Quality Enhancement Research Initiative

The health and well-being of young adult building artisans are germane because of their critical role in infrastructure development. There is a perceived increase and paucity of studies regarding young adult building artisans' involvement in illicit substances, which threatens the achievement of Sustainable Development Goals (SDGs) 3 and 8. This study investigated the underlying causes and recommended feasible measures to prevent or mitigate the use of illicit substances among young adult artisans on construction sites in Nigeria, and, by extension, to improve the achievement of Goals 3 and 8. This research employs a face-to-face interview to collect data in Lagos and Abuja, Nigeria. Findings reveal that there is a prevalent issue of increasing young adult building artisans' illicit substance intake on building sites. This poses a significant threat to occupational health (SDG 3) and workplace safety (SDG 8). Findings also identified 17 underlying causes, including a lack of awareness among artisans, a low educational background and lax safety and management policies. This research contributes to the existing literature on preventing or mitigating illicit substance use among young adult building artisans. It also recognises that preventive or mitigative measures can be useful for mental health stability and, by extension, for achieving the SDGs.

With diversity, equity and inclusion (DEI) initiatives waning in America and with many such attempts at affirmative action being eliminated altogether, how will organizations work to ensure that all employees benefit from feelings of belongingness, caring and support? This editorial examines the devolution of DEI and argues for new approaches to advancing belongingness and health equity. The well-validated 'perceived organizational support' scale (POS) is reviewed in the context of implementing well established tools in new ways that surface disparities in perceptions of organizational caring and support.

ABSTRACTBackgroundRising advanced cancer incidence globally places profound existential distress and psychological burden on family caregivers. We culturally adapted Meaning‐Centered Psychotherapy for Cancer Caregivers (MCP‐C) from Western to Chinese context, targeting existential distress through meaning‐making processes.AimsThis pilot randomized controlled trial aimed to examine the feasibility, acceptability, and preliminary effects of an online MCP‐C (eMCP‐C) among caregivers of patients with advanced cancer.MethodsCaregivers of patients with advanced cancer, experiencing distress related to caregiving, were randomly assigned (1:1) to eMCP‐C or enhanced usual care groups. Over 7 weeks, participants received weekly individual session of eMCP‐C focusing on meaning making and coping with caregiving, whereas enhanced usual care group received resources for mental health treatment and targeted referrals for specific distress problems. Feasibility outcomes were assessed through questionnaires and semi‐structured interviews at 7‐week. Efficacy outcomes were assessed by questionnaire at baseline, 7, and 19 weeks.ResultsForty‐six caregivers enrolled (26–79 years old), among which thirty‐seven (80%) completed the study. Intervention attendance, retention rates, and participant satisfaction were satisfactory. Depression, anxiety, meaning, peace, and self‐esteem improved from baseline to immediate and 3‐month post‐intervention in intervention group. Qualitative analysis revealed three key therapeutic mechanisms: (1) Therapeutic Alliance as a Catalyst for Intrapersonal and Interpersonal Healing, (2) Meaning‐making Through Acceptance and Action, and (3) Empowering Through Affirmation and Self‐Determined Action.ConclusionsFor Chinese caregivers of patients with advanced cancer, eMCP‐C is feasible, well‐accepted, and showed preliminary benefits in psychological distress, meaning, peace, and self‐esteem, compared to an enhanced usual care group.

Purpose This study explores the food choices made by the Roma community in Belfast, with a particular focus on how health and sustainability preferences are expressed. Design/methodology/approach An ethnographic methodology was employed, incorporating semi-structured interviews with 14 Roma women recruited through a local community organisation. Findings Thematic analysis revealed a preference for home cooked meals of fresh food, with a distinct cultural categorisation of these food types as Roma food while ultra-processed and convenience foods were identified as “Northern Irish”. There was an expressed preference for foods perceived as healthy and nutritious despite findings that nutrition is low amongst this social group. Sustainable food knowledge was limited to ethical and organic production, suggesting a need for greater sustainability awareness and promotion amongst the Roma. Research limitations/implications The study's small sample size and location-specific focus may limit broader generalisation; however findings suggest interventions to improve knowledge and awareness and incentivise behaviour change in favour of more nutritious and sustainable choices should account for low literacy levels and should be co-produced with the Roma to be culturally appropriate and avoid paternalist approaches which reinforce their social exclusion. Originality/value Limited research is available regarding the Roma's food behaviours and dietary health, with seemingly nothing written about their role of sustainability in their food choices. The findings address a significant gap in our knowledge about this marginalised group by contributing cultural perspectives on the motivations and barriers affecting their food choices, with particular regard to health and sustainability.

