Despite growing interest in the quality of life of individuals with single-ventricle CHD, the experiences of their siblings remain largely underexamined and heavily reliant on parent-reported outcomes. This study explores the experiences of siblings of individuals with single-ventricle CHD through a qualitative analysis of self-reported narratives.

Siblings of individuals with single-ventricle CHD aged 9 years and older participated in age-based Experience Group sessions. Trained facilitators used semi-structured, open-ended questions to prompt discussion. Qualitative data were coded using inductive thematic analysis to identify salient themes across narratives.

Eighteen siblings participated. Participants (50%, n = 9 female) ranged in age from 9 to 59 years (median age 22 years); most (72%, n = 13) were older than their sibling with single-ventricle CHD. Five themes emerged: 1) adapting to their sibling’s physical limitations, 2) assuming supportive roles in the family, 3) navigating complex and often conflicting emotions, 4) deepening their understanding of the condition over time, and 5) finding normalcy throughout their childhood.

This study provides valuable insights into the nuanced experiences of siblings of individuals with single-ventricle CHD, underscoring the key roles they play in the care journey and describing the unique experiences that have shaped them. These findings can inform tailored, family-centred care models that intentionally include siblings in psychosocial assessment, support interventions, and age-appropriate medically related education and communication.

Health Technology Assessment (HTA) agencies often lay out the methods and processes for recommendations through guidelines. However, evidence suggests that the presence of guidelines does not necessarily lead to more systematic, evidence-based decisions. This article explores the differentiating features of HTA guidelines that have successfully promoted change in decision-making practice.

We compared the development and impact of HTA guidelines over time in eight countries through a multi-case study design. Data from interviews and literature review were analyzed qualitatively by pattern matching.

In settings without a guideline owner, guidelines were most successful if the development process targeted key stakeholders who are able to influence change in an open process of joint learning, and an agency with relevant expertise was assigned to oversee future guideline implementation and revisions. In settings with a clear guideline owner, guidelines were most successful if stakeholders continued to be engaged after guideline publication, to incorporate interim updates and when there was continuous learning between stakeholders and the HTA agency. Enforcing guideline compliance through laws was not found to be a predictor of guideline success nor was the level of HTA institutionalization in a country.

At any stage of HTA institutionalization, HTA guideline success depends on whether the development and revision process successfully builds shared understanding and trust among stakeholders. Ensuring HTA guideline impact requires an open and inclusive approach to stakeholder engagement during and after guideline development, as well as effective accountability mechanisms for guideline ownership.

To describe and understand areas of concordance and discordance between the perceptions and experiences of family physicians and policymakers regarding the implementation and use of virtual care within the Nova Scotian primary care system.

COVID-19 brought rapid change to primary care delivery and accessibility. Virtual care rapidly expanded, facilitating primary care access amidst public health restrictions. Health systems leaders facilitated access to virtual care, developed and implemented guidelines, and created new billing codes. Providers integrated virtual care and operation changes into practice.

Semi-structured interviews with family physicians (n = 20), policymakers (n = 9) and a family physician/policymaker (n = 1) were conducted to understand virtual care implementation and outcomes in Nova Scotia, Canada, identifying benefits and challenges.

All participants discussed patient confidentiality concerns, overreliance potential, and virtual care to promote patient care access. Family physicians discussed provider privacy and burnout. Policymakers discussed virtual care increasing capacity for accepting new patients and challenges evaluating virtual care billing codes. Providers and policymakers shared concerns and policy directions for development and expansion of virtual care. As there is little research from policymaker perspectives on virtual care, reconciling these viewpoints is crucial for effectiveness and sustainability.

This study aims to evaluate the facilitators and barriers to the implementation, adoption, and participation of these programs.

The Prediabetes Intervention, Management, and Evaluation (PRIME) program is an initiative that integrates digital health tools with community pharmacy services to encourage lifestyle behaviour changes among participants with prediabetes. While PRIME demonstrates effectiveness in clinical outcomes, the integration of such programs into community pharmacy services remains limited.

In-depth focus group discussions and one-on-one interviews were conducted with participants and pharmacists who were involved in PRIME. The semi-structured interviews focused on the experiences and perceptions of the implementation of PRIME and its influence on behaviour change. All audio-recorded interviews were transcribed, coded, and analysed using thematic analysis techniques, leading to the development of major themes.

