搜索结果：Religious studies

Family violence is a complex phenomenon that manifests in diverse ways within households. Cultural values and norms of a community, specifically religious affiliation can also influence the relationships and the ways in which family violence can manifest. In our study, we explore family violence (adverse childhood experiences (ACEs), in-law abuse, physical and emotional sibling violence (PESV), intimate partner violence (IPV) among South Asians in the United States. Because of the gaps in previous research, the goal of this study was to explore the relationship between various forms of family violence or violent experiences (PESV, ACEs, IPV and in-law abuse) in South Asian households and the relationship to religious affiliation. To examine these relationships, we utilized survey data (N = 974) from a larger sample of South Asians collected on Reddit. We ran descriptive statistics, chi-squares, independent samples T-tests, and a logistic regression to examine the correlates of religious affiliation. All variables showed a significant relationship at the bivariate level with religious affiliation. Independent samples t-tests showed significant differences between religious and non-religious groups specifically about the experiences of violence (IPV, in-law abuse). Finally, the logistic regression model was also statistically significant with generation status, education, household income, ACEs as correlates. To our knowledge this is the first study to develop new evidence regarding these unique forms of family violence (ACEs, IPV, PESV, in-law abuse) and the relationship with religious affiliation, using a community sample. The study findings have important implications to develop culturally responsive interventions for South Asians.

Religious minority communities face distinctive healthcare barriers during public health crises, yet the communicative mechanisms underlying these barriers remain underexplored. Applying Communication Ecology Theory, this study examines barriers to healthcare access in Israel's Haredi (ultra-Orthodox) community during the COVID-19 pandemic, conceptualizing healthcare inequality as a function of bounded communication ecologies rather than individual non-compliance, with implications for health equity in culturally and religiously diverse societies. A qualitative study was conducted using semi-structured interviews with 30 Haredi community members and analysis of 20 pashkevils (religious street posters) circulated during the pandemic. The Haredi community experienced infection and mortality rates substantially higher than the national average during COVID-19. Both data sources were analyzed thematically, guided by Communication Ecology Theory. Three interconnected barriers emerged: (1) internal versus external-secular communication-reliance on community channels that conveyed partial or misleading health information; (2) rabbinic versus professional authority-prioritization of rabbinic rulings over medical guidance; and (3) religious versus scientific interpretation-viewing the pandemic as divine punishment requiring spiritual rather than medical responses. Healthcare barriers in the Haredi community reflect bounded communication ecologies where information legitimacy depends on alignment with religious authority and theological worldviews. Effective public health engagement requires culturally adapted strategies that operate within existing communication systems, collaborate with rabbinic leadership, and address both informational and structural barriers, thereby advancing health equity in religious minority populations. These findings are relevant for understanding healthcare barriers among religious minorities worldwide.

Religious leaders are trusted in Bangladesh and can promote maternal and child health (MCH)in underserved communities. We assessed the population-level impact of a national training program for religious leaders on knowledge, attitudes, practices, and behaviors (KAPB) related to antenatal care (ANC), facility-delivery, and essential newborn care (ENC). We conducted repeated cross-sectional household surveys among imams, female religious-school teachers, and parents of children aged 0-2 years in 17 clusters across eight districts in Bangladesh at baseline (2019, n = 3,808) and endline following the training program (2021, n = 3,746). Standardized questionnaires captured domain-specific KAPB indicators. Multivariable logistic regression compared endline with baseline, adjusting for age, sex, education, and occupation. Baseline and endline groups were socio-demographically similar, with small differences in education. Compared with baseline, endline participants showed about two-fold increase in ANC knowledge (aOR 2.3, 95% CI 2.1-2.6), positive attitudes (aOR 1.5, 95% CI 1.4-1.6), and reported ANC use (aOR 2.3, 95% CI 2.1-2.6). Knowledge of home-delivery risks increased markedly (aOR 11.9, 95% CI 9.5-14.9), alongside modest improvements in facility-delivery (aOR 1.5, 95% CI 1.4-1.6). Knowledge of essential newborn care improved greatly (aOR 8.9, 95% CI 7.8-10.1), with better early breastfeeding and bathing practices (aOR 1.8, 95% CI 1.7-2.0). Religious leaders also reported sharing health messages more frequently at endline. Despite being a quasi-experimental study that limits causal inference, training religious leaders was found to be associated with improved community knowledge and practices across the MCH care continuum. Findings suggests that integrating such engagement into national health communication platforms may enhance coverage in underserved settings. A key limitation of this study is its quasi-experimental design, which limits causal inference, and the reliance on self-reported outcomes, which may be subject to recall and social desirability bias.

