Background: Homelessness is a major problem that critically impacts the mental health and well-being of the affected individuals. This umbrella review aimed to evaluate the current evidence on the prevalence of mental disorders among homeless people from evidence-based systematic reviews and meta-analyses. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Joanna Briggs Institute (JBI) methodology for umbrella reviews. We searched 12 major databases and additional sources to identify systematically conducted reviews and meta-analyses reporting the prevalence of mental disorders among homeless populations. Results: We evaluated 1,277 citations and found 15 reviews meeting our criteria. Most studies were conducted among high-income countries with samples from different age groups. Studies reported high prevalence rates of depressive and anxiety disorders, schizophrenia spectrum and psychotic disorders, substance use disorders, suicidal behavior, bipolar and mood disorders, neurocognitive disorders and other mental disorders among homeless people. Moreover, studies also reported a high burden of co-occurring mental and physical health problems among the homeless experiencing mental disorders. Conclusion: This umbrella review synthesized the current evidence on the epidemiological burden of mental disorders in homelessness. This evidence necessitates advanced research to explore psychosocial and epidemiological correlates and adopt multipronged interventions to prevent, identify and treat mental disorders among homeless populations.

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Introduction: Homelessness is a major problem that critically impacts the mental health and wellbeing of the affected individuals. This umbrella review aimed to evaluate the current evidence on the prevalence of mental disorders among homeless people from evidence-based systematic reviews and meta-analyses.Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Joanna Briggs Institute (JBI) methodology for umbrella reviews. We searched 12 major databases and additional sources to identify systematically conducted reviews and meta-analyses reporting the prevalence of mental disorders among homeless populations.Results: We evaluated 1,277 citations and found 15 reviews meeting our criteria. Most studies were conducted among high-income countries with samples from different age groups. Studies reported high prevalence rates of depressive and anxiety disorders, schizophrenia spectrum and psychotic disorders, substance use disorders, suicidal behavior, bipolar and mood disorders, neurocognitive disorders, and other mental disorders among homeless people. Moreover, studies also reported a high burden of co-occurring mental and physical health problems among the homeless experiencing mental disorders.Conclusions: This umbrella review synthesized the current evidence on the epidemiological burden of mental disorders in homelessness. This evidence necessitates advanced research to explore psychosocial and epidemiological correlates and adopt multipronged interventions to prevent, identify, and treat mental disorders among homeless populations.

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Objective: Dating violence (DV) is a psychosocial problem which impacts the health and wellbeing of affected individuals. Many studies have reported a high prevalence and various determinants of DV; however, there is a gap of consolidated evidence on this problem. This umbrella review aimed to synthesize the current evidence on the prevalence and determinants of DV from systematic reviews and meta-analyses.Methods: We systematically searched ten major databases and additional sources to retrieve systematic reviews or meta-analyses reporting prevalence or determinants of DV, published as peer-reviewed journal articles in English language till October 13, 2019. We extracted and synthesized the findings, reported the prevalence of DV, and categorized the determinants of DV using the socioecological model.Results: We found 16 eligible systematic reviews and meta-analyses. Most of these studies were conducted in developed countries with a majority of adolescent and young adult participants. Studies reported varying prevalence of physical, sexual, psychological/emotional, and technology-assisted DV ranging from 0.1% to 57.5%, 0.1% to 64.6%, 4.2% to 97%, and 5.8% to 92%, respectively. The determinants of DV at different socioecological levels, including individual behavior, substance abuse, psychiatric conditions, experiencing violence and maltreatment; interpersonal factors like family and peer relationships; community and neighborhood characteristics; patriarchy, culture, and socioeconomic equalities were reported.Conclusions: These findings suggest a high burden of DV among young populations, who are vulnerable to various socioecological determinants of DV. Future research should examine how these factors influence DV and multi-level interventions should be adopted to address the same.

