The scope of cancer survivorship in Africa remains largely unexplored. This scoping review aims to describe current survivorship-related factors and care delivery characteristics in Africa, and to provide insights that can inform a more systematic integration of survivorship care into the broader cancer care continuum. Four databases (PubMed, Embase, Web of Science: Core, CINAHL Plus) were searched for journal articles and grey literature published from 2011 to August 2024 in English. Articles were included if they focused on post-treatment care for African cancer survivors. Covidence® was utilised for screening and data collection. Microsoft Excel was used for data cleaning and analysis. A total of 9417 articles were screened and 181 included. The number of studies per year grew from 6 (2011) to 32 (2023). These comprised 71 conference abstracts and 110 journal articles conducted in 19 African countries. The study methodologies utilised include 97 quantitative, 42 qualitative, 25 programme descriptions, and 18 mixed methods. Childhood survivorship was the focus for 40 studies. Psychosocial effects of cancer and its treatment were discussed in 104 studies. Interest in post-treatment cancer survivorship and related care is increasing across Africa. While significant research has explored the physical and psychosocial effects of cancer, there remains a critical need for studies focused on care coordination, targeted interventions, and strategies to improve quality-of-life outcomes for survivors. The overall scope of post-treatment cancer survivorship care in Africa primarily centres on psychosocial outcomes, with limited emphasis on care coordination. This underscores the need for further research and the development of context-relevant, feasible, and integrated care models within African health systems.

BACKGROUND:Cancer survivorship care has become increasingly complex, with a growing population of people living with and beyond the disease requiring holistic support and follow-up. Connected health (CH) offer a promising solution to enhance care delivery. AIM:This study evaluated the usability and effectiveness of CH, and motivations of participants in the Cancer Thriving and Surviving (CTS) programme in Ireland. METHODS:A cross-sectional survey of persons living with and beyond cancer (PLWBC) who completed the CH-delivered CTS was conducted between December 2022 and April 2023. Closed and open-ended questions captured participants experiences and motivations. Telehealth Usability Questionnaire (TUQ) assessed the CH usability. Qualitative content analysis examined recurring themes in participant responses. RESULTS:Forty-four participants who engaged in CTS completed the survey. Participants were predominantly female (88%), diagnosed with breast cancer (76%), and had third-level education or higher (86%). Slightly over one third (36%) were in full time employment. Motivations for engaging in CTS included seeking peer support, psychosocial assistance, and practical self-management tools. Most respondents agreed that the programme improved their psychological wellbeing (90%), quality of life (76%) and helped them take more control of their health (83%). TUQ scores indicated high usability of the CH systems. CONCLUSION:Findings suggest that the CH-delivered CTS programme effectively benefits PLWBC, improving psychological well-being and quality of life. The high CH system usability and positive user experiences highlight its potential to complement in-person care, supporting the continued development and evaluation of CH systems to enhance cancer survivorship, particularly within Irish digital health initiatives.

Purpose As the number of people living with and beyond cancer increases, connected health technologies offer promise to enhance access to care and support, while reducing costs. However, uptake of connected health technologies may vary depending on sociodemographic and health-related variables. This study aimed to investigate demographic and health predictors of connected health technology use among people living with and beyond cancer.Methods Cross-sectional data from the US Health Information National Trends Survey Version 5 Cycle 4 (H5c4) was used. Regression analysis was used to examine associations between sociodemographic factors and the use of connected health technologies. The sample was restricted to individuals who self-reported a cancer diagnosis or history of cancer.Results In this cycle, 626 respondents self-reported a cancer diagnosis, with 41.1% using connected health technologies (health and wellness apps and/or wearable devices). Most were female (58.9%) and white (82.5%); 43.4% had graduated college or higher education. One third (33.6%) had a household income of $75,000 or more. Respondents who were younger, have higher education, were living as married, had higher incomes, had higher self-rated health and had higher health-related self-efficacy were significantly more likely to use connected health technologies. There were no significant associations between gender, race, stratum, time since diagnosis, history of anxiety or depression, and use of connected health technologies among people living with and beyond cancer.Conclusions Connected health technology use among people living with and beyond cancer is associated with sociodemographic factors. Future research should examine these demographic disparities as the use of connected health technologies in healthcare continues to gather momentum.Implications for cancer survivors The study underscores a disparity in connected heath technology usage among people living with and beyond cancer. There is a pressing need for research into adoption barriers and interventions to ensure equitable digital healthcare integration among this population, especially with the heightened adoption of technology post COVID-19 pandemic.

