Imperial College London

Dr Austen El-Osta

Faculty of MedicineSchool of Public Health

Primary Care Research Manager
 
 
 
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Contact

 

+44 (0)20 7594 7604a.el-osta Website

 
 
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Location

 

323Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Publication Type
Year
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85 results found

Filzmoser N, Kerr G, Webber I, Alaa A, El Asmar M, Karki M, Riboli E, El-Osta Aet al., 2024, Exploring the link between self-management of migraine and emotional wellbeing. A cross-sectional online survey of community- dwelling migraine sufferers, BMC Neurology, Vol: 24, ISSN: 1471-2377

Background:Globally, an estimated 14% of adults live with migraine disease which impacts their physical, emotional and social wellbeing. To target the disease comprehensively, research recommends a multidisciplinary approach to migraine management. Yet, at present, migraine management primarily centers around pharmaceutical treatments. The aim of this study was to investigate the extent to which emotional awareness could influence the uptake of self-care behaviours of community-dwelling adults with migraine.Methods:A cross-sectional online survey explored personal experiences with migraine disease and strategies or behaviours to manage migraine attacks. Chi-squared tests were used to investigate differences in ratings of migraine prevention and management strategies between users and non-users of the strategies. Univariable logistic regressions were used to assess the effectiveness of self-care behaviours to manage or prevent migraine attacks.Results:We surveyed 170 community-dwelling adults with migraine in the United Kingdom, Austria, Germany and the United States. Most (85%) respondents had experienced migraine for over five years, where 42% of attacks usually lasted several days. Whereas we did not differentiate between diagnosis by a neurologist or self-diagnosis, the most common diagnoses in the cohort were migraine without aura (38.9%) and migraine with aura (29%). Staying hydrated was the most popular preventative strategy (87%), 70.2% used prescription medication and 64.9% changed their diet and/or supplements. Almost all ( 92.4%) respondents stated that their mood or emotions could trigger their migraine attacks. Keeping a headache or mood diary was the lowest-rated prevention strategy and was rated as "probably ineffective" or causing "no change" in preventing migraine attacks. Over a third (39.7%) kept track of their physical wellbeing and symptoms. Reasons stated for tracking symptoms included to identify triggers (65.8%), show repor

Journal article

Eljack MMF, Elhadi YAM, Mahgoub EAA, Ahmed KAHM, Mohamed MTAA, Elnaiem W, Mohamedsharif A, Nour AB, Muhammed AEM, Gebril MSM, Asghar MS, El-Osta Aet al., 2023, Physician experiences with teleconsultations amidst conflict in Sudan, Scientific Reports, Vol: 13, ISSN: 2045-2322

The current conflict in Sudan severely hinders the accessibility of health services across the country. To address this, several initiatives were proposed including offering services using teleconsultations. This study aimed to assess Sudanese doctors' teleconsultation experience, perception, and concerns during the recent conflict. This cross-sectional survey focused on Sudanese medical officers, residents, specialists, and consultants living inside or outside the country having a practice license from the Sudan Medical Council and conducting teleconsultations with Sudanese patients during the conflict period. The questionnaire was distributed to personal and professional contacts and via social media platforms in the English language among doctors who provided teleconsultation during the conflict. Data analysis was performed using the Statistical Package for Social Sciences software version 26. The study enrolled 2463 clinicians from 17 different specialties, and females represented more than half the sample (56.8%). Internal medicine was the most frequent specialty (36.1%) and the majority (68.7%) of clinicians had less than 5 years of work experience. Voice call was the most frequent platform (50.1%) used for teleconsultation during the conflict and had the highest convenience score (p < 0.01), whereas messaging platforms had the lowest score. Most clinicians (73.3%) agreed that teleconsultations created a trusted patient-physician relationship and provided good-quality care (61.8%). However, 85.1% highlighted the importance of physical touch in medical practice. Clinicians were concerned that incomplete information (81.4%), missed diagnosis (76.8%), medicolegal problems (71.0%), and prescription errors (68.4%) could arise with teleconsultations. Most respondents (70.7%) emphasized the importance of continuing to offer teleconsultation even after the war abated. In conclusion, physicians who participated in the current study agreed tha

Journal article

Etukakapan A, Desireh G, Ekpotu P, El-Osta Aet al., 2023, Education and training needs of early career pharmacists in self-care: A focus on sore throat and gastrointestinal issues, Education and training needs of early career pharmacists in self-care: A focus on sore throat and gastrointestinal issues, Publisher: FIP, 5660

