Search Results (4,987)

Background/Objectives: Children and adolescents living with HIV (ALHIV) are among the most vulnerable groups affected by HIV and AIDS. Their vulnerability exposes them to several challenges, such as HIV-related stigma and/or interrupted academic activities due to health-related complications. Since they are still minors who cannot independently make decisions regarding their own lives, most of the challenges extend to their caregivers, who sometimes provide care and support under difficult psychological, social, and economic conditions. This study aimed to explore the lived experiences and challenges of primary caregivers caring for ALHIV in Gauteng Province of South Africa. Methods: A qualitative exploratory design with phenomenological orientation was adopted. Eight primary caregivers of ALHIV were purposively sampled and interviewed using individual face-to-face semi-structured interviews. Data was analysed thematically according to the eight steps of Tesch’s qualitative analysis framework. Since it involved human participants, this study was subjected to ethical clearance by the Research Ethics Committee of the University of South Africa, which imposed conditions for upholding ethical principles such as informed consent and confidentiality. Results: Primary caregivers encounter challenges such as regular monitoring of ALHIV who are always sick, treatment adherence monitoring, behavioural management, financial strain, stigma and discrimination, lack of proper nutrition and managing adolescents’ academic difficulties. These challenges require support from multidisciplinary team members which include nurses because they play a crucial role in supporting treatment adherence among ALHIV and in strengthening the capacity of primary caregivers to provide effective treatment support. Conclusions: It is essential to adopt an integrated approach to psychosocial, as well as financial support interventions targeting primary caregivers. Full article

Background: Population aging has led to an increasing proportion of older adults (aged 65 and older) acting as informal caregivers. These caregivers face risks of burden, stress, and depression. While research frequently documents negative psychological outcomes, resilience represents a crucial protective process. This systematic review synthesizes and maps the empirical evidence regarding the association between the socio-ecological resilience process and the well-being of older informal caregivers. Methods: Following Joanna Briggs Institute (JBI) mixed-methods guidelines, a convergent segregated mixed studies systematic review was conducted. A systematic search of Medline (PubMed), CINAHL, PsycINFO, and Scopus identified primary articles (2014–2025) in English and Spanish. Methodological quality was appraised using JBI critical appraisal checklists and the Mixed Methods Appraisal Tool. PROSPERO registration number: CRD420251142190. Results: Thirty-one studies were included. Elevated caregiver resilience was associated with lower reported symptoms of depression and anxiety, higher self-rated health, and positive psychological adaptation. Framed within a social ecological model, personal resources such as spirituality, hope, and self care, alongside relational assets like dyadic relationship quality and mutual coping, demonstrated a positive association with resilience and a reduction in subjective burden. Within the community context, informal peer networks and Online Health Communities functioned as essential supportive resources. On a structural level, both household wealth and the regional availability of long-term care beds acted as moderators for spousal well-being, whereas exceeding 30 weekly caregiving hours acted as a temporal threshold for positive adaptation. Conclusions: These findings suggest that resilience in older caregivers may be best conceptualized not as a static individual trait, but as a multi-level, dynamic socio-ecological process. Rather than relying on individual coping alone, public policies and clinical practice should prioritize systemic, relational, and structural environmental support, including formal respite services and long-term care infrastructure, to preserve the well-being of older spousal caregivers. Full article

