Tag: pubmed

JMIR Ment Health. 2026 Aug 5;13:e77507. doi: 10.2196/77507.

ABSTRACT

BACKGROUND: The burden of mental disorders is high in conflict-affected populations. In Palestine, we piloted Inuka Coaching, a digital intervention adapted from the Friendship Bench delivered by trained and supervised lay coaches. This paper documents the implementation of the intervention in this highly volatile context after October 7, 2023.

OBJECTIVE: This study aimed to describe the implementation of Inuka Coaching, a digital mental health tool based on task shifting, in Palestine and examine contextual challenges, fidelity to the coaching model, and lessons learned regarding recruitment, retention, and delivery during escalating ethnic cleansing.

METHODS: Two Palestinian mental health professionals were trained and certified in the Inuka method as head coaches, and subsequently trained 5 lay coaches. Palestinian adults in Gaza and the West Bank were recruited primarily through social media and received up to 4 structured, text-based coaching sessions typically delivered over 4 weeks depending on participant availability and preference. Standardized mental health screening questionnaires (Self-Reporting Questionnaire-20 [SRQ-20] and Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]) were collected at baseline, immediately after the first coaching session, and 3 months after the final session. Session transcripts were reviewed to assess coaches’ fidelity to the Inuka method, and a focus group discussion explored coaches’ experiences with training, delivery, and contextual challenges.

RESULTS: Between August 2023 and February 2024, a total of 70 participants were enrolled. Baseline assessments indicated high levels of psychological distress: 95.7% (67/70) scored above the PCL-5 threshold of 31, suggesting likely posttraumatic stress disorder, and 69.4% (43/62) scored in the “at risk” range on the SRQ-20. The effectiveness of the method could not be determined as retention was low, with only 7.1% (5/70) completing the program. Coach fidelity was high, with 94.6% (35/37) of transcripts adhering to all 5 steps of the intervention. Coaches reported positive experiences with the method but identified challenges related to recruitment, session continuity, platform usability, and the need for flexibility during acute crises. Key implementation learnings included the importance of early in-person collaboration and training, culturally sensitive framing, flexible delivery and session structures, and robust support for lay coaches.

CONCLUSIONS: While digital, task-shifted mental health interventions can be delivered with fidelity in conflict settings, sustaining engagement during escalating violence remains challenging. Future implementations require flexible design, context-sensitive recruitment and retention strategies, adaptive delivery models, and strong support for lay coaches.

PMID:42555954 | DOI:10.2196/77507

JMIR Public Health Surveill. 2026 Aug 5;12:e97009. doi: 10.2196/97009.

ABSTRACT

BACKGROUND: Blood exposure accidents (BEAs) remain a major occupational hazard for health care providers, particularly in low‑resource settings. Despite their preventable nature, BEAs continue to occur frequently due to gaps in compliance with standard precautions and limited institutional surveillance.

OBJECTIVE: This study aimed to determine the prevalence and factors associated with BEAs among health care providers in Kalemie, Tanganyika Province, Democratic Republic of the Congo.

METHODS: A cross-sectional study was conducted in March 2024 among 316 health care providers randomly selected from 34 health facilities: public facilities (20/34, 58.8%), private facilities (9/34, 26.5%), and faith‑based facilities (5/34, 14.7%). Data were collected using a structured questionnaire adapted from World Health Organization and Centers for Disease Control and Prevention tools. Logistic regression was performed to identify predictors of BEAs, with adjusted odds ratios (AORs), 95% CIs, and P values reported.

RESULTS: The lifetime prevalence of BEAs was 65.8% (208/316), and the 12-month prevalence was 60.4% (191/316). The most frequent causes were unexpected patient movement (81/191, 42.4%) and lack of attention (66/191, 34.6%). Needlestick injuries accounted for 59.2% (113/191) of exposures. Only 36.1% (69/191) of incidents were formally reported. Multivariate analysis identified two independent predictors: (1) noncompliance with standard precautions (AOR 2.921, 95% CI 1.503-5.677; P=.001) and (2) facility type (working in secondary‑level facilities was protective; AOR 0.310, 95% CI 0.144-0.670; P=.003).

CONCLUSIONS: BEAs were highly prevalent among health care providers in Kalemie. Most incidents were preventable, and noncompliance with standard precautions significantly increased risk. Strengthening infection prevention and control measures, ensuring consistent availability of personal protective equipment, and establishing effective surveillance systems are urgently needed to protect health care workers and reinforce health system resilience.

PMID:42555929 | DOI:10.2196/97009

JMIR Dermatol. 2026 Aug 5;9:e98130. doi: 10.2196/98130.

ABSTRACT

BACKGROUND: Outdoor workers receive significantly more UV radiation exposure than indoor workers, increasing their skin cancer risk. Hispanic individuals comprise a large proportion of the outdoor workforce in the United States, but have limited access to culturally tailored prevention resources.

