Socioecological factors influencing physical activity engagement for women across the menopausal transition: a systematic review.

IMPORTANCE: Physical activity during menopause can be effective in reducing the physiological changes associated with reproductive aging that increase risks for noncommunicable diseases, yet many women do not meet the recommendations for physical activity. OBJECTIVE: This study aimed to synthesize factors influencing physical activity for women across menopausal transition phases using a socioecological approach. EVIDENCE REVIEW: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to systematically search 10 databases between 2001 and 2021. A comprehensive search strategy was used to identify studies on physical activity of women in various stages of menopause. A socioecological model was used to categorize the reported barriers and enablers. FINDINGS: Twenty studies met the inclusion criteria. The findings highlight several intrapersonal barriers such as existing health complaints versus enablers such as awareness of the health benefits of physical activity during menopause. Ensuring women's safety, preventing injury, and enhancing exercise self-efficacy were important components of programs. Social support was also an important enabler of women's engagement in activities. CONCLUSIONS AND RELEVANCE: Several barriers and enablers were identified and can inform practitioners and future interventions to encourage physical activity among women in various stages of menopause. For instance, when encouraging physical activity during menopause, practitioners should consider other health complaints, safety, and injury prevention while discussing the benefits of physical activity related to managing menopausal symptoms. There was a lack of theoretically informed studies exploring the barriers and enablers to physical activity for women in various stages of menopause; thus, research designs may not have fully accounted for influences. Future research that combines socioecological and individual theories of behavior is needed to comprehensively understand the complexity of physical activity among women across the menopausal transition.

Falls risk perception measures in hospital: a COSMIN systematic review.

Falls prevention in hospital continues to be a research priority because of the poor health outcomes and financial burdens that can arise. Recently updated World Guidelines for Falls Prevention and Management strongly recommend evaluating patients' concerns about falling as part of a multifactorial assessment. The aim of this systematic review was to evaluate the quality of falls risk perception measures for adults in a hospital setting. This review was conducted using the Consensus-based Standards for the selection of health Measurement Instruments guidelines and provides a comprehensive summary of these instruments, including psychometric properties, feasibility and clinical recommendations for their use. The review followed a prospectively registered protocol, in which a total of ten databases were searched between the years 2002 and 2022. Studies were included if the instruments measured falls risk perception and/or other psychological falls constructs, if they were conducted in a hospital setting and if the target population contained hospital inpatients. A total of 18 studies met the inclusion criteria, encompassing 20 falls risk perception measures. These falls risk perception instruments were grouped into five falls-related constructs: Balance Confidence, Falls Efficacy/Concern, Fear of Falling, Self-Awareness and Behaviour/Intention. Two of the patient reported outcome measures (PROMs) received Class A recommendations (Falls Risk Perception Questionnaire and the Spinal Cord Injury-Falls Concern Scale); however, this rating is only applicable for the populations/context described in the studies. Thirteen PROMs received Class B recommendations, solidifying the need for further validation studies of these PROMs.

The impact of nature-led recovery initiatives for individual and community health post disaster: a systematic literature review.

OBJECTIVES: The impact of disasters on individual and community health can be extensive. As such, there exists the need to establish recovery measures that provides support psychologically and with additional mental health services and resilience building for affected people and their communities. Nature-led recovery is one such approach that has the ability to positively impact the mental health of people and their communities after a disaster. Nature-led recovery focuses on the social, economic and environmental recovery through activities that connect people and their communities to nature and the natural environment with the aim to foster recovery after a disaster. Nature-led recovery initiatives support the connection of people with nature and the natural environment to support such recovery processes. This review considers both community and government-led responses pertaining to nature-led recovery. The aim of this review is to systematically explore the literature on the impact of nature-led recovery initiatives on individual and community health following a disaster. CONTENT: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) following a three-step process of planning, conducting and reporting the review. At least three authors reviewed all eligible articles. SUMMARY: There was significant methodological heterogeneity between the sources identified (n=9). A narrative synthesis identified five key themes; A symbol of loss; Nature: the provider; Fostering community connectedness; Spiritual and emotional nourishment; and Regeneration leads to recovery. OUTLOOK: The positive benefits from nature-led recovery initiatives provide an opportunity to promote community connectedness and resilience following a disaster. Further research is needed to explore the implementation and evaluation of these initiatives for community recovery.

Adult Inpatients' Perceptions of Their Fall Risk: A Scoping Review.