In low-resource settings where unemployment rates are already high, persons with disabilities experience even greater challenges in finding work and employment opportunities. While employers' viewpoints are critical to shaping organizational cultures and employment practices, their perspectives on the employment of people with psychosocial disabilities (PWPD) in rural settings have not been adequately examined. This study explored perspectives of rural employers in Kenya on working with and employing PWPD, so as to strengthen the practice of inclusive work and employment. We utilized a qualitative research methodology to explore the perspectives of a heterogeneous group of employers from Tana River County Kenya. A total of 12 employers participated in the study. We found that employer awareness of inclusive employment practices of PWPD is limited, with several barriers identified. Reported barriers include productivity concerns, occupational hazards, brand image, and disclosure. To improve work and employment rates for PWPD, employers highlighted workplace adjustments, holistic socioeconomic empowerment, and policy changes. Despite differing opinions, employers expressed a willingness to work with and employ PWPD. This study sheds light on the current practices, perceived barriers, and enablers for improving work and employment rates of PWPD in rural settings. While there is a lack of awareness among employers and multiple barriers, it is encouraging to note that employers are willing to work with and employ PWPD. To achieve this, a holistic approach that includes raising awareness on mental illnesses and implementing policies that promote inclusivity is needed.

Using a cohort of 544 postpartum mothers, 6 weeks to 12 months post-delivery in the largely rural Makueni County in Kenya, we aimed to determine: (1) the prevalence of postpartum depression (PPD) and the prevalence of each of the four domains of intimate partner violence (IPV), that is physical violence, sexual violence, emotional violence, and controlling behavior; (2) the co-occurrence of PPD and IPV; (3) risk factors and associations between sociodemographic variables and IPV, PPD and IPV and PPD co-occurring. We concurrently administered a researcher-designed sociodemographic ad hoc questionnaire, the WHO Intimate Partner Violence questionnaire and the Mini-International Neuropsychiatric Interview for adults (MINI Plus) for DSM-IV/ICD10 depression. The prevalence of PPD was 14.5%; Emotional violence 80.3%; Controlling behavior 74.4% (a form of emotional violence); Physical violence 40.3%; Sexual violence 28.9%. We found the following overlaps: 39% of participants reported both physical and emotional violence; 39% had both sexual and emotional violence; 15% experienced physical and sexual violence; and 15% of participants reported physical, sexual, and emotional violence. Postpartum depression was associated with physical violence during pregnancy, self-employed status, history of mood disorders and medical problems in the child. Further, we report associations between various types of IPV and history of depression, physical violence during pregnancy, low education level, marital status, and current depression diagnosis. IPV and PPD were highly prevalent in our population of postpartum mothers. Various types of IPV were significantly associated with various sociodemographic indicators while only sexual violence was significantly associated with PPD. Based on our results, we provide suggestions for potential interventions in the Kenyan setting.

Introduction: COVID-19 global pandemic exposed mental health gaps that have been salient among adolescents and young people. The glaring gaps include lack of information, undefined referral systems, and inadequate human resources for mental health. We aimed to develop a digital web-based platform to support young people's mental health and psychosocial needs during the COVID-19 pandemic.

Caring for a child with cancer can place a number of burdens on families, however it is unclear the extent to which health-care professionals (HCPs) and other personnel supporting families are aware of these burdens. This study sought to explore the needs and challenges encountered by families impacted by pediatric cancer in Ireland from the perspectives of both parents and the personnel who support them. Twenty-one participants, comprising seven parents (one male, six females), and 14 supportive personnel (nine hospital-based volunteers and five HCPs) took part in in-depth semi-structured interviews via Microsoft Teams (December 2020 to April 2021) to obtain a perspective of the needs, challenges, and currently available support for families. A reflexive thematic approach to analysis was employed. The need to navigate a new normal, a sense of riding the wave and reliance on others were perceived to be the primary challenges encountered by families. Participants reported a need for community service provision, connectivity across the health-care system and more accessible psychological support. High levels of overlap across themes were found for parents and supportive personnel, particularly HCPs. Results highlight the significant challenges encountered by families impacted by pediatric cancer. Themes voiced by parents were frequently echoed by HCPs, suggesting this group is attuned to broader family needs. As such, they may be capable of providing insight where parent perspectives are unavailable. While further analysis including children's voices is needed, findings highlight key areas toward which support for families should be directed.

