Comparative analysis of oropharyngeal microbiota in healthcare workers post-COVID-19.

Background: To date, more than 770 million individuals have become coronavirus disease 2019 (COVID-19) convalescents worldwide. Emerging evidence highlights the influence of COVID-19 on the oral microbiome during both acute and convalescent disease phases. Front-line healthcare workers are at an elevated risk of exposure to viral infections, and the effects of COVID-19 on their oral microbiome remain relatively unexplored. Methods: Oropharyngeal swab specimens, collected one month after a negative COVID-19 test from a cohort comprising 55 healthcare workers, underwent 16S rRNA sequencing. We conducted a comparative analysis between this post-COVID-19 cohort and the pre-infection dataset from the same participants. Community composition analysis, indicator species analysis, alpha diversity assessment, beta diversity exploration, and functional prediction were evaluated. Results: The Shannon and Simpson indexes of the oral microbial community declined significantly in the post-COVID-19 group when compared with the pre-infection cohort. Moreover, there was clear intergroup clustering between the two groups. In the post-COVID-19 group, the phylum Firmicutes showed a significant increase. Further, there were clear differences in relative abundance of several bacterial genera in contrast with the pre-infection group, including Streptococcus, Gemella, Granulicatella, Capnocytophaga, Leptotrichia, Fusobacterium, and Prevotella. We identified Gemella enrichment in the post-COVID-19 group, potentially serving as a recovery period performance indicator. Functional prediction revealed lipopolysaccharide biosynthesis downregulation in the post-COVID-19 group, an outcome with host inflammatory response modulation and innate defence mechanism implications. Conclusion: During the recovery phase of COVID-19, the oral microbiome diversity of front-line healthcare workers failed to fully return to its pre-infection state. Despite the negative COVID-19 test result one month later, notable disparities persisted in the composition and functional attributes of the oral microbiota.

The Effect of Night Shift on Blood Pressure in Healthcare Workers.

OBJECTIVE: Individuals across all age groups may experience elevated blood pressure due to a combination of internal and environmental factors. Factors influencing arterial pressure include diet, stress, sleep patterns, and lifestyle. This study aims to investigate the susceptibility to high blood pressure among occupational groups working night shifts. METHOD: The study included healthcare worker participants who had at least six night shifts per month. A control group consisted of participants performing the same roles during daytime. Participants with chronic diseases or those taking blood pressure-affecting medication were excluded. Holter recordings were made over a minimum of 48 hours, including both a free day and a work day. RESULTS: The study involved 114 participants-55 in the study group and 59 in the control group. Statistically significant differences were noted between the groups in the daylight-night ratios of systolic and diastolic pressures, with P values of 0.006 and 0.005, respectively. The systolic daylight-night difference was -5.7 ± 5.5% in the study group and -9.0 ± 7.0% in the control group. The diastolic daylight-night difference was -7.9 ± 9.6% in the study group and -12.7 ± 8.2% in the control group. CONCLUSION: Occupations with nighttime work schedules are often associated with non-dipping blood pressure patterns due to sleep disturbances. It is crucial to consider the blunted dipping of blood pressure induced by night shift work when assessing and monitoring hypertension and related medical conditions.

Examining the Effectiveness of Social Media for the Dissemination of Research Evidence for Health and Social Care Practitioners: Systematic Review and Meta-Analysis.