OBJECTIVE: This exploratory study assessed the perceptions of a culturally tailored narrative video to promote skin cancer prevention among Spanish-speaking Hispanic outdoor workers.

METHODS: A qualitative study was conducted using two focus groups with Hispanic outdoor workers. Prior to viewing the video, participants completed surveys assessing sociodemographic factors, sun exposure, and protective behaviors. Focus group discussions explored video comprehension, cultural relevance, emotional engagement, and dissemination strategies. Quantitative data were summarized descriptively, and qualitative data were analyzed using rapid qualitative analysis.

RESULTS: Among 19 participants, the mean age was 46.5 (SD 15.5) years, and 94.7% (18/19) identified as male. While 47.4% (9/19) reported 6-9 hours of outdoor work per day, more than half (10/19, 52.6%) reported not engaging in sun protection. Participants described the video as culturally resonant, realistic, and engaging. Identification with characters and family-centered themes increased perceived relevance and message credibility. Many participants reported increased awareness of skin cancer risk and greater confidence in adopting sun-protective behaviors. Dissemination recommendations included workplaces, social media, schools, daycares, clinics, and other community settings.

CONCLUSIONS: Our video shows promise in improving skin cancer awareness and prevention, reflecting strong acceptability among participants. Future randomized controlled studies are needed to assess its effectiveness in enhancing long-term sun-protective behaviors.

PMID:42555928 | DOI:10.2196/98130

JMIR Med Educ. 2026 Aug 5;12:e89152. doi: 10.2196/89152.

ABSTRACT

BACKGROUND: AI is increasingly discussed and deployed in health care, yet safe and effective implementation depends on the preparedness, trust, and training of the professionals who are expected to use these tools.

OBJECTIVE: This study aimed to assess current AI use, perceived benefits and concerns, confidence, and training needs among French health care professionals and students.

METHODS: We conducted a national web-based cross-sectional survey distributed through the PulseLife professional community between December 4, 2024, and March 5, 2025. The survey instrument was administered in French and included respondent characteristic items together with 12 substantive closed-ended questions covering current AI use, confidence, perceived benefits, and concerns, and interest in AI-related training. Access was restricted to authenticated individual PulseLife accounts, and multiple submissions from the same account were not allowed. Questions were not mandatory; incomplete questionnaires were retained for item-level analyses, and percentages were calculated using item-specific denominators. Because the exact invitation denominator was not retained by the platform, view, participation, and completion rates could not be calculated. Descriptive statistics and Pearson chi-square tests were performed using R. Internal consistency and exploratory psychometric properties were assessed using the Cronbach α, exploratory factor analysis, and confirmatory factor analysis.

RESULTS: A total of 1625 respondents participated, including 1212 (74.6%) health professionals and 413 (25.4%) students. Among professionals, physicians represented the largest group (642/1212, 53%), followed by nurses (232/1212, 19.1%) and pharmacists (92/1212, 7.6%). Only 6.6% (90/1366) of the respondents reported prior AI-specific training, whereas 78.3% (920/1175) wished to receive such training. Confidence in AI for diagnosis and patient management remained limited: only 9.2% (120/1301) of the respondents reported being very confident. Nearly half (673/1455, 46.3%) of the respondents who answered this item reported no current AI use in professional activity, whereas 10.5% (153/1455) reported frequent use. Physicians and younger respondents reported more frequent AI use, and prior AI training was associated with greater confidence (P<.001 in all cases). Commonly perceived benefits included improved diagnosis (774/1625, 47.6%), time savings (685/1625, 42.2%), reduced medical errors (634/1625, 39%), and improved patient follow-up (593/1625, 36.5%). Frequently reported concerns included algorithmic bias (785/1625, 48.3%), limited transparency (666/1625, 41%), deterioration of the patient-health care professional relationship (628/1625, 38.6%), and data confidentiality (557/1625, 34.3%).

CONCLUSIONS: In this national French sample, formal AI training was uncommon despite high interest in receiving it. These findings support the need for more structured educational initiatives in AI literacy across undergraduate, postgraduate, and continuing professional education. Because this study relied on a convenience sample recruited through a digital platform, the findings should be interpreted as descriptive and exploratory rather than nationally representative.

PMID:42555922 | DOI:10.2196/89152

J Acquir Immune Defic Syndr. 2026 Aug 5. doi: 10.1097/QAI.0000000000003947. Online ahead of print.

ABSTRACT

BACKGROUND: The HIV Prevention Trials Network 094 INTEGRA study sought to fill the gap in implementation science literature by exploring the delivery of integrated prevention and care for HIV and opioid use dependence (OUD) through mobile units to people who inject drugs (PWID).