OBJECTIVE:National Cancer Control Plans (NCCPs) are high-level policy documents that prioritise actions to be taken to improve cancer control activities. As the number of cancer survivors grows globally, there is an urgent need to assess whether and how psychosocial care across the cancer care continuum is included in NCCPs. This review aimed to ascertain the extent to which NCCPs referenced psycho-oncology care for cancer survivors in the post-treatment phase.METHODS:NCCPs were obtained from the International Cancer Control Partnership (ICCP) portal (in November 2021) and reviewed in two phases. In Phase 1, all available NCCPs were screened to determine whether they mentioned psycho-oncology or survivorship. In Phase 2, reviewers extracted data from the NCCPs identified in Phase 1 on the degree that each plan articulated objectives/goals to improve psychosocial care in the post-treatment survivorship phase.RESULTS:We screened 237 NCCPs. Of these, initial potential reference to psycho-oncology and survivorship content were identified in 97 plans (41%). In Phase 1, 57/97 (59%) had reference to psycho-oncology or survivorship content within defined criteria. In Phase 2, 27/97 (28%) had little mention of psycho-oncology specifically in survivorship, 47/97 (48%) had some (general or brief) mention, and the remaining 23/97 (24%) had substantial content/specific sections and clearly articulated goals and/or objectives. Common goals for improving psychosocial care in the post-treatment period included building capacity of healthcare professionals, implementing rehabilitation models, and increasing the utilisation of community services.CONCLUSIONS:Most NCCPs did not reference psycho-oncology and only one-quarter contained clear objectives specifically in the post-treatment survivorship phase.

Objectives: Fibromyalgia (FM), Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and other syndromes with medically unexplained symptoms (MUS) pose significant healthcare challenges. We aimed to synthesize qualitative evidence regarding the experiences of persons with these conditions (PwC) and their healthcare professionals (HCPs).Methods & Measures: Databases were searched using terms relating to FM/ME/CFS/MUS, Experience and Qualitative research. Studies published between 2001-2021 concerning adult PwC or HCP perspectives were included and synthesized using Meta-Aggregation, with confidence established following the ConQual approach.Results: 143 studies were included, with 708 findings aggregated into 82 categories and 13 synthesized findings. PwC narratives reflected a range of themes concerning: The experience of symptoms; The patient journey; Identity loss and change; Managing chronic illness; Understanding and legitimacy; Support needs and experiences; Healthcare needs and experiences; and Managing the healthcare encounters. HCPs perspective themes included: Beliefs and attitudes towards patients; Sensemaking at the limits of medical knowledge; Consultation and management; The patient-clinician relationship; and Barriers and facilitators to care. Conclusion: Sensemaking challenges are at the core of the patient and clinician experience of MUS, FM and ME/CFS. While gaps in biomedical knowledge are clear, this review highlights the need to address the patient-clinician dynamic in the context of uncertainty.

Background:Advancements in cancer treatments have enabled more people worldwide to survive cancer, but many experience lasting impacts. The International Psycho-Oncology Society (IPOS) is a global professional organization which hosts an annual World Congress. This study reviewed survivorship content from the World Congress meetings to understand areas of focus, apparent strengths and weaknesses, and global representation. Methods:Peer-reviewed abstracts presented in 2017, 2018, 2019, and 2021 were reviewed. Abstracts were identified by searching for "survivor." Identified abstracts were read in full to extract content of interest (population of interest, cancer type, number of participants, study design, study topic, first author/country, and international collaboration). Coding was defined a priori. Data were extracted using REDCap. Inter-rater reliability checks were performed. Results:A total of 1813 abstracts were identified and reviewed. The proportion of survivorship-focused abstracts ranged from 13.2%-20.7% annually. Breast cancer dominated survivorship work. The most frequently addressed topics included distress/anxiety/depression (36.6%), quality of life (28.6%), and health behaviors (15.5%). Nearly three-quarters (73%) of abstracts focused on adult populations, and there was apparent international collaboration in 12%-20%. Authorships and abstracts were primarily from high-income countries (91%). Most studies were observational (44%); few were randomized controlled trials (4%). Conclusions:This study found overrepresentation of authorship from some countries. Many topics, patient populations, and countries were not highly represented. IPOS might consider efforts to remedy this imbalance with the ultimate goal of improving psychosocial care for those affected by cancer, globally.