Background: Endothelial dysfunction is a key component of sepsis pathophysiology. The Endothelial Activation and Stress Index (EASIX) is a practical biomarker derived from routine laboratory parameters and indirectly reflects endothelial injury. This study aimed to evaluate the prognostic association of EASIX with in-hospital mortality and organ-support requirements among patients with pneumosepsis admitted to the intensive care unit (ICU). Methods: This retrospective cohort study included 1787 adult patients with pneumosepsis admitted to a tertiary ICU from January 2018 to December 2025. EASIX was calculated from laboratory parameters obtained at ICU admission, and log2-EASIX was used in all analyses. The primary outcome was in-hospital mortality. Secondary outcomes included the need for invasive mechanical ventilation (IMV), vasopressor therapy within the first 24 h, second-line vasopressor therapy, and continuous renal replacement therapy (CRRT) within the first 7 days after ICU admission. Associations with the primary and secondary outcomes were evaluated using univariable and multivariable logistic regression, and discriminative performance was assessed using receiver operating characteristic (ROC) curve analysis. Results: The in-hospital mortality rate was 56.2%. Log2-EASIX was independently associated with in-hospital mortality (OR: 1.191, 95% CI: 1.119–1.268; p < 0.001). ROC analysis showed moderate discrimination for predicting in-hospital mortality (AUC: 0.673, 95% CI: 0.648–0.698), with a ROC-derived exploratory cut-off of 1.47. Patients with log2-EASIX ≥ 1.47 had approximately a two-fold higher risk of in-hospital mortality (OR: 2.039, 95% CI: 1.610–2.584; p < 0.001). In multivariable analyses of the secondary outcomes, log2-EASIX remained independently associated with second-line vasopressor requirement (adjusted OR: 1.104, 95% CI: 1.040–1.171; p = 0.001) and CRRT requirement within 7 days (adjusted OR: 1.317, 95% CI: 1.236–1.404; p < 0.001). However, its associations with IMV and initial vasopressor requirements were not statistically significant after adjustment. Adding log2-EASIX to the Acute Physiology and Chronic Health Evaluation (APACHE) II resulted in a statistically significant but small improvement in discrimination compared with APACHE II alone (AUC: 0.761 vs. 0.740; ΔAUC = 0.021; 95% CI: 0.010–0.032; p < 0.001). Conclusions: EASIX was independently associated with in-hospital mortality and second-line vasopressor requirement, and it remained associated with CRRT requirement after multivariable adjustment. However, serum creatinine alone showed superior discrimination for CRRT, suggesting that the association between EASIX and CRRT may be driven, at least in part, by its creatinine component and should therefore be interpreted cautiously. In contrast, the associations of EASIX with early IMV and initial vasopressor requirements were not significant after multivariable adjustment. Although its discriminative performance for mortality was moderate when used alone, EASIX may provide complementary prognostic information when added to established disease severity assessment. These findings warrant validation in prospective, multicenter studies. Full article

Background: General Practice is facing workforce shortages across Europe. In Italy, the estimated shortage was 5575 General Practitioners in 2024, with high retirement rates and persistent difficulties in attracting new physicians to the profession. This study investigated postgraduate career intentions among medical students and factors associated with interest in General Practice. Methods: A cross-sectional survey using an anonymous 39-item questionnaire was conducted among fifth- and sixth-year medical students at the University of Milan. Associations were assessed using ordinal and multinomial logistic regression. Results: Among 359 respondents (response rate: 46.8%), only 2.2% identified General Practice as their preferred postgraduate career. Students considering General Practice attributed greater importance to community-based work (OR = 18.49, 95% CI 3.35–102.02) and professional autonomy (OR = 4.47, 95% CI 1.03–19.44). Previous community-based primary care experience was associated with choosing General Practice (OR = 32.43, 95% CI 3.85–273.50). Most students perceived theoretical and practical General Practice training as less adequate than that of other specialties, and only 25.1% considered their preparation sufficient to support career decision-making. Conclusions: Strengthening the academic integration of General Practice and meaningful community-based learning opportunities may contribute to more informed career choices while better preparing future physicians for healthcare systems increasingly centred on Primary Health Care. Full article

