Anxiety is common in people with coronary artery disease (CAD), particularly in association with invasive procedures and investigations. Effective provision of information for patients is crucial, but traditional methods may fail to adequately inform or engage some patients. We aimed to synthesise clinical trials evaluating the effectiveness of video animations provided to patients with CAD. We performed a systematic review of Medline, CINAHL Plus, Cochrane Library and PsycINFO from January 2000 to January 2025. Conducted in accordance with PRISMA guidelines and presented with a narrative synthesis. Five randomised-controlled trials met the inclusion criteria. Four included video animations, and one a 'whiteboard animation'. Each evaluated the animations as an addition to standard care. Patient knowledge was improved in all four trials that assessed it, and anxiety was reduced in two out of four trials that assessed it. There was some evidence of beneficial effects of animations on satisfaction and health behaviours. The quality of evidence was not strong, with two trials having a high risk of bias. In conclusion, video animations show potential for their effects on knowledge and anxiety in patients with CAD, but the evidence-base is small.

Background The benefits and side effects of pharmacological treatments for dementia are inherently difficult to qualify. Little is known about how they are discussed with patients and relatives in consultations, despite this having an impact on shared decision making, understanding of medications, and adherence. This study sought to understand how the benefits and side effects of treatments are communicated in clinical encounters. Methods 29 memory assessment clinic consultations across two UK NHS Trusts were video recorded, involving a total of ten doctors, 29 patients and 32 relatives or supporters. The consultations were analysed using content analysis to identify patterns in communication. Results The findings indicted that whilst there were some common approaches to describing medications –approaches varied in ways that could influence understanding and decision-making. Benefits were most frequently presented as symptom management designed to improve symptoms, focused on memory and cognition. Discussions of risk/benefit, prognosis and shared decision making were not present in all consultations. Conclusions Examining the findings in the context of best practice and guidance there are clear recommendations. Our data showed positive framing of the benefits of dementia treatments by clinicians. There was also a lack of consistency in the way that both benefits and side effects could be described. Recommendations include guidance for discussing dementia medications in ways that promote shared decision making including 1) caution about the use of leading language 2) ensuring consistent and transparent communication of benefits using education and training for clinical staff or patient decision aids where appropriate.

Background:Domestic abuse and suicidal ideation are highly prevalent in the United Kingdom, often co-occurring. Numerous practical and psychosocial barriers inhibit help-seeking. This study explored whether community pharmacy could offer an accessible setting for a domestic abuse and suicidal ideation response service. Methods:The design was a randomised cluster feasibility trial. Twelve pharmacies were recruited from one pharmacy organisation, randomised into eight intervention pharmacies and four controls. Thirty-seven pharmacy staff were trained to deliver the Lifeguard Pharmacy intervention, which involved providing a consultation and structured referral or signposting to customers identified as experiencing domestic abuse and/or suicidal ideation. Staff learning from the training was evaluated using the validated Continuing Professional Development reaction questionnaire, analysed using a paired t-test. The intervention ran from January to July 2023 and was accompanied by a nested process evaluation consisting of staff focus groups and a multistakeholder final evaluation workshop with a mix of lay, pharmacy staff and representatives from referral organisations. Data were collected on number and category of client contacts from intervention and control pharmacies; descriptive analyses were performed. Results:After intervention training, pharmacy staff showed statistically significant improvements in their levels of perceived ability, ease and confidence in responding to and referring people in need of help for domestic abuse and suicidal ideation with increased confidence in the ability of other pharmacy staff to support domestic abuse and suicidal ideation. During the intervention period, staff responded to 24 cases in intervention pharmacies: 8 for suicidal ideation, 9 for domestic abuse and 7 for both domestic abuse and suicidal ideation. Of these, 22 were staff-initiated and 2 were client-initiated. Two cases (one suicidal ideation and one domestic abuse) were identified in control pharmacies. Staff participants had a positive perception of the service and its impact on them and their clients. The multistakeholder workshop findings confirmed the feasibility of a staff-initiated response service for both domestic abuse and suicidal ideation in a community pharmacy setting. However, there were challenges marketing and delivering a client-initiated service, and the study was not able to collect all of the information required to inform a future trial. Limitations:There were challenges to collecting data and obtaining informed consent from Lifeguard Pharmacy clients, especially when distressed or time-pressured. Consequently, full data sets were only collected from 4 of the 24 people who used the service. All 12 participating pharmacies were located in 1 region of England, hence a future study would need to test implementation across a broader range of settings. Conclusions:It is feasible to implement a staff-initiated response service for domestic abuse and/or suicidal ideation in selected pharmacies. The combination of staff training, consultation guide, referral tool and client support resources and organisational support empowered staff to proactively identify people experiencing domestic abuse and/or suicidal ideation. Future work:Further development work would be needed before a client-initiated service could be delivered, and a future implementation study is contingent on finding ways to safely consent and collect data from clients. Some preliminary health economic work was conducted but a full health economic analysis would be needed as part of a future study. Funding:This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR133132.

