Sample records for utilizing in-depth interviews

  1. The use of depth interviewing with vulnerable subjects: lessons from a research study of parents with learning difficulties.

    PubMed

    Booth, T; Booth, W

    1994-08-01

    This paper explores the practicalities of using the technique of depth interviewing with people who have learning difficulties. The authors set out to provide other researchers with guidance in the use of the life story approach and to demonstrate its utility with this vulnerable and devalued group of informants. They conclude that depth interviewing can provide new knowledge not accessible through other methods of data collection, and offers a way of giving people with learning difficulties a voice in the making of their own history.

  2. Effectiveness of Social Media for Communicating Health Messages in Ghana

    ERIC Educational Resources Information Center

    Bannor, Richard; Asare, Anthony Kwame; Bawole, Justice Nyigmah

    2017-01-01

    Purpose: The purpose of this paper is to develop an in-depth understanding of the effectiveness, evolution and dynamism of the current health communication media used in Ghana. Design/methodology/approach: This paper uses a multi-method approach which utilizes a combination of qualitative and quantitative approaches. In-depth interviews are…

  3. Baptist Pastoral Leadership: An Analysis for Curriculum Development

    ERIC Educational Resources Information Center

    Christine, David Wayne

    2010-01-01

    Through a qualitative study utilizing in-depth interviews, practitioner opinion was gathered regarding how Christian institutions of higher education, primarily Baptist seminaries, may better utilize formal and continuing education to prepare clergy for pastoral leadership. The sample of ten subjects for this study, drawn from the 550 active…

  4. Young Children's Reactions to Mothers' Disclosure of Maternal HIV+ Serostatus

    ERIC Educational Resources Information Center

    Murphy, Debra A.; Roberts, Kathleen J.; Hoffman, Dannie

    2006-01-01

    Little is known about the impact of maternal disclosure of HIV-positive serostatus on young children. The objective of this study was to explore this topic, utilizing in-depth qualitative interviews. Qualitative interviews were conducted with 47 mothers who had disclosed to their young, well child, and with the children. The most prevalent child…

  5. Conventional wisdoms of woody biomass utilization on federal public lands

    Treesearch

    Dennis R. Becker; Sarah M. McCaffrey; Dalia Abbas; Kathleen E. Halvorsen; Pamela Jakes; Cassandra. Moseley

    2011-01-01

    The appeal of biomass utilization grows as the need for wildfire risk reduction, economic development, and renewable energy generation becomes more pressing. However, uncertainty exists regarding the factors necessary to stimulate use. We draw on in-depth interviews with local industry, agency, community, and tribal representatives from 10 study sites on federal public...

  6. Assessment of the Utilization of HIV Interventions by Sex Workers in Selected Brothels in Bangladesh: An Exploratory Study

    ERIC Educational Resources Information Center

    Huq, Nafisa Lira; Chowdhury, Mahbub Elahi

    2012-01-01

    In this qualitative study of brothel-based Female Sex Workers (FSWs), the authors explored factors that influence safe sex practices of FSWs within an integrated HIV intervention. Qualitative methods, including focus group discussions (FGDs), in-depth interviews and key informant interviews were applied in four brothels in Bangladesh. Young and…

  7. Sacred Practices and Family Processes in a Jewish Context: Shabbat as the Weekly Family Ritual Par Excellence.

    PubMed

    Marks, Loren D; Hatch, Trevan G; Dollahite, David C

    2018-06-01

    The present article provides a deep and more focused look at the utility, meaning, processes, and power involved in a specific, family-level, sacred practice or ritual from Judaism: Shabbat (Sabbath). Content analysis of in-depth interviews with 30 diverse, marriage-based Jewish families living in the United States (N = 77 individuals) yielded three emergent themes: (a) "Shabbat brings us closer together"; (b) How Shabbat brings the family together; and (c) The Power of Blessing the Children. These themes will be discussed respectively, along with related verbatim data from participants' in-depth qualitative interviews. © 2017 Family Process Institute.

  8. Understanding the Psychosocial and Environmental Factors and Barriers Affecting Utilization of Maternal Healthcare Services in Kalomo, Zambia: A Qualitative Study

    ERIC Educational Resources Information Center

    Sialubanje, Cephas; Massar, Karlijn; Hamer, Davidson H.; Ruiter, Robert A. C.

    2014-01-01

    This qualitative study aimed to identify psychosocial and environmental factors contributing to low utilization of maternal healthcare services in Kalomo, Zambia. Twelve focus group discussions (n = 141) and 35 in-depth interviews were conducted in six health centre catchment areas. Focus group discussions comprised women of reproductive age…

  9. Dispelling myths about a new healthful food can be more motivating than promoting nutritional benefits: the case of Tofu.

    PubMed

    Wansink, Brian; Shimizu, Mitsuru; Brumberg, Adam

    2014-04-01

    This study examines what factors impact the adoption of certain types of healthy foods, such as Tofu, by future nutritional gatekeepers. Information on perceived facilitators and barriers to the utilization of barriers would be obtained via interviews and surveys. In-depth laddering interviews and an online survey during 2012 were utilized. The in-depth laddering interviews were conducted with 83 young women and new mothers (non-vegetarians and non-Asians) who were enthusiastic lovers of Tofu. 502 women from the target demographic (between 20 and 35, non-Asian) were recruited from a national panel and surveyed online in 2012. Based on the interviews, 21 primary reasons for trying Tofu (facilitators) and 10 reasons that might be preventative (barriers) were identified. A key finding was that facilitators were not motivating factors for why women adopted Tofu into their diets. Instead, barriers explained more than 44% of the variance for not adopting tofu. When encouraging nutritional gatekeepers to add Tofu to their household diets, it may be more effective to focus on changing the barriers. This study suggests that nutritionists and health practitioners may be more successful in encouraging the adoption of healthy new foods by dispelling their misconceptions rather than focusing on their nutritional benefits. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Evaluation of a novel mentor program to improve surgical care for US hospitals.

    PubMed

    Berian, Julia R; Thomas, Juliana M; Minami, Christina A; Farrell, Paula R; O'Leary, Kevin J; Williams, Mark V; Prachand, Vivek N; Halverson, Amy L; Bilimoria, Karl Y; Johnson, Julie K

    2017-04-01

    To evaluate a novel mentor program for 27 US surgeons, charged with improving quality at their respective hospitals, having been paired 1:1 with 27 surgeon mentors through a state-wide quality improvement (QI) initiative. Mixed-methods utilizing quantitative surveys and in-depth semi-structured interviews. The Illinois Surgical Quality Improvement Collaborative (ISQIC) utilized a novel Mentor Program to guide surgeons new to QI. All mentor-mentee pairs received the survey (n = 27). Purposive sampling identified a subset of mentors (n = 8) and mentees (n = 4) for in-depth semi-structured interviews. Surgeons with expertise in QI mentored surgeons new to QI. (i) Quantitative: self-reported satisfaction with the mentor program; (ii) Qualitative: key themes suggesting actions and strategies to facilitate mentorship in QI. Mentees expressed satisfaction with the mentor program (n = 24, 88.9%) and agreed that mentorship is vital to ISQIC (n = 24, 88.9%). Analysis of interview data revealed four key themes: (i) nuances of data management, (ii) culture of quality and safety, (iii) mentor-mentee relationship and (iv) logistics. Strategies from these key themes include: utilize raw data for in-depth QI understanding, facilitate presentations to build QI support, identify opportunities for in-person meetings and establish scheduled conference calls. The mentor's role required sharing experiences and acting as a resource. The mentee's role required actively bringing questions and identifying barriers. Mentorship plays a vital role in advancing surgeon knowledge and engagement with QI in ISQIC. Key themes in mentorship reflect strategies to best facilitate mentorship, which may serve as a guide to other collaboratives. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. "People Are Messy": Complex Narratives of Supervising New Professionals in Student Affairs

    ERIC Educational Resources Information Center

    Davis, Tiffany J.; Cooper, Diane L.

    2017-01-01

    This study explored how supervisors in student affairs narrate their experiences of supervising new professionals. Utilizing narrative inquiry methodology, data were obtained through in-depth interviews of 13 supervisors and analyzed using thematic and narrative analysis methods. Implications for graduate preparation programs, professional…

  12. External Dynamics Influencing Tattooing among College Students: A Qualitative Analysis

    ERIC Educational Resources Information Center

    Firmin, Michael; Tse, Luke; Foster, Janna; Angelini, Tammy

    2012-01-01

    The study utilized qualitative research methodology to assess external dynamics and their influences on tattooing practices among college students. Twenty-four undergraduates supplied in-depth interviews regarding the external variables related to college students' decisions to tattoo. The present research follows (Tse, Firmin, Angelini, &…

  13. Dream Big: Exploring Empowering Processes of DREAM Act Advocacy in a Focal State

    ERIC Educational Resources Information Center

    Forenza, Brad; Mendonca, Carolina

    2017-01-01

    This original, qualitative research analyzed in-depth interviews with five undocumented, college-age, Latino DREAM Act advocates in a single state. An organizational empowerment framework was utilized to explore processes allied with such advocacy. Four emergent themes transcended the data inductively: (1) Challenging Social Injustice, which…

  14. Teacher Perceptions of Principals' Leadership Qualities: A Mixed Methods Study

    ERIC Educational Resources Information Center

    Hauserman, Cal P.; Ivankova, Nataliya V.; Stick, Sheldon L.

    2013-01-01

    This mixed methods sequential explanatory study utilized the Multi-factor Leadership Questionnaire, responses to open-ended questions, and in-depth interviews to identify transformational leadership qualities that were present among principals in Alberta, Canada. The first quantitative phase consisted of a random sample of 135 schools (with…

  15. State Clean Energy Policies Analysis. State, Utility, and Municipal Loan Programs

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Lantz, Eric

    2010-05-01

    This report relies on six in-depth interviews with loan program administrators to provide descriptions of existing programs. Findings from the interviews are combined with a review of relevant literature to elicit best practices and lessons learned from existing loan programs. Data collected from each of the loan programs profiled are used to quantify the impacts of these specific loan programs on the commonly cited, overarching state clean energy goals of energy security, economic development, and environmental protection.

  16. A Case-Study of the Resources and Functioning of Two Research Ethics Committees in Western India.

    PubMed

    Chenneville, Tiffany; Menezes, Lynette; Kosambiya, Jayendrakumar; Baxi, Rajendra

    2016-12-01

    Assessing the resources and functioning of research ethics committees (RECs) in low-resource settings poses many challenges. We conducted a case study of two medical college RECs (A and B) in Western India utilizing the Research Ethics Committee Quality Assurance Self-Assessment Tool (RECQASAT) as well as in-depth interviews with representative members to evaluate REC effectiveness. REC A and B obtained 62% and 67% of allowable points on the RECQASAT. These scores together with findings from the in-depth interviews suggest the need for significant improvement in REC effectiveness particularly in the areas of membership and educational training, organizational aspects, recording minutes, communicating decisions, and REC resources. Developing evidence-based best practices and strengthening infrastructure are essential to enhancing REC efficacy in low-resource countries.

  17. Islamic Education in a Multicultural Society: The Case of a Muslim School in Canada

    ERIC Educational Resources Information Center

    Ali, Faisal Mohamed; Bagley, Carl

    2015-01-01

    The case study explores the ways in which a prominent, private Canadian Muslim school provides an Islamic education while negotiating its place in an integrated, socially cohesive, multicultural society. The data are derived from an in-depth qualitative investigation utilizing documentary analysis, participant observation, and interviews (N = 22).…

  18. Improving Grievance Arbitration: The Practitioners Speak. Working Paper 1973-07.

    ERIC Educational Resources Information Center

    Davey, Harold W.

    Grievance arbitration is utilized on a nearly universal basis, but the process is malfunctioning in several ways. The study was based on a review of the literature, in field interviews, and in-depth correspondence with knowledgeable management and union practitioners; findings are limited to the arbitration step in contract administration. Twenty…

  19. Que Gacho Es Ser Macho: It's a Drag to Be a Macho Man.

    ERIC Educational Resources Information Center

    Mirande, Alfredo

    1986-01-01

    Focuses on variations in perceptions and conceptions of machismo within Mexican and Latino culture. Studies how Latino fathers living in United States perceive machismo, utilizing data from in-depth interviews. Identifies two models of masculinity, one as compensation for powerlessness, the other grounded in ethics, honor, and courage. (TES)

  20. Healing Images and Narratives: Undocumented Chicana/Latina Pedagogies of Resistance

    ERIC Educational Resources Information Center

    Pérez Huber, Lindsay

    2017-01-01

    This article draws from a longitudinal study of 38 in-depth "testimonio" interviews with 10 undocumented Chicanas/Latinas from 2008 to 2014, first as college students and then as professionals. A Chicana feminist theoretical perspective in education was utilized to explore how undocumented Chicana/Latina ways of knowing emerged in the…

  1. Perspectives on Peer-Mentoring from Taiwanese Science and Engineering Master's Students

    ERIC Educational Resources Information Center

    Lin, Yii-nii

    2014-01-01

    The purpose of this study is to describe the peer-mentoring experience from the perspective of 16 master's students majoring in science or engineering at a research-oriented university in Taiwan. Utilizing a qualitative method of phenomenology, these mentees shared their views about their peer-mentors through in-depth interviews. Participants…

  2. Drug Usage and Health Characteristics in Non-Institutionalized Mexican-American Elderly.

    ERIC Educational Resources Information Center

    Vener, A. M.; And Others

    1980-01-01

    Results of in-depth interviews with 32 elderly Mexican Americans revealed minimal potential hazardous drug interactions. Mexican Americans showed a disinclination to utilize over-the-counter drugs to alleviate minor ailments. Professionals involved in health care delivery systems for the aging should become aware of the special needs of ethnic…

  3. Self-Perceptions of Interpersonal, Intrapersonal, and Leadership Skills among Recent Engineering Graduates: A Qualitative Study

    ERIC Educational Resources Information Center

    Watson, Fallon E.

    2013-01-01

    This study describes the communication-specific soft skills that recent engineering graduates from Accreditation Board for Engineering and Technology (ABET) accredited universities in the state of Kentucky report they use at work. Utilizing a basic interpretive qualitative approach in-depth semi-structured interviews were conducted to obtain the…

  4. Third Spaces: Turkish Immigrants and Their Children at the Intersection of Identity, Schooling, and Culture

    ERIC Educational Resources Information Center

    Isik-Ercan, Zeynep

    2014-01-01

    This qualitative case study utilized hybridity theory, particularly the notion of third spaces, to investigate the ways Turkish immigrants (18 parents and 15 children) negotiate culture, identity, and schooling in the midwestern United States. Data were collected through in-depth interviews, observations, and artifacts, and analyzed using…

  5. Study of the Half-Day/Full-Day Kindergarten Model

    ERIC Educational Resources Information Center

    McInroy, Thomas R.

