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Ethnic minoritized women face cultural and systemic barriers in accessing antepartum and intrapartum care. Healthcare providers play a pivotal role in addressing these challenges, but their perspectives and experiences in delivering culturally competent care remain underexplored.
To synthesise healthcare providers' experiences and perspectives on providing culturally competent antepartum and intrapartum care for ethnic minoritised women.
A qualitative meta-synthesis study design was employed. Six electronic databases were searched from their inception date till January 2025. The included studies were assessed using the method of the Critical Appraisal Skills Programme tool, and findings were meta-synthesised using Sandelowski and Barroso's six-step approach. This review was registered via the International Prospective Register of Systematic Reviews.
Overall, 38 studies were included, and three themes emerged. The first theme revealed how providers' biases and professional training distorted their ability to understand and respect cultural practices. The second theme underscored the impact of systemic barriers such as time constraints, resource scarcity and lack of representation among providers. The final theme highlighted healthcare providers' aspirations for improved communication, targeted training and guidance on building trust to enhance care delivery.
Healthcare providers encounter notable challenges in delivering culturally competent antepartum and intrapartum care, but remain hopeful about bridging gaps in communication and understanding. Practical recommendations include implementing mandatory cultural competency training at all levels of healthcare professional education, increasing resources for interpreters and cultural liaisons and fostering diversity within the healthcare workforce. Future research should explore patient-centred interventions and systemic reforms to improve care for ethnic minoritised women. These findings highlight the need for policies and practices that empower providers to deliver equitable, culturally respectful antepartum and intrapartum care.
No patient or public contribution.
by Myriam El Khoury-Malhame, Souheil Hallit, Maria-Jose Sanchez-Ruiz, Sleiman El Hajj, Rita Doumit
IntroductionAnxiety is one of the major global mental health concerns, particularly amidst accumulating adversities. It is the leading cause of distress in adolescents worldwide and has a profound deleterious impact on their mental and physical health and wellbeing. This paper seeks to identify and validate the psychometric properties of the Arabic version of the GAD-7 in Lebanon, aiming to improve the much-needed overall mental health screening in Middle Eastern countries.
MethodsThis study includes a cross-sectional design including 638 adolescents in Lebanese public schools. Participants aged 15−18 years were assessed using GAD-7 (anxiety), PCL-5 (post-traumatic stress disorder), and PTGi (post-traumatic growth) in their Arabic versions at two-time points, spaced three months apart.
ResultsOur analyses revealed that the 7 items of the GAD-7 converged into a single factor. Composite reliability of scores was adequate in the total sample (ω = .88/ α = .87). The convergent validity for this model was satisfactory. Results showed invariance across gender at the configural, metric, and scalar levels, with males showing a higher level of wellbeing compared to females. The pre-posttest assessment for the GAD-7 scale was conducted on 359 participants; the intraclass correlation coefficient was adequate 0.83 [95% CI.79;.86]. Our analyses also show that anxiety symptoms were significantly correlated with higher PTSD (r = 0.68; p r = −.12; p = .004).
ConclusionThe Arabic GAD-7 among Lebanese adolescents displayed highly satisfactory psychometric properties, underscoring its validity. This scale could be valuable for educators and clinicians as a screening tool to rapidly detect anxiety among this vulnerable age group as GAD-7 is easy-to-use, easy to understand, culturally sensitive for Arab population and age appropriate for 15–18-year-old students.
To assess the feasibility of conducting a pragmatic, multicentre randomised controlled trial (RCT) to test the clinical and cost-effectiveness of a pain management training intervention to support people with persistent musculoskeletal pain and their informal carers.
Two-arm, multicentre, pragmatic, open, feasibility RCT with embedded qualitative study.
National Health Service (NHS) providers in four English hospitals.
Adults receiving NHS care for persistent musculoskeletal pain and their informal carers.
Control: usual NHS care. Experimental: usual NHS care plus a carer-patient pain management training intervention (JOINT SUPPORT), comprising five, 1-hour, group-based sessions for patients and carers, delivered by trained physiotherapists or occupational therapists. Content included understanding pain, pacing, graded activity, fear avoidance, goal-setting, understanding the benefits of physical activity and medication management. This was re-enforced with a workbook. After the group-based sessions, patients and carers were supported through three telephone sessions.
Central randomisation was computer-generated (2:1 Experimental:Control), stratified by hospital and patient-participant age (≤65 years). There was no blinding.
Data collected at baseline and 3 months post-randomisation included screening logs, intervention logs, fidelity checklists and clinical outcomes on quality of life, physical and emotional outcomes, adverse events and resource use. Interviews with 14 patient-carer participants and six health professionals who delivered the intervention.
A total of 76 participants (38 patients; 38 carers) were enrolled. Sixty per cent (312/480) of patients screened were eligible with 12% consenting to be randomised (38/312). Fifty-four per cent (13/24) of the experimental group reached minimal compliance with the JOINT SUPPORT intervention. There was no evidence of treatment contamination. For patient-participant outcomes, within-group differences from baseline to 3 months favoured the control group when assessed by EQ-5D and Generalised Self-Efficacy total score, but favoured the intervention group when assessed by numerical rating scale pain, fatigue and Centre for Epidemiologic Studies Depression Scaletotal score. Qualitative data demonstrated the acceptability of the trial design and JOINT SUPPORT intervention with modifications to improve trial processes.
The JOINT SUPPORT intervention was acceptable to patient-carer dyads and health professionals. Modifications to trial design, particularly enhanced recruitment strategies, are required.
The data that support the findings of this study are available from the corresponding author (TS) on reasonable request. This includes access to the full protocol, anonymised participant-level dataset and statistical code.
by Judy Malas, Sarah C. Khoury, Michael Tanzillo, Gracie A. Fischer, Jean E. Bogner, D’Arcy R. Meyer-Dombard
Municipal solid waste (MSW) landfills represent underexplored microbial ecosystems. Landfills contain variable amounts of antibiotic and construction and demolition (C&D) wastes, which have the potential to alter microbial metabolism due to biocidal or redox active components, and these effects are largely underexplored. To circumvent the challenge of MSW heterogeneity, we conducted a 65-day time series study on simulated MSW microcosms to assess microbiome changes using 16S rRNA sequencing in response to 1) Fe(OH)3 and 2) Na2SO4 to represent redox active components of C&D waste as well as 3) antibiotics. The addition of Fe(OH)3 altered the overall community composition and increased Shannon diversity and Chao1 richness. The addition of a mixture of seven antibiotics (1000 ng/L each) altered the community composition without affecting diversity metrics. Sulfate addition had little effect on microbial community composition or diversity. These results suggest that the microbial community composition in fresh MSW may be significantly impacted by influxes of iron waste and a single application of antibiotics.
FreshRSS 