Introduction Patient Information leaflets (PILs) from the British Association of Urologists (BAUS) are commonly used to communicate to patients about surgical procedures, but previous studies have highlighted that they are too difficult for some patients to read. BAUS PILs have since been rewritten using guidelines which emphasize readability. Objectives To identify if the readability of BAUS PILs has changed compared to historical versions. Methods Current BAUS PILs (published 2020-2025) were compared with historical PILs with similar titles from 2014 to 2016 using a custom Python script. Results Readability scores improved by a significant ( P < .001) albeit small amount (FKGL 8.83 vs 8.67; SMOG 11.86 vs 11.71; FRE 57.06 vs 57.47), and continue to have a suboptimal readability. The revised PILs had significantly fewer long sentences (10.11% vs 6.84% P < .0001), fewer sentences that used the “passive voice” (30.50% vs 16.22% P < .0001) and were shorter (1875.5 words vs 1726 P = .004). Conclusion While there have been small improvements in urology PILs for patients, they remain too difficult for many patients, and more work is needed to improve readability.

Background:Online and digital communications have changed information access, with many people using the internet for health information. Our 2022 systematic review showed that video animations can improve short-term patient and public knowledge but questions remained about their longer-term effectiveness, particularly for non-native speakers and those with low health literacy, and about their effects on attitudes, cognitions (e.g., self-perceptions) and behaviour. Methods:This review updates a previous systematic review on the effectiveness of video animations compared to other information formats. It includes randomised or quasi-randomised controlled trials, focusing on patients' or public understanding of health topics. The same eligibility criteria and search strategy were used, without language restrictions, and multiple databases were reviewed to April 2025 (our 2022 review had searched from database inception to June 2021). Inclusion assessment, data extraction, and quality appraisal were conducted independently by two researchers. Findings are presented through narrative synthesis and albatross plots. Results:We included 87 publications (88 trials), including 50 trials new to this update, focusing on medical procedures (n = 40), condition management (n = 24) and public health (n = 24). The median trial sample size was 120 and trials had been undertaken in 28 different countries. Animations showed positive effects for knowledge [48/60 trials (80%)], attitudes and cognitions [28/53 trials (53%)] and behaviours [20/32 trials (63%)]Null effects were found in 18% studies assessing knowledge, 47% studies of attitudes and cognitions, and 34% studies of behaviour, with one negative effect each in knowledge (2%) and behaviour (3%). Overall, risk of bias was "high" (n = 37), "some concerns" (n = 35), or "low" (n = 16), often due to concerns about randomisation, blinding, small samples, missing data or unpublished protocols. Discussion:Video animations improve patient knowledge and behaviour in the short-term, with some positive effects on attitudes and cognitions. However, higher quality and larger randomised controlled trials are needed to evaluate longer-term outcomes, especially for individuals with low health literacy. Practitioners should consider incorporating animations into public health, health education and healthcare delivery while being mindful of current research limitations. Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559912, PROSPERO CRD42024559912.

