Objective: This study evaluated the effectiveness of health literacy interventions aimed at reducing sugar and sugar-sweetened beverage (SSB) intake among Asian populations and identified the common characteristics of effective interventions through a systematic review of randomised and non-randomised studies. Study design: Systematic review of randomised and non-randomised trials. Methods: A systematic search of five databases identified randomised and non-randomised studies on health literacy interventions aimed at reducing sugar and SSB intake among Asian populations. Screening followed predefined criteria, and data extraction captured the intervention type, delivery, duration, and outcomes. Quality was assessed using the Cochrane Risk of Bias-2 and ROBINS-I tools for bias, and the findings were synthesised to identify effective intervention traits and research gaps. Results: Of the eight included studies, three were face-to-face educational, one behavioural, one online, one mobile text messaging, and two front-of-pack (FOP) labelling interventions. Six out of eight studies measured sugar intake, with four assessing SSB intake. Seven studies reported significant dietary improvements. Overall, bias risk was present, with three rated high. Significant inconsistencies in the two studies were further explored. Conclusion: The effectiveness of health literacy interventions in reducing sugar or sugar-sweetened beverage intake was positive, particularly for face-to-face interventions and FOP labels. Available evidence may inform policymaking for the implementation of health promotion for disease prevention and complement standards of care practices for disease management.

Objectives: The relationship between the volume of medical procedures conducted in hospitals and the resulting health outcomes has been described for various surgical and non-surgical medical interventions. As a policy response to this, several countries have implemented minimum volume standards. However, there is currently a lack of systematically compiled evidence assessing their impact. To close this research gap, we conducted a systematic review on the effects of minimum volume standards in hospitals. Design: Systematic review using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Data sources: MEDLINE, PubMed Central and Bookshelf (PubMed), EMBASE (Elsevier), CENTRAL (Cochrane Library), CINHAL (EBSCO), EconLIT (EBSCO), PDQ-Evidence for Informed Health Policymaking, Health Systems Evidence and three trial registries were searched until June 2023. Additionally, manual searches were conducted. Eligibility criteria for selecting studies: For inclusion in this review, studies must investigate the effects of minimum volume standards. We accepted all categories of outcomes. Following the Cochrane Effective Practice and Organisation of Care (EPOC) criteria, only a strict set of study designs, namely randomised controlled trials, non-randomised controlled trials, controlled before-after studies and interrupted time series studies, were included. No restrictions were placed on language, publication date or publication status. Data extraction and synthesis: Two reviewers independently screened titles and abstracts for eligibility, reviewed the full texts and performed data extraction of the included articles. Risk of bias was assessed using the 'Risk Of Bias In Non-Randomised Studies-of Interventions' (ROBINS-I) tool. Certainty of evidence was rated using the GRADE approach. For data synthesis and statistical analyses, we adhered to the EPOC guidance. Results: We included nine studies into our systematic review. Overall, the outcomes reported in the studies are heterogeneous, which did not allow for a meta-analysis, resulting in a narrative analysis of the found evidence. While travel distance increased and length of stay decreased, other reported outcomes such as complications or reoperations were not affected by the introduction of minimum volume standards. Overall, the risk of bias was considered serious for results on outcomes of seven out of the nine included studies and moderate for the remaining two. The certainty of evidence was rated low for complications, reoperations, length of stay and travel distance and very low for mortality (in-hospital; 30 days). Conclusion: This systematic review does not provide conclusive evidence on the effects of minimum volume standards in hospitals regarding any outcomes. The certainty of evidence for mortality (in-hospital; 30 days) is very low and low for complications, reoperations and travel distance. The results are based on a relatively small number of studies for most outcomes. There is a need for studies researching the effects of minimum volume standards based on a robust study design. Prospero registration number: CRD42022318883.

Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Background: Telehealth technologies can enhance patients' and their families' access to high-quality resources in home-based palliative care. Nurses are deeply involved in delivering telehealth in home-based palliative care. However, no previous integrative systematic reviews have synthesized evidence on nurses' roles, facilitators, and barriers to implementing nurse-delivered telehealth in home-based palliative care. Objective: This integrative systematic review aimed to provide a comprehensive understanding of the roles of nurses and the multilevel facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care, which could inform future policy development, research, and clinical practice. Methods: This integrative systematic review was conducted using Joanna Briggs Institute methodological guidance. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We systematically searched articles published from January 1, 2014, to May 2024 in PubMed, Embase, Web of Science, CINAHL, and Cochrane Library. We included English-language; peer-reviewed; original; and qualitative, quantitative, and mixed methods studies that centered on nurse-delivered telehealth in home-based palliative care. We used the Mixed Methods Appraisal Tool to assess the quality of the included articles. Furthermore, 3 authors independently assessed eligibility, extracted data, and assessed the quality of articles. The entities to extract were identified by research questions of interest regardless of the type of study. We applied a convergent synthesis approach to integrate quantitative and qualitative data. Guided by the updated Consolidated Framework for Implementation Research (CFIR) 2.0, we synthesized the facilitators and barriers to implementing nurse-delivered telehealth in home-based palliative care. Results: This integrative systematic review identified 4819 unique articles, including 34 papers encompassing 29 unique primary research studies. Innovations were mainly delivered by nurses (n=8) and nurse-involved multiprofessional teams (n=18). The roles of nurses in telehealth home-based palliative care involve palliative care nurses, community nurses, nurse coordinators, nurse coaches or nurse navigators, and nurse case managers. Guided by CFIR 2.0, facilitators and barriers to implementing nurse-delivered, telehealth, home-based palliative care were identified to 6 implementation levels and 20 constructs. The key facilitators included the COVID-19 pandemic, cost avoidance to the health care system, engagement of patients and their family caregivers, and so on. The barriers included a lack of reimbursement and payment mechanisms, technical problems, insufficiently trained health care providers, and so on. Conclusions: This integrative systematic review synthesizes evidence on nurses' evolving roles in telehealth home-based palliative care and identifies multilevel facilitators and barriers to nurse-delivered, home-based palliative care implementation. With the empowerment of telehealth technologies, nurses could establish a stronger professional identity and develop leadership in home-based palliative care. Nurses should leverage influence to promote nursing practice, clinical management, and policy support in the implementation of telehealth home-based palliative care. Trial registration: PROSPERO CRD42024541038; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024541038.

Background: The oral health status of older people living in residential aged care facilities (RACFs) is found to be very poor. Many oral health promotion interventions have been tested in RACF settings around the world with varying degrees of success. Aim: The aim of this systematic review is to analyse the health promotion strategies used in oral health promotion interventions in RACF settings and map the behaviour change techniques (BCTs) used in interventions to the Behaviour Change Techniques Taxonomy Version 1 (BCTTV1). This will help us identify the BCTs that are used and how effective they are in improving oral health outcomes for residents and the knowledge, attitudes and skills of caregivers in providing mouth care assistance to residents of RACFs. Methods: A database search was conducted in MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), EMBASE, PsycINFO, CINAHL and Web of Sciences databases to screen for articles relevant to the topic of the review; after full-text review a total of 31 articles comprising both randomised controlled trials and non-randomised intervention studies were included in this review. Risks of bias in randomised studies were assessed using the ROB2 tool and ROBINS-I was used to evaluate non-randomised studies. The description of intervention content in each study was coded for the presence of BCTs by two independent review authors trained in coding BCTs according to BCTTv1. Results: The most commonly used BCTs were 'demonstration of behaviour', 'instruction on how to perform behaviour' and 'credible source'. These BCTs were effective in improving oral health outcomes and knowledge of caregivers on short-term follow-up. A higher number of BCTs were coded in studies that showed significant improvement in oral health outcomes of residents on long-term follow-up with rarely used BCTs related to 'monitoring and feedback' being coded in majority of studies that showed consistent improvement in oral health outcomes of residents. Conclusion: This review identified the most commonly used BCTs used in health promotion interventions to improve oral health among older people in RACFs and found that majority of interventions were targeted towards 'knowledge transfer' and were inconsistent in improving oral health outcomes for residents over long-term. Well conducted studies with use of theoretical behaviour change frameworks to develop oral health promotion interventions are needed as majority of strategies used currently do not demonstrate consistent effectiveness in improving oral health outcomes for residents of RACFs.