Patient falls in hospitals continue to be a global concern due to the poor health outcomes and costs that can occur. A large number of falls in hospitals are unwitnessed and mostly occur due to patient behaviours and not seeking assistance. Understanding these patient behaviours may help to direct fall prevention strategies, with evidence suggesting the need to integrate patients' perspectives into fall management. The aim of this scoping review was to explore the extent of the literature about patients' perceptions and experiences of their fall risk in hospital and/or of falling in hospital. This review was conducted using a five-stage methodological framework recommended by Arksey and O'Malley. A total of nine databases were searched using key search terms such as "fall*", "perception" and "hospital." International peer-reviewed and grey literature were searched between the years 2011 and 2021. A total of 41 articles, ranging in study design, met the inclusion criteria. After reporting on the article demographics and fall perception constructs and measures, the qualitative and quantitative findings were organised into five domains: Fall Risk Perception Measures, Patients' Perceptions of Fall Risk, Patients' Perceptions of Falling in Hospital, Patients' Fear of Falling and Barriers to Fall Prevention in Hospital. Approximately two-thirds of study participants did not accurately identify their fall risk compared to that defined by a health professional. This demonstrates the importance of partnering with patients and obtaining their insights on their perceived fall risk, as this may help to inform fall management and care. This review identified further areas for research that may help to inform fall prevention in a hospital setting, including the need for further research into fall risk perception measures.

A Scoping Review of Community-Based Adult Suicide Prevention Initiatives in Rural and Regional Australia.

The need for continued research into suicide prevention strategies is undeniable, with high global statistics demonstrating the urgency of this public health issue. In Australia, approximately 3000 people end their lives each year, with those living in rural and regional areas identified as having a higher risk of dying by suicide. Due to decreased access and support services in these areas, community-based suicide prevention initiatives provide opportunities to educate and support local communities. A scoping review was conducted to explore the literature pertaining to such programs in rural and/or regional communities in Australia. This review follows the five-stage Arksey and O'Malley (2005) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Nine databases were searched, from which studies were considered eligible if suicide prevention programs were community-based and catered for adults (aged ≥ 18 years) in rural or regional Australia. Ten papers that met our inclusion criteria were included in this review, showcasing a variety of interventions such as workshops, a digital intervention, art therapy, and initiatives to increase education and reduce stigma around suicide. Program engagement strategies included the importance of providing culturally appropriate services, the inclusion of lived experience mentoring, and tailoring the suicide prevention program to reach its targeted audience. Overall, there is a dearth of literature surrounding community-based suicide prevention initiatives for adults in rural and regional Australia. Further evaluation of community-based projects is required to ensure quality improvement and tailored suicide prevention initiatives for rural and regional Australians.

Exploring Hospital Inpatients' Awareness of Their Falls Risk: A Qualitative Exploratory Study.

Patient falls in hospital may lead to physical, psychological, social and financial impacts. Understanding patients' perceptions of their fall risk will help to direct fall prevention strategies and understand patient behaviours. The aim of this study was to explore the perceptions and experiences that influence a patient's understanding of their fall risk in regional Australian hospitals. Semi-structured, individual interviews were conducted in wards across three Australian hospitals. Participants were aged 40 years and over, able to communicate in English and were mobile prior to hospital admission. Participants were excluded from the study if they returned a Standardised Mini-Mental State Examination (SMMSE) score of less than 18 when assessed by the researcher. A total of 18 participants with an average age of 69.8 years (SD ± 12.7, range 41 to 84 years) from three regional Victorian hospitals were interviewed for this study. Data were analysed using a reflexive thematic analysis identifying three major themes; (1) Environment (extrinsic) (2) Individual (intrinsic), and (3) Outcomes, as well as eight minor themes. Participants recognised the hazardous nature of a hospital and their personal responsibilities in staying safe. Falls education needs to be consistently delivered, with the focus on empowering the patient to help them adjust to changes in their clinical condition, whether temporary or permanent.

Exploring mental health clinicians' perceptions of the Zero Suicide Prevention Initiative.