BACKGROUND: Social media use has potential to facilitate the rapid dissemination of research evidence to busy health and social care practitioners. OBJECTIVE: This study aims to quantitatively synthesize evidence of the between- and within-group effectiveness of social media for dissemination of research evidence to health and social care practitioners. It also compared effectiveness between different social media platforms, formats, and strategies. METHODS: We searched electronic databases for articles in English that were published between January 1, 2010, and January 10, 2023, and that evaluated social media interventions for disseminating research evidence to qualified, postregistration health and social care practitioners in measures of reach, engagement, direct dissemination, or impact. Screening, data extraction, and risk of bias assessments were carried out by at least 2 independent reviewers. Meta-analyses of standardized pooled effects were carried out for between- and within-group effectiveness of social media and comparisons between platforms, formats, and strategies. Certainty of evidence for outcomes was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework. RESULTS: In total, 50 mixed-quality articles that were heterogeneous in design and outcome were included (n=9, 18% were randomized controlled trials [RCTs]). Reach (measured in number of practitioners, impressions, or post views) was reported in 26 studies. Engagement (measured in likes or post interactions) was evaluated in 21 studies. Direct dissemination (measured in link clicks, article views, downloads, or altmetric attention score) was analyzed in 23 studies (8 RCTs). Impact (measured in citations or measures of thinking and practice) was reported in 13 studies. Included studies almost universally indicated effects in favor of social media interventions, although effect sizes varied. Cumulative evidence indicated moderate certainty of large and moderate between-group effects of social media interventions on direct dissemination (standardized mean difference [SMD] 0.88; P=.02) and impact (SMD 0.76; P<.001). After social media interventions, cumulative evidence showed moderate certainty of large within-group effects on reach (SMD 1.99; P<.001), engagement (SMD 3.74; P<.001), and direct dissemination (SMD 0.82; P=.004) and low certainty of a small within-group effect on impacting thinking or practice (SMD 0.45; P=.02). There was also evidence for the effectiveness of using multiple social media platforms (including Twitter, subsequently rebranded X; and Facebook), images (particularly infographics), and intensive social media strategies with frequent, daily posts and involving influential others. No included studies tested the dissemination of research evidence to social care practitioners. CONCLUSIONS: Social media was effective for disseminating research evidence to health care practitioners. More intense social media campaigns using specific platforms, formats, and strategies may be more effective than less intense interventions. Implications include recommendations for effective dissemination of research evidence to health care practitioners and further RCTs in this field, particularly investigating the dissemination of social care research. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42022378793; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=378793. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/45684.

Improving healthcare professionals' interactions with patients to tackle antimicrobial resistance: a systematic review of interventions, barriers, and facilitators.

Introduction: Antimicrobial resistance (AMR) is a major public health threat. With the growing emphasis on patient-centred care/ shared decision making, it is important for healthcare professionals' (HCPs) who prescribe, dispense, administer and/or monitor antimicrobials to be adequately equipped to facilitate appropriate antimicrobial use. We systematically identified existing interventions which aim to improve HCPs interaction with patients and examined barriers and facilitators of appropriate the use of such interventions and appropriate antimicrobial use among both HCPs and patientsantimicrobial use while using these interventions. Methods: We searched MEDLINE, EMBASE, Web of Science, Google Scholar, and internet (via Google search engine). We included primary studies, published in English from 2010 to 2023 [PROSPERO (CRD42023395642)]. The protocol was preregistered with PROSPERO (CRD42023395642). We performed quality assessment using mixed methods appraisal tool. We applied narrative synthesis and used the COM-B (Capability, Opportunity, Motivation -Behaviour) as a theoretical framework for barriers and facilitators at HCP and patient levels. Results: Of 9,172 citations retrieved from database searches, From 4,979 citations remained after removal of duplicates. We included 59 studies spanning over 13 countries. Interventions often involved multiple components beyond HCPs' interaction with patients. From 24 studies reporting barriers and facilitators, we identified issues relating to capability (such as, knowledge/understanding about AMR, diagnostic uncertainties, awareness of interventions and forgetfulness); opportunity (such as, time constraint and intervention accessibility) and motivation (such as, patient's desire for antibiotics and fear of litigation). Conclusion: The findings of this review should be considered by intervention designers/adopters and policy makers to improve utilisation and effectiveness.

Education and training of telemental health providers: a systematic review.

Objective: To conduct a systematic literature review of education and training (E&T) programs for telemental health (TMH) providers in the past 10 years to qualitatively clarify field offerings and methodologies, as well as identify areas for future growth. Methods: We searched five major electronic databases: PubMed, PsycINFO, Scopus, CINAHL, and Web of Science for original publications on TMH E&T from January 2013 to May 2023. We extracted information from each publication and summarized key features of training programs including setting, target group, study aims, training modality, methods of assessing quality, and outcomes. Results: A total of 20 articles were selected for the final review. Articles meeting inclusionary criteria were predominantly comprised of case studies and commentaries, focused on a TMH service/practice for a specific region/population, and were performed after 2020. All of the selected studies demonstrated a significant increase in the measured knowledge, skills, and abilities of the participants after TMH training. Nevertheless, there remains a lack of standardization of training methodologies, limited sample sizes and demographics, variability in study methodologies, and inconsistency of competency targets across studies. Conclusion: This systematic review highlighted the diversity of methods for TMH E&T. Future research on this topic could include more varied and larger-scale studies to further validate and extend current findings, as well as explore potential long-term effects of TMH training programs on both provider attitudes and patient outcomes.