Background: Spirituality and religious diversity are increasingly recognized as essential components of holistic nursing care in global healthcare systems. However, their integration into undergraduate nursing education remains heterogeneous and often insufficiently structured, creating a gap between professional values and students' preparedness to address spiritual needs in culturally diverse clinical environments. This study aimed to explore nursing students' perceptions, attitudes, and perceived competencies regarding spirituality, religion, and spiritual care. Methods: A descriptive exploratory survey was conducted on a sample of 69 third-year nursing students (69.6% female; majority aged ≤24 years) enrolled in two universities in Rome, Italy. Data were collected between May and July 2025 using the Nursing Care and Religious Diversity Scale (NCRDS), consisting of 31 items. Statistical analyses included descriptive statistics, internal reliability analyses, group comparisons, and multivariate regression models. Results: Students showed moderate levels of attention to patients' spiritual needs (mean = 3.11, SD = 0.88) and integration of spirituality into care practice, while high importance was attributed to spiritual care skills. University education was perceived as only partially adequate. Multivariate analyses showed that students' personal spirituality is positively associated with the assessment of spiritual needs and the perception of competence, while exposure to contexts characterized by greater religious diversity is associated with a lower perception of preparedness. Conclusions: The results highlight a discrepancy between professional values and perceived operational skills, suggesting the need to systematically integrate spirituality and religious diversity into nursing curricula. These findings highlight the need for a structured integration of spirituality and religious diversity into nursing curricula through targeted educational strategies in order to strengthen students' competencies and promote truly holistic and person-centered care.

Religiosity and spirituality are central to the lives of Filipinos, yet limited research has examined their role in well-being. Although traditionally viewed as distinct constructs, religiosity and spirituality are deeply intertwined among Filipinos, with religious practice serving as a pathway for cultivating spiritual experience. Given the established role of spiritual experience in well-being, daily spiritual experience may represent a key mechanism through which religious practice translates into greater life satisfaction, yet research directly examining this mediating pathway remains limited. A further concern is that widely used spirituality measures, including the Daily Spiritual Experience Scale (DSES; Underwood and Teresi, Annals of Behavioral Medicine 24:22-33, 2002), have been criticized for containing items that overlap with mental and social health outcomes, raising tautological questions about observed associations. The present study addressed both concerns. A theistic 5-item version of the DSES was validated among Filipino Catholics and demonstrated superior psychometric fit over the full 13-item version. Using this validated measure, the study examined whether private religious practices predict life satisfaction and whether daily spiritual experience mediates this relationship in a sample of 1,189 Filipino Catholics (Mage = 18.86, SD = 4.67). Results showed that private religious practices positively predicted life satisfaction, with daily spiritual experience serving as a significant mediator. These findings suggest that private religious practices enhance life satisfaction by fostering an experiential sense of closeness to God that is distinct from general psychological well-being, while also providing a psychometrically robust measure of theistic spirituality for future research among the Filipino faithful.

Given the centrality of religious beliefs in shaping nonaffirming perceptions of marginalized gender identities, this exploratory qualitative study sought to interview Christian religious leaders with the hope of better supporting family therapists and families in developing affirming and celebratory views of transgender and nonbinary identities. Nineteen religious leaders from mainly diverse Mainline Christian Protestant traditions were interviewed. Queer theory-informed thematic analysis revealed four themes that reflect insights in fostering more affirming and inclusive beliefs about transgender and nonbinary people: (1) discuss the misuse and appropriate use of religious theology, (2) be present with people, (3) educate through resources and the humanization of transgender and nonbinary people, and (4) be a living example of affirmation. Implications for family therapists are discussed.