The World Health Organization defines self-care as the ability of individuals, families and communities to promote health, to prevent disease, to maintain health and to cope with illness and disability with or without the support of a healthcare provider.1 By this definition, self-care provides individuals with ample opportunities to actively participate in their healthcare. Recently, there has been a renewed focus on self-care as an integral part of primary healthcare.2 This revolution has been driven largely by an increase in consumerism in a more connected world and a sharp increase in the cost of healthcare globally.As the first point of contact for health- and medication-related inquiries, pharmacists are uniquely positioned in their communities to provide advice and support to the public regarding their medicines and health. This combination of medicines expertise and accessibility means that pharmacists are trusted healthcare providers and facilitators of self-care interventions. However, pharmacists may face barriers hindering their capability to support self-care services. These hindrances include reluctance to change and adopt new cognitive services even when provided in the right conditions, alongside insufficient knowledge or skill in self-care, which have been attributed to poor delivery of self-care support by pharmacists.3, 4 To mitigate the existing knowledge and skills gap, pharmacy practitioners need to be supported to acquire and advance knowledge and skills to support individuals with effective self-care interventions.With this background, FIP convened an insight board in September 2023 to both discuss and better understand the training and education needs of early career pharmacists in self-care with a focus on the management of sore throat and gastrointestinal issues. The meeting sought to explore early career pharmacists’ perspectives on the barriers and facilitators to supporting patients to self-manage sore throat and minor gastrointes

Report

Leyns C, Williems S, Powell R, Camacho V, Fabrega R, De Maeseneer J, Rawaf S, Mangtani P, El-Osta Aet al., 2023, From disease- to people-centred pandemic management: health equity through community organization, health information systems & community oriented primary care, International Journal for Equity in Health, Vol: 22, ISSN: 1475-9276

Background:The COVID-19 pandemic exposed the health equity gap between and within countries. Western countries were the first to receive vaccines and mortality was higher among socially deprived, minority and indigenous populations. Surprisingly, many sub-Saharan countries reported low excess mortalities. These countries share experiences with community organization and participation in health. The aim of this article was to analyse if and how this central role of people can promote a successful pandemic response.Methods:This analysis was partly based on local and national experiences shared during an international and Latin American conference on person-and people-centred care in 2021. Additionally, excess mortality data and pandemic control-relevant data, as well as literature on the pandemic response of countries with an unexpected low excess mortality were consulted.Results:Togo, Mongolia, Thailand and Kenya had a seven times lower mean excess mortality for 2020 and 2021 than the United States of America. More successful pandemic responses were observed in settings with experience in managing epidemics like Ebola and HIV, well-established community networks, a national philosophy of mutual aid, financial government assistance, more human resources for primary care and paid community health workers.Discussion:Since trust in authorities and health needs vary greatly, local strategies are needed to complement national and international pandemic responses. Three key levers were identified to promote locally-tailored pandemic management: well-organized communities, community-oriented primary care, and health information systems. An organized community structure stems from a shared ethical understanding of humanity as being interconnected with each other and the environment. This structure facilitates mutual aid and participation in decision making. Community-oriented primary care includes attention for collective community health and ways to improve health from its r

Journal article

Karki M, El-Asmar M-L, Riboli-Sasco E, El-Osta Aet al., 2023, Public libraries to promote public health and wellbeing: A cross-sectional study of community-dwelling adults, Publisher: Research Square

Purpose of research:To explore the potential of libraries as community hubs to promote mental and physical health and wellbeing.Design:Cross-sectional online survey and interview-based study with community-dwelling adults and library staff.Methods:We analysed data from 605 respondents using a 14-item electronic survey and conducted interviews with 12library users and staff to gauge perceptions. Descriptive statistics and thematic analysis were used to identifykey trends and emergent themes.Results:Libraries remain popular and are considered a'safe place' by members of the community, irrespective ofwhether they are frequent users of services. Library users' lack of awareness of community-facing servicescould act as a hurdle to improving community health and wellbeing. Targeted engagement with residents isneeded to increase awareness of libraries' services, including community interventions to help tackle loneliness and inequalities in digital and health literacy. Library staff often did not feel involved in important decision-making. Various barriers, drivers and practical recommendations were identied to leverage libraries as hubs to promote community health and wellbeing.Conclusion:Libraries already offer a variety of resources that either directly or indirectly support the health and wellbeing ofcommunity-dwelling adults and young people, but public awareness of these services is limited. As we navigatepostpandemic recovery, libraries can serve as platforms for community engagement, fostering resilience,mental health support, and reducing social isolation. Recognising libraries' untapped potential can lead tohealthier communities and improved wellbeing.

Working paper

Rothschild CW, Sedgh G, Brady M, Burke HM, Cover J, Cutherell A, El-Osta A, Holt K, Kumar D, Makumbi Fet al., 2023, Priority indicators for sexual and reproductive health self-care: recommendations from an expert working group, BMJ Sexual & Reproductive Health, Vol: 49, Pages: 315-316, ISSN: 2515-1991

Journal article

Tanna NK, Karki M, Webber I, Alaa A, El-Costa A, Blair Met al., 2023, Knowledge, attitudes, and practices associated with vitamin D supplementation: A cross-sectional online community survey of adults in the UK, PLoS One, ISSN: 1932-6203

