedness, awareness of own needs as well as confidence regarding handling own emotions and interacting with the ill person. However, implementing the learned skills into daily life can be challenging due to internal and external factors. Motivations and challenges for participating as well as potential for improvement were identified. CONCLUSIONS: This pilot study showed an overall positive evaluation and several subjective benefits of the psychoeducational intervention "Being an informal caregiver - strengthening resources". Further research is needed to measure the efficacy of this intervention on informal caregivers' outcomes. Therefore, a multicentre randomized prospective study is planned.

Breaking the burnout cycle: Association of dispositional mindfulness with production line workers' job burnout and the mediating role of social support and psychological empowerment.

Burnout among production line workers has become an issue for their physical and mental health and for the productive efficiency of companies. However, this large group of workers has received insufficient attention, particularly in exploring how employees' dispositional factors are associated with burnout. Therefore, this study aimed to examine the association between dispositional mindfulness and job burnout and the potential mediating roles played by perceived social support and psychological empowerment. Participants in the study included 780 production line workers recruited from a foreign company in China. Participants completed measures related to dispositional mindfulness, perceived social support, psychological empowerment, and job burnout. The results showed that (a) dispositional mindfulness was significantly related to lower burnout (ß = -0.446, 95% CI [-0.552, -0.340]); (b) perceived social support (ß = -0.073, 95% CI [-0.126, -0.025]) and psychological empowerment (ß = -0.106, 95% CI [-0.171, -0.058]) mediated this association individually; and (c) perceived social support and psychological empowerment had a serial mediating effect in this context (ß = -0.055, 95% CI [-0.095, -0.028]). This study revealed the association between dispositional mindfulness and job burnout, with an additional focus on how dispositional mindfulness correlates with other resources, such as perceived social support and psychological empowerment.

The impact of middle managers' digital leadership on employee work engagement.

Background: In the rapidly evolving digital landscape, the role of middle managers in organizational structures and processes is increasingly pivotal. Positioned at the nexus of strategic directives and operational execution, they play an important role in driving digital transformation. This study discusses the under examined domain of middle managers' digital leadership and its impact on employee work engagement in the context of digital transformation. Design: Drawing on Social Exchange Theory, this study investigates the influence of middle managers' digital leadership on employee work engagement through the analysis of survey data from 559 respondents across 11 listed companies in Southwest China. It examines the roles of employee empowerment and affective commitment as pivotal mediating variables and investigates the moderating effect of emotional intelligence in these relationships. Research purposes: The study aims to elucidate the mechanisms by which middle managers' digital leadership fosters employee work engagement, highlighting the importance of emotional intelligence, empowerment, and affective commitment in this process. Findings: The study reveals that middle managers' digital leadership has a significant positive impact on employee work engagement. Employee empowerment and affective commitment serve as mediating factors in the relationship between middle managers' digital leadership and employee work engagement. Emotional intelligence moderates the effect of middle managers' digital leadership on employee empowerment. Meanwhile, emotional intelligence further moderates the chain mediating of employee empowerment and affective commitment between middle managers' digital leadership and employees' work engagement. Implications: This research offers valuable insights into the dynamics of leadership and engagement in the digital era, emphasizing the need for organizations to foster digital leadership capabilities in middle management. It provides practical implications for enhancing employee work engagement through strategic digital leadership, emphasizing the role of employee empowerment, affective commitment and emotional intelligence in adapting to digital transformation.

An Historical Case Study of Trans Exclusion and Empowerment: Implications for Transgender Older Adults and Aging.

Transgender older adults have a long history of exclusion that shapes current experiences with social services. However, scant gerontological research uses archival data, which can provide critical context for service providers. Moreover, sparse research examines how exclusion can be a catalyst for change that social workers could leverage. Empowerment theory provides a theoretical tool to explain how this is possible. This multidisciplinary case study blends community member interviews and archival data to answer this question: How did exclusion shape empowerment and social change for transgender Americans? This study focuses on the events before and after the Compton's Cafeteria Riot, one of the first acts of LGBTQIA+ collective resistance that led to new services for and by transgender Americans. Data reveal how exclusion facilitated the emergence of collective empowerment among transgender women and queer youth in San Francisco. Archival data shows how exclusion preceded self-efficacy, critical consciousness, involvement with similar others, acquisition of new skills, and ultimately action to eliminate social, economic, and political barriers and power imbalances. This study provides both empirical and theoretical tools to contribute new data and perspectives on trans exclusion and empowerment and its implications for social workers serving transgender older adults.

RISEinFAMILY project: the integration of families at neonatal intensive care units (NICUs) to empower them as primary caregivers: study protocol for a stepped wedge cluster controlled trial.

