Mental health disorders among children and young people are a substantial global public health concern. Barriers to accessing specialist mental health services, particularly long waiting times, can exacerbate poor mental health. Recently, there has been an increase in the adoption of social prescribing to support children and young people to address this concern; however, the evidence of its impact on mental health remains limited. The key objective of this study was to explore how children, young people and their families experience the impact of a new social prescribing service in the Northwest of England.

The qualitative study adopted an Interpretive Description (ID) approach defined by Sally Thorne. Reporting of the study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Semistructured interviews were conducted with 15 children and young people aged 8–17 years who had accessed the social prescribing service. In addition, 27 parents and caregivers of children and young people who had accessed the service were also interviewed. This study formed part of an independent evaluation of the service in which interviews took place both face to face and online.

Inductive reflexive thematic analysis outlined by Braun and Clarke was employed to analyse the data.

Five themes emerged which described the perceived impact of the service and the key mechanisms of how the impact may have been achieved. Children and young people described feeling less emotional distress, lower levels of anxiety and increased social confidence. The impact extended beyond those in direct receipt of the service, reducing parental stress, improving family interaction and strengthening relationships. Key mechanisms underpinning the impact included a trusting relationship with a link worker and the learning of cognitive coping strategies that were employed to help overcome emotional distress.

The findings suggest that social prescribing may function as a relational early intervention that supports emotional stabilisation and re-engagement with education and social contexts. However, further research is needed to confirm and quantify the effectiveness across different service models and settings.

Regular physical activity and limiting sedentary behaviour are important aspects in managing multiple sclerosis (MS). Fatigue is a common and disabling symptom in MS, contributing to impairments in activities of daily living and poorer quality of life. This study aims to determine the effectiveness of a physical activity and sedentary behaviour intervention, called iStep-MS, for reducing fatigue in people with MS when delivered across the MS care pathway.

This is a multicentre, two-arm randomised controlled superiority trial with embedded economic and process evaluations. The study will take place across South-East England in acute and community National Health Service settings and charity-funded MS and neurological therapy centres. Intervention deliverers will include a range of healthcare staff such as physiotherapists, occupational therapists, therapy assistants, nurses and exercise therapists. A target sample size of n=198 participants will be randomised 1:1 to the intervention (iStep-MS behaviour change intervention plus usual care) or control (usual care only) arms. Participants will be adults with any type of MS, experiencing MS-related fatigue, relapse-free for >3 months, with a Self-Reported Disability Status Scale category of ≤3.5 (no disability to moderate disability) or 4–6.5 (significant disability). The iStep-MS intervention includes four one-to-one consultation sessions in-person or online with an intervention deliverer over 3 months, incorporating behaviour change techniques aimed at increasing physical activity and reducing sedentary behaviour. The consultations are supported by a handbook designed to help individuals with MS set goals and achieve behavioural changes and a wearable activity tracker for self-monitoring. Outcomes (assessed at baseline, 3 months and 9 months) include self-reported fatigue, quality of life, MS-impact, walking capability, pain, self-efficacy and waist circumference. Sitting, standing and stepping will be measured over 8 days using the activPAL4 device. A process evaluation will assess intervention acceptability, adherence and fidelity, including questionnaires and focus groups with participants and deliverers. A cost-effectiveness analysis will evaluate the value for money of the intervention against usual care.

Ethical approval has been granted by the NHS London—Bloomsbury Research Ethics Committee (reference 25/LO/0272). Results will be disseminated in scientific journals, conferences and to the wider public (eg, newsletters and social media).

ISRCTN16944301.

Policies promote patient-centred tuberculosis (TB) care in Kenya, a high-burden TB country, but implementation remains limited. This study sought to understand the experiences of TB healthcare workers in implementing patient-centred TB services in primary health facilities in Nairobi and explore how the challenges they face can be addressed.

Using collaborative research design, we recruited healthcare workers (n=29) from primary health facilities across three densely populated subcounties in Nairobi and TB stakeholders (n=24) including policymakers and managers. From March to April 2024, we collected data through three workshops with nurses (n=19) and clinical officers/doctors (n=10) and a joint workshop with stakeholders. Participants engaged in group discussions and participatory visual methods to define person-centred care, document practices, identify challenges and develop solutions. Our data analysis applied a framework approach drawing on the social–ecological, TB care cascade and health systems building blocks models.

Healthcare workers identified practices for differentiated TB care across age groups, genders, occupations and comorbidities. Implementation faced multiple challenges including structural, health system, community and patient’s individual constraints. Shortages of funding, workforce and capacity affected close-to-community TB screening (Theme 1). Insufficient testing capacity at lower-level facilities led to diagnostic delays (Theme 2). Inflexible clinic hours and medication stockouts requiring frequent facility visits undermined TB treatment and adherence among working populations (Theme 3). Weak collaboration and referral systems limited support for people facing homelessness, substance use or poverty. Healthcare workers proposed enhanced TB training, increased TB workforce, flexible medication delivery, integrated TB services and strengthened intersectoral collaboration with education, labour and social protection sectors (Theme 4).

Healthcare workers demonstrate willingness and capacity to deliver patient-centred TB care but require strengthened health systems, ongoing training and sustainable intersectoral partnerships. Scaling up identified practices and innovative tools while addressing systemic barriers could improve TB care delivery and outcomes for underserved populations.