Background Alzheimer disease and Alzheimer disease–related dementia represent complex neuropathologies directly challenging individuals, their families, and communities in the United States. To support persons living with dementia, family or informal caregivers often encounter complex financial, psychological, and physical challenges. A widely used solution such as a consolidated web-based assistance or guidance platform is missing, compounding care challenges. Objective In preparation for designing an internet-based artificial intelligence–driven digital resource platform, a qualitative interview study was conducted to characterize the challenges and needs of family caregivers in the United States. Methods A semistructured interview topic guide in English was developed by engaging community partners and research partnerships. Family caregiver participants were purposefully recruited via various means, such as word of mouth, local dementia community service providers, digital recruitment emails, flyers, and social media. Interested individuals were first invited to complete an eligibility screening survey, and eligible individuals were then contacted to arrange a web-based in-depth interview via Zoom (Zoom Video Communications) from January 1, 2022, to May 31, 2022. A follow-up survey was administered in May 2022 to provide an overview of the participants’ demographics, socioeconomic characteristics, and caregiving information. Thematic analysis in a framework approach was used to identify and organize themes and the study findings. Results Following the prescreening of 150 eligible respondents, 20% (30/150) individuals completed both the interviews and follow-up survey, allowing for an in-depth look into the challenges, experiences, and expectations of primary caregivers of people living with dementia. Most participants (20/30, 67%) were primary caregivers of persons with dementia, and 93% (28/30) had provided care for at least a year. Most participants were aged >50 years (25/30, 83%), female (23/30, 77%), White (25/30, 83%), and non-Hispanic (27/30, 90%) and held a bachelor’s or graduate degree (22/30, 73%). Collectively, all participants acknowledged challenges in caring for people living with dementia. Thematic analyses elicited the challenges of caregiving related to functional care needs and financial and legal challenges. In addition, participants identified the need for an integrative digital platform where information could be supplied to foster education, share resources, and provide community support, enabling family caregivers to improve the quality of care and reducing caregiver burden. Conclusions This study emphasized the difficulties associated with the family caregiver role and the expectations and potential for a supportive web-based platform to mitigate current challenges within the caregiving role.

Background: Hypertension and related complications are major contributors to morbidity and mortality in Nepal. Community health workers have been proposed as promising health cadres to meet the growing healthcare demand for non-communicable disease management in other developing countries. Objective: We aimed to explore existing workflows, needs and challenges for hypertension care coordination and to assess the feasibility of establishing a Female Community Health Volunteer (FCHV)-based hypertension management program in Kavre, Nepal. Design: We conducted one focus group discussion with eight FCHVs and twenty-three in-depth interviews with four FCHVs not attending FGD, nine individuals with hypertension, six health workers, and four health officials in two village development committees of Kavre District, Nepal. Applied thematic analysis was performed using NVivo 12. Results: Health literacy related to hypertension was low among both community members and FCHVs. Delay in treatment initiation and loss to follow-up were common patterns despite anti-hypertensive medication compliance. Major health system-related barriers included underutilization of primary healthcare institutions, communication gaps and lack of grass-roots level educational campaigns. Community pharmacies, monthly health camps and increasing governmental attention to NCDs were favorable for improving hypertension management. This study also supports that FCHVs should be provided with adequate training and financial incentives to promote hypertension education, screening and referral in their catchments. Conclusions: Barriers and facilitators identified in this study provide important implications for future hypertension management in Nepal. We recommend hypertension education and screening across Nepal at a grass-root level through FCHVs. Providing professional training and proper financial incentives for FCHVs are warranted. Highlights: Health literacy related to hypertension was low among both community members and Female Community Health Volunteers in Nepal. Delay in treatment initiation and loss to follow-up were common despite relatively high anti-hypertensive medication compliance. Health system-related barriers in research sites included underutilization of primary healthcare institutions, communication gaps, and lack of grass-roots level educational campaigns. Female Community Health Volunteers should be provided with adequate training and financial incentives to promote hypertension management.

<p><b>Objective:</b> Dating violence (DV) is a psychosocial problem which impacts the health and wellbeing of affected individuals. Many studies have reported a high prevalence and various determinants of DV; however, there is a gap of consolidated evidence on this problem. This umbrella review aimed to synthesize the current evidence on the prevalence and determinants of DV from systematic reviews and meta-analyses.</p> <p><b>Methods:</b> We systematically searched ten major databases and additional sources to retrieve systematic reviews or meta-analyses reporting prevalence or determinants of DV, published as peer-reviewed journal articles in English language till October 13, 2019. We extracted and synthesized the findings, reported the prevalence of DV, and categorized the determinants of DV using the socioecological model.</p> <p><b>Results:</b> We found 16 eligible systematic reviews and meta-analyses. Most of these studies were conducted in developed countries with a majority of adolescent and young adult participants. Studies reported varying prevalence of physical, sexual, psychological/emotional, and technology-assisted DV ranging from 0.1% to 57.5%, 0.1% to 64.6%, 4.2% to 97%, and 5.8% to 92%, respectively. The determinants of DV at different socioecological levels, including individual behavior, substance abuse, psychiatric conditions, experiencing violence and maltreatment; interpersonal factors like family and peer relationships; community and neighborhood characteristics; patriarchy, culture, and socioeconomic equalities were reported.</p> <p><b>Conclusions</b>: These findings suggest a high burden of DV among young populations, who are vulnerable to various socioecological determinants of DV. Future research should examine how these factors influence DV and multi-level interventions should be adopted to address the same.</p>