BACKGROUND: Family Integrated Care (FICare) has demonstrated positive outcomes for sick neonates and has alleviated the psychological burden faced by families. FICare involves structured training for professionals and caregivers along with the provision of resources to offer physical and psychological support to parents. However, FICare implementation has been primarily limited to developed countries. It remains crucial to assess the scalability of this model in overcoming social-cultural barriers and conduct a cost-effectiveness analysis. The RISEinFAMILY project aims to develop an adapted FICare model that can serve as the international standard for neonatal care, accommodating various cultural, architectural, and socio-economic contexts. METHODS: RISEinFAMILY is a pluri-cultural, stepped wedge cluster controlled trial conducted in Spain, Netherlands, the UK, Romania, Turkey, and Zambia. Eligible participants include infant-family dyads admitted to the Neonatal Intensive Care Unit (NICU) requiring specialised neonatal care for a minimum expected duration of 7 days, provided there are no comprehension barriers. Notably, this study will incorporate a value of implementation analysis on FICare, which can inform policy decisions regarding investment in implementation activities, even in situations with diverse data. DISCUSSION: This study aims to evaluate the scalability and adaptation of FICare across a broader range of geographical and sociocultural contexts and address its sustainability. Furthermore, it seeks to compare the RISEinFAMILY model with standard care, examining differences in short-term newborn outcomes, family mental health, and professional satisfaction. TRIAL REGISTRATION: ClinicalTrials.gov NCT06087666. Registered on 17 October 2023. PROTOCOL VERSION: 19 December 2022; version 2.2.

Cardiac Rehabilitation Using the Family-Centered Empowerment Model is Effective in Improving Long-term Mortality in Patients with Myocardial Infarction: A 10-year Follow-Up Randomized Clinical Trial.

INTRODUCTION: Cardiac rehabilitation (CR) play a critical role in reducing the risk of future cardiovascular events and enhancing the quality of life for individuals who have survived a heart attack. AIM: To assess the mortality rates and stability of the effects in myocardial infarction (MI) survivors after implementing a Family-Centered Empowerment Model (FCEM)-focused hybrid cardiac rehabilitation program. METHODS: This double-blind randomized controlled clinical trial, conducted at Shariati Hospital, an academic teaching hospital in Tehran, Iran (2012-2023), involved 70 MI patients and their families. Participants were randomly assigned to an FCEM intervention group or standard CR control group. The intervention commenced after the MI patient's safe discharge from the CCU and continued for the entire 10-year follow-up period. Various questionnaires were utilized to collect data on mortality rates and health-related quality of life (HRQoL). RESULTS: The 10-year follow-up period revealed lower mortality rates in the intervention group (5.7%, 11.4%, and 17.1% at 5, 7, and 10 years, respectively) compared to the control group (20%, 37.1%, and 48.9%). After adjusting for age, gender, and BMI, the control group had a four times higher mortality risk (HR: 4.346, 95% CI 1.671-7.307, P = 0.003). The FCEM-focused program demonstrated a significant and sustained positive impact on participants' quality of life for 48 months, with greater improvement compared to the control group. CONCLUSION: This study highlights the effectiveness of FCEM-based hybrid CR programs in enhancing long-term patient outcomes and reducing mortality rates among MI survivors. Further research is needed to explore the potential benefits in larger samples and diverse populations. TRIAL REGISTRATION: This study (Identifier: NCT02402582) was registered in the ClinicalTrials.gov on 03/30/2015.

Finding the person behind caries disease: The dental caregivers' experiences of empowering patients to implement beneficial behavioral changes.

OBJECTIVES: This study aimed to elucidate dental professionals' experiences of how to empower patients at risk of developing new or additional caries to promote caries-related preventive behavioral changes. METHODS: Semi-structured in-depth interviews were conducted, audio-recorded, transcribed verbatim, and subjected to qualitative content analysis. To provide credibility and high-quality data, participant recruitment followed strategic sampling. The 10 participants included nine women and one man; six participants were dentists, and four were dental hygienists. In the data analysis, five descriptive and five strategic themes emerged that formed an overarching theme: Finding the person behind caries disease. RESULTS: The results indicated that by initially getting to know the person behind the patient, trusting relationships and knowledge can be generated to successfully influence patients' behaviors related to caries. The five descriptive themes included: Building a treatment alliance, Understanding habitual patterns, Motivating for changes, Implementing new behaviors, and Preserving behavioral improvements. The descriptive themes each revealed a strategy theme containing several strategy proposals for initiating and supporting caries-preventing behavioral changes. CONCLUSIONS: This study highlights the importance of establishing a treatment alliance to improve the patient's skills, knowledge, and motivation. It underscores the significance of recognizing the individual behind the patient, to facilitate optimal behavior change at the lowest possible level of treatment. CLINICAL SIGNIFICANCE: Our findings could assist in strengthening caries-related health promotion, caries prevention, and understanding of oral health literacy techniques.

Phenomenology and empowerment in self-testing apps.

Although self-testing apps, a form of mobile health (mHealth) apps, are often marketed as empowering, it is not obvious how exactly they can empower their users-and in which sense of the word. In this article, I discuss two conceptualisations of empowerment as polar opposites-one in health promotion/mHealth and one in feminist theory-and demonstrate how both their applications to individually used self-testing apps run into problems. The first, prevalent in health promotion and mHealth, focuses on internal states and understands empowerment as an individual process. However, this version of empowerment has been accused of paternalism and responsibilisation. The second, feminist version considers structural conditions and foregrounds collective, political change, whose realisation is not obviously attainable for an individually used app. By pointing out the flaws of the positions that focus on either internal states or external conditions, and by engaging with theory from critical phenomenology, I argue that the interplay between them is where empowerment can take place. I propose to formulate empowerment in phenomenological terms as a shift in being-in-the-world and discuss how this conceptualisation of empowerment would avoid the criticism of previous empowerment narratives while being realisable by self-testing apps.