Search Results (146)

Patient navigation is a promising intervention to address barriers and improve access to cancer clinical trials. Although navigation has been widely studied across the cancer continuum, its role in facilitating clinical trial participation has not been systematically evaluated. This scoping review aims to identify, characterize, and synthesize evidence on patient navigation interventions designed to increase access to cancer clinical trials. Nine databases were searched for English peer-reviewed articles from inception through 5 March 2025. Two independent researchers screened titles, abstracts, and full texts and extracted data using standardized forms. The results were interpreted using descriptive statistics and collated using predetermined conceptual frameworks. Of 10,238 citations identified, 23 studies met inclusion criteria. All were conducted in North America, and five (21.7%) were randomized controlled trials. Thirteen studies (56.5%) evaluated enrollment outcomes, with mixed results. One randomized trial and two observational studies found no significant effect, while three observational studies and seven single-arm reports suggested improved enrollment. Navigation interventions most commonly included education/information provision (100%), care coordination (60.9%), and empowerment (47.8%). Navigators were primarily lay navigators (73.9%), often selected for community or lived experience; training varied widely, and only two programs reported certification. Fifteen studies (65.2%) targeted equity-deserving groups, most frequently racial and ethnic minorities, with reports of increased representation in trial enrollment. Patient navigation shows promise in improving access to cancer clinical trials, particularly for equity-deserving populations, but current evidence is limited, heterogeneous, and largely observational. Standardized definitions, rigorous trial designs, and reporting of navigator training and outcomes are needed to clarify effectiveness. Full article

This article presents a case study of a program aimed at creating support networks among families of students with functional diversity (motor disability, ASD, DLD, intellectual disability, ADHD, CD) with the purpose of expanding their coping resources in the face of the chronic stress they experience, resilience and empowerment. The program was developed in a public school of infant and primary education in the Community of Madrid (Spain). The design of the program is based on the domains of quality of life. The development of the program followed a qualitative case study approach, framed within the critical participatory action research, and was structured in cycles of planning, action, observation and reflection. These cycles included face-to-face sessions with families, participant observation, collaborative dynamics to record what happened and what was expressed in the sessions, and the analysis of materials produced by the families themselves. In the case study, an inductive approach was used to analyze the collected content, guided by Schalock’s family-adapted quality of life model. The results show an increase in family involvement, a perceived improvement in emotional and practical support, and a greater involvement of families in decision-making and community awareness. It is concluded that placing the well-being of families at the center of educational action improves their stress coping skills, resilience and empowerment, strengths that have an impact on community cohesion and the sustainability of their children’s inclusion processes. Full article

The inclusion of vulnerable groups in cultural life is a central issue of social justice, equality, and sustainable development. While equality ensures formal access to cultural participation, equity requires differentiated, needs-responsive measures that address structural barriers to meaningful engagement. Vulnerable groups—those at increased risk of social exclusion and inequality—often face such barriers despite the recognized role of the arts in promoting well-being, empowerment, and social cohesion. This study examines how Slovenia’s main cultural institutions conceptualize and implement inclusion, focusing on target groups, accessibility measures, and structural challenges and assessing whether their practices reflect principles of equality or equity. A mixed-methods approach combined an online survey of 26 institutions with semi-structured interviews with six representatives. Data were analyzed using descriptive statistics and thematic coding. The findings indicate that inclusion is present but fragmented and largely unsystematic. Institutions predominantly adopt equality-based approaches through general programming and standard adaptations, while equity-oriented, structurally embedded measures remain limited. Groups requiring sensory, communicative, or content-related adaptations are less frequently included. Overall, inclusion remains capacity-driven rather than equity-oriented, highlighting the need for coherent, equity-based frameworks to ensure sustainable and meaningful cultural participation. Full article

Objective: Village Health Volunteers (VHVs) are vital to Thailand’s primary healthcare, yet many face high risks for non-communicable diseases (NCDs). This preliminary study aimed to implement health empowerment theory-based personalized health promotion for individuals in the NCD-risk group. Methods: The preliminary mixed-methods study implemented a 6-month empowerment-based health promotion program for 21 VHV leaders (mean age 62.43 ± 7.28 years) at risk for NCDs. The intervention integrated laboratory data, behavioral and qualitative focus-group insights, and quantitative anthropometric data obtained via bioelectrical impedance analysis (BIA). Results: Participants’ exercise adequacy significantly improved after the intervention, increasing from 8.3% to 61.9% (p = 0.03). BIA revealed a physiological shift toward improved energy homeostasis, including decreased body weight, reduced visceral fat area, and increased muscle hydration. While biochemical markers did not reach statistical significance, clinically favorable downward trends were observed in median HbA1c (8.0% to 7.3%) and LDL cholesterol (141.8 to 119.0 mg/dL), alongside stable renal and liver function. Qualitative thematic analysis identified four primary domains of impact: sustainability and systemic advocacy, personal transformation, broad competence acquisition, and enhanced social capital. Participants reported a marked increase in self-efficacy, transitioning from inactive beneficiaries to active health advocates. This change was largely driven by mastery experiences, such as visible improvements in body composition and functional health literacy. Conclusions: The empowerment program significantly improved physical activity and body composition while fostering the social capital and health literacy necessary for community leadership, suggesting that personal health mastery is a critical precursor to effective systemic advocacy and long-term sustainability in community-led health programs. Full article

