The objective of this study was to test whether an airtime reward increased tuberculosis (TB) Check screening uptake. This served as a feasibility study for the planned Phase 2, which aimed to test behavioural messaging to boost take-up of TB testing among users who were advised to get tested by TB Check.

The study was a randomised controlled trial with a parallel design.

This study assessed mHealth support to boost TB testing in high-burden Cape Town clinics.

Patients aged 18 or above with a valid mobile phone number that had been added within the last 5 years were invited by the Western Cape Department of Health and Wellness through unsolicited text messages to screen for TB using TB Check.

Patients in the intervention group (n=1250) were additionally offered R15 airtime for completing the screening and participating in the research study. Patients were allocated to the intervention or control group through parallel randomisation with equal group size.

The primary outcome was the number of TB Check screenings completed within 1 week of the SMS invitation being sent.

Messages were successfully delivered to 616 patients in the control group and 633 patients in the intervention group. Uptake of the invitation by the intended recipients was very low. Eight users in the control group and 20 users in the intervention group initiated a self-screening (1.3% vs 3.2% of delivered messages; 95% CI of difference (0.2 to 3.5)), but only three users in the control group and seven users in the intervention group successfully completed a self-screening (0.49% vs 1.11% of delivered messages; 95% CI of difference (–0.4 to 1.6)). Low delivery of text message invitations (50.0%) and low completion of users who started the screening (35.7%) posed additional challenges. No adverse events were recorded.

The addition of a small airtime participation reward to unsolicited text message invitations did not appear to be an effective tool to reach targeted individuals in this context. The results of Phase 1 reported here suggested that Phase 2 would not be feasible, so we did not proceed with the planned Phase 2. However, uptake of incentivised self-screening was unexpectedly high among users who were not originally invited (presumably known contacts of the original invitees). Within 5 days of the invitations being sent, 1962 unique self-screenings had taken place using the incentive code; only 7 of these users were originally invited. The lessons learnt from this study can help to inform future efforts to promote TB self-screening, mHealth initiatives and attempts to engage with patients via text message. 

The study was pre-registered with the South African National Clinical Trials Registry (Phase 1 trial no DOH-27-112023-9045, Phase 2 trial no DOH-27-112023-4944) and the Pan African Clinical Trials Registry (Phase 1 trial no PACTR202311529334858).

To evaluate progress in the implementation of the WHO Eastern Mediterranean Regional Office (EMRO) Regional Framework for Action on Diabetes Prevention and Control, identify implementation barriers and facilitators, and provide recommendations for accelerating progress, with a particular focus on fragile, conflict-affected and vulnerable settings (FCVs).

Mixed-methods study combining secondary analysis of quantitative data from WHO datasets with qualitative synthesis of inputs from WHO consultative meetings with EMR member states.

22 countries of the WHO EMR, including 10 classified as FCV and 12 as non-FCV according to World Bank and WHO classifications.

Quantitative data were drawn from the 2021 WHO Country Capacity Survey targeting all EMR countries and other WHO sources. Qualitative data were based on insights from 16 country representatives during a regional WHO EMRO webinar, including non-communicable diseases programme managers, policy leads and WHO country office staff.

Among the 22 countries analysed, only 10% (1/10) of FCVs had a national diabetes action plan compared with 67% (8/12) of non-FCVs. A sugar-sweetened beverage tax was implemented in 75% (9/12) of non-FCVs but in just 10% (1/10) of FCVs. For diabetes management, detailed national guidelines were available in 30% (3/10) of FCVs compared with 83% (10/12) of non-FCVs; insulin was available in primary care in 50% (5/10) of FCVs compared with 83% (10/12) of non-FCVs. Surveillance systems were less robust in FCVs: while 70% (7/10) collected data on diabetes status, only 30% (3/10) had a national diabetes registry, compared with 83% (10/12) of non-FCVs.

Addressing diabetes in the EMR requires strategic collaboration and tailored approaches for FCVs, including strengthened governance, preparedness, integrated care, medication access and surveillance. Prioritising primary healthcare and embedding diabetes prevention and control in universal health coverage and emergency response frameworks is critical to reducing inequities and improving health outcomes in fragile contexts.

Diabetes mellitus is a significant global health challenge, requiring innovative strategies to improve management and mitigate complications. Digital health technologies offer promising solutions to enhance diabetes self-care by providing real-time feedback, improving communication and supporting data-driven decision-making. Despite the increasing adoption of digital self-care interventions, there is a lack of comprehensive synthesis of evidence on their impact, accessibility and integration into healthcare systems. This scoping review aims to map existing research on digital self-care solutions for diabetes management, identify knowledge gaps and highlight best practices and key factors influencing adoption.