OBJECTIVE: Assess knowledge, attitudes, and practices (KAPs) of a diverse population. Identify barriers and facilitators that inform routine vitamin D supplementation and self-care in the community setting. DESIGN: Cross-sectional online voluntary survey. Electronic survey link published on college Qualtrics platform and advertised widely. Study information provided with Participant Information Sheet. SETTING AND PARTICIPANTS: 556 community dwelling adults across the UK. METHODS: The overarching study included two phases, incorporating quantitative and qualitative methodologies. This paper reports findings from the first phase of the FABCOM-D (Facilitators and Barriers to Community (Healthy) Vitamin D status) study. Online survey questions were iteratively developed after background literature searches and piloted to ensure clarity and ease of understanding. Survey responses summarised using frequencies and percentages, and univariable and multivariable logistic regression models explored for any association. A p-value less than 0.05 was considered statistically significant. The Checklist for Reporting Results of Internet E-Surveys guided reporting. Statistical analysis performed using IBM SPSS software. MAIN OUTCOME MEASURES: Awareness of vitamin D information sources, health benefits and testing. Attitudes to supplementation, sun exposure and fortification. RESULTS: Three quarters of the community had some awareness of vitamin D and around half were taking supplements. The two most trusted sources of information included health professionals and the NHS website. Participants were willing to pay for supplements, supporting a self-care agenda. With increasing age, there was significant reduced intake of vitamin D supplements. This aspect needs to be explored further as this could be a concern in deficiency status in the elderly. There was acceptance of food fortification but uncertainty on how to balance food intake with supplementation. CONCLUSION: We were successf

Journal article

Elhadi YAM, Alrawa SS, Alfadul ESA, Mahgoub EAA, El-Osta A, Belal SA, Lucero-Prisno DE, El Dabbah NA, Yahia Aet al., 2023, Consanguinity and willingness to perform premarital genetic screening in Sudan, European Journal of Human Genetics, ISSN: 1018-4813

Consanguineous marriage is prevalent in certain world regions due to cultural, economic, and social reasons. However, it can lead to negative consequences including an increased risk of genetic disorders in offspring. Premarital genetic screening (PMGS) is an important tool to identify and manage these risks before marriage. This study aimed to assess the magnitude of consanguineous marriage, knowledge of genetic diseases and PMGS, and attitudes and willingness to perform PMGS in Sudan. A national household survey was conducted using a multistage sampling technique, with a sample size of 2272 participants. Data were collected from December 2022 to March 2023 using an interviewer-administered questionnaire. A significant proportion of respondents (364/850, 42.8%) were married to consanguineal partners, with various types of relatedness. Moreover, 32.1% (242/755) of single respondents were planning to marry a close relative, signifying the likely persistence of consanguineous marriages in Sudan. The level of knowledge regarding genetic diseases and PMGS was relatively low in many states of Sudan, indicating the need for increased awareness interventions. A significant number of participants (85.2%) agreed that premarital screening is effective in reducing genetic diseases, whereas 71.2% supported the introduction of a mandatory PMGS program. Excluding married participants, 82.3% (1265/1537) of respondents were willing to perform PMGS, if implemented. These findings reflect the public positive attitude towards introducing the PMGS program and policies in Sudan and underscore the importance of addressing the knowledge gap of PMGS before such a potential implementation.

Journal article

World Health Organization, El-Osta A, 2023, Self-care competency framework. Volume 3: curriculum guide for health and care workers to support people’s self-care, Publisher: World Health Organization

The curriculum guide is the third publication in the Self-care competency framework to support health and care workers.It is a resource for educational institutions and curriculum developers to develop competency-based education and training for health and care workers.

Report

Sivarajasingam V, Webber I, Karki M, El-Osta Aet al., 2023, Patient views on the routine use of a two-item screening tool for domestic abuse in general practice: a UK-based cross-sectional study, BJGP Research Conference, Publisher: Royal College of General Practitioners, ISSN: 0960-1643

Conference paper

World Health Organization, El-Osta A, 2023, Self-care competency framework. Volume 2: knowledge guide for health and care workers to support people’s self-care, Publisher: World Health Organization

The knowledge guide is the second publication in the Self-care competency framework to support health and care workers. This describes how health and care workers can apply each of the 10 competency standards in their work, detailing the necessary knowledge, skills and attitudes that underpin the required behaviours.

Report

World Health Organization, El-Osta A, 2023, Self-care competency framework. Volume 1: global competency standards for health and care workers to support people’s self-care, Publisher: World Health Organization

The standards define 10 key competencies for health and care workers to support self-care in their clinical practice as well as the specific, measurable behaviours that demonstrate those competencies, focusing on people-centredness; decision-making; effective communication; collaboration; evidence-informed practice, and personal conduct.

