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Study Type: Cross-sectional analysis of nationally representative survey data

Key Question: What are the patterns of and barriers to telehealth use among older adults in the US in the postpandemic period?

Key Findings:

• Only 31.4% of device-owning older adults used telehealth in 2024; video and phone-only use were near-equal (~12% each), suggesting no clear dominance of video modality
• Higher telehealth use was associated with Hispanic ethnicity (AOR 1.92), lung disease (AOR 2.32), and depression (AOR 1.89); non-metropolitan residence significantly reduced odds (AOR 0.36)
• Video specifically required higher income and independent app use; 45.7% of non-users preferred in-person care and 13.4% reported never being offered telehealth

Clinical Relevance: As NHS England expands remote consultation, these findings highlight equity risks for rural, lower-income, and digitally excluded older patients if audio-only options are deprioritised.

Limitations: US-specific, device-owning sample only, likely underestimating barriers among the most digitally excluded older adults.

Study Type: Pilot study (mixed methods, pre-post design; n=32)

Key Question: Can a peer-led, trauma-informed yoga-based group medical visit improve health outcomes in racially diverse patients with multiple chronic conditions in a safety-net setting?

Key Findings:

• Small pilot (n=32) across two cohorts reported reduced pain and increased sense of belonging following a 5–6 week intervention
• Qualitative themes identified included improved healing relationships and psychosocial wellbeing
• Specific effect sizes, confidence intervals, and quantitative metrics are not reported in the abstract

Clinical Relevance: For NHS clinicians developing culturally sensitive, low-cost group interventions for multimorbid patients in deprived or ethnically diverse populations, this model offers a co-production framework potentially applicable to link worker or social prescribing programmes.

Limitations: The very small sample (n=32), absence of a control group, and lack of reported quantitative effect sizes severely limit generalisability and preclude conclusions about clinical effectiveness.

Study Type: Qualitative multiple case study

Key Question: How do regional public behavioural health boards coordinate child welfare and substance use treatment systems to support parents with substance use disorder?

Key Findings:

• Boards supported cross-system alignment through four main mechanisms: funding, information brokering, relationship development, and strategic planning
• Board disengagement occurred where local stakeholders perceived them as unnecessary or poorly connected to the community
• Rural and Appalachian counties reported closer board–community integration, suggesting geography and resource scarcity may drive collaboration

Clinical Relevance: For UK public health teams managing integrated care system development — particularly across local authority children's services and NHS-commissioned substance use treatment — this highlights how a centralised coordinating body can reduce collaboration barriers, particularly in under-resourced or rural settings.

Limitations: US-specific governance structures (Ohio county boards) limit direct transferability to NHS/local authority commissioning arrangements in England.

Study Type: Retrospective cohort study (using matched implementation and survey data)

Key Question: Does cross-sector system alignment between Nurse-Family Partnership home visitors and community providers improve maternal behaviours and birth outcomes?

Key Findings:

• Stronger coordination with women's care providers was marginally associated with breastfeeding initiation (RR 1.010; 95% CI 1.00–1.02)
• Greater integration with mental health providers showed small positive associations with breastfeeding initiation and continuation at 6 months (RR 1.004; 95% CI 1.00–1.01)
• No significant association found between system alignment and prenatal smoking cessation, low birth weight, or preterm birth

Clinical Relevance: For NHS family nurse partnership commissioners, this suggests inter-agency integration may modestly support breastfeeding but is unlikely alone to shift harder perinatal outcomes.

Limitations: Effect sizes are extremely small and may not represent clinically meaningful differences at population level, limiting actionable conclusions.

Study Type: Qualitative study with participatory design methodology

Key Question: Can human-centred design (HCD) methods be used to develop an improved systems alignment model for newcomer health and well-being within a US federal resettlement coordination framework?

Key Findings:

• HCD across three iterative phases (inspiration, ideation, implementation) produced a prototype alignment model grounded in system mapping, incorporating meeting observations, focus groups, and key informant interviews
• The process identified structural barriers experienced by newcomers and capacity pressures on resettlement system partners
• The resulting model aims to reduce service duplication, address capacity shortages, and sustain collective impact

Clinical Relevance: For UK public health practitioners managing refugee and asylum-seeker health integration, this offers a transferable methodological framework for co-designing cross-agency coordination structures.

Limitations: The prototype model's real-world effectiveness is undemonstrated; no outcome data are presented, limiting conclusions beyond process design.

Study Type: Simulation modelling study

Key Question: Can novel financial mechanisms (specifically an "SDH bond") overcome market disincentives that discourage Medicaid managed care organisations from investing in social drivers of health?

Key Findings:

• The simulation demonstrates a "wrong-pocket problem": MCOs bear SDH investment costs but share benefits with competitors due to patient churn between plans, reducing financial returns below the no-investment baseline
• An SDH bond structure — raising external investor capital distributed across all participating MCOs — resolves this collective action problem by aligning costs and benefits
• Collective MCO participation in the bond mechanism improves both patient health outcomes and MCO profitability through downstream cost savings

Clinical Relevance: For UK public health clinicians, this provides theoretical grounding for why voluntary SDH investment by individual NHS commissioners or ICBs may be systematically underfunded, and supports the case for pooled or ring-fenced financing structures.

Limitations: Simulation outputs depend heavily on modelling assumptions and lack empirical validation in real-world health systems.

Study Type: Cohort study (repeated cross-sectional survey with social network analysis)

Key Question: Can bimodal social network analysis detect process changes in goal alignment and resource sharing within a place-based, multisector youth wellness initiative?

Key Findings:

• Social network clustering (resource sharing within clusters) increased over 9 months (C = 0.33 to 0.45), suggesting strengthening internal cohesion
• Idea alignment around youth wellness needs improved concurrent with planning activities, though overall network size did not grow
• Willingness to contribute to a pooled fund remained mixed, attributed to early implementation stage

Clinical Relevance: For UK public health teams implementing place-based approaches (e.g., Health Determinants Research Collaborations or Marmot Partnerships), this supports social network analysis as a feasible process evaluation tool to track partnership maturity and goal alignment.

Limitations: Single US locality (Pierce County, Washington) with a 9-month follow-up limits generalisability and causal inference about which YWZ activities drove observed changes.

Study Type: Qualitative study with network analysis

Key Question: What is the landscape of cardiovascular disease (CVD) prevention programmes in the Denver metropolitan area, and where are opportunities to strengthen health equity?

Key Findings:

• 89 programmes identified (82 active, 7 inactive) across 10 organisational types, mapped using a simulation model framework spanning clinical to regulatory levels
• Six health equity domains identified, including food insecurity, targeting low-income/minoritised groups, and industry regulation — suggesting equity integration is patchy rather than systematic
• Network gaps were visible across levels, with limited linkage between clinical and upstream determinant-focused interventions

Clinical Relevance: Mirrors NHS challenges in CVD prevention — particularly Core20PLUS5 priorities — where fragmented programme landscapes risk inequitable resource allocation; systems mapping methods could inform local JSNA or ICS CVD strategies.

Limitations: US urban context limits direct transferability; qualitative and network data rely on informant knowledge, risking incomplete programme capture.