Background:Domestic abuse and suicidal ideation are highly prevalent and often co-occur. These issues are distressing and put people in danger from themselves or others. Numerous practical and psycho-social barriers inhibit help-seeking. Community pharmacies are accessible healthcare environments that deliver various public health functions. However, no studies have yet developed and tested a robust intervention for responding to domestic abuse and suicidal ideation in community pharmacy. Objectives:To co-develop a domestic abuse and suicidal ideation response service in community pharmacy; and to test whether the co-developed intervention and a future trial to evaluate it would be feasible and acceptable in community pharmacies. Design and methods:Service scope and resources were co-developed with 36 people (lay and professional) who participated in focus groups, interviews and/or workshops. A randomised feasibility trial tested the deliverability and feasibility of consenting clients and collecting study data, including data for a future economic evaluation. A nested process evaluation, comprising staff focus groups, customer interviews and a wider public survey, assessed the fidelity, acceptability and accessibility. A final feasibility workshop reviewed all feasibility objectives. Setting, participants and interventions:The service was tested for 6 months in eight intervention pharmacies in Lincolnshire. Four more pharmacies acted as controls, providing usual care. In intervention pharmacies, trained staff provided triage assessment and structured signposting to those identified at risk of domestic abuse and/or suicidal ideation. Main outcome measures:Data were collected on the number and type of relevant patient contacts from intervention and control pharmacies. Staff training was evaluated using the Continuing Professional Development-Reaction questionnaire, with before-and-after data analysed via paired t-tests. Feasibility objectives were assessed in a multistakeholder workshop. Qualitative process evaluation data were thematically analysed. Results:Co-development participants considered community pharmacies to be an ideal service setting. Their recommendations for safety, equity, empowerment and discretion were incorporated into service design. Following training, staff showed statistically significant improvements in their perceived ability and confidence in responding to people in need of help for suicidal ideation and/or domestic abuse. The public and pharmacy customers showed positive support and acceptability. During the intervention period, 24 patients needing support were identified in the intervention pharmacies compared to two in the control pharmacies. Stakeholder workshop findings confirmed community pharmacy as an appropriate setting for a staff-initiated intervention and the dual focus on domestic abuse and suicidal ideation. The findings do not support a client-initiated service at this stage due to challenges related to marketing and ensuring sufficient staffing capacity to deliver a safe, high-quality service. Limitations:Limited participant diversity and significant gaps in data collection from clients due to complexities of gaining consent in a pharmacy setting for this type of intervention. Conclusions:A co-developed, staff-initiated response service for suicidal ideation and/or domestic abuse in community pharmacy was found to be feasible to deliver and acceptable to patients and staff. Future work:An implementation study to scale-up service roll-out, evaluate it in diverse settings and streamline operational processes across more organisations is required. Further work is needed to determine how to collect outcome and cost-effectiveness data from people receiving a rapid intervention and/or in distress. Funding details:This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR133132.

IntroductionPeople with intellectual disability experience inequalities across the cancer care continuum, including lower screening participation, later-stage diagnosis, and higher cancer related mortality. Whether European cancer prevention and screening policies explicitly address this population has not been systematically mapped.MethodsThis review aimed to identify and synthesise European national and international policy frameworks, guidelines, and recommendations for cancer prevention and screening that address this population. A systematic search of policy, recommendation and guideline documents across academic databases, grey literature portals, and organisational sources, to August 2025 was under taken. The Population, Concept, Context (PCC) framework guided eligibility. Two reviewers per country screened, extracted, and appraised documents indepen dently using the Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist. Synthesis was narrative, stratified by cancer site and cancer control focus.ResultsSixteen documents met the inclusion criteria, originating from five jurisdictions: the United Kingdom, the Netherlands, Belgium, Denmark, and the European Union more broadly. Fifteen of the sixteen addressed cancer screen ing, one also addressed prevention, and two addressed clinical monitoring. Adjustments for people with intellectual disability were concentrated on breast, cervical, and bowel screening and grouped into accessible information, appoint ment adaptations, carer involvement, consent and capacity support, and work force training. Most documents originated from higher expenditure healthcare systems, and no eligible documents were retrieved from the majority of European Union member states.DiscussionPolicy guidance for cancer prevention and screening for people with intellectual disability is unevenly distributed across Europe and con centrated in a small group of countries. Existing guidance should be extended beyond screening to encompass prevention, treatment, and survivorship, and EU coordination may help address this gap.