Background: The COVID-19 pandemic simultaneously affected vascular risk and healthcare utilization. We evaluated whether monthly trajectories of Brazilian Unified Health System (Sistema Único de Saúde; SUS)-financed hospitalizations for different cerebrovascular categories changed differently during the pandemic in the municipality of São Paulo. Methods: We conducted an ecological time-series study using monthly Hospital Information System of the Brazilian Unified Health System (SIH-SUS), Department of Informatics of the Unified Health System (DATASUS) data from January 2017 through December 2021. Nontraumatic intracranial hemorrhage (I60–I62), cerebral infarction (I63), unspecified stroke (I64), and other cerebrovascular diseases (I65–I69) were included. The analytical dataset comprised 240 monthly observations. Annual IBGE population estimates were used as denominators. The primary analysis used segmented negative-binomial regression with log(population) offset, temporal trend, an immediate level change from March 2020, post-intervention slope change, and annual harmonic terms for seasonality. Poisson and negative-binomial models were compared using overdispersion diagnostics and Akaike information criterion (AIC). Residual autocorrelation, category-by-intervention interactions, alternative intervention dates, and leave-one-month-out influence were assessed. Results: A total of 60,756 hospitalizations were identified. Descriptive differences in mean annual counts between the pre-pandemic and pandemic periods were +3.7% for intracranial hemorrhage, +15.2% for cerebral infarction, −16.2% for unspecified stroke, and −27.2% for other cerebrovascular diseases. All categories were overdispersed (Pearson ratios 2.16–5.05), and AIC was consistently lower for negative-binomial models. In the primary segmented model, March 2020 was associated with an immediate 39.3% decrease in other cerebrovascular diseases (incidence rate ratio [IRR] 0.607; 95% confidence interval [CI] 0.512–0.720; p < 0.001) and a 10.0% decrease in unspecified stroke (IRR 0.900; 95% CI 0.817–0.991; p = 0.032). No statistically significant immediate level change was found for intracranial hemorrhage (IRR 1.018; p = 0.760) or cerebral infarction (IRR 0.868; p = 0.086). No category showed a significant post-intervention slope change. The formal category-by-level-change interaction was significant (Wald p = 0.004), indicating heterogeneity among categories. LjungBox tests at 12 lags showed no significant residual autocorrelation. Conclusions: SUS-financed cerebrovascular hospitalizations showed heterogeneous temporal changes during the pandemic, particularly immediate decreases in I64 and I65–I69. The findings support differences in trajectories across diagnostic categories but do not demonstrate diagnostic migration, individual biological mechanisms, or causality. Changes in care-seeking, referral, coding, diagnostic availability, and healthcare organization remain plausible but untested explanations. Full article

Background: Long-acting monoclonal antibodies have become an important strategy for preventing respiratory syncytial virus (RSV) disease in infants. Nirsevimab is the first product for which substantial post-licensure implementation data are available, whereas real-world evidence on clesrovimab remains limited. Although nirsevimab has demonstrated high efficacy, its uptake varies considerably across countries, healthcare systems, delivery settings, and population subgroups. This World Association for Infectious Diseases and Immunological Disorders (WAidid) consensus document examines the policy, organizational, economic, and equity-related determinants that shape real-world implementation of long-acting monoclonal antibodies for infant RSV prevention. Methods: This study was conducted as a structured narrative review and WAidid expert consensus document. A structured literature search was performed in PubMed and Embase for English-language publications relevant to nirsevimab uptake and implementation, complemented by targeted review of surveillance reports, policy documents, and public health guidance from the ECDC, UKHSA, and CDC, as well as reference lists of selected publications. Eligible sources included observational and real-world implementation studies, systematic reviews and meta-analyses, economic evaluations, guidelines, policy statements, surveillance reports, and relevant narrative reviews. Evidence was synthesized qualitatively according to policy frameworks, financing and reimbursement, delivery pathways, demographic and socioeconomic determinants, and healthcare-system factors influencing uptake. No statistical software was used because no quantitative re-analysis or meta-analysis was performed. Results: Nirsevimab uptake was strongly influenced by national RSV prevention policies, particularly whether countries adopted universal infant monoclonal antibody programs, maternal RSV vaccination strategies, dual maternal–infant approaches, or targeted risk-based models. Universal, publicly funded programs integrated into neonatal care achieved the highest and most homogeneous coverage, especially when administration occurred before hospital discharge and was supported by registry-based recall systems for infants born outside the RSV season. In contrast, fragmented, outpatient-only, insurance-dependent, or partially reimbursed models were associated with lower, delayed, or more variable uptake. Additional determinants included product cost, reimbursement pathways, provider practices, caregiver awareness and health literacy, insurance status, income, race and ethnicity, geographic deprivation, and access to primary pediatric care. Most available evidence comes from high-income countries, limiting generalizability to low- and middle-income settings, where RSV burden is greatest and implementation constraints may differ. Conclusions: Successful implementation of long-acting monoclonal antibodies for infant RSV prevention requires more than regulatory approval and demonstrated efficacy. Equitable uptake depends on clear national recommendations, sustainable public financing, reliable product supply, integration into neonatal and primary pediatric care, proactive identification and recall of eligible infants, and targeted strategies to reduce socioeconomic and geographic disparities. Although many determinants identified in high-income settings are likely relevant globally, their feasibility, relative importance, and impact require dedicated evaluation in low- and middle-income countries. Full article