Background: Diet-related health inequalities are a persistent public health challenge in high-income countries, disproportionately affecting socially and economically disadvantaged populations. Objective: To map the existing evidence on diet-related health inequalities in high-income countries through a scoping review of observational studies, identifying populations most affected and key dietary outcomes across social determinants of health. Methods: We conducted a systematic search of MEDLINE, Web of Science, Scopus, and Embase for observational studies published between January 2011 and March 2021. Eligible studies assessed diet-related health outcomes stratified by at least one PROGRESS-Plus determinant. We followed PRISMA-ScR guidelines and registered the review with PROSPERO (CRD42021234567). Data were charted and analyzed thematically according to PROGRESS categories. Results: A total of 163 studies were included. Most studies focused on education, socioeconomic status, and place of residence, while fewer addressed gender identity, sexual orientation, or disability. Common dietary indicators included fruit and vegetable intake, dietary patterns, and food group consumption. Evidence consistently showed that lower education and income levels were associated with poorer dietary outcomes. Notably, certain population groups (e.g., ethnic minorities, rural residents, individuals with low education or income) experienced cumulative disadvantages. Conclusions: The scoping review highlights persistent and intersecting diet-related health inequalities in high-income countries. It underscores the need for standardized indicators and intersectional approaches in monitoring, research, and policy-making.

Objectives: Considering the growing inter of biobanks, artificial intelligence (AI) and omics research, and their critical impact on public health, this study aimed to explore the current and future public health implications and challenges of AI and omics-driven innovations in biobanking. Study design: Narrative literature review. Methods: A structured literature search was conducted in Scopus, PubMed, Web of Science and IEEExplore databases using relevant search terms. Additional references were identified through backward and forward citation chaining. Key themes were aggregated and analysed through thematic analysis. Results: Thirty-seven studies were selected for analysis, leading to the identification and categorisation of key developments. Several key technical, ethical and implementation challenges were also identified, including AI model selection, data accessibility, variability and quality issues, lack of robust and standardised validation methods, explainability, accountability, lack of transparency, algorithmic bias, privacy, security and fairness issues, and governance model selection. Based on these results, potential future scenarios of AI and omics integration in biobanking and their related public health implications were considered. Conclusions: While AI and omics-driven innovations in biobanking offer specific transformative public health benefits, addressing their technical, ethical and implementation challenges is crucial. Robust regulatory frameworks, feasible governance models, access to quality data, interdisciplinary collaboration, and transparent and validated AI systems are essential to maximise benefits and mitigate risks. Further research and policy development are needed to support the responsible integration of these technologies in biobanking and public health.

Background: Mobile health (mHealth) interventions promoting healthy lifestyle changes offer an adaptable and inexpensive method for accessing health information but require cultural appropriateness and suitability for acceptance and effectiveness in Indigenous populations. No systematic review on effective mHealth interventions for Indigenous women during pregnancy and the early childhood years has been conducted. Objective: This review evaluated the effectiveness of mHealth interventions promoting healthy behaviors for Indigenous mothers and children from conception to 5 years post partum. It also aimed to explore the observed effectiveness differences based on participant engagement, intervention design, and provision of context. Further, the review explored if the interventions were co-designed. Methods: A systematic search of 5 databases was conducted: SCOPUS, MEDLINE, CINAHL, PsycINFO, and ProQuest (Dissertation or Thesis). Studies were included if they were either a randomized controlled trial, pre-post comparison, or a cohort study using mHealth with Indigenous women for maternal and child health following a preregistered PROSPERO protocol (CRD42023395710). HealthInfoNet was searched for gray literature and the reference lists of included studies were hand searched. The initial title and abstract screen for eligibility were performed by 1 reviewer. A full-text screen of eligible studies and a quality appraisal of included studies was performed by 2 reviewers independently. The appraisal tools used were the Mixed Methods Quality Appraisal Tool and the Centre of Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE). A descriptive synthesis of the extracted data was performed. Results: Of the 663 articles screened, only 3 met the eligibility criteria. Each paper evaluated a different mHealth intervention: Remote Prenatal Education; the SMS Parent Action Intervention (two-way text messaging); and the Screening, Brief Intervention and Referral to Treatment (SBIRT) eCHECKUP To Go (web-based screening and intervention). Statistically significant changes were reported in some outcomes, including an increase in the parental participation rate in face-to-face prenatal education; increased rate of breastfeeding initiation and exclusive breastfeeding (2-12 months); improved overall children's behavior related to sleep, diet, physical activity, screen time, and intake of sugary beverages; improved individual children's behavior related to physical activity and sleep; and decrease in alcohol drinks per week and binge drinking episodes per 2 weeks due to time effect. However, no study provided a sample size calculation for the reported significant outcomes. Also, due to the small number of included studies and each study evaluating a different intervention, it was not possible to combine results to ascertain if the participant engagement, intervention design, or community context had any impact on the effectiveness. Conclusions: Due to the lack of sample size calculation, it was not possible to establish whether differences in the effectiveness were due to the interventions or a type I statistical error. Therefore, caution is required in the interpretation of these findings. Trial registration: PROSPERO CRD42023395710; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023395710.