    2012-01-01

    This case study and problem analysis was an in-depth investigation of the half-day/full-day kindergarten model by utilizing interviews and focus groups to provide insight from parents, teachers, and other district personnel as to how the model has impacted the social, emotional, and academic development of the participating students. This study…

  6. Achieving Safety: Safer Sex, Communication, and Desire among Young Gay Men

    ERIC Educational Resources Information Center

    Eisenberg, Anna; Bauermeister, Jose A.; Pingel, Emily; Johns, Michelle Marie; Santana, Matthew Leslie

    2011-01-01

    Conceptualizations of safer sex practices among young gay men (YGM) are frequently structured around communication between partners and the subsequent utilization or absence of condoms in a sexual encounter. Drawing on a sample of 34 in-depth interviews with YGM, ages 18 to 24, the authors explore the ways in which conceptualizations and…

  7. Heroin Abuse and Collective Identity: Correlates and Consequences of Geographical Place

    ERIC Educational Resources Information Center

    Furst, R. Terry; Balletto, Rebecca

    2012-01-01

    Ethnographic and qualitative research were utilized to examine how the effects of geographic place can be related to heroin abuse and collective identity in non-metropolitan areas (NMAs) in the mid-Hudson region of New York State, U.S. The socio-geographic consequences of this interrelationship are explored. In-depth interviews were conducted with…

  8. Teaching about Ethics through Socioscientific Issues in Physics and Chemistry: Teacher Candidates' Beliefs

    ERIC Educational Resources Information Center

    Barrett, Sarah Elizabeth; Nieswandt, Martina

    2010-01-01

    The purpose of this qualitative study was to identify and explain the origins of physics and chemistry teacher candidates' beliefs about teaching about ethics through socioscientific issues (SSI). This study utilized a series of in-depth interviews, while the participants (n = 12) were enrolled in a 9-month teacher education program at an urban…

  9. Embodying the Faith: Religious Practice and the Making of a Muslim Moral Habitus

    ERIC Educational Resources Information Center

    Winchester, Daniel

    2008-01-01

    Despite a number of contemporary theoretical works in sociology and moral philosophy arguing that the project of modern selfhood is necessarily a deeply moral endeavor, there are few empirical studies examining the specific ways in which social actors construct moral selves and lives. Utilizing ethnographic fieldwork and in-depth interviews, this…

  10. Successful Latina Scientists and Engineers: Their Lived Mentoring Experiences and Career Development

    ERIC Educational Resources Information Center

    San Miguel, Anitza M.; Kim, Mikyong Minsun

    2015-01-01

    Utilizing a phenomenological perspective and method, this study aimed to reveal the lived career mentoring experiences of Latinas in science and engineering and to understand how selected Latina scientists and engineers achieved high-level positions. Our in-depth interviews revealed that (a) it is important to have multiple mentors for Latinas'…

  11. "I Want to Do the Right Thing but What Is It?": White Teachers' Experiences with African American Students

    ERIC Educational Resources Information Center

    Henfield, Malik S.; Washington, Ahmad R.

    2012-01-01

    This qualitative study examines 26 White middle school teachers' perceptions of their experiences in a predominantly White middle school with a growing African American student population. Utilizing in-depth focus group interviews, teachers elaborated on their experiences with navigating racial, ethnic and cultural boundaries as they attempted to…

  12. The College Student as Mother: A Phenomenological Examination of Community College Student Experiences

    ERIC Educational Resources Information Center

    Erk, Tiffany

    2013-01-01

    The purpose of this study is to identify how low-SES women who are providing primary childcare for children ages 0-10 experience higher education. In-depth phenomenological interviewing combined with document analysis were the methods utilized. This exploration used a purposive/snowball sample of low-SES mothers who were making satisfactory…

  13. Disaster loss and social media: Can online information increase flood resilience?

    NASA Astrophysics Data System (ADS)

    Allaire, Maura C.

    2016-09-01

    When confronted with natural disasters, individuals around the world increasingly use online resources to become informed of forecasted conditions and advisable actions. This study tests the effectiveness of online information and social media in enabling households to reduce disaster losses. The 2011 Bangkok flood is utilized as a case study since it was one of the first major disasters to affect a substantial population connected to social media. The role of online information is investigated with a mixed methods approach. Both quantitative (propensity score matching) and qualitative (in-depth interviews) techniques are employed. The study relies on two data sources—survey responses from 469 Bangkok households and in-depth interviews with internet users who were a subset of the survey participants. Propensity score matching indicates that social media enabled households to reduce flood losses by an average of 37% (USD 3708 per household), using a nearest neighbor estimator. This reduction is substantial when considering that household flood losses for the matched sample averaged USD 8278. Social media offered information not available from other sources, such as localized and nearly real-time updates of flood location and depth. With this knowledge, households could move belongings to higher ground before floodwaters arrived. These findings suggest that utilizing social media users as sensors could better inform populations during disasters. Overall, the study reveals that online information can enable effective disaster preparedness and reduce losses.

  14. Disaster Loss and Social Media: Can Online Information Increase Flood Resilience?

    NASA Astrophysics Data System (ADS)

    Allaire, M.

    2016-12-01

    When confronted with natural disasters, individuals around the world increasingly use online resources to become informed of forecasted conditions and advisable actions. This study tests the effectiveness of online information and social media in enabling households to reduce disaster losses. The 2011 Bangkok flood is utilized as a case study since it was one of the first major disasters to affect a substantial population connected to social media. The role of online information is investigated with a mixed methods approach. Both quantitative (propensity score matching) and qualitative (in-depth interviews) techniques are employed. The study relies on two data sources - survey responses from 469 Bangkok households and in-depth interviews with twenty-three internet users who are a subset of the survey participants. Propensity score matching indicates that social media enabled households to reduce flood losses by an average of 37% (USD 3,708), using a nearest neighbor estimator. This reduction is massive when considering that total flood losses for the full sample averaged USD 4,903. Social media offered information not available from other sources, such as localized and nearly real-time updates of flood location and depth. With this knowledge, households could move belongings to higher ground before floodwaters arrived. These findings suggest that utilizing social media users as sensors could better inform populations during disasters. Overall, the study reveals that online information can enable effective disaster preparedness and reduce losses.

  15. After critical care: patient support after critical care. A mixed method longitudinal study using email interviews and questionnaires.

    PubMed

    Pattison, Natalie; O'Gara, Geraldine; Rattray, Janice

    2015-08-01

    To explore experiences and needs over time, of patients discharged from ICU using the Intensive Care Experience (ICE-q) questionnaire, Hospital Anxiety and Depression Scale (HADS) and EuroQoL (EQ-5D), associated clinical predictors (APACHE II, TISS, Length of stay, RIKER scores) and in-depth email interviewing. A mixed-method, longitudinal study of patients with >48hour ICU stays at 2 weeks, 6 months, 12 months using the ICE-q, HADS, EQ-5D triangulated with clinical predictors, including age, gender, length of stay (ICU and hospital), APACHE II and TISS. In-depth qualitative email interviews were completed at 1 month and 6 months. Grounded Theory analysis was applied to interview data and data were triangulated with questionnaire and clinical data. Data was collected from January 2010 to March 2012 from 77 participants. Both mean EQ-5D visual analogue scale, utility scores and HADS scores improved from 2 weeks to 6 months, (p=<0.001; p=<0.001), but between 6 and 12 months, no change was found in data from either questionnaire, suggesting improvements level off. These variations were reflected in qualitative data themes: rehabilitation/recovery in the context of chronic illness; impact of critical care; emotional and psychological needs (including sub-themes of: information needs and relocation anxiety). The overarching, core theme related to adjustment of normality. Patient recovery in this population appears to be shaped by ongoing illness and treatment. Email interviews offer a convenient method of gaining in-depth interview data and could be used as part of ICU follow-up. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  16. The "Pathological Gambling and Epidemiology" (PAGE) study program: design and fieldwork.

    PubMed

    Meyer, Christian; Bischof, Anja; Westram, Anja; Jeske, Christine; de Brito, Susanna; Glorius, Sonja; Schön, Daniela; Porz, Sarah; Gürtler, Diana; Kastirke, Nadin; Hayer, Tobias; Jacobi, Frank; Lucht, Michael; Premper, Volker; Gilberg, Reiner; Hess, Doris; Bischof, Gallus; John, Ulrich; Rumpf, Hans-Jürgen

    2015-03-01

    The German federal states initiated the "Pathological Gambling and Epidemiology" (PAGE) program to evaluate the public health relevance of pathological gambling. The aim of PAGE was to estimate the prevalence of pathological gambling and cover the heterogenic presentation in the population with respect to comorbid substance use and mental disorders, risk and protective factors, course aspects, treatment utilization, triggering and maintenance factors of remission, and biological markers. This paper describes the methodological details of the study and reports basic prevalence data. Two sampling frames (landline and mobile telephone numbers) were used to generate a random sample from the general population consisting of 15,023 individuals (ages 14 to 64) completing a telephone interview. Additionally, high-risk populations have been approached in gambling locations, via media announcements, outpatient addiction services, debt counselors, probation assistants, self-help groups and specialized inpatient treatment facilities. The assessment included two steps: (1) a diagnostic interview comprising the gambling section of the Composite International Diagnostic Interview (CIDI) for case finding; (2) an in-depth clinical interview with participants reporting gambling problems. The in-depth clinical interview was completed by 594 participants, who were recruited from the general or high-risk populations. The program provides a rich epidemiological database which is available as a scientific use file. Copyright © 2015 John Wiley & Sons, Ltd.

  17. The Unfolding of a Pre-Kindergarten Program for Four Year Olds.

    ERIC Educational Resources Information Center

    Bouchard, Ruth Ann; Mackler, Bernard

    This report provides an in-depth description of an early (1965) Head Start classroom for 4-year-olds in Harlem, New York City. It is based on direct, in-class observation, but standardized tests and interviews were also utilized. The teacher is described in terms of her role in the preschool, and her behavior in interaction with children and…

  18. Selected Pre-Vocational Students' Experiences of School in Brunei Darussalam

    ERIC Educational Resources Information Center

    Ismail, Lili Mariam; Koay, Teng Leong

    2014-01-01

    There is a lack of studies on the school experiences of students in the pre-vocational programme in Brunei Darussalam. The aim of this study is find out what are the students' experiences at school, what they go through at school and so on. A qualitative approach was utilized whereby in-depth, semi-structured interviews were conducted with seven…

  19. Sister to Sister: Dynamics of Mentoring Relationships among African American Women in Leadership and Nonleadership Positions within Higher Education

    ERIC Educational Resources Information Center

    Stiff, MaNesha M.

    2013-01-01

    The purpose of this study was to identify the dynamics of mentoring relationships among African American women within the higher education profession. Utilizing a phenomenological research design, this researcher conducted in-depth interviews with 10 African American women who are mentors and/or mentees of an African American woman in the higher…

  20. Accounting Education and the Provision of Soft Skills: Implications of the Recent NZICA CA Academic Requirement Changes

    ERIC Educational Resources Information Center

    Low, Mary; Samkin, Grant; Liu, Christina

    2013-01-01

    This research examined the role of accounting education in the provision of soft skills to accounting graduates, and how this may be affected by the recent changes in academic requirements initiated by NZICA. A qualitative research method utilizing in-depth interviews was conducted with accounting graduates, partners of the Big4 accounting firms,…

  1. "Set in Stone" or "Ray of Hope": Parents' Beliefs about Cause and Prognosis after Genomic Testing of Children Diagnosed with ASD

    ERIC Educational Resources Information Center

    Reiff, Marian; Bugos, Eva; Giarelli, Ellen; Bernhardt, Barbara A.; Spinner, Nancy B.; Sankar, Pamela L.; Mulchandani, Surabhi

    2017-01-01

    Despite increasing utilization of chromosomal microarray analysis (CMA) for autism spectrum disorders (ASD), limited information exists about how results influence parents' beliefs about etiology and prognosis. We conducted in-depth interviews and surveys with 57 parents of children with ASD who received CMA results categorized as pathogenic,…

  2. An Examination of the Dynamics of Organizational Culture and Values-Based Leader Identities and Behaviors: One Company's Experience

    ERIC Educational Resources Information Center

    MacTavish, Murray D.; Kolb, Judith A.

    2008-01-01

    This in-depth case study utilized grounded theory methodology to discover how a large privately-owned manufacturing firm in Northeastern USA develops values-based leaders, particularly from minority populations. Over 18 months, interviews with 35 leaders from five levels explored the perceived influence of the environment on leaders' behaviors and…

  3. Pain control and chaplaincy in Aotearoa New Zealand.

    PubMed

    Carey, Lindsay B; Polita, Carla; Marsden, Candace Renee; Krikheli, Lillian

    2014-10-01

    This paper summarizes the results of 100 New Zealand health care chaplains with regard to their involvement in issues concerning pain control within the New Zealand health care context. Both quantitative (via survey) and qualitative methods (in-depth interviewing) were utilized. The findings of this study indicated that approximately 52 % of surveyed hospital chaplains had provided some form of pastoral intervention directly to patients and/or their families dealing with issues concerning pain and that approximately 30 % of hospital chaplains had assisted clinical staff with issues concerning pain. NZ chaplaincy personnel involved in pain-related issues utilized a number of pastoral interventions to assist patients, their families and clinical staff. Differences of involvement between professionally stipended hospital chaplains and their volunteer chaplaincy assistants are noted, as are the perspectives of interviewed chaplains about their pastoral interventions with issues relating to pain. Some implications of this study with respect to chaplaincy utility, training and collaboration with clinical staff are noted, as are comparisons with international findings.

  4. Mental Health, Quality of Life and Gendered Experiences of Japanese Sojourner Graduate Students in the U.S

    ERIC Educational Resources Information Center

    Kuwahara, Natsuko

    2010-01-01

    The present study employed a mixed methods approach to explore well-being, quality of life and experiences among Japanese sojourner graduate students studying in the U.S. utilizing 155 survey responses and 39 in-depth individual interviews. Key measures used include: the K6 screen for risk of serious mental illness (K6) (Kessler et al., 2002), the…

  5. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya

    PubMed Central

    2011-01-01

    Background Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs). In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability Methods We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. Results HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. Conclusions There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources. However, to optimise their contribution, efforts are needed to improve their training, clarify their roles, and improve engagement with the wider community. PMID:21936958

  6. Health facility committees and facility management - exploring the nature and depth of their roles in Coast Province, Kenya.

    PubMed

    Goodman, Catherine; Opwora, Antony; Kabare, Margaret; Molyneux, Sassy

    2011-09-22

    Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs). In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources. However, to optimise their contribution, efforts are needed to improve their training, clarify their roles, and improve engagement with the wider community.

