The demand for home care services has increased with the growth of the older population. Currently, home care workers (HCWs) are experiencing challenges such as poor working conditions, high turnover, fragmented services and dissatisfied clients, which are indicative of limitations on HCWs’ ability to provide quality integrated home care to older people. Therefore, we conducted a scoping review to identify the key elements that affect the capabilities of the HCWs in providing quality integrated care to older people in their homes.
Scoping review.
PubMed, PsycINFO, Scopus, CINAHL, Cochrane, Analysis & Policy Observatory, Australian Association of Gerontology (Australia), WHO, Trove (Australia), Social Care Online (UK) and Google between January 2014 and August 2025.
Studies were included if they focused on the analysis of HCWs’ experience in providing care to older people within home settings and were published in the English language between January 2014 and August 2025.
19 studies met the inclusion criteria out of 2844 retrieved articles. Most studies were conducted in North America (n=8). Qualitative studies were the most commonly reported (n=16). The findings of the studies were combined and categorised into four themes using a narrative synthesis approach. The four themes identified were HCWs’ capability through (1) collaborative practice, (2) education and training, (3) structural conditions at work and (4) personal attributes.
This scoping review on home care for older people highlights four interconnected pillars that shape HCWs’ capabilities. This review provides valuable insights to inform the standards and policies to strengthen HCWs’ capabilities across these domains. Future study is needed to explore the measures taken by agencies to understand and address key elements of HCWs’ capability.
South Asia carries the burden of a rapidly changing climate with floods and extreme heat. These disasters further translate into mental health distress, financial stress and detrimental effects on well-being, with women being the most vulnerable. This study aims to demonstrate that mental health screening, referral and resilience-building group sessions can be successfully administered by community health workers and primary health facility staff in a flood-affected rural population of women in Pakistan and provide evidence on the effectiveness of this approach for improving their mental health status.
A quasi-experimental design with a comparison group will be used for the study, preceded by a formative phase. The formative phase evaluated the feasibility of mental health screening by Lady Health Workers (LHWs) in flood-affected areas using a qualitative approach such as focus group discussions and in-depth interviews. Manuals developed by the study team of mPareshan will be used to train LHWs, Lady Health Supervisors (LHS) and health facility staff. Following this, LHWs will briefly screen women aged 18 to 49 years, administer awareness-raising and resilience-building sessions and refer women who screen positive for depression or anxiety to a primary health facility. Physicians at the health facility will confirm the diagnosis and provide counselling to mild-moderate cases, while severe cases would be referred to specialists. Statistical evaluation of quantitative data and thematic content analysis of qualitative data will be conducted to assess the feasibility and impact of the intervention. This trial is registered at clinicaltrials.gov with number NCT06756165.
The study acquired ethical approval from the Ethical Review Committee at Aga Khan University (2024-10475-30776) and the National Bioethics Committee (4-87/NBC-1158/23/481) in Islamabad. Approval was obtained from relevant provincial authorities. The trial will adhere to the ethical principles of autonomy, anonymity, confidentiality, equity and respect. All eligible participants will be provided with informed consent, details regarding the purpose and procedure of the study, and the right to withdraw at any time. Data and information will be anonymised and stored securely. Dissemination of the results of the trial will occur after its completion to stakeholders, participants and the public.
The use of digitally enabled technology is considered a promising platform to prevent morbidity and enhance youth mental health as youth are growing up in the digital world and accessing the Internet at increasingly younger age. This scoping review will identify, describe and categorise the models, frameworks and strategies that have been used to study the implementation of digital mental health interventions targeted at youth aged 15–34 years.
We will conduct a scoping review following the Arksey-O’Malley five-stage scoping review method and the Scoping Review Methods Manual by the Joanna Briggs Institute. Implementation methods will be operationalised according to pre-established aims: (1) process models that describe or guide the implementation process; (2) evaluation frameworks evaluating or measuring the success of implementation; and (3) implementation strategies used in isolation or combination in implementation research and practice. Primary research studies in all languages will be identified in CINAHL, Cochrane Central Register of Controlled Trials, Embase, ERIC, Education Research Complete, MEDLINE and APA PsycINFO on 6 January 2025. Two reviewers will calibrate screening criteria and the data charting form and will independently screen records and abstract data. We will use the Evidence Standards Framework for Digital Health Technologies by the National Institute for Health and Care Excellence to classify digital interventions based on functions, and a pre-established working taxonomy to synthesise conceptually distinct implementation outcomes. Convergent integrated data synthesis will be performed.