The global rise in pharmaceutical production and consumption has led to an increase in pharmaceutical waste, posing significant risks to both public health and the environment. Improper disposal methods contribute to environmental degradation, including disruptions to aquatic ecosystems and the spread of antimicrobial resistance. Despite these growing concerns, a comprehensive review of pharmaceutical waste management and disposal practices is still lacking. To address this gap, a scoping review was conducted, analyzing 4269 records from three databases (Medline OVID, Web of Science, and Embase) and grey literature, with 67 studies ultimately included. The initial records were identified through a comprehensive search across the aforementioned databases using a structured strategy based on three core concepts: medication waste, disposal methods, and environmental or human health impacts. This was followed by a two-stage screening process guided by the PCC framework and predefined inclusion criteria. The review aims to assess disposal practices and their impacts, identify research gaps, and guide future research toward effective strategies for managing pharmaceutical waste while protecting ecological balance and public health. The publications timeline shows increasing interest in the topic, particularly with a surge in studies during 2022 and 2023. The findings reveal a significant regulatory gap, especially in the Global South, where limited infrastructure and public awareness lead to reliance on household waste disposal. In contrast, medication take-back programs are more common in the Global North. This disparity underscores the urgent need for policy development. Addressing pharmaceutical waste effectively requires coordinated efforts from the pharmaceutical industry, healthcare providers, regulatory bodies, and local communities. Key strategies should include regulatory action, public education, technological innovation, and addressing issues like drug misuse and overconsumption, particularly of antibiotics, which contribute to antimicrobial resistance. A holistic approach is essential to mitigate both environmental and public health risks.

Objectives: The rapid integration of artificial intelligence (AI) in healthcare requires robust legal safeguards to ensure safety, privacy and non-discrimination, crucial for maintaining trust. Yet, unaddressed differences in disciplinary perspectives and priorities risk impeding effective reform. This study uncovers convergences and divergences in disciplinary comprehension, prioritisation and proposed solutions to legal issues with health-AI, providing law and policymaking guidance. Methods: Employing a scoping review methodology, we searched MEDLINE (Ovid), EMBASE (Ovid), HeinOnline Law Journal Library, Index to Foreign Legal Periodicals (HeinOnline), Index to Legal Periodicals and Books (EBSCOhost), Web of Science (Core Collection), Scopus and IEEE Xplore, identifying legal issue discussions published, in English or French, from January 2012 to July 2021. Of 18 168 screened studies, 432 were included for data extraction and analysis. We mapped the legal concerns and solutions discussed by authors in medicine, law, nursing, pharmacy, other healthcare professions, public health, computer science and engineering, revealing where they agree and disagree in their understanding, prioritisation and response to legal concerns. Results: Critical disciplinary differences were evident in both the frequency and nature of discussions of legal issues and potential solutions. Notably, innovators in computer science and engineering exhibited minimal engagement with legal issues. Authors in law and medicine frequently contributed but prioritised different legal issues and proposed different solutions. Discussion and conclusion: Differing perspectives regarding law reform priorities and solutions jeopardise the progress of health AI development. We need inclusive, interdisciplinary dialogues concerning the risks and trade-offs associated with various solutions to ensure optimal law and policy reform.

Objective: By studying the Technology-Organization-Environment Framework (TOE), this research explores the impact of various indicators in technology, organization, and environment on the performance of family doctor services during major public health emergencies. It aims to identify the driving paths to improve performance. Methods: A stratified sampling of 34 community health service centers in Shanghai was conducted, using the comprehensive performance score of family doctors as the outcome variable. The Average Internet Medical Service Person-times and the Information Technology Expenditure per Thousand Population were considered as technology-related variables. The Fiscal Allocation per Thousand Population (/1,000), the Family Doctor Team Members per Thousand Population, and the Medical Social Workers and Volunteers per Thousand Population were identified as organization-related variables. The Proportion of Older Adult Population, Fiscal Allocation per Thousand Population, and the number of patient self-education organizations per thousand population were taken as environment-related variables. Fuzzy-set Qualitative Comparative Analysis (fsQCA) was employed to conduct necessity analysis, truth table analysis, and configurational analysis of antecedent conditions, with robustness tests performed by adjusting consistency thresholds and case frequencies. Results: The study found that the performance of family doctor services was influenced by multiple factors, with no single decisive factor. In overall communities, five configurations, including per capita fiscal allocation and community participation, affected performance, explaining 4.2% of the variance. In central urban areas, information technology expenditure and the Proportion of Older Adult Population were core conditions, influencing 27.5% of performance paths. In non-central urban areas, core conditions such as financial support and IT covered 53.9% of data cases. The fsQCA results, which were robustly tested, begin to provide a strong basis for resource allocation and policy formulation. Conclusion: This study begins to fill the gap in research on family doctor service performance during major public health emergencies, exploring the synergistic effects and causal asymmetry among multiple indicators such as technology, organization, and environment from a holistic, or configurational, perspective.