Report

Smith P, Alaa A, Roboli Sasco E, Bagkeris E, El-Osta Aet al., 2023, How has COVID-19 changed health and social care professionals' attitudes to self-care? A mixed methods research study, PLoS One, Vol: 18, Pages: 1-22, ISSN: 1932-6203

BackgroundThe COVID-19 pandemic fundamentally changed the way services are delivered. Self-care, including good hygiene practices and avoidance of risk was emphasised as the key measure to tackle the pandemic in the early stages.ObjectiveTo understand how self-reported professional attitudes, perceptions and practices of self-care have changed as a result of the COVID-19 pandemic.DesignCross-sectional online survey and semi-structured qualitative interview.SettingHealth care.Participants304 healthcare professionals (HCPs).MethodsA wide range of HCPs, including pharmacists, nurses, doctors, social prescribers and other designations took part in a 27-item anonymous online survey. Semi-structured qualitative interviews with nine healthcare professionals explored attitudes to and practices of self-care before and during the pandemic. Views were sought on the permanence and implications of changes. Data were analysed using routine statistics and thematic analysis to identify major themes.ResultsA total of 304 HCPs responded to the survey fully. Nine participated in a semi-structured interview. There was agreement that the importance of self-care has increased markedly during the pandemic. The percentage of respondents who felt that self-care was ’very’ important to their clients increased from 54.3% to 86.6% since the pandemic. Personal empowerment and capacity of service users to self-care increased significantly during the pandemic. Willingness of patients to engage (74%) and poor understanding of self-care (71%) were cited as the two main barriers to self-care. A close third was digital exclusion (71%), though 86% of respondents recommended online resources and 77% the use of smartphone apps. Survey respondents believed the changes to be permanent and positive. Interviewees reported a major, and positive move to self-care with the pandemic seen as an opportunity to be grasped, but professional education would have to be aligned to make the most of it. They

Journal article

Skinner D, Smith P, El-Osta A, 2023, Self-Care 2030: What does the future of health & wellbeing look like & how do we get there?

Self-care is the oldest & most widely practiced type of care, but it was nearly forgotten in the last three centuries with the rise of the surgery & biomedicine movement. Academicresearch on self-care had also stalled for decades. It is thanks to the advocacy & diligent work of the International Self-Care Foundation & the Self-Care Forum UK that self-care maintained a voice. The Self-Care Academic Research Unit (SCARU) at Imperial College London was established in 2017 as a tripartite collaboration between Imperial School of Public Health, ISF & SCF. To date, SCARU remains as the only university academic unit in the world dedicated to the study of self-care. Our mission is to make the absolute case for self-care. We will do this by ensuring self-care is everybody’s business.Shortly after the establishment of SCARU, interest in self-care exploded & in particular following the publication of WHO Guideline on Self-Care Interventions in 2019. We now have an extensive international network of self-care stakeholders, culminating in the United for Self-Care Coalition spearheaded by the Global Self-Care Federation in 2023. It’s an exciting time for self-care & this report is the first in a series that will be published to celebrate the Seven Pillars of Self-Care & International Self-Care Day 24/7 (24th July) which was established by ISF & is now celebrated worldwide.

Report

Huang D, Goodship A, Webber I, Alaa A, Riboli-Sasco E, Hayhoe B, El-Osta Aet al., 2023, Experience and severity of menopause symptoms and effects on health-seeking behaviours: a cross sectional online survey of community dwelling adults in the United Kingdom, BMC Women's Health, Vol: 23, Pages: 1-10, ISSN: 1472-6874

Background Almost all women will experience menopause, and the symptoms can have a severely detrimental impact on their quality of life. However, there is limited research exploringhealth-seeking behaviours and alternative service design or consultation formats. Group consultations have been successfully deployed in perinatal and diabetic care, improving accessibility and outcomes. This cross-sectional online survey was conducted to explore women’s personal experiences of menopause, including perspectives on group consultations. Methods An online survey investigated the experiences of individuals at all stages of menopause and their receptiveness towards group consultations for menopause. Respondents were categorised by menopause stage according to the STRAW +10 staging system. Associations between menopause stage, acceptability of group consultations and participant demographics were assessed using logistic regression. Results Respondents experienced an average of 10.7 menopausal symptoms, but only 47% of respondents felt they had the knowledge and tools to manage their symptoms. Advice on menopause was sought from a healthcare professional (HCP) by 61% of respondents, the largest trigger for this being severity of symptoms and the main barrier for this was the perception that menopause wasn’t a valid enough reason to seek help. Of the respondents seeking advice from HCP, 32% were prescribed transdermal HRT, 30% received oral HRT, 19% were offered antidepressants, 18% received local oestrogen and 6% were prescribed testosterone. Over three quarters (77%) of respondents indicated that they would join a group consultation for menopause and would be comfortable sharing their experiences with others (75%). Logistic regression indicated premenopausal respondents were 2.84 times more likely than postmenopausal women to be interested in a group consultation where they can meet or learn from others’ experiences.Conclusions This study highlighted a strong

Journal article

El-Osta A, Riboli-Sasco E, El Asmar ML, Karki M, Hayhoe B, Rowe C, Majeed Aet al., 2023, Back to the future: Self-Driven Healthcare 2030 Insights Report, Publisher: Self-Care Academic Research Unit (SCARU), Imperial College London