Background/Objectives: Primary healthcare in Hungary faces acute physician shortages; in the Heves district, eight general practices are permanently vacant, leaving 11,191 residents without continuous care. In September 2025, the Hungarian Charity Service of the Order of Malta launched the Heves Haziorvosi Pilot (HHP), combining on-site nurse triage with remote telemedicine consultations. This study qualitatively evaluated its implementation and early operation. Methods: Three focus group discussions were held in two rounds, before and after implementation, with all 19 professionals delivering the programme (10 practice nurses, 4 general practitioners, 5 degreed professionals). Verbatim Hungarian transcripts were analysed in NVivo 15 (Lumivero, Denver, CO, USA) using the thematic analysis framework of Braun and Clarke with hybrid deductive-inductive coding by three independent researchers until full consensus. Results: Daily physician availability rose from approximately 2 to 8 h, and one remote physician concurrently supported four practices. Participants reported reduced professional isolation among nurses, longer and more focused consultations, and perceived, though unquantified, decreases in non-urgent ambulance use. Implementation was constrained by duplicate paper and digital documentation, patients’ limited familiarity with triage, and unresolved software interoperability and IT ergonomic problems. Conclusions: The hybrid model was perceived as operationally feasible; national scaling would require nursing curriculum reform, administrative simplification, interoperable medical software, and community health literacy programmes. Full article

Globally, physical activity is increasingly acknowledged as an effective strategy for combating non-communicable diseases (NCDs). However, there is a significant global disparity in the integration of sport sciences graduates (SSGs) into national health systems. This study assessed the professional roles of SSGs within healthcare systems and their association with NCD mortality across (n = 34) countries that met the selection criteria, using a cross-national, ecological, and cross-sectional design. Principal component analysis was conducted to reduce the dimensions of the correlated structural indicators. A pre-specified generalized linear model (Gamma family, log link) with HC3 robust standard errors estimated the association between SSG integration and age-standardized NCD mortality, alongside a descriptive analysis of public funding (national or subnational) for SSG services. The findings indicate that integrating SSGs into primary care was associated with approximately 23% lower age-standardized NCD mortality (rate ratio 0.77, 95% CI 0.63–0.94, p = 0.011; approximately 16% to 23% across model specifications) after adjusting for demographic and economic factors, with near-universal public funding (100% of integrated versus 24% of other countries; Fisher’s exact p < 0.001). To our knowledge, this is the first cross-national analysis to link the functional integration of SSGs into primary care with population NCD mortality, and this relationship remained consistent across multiple robustness checks. The implications suggest that functional integration and its public funding may represent promising policy approaches for strengthening preventive health services. Given the ecological, cross-sectional design, longitudinal studies are warranted to establish causality. Full article

Background/Objectives: Social determinants of health, including income, age, education, and gender, have been proposed to shape diabetes self-care capacity, yet their joint associations within Saudi Arabian primary healthcare populations remain poorly delineated. Anchored within the World Health Organization’s Commission on Social Determinants of Health framework and the Social Ecological Model, this study examined both the unadjusted and, via multivariable regression, adjusted associations of four sociodemographic factors with diabetes self-care management and health literacy among adults in southern Riyadh. Methods: A cross-sectional correlational design was employed with 92 adults with type 2 diabetes recruited from primary healthcare centers in southern Riyadh. Data were collected using the Arabic HLS-Q12 (health literacy) and SDSCA-Arabic (self-care management). Non-parametric Spearman rank-order correlations were conducted to examine bivariate associations. Multivariable linear regression was subsequently performed to estimate adjusted associations for each sociodemographic variable. Bivariate analyses were conducted using IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp., Armonk, NY, USA), while multivariable linear regression analyses were performed using Python version 3.12 with the statsmodels package. Results: Income level showed significant, moderate positive unadjusted correlations with both self-care management (rs = 0.40, 95% CI [0.21, 0.56], p < 0.01) and health literacy (rs = 0.41, 95% CI [0.22, 0.57], p < 0.01). Age showed the strongest negative unadjusted correlation with self-care management (rs = −0.49, 95% CI [−0.63, −0.31], p < 0.01) and a significant negative correlation with health literacy (rs = −0.36, 95% CI [−0.53, −0.17], p < 0.01). Educational attainment was significantly associated with both self-care management (rs = 0.29, 95% CI [0.09, 0.47], p < 0.01) and health literacy (rs = 0.26, 95% CI [0.06, 0.44], p < 0.05). Gender did not reach statistical significance for either outcome. A multivariable model adjusting for all four sociodemographic variables confirmed that income and age remained independently associated with both outcomes, whereas education and gender did not. These findings do not establish independent or causal effects from the bivariate correlations alone; the adjusted results are reported separately below. Conclusions: Income and age were independently associated with both diabetes self-care and health literacy after multivariable adjustment, whereas education and gender were not. Findings support equity-focused nursing interventions and age-responsive diabetes education attentive to the social patterning of self-care disparities in southern Riyadh. Full article

