Content area
Background
Cardiovascular disease (CVD) is one of the leading causes of premature death globally. CVD is expensive to treat and therefore carries a significant cost for public healthcare systems and the people in them. Those most likely to develop CVD often report co-occurring mental health concerns such as depression and anxiety, in addition to behavioural factors (e.g. physical inactivity) and physical health conditions (e.g. hypertension, high cholesterol, obesity and diabetes). Due to these inter-connecting issues, healthcare provision for CVD patients necessitates a joined-up care pathway providing holistic, person-centred support. Despite the rapid emergence and growth in attempts to deliver such care, evidence concerning how it is experienced and how to promote engagement is fragmented. This review aims to capture the experiences and factors that influence integrated care engagement, reported by adults with CVD risk factors and mild-to-moderate mental health concerns.
Methods
This systematic review protocol will be reported according to the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-P) guidelines. Proposed database searches will include Emcare, MEDLINE, PsycINFO (via OVID), CINAHL and preprint databases for grey literature. Articles of interest will include adults’ experiences of and factors that influence engagement with integrated care in the UK, specifically for support with CVD risk and mild-to-moderate mental health concerns. Any study design reporting qualitative primary data will be included (excluding conference abstracts). Data on study population (actors/targets), what they do (behaviours) care setting (context), care format (time) and participant experiences and perspectives will be extracted. Where appropriate, thematic synthesis of extracted data will be coded to the Theoretical Domains Framework (TDF), updated Consolidated Framework for Implementation Research (CFIR) and Action, Actor, Context, Target and Time (AACTT) framework.
Discussion
Findings from this review will provide foundation evidence for a behavioural systems map and recommendations for policymakers, commissioners and those involved or interested in integrated care for people at risk of CVD with mental health concerns. Such evidence can be used to develop future intervention strategies to assist the optimisation of integrated care.
Systematic review registration: PROSPERO (CRD42024554282.
Details
1 University College London, NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change (CBC), London, UK (GRID:grid.83440.3b) (ISNI:0000 0001 2190 1201)
2 University College London, NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change (CBC), London, UK (GRID:grid.83440.3b) (ISNI:0000 0001 2190 1201); University of Hertfordshire, Department of Psychology, Sport, and Geography, Hatfield, UK (GRID:grid.5846.f) (ISNI:0000 0001 2161 9644)
3 Population Health Sciences Institute, Newcastle University, NIHR Policy Research Unit in Behavioural and Social Sciences, Faculty of Medical Sciences, Newcastle Upon Tyne, UK (GRID:grid.1006.7) (ISNI:0000 0001 0462 7212)
4 University College London, NIHR Policy Research Unit in Behavioural and Social Sciences, Division of Psychiatry, London, UK (GRID:grid.83440.3b) (ISNI:0000 0001 2190 1201)
5 University of Warwick, NIHR Policy Research Unit in Behavioural and Social Sciences, Coventry, UK (GRID:grid.7372.1) (ISNI:0000 0000 8809 1613); Centre for Behavioral and Implementation Science Interventions (BISI), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore (GRID:grid.4280.e) (ISNI:0000 0001 2180 6431)
6 Population Health Sciences Institute, Newcastle University, NIHR Policy Research Unit in Behavioural and Social Sciences, Faculty of Medical Sciences, Newcastle Upon Tyne, UK (GRID:grid.1006.7) (ISNI:0000 0001 0462 7212); Heidelberg University, Division Public Health, Social and Preventive Medicine, Centre for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim , Mannheim, Germany (GRID:grid.7700.0) (ISNI:0000 0001 2190 4373)
7 Population Health Sciences Institute, Newcastle University, NIHR Policy Research Unit in Behavioural and Social Sciences, Faculty of Medical Sciences, Newcastle Upon Tyne, UK (GRID:grid.1006.7) (ISNI:0000 0001 0462 7212); University of Cambridge, NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Department of Public Health and Primary Care and Cambridge Public Health, Cambridge, UK (GRID:grid.5335.0) (ISNI:0000 0001 2188 5934)
8 University of Bedfordshire, NIHR Policy Research Unit in Behavioural and Social Sciences, Centre for Health, Wellbeing and Behaviour Change, Bedford, UK (GRID:grid.15034.33) (ISNI:0000 0000 9882 7057)
9 University College London, NIHR Policy Research Unit (PRU) in Behavioural and Social Sciences, Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change (CBC), London, UK (GRID:grid.83440.3b) (ISNI:0000 0001 2190 1201); University of Bedfordshire, NIHR Policy Research Unit in Behavioural and Social Sciences, Centre for Health, Wellbeing and Behaviour Change, Bedford, UK (GRID:grid.15034.33) (ISNI:0000 0000 9882 7057)