Abstract Background People with lower levels of literacy or health literacy may struggle to understand conventional health information. Video animations show promise as information tools, yet it is unclear whether video animations help reduce these inequalities in understanding. This study examined whether the effectiveness of video animations in health settings differs according to level of literacy or health literacy. Methods We drew on trials from a recent systematic review of video animations about healthcare or public health topics for patients or the public. We extracted available data on literacy, health literacy, or proxy indicators. One reviewer extracted data and a second checked all entries. Where possible, we conducted subgroup analyses of low and high literacy levels or interaction meta-analyses comparing low versus high literacy groups; otherwise, results were summarised narratively. Results From 88 eligible trials, we extracted health literacy data for 12. Across nine trials reporting knowledge, animations mostly improved knowledge compared with controls in both lower and higher health literacy groups. Effects on attitudes and behaviours were mixed and often small, with few studies reporting results by health literacy level. Across the subgroup analyses available, there was no consistent evidence of a pooled interaction effect of animations according to low and high literacy groups, but both statistical heterogeneity and small subgroup sizes limited precision of estimates. Across 88 trials, 54 (61%) reported education level, 22 (25%) did not, and 12 (14%) involved children or adolescents likely to have similar education levels. Conclusions Overall, the available data suggest that video animations can improve knowledge outcomes in both lower and higher health literacy groups, but their impact on attitudes and behaviour is less clear. Because literacy was rarely reported or analysed in the trials, it remains uncertain whether animations help to reduce literacy-related inequalities in access to, and use of health information. Author Summary Many people find written health information difficult to understand, particularly if they have lower literacy or health literacy. Video animations may make health information easier to follow, but it is not clear whether they help reduce differences in understanding between people with lower and higher literacy levels. We examined 88 trials that tested video animations designed to inform patients or the public about healthcare and public-health topics. We looked for results reported separately for people with different literacy or health literacy levels, or for related measures such as education, socioeconomic deprivation, native language, or cognitive impairment. Only 12 trials provided information that could be used for this purpose. Overall, animations tended to improve knowledge in both lower and higher literacy groups. However, there was little evidence that they worked better for one group than the other. Effects on attitudes and behaviour were less clear. Most trials did not measure or report literacy-related differences, so we cannot yet tell whether animations reduce, maintain, or widen inequalities in understanding and use of health information. Future studies should include people with lower literacy and report results separately by literacy level.

BackgroundDiscussing pharmaceutical treatment for dementia is challenging because of variation in disease progression, lack of curative treatments, and communication difficulties. Research in the context of dementia suggests shared decision making is limited, this study examined how dementia medications are discussed in practice.MethodsFocused video/audio ethnography of clinical appointments (n = 14), semi-structured interviews with patients/supporters (n = 23) and clinicians (n = 5) were employed to examine communication practices.ResultsTwo themes developed; Framing and understanding of information in the context of uncertainty explores how uncertainties around risks and benefits are understood. 'Not worth the risk' or 'nothing to lose' presents how patients/supporters and clinicians balance individuals' contexts/perceived risks/benefits. In the absence of certainty around potential benefits, risk often informed decision-making, particularly for frailer or more vulnerable patients.ConclusionsClinicians should be aware of their influence on decision-making and be cognisant of the way that they frame opinions, which are largely based on clinical experience. Prescribers would benefit from a standardised information source which enables them to describe the likelihood and magnitude of benefits and side effects in a universal way. Accessible information for patients and relatives about the same is also recommended. Patients and relatives make their decisions to take medications in the context of relative uncertainty about the likelihood of benefits, with risk playing a pivotal role in decision making for some.