Natural disasters not only cause material losses but also profoundly impact the psychological world of affected individuals, particularly their core belief systems. This study innovatively proposes the subjective perceptual concept of social capital sense, expanding the limitations of traditional objective measurements of social capital. Focusing on residents in the earthquake-stricken area of Shigatse, Tibet, China, on January 7, 2025, this research explores the dual relationships between core beliefs changes and emotion regulation. The study examines the relationships between core beliefs changes and post-traumatic growth, core beliefs changes and social capital sense, post-traumatic growth and emotion regulation, and social capital sense and emotion regulation, as well as the moderating role of individuals' religiousness orientation. A two-stage questionnaire survey was conducted with 553 affected residents, and structural equation modeling was employed for analysis. The findings reveal that core beliefs changes are significantly positively correlated with post-traumatic growth, and post-traumatic growth is significantly positively correlated with emotion regulation. Core beliefs changes are significantly negatively correlated with social capital sense, while social capital sense is significantly positively correlated with emotion regulation. Religiousness orientation moderates both the relationship between beliefs changes and post traumatic growth and the relationship between core beliefs changes and social capital sense. Among individuals with high religious orientation, the positive relationship between core beliefs changes and post-traumatic growth is stronger, and the negative relationship with social capital sense is weaker. This study provides a theoretical basis for post-disaster psychological interventions, suggesting that differentiated strategies based on the psychological dimensions of affected residents can promote more effective psychological recovery.

This study explored how Muslim clients experience the minimisation or exclusion of religion in therapy and identified their recommendations for making therapeutic practice more inclusive of faith. A qualitative design using reflexive thematic analysis was employed to examine participants' lived experiences and meaning-making processes. Semi-structured interviews were conducted with 25 Muslim adults in the UK who had received therapy in both NHS and private settings. Data were analysed inductively to capture individual and systemic influences shaping the minimisation or exclusion of religion in therapy. Two overarching themes were developed: perceived barriers to discussing religion in therapy reflected therapists' limited confidence and knowledge, secular service frameworks and participants' resulting self-censorship. Recommendations for facilitating religious inclusion captured participants' calls for faith-sensitive competence, proactive engagement with religion in therapy and organisational change to legitimise faith within professional practice. Excluding religion risks marginalising clients' core identities and undermining therapeutic safety and ultimately compromising the effectiveness of treatment. Embedding religious competence within training, supervision and service policy is vital to ensure therapy is culturally responsive, ethically grounded and genuinely inclusive for clients of faith.

Religious service attendance is associated with better well-being, but observational associations do not establish causation. We analyse six annual waves of the New Zealand Attitudes and Values Study () to estimate causal effects of monthly attendance on 24 well-being indicators using target trial emulation. Deterministic 'make everyone attend' contrasts fail positivity: only 2-3% of non-attenders initiate attendance per year. We therefore estimate supported stochastic interventions () among baseline non-attenders () using a sequentially doubly robust estimator with cross-validated machine learning. Effects are selective: small gains appear in meaning and purpose, forgiveness, and sexual satisfaction, with little movement in somatic health, psychological distress, social belonging, or perceived social support. A comparison exposure (+1 hour per week socialising with others) does not reproduce the pattern. We interpret the selective pattern through a prominent cooperative account of religion: gains concentrate in coordination-relevant domains rather than in direct health pathways.

Medical students are exposed to human suffering more frequently and intensely than before they began their training, but they are often not sufficiently educated for these experiences. To our knowledge, perspectives of suffering among medical students have never been explored or classified. We aimed to measure and describe the philosophical and religious views of human suffering among medical students. First- through fourth-year medical students at a midwestern medical school were asked to complete an anonymous survey about their views of suffering using the Views of Suffering Scale. Information regarding student demographics, specialty interests, previous experiences, raised religious identities, and current religious identities were collected and evaluated against ten subscales common to specific religious and non-religious groups. Students identifying with a religious tradition tended to endorse suffering perspectives consistent with that tradition, while atheist and agnostic students were more likely to endorse Random and Unorthodox perspectives. Compared to preclinical medical students, clinical students reported higher scores for the subscales of Limited Knowledge, Providence, and Soul-Building. Students differed in suffering perspectives, especially by religious identity and preclinical and clinical cohorts. This study provides a foundation to further explore beliefs about suffering among healthcare trainees and how these beliefs may influence patient care and student resilience. The online version contains supplementary material available at 10.1186/s13010-026-00219-0.