Cross-sectional study of the association between burnout and work overload and work-life imbalance among medical personnel in Liaoning, China: role of specialty.

OBJECTIVES: Burnout is common among medical personnel in China and may be related to excessive and persistent work-related stressors by different specialties. The aims of this study were to assess the prevalence of burnout, work overload and work-life imbalance according to different specialties and to explore the effect of specialty, work overload and work-life imbalance on burnout among medical personnel. DESIGN: A cross-sectional study. SETTING: This study was conducted in 1 tertiary general public hospital, 2 secondary general hospitals and 10 community health service stations in Liaoning, China. PARTICIPANTS: A total of 3299 medical personnel participated in the study. METHODS: We used the 15-item Chinese version of the Maslach Burnout Inventory General Survey (MBI-GS) to measure burnout. Multivariable logistic regression models were used to explore the association between medical specialty, work overload, work-life imbalance and burnout. RESULTS: 3299 medical personnel were included in this study. The prevalence of burnout, severe burnout, work overload and work-life imbalance were 88.7%, 13.6%, 23.4% and 23.2%, respectively. Compared with medical personnel in internal medicine, working in obstetrics and gynaecology (OR=0.61, 95% CI 0.38, 0.99) and management (OR=0.45, 95% CI 0.28, 0.72) was significantly associated with burnout, and working in ICU （Intensive Care Unit）(OR=2.48, 95% CI 1.07, 5.73), surgery (OR=1.66, 95% CI 1.18, 2.35) and paediatrics (OR=0.24, 95% CI 0.07, 0.81) was significantly associated with severe burnout. Work overload and work-life imbalance were associated with higher ORs for burnout (OR=1.64, 95% CI 1.16, 2.32; OR=2.79, 95% CI 1.84, 4.24) and severe burnout (OR=4.33, 95% CI 3.43, 5.46; OR=3.35, 95% CI 2.64, 4.24). CONCLUSIONS: Burnout, work overload and work-life imbalance were prevalent among Chinese medical personnel but varied considerably by clinical specialty. Burnout may be reduced by decreasing work overload and promoting work-life balance across different specialties.

Assessing safe chemotherapy needs and practices in Ile-Ife, Nigeria: a multi-disciplinary quality improvement project.

OBJECTIVE: To explore the gaps in the safe handling, administration, preparation and disposal of chemotherapy agents in low and middle-income countries. DESIGN: Two surveys comprising a needs assessment survey and an American Cancer Society (ACS) ChemoSafe Facility Assessment. SETTING: 2019 African Research Group for Oncology Symposium in South-West Nigeria (needs assessment) and the 2021 virtual engagement (ChemoSafe Assessment). PARTICIPANTS: Health professionals (n=50 of 98) from multiple institutions across Nigeria (needs assessment survey) and a designated task force of health professionals (n=10) from one teaching hospital in Southwest Nigeria(ChemoSafe Facility Assessment). RESULTS: In 2019, 75% of survey respondents (n=50) reported a lack of training resources for safe handling of chemotherapy. Additionally, 61% felt dissatisfaction with assessment practices for preparing and administering chemotherapy. ChemoSafe is a programme developed by the ACS to assess the ability of a facility to handle hazardous drugs. The 2021 ACS ChemoSafe survey administered at one teaching hospital indicated several areas for improvement to promote concordance with international standards for safe handling. Thirty-three (19.5%) items received a 'Yes' response (ie, met compliance with international standards). CONCLUSION: There is a need for the implementation of training resources for handling, administering and disposing of chemotherapy at sites across Nigeria. Strategies to identify and prioritise areas of need must be implemented in the context of available resources.

Evaluating the process of practice enhancement for exclusive breastfeeding (PEEB): a participatory action research approach for clinical innovation.