Self-care and Self-Driven Healthcare (SDH) have emerged as important strategies for addressing the burden of NCDs. While self-care refers to the actions that individuals can take to maintain and improve their own health (e.g., healthy eating, physical activity, etc.), Self-Driven Healthcare (SDH) is an umbrella term initially proposed by Innovate UK to conceptualise aspects of healthcare delivery that can support people in becoming more engaged in their own health and wellbeing management rather than being passive receivers of healthcare.The SDH approach involves individuals taking a more active role in managing their personal health and wellbeing journey, such as by using technology to monitor and track their health status and engaging with healthcare providers to make better-informed decisions about their care. Digital health technologies, such as wearable devices and mobile health apps, can help individuals monitor and track their health status, identify early warning signs of disease, and manage chronic conditions more effectively. For example, smartphone apps that track physical activity can help individuals set goals and monitor their progress towards meeting them, whereas patients with diabetes who use digital health tools to monitor and manage their condition are more likely to achieve better glycaemic control and have fewer hospitalisations than those who do not use these tools. Crucially, SDH also has the potential to address health disparities by democratising access to self-care interventions and improving access to healthcare for underserved populations. The development of cross-cutting SDH solutions presents a real opportunity for the UK to build and grow companies with a large international market, and to become a global leader in the SDH landscape and knowledge economy. To address this call to action from Innovate UK, Quantifique (QNTfQ) was established specifically to help unlock the potential of SDH by accelerating the development, adoption, and di

Report

El-Osta A, Riboli Sasco E, Barbanti E, Webber I, Alaa A, Karki M, El Asmar M, Almadi M, Massoud F, Alboksmaty A, Majeed Aet al., 2023, Tools for measuring individual self-care capability: a scoping review, BMC Public Health, Vol: 23, Pages: 1-31, ISSN: 1471-2458

BackgroundOur ability to self-care can play a crucial role in the prevention, management and rehabilitation of diverse conditions, including chronic non-communicable diseases. Various tools have been developed to support the measurement of self-care capabilities of healthy individuals, those experiencing everyday self-limiting conditions, or one or more multiple long-term conditions. We sought to characterise the various non-mono-disease specific self-care measurement tools for adults as such a review was lacking.ObjectiveThe aim of the review was to identify and characterise the various non-mono-disease specific self-care measurement tools for adults. Secondary objectives were to characterise these tools in terms of their content, structure and psychometric properties.DesignScoping review with content assessment.MethodsThe search was conducted in Embase, PubMed, PsycINFO and CINAHL databases using a variety of MeSH terms and keywords covering 1 January 1950 to 30 November 2022. Inclusion criteria included tools assessing health literacy, capability and/or performance of general health self-care practices and targeting adults. We excluded tools targeting self-care in the context of disease management only or indicated to a specific medical setting or theme. We used the Seven Pillars of Self-Care framework to inform the qualitative content assessment of each tool.ResultsWe screened 26,304 reports to identify 38 relevant tools which were described in 42 primary reference studies. Descriptive analysis highlighted a temporal shift in the overall emphasis from rehabilitation-focused to prevention-focused tools. The intended method of administration also transitioned from observe-and-interview style methods to the utilisation of self-reporting tools. Only five tools incorporated questions relevant to the seven pillars of self-care.ConclusionsVarious tools exist to measure individual self-care capability, but few consider assessing capability against all seven pillars of s

Journal article

Sivarajasingam V, Webber I, Riboli-Sasco E, Alaa A, El-Osta Aet al., 2023, Investigating public awareness, prevailing attitudes and perceptions towards domestic violence and abuse in the UK: a qualitative study, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 73, ISSN: 0960-1643

Journal article

El-Osta A, Riboli-Sasco E, 2023, Characterising extant technology related barriers & enablers for streamlined delivery of BP@home in North Central London: Report for NCL LTC Clinical Network, Publisher: Self-Care Academic Research Unit, Imperial College London

Report objectives:This report summarises the key findings of a place-based evaluation to identify barriers and enablers to the streamlined use of digital tools to support successfulimplementation of BP@home in North Central London (NCL). Specifically, we characterised the IT landscape in NCL, investigated the views and experiences of HCPs regarding the use of place-based IT solutions and processes, and synthesised a list of evidence-based recommendations for the consideration of NCL leadership team.Methods:We used a mixed methods research approach and six phases of investigation to address these aims, including desktop research, personal interviews and focusgroups, action research, data analysis, synthesis and reporting.Results:The evaluation showed that there was a lack of standardisation across IT systems, internal processes and templates in PCNs in NCL, leading to challenges inimplementing and using digital tools to support BP@home. These challenges were not unique to NCL. AccurX and the locally created NCL template are the most widely used IT tools to support the program in NCL. Other digital platforms being tested in NCL include Suvera, each with unique strengths and weaknesses. Other digital tools, such as Omron Connect, could be considered to support management of hypertension and other chronic conditions. HCPs faced challenges with patient engagement, data quality, IT system integration and resource allocation, but generally felt that the current approach works. Basic requirements for the use andadoption of IT tools and systems include adequate resources, stakeholder engagement, user-friendly interfaces, and interoperability between different systems. We proposed 16 actionable insights and recommendations that could be implemented to help improve the delivery of BP@home in NCL. These includestandardising IT systems, improving patient engagement, providing adequate training and support, and promoting the benefits of remote monitoring.Conclusion:On balance, we