Aboriginal and Torres Strait Islander adolescents living in rural communities do not have sufficient access to health promotion services. Community programs that respond to adolescent needs, highlight community strengths, and are locally tailored are needed. Set in Queensland (Australia), this study was cross-sectional and qualitative in design. Using implementation science and Aboriginal and Torres Strait Islander frameworks, this study aimed to identify community priorities for the co-design of a culturally appropriate, empowerment-focused nutrition program with rural Aboriginal and Torres Strait Islander adolescents. Through community yarning, the barriers, enablers, and opportunities for program implementation were explored within an Aboriginal and Torres Strait Islander community-controlled health organization. Ten adolescents, two parents/caregivers, eight healthcare staff, six community leaders, and four Elders participated. Thematic analysis identified six themes that outline community health priorities, contextualization to the local food environment, and the importance of cooking skills for empowerment and involving the family unit. Thematic analysis also explored community preferences for program evaluation. Themes were integrated with other knowledge sources to develop a program outline that is aligned with evidence-based practice and community voice. Implementation of the co-designed program is recommended and will be explored in partnership with the community through future research. Full article

This study’s purpose is to explore the factors that support and impede women’s economic empowerment in rural settings of Saudi Arabia. A qualitative study was conducted in particular rural settings of Saudi Arabia. Data were collected through semi-structured interviews with 18 rural women. A thematic analysis was performed to analyze and present the findings. The findings reveal the challenges that women face that limit their engagement in economic activities, such as low levels of education, limited access to finance, and societal and cultural barriers. Moreover, there are opportunities for women’s empowerment via technical training, policy reforms and infrastructural development. Hence, women’s engagement in economic activities is vital for their personal development as well as overall economic growth. It is necessary to uplift the economy with women’s engagement in economic activities by emphasizing community-based programs, redesigning gender-sensitive policy and providing initial finance to start activities. Thus, policymakers should focus on creating environments that provide access to technical education, financial inclusion, and startup initiatives. Moreover, tailored programs based on women’s needs in rural settings could be highly supportive in empowering them economically. Full article

This study examined how pedagogical strategies can support student-coaches’ (SCs) empowerment and promote preservice teachers’ (PSTs) professional learning within Sport Education (SE) seasons. Sixty-seven tenth-grade students (aged 15–18) participated in SE units taught by three PSTs (two males, one female, aged 22–25) enrolled in a master’s degree program in Teaching of Physical Education in Primary and Secondary Education in northern Portugal. Data were collected through participant observation, informal and focus group interviews, and PSTs’ reflective diaries within a Collaborative Action Research (CAR) framework and analyzed thematically. Three CAR cycles addressed key challenges: (1) encouraging SCs to assume responsibility for their role, (2) fostering inclusive and supportive team interactions, (3) strengthening SCs’ sport-specific and instructional knowledge. Guided by a facilitator, PSTs implemented strategies including pre-lesson meetings, structured communication routines, task-modification and feedback cards, accountability systems, and visual identification of SCs. Findings suggest that SCs’ empowerment was progressively constructed through interconnected psychological, relational and pedagogical processes, supported by structured mediation and iterative reflection. Simultaneously, engagement in CAR cycles enabled PSTs to develop adaptive instructional decision-making and mediation strategies. The study highlights how empowerment in SE is shaped through relational and pedagogical conditions and illustrates how CAR can foster reciprocal learning between SCs and PSTs in authentic teacher education contexts. Full article

Background/Objectives: Digitalization creates new opportunities for social participation and access to services; however, individuals who lack access to digital resources or the ability to use them effectively are often unable to benefit from these developments. This uneven distribution reflects differences in digital capital that enhance technical competence and support psychosocial dimensions, contributing to empowerment. Such inequalities are particularly pronounced where age- and gender-based disadvantages intersect, generating distinctive forms of exclusion and vulnerability. Within the framework of digital capital theory, this study aims to explore how older women learners’ digital capital is shaped through a structured Digital Competence Training Program and how its growth influences their empowerment experiences. Methods: This qualitative case study utilized semi-structured interviews with 13 older women learners, two policymakers, and an educator. Results: Learners achieved gains beyond technical skills, including greater autonomy, self-confidence, and social connectedness. Despite technical and structural limitations, participants described the program as transformative, strengthening competence and belonging. Conclusions: The training program is an important pathway for strengthening older women’s digital capital and fostering empowerment beyond technical skill acquisition. However, its transformative potential depends on broader structural and institutional conditions, underscoring the need for inclusive, community-based digital education policies to sustain digital participation in later life. Full article