  7. "Music Fit for Us Minorities": Latinas/os' Use of Hip Hop as Pedagogy and Interpretive Framework to Negotiate and Challenge Racism

    ERIC Educational Resources Information Center

    Pulido, Isaura

    2009-01-01

    Using Critical Race and Latino Critical theories, this study examines 20 in-depth interviews conducted by the author with Mexican and Puerto Rican youth from the Chicago area. The author contends that youth utilized hip hop music in multiple and overlapping ways, engaging hip hop music as both a pedagogy that centers the perspectives of people of…

  8. Transitioning the California Energy Commission Eligible Equipment List to a National Platform

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Truitt, Sarah; Nobler, Erin; Krasko, Vitaliy

    The Energy Commission called on the National Renewable Energy Laboratory's (NREL)'s Solar Technical Assistance Team to explore various pathways for supporting continued evolution of the list. NREL staff utilized the Database of State Incentives for Renewables and Efficiency (DSIRE), California Solar Initiative (CSI) data, and information from in-depth interviews to better understand the impact of a lack of an updated list and suggest potential solutions. A total of 18 people from state energy offices, rebate program administrators, utilities, national testing laboratories, private companies, nonprofit organizations, and the federal government were interviewed between July and September 2013. CSI data were analyzedmore » to illustrate the monetary benefits of the algorithm behind calculating performance of PV modules included on the list. The primary objectives of this study are to: 1) Determine the impact of not maintaining the list, and 2) Explore alternatives to the State of California's maintenance of the list.« less

  9. Peer assisted learning as a formal instructional tool.

    PubMed

    Naqi, Syed Asghar

    2014-03-01

    To explore the utility of peer assisted learning (PAL) in medical schools as a formal instructional tool. Grounded theory approach. King Edward Medical University, Lahore, from July 2011 to December 2011. A study was designed using semi-structured in-depth interviews to collect data from final year medical students (n=6), residents (n=4) and faculty members (n=3), selected on the basis of non-probability purposive sampling. The qualitative data thus generated was first translated in English and transcribed and organized into major categories by using a coding framework. Participants were interviewed two more times to further explore their perceptions and experiences related to emergent categories. An iterative process was employed using grounded theory analysis technique to eventually generate theory. PAL was perceived as rewarding in terms of fostering higher order thinking, effective teaching skills and in improving self efficacy among learners. PAL can offer learning opportunity to medical students, residents and faculty members. It can improve depth of their knowledge and skills.

  10. In-Depth Interviewing as Qualitative Investigation.

    ERIC Educational Resources Information Center

    Books, Marilyn

    A discussion of in-depth interviewing as a method for research on language teaching and learning situates the technique within the continuum of research methodology and differentiates it from quantitative research methods. The strengths and weaknesses of in-depth interviewing are examined, methods of sampling are discussed, and advice on the…

  11. Mentors Lead and Leaders Mentor: A Qualitative Study of the Impact of Mentoring on the Pathway to the Presidency of Ethnic Minority Female Illinois Community College Presidents

    ERIC Educational Resources Information Center

    Stutz, Melissa

    2014-01-01

    This study was a qualitative study of the effect of mentoring on the career path of women who are members of racial and ethnic minority groups and have become presidents of community colleges in the state of Illinois. It used a multiple case study method utilizing in-depth interviews, documentation review and observations. Research shows nearly…

  12. Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey

    PubMed Central

    2013-01-01

    The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications. PMID:24267412

  13. Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey.

    PubMed

    Stussman, Barbara J; Bethell, Christina D; Gray, Caroline; Nahin, Richard L

    2013-11-23

    The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications.

  14. 77 FR 74267 - Agency Information Collection Activities; New Information Collection Request: Driver and Carrier...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    .... Estimated Number of Respondents: 1,039 [(2 carrier in-depth interviews + 20 carrier pre test web interviews...-depth interviews x 30 minutes/60 minutes + 20 carrier pre-test web interviews x 20 minutes/60 minutes...

  15. 75 FR 37811 - Agency Information Collection Request; 30-Day Public Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-30

    ... respondent response In-depth interview screening 500 1 10/60 83 In-depth interview main interview 360 1 1 360 Focus group screening 800 1 10/60 133 Focus group main interview 400 1 2 800 Web-based message testing main interview........ 660 1 1 660 Omnibus survey questions main interview......... 4,000 1 10/60 667...

  16. 75 FR 19974 - Agency Information Collection Request. 60-Day Public Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... response hours In-depth interview screening 500 1 10/60 83 In-depth interview main interview 360 1 1 360 Focus group screening 800 1 10/60 133 Focus group main interview 400 1 2 800 Web-based message testing main interview........ 660 1 1 660 Omnibus survey questions main interview......... 4,000 1 10/60 667...

  17. "She has a real connection with them": Reimagining and expanding our definitions of Black masculinity and mentoring in education through female masculinity.

    PubMed

    Love, Bettina L

    2017-10-02

    Through narrative inquiry, utilizing in-depth interviews and field observations, the goal of this research is to begin a dialogue within the field of education and mentoring scholarship that expands the mentoring of Black males beyond traditional norms of sex and gender identities/performances to reimagine the ways in which Black female masculinity can be a site of mentoring for Black and Brown boys.

  18. Use of Dictionary of Occupational Titles (DOT) on formwork carpentry--a comparison between the United States and Hong Kong.

    PubMed

    Lee, Gloria K L; Chan, Chetwyn C H

    2003-01-01

    This study aimed at investigating the utilization and applicability of the Dictionary of Occupational Titles (DOT) as a methodology to study the job profile (nature and physical demand) of formwork carpentry in the local situation. Thirty male formwork carpenters were recruited by convenient sampling to participate in a two-hour interview, with reference to the DOT Physical Demand Questionnaire (DOTPDQ) and the WestTool Sort Questionnaire. The information obtained was further consolidated by comparing the results from the interview to three construction sites and training guidelines from the formwork carpentry training centers. The triangulation of the data formulated a job profile of formwork carpenters. The results from the DOTPDQ revealed that workers' work demands were standing, walking, pushing, pulling, reaching, climbing, balancing, stooping, crouching, lifting, carrying, handling and near acuity. This produced an agreement of 84.6% with the original DOT. A discrepancy was found in the demands of kneeling, fingering, far acuity and depth perception. The discrepancy between the data from the United States and local appeared to be minimal. It was thus inferred that the DOT-based job profile was largely valid for describing formwork carpentry in Hong Kong. In-depth analysis should be conducted to further substantiate the validity of utilizing the DOT system for other job types and their physical demands.

  19. Health provider perspectives on mental health service provision for Chinese people living in Christchurch, New Zealand

    PubMed Central

    ZHANG, Qiuhong; GAGE, Jeffrey; BARNETT, Pauline

    2013-01-01

    Background Migration imposes stress and may contribute to the incidence of mental illness among natives of mainland China living overseas. Both cultural norms and service inadequacies may act as barriers to accessing needed mental health services. Objective Assess New Zealand health providers' perspectives on the utilization of mental health services by immigrants from mainland China. Methods A qualitative study in Christchurch, New Zealand involved in-depth interviews with nine mental health professionals with experience in providing services to Chinese clients. The interviews were transcribed and thematically analysed. Results Four main themes emerged from the interviews: (1) specific mental health concerns of Chinese migrants; (2) subgroups of migrants most likely to manifest mental health problems; (3) barriers to accessing services; and (4) the centrality of social support networks to the mental health of Chinese migrants. Conclusions Qualitative research with health providers in high-income countries who provide mental health services to the growing numbers of migrants from mainland China can identify areas where improved cultural sensitivity could increase both the utilization of mental health services by Chinese immigrants and the effectiveness of these services. PMID:24991180

  20. Usability and utility evaluation of the web-based "Should I Start Insulin?" patient decision aid for patients with type 2 diabetes among older people.

    PubMed

    Lee, Yew Kong; Lee, Ping Yein; Ng, Chirk Jenn; Teo, Chin Hai; Abu Bakar, Ahmad Ihsan; Abdullah, Khatijah Lim; Khoo, Ee Ming; Hanafi, Nik Sherina; Low, Wah Yun; Chiew, Thiam Kian

    2018-01-01

    This study aimed to evaluate the usability (ease of use) and utility (impact on user's decision-making process) of a web-based patient decision aid (PDA) among older-age users. A pragmatic, qualitative research design was used. We recruited patients with type 2 diabetes who were at the point of making a decision about starting insulin from a tertiary teaching hospital in Malaysia in 2014. Computer screen recording software was used to record the website browsing session and in-depth interviews were conducted while playing back the website recording. The interviews were analyzed using the framework approach to identify usability and utility issues. Three cycles of iteration were conducted until no more major issues emerged. Thirteen patients participated: median age 65 years old, 10 men, and nine had secondary education/diploma, four were graduates/had postgraduate degree. Four usability issues were identified (navigation between pages and sections, a layout with open display, simple language, and equipment preferences). For utility, participants commented that the website influenced their decision about insulin in three ways: it had provided information about insulin, it helped them deliberate choices using the option-attribute matrix, and it allowed them to involve others in their decision making by sharing the PDA summary printout.

  1. Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora.

    PubMed

    Sabri, Bushra; Huerta, Julia; Alexander, Kamila A; St Vil, Noelle M; Campbell, Jacquelyn C; Callwood, Gloria B

    2015-11-01

    This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women.

  2. Facilitating factors and barriers to malaria research utilization for policy development in Malawi.

    PubMed

    Mwendera, Chikondi A; de Jager, Christiaan; Longwe, Herbert; Phiri, Kamija; Hongoro, Charles; Mutero, Clifford M

    2016-10-19

    Research on various determinants of health is key in providing evidence for policy development, thereby leading to successful interventions. Utilization of research is an intricate process requiring an understanding of contextual factors. The study was conducted to assess enhancing factors and barriers of research utilization for malaria policy development in Malawi. Qualitative research approach was used through in-depth interviews with 39 key informants that included malaria researchers, policy makers, programme managers, and key stakeholders. Purposive sampling and snowballing techniques were used in identifying key informants. Interview transcripts were entered in QSR Nvivo 11 software for coding and analysis. Respondents identified global efforts as key in advancing knowledge translation, while local political will has been conducive for research utilization. Other factors were availability of research, availability of diverse local researchers and stakeholders supporting knowledge translation. While barriers included: lack of platforms for researcher-public engagement, politics, researchers' lack of communication skills, lack of research collaborations, funder driven research, unknown World Health Organization policy position, and the lack of a malaria research repository. Overall, the study identified facilitating factors to malaria research utilization for policy development in Malawi. These factors need to be systematically coordinated to address the identified barriers and improve on malaria research utilization in policy development. Malaria research can be key in the implementation of evidence-based interventions to reduce the malaria burden and assist in the paradigm shift from malaria control to elimination in Malawi.

  3. Surviving testicular cancer: the Lebanese lived experience.

    PubMed

    Saab, Mohammad; Noureddine, Samar; Abu-Saad Huijer, Huda; Dejong, Jocelyn

    2014-01-01

    Testicular cancer is thought to have a great impact on its survivors, yet there has been limited literature on the topic globally and no literature on the topic in Lebanon and the Arab region. The purpose of this study was to explore the lived experience of Lebanese testicular cancer survivors and gain an in-depth understanding of the psychosexual aspect of their experience. A hermeneutic phenomenological approach with semistructured digitally recorded interviews and observational field notes was utilized. A purposive sample of Lebanese testicular cancer survivors, aged between 18 and 50 years, in remission for at least 3 years, and willing to share personal information was recruited. Interviews were transcribed verbatim in Arabic. Data saturation was achieved at the seventh interview; a total of eight informants were recruited. The opening question was, "Tell me about your life since you got treated for testicular cancer," and was followed by probing questions. Two to three weeks after the initial interview, informants were called to validate the investigators' primary analysis. Six core themes emerged: cancer perception in the Lebanese culture; "do not show, do not tell"; cancer experience is a turning point; fertility, manhood, and relationships; coping with cancer; and preserved aspects of life. The findings provide an in-depth understanding of the experience of Lebanese testicular cancer survivors with a focus on the psychosexual aspect of this experience. The results suggest the need to educate patients about testicular cancer and its effect on their fertility.

  4. Culturally familiar environment among immigrant Korean elders.

    PubMed

    Son, Gwi-Ryung; Kim, Hye-Ryoung

    2006-01-01

    This study's purpose was to describe the concept of familiarity for immigrant Korean elders as expressed through clothing, objects, songs/music, foods, and associated feelings. A descriptive exploratory design with in-depth, face-to-face interviews was used. A convenience sample of 14 immigrant Korean elders, age 63 to 82 years, was recruited from a Korean senior apartment complex. Interviews were tape-recorded and then transcribed in Korean by the first author. Constant comparative analysis was used to derive eight themes related to feelings and practice associated with culturally familiar items: homesickness, comfort, pleasure, mixed feelings, attachment, pride, nostalgic practice, and essentiality. These findings about familiarity could be utilized with ethnic minority elders to enhance their sense of belonging and physical and psychological comfort.

  5. Reporting on first sexual experience: The importance of interviewer-respondent interaction

    PubMed Central

    Poulin, Michelle

    2010-01-01

    Survey methodologists typically seek to improve data on sensitive topics by standardizing surveys and avoiding the use of human interviewers. This study uses data collected from 90 never-married young adults in rural Malawi to compare reports on first sexual encounters between a standard survey and an in-depth interview. A significant fraction of young women who claimed in the survey to have never been sexually active affirmed sexual experience during the in-depth interview, fielded shortly thereafter. Two elements of the in-depth interview, flexibility and reciprocal exchange, foster trust and more truthful reporting. The findings contradict the long-standing presumption that face-to-face interviews are inherently threatening when the topic is sex. PMID:20357897

  6. Utilization of Health Research Recommendation in Policy and Planning in Nepal.

    PubMed

    Dhimal, M; Pandey, A R; Aryal, K K; Budhathoki, C B; Vaidya, D L; Karki, K K; Onta, S

    2016-09-01

    Over the past decade in Nepal, a large number of studies have been carried in a variety of health areas; however whether evidence derived from these studies has been used to inform health policy has not been explored. This study aims to assess the utilization of recommendations from health research in health policy and plans, and to identify the factors that influence utilization of research findings by policy makers' in Nepal. Qualitative study incorporating literature review and semi-structured interviews was used. Research reports and health related policies were collected from governmental and non-governmental bodies. Documents were reviewed to identify the utilization of research-based recommendations in health policy and plan formulation. In-depth interviews were conducted with key policy makers and researchers to identify factors that hinder the utilization of research recommendations. A total of 83 health related research reports were identified, of which 48 had recommendations. Four policies and three plans, from total 21 identified plans and policies, were found to have incorporated recommendations from research. Of the 48 studies that had recommendations, 35 were found to be used in the policy making process. Lack of appropriate communication mechanisms, and concerns related to the quality of research conducted, were the main factors hindering the translation of evidence into policy. Communication gaps exist between researchers and policy makers, which seem to have impeded the utilization of research-based information and recommendations in decision-making process. Establishing a unit responsible for synthesizing evidences and producing actionable messages for policy makers can improve utilization of research findings.

  7. The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons

    PubMed Central

    Culbert, Gabriel J.; Bazazi, Alexander R.; Waluyo, Agung; Murni, Astia; Muchransyah, Azalia P.; Iriyanti, Mariska; Finnahari; Polonsky, Maxim; Levy, Judith; Altice, Frederick L.

    2015-01-01

    Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03–1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00–1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners. PMID:26400080

  8. Condom utilization and sexual behavior of female sex workers in Northwest Ethiopia: A cross-sectional study.

    PubMed

    Tamene, Masresha Molla; Tessema, Gizachew Assefa; Beyera, Getahun Kebede

    2015-01-01

    Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. A quantitative cross-sectional study triangulated with qualitative method was conducted from March 20 - April 10, 2014 in Gondar town. The quantitative data were collected through interviewing 488 female sex workers while in-depth interview was administered to collect qualitative data from 10 female sex workers. The collected data were entered into EPI-INFO version 3.5.3 and exported to SPSS version 20.0 software for analysis. Logistic regression analysis was done to determine the association between condom utilization and independent variables. This study revealed that less than half (47.7%) of the respondents utilized condom with any type of client. Secondary education or above, perceiving themselves at risk of HIV/AIDS infection, having awareness that sexually transmitted infections could increase HIV infection, being tested for HIV/AIDS in the last 12 months, and having lower number of clients in a month were positively associated with condom utilization. This finding depicted that condom utilization was low among female sex workers. Thus, developing and implementing target oriented behavioral change and communication strategies are needed to prevent the risk of acquiring HIV/AIDS and other sexually transmitted infections in female sex workers.

