The aim of this systematic review is to identify and describe the experiences, barriers and provision of post-diagnostic support in UK rural areas; from the perspective of people living with dementia, healthcare professionals and informal family caregivers.

People living with dementia in rural areas experience numerous barriers to accessing post-diagnostic support.

Systematic Review.

Systematic searches will be conducted in the following databases; SCOPUS, PubMed, PsychINFO and CINAHL Plus. Systematic review tool Rayyan.ai will be used to screen titles and abstracts, prior to full-text review. Following data extraction, The Critical Appraisal Skills Programme (CASP) tool will be used to appraise the quality of studies and assess risk of bias. The data will be deductively analysed through the lens of the Candidacy Framework's 6 dimensions, with a secondary inductive analysis capturing any themes that fall outside of the framework.

242 papers have been screened by first and second reviewer. 15 papers included. Papers still being analysed for full review. Will be complete by March 2024.

This systematic review will help improve understanding of the rural barriers and experiences of post-diagnostic support, and allow researchers and stakeholders to develop and optimise specially tailored dementia interventions in line with the needs of people residing in UK rural communities.

First reviewer: Danielle Bilkey, Second Reviewer: Dr Ellena Businge, Supervisor: Dr Nicolas Farina.

Brain in Hand (BIH) is a UK-based digital self-support system for managing anxiety and social functioning.

To identify the impact of BIH on the psychological and social functioning of adults with autism.

Adults with diagnosed or suspected DSM-5 (level 1) autism, identified by seven NHS autism services in England and Wales, were recruited for a 12-week prospective mixed-methods cohort study. The primary quantitative outcome measures were the Health of the Nation Outcome Scales for People with Learning Disabilities (HONOS-LD) and the Hospital Anxiety and Depression Scale (HADS). Fisher's exact test explored sociodemographic associations. Paired t-test was utilised for pre–post analysis of overall effectiveness of BIH. Multivariable linear regression models, univariable pre–post analysis, Wilcoxon signed-rank test, logistic regression analysis, Bonferroni correction and normative analysis were used to give confidence in changes identified. A thematic analysis of semi-structured exist interviews following Braun and Clarke's six-step process of 10% of participants who completed the study was undertaken.

Sixty-six of 99 participants completed the study. There was significant reduction in mean HONOS-LD scores, with 0.65 s.d. decrease in those who used BIH for 12 weeks. Significant positive changes were identified in HONOS-LD subdomains of ‘self-injurious behaviours’, ‘memory and orientation’, ‘communication problems in understanding’, ‘occupation and activities’ and ‘problems with relationship’. A significant reduction in the anxiety, but not depression, component of the HADS scores was identified. Thematic analysis showed high confidence in BIH.

BIH improved anxiety and other clinical, social and functioning outcomes of adults with autism.