INTRODUCTION:Public and patient involvement (PPI) may be utilised to improve aspects of trial conduct. This study within a trial (SWAT) aimed to examine if a PPI-informed participant information leaflet (PIL) could improve recruitment, retention, and quality of decision-making of an exercise-based rehabilitation trial (RESTORE II) for upper gastrointestinal (UGI) cancer survivors. METHODS:This SWAT was conducted over two phases. Phase 1 applied qualitative methods to develop and refine a PPI-informed PIL. Phase 2 embedded a randomised controlled double-blind SWAT within the RESTORE II trial, comparing a standard PIL (PIL A) to the PPI-informed PIL (PIL B) in terms of recruitment, retention, and quality of decision-making (Decision Making Questionnaire [DMQ]). RESULTS:Phase 1 recruited 16 PPI members (mean age 67.01 [9.28] years, mostly male [81.25%] and all UGI cancer survivors). Participants reviewed the standard PIL A and made suggestions for improvement, including revisions to the layout, title, text, provision of key information on the first page, and greater emphasis on the potential benefits of participation. This feedback was used to draft the alternative PIL B, which the Phase 1 participants reviewed and refined through minor changes to the appearance, text, and layout. In Phase 2, 307 potential RESTORE II trial participants were randomised to receive either PIL A (n = 154) or PIL B (n = 153). The overall recruitment rate was 28.7%. (PIL A 26.6% vs. PIL B 30.7%, OR 1.22 [95% CI 0.74 to 2.01, p = 0.43]), retention was 84.1% (PIL A 85.4% vs. PIL B 83.0%, OR 0.84 [95% CI 0.26 to 2.65, p = 0.760]). No significant difference in mean (SD) DMQ scores was observed: PIL A: 29.1 (4.4) vs. PIL B: 29.1 (5.1) (mean difference 0.03, 95% CI -1.64 to 1.69, p = 0.49). CONCLUSIONS:A PPI-informed PIL did not improve recruitment, retention, or decision-making for the RESTORE II trial. PATIENT OR PUBLIC CONTRIBUTION:Patients with UGI cancer informed the development of the interventional PIL B. Author P.B. provided input from the patient's perspective throughout the SWAT as a member of the Trial Steering Committee, providing oversight to the SWAT management, and contributed to analysis and the production of this manuscript. TRIAL REGISTRATION:SWAT Registration: The Northern Ireland Hub for Trials Methodology Research, SWAT Store, SWAT 100 https://www.qub.ac.uk/sites/TheNorthernIrelandNetworkforTrialsMethodologyResearch/FileStore/Filetoupload,914713,en.pdf. Host Trial Registration Clinical Trials. gov https://clinicaltrials.gov/study/NCT03958019.