  9. I was being myself but being an actor too: the experience of a Black male in interracial psychotherapy.

    PubMed

    Qureshi, Adil

    2007-12-01

    In recent years, investigators have indicated that the psychotherapy process is of considerable importance in the context of interracial psychotherapy. Despite the interest in the area, minimal research has examined how racial difference impacts the psychotherapy process. This study examines the lived experience of interracial psychodynamic psychotherapy via an in-depth interview with an African-American man who had been in therapy with a European American therapist. This qualitative study utilizes a hermeneutic phenomenological approach, which accepts that understanding is contingent on both sociohistorical situatedness and relational dynamics. The study participant was chosen because of his interest in the area and willingness to explore it in detail with the interviewer. A number of themes emerged, the most salient of which are the multidimensionality of the experience and the 'absent presence' of race in the therapy process. This client's experience was both positive and negative, and in many cases, the same process-related variables contributed both positively and negatively to the client's therapeutic experience. Issues of trust, perceived cultural issues and therapy focus contributed to and detracted from the therapy experience. The depth of the therapy experience was limited by the therapist not explicitly addressing race.

  10. Women's experience of pre-implantation genetic diagnosis: a qualitative study.

    PubMed

    Karatas, J C; Barlow-Stewart, K; Strong, K A; Meiser, B; McMahon, C; Roberts, C

    2010-08-01

    To provide an in-depth account of the experience of pre-implantation genetic diagnosis (PGD). Exploratory qualitative interview study. Participants were recruited from one major in vitro fertilization (IVF) clinic in Sydney, Australia. Data were collected through 14 in-depth interviews with women at different stages of PGD, utilized a thematic approach and facilitated by NVivo software. Women reported using PGD as empowering and led them to feel in control of their reproductive futures. Health professionals who did not tell women about PGD were seen as a barrier to accessing treatment. The ability to select embryos free from the genetic condition (for which it was at risk) alleviated stress. Despite this, stress experienced with PGD was significant for women, and often related to past experiences of reproductive trauma and grief. The outcome of embryos was also the cause of stress for women. Women undergoing PGD have a diverse range of reproductive and genetic histories, psychosocial circumstances and world views that all interact and impact their experience of PGD. Successful support and care of these women should address all of these factors and tailor the support provided for women using this physically and emotionally complex form of reproductive technology. (c) 2010 John Wiley & Sons, Ltd.

  11. Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora

    PubMed Central

    Sabri, Bushra; Huerta, Julia; Alexander, Kamila A.; St.Vil, Noelle M.; Campbell, Jacquelyn C.; Callwood, Gloria B.

    2016-01-01

    Objective This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). Methods We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. Results A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. Conclusion There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women. PMID:26548679

  12. [A Grounded Theory Approach on Nurses' Experience with Workplace Bullying].

    PubMed

    Kang, Jiyeon; Yun, Seonyoung

    2016-04-01

    The purpose of this qualitative study was to explore the workplace bullying experience of Korean nurses. Participants were twenty current or former hospital nurses who had experienced workplace bullying. Data were collected through focus group and individual in-depth interviews from February to May, 2015. Theoretical sampling method was applied to the point of theoretical saturation. Transcribed interview contents were analyzed using Corbin and Strauss's grounded theory method. A total of 110 concepts, 48 sub-categories, and 17 categories were identified through the open coding process. As a result of axial coding based on the paradigm model, the central phenomenon of nurses' workplace bullying experience was revealed as 'teaching that has become bullying', and the core category was extracted as 'surviving in love-hate teaching' consisting of a four-step process: confronting reality, trial and error, relationship formation, and settlement. The relationship formation was considered to be the key phase to proceed to the positive settlement phase, and the participants utilized various strategies such as having an open mind, developing human relationships, understanding each other in this phase. The in-depth understanding of the workplace bullying experience has highlighted the importance of effective communication for cultivating desirable human relationships between nurses.

  13. Informing Mitigation of Disaster Loss through Social Media: Evidence from Thailand

    NASA Astrophysics Data System (ADS)

    Allaire, M.

    2015-12-01

    This paper is the first to investigate the role of online information and social media in enabling households to reduce natural disaster losses. The historic 2011 Bangkok flood is utilized as a case study to assess how internet use allowed households to mitigate flood losses. This event was one of the first major disasters to affect an urban area with a substantial population connected to social media. The role of online information is investigated with a mixed methods approach, using both quantitative (propensity score matching and multivariate regression analysis) and qualitative (in-depth interviews) techniques. The study relies on two data sources - survey responses from 469 Bangkok households and in-depth interviews with internet users who are a subset of the survey participants. Propensity score matching indicates that social media use enabled households to reduce mean total losses by 37%, using a nearest neighbor estimator. Average loss reductions amounted to USD 3,708 to USD 4,886, depending on the matching estimator. In addition, regression analysis suggests that social media use is associated with lower flood losses (average reduction of USD 2,784). These reductions are notable when considering that total flood losses in 2011 averaged USD 4,903. Social media offered information that was not available from other sources, such as localized and nearly real-time updates of flood location and depth. With knowledge of current flood conditions, Bangkok households could move belongings to higher ground before floodwaters arrived. These findings suggest that utilizing social media users as sensors could better inform populations during natural disasters, particularly in locations that lack real-time, accurate flood monitoring networks. Therefore, expanded access to the internet and social could especially be useful in developing countries, ungagged basins, and highly complex urban environments. There is also an enormous opportunity for disseminating government disaster communication through social media. Overall, the study reveals that online information can enable effective disaster preparedness and reduce flood losses.

  14. Perceptions of patients on the utility or futility of end-of-life treatment.

    PubMed

    Rodriguez, K L; Young, A J

    2006-08-01

    Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few. Patients were allowed to discuss their concerns about end-of-life care, so that their ideas about treatment futility or utility could be extrapolated by us. In this cross-sectional study, in-depth, semistructured interviews were conducted with 30 elderly people who were receiving outpatient care in a large, urban Veterans Affairs medical centre in the US. Each of their healthcare providers was also interviewed. Participants were asked to consider four terms commonly used in advance directive forms (ie, life-sustaining treatment, terminal condition, state of permanent unconsciousness and decision-making capacity) and to discuss what these terms meant to them. Audiotapes of the open-ended interviews were transcribed and responses were coded and categorised by constant comparison, a commonly used qualitative method. The following four factors were taken into account by the participants when discussing end-of-life interventions and outcomes: (1) expected quality of life; (2) emotional and financial costs of treatment; (3) likelihood of treatment success; and (4) expected effect on longevity. Although the terms "utility" or "futility" were not generally used by the participants, segments of speech indicating their perceptions of these terms were identified. Treatment was not always discussed in the same way by patients and providers, but seemed to reflect the same four concerns. Therefore, it may be fruitful for providers to focus on these concerns when discussing end-of-life treatment options with their patients.

  15. Bullying of youth with autism spectrum disorder, intellectual disability, or typical development: Victim and parent perspectives

    PubMed Central

    Zeedyk, S.M.; Rodriguez, G.; Tipton, L.A.; Baker, B.L.; Blacher, J.

    2014-01-01

    In-depth interviews conducted separately with 13-year-olds with autism spectrum disorder (ASD), intellectual disability (ID), or typical development (TD) and their mothers investigated the experiences of victimization in the form of bullying. Coded constructs from the interviews were utilized to compare groups on the frequency, type, and impact of victimization. Youth with ASD were victimized more frequently than their ID or TD peers, and the groups differed with regard to the type of bullying and the impact it had, with ASD youth faring the worst. Higher internalizing problems and conflict in friendships were found to be significant predictors of victimization, according to both youth- and mother-reports. These predictors were found to be more salient than ASD status alone. Implications for practice are discussed. PMID:25285154

  16. Improving Hospital Services Based on Patient Experience Data: Current Feedback Practices and Future Opportunities.

    PubMed

    Kaipio, Johanna; Stenhammar, Hanna; Immonen, Susanna; Litovuo, Lauri; Axelsson, Minja; Lantto, Minna; Lahdenne, Pekka

    2018-01-01

    Patient feedback is considered important for healthcare organizations. However, measurement and analysis of patient reported data is useful only if gathered insights are transformed into actions. This article focuses on gathering and utilization of patient experience data at hospitals with the aim of supporting the development of patient-centered services. The study was designed to explore both current practices of collecting and utilizing patient feedback at hospitals as well as future feedback-related opportunities. Nine people working at different hierarchical levels of three university hospitals in Finland participated in in-depth interviews. Findings indicate that current feedback processes are poorly planned and inflexible. Some feedback data are gathered, but not systematically utilized. Currently, it is difficult to obtain a comprehensive picture of the situation. One future hope was to increase the amount of patient feedback to be able to better generalize and utilize the data. Based on the findings the following recommendations are given: attention to both patients' and healthcare staff's perspectives when collecting feedback, employing a coordinated approach for collecting and utilizing patient feedback, and organizational transformation towards a patient-centric culture.

  17. Early childhood experiences, cultural beliefs, and oral health of Mexican American women.

    PubMed

    Miltiades, Helen B

    2013-01-01

    This qualitative article examines how financial resources, cultural beliefs, and early childhood experiences affect perceptions of oral health and dental utilization of middle-aged and older Mexican American women. Fourteen in-depth qualitative interviews were conducted. The women's ages range from 49 to 87 years. Most had not visited the dentist in more than 2 years. Most women's early childhood experiences did not include dental visits or dental instruction. Some believed tooth loss was a normal aging process. Misconceptions regarding preventive care, the belief that dental visits were only necessary when experiencing pain, and finances were the primary reasons for not visiting the dentist. The results lend insight into the oral health, self-care practices, and dental utilization of middle-aged and older immigrant Mexican American women.

  18. South Asian women's coping strategies in the face of domestic violence in the United States.

    PubMed

    Bhandari, Shreya

    2018-02-01

    We conducted in-depth telephone interviews with a convenience sample of 20 South Asian women experiencing domestic violence in the United States. Utilizing the emotion-focused and problem-focused coping framework, the researchers analyzed the narratives of abused South Asian women. Emotion-focused coping strategies include (a) spirituality and/or religion and (b) the role of children. Problem-focused coping strategies include (c) informal and formal support and (d) strategies of resisting, pacifying, safety planning. Implications for practice and future research in the United States and internationally are discussed.

  19. Femininity, Masculinity, and Body Image Issues among College-Age Women: An In-Depth and Written Interview Study of the Mind-Body Dichotomy

    ERIC Educational Resources Information Center

    Leavy, Patricia; Gnong, Andrea; Ross, Lauren Sardi

    2009-01-01

    In this article we investigate college-age women's body image issues in the context of dominant femininity and its polarization of the mind and body. We use original data collected through seven in-depth interviews and 32 qualitative written interviews with college-age women and men. We coded the data thematically applying feminist approaches to…

  20. Chagas Disease, Migration and Community Settlement Patterns in Arequipa, Peru

    PubMed Central

    Gilman, Robert H.; Cornejo del Carpio, Juan G.; Naquira, Cesar; Bern, Caryn; Levy, Michael Z.

    2009-01-01

    Background Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles have become established. We examined the history of migration and settlement patterns in these communities, and their connections to Chagas disease transmission. Methodology/Principal Findings This was a qualitative study that employed focus group discussions and in-depth interviews. Five focus groups and 50 in-depth interviews were carried out with 94 community members from three shantytowns and two traditional towns near Arequipa, Peru. Focus groups utilized participatory methodologies to explore the community's mobility patterns and the historical and current presence of triatomine vectors. In-depth interviews based on event history calendars explored participants' migration patterns and experience with Chagas disease and vectors. Focus group data were analyzed using participatory analysis methodologies, and interview data were coded and analyzed using a grounded theory approach. Entomologic data were provided by an ongoing vector control campaign. We found that migrants to shantytowns in Arequipa were unlikely to have brought triatomines to the city upon arrival. Frequent seasonal moves, however, took shantytown residents to valleys surrounding Arequipa where vectors are prevalent. In addition, the pattern of settlement of shantytowns and the practice of raising domestic animals by residents creates a favorable environment for vector proliferation and dispersal. Finally, we uncovered a phenomenon of population loss and replacement by low-income migrants in one traditional town, which created the human settlement pattern of a new shantytown within this traditional community. Conclusions/Significance The pattern of human migration is therefore an important underlying determinant of Chagas disease risk in and around Arequipa. Frequent seasonal migration by residents of peri-urban shantytowns provides a path of entry of vectors into these communities. Changing demographic dynamics of traditional towns are also leading to favorable conditions for Chagas disease transmission. Control programs must include surveillance for infestation in communities assumed to be free of vectors. PMID:20016830

  1. Designing insurance to promote use of childhood obesity prevention services.

    PubMed

    Rask, Kimberly J; Gazmararian, Julie A; Kohler, Susan S; Hawley, Jonathan N; Bogard, Jenny; Brown, Victoria A

    2013-01-01

    Childhood obesity is a recognized public health crisis. This paper reviews the lessons learned from a voluntary initiative to expand insurance coverage for childhood obesity prevention and treatment services in the United States. In-depth telephone interviews were conducted with key informants from 16 participating health plans and employers in 2010-11. Key informants reported difficulty ensuring that both providers and families were aware of the available services. Participating health plans and employers are beginning new tactics including removing enrollment requirements, piloting enhanced outreach to selected physician practices, and educating providers on effective care coordination and use of obesity-specific billing codes through professional organizations. The voluntary initiative successfully increased private health insurance coverage for obesity services, but the interviews described variability in implementation with both best practices and barriers identified. Increasing utilization of obesity-related health services in the long term will require both family- and provider-focused interventions in partnership with improved health insurance coverage.

  2. Perceptions of coercion, discrimination and other negative experiences in postpartum contraceptive counseling for low-income minority women.

    PubMed

    Yee, Lynn M; Simon, Melissa A

    2011-11-01

    Using in-depth qualitative methods, we investigated negative contraception counseling experiences, including those felt to be coercive or discriminatory, in a population of postpartum urban minority women. Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women who had received care at a Medicaid-funded obstetrics clinic. In-person one-on-one interviews were then reviewed for themes using an iterative process of qualitative analysis. In this sample of African American (63%) and Hispanic (37%) women (median age 26), 73% had unplanned pregnancies. Features of negative counseling experiences included having insufficient, non-physician-directed and impersonal counseling. Most women had experienced episodes of poor communication with providers; 10 described feeling coerced or perceiving racially-based discrimination in counseling. Negative experiences with contraceptive counseling may affect contraception utilization. Contraceptive education should respect each individual's autonomy, culture, and values.

  3. [In-depth interviews and the Kano model to determine user requirements in a burns unit].