This study assessed pregnant women's awareness and attitudes toward umbilical cord blood donation and banking, and identified independent factors associated with awareness. This study was conducted in Gaziantep Province, Turkey, between March and June 2025, using a descriptive, cross-sectional design involving 204 pregnant women. Participants were recruited using a non-probability convenience sampling method. Data were collected via an online questionnaire that assessed socio-demographic characteristics and knowledge and attitudes towards umbilical cord blood donation and banking. Awareness levels were categorized as "no knowledge", "limited knowledge", and "sufficient knowledge", and dichotomized as "insufficient" versus "partial/sufficient" for regression analysis. Descriptive statistics and the Chi-square test were used to analyze the data. In addition to descriptive statistics, binary logistic regression analysis was performed to identify independent factors associated with awareness of umbilical cord blood donation and banking. Statistical significance was set at p&#x2009;<&#x2009;0.05. The average age of the pregnant women was 30.38&#x2009;&#xb1;&#x2009;4.48. Only 3.9% had sufficient knowledge about UCB donation and banking, while the majority (96.1%) had never received any information about UCB donation, and none had ever donated before. The main reason for not donating was a lack of information (89.7%). The income and education level of the pregnant women were significantly associated with their knowledge and attitudes towards UCB donation and banking (p&#x2009;<&#x2009;0.05). A family history of disease positively influenced knowledge and attitudes (p&#x2009;<&#x2009;0.05), whereas religious beliefs negatively influenced donation intentions. Again, most pregnant women (79.9%) stated that they wanted to receive education about UCB donation and banking. Binary logistic regression analysis identified education level as the strongest independent predictor of awareness. In light of these findings, education on UCB donation and banking should be included in prenatal care processes. Involving women, families, and communities in awareness-raising initiatives can increase knowledge and participation in donation programmes.

This qualitative literature review examines Somali perceptions of mental health and illness in Western Europe, focusing on how cultural, religious, and biomedical frameworks intersect to shape experiences and help-seeking behaviors. Using a narrative literature review, we analyzed 11 qualitative studies from Scandinavia and Western Europe. Findings indicate that Somalis communities understand mental health primarily through cultural and religious perspectives. The relationship with God is considered crucial, while recognizing external factors such as war and migration that can affect mental health. Somalis conceptualize mental health along a continuum, often using culturally specific idioms of distress rather than biomedical diagnoses. Shame, stigma, and fear of discrimination within and outside Somali communities present significant barriers to seeking mental health care. Additionally, the challenges of migration, acculturation, and cultural differences with healthcare systems further complicate access to support. The discussion emphasizes the importance of cross-cultural competence in clinical care and identifies gaps in research, particularly regarding second-generation Somali immigrants and their evolving mental health narratives. Additionally, there is a need for qualitative data to better understand the perceptions and experiences of young second-generation Danish-Norwegian-Somali individuals regarding worries of the mind and their approaches to seeking help. Future studies should explore how generational differences influence mental health perceptions and help-seeking behaviors. Future studies must address these gaps to inform culturally responsive interventions for Somali communities in Europe.

Suicide remains a critical public health issue in Hungary, a country with historically high suicide rates. This study investigates the relationship between regional religious affiliation and suicide mortality from 2000 to 2022, shedding light on the influence of social and cultural factors in suicide prevention. Data were sourced from the national population register and the three most recent censuses. We applied quantile and gamma regressions to explore the associations between age-standardised suicide rates and the age-standardised incidence rates of religious affiliation across regions, reflecting the religious composition. Our findings confirm a continued nationwide decline in suicide mortality, yet regional variations persist, particularly in relation to religious affiliation. Suicide rates were significantly lower in regions with higher proportions of Roman Catholics (p&#x2009;=&#x2009;0.008) and higher in areas with a greater percentage of non-religious individuals (p&#x2009;=&#x2009;0.007). These trends held steady before and during the COVID-19 pandemic. Notably, the geographic distribution of Catholics and suicide rates displayed opposing patterns across Hungary's eight statistical regions. These results, based on robust census data, suggest that Catholic affiliation may have a protective effect against suicide, potentially through enhanced social cohesion and community support. Understanding these regional patterns can inform more targeted mental health interventions and highlight the critical role of social and cultural factors in suicide prevention.