Report

Riboli-Sasco E, El-Osta A, Alaa A, Webber I, Karki M, El Asmar ML, Purohit K, Painter A, Hayhoe Bet al., 2023, Triage and diagnostic accuracy of Online Symptom Checkers: a systematic review, Journal of Medical Internet Research, Vol: 25, Pages: 1-18, ISSN: 1438-8871

Background:In the context of a deepening global shortage of health workers and, in particular, the COVID-19 pandemic, there is growing international interest in, and use of, online symptom checkers (OSCs). However, the evidence surrounding the triage and diagnostic accuracy of these tools remains inconclusive.Objective:This systematic review aimed to summarize the existing peer-reviewed literature evaluating the triage accuracy (directing users to appropriate services based on their presenting symptoms) and diagnostic accuracy of OSCs aimed at lay users for general health concerns.Methods:Searches were conducted in MEDLINE, Embase, CINAHL, Health Management Information Consortium (HMIC), and Web of Science, as well as the citations of the studies selected for full-text screening. We included peer-reviewed studies published in English between January 1, 2010, and February 16, 2022, with a controlled and quantitative assessment of either or both triage and diagnostic accuracy of OSCs directed at lay users. We excluded tools supporting health care professionals, as well as disease- or specialty-specific OSCs. Screening and data extraction were carried out independently by 2 reviewers for each study. We performed a descriptive narrative synthesis.Results:A total of 21,296 studies were identified, of which 14 (0.07%) were included. The included studies used clinical vignettes, medical records, or direct input by patients. Of the 14 studies, 6 (43%) reported on triage and diagnostic accuracy, 7 (50%) focused on triage accuracy, and 1 (7%) focused on diagnostic accuracy. These outcomes were assessed based on the diagnostic and triage recommendations attached to the vignette in the case of vignette studies or on those provided by nurses or general practitioners, including through face-to-face and telephone consultations. Both diagnostic accuracy and triage accuracy varied greatly among OSCs. Overall diagnostic accuracy was deemed to be low and was almost always lower than t

Journal article

Thioye AT, Watt Rothchild C, Kumar D, Kingshott E, Whimkey K, Biswas P, Garcon S, El-Osta A, Mechael P, Hancock Het al., 2023, State of self-care report progress and potential of self-care: taking stock and looking ahead, Publisher: Population Services International

EXECUTIVE SUMMARYSelf-care interventions are among the most promisingand exciting new approaches to improve health andwell-being, placing people at the center of care andallowing individuals to be agents of their own healthSelf-care has the potential to reshape the way healthcare is delivered, and the ways in which individualsseek care Moreover, self-care holds the potentialto make healthcare more accessible, affordable,convenient, and equitable This is especially importantfor vulnerable populations who are often out of reachof, or underserved by, conventional health services. This report aims to take stock of the sexual andreproductive health (SRH) self-care field and documentits progress since the publication of the WHO Guideline.

Report

Manisha K, El-Asmar M, Riboli-Sasco E, Loombia P, Harland D, Neville R, El-Osta Aet al., 2023, What is the potential of public libraries to promote public mental health and wellbeing? Findings from a cross-sectional study of community-dwelling adults, Sage Open, ISSN: 2158-2440

Purpose of research:To explore the potential of libraries as community hubs to promote mental and physical health and wellbeing.Design:Cross-sectional online survey and interview-based study with community-dwelling adults and library staff.Methods:We analysed data from 58 respondents using a 14-item electronic survey and conducted interviews with 12 library users and staff to gauge perceptions. Descriptive statistics and thematic analysis were used to identify key trends and emergent themes.Results:Libraries remain popular and are considered a 'safe place' by members of thecommunity, irrespective of whether they are frequent users of services. Library users' lack of awareness of community-facing services could act as a hurdle to improving community health and wellbeing. Targeted engagement with residents is needed to increase awareness of the services libraries offer, including community interventions to help tackle loneliness and inequalities in digital and health literacy. Library staff often did not feel involved in important decision-making. Various barriers and drivers and practical recommendations were identified to leverage libraries as hubs to promotecommunity health and wellbeing.Conclusion:Libraries already offer a variety of resources that either directly or indirectly support the health and wellbeing of community-dwelling adults and young people, but public awareness of these services is limited. By acting as community hubs, libraries are ideally suited to deliver interventions to help tackle the increasing health and digital inequalities following the advent of the COVID-19 pandemic.

