While diabetes prevention programmes (DPPs) effectively reduce the risk of type 2 diabetes, optimising referral to these programmes is challenging. Our prior research (a qualitative study on the pilot of the National Diabetes Prevention Programme (NDPP) and a systematic review) identified a range of barriers and facilitators to referral from healthcare workers’ perspectives. This study aims to gain consensus on the main factors influencing referral to a newly established NDPP and using the Behaviour Change Wheel (BCW) to select behaviour change techniques (BCTs) for an implementation strategy to improve referral to the programme in the future.

A two-round modified online Delphi survey prioritised 17 barriers and facilitators of the referral process, followed by a mapping exercise with the BCW, which guided the identification of techniques to change referral behaviour from general practice.

The survey took place online with healthcare professionals working in the primary care setting in Ireland (April to June 2024). The NDPP was in the pilot phase and was not available in all areas. This study sought to learn from this pilot phase to inform the referral process, which was not yet fully established.

Healthcare professionals eligible to refer or involved in referral to the NDPP in Ireland (general practitioners, practice nurses and dietitians delivering the NDPP) took part in the Delphi survey. Recruitment was through a number of gatekeepers, a health service manager and professional groups who shared invitations to participate with eligible healthcare professionals.

In the Delphi survey round 1, respondents were asked to rate the importance of 17 factors (nine facilitators and eight barriers) influencing referral on a 5-point Likert scale (not important to very high importance) and an open text box captured other suggested important factors. Barriers included limited practical information about the availability of the programme, concerns about workload, competing priorities and concern about patient motivation, the time commitment for patients and referral delays. Facilitators included electronic referral and feedback, promotion of the programme by healthcare professionals and consultation with patients before referral. Consensus was defined as agreement of ≥70% for each factor in the combined categories of high importance/very high importance, low/moderate importance or not important. Factors not reaching consensus after the first round were included in round 2 with any new factors from round 1. Factors that did not reach consensus or reached consensus as not important or of low/moderate importance were excluded. Only factors reaching consensus as being of high importance/very high importance across the two rounds were included in the final prioritised list.

The Delphi survey had 37 responses to round 1 and 23 (62%) responses to round 2. 12 factors reached consensus as being of high/very high importance to improve referral. The 12 factors are mapped to seven intervention functions in the BCW and to nine key BCTs (feedback on the outcome of the behaviour, social support, instruction on how to perform a behaviour, information about the health consequences, information about social and environmental consequences, demonstration of the behaviour, prompts/cues, credible source and restructuring the physical environment). The strategy to improve referrals should include education delivered by educators to referrers, educational materials on the DPP and practical support to facilitate referrals. The health service should continue to provide electronic referrals and electronic prompts to refer could be considered as part of the electronic health record.

This study systematically prioritises factors perceived to influence referral and identifies BCTs to improve referral to an NDPP. The BCTs are a starting point for a strategy to improve referral to DPPs. Further consultation with stakeholders is recommended to discuss the acceptability, feasibility and operationalisation of the BCTs in the Irish setting.

Women doctors face considerable challenges navigating family planning, pregnancy and motherhood. Their experiences can have relevance for health system functioning, including doctor retention. This scoping review synthesises research on family planning, fertility, pregnancy and motherhood among women doctors in the EU and the UK.

Scoping review conducted according to JBI best practice guidance.

MEDLINE, CINAHL, Academic Search Complete, PsycInfo and Web of Science were searched, and supplemented with backwards and forwards citation chasing.

Peer-reviewed, original research, in English, focusing on either fertility and family planning, pregnancy and/or motherhood among women doctors in an EU country(s) and/or the UK.

Data were extracted independently by two authors. Data were synthesised using deductive content analysis and collated using narrative synthesis.

In total, 34 studies were identified. Family planning appears complicated by medical careers. Medical specialty choice is particularly impacted, with certain specialties (eg, General Practice) considered particularly family friendly and others markedly less so. Pregnancy complications among women doctors, especially surgeons, were documented. However, women doctors’ and non-doctors’ pregnancy outcomes were overall not significantly different. Notably, doctor-mothers had fewer children and were more likely to report making compromises or facing negative consequences when balancing family and career than doctor-fathers.

Women doctors in the EU and UK report challenges in balancing work and motherhood. With the potential for their experiences to impact on health system functioning and patient outcomes, training bodies and health organisations should take proactive action to better support women doctors and ensure they can remain in the profession and practice in their desired specialty. Future research examining working practices/schedules during pregnancy, breastfeeding experiences, parenting and childcare and maternal mental health will support a better understanding of women doctors’ experiences and facilitate implementation of effective supports.

To address the lack of accurate and accessible mental health medicines-information resources for children, young people and their parents/guardians using design thinking to co-design free-to-use, video resources tailored to this audience.

A multiphase qualitative case study using the Double Diamond model of Design Thinking: Discover, Define, Develop and Deliver. This included iterative prototyping, thematic analysis and public and patient involvement throughout.

Dublin, Ireland with online distribution of the final resources internationally through a free, open-access platform.

A multidisciplinary co-design team including two specialist mental health pharmacists, two academic pharmacists, five consultant psychiatrists, a psychiatric nurse, a youth content specialist, three youth activists and a parent representative.

26 co-designed, medicines-information videos were created, including versions for children (voiced by children), parents/guardians and young people. Videos feature storytelling formats with Bitmoji characters. Feedback from youth and parent collaborators guided design and content. Since launch, www.youthmed.info has had over 25 000 website views and more than 30 000 video views, with engagement from over 91 countries. The resources are also linked on national and international clinical and charity platforms.

Youth Med.Info addresses a gap in accessible, accurate mental health medicines-information by placing users – children, young people, parents/guardians and clinicians—at the centre of its design.