Seven focus groups and twenty interviews were conducted among 37 participants and 10 pharmacists. Five themes were developed: 1) Intrinsic motivations towards better health; 2) Influence of rapport building; 3) Improved convenience to healthcare access; 4) Resource and support; and 5) Innovation with digital health. Key barriers were related to the use of digital health tools (technical difficulties, lacking engaging functionalities) and resources (workload management, availability of prediabetes-specific guidelines). The participants perceived the blended approach of in-person support with technology-assisted interventions in PRIME as an effective way to build healthier lifestyles. While community pharmacy-based prediabetes management programs like PRIME can be effective in driving healthier lifestyles, several barriers hinder their broader adoption. Addressing these barriers could enhance the implementation and uptake of these programs.

Individuals living with advanced pancreatic cancer (APC) face a poor prognosis and high symptom burden. Although exercise training is an evidence-based approach in improving physical and psychological health outcomes in those living with and beyond a cancer diagnosis, there is limited research exploring its role and integration within advanced pancreatic care. The aim of this study was to explore the exercise experiences and perspectives of individuals living with APC in Canada.

Using a qualitative interpretive description methodology, we conducted semi-structured interviews with 6 individuals diagnosed with advanced (stage III or IV) exocrine pancreatic cancer from across Canada. Interviews were transcribed verbatim, and transcripts were analyzed using reflexive thematic analysis. Inductive and deductive analysis was conducted using the Behaviour Change Wheel and Theoretical Domains Framework as guiding lenses.

Three themes were identified impacting how individuals living with APC perceive and experience exercise: (1) Taking control of my journey; (2) Building the motivation; and (3) If it was a program for me.

This study highlights aspects of the perception of exercise in pancreatic cancer care among individuals living with advanced disease in Canada. Integration of progressive programming, realistic goal setting, and fostering of a supportive environment were identified as important considerations for the care context.

To explore consumers’ understanding of whole-grain foods and their processing and food industry personnel’s perceptions of whole-grain foods in processing classification systems.

Semi-structured focus groups and interviews.

Online.

Consumers (n 28) ≥ 18 years frequently purchasing/consuming grain foods. Food industry personnel (n 16) currently/recently employed within the grain industry.

Consumers generally used whole-refined grain comparisons to gauge the level of processing, perceiving whole grains as less processed. While some suggested processing elements, such as additives, may influence their food choices, healthfulness was typically judged based on the presence or absence of certain nutrients. Often, other drivers of behaviour took precedence (e.g. cost, familial preferences and culinary skills). Food industry personnel viewed food processing as complex but oversimplified in current food processing classification systems. They considered that while some processed foods can be unhealthful, this does not apply to all processed foods. They emphasised the importance of holistic consumer education including that processing needs to be considered together with the food’s nutritional composition to help consumers differentiate between less healthy and ‘healthier’ processed foods (e.g. a highly processed refined grain food with added fats and sugars, and a fortified whole-grain product).

Messaging around food processing should be considered alongside those on nutritional quality of foods to ensure consumers are informed in their understanding of a food’s healthfulness. Policy measures addressing food processing should reflect its complexities, including the different types and functions of processing and their rationale, particularly in the context of whole grains.

Price promotions are widely used in supermarkets and are more commonly applied to less healthy foods and beverages. We aimed to examine how supermarket price promotions influence food and beverage purchasing among households with school-aged children in Australia, and how perceptions vary by income.

A cross-sectional qualitative study using semi-structured interviews, analysed using thematic analysis.

Australia, within the supermarket retail food environment.

Twenty-two parents or caregivers of school-aged children from households with differing income levels.

Participants across income groups reported using supermarket price promotions as a budgeting strategy, particularly in the context of rising food costs. Price promotions were described as encouraging unplanned purchases, most often for unhealthy foods and beverages. Compared with higher-income households, lower-income households reported greater awareness of supermarket pricing strategies and more frequent purchasing of price-promoted products. Participants perceived that healthy options were less frequently discounted and suggested that increasing promotions for healthy foods and beverages would better support healthy diets.

Supermarket price promotions were perceived to shape purchasing decisions, often encouraging purchases of less healthy foods and beverages. Regulatory approaches that reduce promotions on less healthy products while improving the affordability of healthier options may support healthier and more equitable food environments, particularly for households experiencing financial constraints.