A qualitative exploration of the early adoption of an electronic medical record system for type 1 diabetes management in Rwanda.

Background: Delivering adequate quality care remains a challenge in many low-and middle-income countries (LMICs), especially for people living with type 1 diabetes (T1D), requiring a complex treatment regimen. Digital health solutions, including electronic medical record (EMR) systems, have shown potential to improve delivery and quality of care but still require a successful implementation.

Objective: To analyze the adoption of a newly implemented EMR system in Rwanda from the perspectives of individuals with T1D, health care providers, and experts.

Establishing trust through home visits during pregnancy: a realist evaluation of a Danish breastfeeding support intervention.

Background: Breastfeeding has numerous health benefits but social inequality in breastfeeding is documented in many high-income countries. The evidence for improving breastfeeding support through prenatal encounters is conflicting, but points towards a mechanism activated through a positive relationship between the families and their health care providers. A Danish intervention included a home visit by a health visitor during pregnancy to prolong breastfeeding and reduce social inequality in its rates.

Refugee mothers' mental health in Denmark: possibilities and limits of home visiting programs.

Purpose: To explore the experiences of refugee mothers and community health nurses participating in a nurse home visiting program in Denmark, focusing on the program's effects on the psychosocial well-being of refugee mothers during the transition to motherhood.

Methods: The nurse home visiting program was an add-on the public care offered to all families, with extra training of the community health nurses and more time to engage with the families with immigrant and refugee backgrounds. Community health nurses (12) and participating women (9) participated in qualitative interviews between September and December 2020, following the program's conclusion.

The Development of an Electronic Medical Record System to Improve Quality of Care for Individuals With Type 1 Diabetes in Rwanda: Qualitative Study.

Background: Electronic medical record (EMR) systems have the potential to improve the quality of care and clinical outcomes for individuals with chronic and complex diseases. However, studies on the development and use of EMR systems for type 1 (T1) diabetes management in sub-Saharan Africa are few.

Objective: The aim of this study is to analyze the need for improvements in the care processes that can be facilitated by an EMR system and to develop an EMR system for increasing quality of care and clinical outcomes for individuals with T1 diabetes in Rwanda.

Strengthening health visitors' breastfeeding support: Results from a cluster randomised study.

Aims: To assess the effect of the education programme on three constructs of health visitors' breastfeeding support: knowledge, self-efficacy and action competence. Furthermore, the study aimed to confirm the factor structure of these three constructs.

Background: Health professionals are key in supporting breastfeeding women but studies report gaps in health professionals' breastfeeding support knowledge and competences.

Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings.

Ethnic disparities in stillbirth exist in Europe and suboptimal care due to miscommunication is one contributing cause. The MAMAACT intervention aimed to reduce ethnic disparity in stillbirth and newborns' health through improved management of pregnancy complications. The intervention encompassed training of antenatal care midwives in cultural competencies and intercultural communication combined with health education materials for the expecting parents about symptoms of pregnancy complications.

Qualitative Systematic Literature Review: Participatory Visual Methods in Community Health Interventions With Migrants.

This systematic review investigates how participatory visual methods (PVMs) (1) are applied in community health interventions (CHIs) with adult migrant populations and (2) identify potentials for participation. The search was performed in PubMed in 2021 and 2023. Eighteen articles fulfilled inclusion criteria as they investigated a CHI targeting migrants and used a visual method.

Improving health literacy responsiveness to reduce ethnic and social disparity in stillbirth and infant health: A cluster randomized controlled effectiveness trial of the MAMAACT intervention.

Objective: The MAMAACT intervention aims to reduce ethnic and social disparities in stillbirth and infant death by improving communication between pregnant women and midwives regarding warning signs of pregnancy complications. This study evaluates the effect of the intervention on pregnant women's health literacy (two domains from the Health Literacy Questionnaire) and complication management - interpreted as improved health literacy responsiveness among midwives.

Design: Cluster randomized controlled trial, 2018-2019.

Transnational prenatal care among migrant women from low-and-middle-income countries who gave birth in Montreal, Canada.

Objectives: There is little research examining transnational prenatal care (TPC) (i.e., prenatal care in more than one country) among migrant women.

Effectiveness of a community-based support programme to reduce social inequality in exclusive breastfeeding: study protocol for a cluster-randomised trial.

Background: Breastmilk is the ideal nutrition for infants, and breastfeeding protects infants and mothers from a range of adverse health outcomes. In Denmark, most mothers initiate breastfeeding but many cease within the first months resulting in just 14% reaching the World Health Organization recommendation of six months of exclusive breastfeeding. Furthermore, the low breastfeeding proportion at six months is characterised by a marked social inequality.

Evidence in public health: An integrated, multidisciplinary concept.

Aims: Traditionally, evidence in public health has been founded in health sciences using the hierarchy of evidence. In this Commentary, we argue that we need a combination of evidence based on a broad range of scientific disciplines and methodologies to best translate research into improved public health.

Methods: Using existing concepts of evidence such as the hierarchy of evidence and the evidence typology, we discuss their pitfalls in public health science and suggest a way forward.

Breastfeeding trajectories of young and short-term educated mothers and their partners; experiences of a journey facing tailwind and headwind.