The review will follow Arksey and O’Malley’s framework and adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. A systematic search will be conducted in Medline, Scopus, Embase, CINAHL and Google Scholar, focusing on studies published from January 2004 to December 2024 in English, French, Arabic, Portuguese, Spanish, Italian, Czech, Slovak and Chinese. Studies reporting on digital self-care solutions for diabetes management will be included, covering experimental and quasi-experimental study designs. Data extraction will cover study and participant characteristics, digital solution features, and barriers and facilitators to adoption. Ethical and equity considerations will also be analysed using established frameworks. Two reviewers will independently screen studies, with discrepancies resolved by a third reviewer.

This scoping review will provide a comprehensive understanding of digital self-care solutions for diabetes management, offering insights to inform future research and enhance self-care practices globally. Findings will be disseminated through peer-reviewed publications, conferences and interest holder engagements to inform clinical practice and policy development. As this study involves the review of existing literature, ethical approval is not required.

To characterise the information needs and experiences of receiving COVID-19 vaccine information by youth with mental health concerns.

Thematic analysis of semistructured interview transcripts.

Semistructured interviews via WebEx video conferencing or by telephone.

46 youth aged 16–29 with one or more self-reported mental health concerns and six family members of youth.

Our analysis generated four main themes: (1) information content and characteristics; (2) critical appraisal; (3) modulators of information-seeking behaviour; and (4) unmet information needs.

Our findings suggest that youth with mental health concerns have unique information needs and processing patterns influenced by their environments and experiences with mental health concerns. Participants identified barriers to receiving reliable health information and suggested ways to improve this process.

Mental illness typically onsets during the developmental stages from adolescence to emerging adulthood (ages 15–24 years), referred to as ‘youth’. A subset of youth with mental illness may be identified as having ‘complex’ mental health needs, defined based on requiring prolonged, extensive and resource-intensive services across multiple sectors, functional impairment, and comorbid challenges or multimorbidity . Effective early intervention for youth with complex mental illness is crucial to prevent the sequelae of long-term mental health problems. Several resource-intensive outpatient models have been developed to meet the needs of youth with complex mental illness; however, to the best of our knowledge, no scoping review has synthesised the available evidence on these interventions. A comprehensive synthesis of existing intensive outpatient interventions is needed to identify, target and inform future research and clinical efforts to better serve youth with complex mental illness. As such, the proposed scoping review will address the following research questions: (1) What intensive outpatient interventions have been evaluated for youth with complex mental illness? (2) To which populations are these interventions targeted? and (3) What outcomes have been examined within the context of these models?

This review will follow the Arksey and O’Malley framework for scoping reviews, and we will report the results following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) recommendations. We will conduct a comprehensive literature search across seven academic databases to identify relevant peer-reviewed material in English from 1990 to the present. Inclusion criteria will address evaluations of outpatient models of care with intensive components targeted to youth ages 15–24 with features of complex mental illness. Studies will be screened independently for eligibility by two reviewers in Covidence using clear inclusion criteria. We will then collate, summarise and present the findings to provide a comprehensive overview of the existing evidence.

Ethical approval will not be required, as no data will be collected for the proposed project. Results will be disseminated in peer-reviewed articles, presented at conferences and shared with stakeholders to inform the development, implementation and evaluation of comprehensive transdiagnostic services targeting youth with complex mental illness.

Visual perception is a fundamental skill that plays a central role in sensing the external environment. Deficits can lead to impairments in everyday activities. Visual perception is known to be impaired in Alzheimer’s disease (AD). However, the extent to which visual perception is impaired in mild cognitive impairment (MCI), often a prodromal state of AD, has not been sufficiently investigated. This study aims to assess visual perceptual abilities in people with MCI and mild AD compared with healthy controls. It will also investigate whether executive functions, activities of daily living and intelligence are affected in this context, providing new insights into the research of visual perception together with MCI and mild AD.

People with MCI, mild AD and healthy controls will be assessed for cognitive deficits using the Syndrom-Kurztest (SKT). Visual perceptual performance will be assessed using the German version of the Developmental Test of Visual Perception-Adolescent and Adult: Second Edition (DTVP-A:2; Frostings Entwicklungstest der visuellen Wahrnehmung – Jugendliche und Erwachsene 2. Auflage). Activities of daily living will be assessed through the Erlangen Test of Activities of Daily Living in Persons with Mild Dementia or Mild Cognitive Impairment (ETAM) and the Bayer Activities of Daily Living Scale (B-ADL). Executive functions will be measured using the German adaptation of the Behaviour Rating Inventory of Executive Function - Adult (BRIEF-A) and intelligence will be assessed using the Matrix Reasoning and Vocabulary Test of the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV). Data analysis will involve descriptive analyses, linear regression analyses, multivariate analysis of variance, mediation analysis and structural equation modelling.

This study has received approval from the Ethics Committee of Helmut Schmidt University/University of the Federal Armed Forces Hamburg, Germany (number: 2023_009). Findings will be disseminated through peer-reviewed publications and presentations at national and international conferences.

Registered at OSF https://doi.org/10.17605/OSF.IO/PM5AV