    PubMed

    González-Revaldería, J; Holguín-Holgado, P; Lumbreras-Marín, E; Núñez-López, G

    To determine the healthcare requirements of patients in a Burns Unit, using qualitative techniques, such us in-depth personal interviews and Kano's methodology. Qualitative methodology using in-depth personal interviews (12 patients), Kano's conceptual model, and the SERVQHOS questionnaire (24 patients). All patients had been hospitalised in the last 12 months in the Burns Unit. Using Kano's methodology, service attributes were grouped by affinity diagrams, and classified as follows: must-be, attractive (unexpected, great satisfaction), and one-dimensional (linked to the degree of functionality of the service). The outcomes were compared with those obtained with SERVQHOS questionnaire. From the analysis of in-depth interviews, 11 requirements were obtained, referring to hotel aspects, information, need for closer staff relationship, and organisational aspects. The attributes classified as must-be were free television and automatic TV disconnection at midnight. Those classified as attractive were: individual room for more privacy, information about dressing change times in order to avoid anxiety, and additional staff for in-patients. The results were complementary to those obtained with the SERVQHOS questionnaire. In-depth personal interviews provide extra knowledge about patient requirements, complementing the information obtained with questionnaires. With this methodology, a more active patient participation is achieved and the companion's opinion is also taken into account. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Estimation of utilities in attention-deficit hyperactivity disorder for economic evaluations.

    PubMed

    Lloyd, Andrew; Hodgkins, Paul; Sasane, Rahul; Akehurst, Ron; Sonuga-Barke, Edmund J S; Fitzgerald, Patrick; Nixon, Annabel; Erder, Haim; Brazier, John

    2011-01-01

    Attempts to estimate the cost effectiveness of attention-deficit hyperactivity disorder (ADHD) treatments in the past have relied on classifying ADHD patients as responders or non-responders to treatment. Responder status has been associated with a small gain in health-related quality of life (HR-QOL) [or utility, as measured using the generic QOL measure EQ-5D] of 0.06 (on a scale from 0 being dead to 1.0 being full health). The goal of the present study was to develop and validate several ADHD-related health states, and to estimate utility values measured amongst the general public for those states and to re-estimate utility values associated with responder status. Detailed qualitative interview data were collected from 20 young ADHD patients to characterize their HR-QOL. In addition, item-by-item clinical and HR-QOL data from a clinical trial were used to define and describe four health states (normal; borderline to mildly ill; moderately to markedly ill; and severely ill). ADHD experts assessed the content validity of the descriptions. The states were rated by 100 members of the UK general public using the time trade-off (TTO) interview and visual analog scale. Statistical mapping was also undertaken to estimate Clinical Global Impression-Improvement (CGI-I) utilities (i.e. response status) from Clinical Global Impression-Severity (CGI-S) defined states. The mapping work estimated changes in utilities from study baseline to last visit for patients with a CGI-I score of ≤ 2 or ≤ 3. The validity of the four health states developed in this study was supported by in-depth interviews with ADHD experts and patients, and clinical trial data. TTO-derived utilities for the four health states ranged from 0.839 (CGI-S state 'normal') to 0.444 (CGI-S state 'severely ill'). From the mapping work, the change in utility for treatment responders was 0.19 for patients with a CGI-I score of ≤ 2 and 0.15 for patients with a CGI-I score of ≤ 3. The present study provides utilities for different severity levels of ADHD estimated in a TTO study. This approach provides a more granular assessment of the impact of ADHD on HR-QOL than binary approaches employed in previous economic analyses. Change in utility for responders and non-responders at different levels of CGI-I was estimated, and thus these utilities may be used to compare health gains of different ADHD interventions.

  5. The lived experiences of adolescents with sickle cell disease in Kingston, Jamaica.

    PubMed

    Forrester, Andrea Brown; Barton-Gooden, Antoinette; Pitter, Cynthia; Lindo, Jascinth L M

    2015-01-01

    To explore the lived experiences of adolescents with sickle cell disease, in Kingston, Jamaica. A descriptive qualitative design was used for this research. In-depth interviews were conducted with six adolescents with sickle cell disease at a Sickle Cell Unit operated by the University of the West Indies. Interviews were audiotaped, transcribed, and thematically analyzed. The majority of the adolescents demonstrated a positive self-concept. They reported strong family, school, and peer support which made them feel accepted. All were actively engaged in social activities such as parties, but had challenges participating in sporting activities. Various coping strategies were utilized to address challenges of the disease including praying, watching television, and surfing the Internet. Sickle cell disease can be very challenging for the adolescent, but with positive self-concept and increased social support, especially from family and peers, these adolescents were able to effectively cope with their condition and live productive lives.

  6. Passing Through: Meanings of Survivorship and Support Among Filipinas With Breast Cancer

    PubMed Central

    Burke, Nancy J.; Villero, Ofelia; Guerra, Claudia

    2012-01-01

    Breast cancer among Filipinas in the United States is a major but largely neglected cancer disparity. In 2004, a community– university partnership resulted in the first Filipina breast cancer support group in the San Francisco Bay Area. Building on this partnership, we explored the social and cultural contexts of Filipinas’ experiences with breast cancer to inform development of culturally appropriate and sustainable support services and outreach. We utilized multiple qualitative methods (participant observation, individual and small group in-depth qualitative interviews) to identify meanings of survivorship and support. Interviews and observations revealed the influences of social context and immigration experiences on women’s understandings of cancer, what “surviving” cancer means, and what it means to take care of someone with breast cancer (or be taken care of). Our findings highlight the importance of a transnational perspective for the study of immigrant women’s experiences of cancer and survivorship. PMID:21876208

  7. Survivor experience of a child sexual abuse prevention program: a pilot study.

    PubMed

    Barron, Ian G; Topping, Keith J

    2013-09-01

    Addressing gaps in the research, the current study assesses the impact of a community-based child sexual abuse prevention program on known survivor knowledge/skills, disclosures, and subjective experience. Methodologically, novel measures of program fidelity and implementation cost are applied. A pre- posttest wait-list control design was utilized with intervention (n = 10) and comparison groups (n = 10). Measures included a standardized knowledge/skill questionnaire, coding of disclosures, subjective experience questionnaires, in-depth interviews, video analysis of program adherence, and a measure of cost. Analysis involved nonparametric tests and thematic analysis of interview and video data. Cost was calculated for the group and per survivor. Survivors achieved significant gains in knowledge/skills, made further disclosures, and were positive about their program experience. No gains were identified in the control group. Costs were small. Future studies need to explore survivor experience of programs delivered in classrooms.

  8. Passing through: meanings of survivorship and support among Filipinas with breast cancer.

    PubMed

    Burke, Nancy J; Villero, Ofelia; Guerra, Claudia

    2012-02-01

    Breast cancer among Filipinas in the United States is a major but largely neglected cancer disparity. In 2004, a community- university partnership resulted in the first Filipina breast cancer support group in the San Francisco Bay Area. Building on this partnership, we explored the social and cultural contexts of Filipinas' experiences with breast cancer to inform development of culturally appropriate and sustainable support services and outreach. We utilized multiple qualitative methods (participant observation, individual and small group in-depth qualitative interviews) to identify meanings of survivorship and support. Interviews and observations revealed the influences of social context and immigration experiences on women's understandings of cancer, what "surviving" cancer means, and what it means to take care of someone with breast cancer (or be taken care of). Our findings highlight the importance of a transnational perspective for the study of immigrant women's experiences of cancer and survivorship.

  9. Voices of Dissent: Unpacking Vietnamese International Student Experience

    ERIC Educational Resources Information Center

    Huong, Le; Koo, Fung Kuen; Arambewela, Rodney; Zutshi, Ambika

    2017-01-01

    Purpose: The purpose of this paper is to examine Vietnamese international students' experiences with the campus learning environment by analysing differences in staff and student perceptions. Design/Methodology/Approach: Two focus groups (n = 12) and ten in-depth interviews were conducted with Vietnamese students and four in-depth interviews with…

  10. Perceptions about Iranian-Kurds' ethnic-inequality in health.

    PubMed

    Yari, Arezoo; Nedjat, Saharnaz; Asadi-Lari, Mohsen; Majdzadeh, Reza

    2017-09-12

    Evidence shows ethnic-inequality is a very effective variable in the Community and individual health associated outcomes. This study focused on gaining a deeper understanding of people's perception on inequality of health in Iranian-Kurds and its determinants. The study was conducted in the three cities of Marivan, Sanandaj (capital of Kurdistan province in Iran) and Tehran (capital of the country). The study was conducted through 34 in-depth interviews and ten focus group discussions with health services users, academic graduates and health delivery service personnel. Consensus on social, mental and physical health inequality did not exist within the study participants. However, there were concerns about differences in healthcare access and utilization. Several participants believed that access to health services and socio-cultural differences of Kurds affected the healthcare utilization. Since, people perceived ethnic-inequality in healthcare access and utilization, ethnicity must be considered as a mandatory stratifier in monitoring health status and a concern during planning health interventions. People's awareness, resources management and allocation are factors requiring more consideration when choosing policy options.

  11. Qualitative Assessment of Learning Strategies among Medical Students Using Focus Group Discussions and In-depth Interviews.

    PubMed

    Joshi, Anuradha Sujai; Ganjiwale, Jaishree Deepak; Varma, Jagdish; Singh, Praveen; Modi, Jyoti Nath; Singh, Tejinder

    2017-12-01

    Globally, students with top academic performance and high intellectual capacity usually opt to study medicine. However, once students get enrolled, their academic performance varies widely. Such variations appear to be determined by various factors, one of them being types of learning strategies adopted by students. The learning strategies utilized by the students with better academic performance are likely to be more effective learning strategies. The objective is to identify effective learning strategies used by medical students. This study was carried out among the MBBS students of Final Professional Part I. Students were categorized into three groups namely: high, average, and low rankers based on overall academic performance in second Professional University examination. First, a questionnaire consisting of closed- and open-ended questions was administered to students, to find their learning strategies. Subsequently, focus group discussion and in-depth interviews were conducted for high- and low-rankers. Discussions were audio-recorded, transcribed, and analyzed. Key statements were highlighted, collated, and categorized into general themes and sub-themes. Evident themes which emerged as effective strategies were hard work in the form of regularity of studies, meticulous preparation of notes, constructive use of time, utilization of e-learning, learning styles and deep learning approach and regular ward visits. Intrinsic motivation, family support, balancing physical activities and studies, guidance by seniors, teachers, dealing with nonacademic issues such as language barriers and stress were also identified as important strategies. Disseminating effective learning strategies in a systematic manner may be helpful to students in achieving better academic outcomes. Furthermore, educationists need to modulate their teaching strategies based on students' feedback.

  12. Mobilizing male opinion leaders’ support for family planning to improve maternal health: a theory-based qualitative study from Pakistan

    PubMed Central

    Azmat, Syed Khurram

    2011-01-01

    Purpose Pakistan is a patriarchal society in which male opinion leaders play an important role in determining health-seeking behaviors pertaining to family planning (FP) among their respective communities. This research focuses on cataloguing the perceptions of opinion leaders (clergymen, health professionals, and social workers) about the barriers for using services and practical solutions for promoting FP in the slums of Karachi, Pakistan. Materials and methods A qualitative study using an open-ended, semistructured interview schedule with hypothetical scenarios and in-depth interviews with a purposive sample of 45 opinion leaders (25 mosque imams/clergymen, 12 nonallopathic health professionals, and eight social workers/activists) was conducted in 2006–2007 in Karachi, Pakistan. Transcripts were coded thematically utilizing NVivo by using an adapted constant comparison analysis process as described by Strauss and Corbin. Results Seven key themes were derived from the in-depth interviews. Five themes provide insight into the opinion leaders’ perceptions of barriers to FP and modern contraception methods. Among the barriers religious taboos and cultural pressures were particularly note-worthy. Two themes offered opportunities for more effective development and implementation of FP programs. Conclusion It is evident from the study that opinion leaders in the community and the clergy lack the understanding of the importance of birth spacing. However, because they have a great deal of influence on the community at large, it is imperative to interact with them to build their capacity in order to propagate the messages of FP and improve maternal health and reproductive health in general. PMID:22247617

  13. Perceived utility and relevance of intern wellbeing sessions.

    PubMed

    Ward, Susannah; Outram, Sue; Heslop, Ben

    2018-02-21

    We conducted a pilot project assessing the perceived utility and relevance of wellbeing sessions provided to interns at a large regional teaching hospital in Australia with the aim of promoting intern wellbeing and fostering a nurturing and supportive learning and work hospital culture. Our intervention involved two separate 60 minute lectures covering wellbeing topics and skills, to approximately 50 interns within protected teaching time, along with emailed wellbeing resources. Participants were emailed an on-line survey asking questions about value and novelty of the sessions, and work satisfaction and stress, as well as open comments. A request for an additional interview to explore responses in more depth was included. Fifty interns attended at least one of the sessions and 35 participated in the survey, six to an additional interview. Survey and interview data showed that the majority of interns perceived the sessions as valuable, relevant and useful and felt that ongoing sessions would benefit junior medical officers (JMOs) in future years. Feedback highlighted the importance of providing future sessions in-person, incorporating an interactive approach and emphasized that work site factors and medical culture play a large causative role in their stress. We conclude that wellbeing sessions are acceptable and useful to interns and should be incorporated into hospital teaching curricula, and evaluated. However these programs are unlikely to change the high stress experienced unless external and systemic stressors are addressed by all stakeholders. This article is protected by copyright. All rights reserved.

  14. The use of music in aged care facilities: A mixed-methods study.

    PubMed

    Garrido, Sandra; Dunne, Laura; Perz, Janette; Chang, Esther; Stevens, Catherine J

    2018-02-01

    Music is frequently used in aged care, being easily accessible and cost-effective. Research indicates that certain types of musical engagement hold greater benefits than others. However, it is not clear how effectively music is utilized in aged care facilities and what the barriers are to its further use. This study used a mixed-methods paradigm, surveying 46 aged care workers and conducting in-depth interviews with 5, to explore how music is used in aged care facilities in Australia, staff perceptions of the impact of music on residents, and the barriers to more effective implementation of music in aged care settings.

  15. Structural Violence in Health Care: Lived Experience of Street-Based Female Commercial Sex Workers in Kathmandu.

    PubMed

    Basnyat, Iccha

    2017-01-01

    Thirty-five in-depth, semi-structured interviews were conducted with female, street-based, commercial sex workers in Kathmandu, Nepal. The framework of structural violence guided this study in identifying the structural context that impacts the female sex workers' lives and may cause harm to their health. Structural violence in health care was revealed through thematic analysis as (a) discrimination, (b) forced choice, and (c) limitations to health information sources. Lived experiences highlight how the sex workers engaged with structural limitations in health care access, services, and utilization. Structural violence conveys a message about who is entitled to health care and what a society emphasizes and expects regarding acceptable health behavior. Examining the structural violence highlighted how the sex workers negotiated, understood, and engaged with structural limitations in health care access, services, and utilization. © The Author(s) 2015.

  16. An Inside Look at Homeless Youths’ Social Networks: Perceptions of Substance Use Norms1

    PubMed Central

    Melander, Lisa A.; Tyler, Kimberly A.; Schmitz, Rachel M.

