Background: A recent National Institute on Drug Addiction Call to Action focused on expanding methadone treatment access for individuals with opioid use disorder (OUD). One research priority identified was optimal educational and support structures, including training to provide methadone across multiple healthcare settings (e.g., primary care, opioid treatment programs [OTPs], pharmacies) and healthcare workers (HCWs) (e.g., providers, pharmacists). This scoping review sought to better understand HCWs’ knowledge, attitudes, and stigma as it relates to methadone provision. Methods: Four databases (PubMed, PsycInfo, CINAHL, Web of Science) were searched for publications between 2010 and 2022 using keywords—methadone, HCW, outpatient setting, knowledge, attitudes, and stigma, focusing on HCWs in general and pharmacists specifically. Results: A total of 2,747 articles were identified and 14 met inclusion criteria for review. Settings included OTPs (n = 4), specialty addiction treatment clinics (n = 3), community pharmacies (n = 2), and multiple settings (n = 5). All articles (n = 14) examined methadone-related attitudes. Despite approval of methadone in 1972 to treat OUD, four articles illustrated continued methadone-related stigma held by HCWs. In response to COVID-19-related policy changes allowing methadone take-home flexibility, OTP clinicians expressed a range of attitudes concerning patient risk and potential program liability around diversion and misuse. One article assessing knowledge suggested that, even when most pharmacists correctly answered knowledge questions, a significant minority had misunderstandings that could undermine effective treatment. Conclusions: Given the current imbalance between methadone treatment demand and availability, there is a critical need to expand outpatient methadone services. Pharmacists partnering with OTPs represent a logical but underutilized access point. We identified key areas to improve HCWs methadone-related knowledge, attitudes, and stigma. Future research should explore the impact of outpatient pharmacy-OTP and other expansion services, and systematic training, education, and evaluation of methadone-related understanding, including assessment tools to measure knowledge, attitudes, and stigma.

Background: The Family Caregiver Medication Administration Hassle Scale (FCMAHS) assesses the stress experienced by family caregivers in managing daily medication regimens for older adults. However, its suitability for the Taiwanese healthcare context has not yet been established. Objective: To translate, cross-culturally adapt, and evaluate the reliability and validity of a Traditional Chinese version of the FCMAHS (FCMAHS-TC). Methods: A two-phase cross-sectional study was conducted. In Phase I, the FCMAHS was translated into Traditional Chinese. In Phase II, a convergent mixed-methods study was carried out with a convenience sample of 138 family caregivers who completed the FCMAHS-TC. In parallel, 12 of those participants were interviewed to explore their experiences with medication administration tasks and associated stress. Content validity was assessed using the content validity index (CVI), whereas reliability was evaluated through Cronbach’s alpha and intraclass correlation coefficients (ICCs). Exploratory factor analysis (EFA) was performed to investigate the FCMAHS-TC’s factor structure. Qualitative data from interviews were analyzed using content analysis to provide triangulated evidence of scale adaptability. Results: The FCMAHS-TC demonstrated strong internal consistency (Cronbach’s alpha = 0.94) and test-retest reliability (ICC = 0.78). Expert evaluation indicated strong content validity, with the item- and scale-CVI value reaching 1.0. The EFA identified four key factors: information seeking and sharing, scheduling logistics, medication filling and prescription management, and safety issues, accounting for 59.57% of the total variance. Qualitative findings supported the factor structure identified and further highlighted care coordination among caregivers as an additional challenge. Conclusion: The FCMAHS-TC is a valid and reliable tool for healthcare professionals in Taiwan to assess the challenges and stress associated with medication administration among family caregivers. Future research should explore social and demographic determinants of medication-related caregiving stress and develop targeted interventions to support caregivers in Taiwan.