Journal article

El-Osta A, Smith P, Leyns CC, Steenfeldt-Foss OW, Webber Det al., 2023, Empowerment of Community Members, Person Centered Medicine, Editors: Mezzich, Appleyard, Glare, Snaedal, Wilson, Pages: 687-702

A significant aspect of Person Centered Medicine involves the empowerment of individuals and communities, recognizing them as actors and protagonists in the construction of their own health. Thus, the empowering of community members may be helpfully framed by the proper understanding of person-centered care. Core notions or principles of this approach posit whole contextualised persons as the centre of health and as the goal and protagonists of health actions. But what is the relevant context? In recent years, it has become clear that the persons’ health is intimately linked to their social situation and to the broader environment in which they live.Substantial attention is directed in this manuscript to the understanding and procedures related to self-care praxis, including the Seven Pillars of Self-Care, the Self-Care Continuum and the Self-Care Matrix. Some attention is given to the emerging concept of inter-care or mutual care, and its potential conceptual and policy implications.This chapter focuses on three contextual levels—firstly, whole contextualised individuals and the range of their activities and behaviours relevant to their health. Secondly considered is the social situation (family and community) and, thirdly, the broader environment (the health system and the green and built environment) and how these can affect the health of persons as individuals and communities. Everyone lives in some sort of community and environment, which may either empower and enrich or hinder their health. A person-centred approach should consider these broader contexts while focusing on the persons involved.The chapter concludes with a discussion on the social and economic impact of self-care and inter-care by the empowered individuals and community, and how such forms of care can be considered as fundamental acts of person-centeredness.

Book chapter

Imperial College London Self-Care Academic Research Unit SCARU, El-Osta A, 2023, Written evidence submitted by Imperial College London Self-Care Academic Research Unit (SCARU) (PHS0040): The UK should establish itself as the world leader in Self-Driven Healthcare to support the health and wellbeing of people from all walks of life and in various settings, Prevention in health and social care Inquiry, https://committees.parliament.uk/writtenevidence/117313/pdf/, Publisher: UK Parliament Committees

Report

El-Osta A, Riboli-Sasco E, Banarsee R, 2023, Identifying technology related barriers & enablers to streamlining delivery of BP@home in NCL, Publisher: The Self-Care Academic Research Unit (SCARU)

Report objectives:This report summarises the key findings of a place-based evaluation to identify barriers and enablers to the streamlined use of digital tools to support successfulimplementation of BP@home in North Central London (NCL). Specifically, we characterised the IT landscape in NCL, investigated the views and experiences ofHCPs regarding the use of place-based IT solutions and processes, and synthesised a list of evidence-based recommendations for the consideration of NCL leadership team.Methods:We used a mixed methods research approach and six phases of investigation to address these aims, including desktop research, personal interviews and focusgroups, action research, data analysis, synthesis and reporting.Results:The evaluation showed that there was a lack of standardisation across IT systems, internal processes and templates in PCNs in NCL, leading to challenges inimplementing and using digital tools to support P@home. These challenges were not unique to NCL. AccurX and the locally created NCL template are the most widelyused IT tools to support the program in NCL. Other digital platforms being tested in NCL include Suvera, each with unique strengths and weaknesses. Other digital tools,such as Omron Connect, could be considered to support management of hypertension and other chronic conditions. HCPs faced challenges with patient engagement, data quality, IT system integration and resource allocation, but generally felt that the currentapproach works. Basic requirements for the use and adoption of IT tools and systems include adequate resources, stakeholder engagement, user-friendly interfaces, and interoperability between different ystems. We proposed 16 actionable insights and recommendations that could be implemented to help improve the delivery of BP@home in NCL. These include standardising IT systems, improving patient engagement, providing adequate training and support, and promoting the benefits of remote monitoring.Conclusion:On balance, we rec

Report

Rothschild C, Sedgh G, El-Osta A, 2023, Sexual & reproductive health self-care measurement tool, Sexual & Reproductive Health Self-Care Measurement Tool, https://www.psi.org/project/self-care/sexual-reproductive-health-self-care-measurement-tool/, Publisher: Self-Care Trailbalzer Group, Frist Edition

The Sexual and Reproductive Health Self-Care Measurement Tool aims to provide a global standard approach to practical and accurate measurement of sexual and reproductive (SRH) self-care interventions, with a focus on three specific interventions: self-injectable hormonal contraception, HIV self-testing, and self-managed abortion. Led by the SCTG’s Evidence and Learning Working Group (ELWG), the SRH Self-Care Measurement Tool was developed through a consensus-driven process by a group of global experts, including academics, implementers, donors, and intergovernmental bodies, with the goal of identifying a minimum set of priority indicators for each of these self-care interventions.