    2016-01-01

    Substance use among homeless young people is a pervasive problem, and there have been many efforts to understand more about the dynamics of this health compromising behavior. The current study examined perceived substance use norms within homeless youths’ social networks utilizing in-depth interviews. The sample included 19 homeless individuals aged 16 to 21. Four elements of substance use within networks emerged: substance use choices, drug use safety issues, encouragement and/or discouragement, and appropriate situations in which substance use is condoned. These findings provide unique insight into the norms associated with drug and alcohol use within homeless youths’ social networks. PMID:26989340

  17. Surviving the Distance: The Transnational Utilization of Traditional Medicine Among Oaxacan Migrants in the US.

    PubMed

    González-Vázquez, Tonatiuh; Pelcastre-Villafuerte, Blanca Estela; Taboada, Arianna

    2016-10-01

    Transnational health practices are an emergent and understudied phenomenon, which provide insight into how migrants seek care and tend to their health care needs in receiving communities. We conducted in depth interviews with return migrants (N = 21) and traditional healers (N = 11) to explore transnational health practices among Mixtec migrants from Oaxaca, specifically in relation to their utilization of traditional healers, medicinal plants, and folk remedies. In established migrant destination points, folk remedies and plants are readily available, and furthermore, these resources often travel alongside migrants. Traditional healers are integral to transnational networks, whether they migrate and provide services in the destination point, or are providing services from communities of origin. Findings encourage us to rethink migrants' communities of origin typically thought of as "left behind," and instead reposition them as inherently connected by transnational channels. Implications for transnational health care theory and practice are addressed.

  18. Defying Unjust Authority: An Exploratory Study

    PubMed Central

    Zimbardo, Philip G.

    2010-01-01

    This research explores the psychological factors potentially involved in fostering disobedience to an unjust authority. Our paradigm was modeled after that of the Utrecht Studies on Obedience (Meeus and Raaijmakers European Journal of Social Psychology 16:311-324, 1986) in which participants are ordered to give each of 15 increasingly hostile comments to a participant/victim whenever he fails a trial. Although 30% of our sample followed commands to insult the other participant (confederate), the majority did refuse to do so at some point in the escalating hostility sequence. Our procedure utilized conditions known from prior research to increase the ratio of disobedience to obedience: proximity of teacher to learner plus remote authority. In order to better understand some of the cognitive and affective processes that may predict such defiant behaviour, we utilized a variety of measures, among them, behavioural observations, individual difference assessments, and in depth post-experimental interviews. PMID:20461226

  19. Defying Unjust Authority: An Exploratory Study.

    PubMed

    Bocchiaro, Piero; Zimbardo, Philip G

    2010-06-01

    This research explores the psychological factors potentially involved in fostering disobedience to an unjust authority. Our paradigm was modeled after that of the Utrecht Studies on Obedience (Meeus and Raaijmakers European Journal of Social Psychology 16:311-324, 1986) in which participants are ordered to give each of 15 increasingly hostile comments to a participant/victim whenever he fails a trial. Although 30% of our sample followed commands to insult the other participant (confederate), the majority did refuse to do so at some point in the escalating hostility sequence. Our procedure utilized conditions known from prior research to increase the ratio of disobedience to obedience: proximity of teacher to learner plus remote authority. In order to better understand some of the cognitive and affective processes that may predict such defiant behaviour, we utilized a variety of measures, among them, behavioural observations, individual difference assessments, and in depth post-experimental interviews.

  20. Promoting resiliency among palliative care clinicians: stressors, coping strategies, and training needs.

    PubMed

    Perez, Giselle K; Haime, Vivian; Jackson, Vicki; Chittenden, Eva; Mehta, Darshan H; Park, Elyse R

    2015-04-01

    Palliative care clinicians (PCCs) are susceptible to burnout, as they regularly witness immense patient and family suffering; however, little is known about their specific challenges and training needs to enhance their long-term sustainability. The purpose of this qualitative study was to explore common stressors, coping strategies, and training needs among PCCs in efforts to inform the development of a targeted Resiliency Program. Utilizing a semistructured interview guide, we conducted a series of in-depth interviews with 15 PCCs at the Massachusetts General Hospital. Content analysis highlighted three main areas of stressors: (1) systematic challenges related to managing large, emotionally demanding caseloads within time constraints; (2) patient factors, such as addressing patients' mutable needs, managing family dynamics, and meeting patient and family demands and expectations; and (3) personal challenges of delineating emotional and professional boundaries. Engaging in healthy behaviors and hobbies and seeking emotional support from colleagues and friends were among the most common methods of coping with stressors. In terms of programmatic topics, PCCs desired training in mind-body skills (e.g., breathing, yoga, meditation), health education about the effects of stress, and cognitive strategies to help reduce ruminative thoughts and negative self-talk. A majority of clinicians stressed the need for brief strategies that could be readily integrated in the workplace. These results suggest that an intervention aimed to enhance PCC sustainability should focus on utilizing a skill-building approach to stress reduction that imparts strategies that can be readily utilized during work hours.

  1. Addressing underutilization of consumer health information resource centers: a formative study*

    PubMed Central

    Kennedy, May G.; Kiken, Laura; Shipman, Jean P.

    2008-01-01

    Problem: Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Method: Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. Results: There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Conclusions: Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted. PMID:18219380

  2. Addressing underutilization of consumer health information resource centers: a formative study.

    PubMed

    Kennedy, May G; Kiken, Laura; Shipman, Jean P

    2008-01-01

    Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted.

  3. Forging Paths through Hostile Territory: Intersections of Women's Identities Pursuing Post-Secondary Computing Education

    ERIC Educational Resources Information Center

    Ratnabalasuriar, Sheruni

    2012-01-01

    This study explores experiences of women as they pursue post-secondary computing education in various contexts. Using in-depth interviews, the current study employs qualitative methods and draws from an intersectional approach to focus on how the various barriers emerge for women in different types of computing cultures. In-depth interviews with…

  4. Combining food records with in-depth probing interviews improves quality of dietary intake reporting in a group of South Asian women.

    PubMed

    Kruger, Rozanne; Stonehouse, Welma; von Hurst, Pamela Ruth; Coad, Jane

    2012-04-01

    To investigate if the addition of an in-depth interview focused on cultural dietary practices could improve the quality of dietary data from food records among South Asian women in New Zealand. Cross-sectional data were collected from 134 South Asian women (≥20 years), living in Auckland. Dietary data were collected using four-day food records. Nutritional analysis revealed 33.6% under-reporting of energy intakes. All women were recalled for an in-depth probing interview focused on culture-specific foods and dietary practices. The interview revealed extensive use of dairy products and plant oils. The nutrient content of the food record alone and the food record plus interview were compared; median energy intakes were 6,852 kJ vs 7,246 kJ (p<0.001); under-reporting decreased by 14.2%, and total fat and protein intakes (g/day) increased (p<0.001). Estimates of poly- and mono-unsaturated fatty acids increased significantly (p<0.001) due to greater use of plant oils due to greater use of plant oils replacing saturated fatty acid-rich fats in food preparation. A significant increase (17%) (p<0.001) in calcium intake reflects the higher dairy intake identified with the interview. The addition of an in-depth probing interview to a four-day food record enhanced food intake reporting. Self-reported dietary assessments in immigrant population groups require quality control for accuracy. Methods to ensure high-quality dietary data are essential to assess health outcomes and to inform public health interventions, especially in immigrant populations. © 2012 The Authors. ANZJPH © 2012 Public Health Association of Australia.

  5. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa

    PubMed Central

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Background Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. Methods The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. Results The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. Conclusion This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement. PMID:29535529

  6. Examining leadership as a strategy to enhance health care service delivery in regional hospitals in South Africa.

    PubMed

    Govender, Sagaren; Gerwel Proches, Cecile N; Kader, Abdulla

    2018-01-01

    Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province. The mixed-method research approach was utilized. Purposive sampling and stratified random sampling were employed in the research setting, and in-depth, semistructured interviews and questionnaires were used to collect data. Data were analyzed using the Nvivo computer software package for in-depth interviews and the Statistical Package for the Social Sciences (SPSS) software for the quantitative analysis. The research findings showed that the current leadership framework adopted by the health care leaders in regional hospitals in KZN is weak and is contributing to poor health care service delivery. This study, therefore, aimed to address the current challenges and weaknesses that are impacting negatively on health care service delivery in regional hospitals in the KZN Province and made recommendations for improvement.

  7. Exploration of the administrative aspects of the delivery of home health care services: a qualitative study.

    PubMed

    Shahsavari, Hooman; Nasrabadi, Alireza Nikbakht; Almasian, Mohammad; Heydari, Heshmatolah; Hazini, Abdolrahim

    2018-01-01

    Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task. The purpose of this study was to explore the administrative aspects of the delivery of home health care services. This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method. 23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories. Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.

  8. The school-to-work transition of people with mental handicap in Hong Kong.

    PubMed

    Ping-Ying Li, Eria

    2000-01-01

    The purpose of this study was to examine the school-to-work experience of people with mental handicap in Hong Kong. Fourteen young adults with mild mental handicap participated in in-depth interviews. An interview guide was utilized which included topics related to the participants' vocational preferences, work motivation and post-school placements. Data were analyzed according to a constant comparative method and content analysis. Three-quarters of the participants expressed job preferences. Three-quarters of the participants had taken a vocational training program unrelated to their job preferences. Half of the participants who had taken up open employment had not obtained their preferred jobs. None of the participants who had completed vocational training obtained job placements that matched their vocational training programs. All of the participants except five were not involved in making independent decisions regarding employment. The need to improve the quality of vocational services and empower people with mental handicap to take up self-determining roles are discussed.

  9. "You're Really Gonna Kick Us All Out?" Sustaining Safe Spaces for Community-Based HIV Prevention and Control among Black Men Who Have Sex with Men.

    PubMed

    Garcia, Jonathan; Parker, Caroline; Parker, Richard G; Wilson, Patrick A; Philbin, Morgan M; Hirsch, Jennifer S

    2015-01-01

    Black men who have sex with men (BMSM) experience among the highest rates of HIV infection in the United States. We conducted a community-based ethnography in New York City to identify the structural and environmental factors that influence BMSMs vulnerability to HIV and their engagement with HIV prevention services. Methods included participant observation at community-based organizations (CBOs) in New York City, in-depth interviews with 31 BMSM, and 17 key informant interviews. Our conceptual framework shows how creating and sustaining safe spaces could be a critical environmental approach to reduce vulnerability to HIV among BMSM. Participant observation, in-depth and key informant interviews revealed that fear and mistrust characterized men's relation to social and public institutions, such as churches, schools, and the police. This fear and mistrust created HIV vulnerability among the BMSM in our sample by challenging engagement with services. Our findings suggest that to be successful, HIV prevention efforts must address these structural and environmental vulnerabilities. Among the CBOs that we studied, "safe spaces" emerged as an important tool for addressing these environmental vulnerabilities. CBOs used safe spaces to provide social support, to address stigma, to prepare men for the workforce, and to foster a sense of community among BMSM. In addition, safe spaces were used for HIV and STI testing and treatment campaigns. Our ethnographic findings suggest that safe spaces represent a promising but so far under-utilized part of HIV prevention infrastructure. Safe spaces seem integral to high impact comprehensive HIV prevention efforts, and may be considered more appropriately as part of HIV capacity-building rather than being nested within program-specific funding structures.

  10. Changed and changing gender and family roles and domestic violence in African refugee background communities post-settlement in Perth, Australia.

    PubMed

    Fisher, Colleen

    2013-07-01

    In this study, domestic violence (DV) in five African refugee background communities post-settlement in Perth, Australia, is investigated-specifically, the interrelationship between experiences of DV, and changed and changing gender and family roles and responsibilities. The participatory qualitative design utilized in-depth interviews with 54 members of the Somalian, Sierra Leonean, Ethiopian, Liberian and Sudanese Communities, and focus groups with 24 professionals who support them. Three key dimensions of this interrelationship are discussed: "male loss of the breadwinner role and status," "financial independence," and "mismatch between formal response and expectations." The importance of understanding experiences of DV within the context of cultural transition is highlighted here.

  11. Post-Separation Abuse of Women and their Children: Boundary-setting and Family Court Utilization among Victimized Mothers

    PubMed Central

    Zeoli, April M.; Rivera, Echo A.; Sullivan, Cris M.; Kubiak, Sheryl

    2013-01-01

    Continued abuse of themselves and their children is a concern for many mothers leaving intimate partner violence (IPV) perpetrating husbands. This research examines women’s responses to abuse committed by ex-husbands with whom they had undergone custody disputes. In-depth, qualitative interviews were conducted with 19 mothers who had divorced IPV-perpetrating husbands between one and three years prior. Participants were located through publicly available family court divorce records and interviews were examined using analytic induction. Women’s strategies to protect themselves and their children from abuse involved setting boundaries to govern their interactions with ex-husbands. Mothers often turned to family court for assistance in setting boundaries to keep children safe, but found that family court did not respond in ways they believed protected their children. Conversely, when women turned to the justice system for restraining orders or called the police for help against IPV, they generally found the justice system responsive. PMID:23956494

  12. Utility of action checklists as a consensus building tool

    PubMed Central

    KIM, Yeon-Ha; YOSHIKAWA, Etsuko; YOSHIKAWA, Toru; KOGI, Kazutaka; JUNG, Moon-Hee

    2014-01-01

    The present study’s objective was to determine the mechanisms for enhancing the utility of action checklists applied in participatory approach programs for workplace improvements, to identify the benefits of building consensus and to compare their applicability in Asian countries to find the most appropriate configuration for action checklists. Data were collected from eight trainees and 43 trainers with experience in Participatory Action-Oriented Training. Statistical analysis was performed in SPSS using the package PASW, version 19.0. The difference in the mean score for the degree of the utility of action checklists between countries was analyzed using ANOVA methods. Factor analysis was performed to validate the action checklists’ utility. Pearson Correlation Coefficients were then calculated to determine the direction and strength of the relationship between these factors. Using responses obtained from trainees’ in-depth interviews, we identified 33 key statements that were then classified into 11 thematic clusters. Five factors were extracted, namely “ease of application”, “practical solutions”, “group interaction”, “multifaceted perspective” and “active involvement”. The action checklist was useful for facilitating a participatory process among trainees and trainers for improving working conditions. Action checklists showed similar patterns of utility in various Asian countries; particularly when adjusted to local conditions. PMID:25224334

  13. How Non Consumers Differ from Consumers: A Qualitative Approach to Synthesize the Attributes of Iron Folic Acid End Users

    PubMed Central

    Bali, Surya; Tiwari, Sharad; Singh, Daneshwar; Arutagi, Viswanath; Kale, Saket; Pal, DInesh Kumar

    2017-01-01

    Introduction Anaemia continues to be a major hurdle to achieve optimum health in Indian population context. Although government continues to promote Iron Folic Acid (IFA) supplementation as one of the key strategies to combat with burden of anaemia, the expected level of IFA consumption and subsequent anaemia reduction could not be achieved. This study tries to investigate those influences, concerns, experiences and behaviour from an end user perspective through a qualitative methodology which may affect the IFA consumption ambi-directionally. Aim To explore and understand the several aspects related with anaemia and IFA supplementation with special emphasis to reveal the contributory factors behind low level of IFA consumption at consumer end. Materials and Methods A community based qualitative study was conducted in clusters identified through multileveled stratification from a state of central India. A conceptual construct was made in priory for this study. As the research question was related with policy, this study adapted a framework technique for making interview topic guides. Two consumers and two non consumers from each identified cluster were interviewed in depth. The data obtained through 160 in depth interviews (from 80 consumers and 80 non consumers) was utilized for thematic framework, linkage association and to typify the phenomenon. Results Ignorance, difficult intake, meaninglessness, misconceptions and discontentment with the system were the major dimensions (sub themes) associated with discontinuation. All these sub themes were further converged into major theme of informational discontinuity. Investigators further typified the users/non users into persistent user, potential defaulters, impending defaulters and absolute non users. Conclusion Informational gap seems to be the fundamental factor behind sub optimum IFA consumption. On a policy perspective, all the attempts should be done to instigate arise felt need’ among target groups for IFA consumption. PMID:28658813

  14. What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California.

    PubMed

    Sanchez-Flack, Jennifer C; Baquero, Barbara; Linnan, Laura A; Gittelsohn, Joel; Pickrel, Julie L; Ayala, Guadalupe X

    2016-01-01

    To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers' grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and sociocultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers.