SETTING: Five U.S. INTEGRA sites with diverse implementation landscapes disproportionately affected by the HIV and opioid epidemics (New York, Philadelphia, Washington, DC, Houston, Los Angeles) .

METHODS: In-depth qualitative interviews from an embedded implementation science evaluation were conducted with 37 clinical and research INTEGRA staff delivering integrated care through mobile units. Pragmatic qualitative analysis was guided by the PRISM framework to identify key implementation needs, challenges, and solutions for delivering the INTEGRA intervention via mobile units in local neighborhoods.

RESULTS: Staff described how mobile delivery of INTEGRA reduced key barriers that limit PWID access to HIV and OUD services. Yet, they also detailed complex implementation needs, including the proactive coordination among staff to ensure sustained access to INTEGRA services, navigating internal and external spaces to deliver services, maintenance-related demands to keep the mobile unit’s infrastructure operational, and interdependent efforts that bridged the mobile unit’s service delivery within the extant health systems and community landscapes.

CONCLUSION: Findings demonstrated that mobile integrated care models can reduce access barriers for PWID but require tailored implementation strategies to address operational, spatial, infrastructural, and community-level demands. Results may help inform an implementation blueprint for similar communities working to respond to the intersecting HIV and opioid epidemics affecting PWID across U.S. settings.

PMID:42555913 | DOI:10.1097/QAI.0000000000003947

Am J Drug Alcohol Abuse. 2026 Aug 5:1-8. doi: 10.1080/00952990.2026.2707638. Online ahead of print.

ABSTRACT

Background: Previous research indicates that workplace culture influences employees’ alcohol use. Given the unique environment of the restaurant industry, this study examined how cultural factors contribute to on-the-job alcohol use among food servers.Objective: The study aimed to contribute to the growing literature on alcohol use in restaurants by identifying, analyzing, and reporting themes explaining how workplace culture influences employee drinking behavior. Guided by three research questions, it examined the roles of organizational artifacts, espoused values, and basic assumptions on drinking behaviors in the workplace.Methods: A descriptive qualitative design was used to explore restaurant food servers’ perceptions of workplace influences on alcohol use. Data was collected on 12 semi-structured Zoom interviews and questionnaires completed by 88 participants recruited through a Facebook restaurant worker group. Interview data were analyzed using iterative thematic analysis in NVivo, while questionnaire data were summarized using descriptive statistics.Results: Findings showed that workplace artifacts such as alcohol-related branding, advertising, and social cues reinforce norms that encourage alcohol use. Despite formal zero-tolerance policies, inconsistent enforcement, peer influence, and managerial practices often normalize drinking at work. Underlying assumptions, including managerial tolerance and unwritten expectations, further sustain a workplace culture in which on-the-job alcohol use is accepted.Conclusions: Alcohol-related behaviors appear embedded in restaurant culture, with formal policies frequently contradicted by informal norms. The results highlight perceived alcohol availability and the role of passive leadership in enabling misuse. Strengthening alcohol policies, improving staff training, and increasing leadership accountability may help promote safer and more productive workplaces.

PMID:42555896 | DOI:10.1080/00952990.2026.2707638

Neurology. 2026 Sep 8;107(5):e218377. doi: 10.1212/WNL.0000000000218377. Epub 2026 Aug 5.

ABSTRACT

BACKGROUND AND OBJECTIVES: Patients with myasthenia gravis (MG) are frequently associated with other autoimmune diseases. However, the temporal relationship between autoimmune diseases and MG remains unclear. This study aimed to evaluate the rates and temporal patterns of autoimmune diseases during the 10 years preceding MG diagnosis.

METHODS: This retrospective population-based cohort study analyzed claims data from the Korean National Health Insurance Service between 2010 and 2021 and included individuals aged ≥20 years. MG was defined using the International Classification of Diseases, 10th Revision (ICD-10) code (G70.0) and Rare Intractable Disease registration (V012). Each MG case was matched with 10 controls by age, sex, and index year. Outcomes were autoimmune thyroid disease (AITD), systemic lupus erythematosus (SLE), seropositive rheumatoid arthritis (SRA), Sjögren syndrome (SjS), psoriasis, type 1 diabetes mellitus (T1DM), Crohn disease, and ulcerative colitis occurring during the 10 years before the index year. Rate ratios (RRs) and 95% CIs were estimated using Poisson regression models for 0-2, 2-5, and 5-10 years before the index year.

RESULTS: A total of 8,355 patients with MG and 83,550 matched controls were included. The mean age (SD) was 53.7 (16.0) years, and 44.1% were male. Patients with MG had a higher rate of any autoimmune disease during 10 years before diagnosis than controls (RR 2.12, 95% CI 1.97-2.28), with the highest rates in 0-2 years before diagnosis (RR 4.27, 95% CI 3.78-4.83). SLE (RR 4.87, 95% CI 2.71-8.77), SjS (RR 4.75, 95% CI 3.01-7.50), AITD (RR 3.66, 95% CI 3.29-4.07), and SRA (RR 2.45, 95% CI 1.89-3.19) showed the strongest associations. Psoriasis (RR 1.68, 95% CI 1.25-2.25) and T1DM (RR 2.03, 95% CI 1.52-2.71) were associated with MG only within 0-2 years before diagnosis, whereas Crohn disease and ulcerative colitis were not associated.