The socio-ecological transition requires not only technological innovation but also new ways of recognizing the social, environmental, and territorial value generated by collective action. Many of these positive externalities remain invisible in conventional assessment frameworks, limiting the legitimacy, financing, and scaling of local sustainability initiatives. This article presents a strategic framework designed to identify and structure positive externalities in collective self-consumption and other transformative projects. The method combines four components: (i) normative identification through the Sustainable Development Goals; (ii) balanced multi-stakeholder participation to surface diverse perspectives; (iii) perceptive mapping using an adapted Kano model; and (iv) strategic articulation. The framework was applied in two contrasting contexts: an energy community centered on shared renewable production, and a women’s empowerment program focused on capability-building and social innovation. These applications do not aim at empirical replication or the validation of results, but at examining how the framework supports collective recognition and strategic structuring in different organizational settings. Across these distinct settings, it led to the formulation of coherent and actionable strategic roadmaps, illustrating how positive externalities can inform governance choices, strengthen institutional legitimacy, and support long-term project consolidation. These results suggest that collective recognition enables externalities to structure strategic action beyond their original sector, demonstrating the potential transferability of the approach. Developed within a research program supported by the French Agency for Ecological Transition (ADEME) and the national urban-transition initiative (PUCA), the framework provides a practical decision architecture for structuring shared value within coordinated strategies. Full article

Background: In today’s dynamic healthcare environment, Changi General Hospital (CGH) has positioned staff wellbeing and engagement as fundamental priorities that underpin workforce sustainability and quality care delivery. Recognizing that allied health professionals (AHPs) face unique emotional demands and potential empathy fatigue, the CGH Allied Health Division (AHD) uses three strategic pillars: individual empowerment, leaders as key stewards and institutional support systems to address staff wellbeing and engagement. This paper will evaluate the outcomes of implementing the programs and identifying the barriers and enablers to achieving staff wellbeing and engagement. Methods: It adopts a mixed-methods approach using both quantitative survey data and qualitative feedback. Results: A total of 314 AHPs participated with a mean employment duration of 8.89 years. While 95% agreed that their work was meaningful and 76.8% reported happiness at work, 40.8% did not experience being recognized by the organization and approximately 30% did not find higher management responsive to their needs or transparent in their communication. Qualitative analysis revealed concerns about psychological safety of sharing one’s opinions and concerns, and a desire for better renumeration and career progression. Conclusions: AHPs reported happiness and meaningfulness in their clinical work. However, issues with organizational recognition, higher management responsiveness and transparency, as well as psychological safety were elicited. Working towards addressing fostering psychological safety and enhancing recognition and communication with management are important in order to develop and sustain a thriving healthcare workforce capable of high-quality patient care. Overall, the findings reinforced AHD direction of putting employee wellbeing and engagement as a strategic priority. Full article

Background: Food allergy [FA] is a growing public health concern among school-age children, with schools and childcare/daycare settings representing high-risk environments for accidental exposure and anaphylaxis. Objective: To systematically review evidence on digital health interventions supporting FA education, prevention, and management in school settings. Methods: A systematic search of PubMed, Scopus, Web of Science, and CINAHL was conducted to identify studies published between January 2015 and December 2025 [PROSPERO CRD420251185553]. Eligible studies evaluated e-learning, mHealth, or web-based programs targeting school staff, parents, or students. Results: Sixteen studies met inclusion criteria. Digital health emerged as a catalyst for professional development, interprofessional communication, and health equity within school communities. Interventions consistently improved knowledge, preparedness, and self-efficacy in anaphylaxis management among school staff, strengthened parental empowerment and communication with schools, and supported coping and inclusion among allergic children. Evidence on clinical outcomes; however, remains limited. Conclusions: Digital health can meaningfully enhance school preparedness and reduce inequalities in allergy management. Integrating digital tools into national school health frameworks—particularly where school nursing is not yet institutionalized—may represent a pivotal step toward safer, more equitable inclusion of children with food allergy. Full article