BackgroundWhile Therapeutic Recreation (TR) camp programmes have been extensively analysed, less is known about hospital outreach programmes (HOPs). This study examined parent, volunteer and health care provider (HCP) perceived core features and outcomes of a hospital-based TR programme for children with serious illness.MethodsParticipants were either 1) a HCP within a hospital setting, 2) a volunteer with HOP, or 3) the parent of a child with serious illness. Semi-structured interviews were completed remotely and analysed using a reflexive thematic approach.ResultsNineteen participants (5 parents, 5 HCPs, 9 volunteers) were interviewed. Core features of the HOP included the importance of play as an anchor to the present moment and as a vehicle to challenge and grow, creation of a safe space allowing child and family needs to be met, and meeting families where they are. Perceived outcomes of attending the HOP included changing the focus from being sick to being a child, and developing a sense of solidarity amongst peers for both children and parents.ConclusionsThese results highlight the important contribution of the HOP in supporting children regain a sense of self that is greater than illness, allowing them to reconnect with their values and express themselves, while supporting growth and self-esteem.

Background: To date, there have been no large-scale population studies of autistic traits (AUT) conducted in Africa. Aim: The study aimed to estimate the prevalence and characteristics of autism spectrum disorders in a large sample of Kenyan adolescents and young adults. Setting: Tertiary academic institutions (87%) and directly from the community (13%). Methods: Our study surveyed 8918 youths (aged 15–25 years) using the autism spectrum quotient (AQ). Based on AQ scores, we derived groups with low (L-AUT), borderline (B-AUT), and high (H-AUT) autistic traits. Relationships of AUT with demographic factors, psychosis, affectivity and stress were investigated. Results: Internal consistency of the AQ in the population was excellent (Cronbach’s α = 0.91). Across all participants, 0.63% were estimated as having H-AUT, while 14.9% had B-AUT. Amongst community youth, prevalence of H-AUT was 0.98%. Compared to those with low and borderline traits, H-AUT participants were more likely to be males, to have lower personal and parental educational attainment, and to be of a lower socioeconomic status. The H-AUT group also had higher psychotic and affective symptoms as well as higher psychosocial stress than other groups. Conclusion: The prevalence of H-AUT amongst Kenyan youth is comparable to Autism spectrum disorder (ASD) rates in many countries. Autistic traits in Kenya are associated with worse social and clinical profiles. Further research on autism across Africa is needed to investigate cross-cultural heterogeneity of this disorder, and to guide healthcare policy.

Aim As healthcare systems are increasingly burdened, the efficiencies and cost savings offered by connected health (CH, i.e. two-way communicative healthcare technologies such as eHealth or mHealth) present an attractive solution for supporting families impacted by cancer. More research is required, however, to examine attitudes towards CH to better facilitate its use in practice. This study seeks to examine the utility, barriers and facilitators of CH use for families affected by paediatric cancer living in Ireland. Methods Healthcare professionals (n = 5) and parents of children with cancer (n = 7) completed semi-structured interviews on their experiences of and attitudes to CH via Microsoft Teams. A reflexive thematic approach to analysis was employed. Results CH was perceived to provide support for a number of current needs with themes of ‘shifting responsibilities’, ‘individualisation of care’ and ‘knowledge as power’. Through facilitating communication, information sharing and monitoring of child health, CH was perceived to support decreased parental burden and increased parental control, with positive child outcomes thought likely. Perceived barriers and facilitators to the use of CH included the ‘importance of trust’, ‘pace of change’ and ‘access’. Conclusion While results suggest an acceptance of CH across key stakeholders, barriers and facilitators should be considered to support effective implementation. While further analysis of the efficacy of CH to support families impacted by paediatric cancer is needed, these findings highlight key areas where CH may be effectively employed.

Connected health technologies have the potential to improve access to cancer care and support and reduce costs. We aimed to assess the impacts of interventions delivered using connected health technologies on psychological and quality of life (QoL) outcomes in people living with and beyond cancer.