Report

El-Osta A, Kerr G, Alaa A, Asmar MLE, Karki M, Webber I, Sasco ER, Blume G, Beecken W-D, Mummery Det al., 2023, Investigating self-reported efficacy of lifestyle medicine approaches to tackle erectile dysfunction: a cross-sectional eSurvey based study, BMC Urology, Vol: 23, Pages: 1-12, ISSN: 1471-2490

Background:Erectile dysfunction (ED) is the most common sexual dysfunction in men. Some types of ED are amenable to treatment using lifestyle medicine approaches with or without pharmacotherapy.Aim:Investigate self-reported efficacy of lifestyle medicine approaches to tackle ED.Methods:A cross-sectional online survey of 1177 community dwelling adults explored the prevalence and methods used to tackle ED in the community setting. We examined differences between participants with and without ED. Variables associated with ED in univariable analyses were included in a multivariable logistic regression to identify variables independently associated with the condition.Outcomes:Self-reported measure: perceived effectiveness of lifestyle medicine interventions to tackle ED.Results:Most respondents (76.5%) had experienced ED, and this was associated with having a long-term condition, taking anti-hypertensive medication, hypercholesterolaemia and obesity. Medication was the most common management strategy overall (65.9%), followed by stress management (43.5%) and weight loss (40.4%). Over half (53.9%) did not use any lifestyle modification strategies to tackle ED. Only 7.0% of ED sufferers received a mental health assessment and 29.2% received other tests (e.g., blood test, medical imaging) by GPs. Cardiovascular training was identified as the best rated strategy by its users (37.8%). Supplements (35.1%) and weight training/physical activity (32.6%) were also positively rated.Clinical implicationsStructured education to general practitioners and community dwelling adults about the impact of lifestyle behaviour modification and how this could influence the appearance or trajectory of ED could help improve personal choice when tackling ED.Strengths and limitations:To our knowledge, this is the first study to collect eSurvey responses from community dwelling adults to gauge their reliance and perceived effectiveness of lifestyle medicine approaches to tackle ED. The principal li

Journal article

Tanna N, Karki M, El-Osta A, Webber I, Alaa A, Blair Met al., 2023, Knowledge, attitudes and practices associated with Vitamin D supplementation: a cross-sectional online community survey of adults in the UK, Publisher: Public Library of Science (PLoS)

Working paper

Dallera G, Alaa A, Kreindler J, El Osta A, Harris Met al., 2022, Evaluating the feasibility and acceptability of a safety protocol to mitigate SARS-CoV-2 transmission risks when participating in full-capacity live mass events: a cross-sectional survey and interview-based study, BMJ Open, Vol: 12, ISSN: 2044-6055

Objective: Investigate the feasibility and acceptability of a novel COVID-19 safety protocol combining professionally witnessed home-based videoed pre-event testing and a data-driven risk assessment model that was piloted at the Standon Calling Festival in July 2021.Design: Observational study using a sequential explanatory mixed-methods design involving a survey, personal interviews and group discussions with a cross section of participants.Setting: Standon Calling Festival, Hertfordshire, England.Participants: 4726 adults who attended Standon Calling and consented to participate in the study.Results: Nearly a quarter (23.1%; 1093) attendees (women 65%, men 35%) responded to the postevent survey. Eleven participants were interviewed before thematic saturation was reached. The majority (81.0%) of respondents found the at-home testing protocol convenient and of reasonable cost (73.6%). Confidence in the test result was enhanced due to professional-supported videoing (76.2%), whereas 72.6% had confidence in the security of the data. Videoed self-testing helped 45.0% of respondents to feel more confident in their lateral flow testing technique. The majority (85.5%) felt safer at the event and 93.7% agreed that the protocol did not interfere with their enjoyment of the event. Themes generated from interviews showed that the protocol could be applied to other disease areas and events, but there were concerns that over-reliance on test results alone could lead some people to have a false sense of security around the safety of the live event.Conclusions: Our study showed that a protocol that combines professionally witnessed home-based videoed pre-event testing is highly acceptable and feasible, and it can inform decision making and support the safe reopening of live mass events at full capacity. Although COVID-19 is now considered endemic in the UK, this protocol can be of value for other countries where the live events industry remains heavily impacted. Risk modelling sh

Journal article

El-Osta A, Rowe C, Majeed A, 2022, Developing a shared definition of Self-Driven Healthcare to enhance the current healthcare delivery paradigm

Self-Driven Healthcare (SDH) is an umbrella term introduced by Innovate UK to conceptualise aspects of healthcare delivery that can support people in becoming more engaged in their own health and wellbeing management rather than being passive receivers of healthcare. The defining characteristics of SDH solutions include activities that empower people to play a more effective role in maintaining their own health and wellbeing, including those activities concerned with primary prevention and health promotion (e.g., to detect diseases earlier and proactively collaborate with a growing range of healthcare professionals to manage their illnesses). Innovate UK is interested in developing thought leadership around the emergent concept of SDH, and to determine if this is an area it should in invest in. The commentary introduces the concept of SDH and discusses the possible challenges and barriers that need to be addressed to realise the full potential of this approach.

Journal article

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