DISCUSSION: Autoimmune diseases were more frequent in the years preceding MG diagnosis than in controls, particularly within 2 years before diagnosis. Strong associations were observed for SLE, SjS, AITD, and SRA. However, these findings should be interpreted with caution because of limitations of administrative claims data.

PMID:42555884 | DOI:10.1212/WNL.0000000000218377

JMIR Mhealth Uhealth. 2026 Aug 5;14:e85658. doi: 10.2196/85658.

ABSTRACT

BACKGROUND: There is an urgent and critical need to support the mental health of health care providers, given high rates of stress and burnout. Although the issues are complex, digital access to information and support can help address the needs, as technology can facilitate on-demand links to private, customized resources, including peer support. Beyond Silence (McMaster University) is an evidence-informed mobile health platform co-designed with health care workers and grounded in prior evidence that mental health literacy and peer support can reduce stigma and facilitate earlier help-seeking.

OBJECTIVE: This study aimed to (1) explore how health care workers across diverse health care settings use the app and (2) identify opportunities and barriers to implementation.

METHODS: A multiple-case study framework, informed by the Consolidated Framework for Implementation Research (CFIR), was applied to capture 4 months of implementation across a purposive sample of 7 diverse Canadian health care organizations. Implementation within each organization was led by designated organizational champions who leveraged existing communication channels and standardized promotional materials to invite employees to voluntarily download and use the app. Implementation outcomes were assessed using app analytics (downloads and feature use) and semistructured baseline and follow-up interviews with organizational champions to explore contextual influences on uptake.

RESULTS: Approximately 1066 employees downloaded the app over the 4-month period, ranging from <2% to >45% of employees across the 7 organizations. Interviews with 28 organizational champions noted that there was good leadership support for the technology, aligning with their mission to address employee mental health. Barriers to use, however, included workplace culture surrounding mental health and help-seeking, lack of awareness about when and how to use the app, and infrastructure-related challenges, such as limited time and a lack of private spaces to download and use the technology.

CONCLUSIONS: Effective implementation is a precondition for positive outcomes; therefore, strategies are needed to optimize technology implementation. Recommendations include evaluating organizational readiness, building mental health literacy, creating a multimodal communication and implementation plan, addressing technology requirements, and embedding the technology into organizational policies and practices. This study highlights key challenges in the implementation of the Beyond Silence peer support platform for health care workers, including slow adoption linked to mental health stigma, competing demands, and limited frontline engagement. Addressing these barriers will require innovative, trust-building strategies to support meaningful uptake and sustained use.

PMID:42555844 | DOI:10.2196/85658

Clin J Oncol Nurs. 2026 Aug 3;30(4):275-282. doi: 10.1188/26.CJON.275-282.

ABSTRACT

BACKGROUND: Environmental services (EVS) workers in healthcare settings are at risk for exposure to hazardous drugs, including antineoplastic drugs, because of their role in cleaning, sanitizing, and disinfecting surfaces where patients have received these drugs. Personal protective equipment (PPE) is critical for minimizing exposure; because oncology nurses rely on EVS partners to maintain safe care environments, inconsistent PPE use has direct implications for team safety and oncology practice.

OBJECTIVES: This study aimed to assess PPE use among EVS workers in oncology and non-oncology settings, identify gaps between self-reported and observed PPE use, and explore factors influencing use.

METHODS: The team employed a mixed-methods approach, combining observational data with verbally administered questionnaire data. Twelve EVS workers from various units participated. Observations of PPE use and responses to adapted survey instruments provided insights into practices and perceptions.

FINDINGS: Results revealed discrepancies between self-reported and observed PPE use, and participants frequently overestimated use. Participants commonly wore gloves, but they underused gloves tested for use with hazardous drugs, particularly in oncology settings. The team identified training gaps as barriers to consistent PPE use, and social desirability bias may explain the discrepancy between self-reported and observed PPE use.

PMID:42555788 | DOI:10.1188/26.CJON.275-282

Clin J Oncol Nurs. 2026 Aug 3;30(4):270-274. doi: 10.1188/26.CJON.270-274.

ABSTRACT

Chemotherapy-induced neutropenia is a frequent complication in patients with cancer that can lead to severe outcomes like sepsis, hospitalizations, and treatment delays. A neutropenic sepsis care bundle was implemented in an.

PMID:42555784 | DOI:10.1188/26.CJON.270-274