Background: Care partners (CPs) are vital to supporting people living with dementia (PLWD) before, during and after hospitalization. Recruiting CPs for research is critical to developing effective, real‐world interventions, yet evidence from hospital settings remains scarce. This study highlights the challenges and lessons learned from ten months of recruiting CPs of PLWD for a hospital‐based pilot trial. Method: From April 2024 to January 2025, the study team conducted nine virtual meetings with hospital nurse champions and coordinators and five in‐person study team meetings to discuss study updates, recruitment challenges, and solutions. All meetings were video recorded, transcribed verbatim, and analyzed thematically using the Social Marketing Framework. Two researchers independently coded the data, with a third resolving discrepancies to achieve consensus. Data triangulation and member checking with nurse champions and coordinators ensured analytic rigor. Result: Our preliminary results identified 13 recruitment challenges across three domains (Table 1): identifying CPs, promoting and advertising the study, and communicating and collaborating as an academic‐health system team. To address these challenges, we implemented 20 solutions. The study team attended monthly hospital electronic health record office hours to improve familiarity with the patient chart system and took over screening tasks to reduce nurse champions’ time demand. Nurse champions were encouraged to contact CPs more frequently through in‐person check‐ins and phone calls, supporting CPs’ participation. Increasing study poster/flyer visibility, sharing study information during unit check‐ins and in‐service meetings, and offering incentives enhanced staff awareness and trust. Standardizing communication channels improved the study team's responsiveness to issues, minimized miscommunication, and reduced redundancy. As a result, the average enrollment rate surged to 33.4% between August 2024 and late‐January 2025, up from 1.9% between April and July 2024 (Figure 1). The monthly recruitment goal was met and exceeded in three of the six months, compared to none before implementation (Figure 2). Conclusion: Recruiting CPs in hospital settings is challenging, necessitating close collaboration with clinicians to navigate logistical and procedural complexities. Lessons learned from our study highlight challenges and implemented solutions led to a marked improvement in recruitment outcomes, offering valuable insights to enhance CP recruitment for research in similar environments.

Background: Recruiting care partners (CPs) of hospitalized people living with dementia is challenging due to rapid discharge timelines and complex inpatient workflows. This study identified barriers to CP recruitment encountered during the first year of a hospital-based randomized controlled trial and the strategies implemented in response to them. Methods: A qualitative descriptive study using thematic analysis of twelve study coordination and implementation meeting transcripts was conducted. Recruitment outcomes were examined to assess changes before and after implementation of the enhanced recruitment workflow. Results: Eight recruitment barriers were identified, including fragmented electronic health record (EHR) documentation, uncertainty in CP presence, limited clinician availability, passive study promotion, and inefficient clinical–research team collaboration. Nine strategies were developed and implemented in response to these barriers. The enhanced recruitment workflow was temporally associated with an increase in average monthly enrollment from 0.25 participants (April–July 2024) to 4 participants (August 2024–December 2025). Over the same periods, the cumulative enrollment rate was 3% and 23%, respectively. Conclusions: Care partner recruitment in inpatient settings is highly context-dependent and requires iterative, implementation-informed adaptation. Effective recruitment may be supported by embedding processes into routine inpatient workflows, clarifying recruitment roles, leveraging EHR-supported identification, and maintaining close clinical–research team collaboration to respond to the unpredictable presence of care partners and short discharge windows.

Public health nurses (PHNs) may be well positioned to address planetary health challenges through their clinical, population health, and community‐based roles, yet their contributions to planetary health practice remain understudied. This qualitative study used reflexive thematic analysis to examine PHNs’ roles, contributions, and capacities related to planetary health practice in public health departments. Semi‐structured interviews were conducted from October 2024 to February 2025 with 30 participants, including 13 PHNs, 11 public health leaders, and 6 community‐based organization representatives across 10 U.S. states. Participants described a spectrum of PHN engagement in planetary health work, ranging from active practice to unrealized capacity. Four interrelated themes described mutually reinforcing dimensions of PHN practice relevant to planetary health: ethical and justice‐oriented responsibility, trust‐based relational care, bridging clinical and population health, and translating environmental data into action and advocacy. Across participant groups, PHNs were described as trusted community partners able to integrate clinical insight with systems‐level public health action. These capacities were enacted to varying degrees across public health department contexts. Leadership support, workforce development, and organizational alignment may strengthen integration of these capacities into routine public health nursing practice.