Background with Europe's demographic diversity growing due to immigration, understanding and addressing the barriers to healthcare experienced by immigrants is of paramount importance. However, an updated systematic review of the literature on this topic is missing. Methods we systematically searched the PubMed and Scopus databases to synthesise quantitative evidence regarding self-perceived barriers to healthcare access faced by immigrants in Europe. Peer-reviewed articles, written in English, published from 2011 onwards, studying adult populations not in detention centres were eligible for the review. Articles were charted according to the population of study, sample size, geographical area and level of study (local vs national), and applied methodology (descriptive vs inferential). Results linguistic and health literacy barriers emerge as the most prominent, and most studied, barriers to healthcare for immigrants. The extant literature covers disproportionally Northern European countries; often uses small sample sizes and convenience sampling; and is particularly limited as far as the undocumented population is concerned. Discussion policies should aim at increasing the availability of interpreters and healthcare materials translated in different languages, as well as at better training health professionals to address specific immigrants’ needs. We encourage future research to focus on healthcare barriers faced by immigrants in Southern and Central European contexts; to improve results’ robustness and external validity by using high quality sampling techniques and larger sample sizes, and including native populations as comparison groups; and to put more attention to the experience of undocumented immigrants, as they are the immigrant population with the most critical and precarious healthcare status.

Aims: The World Health Organization (WHO) Health Emergency Programme funded three systematic reviews to inform development of guidance for emergency preparedness in health emergencies. The current review investigated the type of learning interventions that have been developed and used during health emergencies, and how they were developed. Methods: We searched PubMed, CINAHL, Communication and Mass Media Complete (EBSCO), and Web of Science. Study quality was appraised by WHO-recommended method-specific checklists. Findings were extracted using a narrative summary approach. Results: 187 studies were included. Studies were split between online, in-person, and hybrid modalities, conducted mostly by hospitals and universities, and most frequently training nurses and doctors. Studies emphasized experiential learning to develop and reinforce skills; online learning for knowledge dissemination; multi-sectoral partnerships, institutional support and carefully constructed planning task forces, rapid training development and dissemination, and use of training models. Conclusion: It Most studies evaluated only knowledge or self-confidence of trainees. Relatively few assessed skills; evaluations of long-term outcomes were rare. Little evidence is available about comparative effectiveness of different approaches, or optimum frequency and length of training programming. Based on principles induced, six recommendations for future JIT training are presented.

Background: Knowledge translation (KT) interventions encompass a variety of activities, platforms, tools, approaches, and strategies designed to leverage research evidence to enhance health policy and practice. This study aims to review and synthesize existing evidence regarding the sources of evidence for KT, platforms and tools, and their opportunities and challenges in strengthening health policy and practice. Methods: A qualitative synthesis of the literature was conducted, adhering to scoping review guidelines. Relevant articles were identified through searches in seven databases (PubMed, Scopus, Embase, CINAHL, Cochrane, PsycINFO, and Web of Science) utilizing keywords combined with Boolean operators. Additional articles were searched in Google Scholar. The search included articles published globally up to July 30, 2023, and was restricted to English-language publications. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist was followed. Thematic analysis was performed, organizing emerging themes into four overarching categories: the source of evidence for KT, platforms and tools, opportunities, and challenges. Results: The final review included 64 articles. Several themes emerged in each category of analysis. For instance, the source of evidence for KT interventions was primarily derived from review-informed findings and tacit knowledge. KT interventions were facilitated through various platforms and tools, such as advisory committees, review and monitoring meetings, policy dialogues, frameworks, and digital tools including social media. Identified opportunities for KT included health system leadership, knowledge co-production, partnerships, organizational readiness, and evidence contextualization. Conversely, challenges included inadequate institutionalization of integrated approaches, organizational hierarchies, and fragmentation of KT efforts. Conclusions: This study synthesizes insights into the sources of knowledge, KT platforms, and institutional arrangements, as well as the opportunities and challenges associated with KT interventions. The synthesized knowledge, drawn from reviews and experiential learning, can serve as a valuable resource for KT, disseminated through diverse platforms. Collaborative partnerships among evidence producers, users, and knowledge brokers, supported by appropriate frameworks, are essential for enhancing KT and improving health policy and practice.