Cancer-related pain is a prevalent and debilitating symptom that significantly impairs patients' quality of life, leading to physical discomfort as well as emotional and psychological distress. Despite the availability of effective pain control strategies, cancer pain remains inadequately managed worldwide. This challenge is multifactorial, involving barriers related to patients, healthcare providers, healthcare systems, and deficiencies in coordinated multidisciplinary care. This systematic review followed the PRISMA 2020 guidelines and was registered with PROSPERO (CRD420251027582). A comprehensive search of SCOPUS, PubMed, MEDLINE, EMBASE, ScienceDirect, the Cochrane Library, and Google Scholar was conducted for studies published between 2015 and 2025. Qualitative, quantitative, and mixed-methods studies examining barriers to cancer pain management from patient and healthcare professional perspectives were included. Study quality was assessed using the Newcastle-Ottawa Scale, and findings were synthesized narratively. A total of 244 records were identified, with 23 studies meeting the inclusion criteria after screening and eligibility assessment. Overall methodological quality was good, although most studies were cross-sectional. Four major categories of barriers were identified: patient-related, healthcare provider-related, healthcare system-related, and multidisciplinary care-related barriers. Patient-related barriers were most frequently reported fear of opioid addiction, concerns about side effects, under-reporting of pain, fatalistic beliefs, and cultural or religious influences. Provider-related barriers involved inadequate training, poor pain assessment practices, opioid-related concerns, and limited inter-professional communication. System-level barriers included restrictive opioid regulations, limited access to analgesics, staffing shortages, and lack of standardized protocols. Multidisciplinary barriers reflected poor care coordination, insufficient patient education, and lack of individualized pain management plans. Cancer pain management is hindered by interconnected barriers across patient, provider, and system levels. Addressing these challenges requires improved clinical practices, targeted professional education, balanced opioid policies, and strengthened multidisciplinary collaboration to enhance patient outcomes and quality of life.

Decision-making surrounding cardiopulmonary resuscitation (CPR) presents persistent ethical challenges in acute and critical care. Existing evidence points to ambiguous do-not-resuscitate pathways, moral distress, family-driven demands, and systemic pressures, yet these influences are often examined separately. This review synthesizes current evidence to clarify the ethical, relational, and organizational dynamics that influence CPR-related decisions. We conducted a structured narrative review of four databases (Web of Science, PubMed, Scopus, Embase) for studies published between 2020 and 2025. Eligible studies included. Data was analyzed using reflexive thematic analysis. Twenty-two studies were included. Seven interrelated themes emerged: (1) Futility, inappropriate and symbolic CPR; (2) Moral distress, emotional burden and moral residue; (3) Ethical ambiguity and unclear decision pathways; (4) Hierarchy, power and constrained nursing moral agency; (5) Family influence, cultural and religious norms, and truth-telling practices; (6) Systemic, legal and organizational drivers of ethically problematic practice; and (7) Ethical competence, moral sensitivity, advocacy and ethics support. Together, these findings informed the development of an Ethical Pathways Model (EPM) that conceptually depicts how contextual, relational, and individual determinants may converge to shape ethical decision trajectories in resuscitation and how conflicted pathways may contribute to symbolic or non-beneficial CPR and clinician moral distress. Ethical challenges in resuscitation are largely system-produced rather than individual failings. The EPM offers an integrative conceptual framework that may help inform clearer policies, strengthen communication, and guide the development of accessible ethics support to promote more value-concordant resuscitation care and reduce clinician moral distress.

Discrete choice experiments (DCEs) are widely used in healthcare to estimate willingness-to-pay (WTP) but may be affected by hypothetical bias (HB), especially in morally sensitive contexts. While cheap-talk is proposed as a mitigation strategy, its effectiveness in health-related DCEs involving moral trade-offs remains unclear. This study examines how cheap-talk influences WTP in such settings. A split-sample DCE on organ transplantation policies was conducted, involving trade-offs between cost and morally salient outcomes: saving lives ("being alive") and improving quality of life ("having a life"). Respondents (N&#x202f;=&#x202f;651) were randomly assigned to one of three survey arms: control (no manipulation), cheap-talk, or cheap-talk with follow-up question. Multinomial logit model in WTP space with a Taboo Trade-off Aversion (TTOA) specification was used to estimate treatment effects and interactions with religiosity. Exposure to the cheap-talk script reduced WTP for saving lives, indicating increased attention to financial considerations. WTP for quality-of-life improvements and avoiding taboo trade-offs remained unchanged. Religious respondents reported higher WTP to avoid taboo trade-offs in the control arm, but this gap disappeared under cheap-talk, showing that deliberation moderates monetary expressions among religious individuals without altering underlying convictions. Cheap-talk promotes more reflective decision-making in morally sensitive health-related choices, particularly among individuals with strong moral or religious convictions. It reduces elevated WTP for taboo trade-offs, while its effect on other respondents is limited. Future research should combine stated and revealed preference data and explore models that account for non-compensatory moral decision rules to better capture complex moral preferences DCEs.