BACKGROUND: Despite the known benefits of exclusive breastfeeding, global rates remain below recommended targets, with Ireland having one of the lowest rates in the world. This study explores the efficacy of Participatory Action Research (PAR) and Work-Based Learning Groups (WBLGs) to enhance breastfeeding practices within Irish healthcare settings from the perspective of WBLG participants and facilitators. METHODS: Employing a PAR approach, interdisciplinary healthcare professionals across maternity, primary, and community care settings (n = 94) participated in monthly WBLGs facilitated by three research and practice experts. These sessions, conducted over nine months (November 2021 - July 2022), focused on critical reflective and experiential learning to identify and understand existing breastfeeding culture and practices. Data were collected through participant feedback, facilitator notes, and reflective exercises, with analysis centered on participant engagement and the effectiveness of WBLGs. This approach facilitated a comprehensive understanding of breastfeeding support challenges and opportunities, leading to the development of actionable themes and strategies for practice improvement. RESULTS: Data analysis from WBLG participants led to the identification of five key themes: Empowerment, Ethos, Journey, Vision, and Personal Experience. These themes shaped the participants' meta-narrative, emphasising a journey of knowledge-building and empowerment for breastfeeding women and supporting staff, underlining the importance of teamwork and multidisciplinary approaches. The project team's evaluation highlighted four additional themes: Building Momentum, Balancing, Space Matters, and Being Present. These themes reflect the dynamics of the PAR process, highlighting the significance of creating a conducive environment for discussion, ensuring diverse engagement, and maintaining energy and focus to foster meaningful practice changes in breastfeeding support. CONCLUSION: This study highlights the potential of WBLGs and PAR to enhance the understanding and approach of healthcare professionals towards breastfeeding support. By fostering reflective and collaborative learning environments, the study has contributed to a deeper understanding of the challenges in breastfeeding support and identified key areas for improvement. The methodologies and themes identified hold promise to inform future practice and policy development in maternal and child health.

Assessment of Knowledge of Legal Provisions on Organ Donation and Transplantation amongst Healthcare Workers in Nigeria: A Cross-sectional Study.

BACKGROUND: Advancements in the medical field have made organ transplantation an attractive treatment option for patients when indicated. Shortage of organs and commodification of organs are major challenges encountered in organ donation and transplantation. These could potentially breed unethical practices, if the process is not well regulated. AIM: The aim of this study was to assess the knowledge of healthcare workers (HCWs) on the legal provisions regulating organ donation and transplantation in Nigeria. METHODOLOGY: This cross-sectional study was conducted amongst physicians and nurses across Nigeria. Knowledge of legal provisions on organ donation and transplantation was assessed using a validated questionnaire that had 21 questions derived from the National Health Act. Each correctly answered question was given 1 point with a total obtainable score of 21 points. A score of ≥14 points was classified as good knowledge. P <0.05 was considered significant. RESULTS: A total of 836 physicians and nurses with a mean age of 37.61 ± 9.78 years participated in the study. Females and physicians constituted 53.3% and 62.9% of the respondents, respectively. The mean knowledge score of the respondents was 9.70 ± 2.91 points. Eighty-three (9.9%) respondents had a good knowledge score. There was a significantly higher proportion of male HCWs (P < 0.037) and older HCWs (P = 0.017) with good knowledge of legal provisions. On logistic regression, age was the only factor found to be associated with good knowledge of legal provision (adjusted odds ratio: 3.92; confidence interval: 1.33-11.59; P = 0.01). CONCLUSION: The overall knowledge of legal provisions on organ donation and transplant was very poor amongst HCWs in Nigeria. There is a need to educate them on these provisions to curb unethical practices.

Interprofessional Collaboration amongst Healthcare Workers of a Tertiary Hospital in North-Eastern Nigeria.

BACKGROUND: Interprofessional collaboration in healthcare is important to optimise healthcare delivery. However, relatively few studies have been conducted on the topic in Nigeria, especially in the North. OBJECTIVE: The objective of this study was to determine the levels of interprofessional collaboration, enablers and barriers amongst healthcare workers. MATERIALS AND METHODS: Data were collected using a five-domain modified Assessment of Interprofessional Team Collaboration Scale questionnaire, with a Likert scale of 1-5. The ideal mean score was ≤2 for the barriers domain and ≥4 for the other domains. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 23. RESULTS: Two hundred and sixty-six participants responded to the questionnaire. Male and female respondents were 131 (49.2%) each. Half of the respondents were 31 to 40 years old. One hundred and thirty-six (51.1%) of the respondents were nurses, and 48 (18.0%) were doctors. The modal working experience was 6-11 years (41.4%), and 117 (44.0%) respondents had at least a bachelor's degree. The mean scores for the domains were 4.1032 for partnership, 3.2383 for cooperation, 3.6309 for coordination, 4.2844 for enablers and 3.7902 for barriers. CONCLUSION: There was adequate level of partnership and enablers amongst the healthcare workers but insufficient cooperation and coordination and high level of barriers. Staff training on cooperation, coordination and identified barriers is necessary to improve interprofessional collaboration in the hospital.