Levels of mental health awareness in rural Kenya remain very low with higher levels of stigma and discrimination towards people with psychosocial disabilities, especially for women. This study aimed to describe the levels and correlates of mental health knowledge, discrimination and social functioning among rural women with psychosocial disabilities in Kenya. We randomly recruited 25 women living with psychosocial disabilities in a rural county. Mental health knowledge was measured by Mental Health Knowledge Schedule (MAKS), anticipated discrimination was measured by Questionnaire on Anticipated Discrimination while social functioning was measured using the Social Functioning questionnaire. The mean age of study participants was 36.6 ± 3.0 and the mean score of MAKS was 21.9 ± 30. The most endorsed item was referring a friend with mental illness to a professional to seek help. The prevalence of low social functioning was 64%. In terms of identification of mental illness, majority (88%) identified depression as a mental illness. Higher mental health knowledge was associated with a higher level of education (p = 0.012), being self-employed as opposed to unemployed (p = 0.018) and earning monthly income (p = 0.023). The most frequent reason for anticipated discrimination was friends and neighbors knowing about their mental health problems (24.0%). Anticipated discrimination was associated with participants who had ever been treated for a mental health problem (p = 0.05). Poor social functioning was significantly correlated with the number of years lived with disability (p < 0.001). Poor mental health awareness and discrimination against people with psychosocial disabilities limit their functioning, health-seeking and recovery in Kenya. There is need for prioritization of mental health services and increased mental health awareness to improve health-seeking behavior, social participation and recovery for persons with psychosocial disabilities.

Quality improvement methods could assist in achieving needed health systems improvements to address mental health and substance use, especially in low-middle-income countries (LMICs). Online learning is a promising avenue to deliver quality improvement training. This Computer-based Drug and Alcohol Training Assessment in Kenya (eDATA-K) study assessed users’ experience and outcome of a blended-eLearning quality improvement course and collaborative learning sessions. A theory of change, developed with decision-makers, identified relevant indicators of success. Data, analyzed using descriptive statistics and thematic analysis, were collected through extensive field observations, the eLearning platform, focus group discussions, and key informant interviews. The results showed that 22 community health workers and clinicians in five facilities developed competencies enabling them to form quality improvement teams and sustain the new substance-use services for the 8 months of the study, resulting in 4591 people screened, of which 575 received a brief intervention. Factors promoting course completion included personal motivation, prior positive experience with NextGenU.org’s courses, and a certificate. Significant challenges included workload and network issues. The findings support the effectiveness of the blended-eLearning model to assist health workers in sustaining new services, in a supportive environment, even in a LMIC peri-urban and rural settings.

Abstract Background Peripartum adolescents experience significant interpersonal transitions in their lives. Depression and emotional distress are often exacerbated by adolescents’ responses to these interpersonal changes. Improved understanding of pregnancy-related social changes and maladaptive responses to these shifts may inform novel approaches to addressing the mental health needs of adolescents during the perinatal period. The paper aims to understand the sources of psychological distress in peripartum adolescents and map these to Interpersonal Psychotherapy’s (IPT) problem areas as a framework to understand depression. Method We conducted interviews in two Nairobi primary care clinics with peripartum adolescents ages 16–18 years (n = 23) with experiences of depression, keeping interpersonal psychotherapy framework of problem areas in mind. We explored the nature of their distress, triggers, antecedents of distress associated with an unplanned pregnancy, quality of their relationships with their partner, parents, and other family members, perceived needs, and sources of support. Results We found that the interpersonal psychotherapy (IPT) framework of interpersonal problems covering grief and loss, role transitions, interpersonal disputes, and social isolation was instrumental in conceptualizing adolescent depression, anxiety, and stress in the perinatal period. Conclusion Our interviews deepened understanding of peripartum adolescent mental health focusing on four IPT problem areas. The interpersonal framework yields meaningful information about adolescent depression and could help in identifying strategies for addressing their distress.

In low-income settings, the informal economy is a practical alternative to work and employment for persons with disabilities. However, the COVID-19 pandemic negatively affected the informal economy. This study aimed to explore the experiences of women with psychosocial disabilities in Kenya during the pandemic. We found that the pandemic worsened their experiences of work and employment, and they did not receive any social welfare or support from the government. Our findings suggest that pandemic management must adopt inclusive and context-sensitive approaches that support persons with psychosocial disabilities. Social welfare and protection for persons with disabilities are relevant for socio-economic empowerment and inclusion.