  15. Opiate Users' Perceived Barriers Against Attending Methadone Maintenance Therapy: A Qualitative Study in China

    PubMed Central

    Lin, Chunqing; Wu, Zunyou; Detels, Roger

    2012-01-01

    Methadone maintenance therapy (MMT) in China is facing challenges such as high relapse rates and low coverage. The study assessed factors influencing MMT utilization among opiate users. In-depth interviews were conducted among 30 opiate users in 2008 to ascertain the barriers against seeking MMT. Data were analyzed using ATLAS.ti. Barriers to the treatment included requirement of registration with police, perceived discrimination, logistic difficulties, side effects, fear of being addicted to another drug, lack of additional services, and economic burden. The result suggests the need for structural changes such as improving comprehensive services, simplifying application procedure, and enhancing referral system. The study's limitations are noted. PMID:21417558

  16. The efficiency and effectiveness of utilizing diagrams in interviews: an assessment of participatory diagramming and graphic elicitation.

    PubMed

    Umoquit, Muriah J; Dobrow, Mark J; Lemieux-Charles, Louise; Ritvo, Paul G; Urbach, David R; Wodchis, Walter P

    2008-08-08

    This paper focuses on measuring the efficiency and effectiveness of two diagramming methods employed in key informant interviews with clinicians and health care administrators. The two methods are 'participatory diagramming', where the respondent creates a diagram that assists in their communication of answers, and 'graphic elicitation', where a researcher-prepared diagram is used to stimulate data collection. These two diagramming methods were applied in key informant interviews and their value in efficiently and effectively gathering data was assessed based on quantitative measures and qualitative observations. Assessment of the two diagramming methods suggests that participatory diagramming is an efficient method for collecting data in graphic form, but may not generate the depth of verbal response that many qualitative researchers seek. In contrast, graphic elicitation was more intuitive, better understood and preferred by most respondents, and often provided more contemplative verbal responses, however this was achieved at the expense of more interview time. Diagramming methods are important for eliciting interview data that are often difficult to obtain through traditional verbal exchanges. Subject to the methodological limitations of the study, our findings suggest that while participatory diagramming and graphic elicitation have specific strengths and weaknesses, their combined use can provide complementary information that would not likely occur with the application of only one diagramming method. The methodological insights gained by examining the efficiency and effectiveness of these diagramming methods in our study should be helpful to other researchers considering their incorporation into qualitative research designs.

  17. Lessons from Early Medicaid Expansions Under Health Reform: Interviews with Medicaid Officials

    PubMed Central

    Sommers, Benjamin D; Arntson, Emily; Kenney, Genevieve M; Epstein, Arnold M

    2013-01-01

    Background The Affordable Care Act (ACA) dramatically expands Medicaid in 2014 in participating states. Meanwhile, six states have already expanded Medicaid since 2010 to some or all of the low-income adults targeted under health reform. We undertook an in-depth exploration of these six “early-expander” states—California, Connecticut, the District of Columbia, Minnesota, New Jersey, and Washington—through interviews with high-ranking Medicaid officials. Methods We conducted semi-structured interviews with 11 high-ranking Medicaid officials in six states and analyzed the interviews using qualitative methods. Interviews explored enrollment outreach, stakeholder involvement, impact on beneficiaries, utilization and costs, implementation challenges, and potential lessons for 2014. Two investigators independently analyzed interview transcripts and iteratively refined the codebook until reaching consensus. Results We identified several themes. First, these expansions built upon pre-existing state-funded insurance programs for the poor. Second, predictions about costs and enrollment were challenging, indicating the uncertainty in projections for 2014. Other themes included greater than anticipated need for behavioral health services in the expansion population, administrative challenges of expansions, and persistent barriers to enrollment and access after expanding eligibility—though officials overall felt the expansions increased access for beneficiaries. Finally, political context—support or opposition from stakeholders and voters—plays a critical role in shaping the success of Medicaid expansions. Conclusions Early Medicaid expansions under the ACA offer important lessons to federal and state policymakers as the 2014 expansions approach. While the context of each state’s expansion is unique, key shared experiences were significant implementation challenges and opportunities for expanding access to needed services. PMID:24834369

  18. How is shared decision-making defined among African-Americans with diabetes?

    PubMed

    Peek, Monica E; Quinn, Michael T; Gorawara-Bhat, Rita; Odoms-Young, Angela; Wilson, Shannon C; Chin, Marshall H

    2008-09-01

    This study investigates how shared decision-making (SDM) is defined by African-American patients with diabetes, and compares patients' conceptualization of SDM with the Charles model. We utilized race-concordant interviewers/moderators to conduct in-depth interviews and focus groups among a purposeful sample of African-American patients with diabetes. Each interview/focus group was audio-taped, transcribed verbatim and imported into Atlas.ti software. Coding was done using an iterative process and each transcription was independently coded by two members of the research team. Although the conceptual domains were similar, patient definitions of what it means to "share" in the decision-making process differed significantly from the Charles model of SDM. Patients stressed the value of being able to "tell their story and be heard" by physicians, emphasized the importance of information sharing rather than decision-making sharing, and included an acceptable role for non-adherence as a mechanism to express control and act on treatment preferences. Current instruments may not accurately measure decision-making preferences of African-American patients with diabetes. Future research should develop instruments to effectively measure decision-making preferences within this population. Emphasizing information-sharing that validates patients' experiences may be particularly meaningful to African-Americans with diabetes.

  19. [Methodological design for the National Survey Violence Against Women in Mexico].

    PubMed

    Olaiz, Gustavo; Franco, Aurora; Palma, Oswaldo; Echarri, Carlos; Valdez, Rosario; Herrera, Cristina

    2006-01-01

    To describe the methodology, the research designs used, the estimation and sample selection, variable definitions, collection instruments, and operative design and analytical procedures for the National Survey Violence Against Women in Mexico. A complex (two-step) cross-sectional study was designed and the qualitative design was carried out using in-depth interviews and participant observation in health care units. We obtained for the quantitative study a total of 26 240 interviews in women users of health services and 2 636 questionnaires for health workers; the survey is representative of the 32 Mexican states. For the qualitative study 26 in-depth interviews were conducted with female users and 60 interviews with health workers in the States of Quintana Roo, Coahuila and the Federal District.

  20. An Alternative Approach to Conceptualizing Interviews in HRD Research

    ERIC Educational Resources Information Center

    Wang, Jia; Roulston, Kathryn J.

    2007-01-01

    Qualitative researchers in human resource development (HRD) frequently use in-depth interviews as a research method. Yet reports from qualitative studies in HRD commonly pay little or no analytical attention to the co-construction of interview data. That is, reports of qualitative research projects often treat interviews as a transparent method of…

  1. Utilization of maternal health-care services by tribal women in Kerala.

    PubMed

    Jose, Jinu Annie; Sarkar, Sonali; Kumar, S Ganesh; Kar, Sitanshu Sekhar

    2014-01-01

    The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services.

  2. Uses and Applications of Climate Forecasts for Power Utilities.

    NASA Astrophysics Data System (ADS)

    Changnon, Stanley A.; Changnon, Joyce M.; Changnon, David

    1995-05-01

    The uses and potential applications of climate forecasts for electric and gas utilities were assessed 1) to discern needs for improving climate forecasts and guiding future research, and 2) to assist utilities in making wise use of forecasts. In-depth structured interviews were conducted with 56 decision makers in six utilities to assess existing and potential uses of climate forecasts. Only 3 of the 56 use forecasts. Eighty percent of those sampled envisioned applications of climate forecasts, given certain changes and additional information. Primary applications exist in power trading, load forecasting, fuel acquisition, and systems planning, with slight differences in interests between utilities. Utility staff understand probability-based forecasts but desire climatological information related to forecasted outcomes, including analogs similar to the forecasts, and explanations of the forecasts. Desired lead times vary from a week to three months, along with forecasts of up to four seasons ahead. The new NOAA forecasts initiated in 1995 provide the lead times and longer-term forecasts desired. Major hindrances to use of forecasts are hard-to-understand formats, lack of corporate acceptance, and lack of access to expertise. Recent changes in government regulations altered the utility industry, leading to a more competitive world wherein information about future weather conditions assumes much more value. Outreach efforts by government forecast agencies appear valuable to help achieve the appropriate and enhanced use of climate forecasts by the utility industry. An opportunity for service exists also for the private weather sector.

  3. The promise of recovery: narratives of hope among homeless individuals with mental illness participating in a Housing First randomised controlled trial in Toronto, Canada

    PubMed Central

    Kirst, Maritt; Zerger, Suzanne; Wise Harris, Deborah; Plenert, Erin; Stergiopoulos, Vicky

    2014-01-01

    Objectives Hope is widely embraced as an important factor in the recovery process. The role of housing in inspiring hope and facilitating recovery has been explored with homeless populations but is not well understood. This study explores perspectives on hopes for recovery and the role of housing on these hopes from the perspective of homeless adults experiencing mental illness participating in a multisite Housing First randomised controlled trial in Canada. The study draws on data from in-depth qualitative interviews with participants from the Toronto, Ontario site of the ‘At Home/Chez Soi’ Project. Design In-depth interviews were conducted with a subsample of participants from a larger Housing First randomised controlled trial. Setting The research took place in Toronto, Canada. Participants 60 participants in the larger trial (36 from the Housing First group and 24 from the Treatment as Usual group) took part in in-depth interviews. Method Participants for the in-depth interviews were purposively selected from the larger trial sample in Toronto and participated in an interview at the beginning of the study (baseline). Data from the baseline interviews were analysed using the constant comparative method derived from grounded theory methods. Results Participants’ narratives show clear visualisation of goals for recovery, and emphasise that housing is an integral factor that can facilitate hope and support dimensions of recovery. However, some participants had difficulty adjusting to housing, and were concerned about feeling socially isolated, which could have negative implications for hopefulness and recovery. Conclusions Housing First interventions should explicitly incorporate hope-inspiring, recovery-oriented approaches and support participants while adjusting to housing in order to sustain hopefulness. PMID:24589826

  4. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia.

    PubMed

    Titaley, Christiana R; Hunter, Cynthia L; Dibley, Michael J; Heywood, Peter

    2010-08-11

    Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java areas. Health education strategies are required to increase community awareness about the importance of health services along with the existing financing mechanisms for the poor communities. Public health strategies involving traditional birth attendants will be beneficial particularly in remote areas where their services are highly utilized.

  5. Why do some women still prefer traditional birth attendants and home delivery?: a qualitative study on delivery care services in West Java Province, Indonesia

    PubMed Central

    2010-01-01

    Background Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. Methods A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. Results The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. Conclusions A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java areas. Health education strategies are required to increase community awareness about the importance of health services along with the existing financing mechanisms for the poor communities. Public health strategies involving traditional birth attendants will be beneficial particularly in remote areas where their services are highly utilized. PMID:20701762

  6. School Nurses' Experiences with Motivational Interviewing for Preventing Childhood Obesity

    ERIC Educational Resources Information Center

    Bonde, Ane Høstgaard; Bentsen, Peter; Hindhede, Anette Lykke

    2014-01-01

    Motivational interviewing is a counseling method used to bring about behavior change; its application by school nurses for preventing obesity in children is still new. This study, based on in-depth interviews with 12 school nurses, shows how school nurses adapted motivational interviewing and integrated it into their daily practice along with…

  7. Helping Mathematics Teachers Develop Noticing Skills: Utilizing Smartphone Technology for One-on-One Teacher/Student Interviews

    ERIC Educational Resources Information Center

    Chao, Theodore; Murray, Eileen; Star, Jon R.

    2016-01-01

    Teaching mathematics for understanding requires listening to each student's mathematical thinking, best elicited in a one-on-one interview. Interviews are difficult to enact in a teacher's busy schedule, however. In this study, the authors utilize smartphone technology to help mathematics teachers interview a student in a virtual one-on-one…

  8. The In-Depth Interview as a Research Tool for Investigating the Online Intercultural Communication of Asian Internet Users in Relation to Ethics in Intercultural Research

    ERIC Educational Resources Information Center

    Fetscher, Doris

    2013-01-01

    Virtual intercultural communication is of great interest in intercultural research. How can a researcher gain access to this field of investigation if s/he does not or only partially speaks the languages used by the subjects? This study is an example of how categories relevant to research can be accessed through in-depth interviews. The interview…

  9. Types of Dental Fear as Barriers to Dental Care among African American Adults with Oral Health Symptoms in Harlem

    PubMed Central

    Siegel, Karolynn; Schrimshaw, Eric W.; Kunzel, Carol; Wolfson, Natalie H.; Moon-Howard, Joyce; Moats, Harmon L.; Mitchell, Dennis A.

    2013-01-01

    To examine the types of dental fear experienced by African American adults and the role of these fears in the utilization of dental care, in-depth interviews were conducted with a street-intercept sample of 118 African Americans living in Harlem, New York City, who had experienced at least one oral health symptom in the past six months. Despite their oral symptoms, participants delayed or avoided dental care (often for years) due to a variety of dental fears, including fears of: 1) pain from needles; 2) the dental drill; 3) having teeth extracted; 4) contracting an illness (e.g., HIV/AIDS) from unsanitary instruments; 5) X-rays; 6) receiving poor quality care or mistreatment. These findings provide insights into the situations that provoke fears about dental treatment among African Americans and suggest strategies to address these fears in order to remove these barriers and increase the utilization of dental care by African American adults. PMID:24212175

  10. In their own words: describing Canadian physician leadership.

    PubMed

    Snell, Anita J; Dickson, Graham; Wirtzfeld, Debrah; Van Aerde, John

    2016-07-04

    Purpose This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health system. This mixed-methods research study offers baseline data relative to this purpose, and also describes physician leaders' views on fundamental aspects of their leadership responsibility. Design/methodology/approach A survey with both quantitative and qualitative fields yielded 689 valid responses from physician leaders. Data from the survey were utilized in the development of a semi-structured interview guide; 15 physician leaders were interviewed. Findings A profile of Canadian physician leadership has been compiled, including demographics; an outline of roles, responsibilities, time commitments and related compensation; and personal factors that support, engage and deter physicians when considering taking on leadership roles. The role of health-care organizations in encouraging and supporting physician leadership is explicated. Practical implications The baseline data on Canadian physician leaders create the opportunity to determine potential steps for improving the state of physician leadership in Canada; and health-care organizations are provided with a wealth of information on how to encourage and support physician leaders. Using the data as a benchmark, comparisons can also be made with physician leadership as practiced in other nations. Originality/value There are no other research studies available that provide the depth and breadth of detail on Canadian physician leadership, and the embedded recommendations to health-care organizations are informed by this in-depth knowledge.