Background/Objectives: In recent decades, new technologies have been progressively integrated into various areas of mental health care. Mobile applications are potentially effective tools that allow psychiatric patients themselves to access self-management resources and tools within the community setting. Mental health nursing plays a key role in enabling patients to take an active role in their care and in promoting activities that foster their involvement and empowerment. The primary aim of this pilot study was to develop the PsyAPP mobile application to support both nurses and individuals with mental illness in managing care and improving health outcomes, and to assess its feasibility within a real-world clinical setting. Methods: A mobile application (PSYAPP) and a complementary web-based nursing management platform were designed and implemented. A total of 20 psychiatric patients enrolled in a partial hospitalization program in Soria (Spain) participated. Participants were assigned to experimental (app users) and control groups. Psychological empowerment, global functioning, and suicide risk were assessed before and after the intervention. Results: Patients who used the application showed significantly greater psychological empowerment (W = 2.04, p ≤ 0.04) compared with the control group. Statistically significant improvements were observed in psychological, social, and occupational functioning. Regarding suicide risk, no statistically significant changes were detected between pre- and post-intervention measurements in either group. Overall, PSYAPP demonstrated feasibility and potential utility as an innovative tool to support mental health care follow-up. Conclusions: This study developed and implemented a mobile application designed to enhance mental health care by supporting both patients and psychiatric nurses. Results showed significant improvements in global functioning in both the app and control groups, suggesting that rehabilitative treatment contributed to overall progress. Suicide risk did not significantly change within groups, although improvements were seen in the full sample, likely due to clinical care rather than app use. Only the experimental group demonstrated increased psychological empowerment, indicating that the app may effectively enhance patient engagement and involvement in their own care. Full article

Background: The Rohingya refugee crisis is one of the largest humanitarian emergencies of the 21st century, with nearly one million Rohingya residing in overcrowded camps in southern Bangladesh. Women and children face the greatest vulnerabilities, including inadequate access to education and healthcare, which exacerbates their risks and limits opportunities for personal and community development. While international organizations continue to provide aid, resources remain insufficient, particularly in maternal and child healthcare, highlighting the urgent need for sustainable interventions. Objectives: The Hope Foundation for Women and Children in Bangladesh launched a pilot project for the Health Assistant Training (HAT) program to address critical gaps in healthcare and education for the Rohingya community. This nine-month training program equips young Rohingya women with essential knowledge and skills to support maternal health services in both clinical and community settings. Design: We conducted a qualitative evaluation of the HAT Program to explore its acceptance and anticipated benefits for both participants and the community. Methods: The research team used semi-structured interviews, focus groups, and field observations to explore the HAT Program’s impact on young Rohingya women and their community. They analyzed data through thematic analysis, developing a coding framework and identifying key themes to uncover patterns and insights. Results: The results were categorized into four themes: (1) community acceptance of the HAT Program, (2) the HAT Program’s impact on the health assistant trainees, (3) the impact of the HAT Program on the community, and (4) the potential ways to expand the HAT Program. Conclusions: This research underscores the program’s impact on improving healthcare access, enhancing women’s empowerment, and promoting community resilience. By situating this initiative within the broader context of refugee health, education, and capacity-building, this research highlights the HAT program’s potential as a replicable model in Bangladesh and in other humanitarian settings. Full article

The paper aims to investigate challenges faced by fishing communities in developing fishing tourism. Using a case study approach and qualitative research methods, it explores fishing tourism in Thermaikos and Strymonikos Gulf (Thessaloniki, Northern Greece). This is an alternative form of tourism which was initiated by the local LEADER/CLLD Fisheries and Marine Operational Program 2014–2020. A semi-structured questionnaire was designed to conduct in-depth interviews, and a snowball sampling technique was used to select participants. Thematic content analysis elaborates on challenges faced by those fishing communities (mainly economic and cenvironmental) that hinder the sustainability of fishing communities and their livelihood. Findings are presented through an Ishikawa (fishbone) diagram, illustrating the cause-and-effect relationships underlying the challenges identified. To promote the well-being of local fishing communities and ensure the sustainability of fishing tourism, the paper recommends legislative reforms and empowerment of fishermen/women through targeted educational initiatives. These recommendations also serve as potential directions for future research. Full article

This interdisciplinary pilot study examines the use of Natural Language Processing (NLP) techniques, specifically Large Language Models (LLMs) with Prompt Engineering (PE), to analyze economic vulnerability from qualitative self-narratives. Seventy narratives from twenty-five women in the Palk Bay coastal region of Rameshwaram, India were analyzed using a schema adapted from a contextual empowerment framework. The study operationalizes theoretical constructs into structured Information Extraction (IE) templates, enabling systematic identification of multiple vulnerability aspects, contributing factors, and experiential expressions. Prompt templates were iteratively refined and validated through dual-annotator review, achieving an F1-score of 0.78 on a held-out subset. Extracted elements were examined through downstream analysis, including pattern grouping and graph-based visualization, to reveal co-occurrence structures and recurring vulnerability configurations across narratives. The findings demonstrate that LLMs, when aligned with domain-specific conceptual models and supported by human-in-the-loop validation, can enable interpretable and replicable analysis of self-narratives. While findings are bounded by the pilot scale and community-specific context, the approach supports translation of narrative evidence into community-level program design and targeted grassroots outreach, with planned expansion to multi-site, multilingual datasets for broader applicability. Full article