Pharmacogenomics can convert stable DNA variation into prescribing information, but its value in primary care depends on whether a result changes a decision at the right moment. This narrative review critically examines selected actionable gene–drug pairs, implementation models, conflicting evidence, and unresolved questions for family physicians managing multimorbidity and polypharmacy. A targeted search of PubMed/MEDLINE and current pharmacogenomic guideline resources was updated through 14 August 2026, prioritizing clinical guidelines, randomized and pragmatic trials, implementation studies, and primary-care evidence. Guideline actionability describes how an available result can guide treatment; it does not by itself establish that testing should be ordered. Selected examples include clopidogrel, statins, metoprolol, antidepressants, codeine and tramadol, proton-pump inhibitors, nonsteroidal anti-inflammatory drugs, and warfarin, together with shared-care medicines such as thiopurines and carbamazepine. In PREPARE, a defined 12-gene panel linked to prescribing recommendations reduced clinically relevant adverse drug reactions within a specific European workflow. Other trials showed that benefit is drug-, population-, comparator-, and workflow-dependent. Pharmacogenomics does not replace assessment of organ function, interactions, adherence, frailty, or patient preference. This review proposes selective, clinically triggered panel testing as a pragmatic model for primary care, with structured, reusable results and concise decision support. Future work should define who benefits, improve ancestry representation, account for phenoconversion, and demonstrate health-system-specific cost-effectiveness. Pharmacogenomics is best understood as an additional medication-safety input rather than a stand-alone precision-medicine solution. Full article

Background: Depression is a major global health burden, requiring culturally appropriate assessment instruments, but no validated Kazakh-language version of the Patient Health Questionnaire-9 (PHQ-9) is available. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Kazakh PHQ-9 in a community-based, non-clinical sample. Methods: This cross-sectional study included 503 Kazakh-speaking adults (mean age = 24.0 years, SD = 10.1; 51.3% women and 48.7% men) who completed the Kazakh PHQ-9 and Generalized Anxiety Disorder-7 (GAD-7) questionnaires. Internal consistency, structural validity, measurement invariance across genders, and convergent validity were assessed. Results: Internal consistency was excellent (Cronbach’s α = 0.91), and both one-factor and correlated two-factor models showed excellent fit (CFI = 0.998; TLI = 0.997–0.998; RMSEA = 0.046–0.048; SRMR = 0.050–0.052), with a slightly better fit for the latter. Measurement invariance across genders was supported, and PHQ-9 and GAD-7 scores were strongly correlated (r = 0.68, p < 0.001). Conclusions: The Kazakh PHQ-9 demonstrated excellent internal consistency and structural validity, measurement invariance across genders, and strong convergent validity in this non-clinical sample. These findings support its use for assessing depressive symptoms in Kazakh-speaking adults. Clinical validation is needed to establish diagnostic validity and screening performance. Full article

Ebola alerts reveal the truth about preparedness. They show whether a health system can recognize danger early, protect health workers, isolate and care for patients, trace contacts, communicate clearly, and sustain public trust before fear replaces cooperation. In the Pandemic Agreement Era, this truth has become harder to ignore. The 2026 Bundibugyo virus disease outbreak in the Democratic Republic of the Congo and Uganda is a sharp reminder that the principles of pandemic prevention, preparedness, response, equity, and cooperation become meaningful only when they work where the first cases occur. In the absence of licensed vaccines and specific treatments for Bundibugyo virus disease, preparedness depends on the basic functions of public health: surveillance, diagnosis, infection prevention and control, referral, risk communication, community engagement, and operational coordination. These functions are often described as routine. They are not. During high-consequence infectious disease alerts, they serve as the primary protective infrastructure. Ebola also exposes a deeper ethical failure. Frontline countries and communities are expected to contain threats of global relevance, but international support often intensifies only after the risk becomes visible beyond the affected area. This reactive model is neither fair nor efficient. The WHO Pandemic Agreement defines a political direction for a more equitable and coordinated global response. Here, Ebola is not presented as a typical pandemic event but as an operational test of preparedness, solidarity, early support to affected settings, and international cooperation. Ebola alerts test whether that direction can become an operational reality before escalation. Digital tools, telemedicine, and artificial intelligence may strengthen this agenda but only when they make local systems faster, safer, more trusted, and more usable. Ebola preparedness is therefore not only a technical task. It is a test of responsibility. Full article