Background Children and young people with symptomatic pes planus (flat feet) often seek treatment from healthcare professionals. There are various treatment options, but there is a lack of high-quality evidence about which is most effective. Objectives To assess the clinical and cost-effectiveness of prefabricated orthoses, plus exercise and advice, compared with exercise and advice alone on physical function, measured using the physical domain of the Oxford Ankle Foot Questionnaire for Children, among children with symptomatic pes planus. Design and methods A pragmatic, multicentre, two-armed individually randomised controlled trial with an internal pilot, economic evaluation and qualitative study. Setting and participants Children and young people aged 6–14 years with symptomatic flat feet were recruited from hospital or community healthcare facilities in England and Wales. Participants were randomised 1 : 1 using a secure web-based randomisation system and followed up for up to 12 months. Interventions We planned to provide all participants with advice and exercises, with the intervention group also receiving a prefabricated orthosis. Due to the nature of the study treatments, blinding of participants or the research team was not possible. Main outcome measures The primary outcome was the physical domain subscale of the Oxford Ankle Foot Questionnaire for Children over the 12-month follow-up. Secondary outcomes included the physical domain subscale at 3, 6 and 12 months, and the ‘School and Play’ and ‘Emotional’ domains of the Oxford Ankle Foot Questionnaire, pain scores, healthcare resource use, EQ-5D-Y and Child Health Utility 9D at all time points. The qualitative study drew on health literacy and health belief perspectives and examined fidelity and explored the experiences of being in the trial for those receiving and delivering the study treatments. Results COVID-19 severely delayed trial set-up and recruitment and the study closed before meeting its recruitment target. Of 549 participants assessed for eligibility, 134 were randomised (intervention n = 70, control n = 64). The mean age of participants was 10.6 years (range 6.3–14.8) and 55.2% were male. No adverse events were reported. The planned statistical and health economic analyses could not be fully conducted due to the limited data. The qualitative study identified pain, posture and gait as the most common concerns by participants with pain relief as the primary motivator for seeking health care. Participants generally reported little understanding of their condition with barriers including misattribution (e.g. growing pains). Misinformation was common emphasising a need for accessible accurate education materials and structured follow-up care. There was a common belief that orthoses were superior to exercises leading to high levels of adherence, satisfaction and outcomes with orthoses compared with poor adherence, and low perceived efficacy with exercises linked to challenges incorporating these into daily routines. Limitations We could not deliver the study objectives as planned. Due to the limited data available, we were unable to undertake the planned analysis. Conclusions The COVID-19 pandemic significantly impacted trial set-up and recruitment. Extending the study was not feasible due to cost and time constraints. Future work The evidence for the clinical and cost-effectiveness of orthotics for the treatment of symptomatic flat feet in children remains inconclusive and an area for further research. Funding This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR127510.

Efficient, equitable health research depends on understanding why people decide to take part. The aims of this overview were to update the version published in 2020, identifying psychosocial influences on participation and mapping them to recruitment research and psychological theory. Searches were undertaken in February 2024. Qualitative, quantitative, and mixed-methods systematic reviews were identified, without language or date limits. Methodological quality was rated using AMSTAR-2, and low-quality reviews were excluded. Barriers and facilitators were identified inductively and mapped to the Theoretical Domains Framework (TDF) and COM-B model, and to empirical recruitment research. The update included 70 reviews, including 44 new reviews, covering a breadth of populations and settings, and drawing on 1940 primary studies (1428 unique). We identified 15 facilitators, most commonly: altruism, potential for personal benefit and trust. Incentives and convenient, low-burden research were also facilitators. Another 10 facilitators were new to this update. There were 16 barriers, most commonly: perceived risk, practical difficulties, and distrust of researchers. Many barriers applied to specific designs, particularly randomised trials. Factors that were barriers or facilitators include the influence of others and information quality. Barriers and facilitators were coded to the Motivation and Opportunity components of the TDF, particularly knowledge and social influences; only two factors were coded to a Capability. Psychosocial influences and empirical recruitment research had some overlap, but some barriers and facilitators had not been evaluated. Common barriers and facilitators to research participation were identified, some new to this update, which could be addressed through targeted recruitment strategies to increase the efficiency and generalisability of primary research. Factors affecting participation are not only personal; they are also normative and social. The priorities are to change the ways we recruit to research (perhaps tested in SWATs) and identify barriers and facilitators in areas not well covered in current research. PROSPERO CRD42017062738. Registered on April 2017.