Male ritual circumcision (MRC) and female genital mutilation (FGM) are traditional practices involving irreversible modification of the genitalia, deeply embedded in cultural and religious contexts but subject to radically different medico-legal and ethical evaluations. While MRC is generally tolerated or regulated within European legal systems as an expression of religious freedom, FGM is universally condemned as a serious violation of human rights. This paper examines whether a meaningful medico-legal comparison between these two practices is possible. A narrative, non-systematic review was conducted, drawing on historical sources, forensic and medical literature, bioethical analyses, and European legal frameworks. The comparison focuses on consent, parental authority, assessment of harm, protection of bodily integrity, and the role of cultural and religious justification. Despite significant differences in extent of injury, health consequences, and intent, both MRC and FGM are performed on minors incapable of providing informed consent and result in permanent bodily alteration. The medico-legal tolerance of MRC is largely grounded in its perceived proportionality of harm, potential health benefits, and cultural recognition, whereas FGM is characterized by intrinsic harm, lack of medical benefit, and its function in controlling female sexuality. The divergent legal treatment reflects not only objective assessments of medical risk but also normative and political choices regarding which cultural practices are deemed compatible with fundamental rights. The comparison between MRC and FGM exposes a persistent asymmetry in medico-legal and ethical standards applied to non-consensual genital modification of minors. While FGM remains rightly subject to absolute prohibition, MRC continues to challenge the coherence of child-protection principles in pluralistic societies. Greater emphasis on bodily integrity, proportionality, and the possibility of deferring non-therapeutic interventions until personal autonomy can be exercised is needed to reconcile cultural freedom with the paramount interest of the child.

This study investigated the relationship between parents perceptions of children's values in Indonesian families, focusing on economic, social, emotional, and religious dimensions. The investigation was based on background factors, such as gender, location of residence, and education level, as well as correlations and regressions between dimensions of children's values. The study participants consisted of 255 parents living in various urban and rural areas in Indonesia. Data were collected using the Children's Values Scale adapted for the Indonesian context. The study findings showed that there were no significant differences in children's perceptions of values based on gender or education level. However, there were significant differences based on location of residence, especially on economic and religious dimensions. Pearson correlation analysis revealed a significant positive relationship between social and emotional dimensions, while a negative relationship was found between economic and emotional dimensions in some contexts. The results of multiple linear regression analysis using the Stepwise method showed that economic and religious dimensions had a significant impact on overall family relationship patterns. This study highlights the importance of understanding the factors that influence parents' perceptions of children's values to support effective and harmonious parenting in Indonesian families.

Vaccination is a critical public health intervention in humanitarian and low- and middle-income country (LMIC) settings, where populations face heightened risks of vaccine-preventable diseases. Community Engagement (CE) offers a pathway to address challenges related to local ownership, trust, and acceptance, yet its effectiveness in these contexts remain underexplored. We conducted an umbrella scoping review of published reviews to synthesise evidence on the role of CE in vaccination delivery in humanitarian and LMIC contexts. Reviews were identified through searches of PubMed, Web of Science, Embase, and Google Scholar, screened in Covidence, and appraised using the Database of Abstracts of Reviews of Effects (DARE) criteria. Data were mapped against the International Federation of the Red Cross and Red Crescent Societies (IFRC) CE Impact Framework. Of 303 deduplicated studies, 39 met inclusion criteria. Most focused on routine childhood vaccines. CE activities were widespread, typically involving community participation, two-way communication, capacity strengthening, and feedback mechanisms. CE interventions were consistently associated with improved vaccine uptake, reduced hesitancy, and enhanced trust. Effective strategies included co-management of campaigns, engagement of religious and community leaders, culturally tailored communication, and school- or home-based delivery supported by trusted local figures. Multi-component interventions combining education, outreach, and digital tools were particularly effective. However, considerable variability existed in how CE was defined and operationalised across studies. CE should be recognised as a core pillar of vaccination strategy rather than an optional addition. It builds trust, fosters ownership, and addressed sociocultural barriers to access. Tailored, multi-component approaches leveraging trusted community figures are especially promising. Definitional ambiguity and inconsistent evaluation frameworks currently limit understanding of what works, for whom, and in what context. Future research should prioritise standardising CE definitions, developing context-sensitive theories of change, and strengthening methods for evaluating CE's contribution to vaccine coverage and equity.