Suicide continues to impact rural and regional families and communities across Australia and has become a key focus of healthcare, research, and government policy in recent years. The challenge for healthcare organizations is to translate policy visions and research for clinicians to effectively embed in day to day practice when supporting people who experience suicidal crisis. This study explored the introduction of an evidence-based Zero Suicide framework that includes a suicide prevention pathway and training package to a rural and regional community mental health team in Victoria, Australia. A qualitative semi-structured interview technique was used to explore the perceptions of mental health clinicians of the Zero Suicide approach, the training package and the barriers to inform its implementation across a specialist mental health service. Clinicians were complimentary of the intent of Zero Suicide and the training package and felt they had increased confidence in delivering suicide safe care. Four major themes were identified through thematic analysis: (i) Minimizing risk with realistic expectations; (ii) A good approach to making a difference; (iii) Lessons learnt; and (iv) Barriers to implementation needing to change culture. Overall participants identified the importance of continued regular suicide prevention training for all staff but also in tailoring it to different consumer and clinician needs. In addition, organizational structure and adequate staff resourcing were important to participants as was working within a safety culture.

Compliance with the Zero Suicide Initiative by Mental Health Clinicians at a Regional Mental Health Service: Development and Testing of a Clinical Audit Tool.

AIM: The aim of this study is to investigate the compliance of mental health clinicians in applying the Zero Suicide (ZS) approach to their clinical practice in a rural and regional health community setting. METHODS: A retrospective clinical audit of six mental health teams was undertaken at a single site. A clinical audit tool was developed and validated using a six-step approach. The data was extracted and analysed via descriptive and inferential statistics and compared to a specialised mental health team, experienced with the ZS approach. RESULTS: A total of 334 clinical records were extracted for January, April, August, November 2019 and June 2020. The clinical audit and analysis confirmed that the mental health teams are not consistently using the assessments from their training and are therefore not implementing all of these elements into their practice. This could have implications for the risk formulation and treatment for people at risk of suicide. CONCLUSIONS: The use of a validated clinical audit tool can be beneficial to establish compliance with the mental health clinicians and to determine any areas requiring further improvement. Further education and reinforcement may be required to ensure consistency with incorporating the elements of ZS into everyday clinical practice.

An exploration into suicide prevention initiatives for mental health nurses: A systematic literature review.

Mental health and suicide prevention are national health priorities in Australia, with research currently focussed towards the ZERO Suicide (ZS) initiative. The aim of this review was to evaluate the impact of suicide prevention programmes, in particular the ZS prevention initiative. A systematic review using the PRISMA guidelines was conducted using six EBSCO Host databases; Academic Search Complete, Australian/New Zealand Reference Centre, CINAHL Complete, MEDLINE, APA PsycINFO, and APA Psyc Articles. The data extracted from the eligible papers were analysed using a thematic approach. The final data set consisted of fourteen (n = 14) peer-reviewed articles meeting the eligibility criteria, which included quantitative (n = 10), mixed methods (n = 2), and qualitative studies (n = 2). Results indicated variances between suicide prevention programmes with some papers examining single workshops and others assessing multimodal, organizational interventions. Five major themes were produced from this review including measuring the success of suicide prevention programmes, improvements to the delivery of suicide prevention programmes, barriers to implementing changes, cultural considerations, and further research required for suicide prevention programmes. This review concludes that further long-term research is required to evaluate the implementation and efficacy of suicide prevention programmes in health care. Cultural awareness in suicide prevention training is another area that may benefit from further research. A growing body of evidence establishes the need for multimodal and organizational approaches for suicide prevention initiatives.

A thematic analysis of the perceptions of a community-based exercise program on the health and well-being of ageing adults.

This study explores a weekly community-based exercise program (CBEP) for ageing adults in Gippsland, Victoria, Australia. This program aims to improve the health and well-being of ageing adults and was evaluated using an exploratory qualitative study design. Four focus group discussions and two individual interviews were conducted before a thematic analysis using Braun & Clark's (2006) six-step approach. A total of 23 participants were involved in the study over a 6-week period. The thematic analysis resulted in two main themes: (a) meeting community needs and (b) benefits to health and well-being. Five minor themes stemmed from these two themes, in which participants identified that a service gap existed within the community and the program was adaptive in its design to meet community needs. Participants reported benefits to health and well-being, specifically perceived improved mobility and independence, social connections and 'recharging the batteries to feel good'. The inclusion of Tai Chi exercises was noted for increased vitality and pain management benefits. The role of the exercise instructor was deemed to be instrumental to the success of the CBEP. The CBEP provides motivation for older adults to attend, increasing physical activity. Future CBEPs for ageing adults should provide a social component and relevant health education for participants. Exercises should be safely adapted by the exercise instructor to suit people of various abilities and to promote a more 'inclusive' environment.