A critical component of Saudi Arabia's Vision 2030 reform agenda is its alignment with the Sustainable Development Goals (SDGs), particularly SDG 3, which is dedicated to the promotion of health and well-being for all. This narrative review offers a mid-term assessment of Saudi Arabia's progress in attaining these objectives, with a particular emphasis on the public health initiatives and comprehensive healthcare reforms that have been implemented as part of this vision. The Kingdom has accomplished substantial reductions in maternal and neonatal mortality rates, with skilled birth attendance reaching nearly universal levels. Saudi Arabia is a regional leader in the field of infectious diseases, having achieved the 95-95-95 HIV targets and significantly reduced the incidences of tuberculosis and malaria. Additionally, the rates of premature mortality from conditions such as cancer, diabetes, and cardiovascular diseases have decreased as a result of efforts to combat non-communicable diseases. Mental health services have been substantially expanded, which has resulted in one of the lowest suicide rates reported worldwide. Substantial investments have collectively improved the universality and quality of healthcare services in health infrastructure, such as the expansion of primary healthcare centers and the integration of digital health solutions, which have supported these health achievements. Saudi Arabia continues to confront persistent obstacles, including the management of the increase in non-communicable diseases, the mitigation of environmental health risks, and the reconciliation of healthcare access disparities, despite these accomplishments. The review recommends that the social determinants of health be addressed through a sustained commitment to cross-sectoral collaboration, enhanced data collection and utilization for health policy-making, and further integration of technology in healthcare delivery. This review not only emphasizes the Kingdom's successes but also the intricate challenges it has encountered, providing valuable insights into the strategic planning required to maintain health gains and achieve SDG 3 by 2030. Saudi Arabia's innovative approach and robust policy implementation serve as a model for the integration of health priorities into national development frameworks, thereby improving health outcomes and contributing to sustainable development.

Background: Health Impact Assessment (HIA) procedures can include the assessment of inequalities and inequities associated with the distribution of environmental health risks and benefits, aimed at attenuating the exacerbation of environmental health disparities. This systematic review, conducted as part of the Joint Action Prevent Non-Communicable Diseases initiative, explores methods for assessing health inequalities and equity within HIA frameworks, particularly in local projects affecting the distribution of environmental risks and benefits. Methods: Adhering to the PRISMA guidelines, a systematic review of the scientific literature was conducted using the MEDLINE/PubMed, Scopus, and Embase databases, searching until March 8, 2024. Furthermore, a grey literature analysis encompassed the Institutional Repository for Information Sharing (IRIS) of the World Health Organization, to identify guidelines and recommendations addressing equity considerations in HIAs. Studies were included based on predefined eligibility criteria if they explored issues related to inequalities, inequities, and vulnerabilities within the context of HIAs. Data extraction focused on methodologies that incorporated equity considerations within the HIA framework, particularly concerning local urban planning initiatives, transport infrastructure, and industrial settings. Results: A total of 33 studies met the inclusion criteria. Among these, eight documents from the grey literature, identified as guidelines and guidance, underscored the importance of prioritizing equity to ensure that health impacts are addressed fairly across diverse population groups. The remaining 25 peer-reviewed studies employed a combination of quantitative and qualitative methodologies. Quantitative approaches, including exposure-response modeling and Geographic Information System (GIS) mapping, were utilized to evaluate spatial and demographic health disparities. Qualitative methods, such as focus groups, interviews, and participatory tools, provided insights into the lived experiences of vulnerable populations affected by local interventions. Studies addressing urban and transportation planning predominantly emphasized socioeconomic stratification, whereas those focused on industrial settings highlighted occupational hazards and community vulnerabilities. Conclusion: This review highlights the diverse and fragmented approaches used to address health inequalities and equity in HIA. It underscores the need for interdisciplinary and systematic methodologies that integrate quantitative and qualitative perspectives, ensuring equity remains a central consideration in policymaking and project implementation. Finally, it proposes a practical framework for integrating equity into HIA.