BackgroundPeople who use drugs possess valuable expertise, knowledge, needs, and preferences as part of their lived experience, which should be incorporated into overdose-focused public health programs and policies.MethodsWe formed a community advisory board composed of 16 clients from four syringe services programs (SSPs) in Wisconsin for an overdose prevention research study to inform project priorities. Over 6 meetings spanning 10 months, the board engaged in a root cause analysis facilitated by SSP staff and University researchers using a semi-structured assessment technique from the Community Anti-Drug Coalitions of America. The board then identified solutions to each root cause and rated solutions on two dimensions: impact and effort required to implement. Similar solutions were combined by averaging effort and impact scores respectively. After the activity concluded, we gathered members’ perceptions of the activity using a brief, open-ended questionnaire.ResultsMembers identified nine root causes of overdose that spanned individual (e.g., solitary drug use), structural (e.g., inaccessible or suboptimal substance use treatment programs), and policy (e.g., criminalization of drug use) drivers of overdose occurrence and fatality risk. Substance use stigma was a cross-cutting, fundamental driver of all root causes. The board proposed 28 solutions responsive to these root causes, including changing policies, implementing whole-person focused harm reduction and treatment programs, and incorporating people with lived/living experience of drug use into the design and implementation of public health programs. Members felt the activity was meaningful and effectively facilitated, but highlighted that several solutions were unable to be acted upon in the context of the research study.ConclusionThis work reinforces a need for multi-dimensional, comprehensive interventions, programs, and policies to address the overdose crisis. Collectively, new and continued overdose prevention programming should broaden access to and use of harm reduction tools (e.g., naloxone, drug checking) and substance use and mental health treatments as well as reform policies that negatively impact the health of people who use drugs. Our findings underscore the need to incorporate the expertise of directly impacted populations into future research and program planning focused on overdose prevention by partnering with people who use drugs.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12954-025-01368-9.

A consistent approach to track Long COVID symptoms at the Veterans Health Administration (VHA) was lacking. To reach consensus among clinical stakeholders on how long COVID symptoms should be assessed at VHA outpatient visits and recommend an assessment battery. Hybrid Delphi-Nominal Group approach. Members of the VHA Long COVID Field Advisory Board (FAB) and the VHA Long COVID Community of Practice (CoP) participated. Veteran stakeholders provided input. A literature review and clinician questionnaires identified 68 instruments across 14 symptom domains. In the first consensus round, FAB members excluded instruments with limited clinical usability. The remaining 25 instruments were ranked by CoP members. Multiple rounds of asynchronous voting were conducted until one instrument remained per domain. The top instruments were grouped into 3 batteries. Final consensus on a preferred battery was reached through additional voting. Veterans from the Los Angeles Veteran Engagement Panel assessed clarity, burden, and feasibility. The final battery included the Modified Yorkshire COVID-19 Rehabilitation Survey, VHA Whole Health Well-Being Signs, the Exercise Vital Signs Questionnaire, and the 2-Minute Step Test. Whole Health questions were also included to support the VHA's Whole Health System mission. Symptom-specific instruments already used in VHA routine care were not included in the final battery, as clinics already had access to them. A structured, rapid consensus process was used to identify a battery of symptom instruments to standardize Long COVID symptom assessment across VHA clinics.

Scientists are experiencing unprecedented challenges to the time honored conventions that usually guide consensus building and health communications. This editorial offers a primer on this journal's peer review process and argues that professional societies, the private sector and non-governmental organizations need to fill the void being created by disinvestments in our federal and state public health infrastructure. The process that guides our peer reviewers and composite reviewers is described. The vital importance of peer reviewers sharing their expertise with fellow scientists via narrative feedback on studies is emphasized. An interview with an exemplary composite reviewer, our Associate Editor in Chief, Dr Kerry Redican, is offered as a way to underscore the rigor needed to preserve the integrity of the scientific method at a time when science is being threatened by ideological clashes.

Stress from the COVID-19 pandemic may have had a profound impact on the mental health of Reserve and National Guard (RNG) women Veterans, especially if they have a history of traumatic brain injury (TBI). This cross-sectional study aimed to assess the potential mediating effect of stress stemming from the COVID-19 pandemic on the association between TBI and depression symptoms. Women RNG Veterans between the ages of 18 and 60 were interviewed about their lifetime history of TBI, symptoms of depression, and any stressful experiences resulting from the COVID-19 pandemic. Using interview responses, we utilized exploratory factor analysis (EFA) to approximate COVID-19 stress. We then used the results from EFA in mediation analysis of linear regression models of TBI history on depression. Ethical approval for the study and analyses was obtained from the University of Iowa Institutional Review Board (IRB) (IRB ID #201911171). We identified 9 items across a 3-factor model ("Stress about Daily Necessities," "Stress about Health," "Increasing Alcohol Use") that approximated COVID-19 stress. Of the 351 women Veterans included in this study, 145 (41.3%) had history of TBI. Those with TBI had more severe symptoms of depression (risk difference: 1.81, 95% CI: 0.41-3.20) than those without TBI. Total COVID-19 stress mediated the association between TBI and symptoms of depression (indirect effect: 0.67; 95% CI: 0.24-1.21; 35.5% mediated). Stress about Daily Necessities alone also mediated the TBI-depression association (indirect effect: 0.65; 95% CI: 0.44-0.84; 34.8% mediated). Women RNG Veterans with prior TBI reported more severe depression symptoms than those without TBI, and these depression symptoms seem to be exacerbated upon the introduction of stress because of the COVID-19 pandemic. Future research of this complex TBI-stress-depression relationship should be longitudinal in nature, especially as the long-term effects of the COVID-19 pandemic continue to emerge, to understand how events that introduce significant economic and health-related consequences affect how symptoms of depression and responses to stress evolve over time.