Despite national efforts to improve research inclusion, people from underserved communities remain underrepresented in dementia trials. Barriers occur at the point of initial engagement and also within the participation pathway itself, as the structure and burden of early screening procedures can discourage continuation. ACCESS D (Advancing Community Collaboration and Engagement Strategies in Dementia) aims to address these challenges by testing a community-based model that combines co-produced engagement events, low-burden research participation, and real-time support from the South Central Ambulance Service (SCAS), a trusted, community-visible National Health Service (NHS) healthcare workforce serving the counties of Hampshire, Oxfordshire, Buckinghamshire and Berkshire in Southern England, UK.

ACCESS D is a 12-month mixed-methods feasibility study recruiting 100 adults aged 50–90 years with either (1) a diagnosis of mild cognitive impairment or dementia or (2) a self- or proxy-reported memory concern affecting daily life. The study will deliver between 12–18 co-produced community outreach events in non-clinical settings, supported by SCAS research paramedics and nurses. Following written (paper or digital) informed consent, participants will complete a core questionnaire and may optionally take part in one or more low-burden research opportunities designed to provide supported, first-hand experience of dementia research. Feasibility outcomes, including pathway progression and opt-in to future dementia research contact, will be descriptively summarised and stratified using National Institute of Health and Care Research (NIHR) INCLUDE-aligned underserved characteristics. Qualitative interviews and focus groups with participants and staff will examine acceptability, perceived value, barriers and enablers and implementation learning, analysed using thematic analysis and integrated with quantitative findings.

The study has received a favourable opinion from the Southwest-Frenchay Research Ethics Committee and Health Research Authority approval (IRAS 361074). Findings will be disseminated via peer-reviewed publications, conference presentations and co-produced lay outputs for community partners and participants. These outputs will be accompanied by an implementation toolkit for research teams and a visual summary for potential participants.

Antimicrobial resistance (AMR) poses a serious threat across human, animal and environmental health. The One Health approach emphasises multisectoral collaboration and is critical in addressing AMR. While One Health governance has gained recognition from international organisations, there remains limited understanding of how it can be effectively implemented across institutional, social, economic and political contexts. This scoping review aims to explore the design and implementation of One Health governance across contexts.

Scoping review

We searched PubMed, Scopus, Web of Science and grey literature sources in December 2024, updating our search in March 2026.

Eligible sources included empirical and conceptual work on One Health governance.

We searched for and screened documents and extracted data following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We then applied qualitative analysis to examine governance mechanisms; implementation contexts; conceptualisations of effectiveness; evidence of effectiveness and key barriers and facilitators.

We included 171 documents from over 50 countries. We explored six dimensions of One Health governance: participation, leadership, coordination, decision-making, resourcing and accountability. Existing governance structures and wider aspects of country context shaped One Health governance. While there was broad agreement on the goals of One Health governance—namely, to support disease prevention, detection and response—empirical evidence on effective approaches was relatively limited. Facilitators included strong political will and crisis-driven momentum, while barriers included siloed systems, sectoral dominance, limited accountability, inadequate funding and lack of institutionalisation.

This review highlights the range of approaches to One Health governance that exist and outlines how context may shape the design and implementation of One Health governance. Evaluative research should further explore which approaches to One Health governance are most effective in specific contexts. These insights are particularly relevant for AMR, where sustained cross-sectoral governance beyond outbreak-driven responses is essential to counter the ‘silent pandemic’.

Historically, patients diagnosed with recurrent head and neck cancer (rHNC) had a poor prognosis with the majority receiving best supportive care. Significant treatment advances over the past decade have changed the landscape for curative and non-curative management of rHNC with more treatment options for patients. This requires providing large amounts of information about treatment options and patients may experience different short-, medium- and long-term toxicities. To address complex discussions on treatment decisions and to identify potential unmet needs and provide timely support, the study aim is to co-produce a bespoke Patient Decision Aid (PDA) and a Patient Concerns Inventory (PCI) for the rHNC population.