Background: Sexual and reproductive health (SRH) programmes and services aim to prevent complications of pregnancy and childbirth, unintended pregnancies, unsafe abortions, complications caused by sexually transmitted infections, including HIV, sexual violence and impacts from avoidable cancer. Objective: To systematically identify published economic evaluations of SRH programmes and services, assess the methods used and analyse how costs and outcomes are estimated in these studies. Settings: Low- and middle-income countries. Design: Systematic review and narrative synthesis. Methods: Eight databases were searched, including EMBASE, MEDLINE, Scopus, Health Technology Assessment, Web of Science, PsycINFO, National Health Service Economic Evaluation Database (NHS EED) and African Journals Online (AJOL) from 1998 to December 2023. The inclusion and exclusion criteria were developed using the Population, Intervention, Comparator, Outcome and Study Design framework. The review included economic evaluations alongside randomised trials and economic studies with modelling components. Study characteristics, methods and results of economic evaluations were extracted and tabulated. The quality of the studies was assessed using the Consensus Health Economic Criteria list and Philips checklists for trial-based and model-based studies, respectively. The review followed the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the results were synthesised narratively in line with Centre for Reviews and Dissemination guidance. Results: 7575 studies were screened and categorised. 20 studies were included in the review. The studies assessed the cost-effectiveness and costs of SRH programmes and services from an individual, healthcare or societal perspective. The main SRH programme considered was contraceptive services. The main outcome measures reported were disability-adjusted life years, quality-adjusted life years, couple years of protection and pregnancies averted. Most of the studies did not indicate the costing approach used, and many of the studies evaluated direct medical costs only. Most of the study designs were model-based with significant heterogeneity between the models. The review showed that many studies did not fulfil all of the requirements for a high-quality economic evaluation. 1 out of the 20 studies reviewed considered equity. Conclusions: The review revealed heterogeneity in approaches to evaluating the costs and outcomes of SRH programmes. These methodological limitations may have implications for their use by public health decision-makers to inform optimal decision-making. Prospero registration number: CRD42023435241.

Background: Corporate wellness programs are increasingly using digital technologies to promote employee health. Digital wellness programs (DWPs) refer to initiatives that deliver health interventions through digital tools. Despite a growing body of evidence on DWPs, the literature remains fragmented across multiple health domains. Objective: This study aims to provide a comprehensive synthesis of existing research on the efficacy (eg, impact on employee's physical health, mental well-being, behavioral changes, and absenteeism) and acceptability (eg, engagement, perceived usefulness, and adoption) of employer-provided DWPs. Specifically, we aim to map the extent, range, and nature of research on this topic; summarize key findings; identify gaps; and facilitate knowledge dissemination. Methods: We conducted a meta-review of studies published between 2000 and 2023. We adopted a database-driven search approach, including the MEDLINE, PsycINFO, ProQuest Central, and Web of Science Core Collection databases. The inclusion criteria consisted of (1) review articles; (2) publications in English, French, or German; (3) studies reporting on digital health interventions implemented in organizations; (4) studies reporting on nonclinical or preclinical employee populations; and (5) studies assessing the efficacy and acceptability of employer-provided DWPs. We performed a descriptive numerical summary and thematic analysis of the included studies. Results: Out of 593 nonduplicate studies screened, 29 met the inclusion criteria. The most investigated health domains included mental health (n=19), physical activity (n=8), weight management (n=6), unhealthy behavior change (n=4), and sleep management (n=2). In total, 24 reviews focused on the efficacy of DWPs, primarily in relation to health-related outcomes (eg, stress and weight), while fewer reviews addressed organization-related outcomes (eg, burnout and absenteeism). Four reviews explored the mechanisms of action, and 3 assessed the acceptability of DWPs using various measures. Overall, the findings support the efficacy and acceptability of DWPs, although significant gaps persist, particularly regarding the durability of outcomes, the role of technology, and the causal mechanisms underlying behavioral change. Conclusions: While DWPs show promise across a variety of health domains, several aspects of their effectiveness remain underexplored. Practitioners should capitalize on existing evidence of successful DWPs while acknowledging the limitations in the literature.