Objective Effective decision-making is crucial for children and young people's trial participation, but specific tools to measure it are lacking. The TRECA (TRials Engagement in Children and Adolescents) Decision-Making Questionnaire (DMQ) was developed to fill this gap and has been evaluated for reliability and validity. Methods We created the TRECA Decision-Making Questionnaire, based on similar measures for adults, and recruited participants through seven Studies-Within-a-Trial (SWATs). Participants were randomly assigned to receive trial information either as a printed Participant Information Sheet or Multimedia Information, or both, and asked to complete the DMQ. We calculated item completion rates, item-remainder statistics and Cronbach’s Alpha, and conducted factor analysis. Results 549 participants (433 parents/guardians, 116 older children) completed a DMQ. It had high completion rates and internal consistency (Alpha = 0.88 for parents/guardians and 0.84 for older children) and moderate to high inter-item correlations. The DMQ had a single factor accounting for 53% of variance. Conclusions The TRECA DMQ is a useful tool for evaluating research participation decisions in older children, as well as parents and guardians. Practice implications Our study suggests that the TRECA DMQ can be used to assess the quality of decision-making about trials in parents, guardians and older children.

ABSTRACT Background People with intellectual disability have higher rates of cancer mortality than the general population. Cancer prevention programmes and screenings are recommended in adults, including those with intellectual disability. The opinions of relevant parties are important to ensure that people with intellectual disability can achieve equity in cancer outcomes. The aim of this paper is to report the findings of two workshops held in Ireland and Türkiye in 2023, which identified key issues affecting prevention, diagnosis and management of cancer in people with intellectual disability. Methods Researchers, practitioners, policymakers and other stakeholders with a role in cancer prevention programmes or cancer care ( n = 44) participated in ‘World Café’ workshop meetings in Dublin and Ankara. The findings were synthesised under the Dahlgren and Whitehead (1991) Social Determinants of Health framework. Results Both workshops identified that people with intellectual disability face challenges including: limited available cancer data in this population, health issues overshadowing cancer diagnosis, and social barriers such as low health literacy. Involving families, professionals and promoting self‐advocacy, while tailoring health services with inclusive decision making were prominent themes in both workshops as solutions. Research and person‐centered healthcare were identified as critical for developing effective cancer prevention programmes. Conclusion For people with intellectual disability to benefit from effective cancer prevention programmes, reasonable adjustments must be made by policymakers, health institutions, primary healthcare professionals and non‐government organisations, and research evidence must underpin decisions.

BACKGROUND:Domestic abuse (DA) and suicidal ideation (SI) are prevalent and often co-occur. Numerous practical and psychosocial barriers inhibit help-seeking, including accessibility and confidentiality concerns. Pharmacies are accessible and may be perceived as a discreet venue for a DA and SI response service. OBJECTIVE:To co-develop a community pharmacy response service for people experiencing domestic abuse or suicidal ideation. METHODS:Overall, 36 unique individuals contributed at least once to a series of focus groups, interviews or workshops to co-develop the service components. Participants had lived experience of DA/SI or were professionals from DA/SI support services or pharmacies. Audio recordings and field notes from events were thematically analysed. Specific themes were identified and informed the development of the service components. KEY FINDINGS:Participants supported the development of this new service and considered community pharmacies to be an ideal setting. They thought of the service as a lifeline, that would offer hope. Under this main concept of hope, five main themes were identified: Safety, Empathy, Empowerment, Equity, and Discretion. Participants' practical considerations were incorporated into the service design, including the name choice of "Lifeguard Pharmacy", the strapline "Bringing Hope to Life", and the development of a "Client Flowchart" outlining how to welcome a client, arrange for a consultation, and then guide clients out of the pharmacy afterwards. CONCLUSIONS:Overall, the findings supported the development and introduction of this pharmacy-based intervention, which may help overcome barriers to help-seeking for DA or SI due to its sense of hope, accessibility, and discretion.