The prevalence, determinants, and consequences of post-COVID in healthcare workers: A cross-sectional survey.

Data on post-coronavirus disease (COVID) in healthcare workers (HCWs) are scarce. We aimed to assess prevalence, determinants, and consequences of post-COVID in HCWs. In fall 2022, we performed a cross-sectional survey in a tertiary care hospital with a web-based questionnaire sent to HCWs. Post-COVID was defined as persistent/new symptoms 3 months after acute COVID. Propensity score weighting was performed to assess the impact of post-COVID on return-to-work. 1062 HCWs completed the questionnaire, 713 (68%) reported at least one COVID, and 109 (10%) met the definition for post-COVID, with workplace contamination reported in 51 (47%). On multivariable analysis, risk factors for post-COVID were female gender (p = 0.047), ≥50 years (p = 0.007), immunosuppression (p = 0.004), ≥2 COVID episodes (p = 0.003), and ≥5 symptoms during acute COVID (p = 0.005). Initial sick leave was prescribed for 94 HCWs (86% post-COVID), for a median duration of 7 [7-9] days, and extended for 23. On return-to-work, 91 (84%) had residual symptoms, primarily asthenia/fatigue (72%) and cognitive impairment (25%). Cognitive impairment at return-to-work was associated with post-COVID. Ten HCWs (9%) received a medical diagnosis of post-COVID, 8 consulted the occupational physician, and four required work adaptation. Post-COVID affected 10% of HCWs. Long-term consequences included repeated sick leaves and residual symptoms on return-to-work.

Competence of healthcare professionals in stroke care pathways: a cross-sectional study.

AIMS: To describe healthcare professionals' self-assessed competence in stroke care pathways based on their self-evaluation and identify the factors associated with competence. DESIGN: A cross-sectional, descriptive explorative study design was used. METHODS: The data were collected during May and September 2021 through a survey sent to healthcare professionals (N=1200, n=215) working in neurological care. Competence in stroke care pathways was measured using the RN-STROKE, PT-STROKE and OT-STROKE instruments defined by four-factor model. The instruments' validity and reliability were confirmed through exploratory factor analysis and Cronbach's alpha. K-means clustering, one-way ANOVA, Chi Square, Mann Whitney U and Kruskal-Wallis were used to analyze the data. The results were reported as frequencies, percentages, mean and standard deviation. The results were reported according to STROBE guidelines. RESULTS: Four main areas of healthcare professionals' competence in stroke care pathways were identified: (1) counseling and interaction competence (2) competence to use evidence-based information, (3) self-management and development competence, and (4) multiprofessional and collaboration competence. The study then identified three competence profiles of healthcare professionals working in the stroke care pathway. Professionals in Profile A evaluated their competence at the highest level, those in Profile B at the average level, and those in Profile C at the lowest level. Healthcare professionals' occupation and participation in their organisation's expert network were found to be associated with competence profiles. CONCLUSION: The overall competence of healthcare professionals in the stroke care pathway was rated as good, but competence to use evidence-based information in clinical practice, in particular, should be improved. Organisations should, therefore, increase education and training in this area and provide adequate resources to enable the use of evidence-based information in clinical work. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The study identifies three profiles relating to healthcare professionals' competence in the stroke care pathway, which can be used to create continuous education and ensure better patient care according to participants' profiles. REPORTING METHOD: The study was reported using the STROBE Statement checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Compliance and adherence to hand hygiene practices for effective infection control.

Hand hygiene (HH) is the most effective way to curb the spread of healthcare-associated infections. Nonetheless, healthcare personnel encounter difficulties in adhering to WHO HH recommendations. This study aimed to investigate HH compliance and adherence after the implementation of an action plan in a municipal hospital in Moscow. An initial evaluation of HH compliance among clinical health workers was carried out in June 2022 according to the WHO HH guidelines followed by a 3-month re-audit of HH practices. The results were compared to the baseline to evaluate compliance and adherence to HH among healthcare personnel. From June to September 2022, there were 2,732 moments of contact with patients or their immediate surroundings. The HH total compliance rate significantly (p < 0.05) increased from 52.3% in June 2022 to 83.3% in September 2022 with a 75% overall total compliance rate. The profession-specific total compliance rate was highest among nurses (79.6%) and lowest among ancillary staff (69.7%). Staff were also more adherent to the before-moments compared to the after-moments of the HH guidelines. Monthly re-audits and providing feedback resulted in a significant improvement in compliance and adherence with HH guidelines after implementation of the action plan.