Objective: To explore needs, experiences and socio-cultural context of young and short-term educated mothers and their partners affecting breastfeeding duration and self-efficacy during pregnancy and the first months following birth.

Design: A qualitative study was conducted using Malterud's method of Systematic Text Condensation.

Setting: Data collection took place in two rural regions in Denmark between October and December 2020.

Knowledge About How to Manage Warning Signs of Pregnancy Complications Among Immigrants and Their Descendants Compared to Women of Danish Origin.

Objectives: Ethnic differences in perinatal morbidity and mortality are starting points for social inequality in health. Increased incidence and severity of some pregnancy complications are found among immigrant women compared to ethnic majority women in high-income settings. However, little is known about immigrant women's assessment and management of warning signs.

Disparities in postpartum depression screening participation between immigrant and Danish-born women.

Background: Qualitative studies suggest that immigrant women experience barriers for postpartum depression (PPD) screening. This study examines the prevalence of participation in PPD screening in the universal home-visiting programme in Denmark, in relation to migrant status and its association with acculturation factors, such as length of residence and age at migration.

Methods: The sample consists of 77 694 births from 72 292 mothers (2015-18) that participated in the programme and were registered in the National Child Health Database.

A scoping review on the measurement of transnationalism in migrant health research in high-income countries.

Background: Migrants commonly maintain transnational ties as they relocate and settle in a new country. There is a growing body of research examining transnationalism and health. We sought to identify how transnationalism has been defined and operationalized in migrant health research in high income countries and to document which populations and health and well-being outcomes have been studied in relation to this concept.

Recommendations for ethnic equity in health: A Delphi study from Denmark.

Aims: A key issue in public health is how to approach ethnic inequities. Despite an increased focus on the health of people from ethnic minorities in the last 15 years, significant ethnic health inequities still exist in Denmark. These arise during pregnancy and are exacerbated by higher rates of exposure to health risks during the life course.

Understanding the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes: a realist evaluation.

Background: Despite an increasing use and positive effects of peer support interventions, little is known about how the outcomes are produced. Thus, it is essential not only to measure outcomes, but also to identify the mechanisms by which they are generated. Using a realist evaluation approach, we aimed to identify the mechanisms generating outcomes in a Danish peer support intervention for socially vulnerable people with type 2-diabetes (peers).

Implementation, Mechanisms and Context of the MAMAACT Intervention to Reduce Ethnic and Social Disparity in Stillbirth and Infant Health.

The MAMAACT intervention aimed to address ethnic and social disparity in stillbirth and infant health by improving management of pregnancy complications. This process evaluation of the intervention was guided by the British Medical Research Council's framework. We examined implementation through dose, reach, and fidelity, important mechanisms and the influence of contextual factors.

First perinatal psychiatric episode among refugee and family-reunified immigrant women compared to Danish-born women: a register-based study.

Purpose: This study aimed at examining psychiatric morbidity in the perinatal period among refugees and family-reunified immigrants compared to Danish-born women, including predictors of psychiatric morbidity according to migration history.

Methods: Inclusion criteria were women who had a residence permit in Denmark and gave birth to a live child between 1 April 1998 and 31 December 2014. The study included 7804 refugee women, 21,257 family-reunified women, and 245,865 Danish-born women.

Health literacy responsiveness: a cross-sectional study among pregnant women in Denmark.

Communication barriers in healthcare encounters contribute to ethnic inequality in health outcomes. This study aimed to examine, in a large national Danish sample of women, whether ethnicity was associated with pregnant women's Active engagement with healthcare providers. A cross-sectional survey of 1898 pregnant women attending 19 Danish maternity wards.

Social and ethnic disparities in stillbirth and infant death in Denmark, 2005-2016.

Ethnic disparity in stillbirth and infant death has been demonstrated in Europe. As the relation between migration and health change over time, this population based register study investigated the recent figures and explored if potential differences could be explained by the well-known educational and income inequalities in stillbirth and infant death using a novel approach. Stillbirth and infant mortality varied considerably according to country of origin, with only immigrants from China, Norway, and Poland having an overall lower risk than Danish women.

Implementing the MAMAACT intervention in Danish antenatal care: a qualitative study of non-Western immigrant women's and midwives' attitudes and experiences.

Introduction: Immigrant women have an increased risk of negative pregnancy and birth outcomes compared to women from European host populations. Similar trends are seen in Denmark, where especially some groups of non-Western immigrant women have an increased risk of stillbirth and infant mortality. This study reports on an implementation analysis of The MAMAACT Intervention, which was developed to increase midwives' and women's responses to pregnancy complications (trial registration number: NCT03751774).

Organisational barriers to implementing the MAMAACT intervention to improve maternity care for non-Western immigrant women: A qualitative evaluation.

Background: In Europe, the number of children born by non-Western immigrant women is rising and these women have an increased risk of negative pregnancy and birth outcomes, compared to the host populations. Several individual and system barriers are associated with immigrant women's access to maternity care. Scientific evaluations of interventions to enhance the health of immigrant women in the maternity setting are lacking, and there is a need for further development of the evidence base on how health care system initiatives may mitigate ethnic inequities in reproductive health.