(1) Background: Preconception care (PCC) is an important component of preventive reproductive healthcare and public health because modifiable risk factors affecting maternal, neonatal, and longer-term health may be present before conception. Despite broad recognition of its potential value, substantial uncertainty remains regarding how PCC should be organised, financed, and implemented across different healthcare systems. (2) Methods: This structured narrative review synthesised evidence on healthcare- provider models, financing, affordability, willingness to pay (WTP), and barriers and facilitators affecting PCC implementation. A structured search of PubMed, Scopus, and Web of Science Core Collection covered publications from January 2010 to March 2026 and was updated on 14 July 2026. Original research studies, systematic and scoping reviews, narrative reviews, clinical guidelines, policy reports, and relevant methodological or health-economic publications were considered. A structured qualitative appraisal was used to interpret evidence according to study design or evidence type, directness to PCC, healthcare-system context, methodological limitations, and consistency across sources. A total of 61 publications were retained in the structured evidence synthesis. (3) Results: No single PCC delivery model was consistently supported as universally applicable. Across heterogeneous settings, the evidence more consistently supported broad principles including accessibility, continuity of care, multidisciplinary coordination, clear professional roles, financial accessibility, and integration with existing healthcare pathways. Implementation was constrained by insufficient training, consultation-time limitations, unclear professional responsibilities, fragmented service organisation, inadequate reimbursement, and socioeconomic inequalities. Evidence on WTP, specific financing arrangements, and digital delivery models was more limited and context-dependent. (4) Conclusions: The available evidence supports PCC as an important preventive reproductive-health strategy, but the optimal organisational and financing models remain uncertain and are likely to depend on healthcare-system context. Integrated and multidisciplinary approaches appear promising, although specific provider configurations, financing mechanisms, and digital interventions require further comparative and longitudinal evaluation. The author-developed hypothetical conceptual model proposed in this review should therefore be interpreted as a hypothesis-generating synthesis of the available evidence rather than as an empirically validated clinical pathway or causal model. Full article

Background/Objectives: Although lung cancer is the leading cause of cancer-related deaths in the United States, rates of screening have remained persistently low nationwide. This study sought to identify barriers, facilitators, and support strategies necessary for implementing a novel community health navigator workflow to improve lung cancer screening uptake in both rural and urban settings. Methods: Semi-structured interviews were conducted with primary care providers (n = 5), community scientists (n = 7), community health navigators (n = 4), and radiology staff (n = 2). Interview transcripts were analyzed using a rapid qualitative analysis approach. Three authors coded based on the Consolidated Framework for Implementation Research (CFIR) and the Expert Recommendations for Implementing Change (ERIC) frameworks using a hybrid deductive–inductive approach. Results: Participants highlighted several primary barriers: access to knowledge and information (e.g., knowledge of eligibility, knowledge of insurance coverage), IT infrastructure (e.g., quality of pack-year data), relative priority (e.g., need to discuss other conditions), and patient needs and resources (e.g., time off work, transportation, difficulty scheduling). Key facilitators for screening were again IT infrastructure (e.g., automated electronic health record alerts) as well as relational connections (e.g., trust between patients and providers). To address provider-level barriers, participants recommended educational meetings, using clinical champions, and providing feedback on current lung cancer screening rates. To address patient-level barriers, participants recommended health education tools, providing transportation vouchers, hosting weekend lung cancer screening clinics, and assisting with scheduling. Conclusions: A community navigator approach to lung cancer screening should address key barriers to implementation on both the patient and provider level, including knowledge, prioritization, and patient access. Full article