Background Domestic abuse (DA) and suicidal ideation (SI) are prevalent and often co-occur. Numerous practical and psychosocial barriers inhibit help-seeking, including accessibility and confidentiality concerns. Early intervention and referral are essential for both DA and SI. Pharmacies are accessible and may be perceived as a discreet venue for a DA and SI response service. There is a growing body of literature about the role of community pharmacy teams in suicide prevention and assisting domestic abuse victims globally. Whilst there have been some interventions in UK pharmacies to support domestic abuse victims and encouragement of staff training in suicide prevention, there is currently no commissioned service for DA and/or SI in pharmacies in the UK. Objective To assess public acceptability of a novel response service in community pharmacy for people in danger from domestic abuse and/or suicidal ideation.MethodsData collection consisted of an online public survey running for 6 weeks and qualitative interviews with pharmacy customers. Descriptive statistics were used to present the survey results and interviews were audio recorded, transcribed verbatim and then analysed using the Framework Analysis method and NVivo 11. Results The majority of 501 survey respondents and all 12 customer interview participants were supportive of offering a response service for DA and/or SI in community pharmacy. Participants emphasised the need for appropriate staff training and support. They considered it an ethical and accessible approach and the majority said that they would recommend such a service to family or friends, and use it themselves if needed. However, awareness of the service was low and marketing materials were considered insufficiently clear. Conclusions There is strong public support and acceptability for a response service covering both suicidal ideation and domestic abuse in community pharmacies. Further research is required to develop appropriate marketing materials.

Aim To describe and interpret the sexual health experiences of men with IBD. Design Interpretive qualitative study. Methods In-depth, semi-structured interviews were conducted with 22 men with a diagnosis of Inflammatory Bowel Disease. Interviews were digitally audio-recorded and transcribed verbatim. Data were analysed using constant comparative, thematic analysis. Results Three themes were identified from interview data: (1) the disease shapes intimate connections, (2) the disease thwarts sexual experiences and (3) the disease disrupts male gender norms. Men reported that active disease lowered libido and could change pre-, inter- and post-coital sexual practices. All participants noted that health professionals did not initiate the discussion of sexual health and well-being needs in the outpatient hospital setting. Men who engaged in receptive anal sex reported a lack of disease-specific guidance and understanding from professionals. ConclusionInflammatory bowel disease can negatively impact the sexual well-being, gender identity and activities of men. Further research is required to identify the care preferences of men with IBD and clarify the barriers and facilitators to sexual health assessment so that nurses may better support the health needs of this population. Implications for the Profession and Patient Care This study highlights the need for sexual health and well-being support that is specific to disease and gender in IBD. There is a paucity of information and guidance for men with peri-anal disease and proctitis who engage in receptive anal sex, which requires urgent attention. Reporting Method Reporting follows the COREQ checklist. Patient or Public Contribution A patient and public involvement group informed the development of the study design. The group reviewed public facing documents and interview guides. One member of the group provided comments on the identified themes.

Rapid developments in digital technologies and easy internet access has transformed the potential for digital information and education of patients. Video animations are increasingly available but have not been evaluated systematically. This review aimed to collate trials of video animations for patients versus other forms of delivery. Included studies had the following features: controlled design with random or quasi-random allocation; patients being informed about any health condition or members of the public being informed about a public health topic; comparing video animation with another delivery format; animation delivered either instead of, or in addition to another format. Knowledge was the primary outcome; secondary outcomes were attitudes and cognitions (e.g. satisfaction); behaviours (e.g. skills). Multiple digital databases were searched 1996-2021 using a defined strategy. We also undertook citation searching. Dual, independent decision-making for inclusion assessment, data extraction and quality appraisal. Study appraisal with the Cochrane ROB2 tool. Narrative synthesis of findings. We included 38 trials, focussed on: explaining medical or surgical procedures (n=17); long-term conditions (n=11); public health, health-promotion or illness-prevention (n=10). Studies evaluated cartoon animations (n=30), 3D animations (n=6), ‘white-board’ animations (n=1) or avatars (n=1). Knowledge was assessed in 28 studies, showing greater knowledge from animations in 19. Attitudes and cognitions were assessed in 21 studies, and animations resulted in positive outcomes in six. Patient behaviours were assessed in nine studies, with animations resulting in positive outcomes in four. Overall risk of bias was: ‘high’ (n=18), ‘some concerns’ (n=16) or ‘low’ (n=4). The overall evidence base is highly variable, with mostly small trials. Video animations show promise as patient information tools, particularly for effects on knowledge, but bigger, better designed trials are needed.