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Beyond barriers: a qualitative evidence synthesis protocol of South Asian involvement in mental health research in high-income countries

Por: Khan · N. A. · Coventry · P. A. · Ali · H. · Fulbright · H. · Brown · J. V. E.
Introduction

There is a recognised need to provide equity in healthcare through inclusion of ethnic minorities in research. South Asians, the largest ethnic minority group in the UK, experience high levels of mental illness, often against the backdrop of socioeconomic deprivation and discrimination. The research community recognises that South Asian communities are often excluded from health research. Efforts have been made to understand the barriers and facilitators to their participation. However, the participation of individuals at the intersection of mental ill health and South Asian ethnicity remains understudied. This is a protocol for the synthesis of qualitative evidence from mental health research studies about participation, motivation and barriers to recruitment of South Asians in high-income countries.

Methods and analysis

We will search 10 databases for qualitative evidence on participation of South Asian individuals in mental health research studies in high-income countries: MEDLINE, EMBASE, PsycINFO, Health Management Information Consortium, Social Policy and Practice, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Social Sciences Citation Index, Science Citation Index Expanded and ProQuest Dissertations and Theses Citation Index. Search terms for the following five concepts will be used: (1) South Asia, (2) ethnic minority, (3) mental health conditions, (4) barriers and facilitators to participation and (5) high-income countries. No date restriction will be applied to the search. Searches will be limited to studies in the English language. Study selection and data extraction will be performed by two researchers independently, using Covidence. Demographic data, thematic outputs and salient discussion points will be extracted from final full-text inclusions and entered into NVivo for coding. Meta-ethnographic approaches using first and second-order constructs from included studies will be used to form third-order constructs. This synthesis will generate new knowledge regarding the intersectionality of mental health and South Asian ethnicity.

Ethics and dissemination

Ethical approval is not required as this study is a synthesis of published data. This review will provide new knowledge regarding the requirements for researchers and practitioners to advance the involvement of South Asian populations in mental health research. This will undoubtedly enhance equity in the long term, reduce the burden of mental disorders and enable the provision of more effective mental health care for South Asian communities.

PROSPERO registration number

CRD42025626382.

PEP-Hep: A cluster randomised controlled trial of a prison education programme to improve hepatitis B and C testing uptake and treatment initiation in Ghana - A study protocol

Por: Senoo-Dogbey · V. E. · Dzansi · G. · Akpagloh · M. C. · Wuaku · D. A. · Owusu Darkwa · I. · Boadu · A. A. · Michael · D. A. · Dzantor · E. K. · Anatsui · P. J.
Introduction

Viral hepatitis B (HBV) and C (HCV) infections remain major public health threats in Ghana, with prevalence rates significantly higher in prison populations than in the general population. Despite this, incarcerated individuals are frequently excluded from national testing and treatment programmes. Overcrowding, poor sanitation and limited access to healthcare create a high transmission risk. There is an urgent need for targeted, evidence-based interventions to address this health inequity and support Ghana’s progress towards viral hepatitis elimination.

This protocol describes a study designed to evaluate the effectiveness of a multicomponent targeted educational intervention in increasing knowledge, intention to test, testing uptake and treatment initiation for HBV and HCV among adult prison inmates in the Greater Accra and Eastern Regions of Ghana.

Methods and analysis

A cluster randomised controlled trial (RCT) with a 1:1 parallel design will be conducted in eight prisons stratified by gender (six male, two female) with 208 inmates per arm. The intervention group will receive the Prison Education for Prevention of Hepatitis Intervention, comprising an education programme (posters, infographics, film screenings, peer-led discussions and structured health education) alongside HBV and HCV testing, treatment and care linkage. The control group will receive standard health education and basic printed materials. Testing intentions, uptake, prevalence and treatment outcomes will be measured. Cost-effectiveness analysis will inform sustainability and scale-up. The primary endpoint is uptake of hepatitis B and C testing. Secondary outcomes include changes in hepatitis knowledge and testing intentions, prevalence of hepatitis B and C, treatment uptake among diagnosed inmates, linkage to hepatitis care services and cost-effectiveness of the intervention.

Data will be analysed, accounting for prison clustering, using mixed-effects models and regression methods. Outcomes include testing uptake, knowledge, intentions, prevalence, treatment initiation and sustained virologic response, adjusted for key covariates. Baseline characteristics and intervention reach will be summarised descriptively. Analyses will follow intention-to-treat and Consolidated Standards of Reporting Trials guidelines. Cost-effectiveness will estimate Incremental Cost Effectiveness Ratio (ICERs) per inmate tested, infection detected and treatment initiated.

Ethics and dissemination

The RCT was approved by the College of Health Sciences ethics and protocol review committee (no. CHS-E/M.1-P 4.7/2025–2026). Results will be presented at relevant national and international meetings and conferences and will be published in international peer-reviewed journals. Furthermore, we plan to communicate the results to relevant stakeholders in the Ghanaian Prisons and Healthcare systems.

Trial registration number

PACTR202512558588684.