Introduction: There is no recent consensus on the effectiveness of teledentistry versus in-person examination in the diagnosis of dental caries, especially after the COVID-19 pandemic. Objective: To assess the diagnostic accuracy of teledentistry versus in-person examination for dental caries diagnosis (PROSPERO #CRD42023410962). Methods: This systematic review and meta-analysis compared the effectiveness of teledentistry versus in-person examination for dental caries diagnosis. The eligibility criteria were peer-reviewed studies published in English between January 2013 and December 2021 that reported diagnostic parameters (specificity and sensitivity) for caries detection in primary and permanent dentition. Articles were extracted using search strategies from PubMed and CINAHL databases and screened using PRISMA-DTA guidelines, following a review for quality assessment and risk of bias using the QUADAS-2 and JBI Critical Appraisal Checklists. Meta-analysis was conducted in R using the MADA package. A descriptive analysis of the sensitivity, specificity, diagnostic odds ratio, and confidence intervals was performed with respective forest plots. Heterogeneity was assessed using Cochrane and Higgins's 2 tests. Univariate measures of diagnostic accuracy were performed based on the DerSimonian-Laird random effect and reported summary diagnostic odds ratios. Results: Twelve studies met the inclusion criteria and were reviewed and included in the meta-analysis. The diagnostic parameters ranged from 45.6% to 88.3% for sensitivity, 55.2% to 98.3% for specificity, 79% to 92% for positive predictive value, 48% to 97% for negative predictive value, and 70% to 96% for accuracy. The κ scores ranged from 0.46 to 0.89 for teledentistry modalities. Tests for equality of sensitivities and specificities were significant ( < 0.001). The studies were not heterogeneous with Cochran's : 14.502 ( = 0.206) and Higgins's 2 of 24%. The multivariable analysis showed a diagnostic odds ratio based on the DerSimonian-Laird random effect of 35.14, which indicates that the odds of caries detection via teledentistry is 35 times more true positive (i.e., correctly identifying a positive condition) than false positive. Conclusions: Diagnosis of caries via teledentistry is effective and comparable to in-person diagnosis. Remote assessments are consistent in diagnostic accuracy for caries.Knowledge Transfer Statement:This systematic review and meta-analysis added to the evidence about using teledentistry assessment as a diagnostically accurate tool to detect dental caries. Using teledentistry dental practices could promote greater access to dental and oral health care in the absence of in-person assessment.

Introduction: There is no recent consensus on the effectiveness of teledentistry versus in-person examination in the diagnosis of dental caries, especially after the COVID-19 pandemic. Objective: To assess the diagnostic accuracy of teledentistry versus in-person examination for dental caries diagnosis (PROSPERO #CRD42023410962). Methods: This systematic review and meta-analysis compared the effectiveness of teledentistry versus in-person examination for dental caries diagnosis. The eligibility criteria were peer-reviewed studies published in English between January 2013 and December 2021 that reported diagnostic parameters (specificity and sensitivity) for caries detection in primary and permanent dentition. Articles were extracted using search strategies from PubMed and CINAHL databases and screened using PRISMA-DTA guidelines, following a review for quality assessment and risk of bias using the QUADAS-2 and JBI Critical Appraisal Checklists. Meta-analysis was conducted in R using the MADA package. A descriptive analysis of the sensitivity, specificity, diagnostic odds ratio, and confidence intervals was performed with respective forest plots. Heterogeneity was assessed using Cochrane Q and Higgins's I(2 )tests. Univariate measures of diagnostic accuracy were performed based on the DerSimonian-Laird random effect and reported summary diagnostic odds ratios. Results: Twelve studies met the inclusion criteria and were reviewed and included in the meta-analysis. The diagnostic parameters ranged from 45.6% to 88.3% for sensitivity, 55.2% to 98.3% for specificity, 79% to 92% for positive predictive value, 48% to 97% for negative predictive value, and 70% to 96% for accuracy. The kappa scores ranged from 0.46 to 0.89 for teledentistry modalities. Tests for equality of sensitivities and specificities were significant (P < 0.001). The studies were not heterogeneous with Cochran's Q: 14.502 (P = 0.206) and Higgins's I-2 of 24%. The multivariable analysis showed a diagnostic odds ratio based on the DerSimonian-Laird random effect of 35.14, which indicates that the odds of caries detection via teledentistry is 35 times more true positive (i.e., correctly identifying a positive condition) than false positive. Conclusions: Diagnosis of caries via teledentistry is effective and comparable to in-person diagnosis. Remote assessments are consistent in diagnostic accuracy for caries. Knowledge Transfer Statement: This systematic review and meta-analysis added to the evidence about using teledentistry assessment as a diagnostically accurate tool to detect dental caries. Using teledentistry dental practices could promote greater access to dental and oral health care in the absence of in-person assessment.