Ethical approval is not applicable as this scoping review will be conducted only on data presented in the published literature. Findings will be published and directly infused into our multidisciplinary team of academic researchers, youth partners, health professionals and knowledge users (healthcare and non-governmental organisation decision makers) to co-design and pilot test a digital psychoeducational health intervention to engage, educate and empower youth to be informed stewards of their mental health.
Imposter Phenomenon is characterised by persistent self-doubt despite objective success. It has been associated with anxiety, burnout and reduced job satisfaction. Little is known about imposter phenomenon’s presence and impact in Trauma and Orthopaedic surgery. This study aims to determine the prevalence and predictors of Imposter Phenomenon among UK orthopaedic surgeons, further mapping domains that affect leadership and professional development.
Cross-sectional survey using the validated Clance Imposter Phenomenon Scale (CIPS).
The survey was distributed to UK orthopaedic surgeons between 20 October 2023 and 28 February 2024 via Training Programme Directors and the British Orthopaedic Association.
Orthopaedic trainees and consultant surgeons (n=441)
Imposter Phenomenon severity measured using CIPS (mild: 41–60, moderate: 61–80 and severe: 81–100). Univariate and multivariate analyses identified predictors of this severity. Self-reported impact of Imposter Phenomenon assessed across personal and leadership domains.
92% of respondents reported moderate to intense Imposter Phenomenon symptoms (mean CIPS=65.17). Trainees had significantly higher mean scores (70.64±13.85) compared with consultants (59.82±15.71). Female surgeons reported significantly higher mean scores (72.57±13.35) than male surgeons (61.19±15.74). Female gender, non-consultant training grade and time out of training were predictors of severity (p
The Imposter Phenomenon is highly prevalent among UK orthopaedic surgeons; disproportionately affecting women, trainees and those taking career breaks. Imposter Phenomenon significantly impacts leadership aspirations and career development, potentially contributing to reduced diversity in surgical leadership. Targeted interventions addressing Imposter Phenomenon are needed to support equitable leadership development in Trauma and Orthopaedic surgery.
School environments that encourage children to be physically active can embed lifelong positive health behaviours and contribute towards reducing health inequalities. The Health and Activity of Pupils in the Primary Years (HAPPY) study aims to: (1) explore the extent to which the WHO criteria for creating active school environments are implemented by primary schools and (2) examine associations between active school environments and children’s physical activity, mental health and educational performance.
The HAPPY study is a quasi-experimental study comprising: (1) a survey of state-funded Greater London primary schools to identify implementation of the WHO’s six criteria and (2) a cross-sectional study to examine associations between schools’ active environment score (derived from the school survey) and pupils’ physical activity, mental health and educational performance. For our cross-sectional study, we will recruit up to 1000 year-three children (aged 7–8 years). Our primary outcome is accelerometer (GENEActiv) assessed physical activity, our secondary outcomes are parent-reported child mental health (Strengths and Difficulties Questionnaire) and teacher-reported educational performance (age-related expectations). Using multilevel mixed-effects regression models, we will examine associations between the active environment score and physical activity. Physical activity will be included as a measure of acceleration and also different intensities (light, moderate, vigorous). We will repeat this analysis to examine associations between the active environment score and mental health and educational performance. We will adjust for school characteristics and area-level deprivation and include pupil characteristics (eg, sex, ethnic group) as covariates. Clustering at the school level will be included as a random effect.
Ethical approval has been obtained from Imperial College Research Ethics Committee (ref: 6800895). Findings will be disseminated through a summary report to all participating schools, peer-reviewed publications, presentations at national and international conferences and National Institute for Health and Care Research policy briefings.