Family communication dysfunction significantly impacts HIV medication adherence and mental health outcomes among adolescents in sub-Saharan Africa, yet evidence-based family interventions remain scarce in resource-limited settings. This qualitative descriptive study examined family communication transformation following culturally adapted Multiple Family Group Therapy (MFGT) for adolescents living with HIV and their families in rural Ghana. Focus group discussions were conducted with 20 caregivers and 19 adolescents who completed the 11-session intervention. All core therapeutic content was delivered across sessions 1 through 10; the 11th session comprised a graduation ceremony and sustainability planning. Reflexive thematic analysis revealed four major themes: preintervention dysfunction (public shaming, adolescent defiance, spousal teknonymy, extended family triangulation); MFGT-facilitated skills (tone modulation, privacy-preserving correction, active listening); postintervention transformation (caregiver behavioral consolidation, adolescent reciprocal adaptation, spousal reconnection); and sustaining mechanisms (observational learning, metacognitive awareness, positive reinforcement, peer accountability). Communication improvements occurred bidirectionally, with caregiver changes catalyzing adolescent adaptations. Findings are theoretically interpreted through family systems theory, communication accommodation theory, social cognitive theory, and self-determination theory. Culturally adapted MFGT successfully transformed communication patterns while preserving traditional authority structures, suggesting potential for integration within HIV care systems in resource-limited settings.

People experiencing homelessness face profound health inequalities, including high rates of mental and physical illness, problematic substance use, injury and reduced life expectancy. While the therapeutic benefits of greenspace are established, research on nature-based interventions for this population remains limited. This study explores how a tailored green social prescribing programme delivered through a supervised community garden and nature-based activity project can improve wellbeing amongst people experiencing homelessness. The research was conducted at a primary care centre in Scotland. Semi-structured interviews with centre clients (n = 11) and programme staff (n = 3) captured experiences and perceived therapeutic processes. Data were analysed using reflexive thematic analysis and informed by an existing greenspace programme theory model. Five themes are presented in relation to nature, the individual-self, and the social-self. Findings suggest that greenspace interventions accessed through tailored green social prescribing have the potential to be therapeutic for people experiencing homelessness. To realise these benefits, interventions must accommodate individuals' capacities and circumstances, which may differ from other populations.

Sexually and gender minoritized (SGM) young adults with disabilities navigate workplaces shaped by cisnormative, heteronormative, and ableist ideals of employability, professionalism, productivity and fit. However, little is known about how disability, sexuality and gender intersect in their employment experiences. Drawing on semi-structured interviews with 10 SGM young adults with disabilities aged 20 to 30 years in Canada, we examined how participants navigated employment, disclosure, accommodation, and workplace inclusion. Through intersectionality‑informed reflexive thematic analysis, we developed four themes: (1) being positioned as unemployable through organizational ideals of capacity, qualification, and productivity; (2) managing disclosure, concealment, and passing in cis-ableist workplaces; (3) performing affective labor to maintain workplace fit; and (4) reimagining inclusion through universal flexibility, transparent policies and diverse workforces. Participants often avoided disclosure, self-accommodated, tolerated misrecognition, and managed others' perceptions of their identities and access needs to protect their employment. The concept of "managing fit" captures the labor these marginalized workers perform, and the costs they absorbed, to reconcile their bodies, identities and access needs with workplace expectations. These findings demonstrate how intersecting cis-ableist norms influence employability and highlight the need to replace individualized approaches to accommodation with organizational practices that anticipate and normalize bodily, gender, and access diversity.