Should We Think of Early Career Cheaters as Capable of Stewardship?

Resistance to acknowledging and curbing cheating should be seen as expressing academic organizations' dereliction of their tacit early career health professional self-regulatory duties. Cheating among students and trainees deserves ethical attention, scrutiny, and self-regulatory responses because cheating behaviors express characterological vices that undermine trust and trustworthiness, which, among other virtues, are key to good stewardship and other duties of health professionals.

'Possibilities and challenges for older couples to continue ageing in place'.

Ageing in place is an imminent concern for both older couples and communities. Identifying ways to support ageing in place is required to meet the needs and challenges of older couples and social services systems. Through focus groups with a total of 46 participants and a constant comparative methodology, this study aimed to explore and describe the experiences and reasoning of spousal carers, healthcare professionals, and stakeholders regarding possibilities for older couples to age in place. The findings consisted of one main category, 'Facilitating ageing in place is a win-win situation with challenges' and four interrelated categories, 'Focus on older couples - building relationships and providing adequate services', 'Engaged civil society as a source of care and social inclusion,' 'Motivated professionals with competence and time,' and 'Services working together for a sustainable society,' that present possibilities and challenges for ageing in place. This study suggests that facilitating ageing in place is possible but involves a complex series of challenges that can be linked to different contexts ranging from individuals and couples to civil society, services provided, organisational systems, and existing resources. All these aspects need to be considered and balanced to achieve a situation that contributes to older couples' possibilities to age in place as well as to a sustainable society.

Fostering the Facilitator: Promoting Clinical Educators' Interprofessional Education Facilitation Skills and Socialization Using Exclusively Online Learning.

Health professions educators can benefit from continuing education to more effectively facilitate interprofessional education (IPE) in clinical settings. Online learning formats enable broader participation and overcome barriers to in-person events, though few studies describe the most effective platforms and methods of online continuing education for this purpose. In the context of the COVID-19 pandemic, we developed a 6-week interactive online program implemented via an integrated online educational platform (OEP) to equip participants with knowledge and skills to better facilitate IPE in clinical settings. Program outcomes evaluation involved mixed-methods data analysis from OEP site usage statistics, pre/post-program surveys, pre/post program validated self-assessment surveys, and post-pro¬gram focus group. Twenty-four participants representing 5 professions from inpatient and outpatient clinical settings completed the program. Quantitative findings include statistically significant improvement in all of 11 measures of IPE knowledge and skills developed for this study, 4 of 9 socialization measures, and 7 of 18 facilitation measures. Qualitative findings include participants placing value on multiple modes of instruction, facilitated small group engagement, brief condensed asynchronous content, clear expectations of program time commitment, and detailed understanding of the OEP.

Optimiser le co-enseignement patient/professionnel de santé.

INTRODUCTION: Patient engagement in the training of future health professionals is on the rise, given that the information patients transmit is immensely valuable to students. In addition, their involvement, alongside health professionals, in the formulation of academic materials should improve the quality of care in the long run. Little is written about good practice in involving patients in teaching, and even less about co-teaching, which is a demanding activity. We conducted a study with pairs of teachers who co-taught in health partnership workshops to develop best practice recommendations to optimize the roll-out of patient-healthcare professional co-teaching. PURPOSE OF THE RESEARCH: This qualitative study aims to present these recommendations of good practices of co-teaching. RESULTS: The data collected made it possible to develop, evaluate, and adjust six good practices to guide the pairs during the co-teaching process: knowledge of the subject taught, regular meetings, teaching framework and materials, role definition, symmetry and complementarity in the pair, and a debriefing session following each teaching session. CONCLUSION: Patient involvement in co-teaching requires rigorous preparation. The application of good practice recommendations facilitates this preparation process.

Feasibility, acceptability, and initial efficacy of empathic communication skills training to reduce lung cancer stigma in Nigeria: a pilot study.