Impact of the COVID-19 pandemic on the mental health of those who identify as women of low socioeconomic status and living with diabetes: a scoping review protocol

Por: Pucnin · N. · Bowen · J. M. · Hassan · D. · Stanimirovic · A. · Rac · V. E.
Introduction

With the COVID-19 pandemic driving people into social isolation, causing a financial crisis and creating uncertainty, individuals were at an even greater risk of experiencing negative mental health outcomes. Individuals who identify as women living with diabetes mellitus (DM) of low socioeconomic status (SES) are potentially at increased risk of negative mental health outcomes secondary to health-related risks of COVID-19, as well as financial barriers to access to medications and diabetes-care supplies.

Objective

The objective of this scoping review is to investigate how the COVID-19 pandemic affected the mental health of those who identify as women living with DM of low SES including the consequences of public health measures put in place to stop the spread of the virus. The review aims to identify what is known about the impact of COVID-19 on this and identify potential areas for further investigation.

Methods and analysis

The scoping review protocol was developed with guidance from the framework created by Arksey and O’Malley and refinements from the Joanna Briggs Institute and Levac et al published studies employing experimental and correlational designs to collect quantitative and/or qualitative data will be considered. Search strategies were developed for the MEDLINE, Embase and PsycINFO databases to identify relevant sources. Article titles and abstracts will be screened for eligibility by two independent reviewers. Full-text review will be conducted by two reviewers with a third reviewer being included if disagreement must be resolved. Data extraction will be conducted by two reviewers, one extraction and one quality check, and a third will resolve conflict if necessary. Data will be synthesised and reported in a narrative structure that provides a thematic analysis of the currently available literature.

Ethics and dissemination

As this is a scoping review, there are no ethical approval requirements. There is to be a full publication of findings and analysis in a peer-reviewed journal.

Analysis of factors associated with hepatitis B and C exposure and reporting patterns among healthcare workers in a tertiary care facility: a cross-sectional study

Por: Narh Lasidji · B. · Senoo-Dogbey · V. E. · Appiah · I. K.
Objectives

To assess the prevalence of occupational exposure to hepatitis B and C, examine exposure reporting patterns and identify associated factors among healthcare workers (HCWs) in a military hospital in Ghana.

Design

Analytical cross-sectional study.

Setting

A 500-bed tertiary military healthcare facility in Accra, Ghana.

Participants

A total of 369 HCWs were selected using stratified random sampling and completed a structured questionnaire. Data were collected through a structured questionnaire administered to 369 respondents. Bivariate and multivariate analyses were conducted using STATA V.17. Proportions, ORs and corresponding 95% CIs were calculated, with a significance level set at 0.05.

Outcome measures

Primary outcomes were the prevalence of occupational exposure to bloodborne pathogens (hepatitis B virus (HBV) and hepatitis C virus (HCV)) and the rate of reporting these exposures.

Results

In the 12 months prior to the study, 20.1% of HCWs reported exposure to HBV or HCV. Exposures were more common during weekdays (60.8%) and afternoon shifts (47.3%). Only 37.8% of exposure incidents were reported. Male HCWs were more likely to report exposures than females (OR 82.5, 95% CI 2.5 to 273). Diploma holders were less likely to report compared with degree holders (OR 0, 95% CI 0 to 0.3).

Conclusions

The study demonstrates that HCWs in the military health facility face a significant risk of exposure to bloodborne pathogens, yet under-reporting remains high. Strengthened training, clear reporting systems and supportive workplace policies are urgently needed to address these gaps and safeguard both staff and patient safety.

Integrating artificial intelligence in community-based diabetes care programmes: enhancing inclusiveness, diversity, equity and accessibility a realist review protocol

Por: Hassan · S. · Ibrahim · S. · Bielecki · J. · Stanimirovic · A. · Mathew · S. · Hooey · R. · Bowen · J. M. · Rac · V. E.
Introduction

Marginalised populations—such as racialised groups, low-income individuals, newcomers and those in rural areas—disproportionately experience severe diabetes-related complications, including diabetic foot ulcers, retinopathy and amputations, due to systemic inequities and limited access to care. Although community-based programmes address cultural and accessibility barriers, their isolation from mainstream healthcare systems leads to fragmented care and missed opportunities for early intervention.

Artificial intelligence (AI)-powered technologies can enhance accessibility and personalisation, particularly for underserved populations. However, integrating AI into community settings remains underexplored, with socioethical concerns around inclusion, diversity, equity and accessibility requiring urgent attention.

This realist review aims to examine how, why and under what circumstances AI applications can be effectively integrated into community-based diabetic care for marginalised populations. The review will develop a programme theory to guide ethical, inclusive and effective AI implementation to ensure AI-driven innovations address health disparities and promote culturally sensitive, accessible care for all.

Methods and analysis

Using the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) extension for Reviews guidelines, this realist review will systematically search MEDLINE, Embase, CINAHL, Cochrane library, Google Scholar and Scopus, alongside grey literature. A two-stage screening process will identify eligible studies, and data extraction will use a developed tool. Synthesis will employ realist logic, analysing relationships between contexts (eg, organisational capacity), mechanisms (eg, AI functionalities) and outcomes (eg, reduced disparities).

Ethics and dissemination

Ethics approval is not required for conducting this realist review. Ethics approval will be obtained from the University of Toronto; however, following the completion of the realist review for patients and community members’ engagement to support knowledge mobilisation and dissemination to ensure practical application and reciprocity.

PROSPERO registration number

This protocol was registered at PROSPERO (CRD42025636284).

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