Effective communication about cancer diagnosis and prognosis in sub-Saharan African oncology settings is often challenged by the cancer-related shame and stigma patients and families experience. Enhancing empathic communication between health care providers, including physicians and nurses, and oncology patients and their families can not only reduce cancer stigma but also improve patient engagement, treatment satisfaction, and quality of life. To reduce lung cancer stigma, we adapted an evidence-based empathic communication skills training intervention to reduce patients' experience of stigma in Nigeria and conducted a pilot study examining the feasibility and acceptability of the empathic communication skills training. Thirty health care providers, recruited from University College Hospital, Ibadan, and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, participated in a 2.25-hour didactic and experiential training session. Participant surveys were completed before and after the training. Overall, participants reported highly favorable training evaluations, with at least 85% of health care providers agreeing or strongly agreeing to survey items assessing training relevance, novelty, clarity, and facilitator effectiveness. Self-efficacy to communicate empathically with patients increased significantly from before-training (Mean [SD] = 3.93 [0.28]) to after-training (Mean [SD] = 4.55 [0.15]; t29 = 3.51, P < .05). Significant improvements were observed in health care provider reports of empathy toward lung cancer survivors and attitude toward lung cancer care as well as significant reductions in lung cancer blame were noted. The empathic communication skills training was feasible, well received by oncology clinicians in Nigeria, and demonstrated improvements in health care provider-reported outcomes from before- to after-training.

Digital Lifestyle Interventions for Young People With Mental Illness: A Qualitative Study Among Mental Health Care Professionals.

BACKGROUND: Given the physical health disparities associated with mental illness, targeted lifestyle interventions are required to reduce the risk of cardiometabolic disease. Integrating physical health early in mental health treatment among young people is essential for preventing physical comorbidities, reducing health disparities, managing medication side effects, and improving overall health outcomes. Digital technology is increasingly used to promote fitness, lifestyle, and physical health among the general population. However, using these interventions to promote physical health within mental health care requires a nuanced understanding of the factors that affect their adoption and implementation. OBJECTIVE: Using a qualitative design, we explored the attitudes of mental health care professionals (MHCPs) toward digital technologies for physical health with the goal of illuminating the opportunities, development, and implementation of the effective use of digital tools for promoting healthier lifestyles in mental health care. METHODS: Semistructured interviews were conducted with MHCPs (N=13) using reflexive thematic analysis to explore their experiences and perspectives on using digital health to promote physical health in youth mental health care settings. RESULTS: Three overarching themes from the qualitative analysis are reported: (1) motivation will affect implementation, (2) patients' readiness and capability, and (3) reallocation of staff roles and responsibilities. The subthemes within, and supporting quotes, are described. CONCLUSIONS: The use of digital means presents many opportunities for improving the provision of physical health interventions in mental health care settings. However, given the limited experience of many MHCPs with these technologies, formal training and additional support may improve the likelihood of implementation. Factors such as patient symptomatology, safety, and access to technology, as well as the readiness, acceptability, and capability of both MHCPs and patients to engage with digital tools, must also be considered. In addition, the potential benefits of data integration must be carefully weighed against the associated risks.

Effect of integration of prescription drug monitoring program data in the electronic health record on queries by primary care providers.

Objective: To evaluate the impact of PDMP integration in the EHR on provider query rates within twelve primary care clinics in one academic medical center. Methods: Using linked data from the EHR and state PDMP program, we evaluated changes in PDMP query rates using a stepped-wedge observational design where integration was implemented in three waves (four clinics per wave) over a five-month period (May, July, September 2019). Multivariable negative binomial general estimating equations (GEE) models assessed changes in PDMP query rates, overall and across several provider and clinic-level subgroups. Results: Among 206 providers in PDMP integrated clinics, the average number of queries per provider per month increased significantly from 1.43 (95% CI 1.07 - 1.91) pre-integration to 3.94 (95% CI 2.96 - 5.24) post-integration, a 2.74-fold increase (95% CI 2.11 to 3.59; p < .0001). Those in the lowest quartile of PDMP use pre-integration increased 36.8-fold (95% CI 16.91 - 79.95) after integration, significantly more than other pre-integration PDMP use quartiles. Conclusions: Integration of the PDMP in the EHR significantly increased the use of the PDMP overall and across all studied subgroups. PDMP use increased to a greater degree among providers with lower PDMP use pre-integration.