  11. "Not Homeless Yet. I'm Kind of Couch Surfing": Finding Identities for People at a Homeless Shelter.

    PubMed

    Terui, Sachiko; Hsieh, Elaine

    2016-01-01

    The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.

  12. Learner factors associated with radical conceptual change among undergraduates

    NASA Astrophysics Data System (ADS)

    Olson, Joanne Kay

    Students frequently enter learning situations with knowledge inconsistent with scientific views. One goal of science instruction is to enable students to construct scientifically accepted ideas while rejecting inaccurate constructs. This process is called conceptual change. This study examined factors associated with students at three levels of conceptual change to elucidate possible influences on the conceptual change process. Factors studied included motivation (including utility value, interest, attainment value, mood, self efficacy, and task difficulty), prior experiences with science, perceptions of the nature of science, connections to objects or events outside the classroom, and specific activities that helped students learn. Four science classes for undergraduate preservice elementary teachers participated in the study, conducted during a three week unit on electricity. Data sources included concept maps, drawings, reflective journal entries, quizzes, a science autobiography assignment, and interviews. Concept maps, drawings, and quizzes were analyzed, and students were placed into high, moderate, and low conceptual change groups. Of the ninety-eight students in the study, fifty-seven were interviewed. Perhaps the most important finding of this study relates to the assessment of conceptual change. Interviews were conducted two months after the unit, and many items on the concept maps had decayed from students' memories. This indicates that time is an important factor. In addition, interview-derived data demonstrated conceptual change levels; concept maps were insufficient to indicate the depth of students' understanding. Factors associated with conceptual change include self efficacy and interest in topic. In addition, moderate conceptual change students cited specific activities as having helped them learn. Low and high students focused on the method of instruction rather than specific activities. Factors not found to be associated with conceptual change include: utility value, mood, task difficulty, and prior experiences with science, and connections to objects and events outside the classroom. Attainment value, perceptions of the nature of science, and mood cannot be ruled out as possible factors due to the problematic nature of assessing them within the context of this study.

  13. "We have been working overnight without sleeping": traditional birth attendants' practices and perceptions of post-partum care services in rural Tanzania.

    PubMed

    Mahiti, Gladys R; Kiwara, Angwara D; Mbekenga, Columba K; Hurtig, Anna-Karin; Goicolea, Isabel

    2015-02-03

    In many low-income countries, formal post-partum care utilization is much lower than that of skilled delivery and antenatal care. While Traditional Birth Attendants (TBAs) might play a role in post-partum care, research exploring their attitudes and practices during this period is scarce. Therefore, the aim of this study was to explore TBAs' practices and perceptions in post-partum care in rural Tanzania. Qualitative in-depth interview data were collected from eight untrained and three trained TBAs. Additionally, five multiparous women who were clients of untrained TBAs were also interviewed. Interviews were conducted in February 2013. Data were digitally recorded and transcribed verbatim. Qualitative content analysis was used to analyze data. Our study found that TBAs take care of women during post-partum with rituals appreciated by women. They report lacking formal post-partum care training, which makes them ill-equipped to detect and handle post-partum complications. Despite their lack of preparation, they try to provide care for some post-partum complications which could put the health of the woman at risk. TBAs perceive that utilization of hospital-based post-partum services among women was only important for the baby and for managing complications which they cannot handle. They are poorly linked with the health system. This study found that the TBAs conducted close follow-ups and some of their practices were appreciated by women. However, the fact that they were trying to manage certain post-partum complications can put women at risk. These findings point out the need to enhance the communication between TBAs and the formal health system and to increase the quality of the TBA services, especially in terms of prompt referral, through provision of training, mentoring, monitoring and supervision of the TBA services.

  14. Theorizing the Process of Leaving a Violent Marriage and Getting a Divorce in Tehran.

    PubMed

    Nikparvar, Fatemeh; Stith, Sandra; Myers-Bowman, Karen; Akbarzadeh, Mojgan; Daneshpour, Manijeh

    2017-12-01

    This study utilized qualitative methods to develop a theory regarding the process used by Tehranian women who leave violent marriages to get a divorce. Findings from semistructured, in-depth interviews with nine women in Tehran who left their abusive husbands suggested that there are six stages in this process: "denial," "using cognitive and internal strategies to save marriage," "using behavioral and external strategies to save marriage," "seeking power to end violence," "preparation to leave marriage," and "termination" stage. The implications of this study help therapists working with women in Tehran who are living in violent marriages and provide effective prevention and intervention services that are appropriately targeted to the specific needs of Iranian women.

  15. Why Cancer Patients Seek Islamic Healing.

    PubMed

    Suhami, Norhasmilia; Muhamad, Mazanah Bt; Krauss, Steven Eric

    2016-10-01

    Islamic healing is frequently referred to as the treatment of choice by many Muslim cancer patients in Malaysia. Despite its widespread use, there is limited information relating to patients' healing preferences. With rising cancer rates in the country, this issue has become a concern to public health policy makers. The purpose of this study was to understand why cancer patients seek Islamic healing. This qualitative study utilized in-depth interviews with 18 cancer patients. The findings indicate three main reasons: (1) recommendations from family, friends and doctors; (2) belief in Islamic healing and (3) the perceived ineffectiveness and dissatisfaction with conventional treatments. Islamic healing will likely continue to be popular complementary cancer treatment in Malaysia as it is grounded in strong cultural and religious beliefs.

  16. Factors influencing utilization of postpartum CD4 count testing by HIV-positive women not yet eligible for antiretroviral treatment.

    PubMed

    Gilles, Kate P; Zimba, Chifundo; Mofolo, Innocent; Bobrow, Emily; Hamela, Gloria; Martinson, Francis; Hoffman, Irving; Hosseinipour, Mina

    2011-03-01

    Delayed antiretroviral initiation is associated with increased mortality, but individuals frequently delay seeking treatment. To increase early antiretroviral therapy (ART) enrollment of HIV-positive women, antenatal clinics are implementing regular, postpartum CD4 count testing. We examined factors influencing women's utilization of extended CD4 count testing. About 53 in-depth interviews were conducted with nurses, patients, social support persons, and government health officials at three antenatal clinics in Lilongwe, Malawi. Counseling and positive interactions with staff emerged as facilitating factors. Women wanted to know their CD4 count, but didn't understand the importance of early ART initiation. Support from husbands facilitated women's return to the clinic. Reminders were perceived as helpful but ineffectively employed. Staff identified lack of communication, difficulty in tracking, and referring women as barriers. Counseling messages should emphasize the importance of starting ART early. Clinics should focus on male partner involvement, case management, staff communication, and appointment reminders. Follow-up should be offered at multiple service points.

  17. A Qualitative Study of the Formation and Composition of Social Networks Among Homeless Youth

    PubMed Central

    Tyler, Kimberly A.; Melander, Lisa A.

    2011-01-01

    Although social networks are essential for explaining protective and risk factors among homeless youth, little is known about the formation and composition of these groups. In this study, we utilized 19 in-depth interviews with homeless youth to investigate their social network formation, role relationships, housing status, and network member functions. Our findings reveal that the formation of these networks occurred in different ways including meeting network members through others or in specific social situations. The majority of social network members were currently housed and provided various functions including instrumental and social support and protection. Responses from participants provide valuable insight into the formation of social networks and potentially explain their subsequent involvement in risky behaviors. PMID:22121330

  18. The experience of older patients with cancer in phase 1 clinical trials: a qualitative case series.

    PubMed

    Kvale, Elizabeth A; Woodby, Lesa; Williams, Beverly Rosa

    2010-11-01

    This article explores the experiences of older patients with cancer in phase 1 clinical trials. Conducting a case series of face-to-face, in-depth, open-ended interviews and using qualitative methods of analysis, we find that the psychosocial process of social comparison is relevant for understanding older adults' phase 1 clinical trial participation. Social comparison influences decisions to enroll in a phase 1 clinical trial, shapes perceptions of supportive care needs, and encourages the utilization of hope. Additional research should develop strategies for addressing supportive care needs among this patient cohort whose use of social comparison can inhibit articulation of pain, suffering, and symptom burden as well as use of informal support systems.

  19. What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California

    PubMed Central

    Sanchez-Flack, Jennifer C.; Baquero, Barbara; Linnan, Laura A.; Gittelsohn, Joel; Pickrel, Julie L.; Ayala, Guadalupe X.

    2016-01-01

    To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers’ grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and socio-cultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers. PMID:26800243

  20. Home care packages: insights into the experiences of older people leading up to the introduction of consumer directed care in Australia.

    PubMed

    Day, Jenny; Taylor, Ann Clare Thorington; Summons, Peter; Van Der Riet, Pamela; Hunter, Sharyn; Maguire, Jane; Dilworth, Sophie; Bellchambers, Helen; Jeong, Sarah; Haydon, Gunilla; Harris, Margaret; Higgins, Isabel

    2017-04-01

    This paper reports phase one, conducted from March to June 2015, of a two-phase, qualitative descriptive study designed to explore the perceptions and experiences of older people before and after the introduction of consumer directed care (CDC) to home care packages (HCP) in Australia. Eligible consumers with a local HCP provider were mailed information about the study. Data collection occurred before the introduction of CDC and included face-to-face, in-depth interviews, summaries of interviews, field notes and reflective journaling. Semi-structured questions and 'emotional touchpoints' relating to home care were used to guide the interview conversation. Line-by-line data analysis, where significant statements were highlighted and clustered to reveal emergent themes, was used. Five older people, aged 81 to 91 years, participated in the study. The four emergent themes were: seeking quality and reciprocity in carer relationships; patchworking services; the waiting game; and technology with utility. Continuity of carers was central to the development of a trusting relationship and perceptions of care quality among older consumers. Care coordinators and workers should play a key role in ensuring older people receive timely information about CDC and their rights and responsibilities. Participants' use of contemporary technologies suggests opportunities to improve engagement of HCP clients in CDC.

  1. Modeling of Depth Cue Integration in Manual Control Tasks

    NASA Technical Reports Server (NTRS)

    Sweet, Barbara T.; Kaiser, Mary K.; Davis, Wendy

    2003-01-01

    Psychophysical research has demonstrated that human observers utilize a variety of visual cues to form a perception of three-dimensional depth. However, most of these studies have utilized a passive judgement paradigm, and failed to consider depth-cue integration as a dynamic and task-specific process. In the current study, we developed and experimentally validated a model of manual control of depth that examines how two potential cues (stereo disparity and relative size) are utilized in both first- and second-order active depth control tasks. We found that stereo disparity plays the dominate role for determining depth position, while relative size dominates perception of depth velocity. Stereo disparity also plays a reduced role when made less salient (i.e., when viewing distance is increased). Manual control models predict that position information is sufficient for first-order control tasks, while velocity information is required to perform a second-order control task. Thus, the rules for depth-cue integration in active control tasks are dependent on both task demands and cue quality.

  2. The efficiency and effectiveness of utilizing diagrams in interviews: an assessment of participatory diagramming and graphic elicitation

    PubMed Central

    Umoquit, Muriah J; Dobrow, Mark J; Lemieux-Charles, Louise; Ritvo, Paul G; Urbach, David R; Wodchis, Walter P

    2008-01-01

    Background This paper focuses on measuring the efficiency and effectiveness of two diagramming methods employed in key informant interviews with clinicians and health care administrators. The two methods are 'participatory diagramming', where the respondent creates a diagram that assists in their communication of answers, and 'graphic elicitation', where a researcher-prepared diagram is used to stimulate data collection. Methods These two diagramming methods were applied in key informant interviews and their value in efficiently and effectively gathering data was assessed based on quantitative measures and qualitative observations. Results Assessment of the two diagramming methods suggests that participatory diagramming is an efficient method for collecting data in graphic form, but may not generate the depth of verbal response that many qualitative researchers seek. In contrast, graphic elicitation was more intuitive, better understood and preferred by most respondents, and often provided more contemplative verbal responses, however this was achieved at the expense of more interview time. Conclusion Diagramming methods are important for eliciting interview data that are often difficult to obtain through traditional verbal exchanges. Subject to the methodological limitations of the study, our findings suggest that while participatory diagramming and graphic elicitation have specific strengths and weaknesses, their combined use can provide complementary information that would not likely occur with the application of only one diagramming method. The methodological insights gained by examining the efficiency and effectiveness of these diagramming methods in our study should be helpful to other researchers considering their incorporation into qualitative research designs. PMID:18691410

  3. Interviewing to develop Patient-Reported Outcome (PRO) measures for clinical research: eliciting patients’ experience

    PubMed Central

    2014-01-01

    Patient-reported outcome (PRO) measures must provide evidence that their development followed a rigorous process for ensuring their content validity. To this end, the collection of data is performed through qualitative interviews that allow for the elicitation of in-depth spontaneous reports of the patients’ experiences with their condition and/or its treatment. This paper provides a review of qualitative research applied to PRO measure development. A clear definition of what is a qualitative research interview is given as well as information about the form and content of qualitative interviews required for developing PRO measures. Particular attention is paid to the description of interviewing approaches (e.g., semi-structured and in-depth interviews, individual vs. focus group interviews). Information about how to get prepared for a qualitative interview is provided with the description of how to develop discussion guides for exploratory or cognitive interviews. Interviewing patients to obtain knowledge regarding their illness experience requires interpersonal and communication skills to facilitate patients’ expression. Those skills are described in details, as well as the skills needed to facilitate focus groups and to interview children, adolescents and the elderly. Special attention is also given to quality assurance and interview training. The paper ends on ethical considerations since interviewing for the development of PROs is performed in a context of illness and vulnerability. Therefore, it is all the more important that, in addition to soliciting informed consent, respectful interactions be ensured throughout the interview process. PMID:24499454

  4. How Technology Affects Teaching.

    ERIC Educational Resources Information Center

    Wiske, Martha Stone; And Others

    This study presents composite profiles of teachers who were interviewed in order to assess how they are being affected by the challenges and opportunities presented by computer technology use. In-depth interviews were held with 76 teachers from 10 sites around the country, and the interview data were analyzed to identify themes and to construct…

  5. Industrial demand side management: A status report

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Hopkins, M.F.; Conger, R.L.; Foley, T.J.

    This report provides an overview of and rationale for industrial demand side management (DSM) programs. Benefits and barriers are described, and data from the Manufacturing Energy Consumption Survey are used to estimate potential energy savings in kilowatt hours. The report presents types and examples of programs and explores elements of successful programs. Two in-depth case studies (from Boise Cascade and Eli Lilly and Company) illustrate two types of effective DSM programs. Interviews with staff from state public utility commissions indicate the current thinking about the status and future of industrial DSM programs. A comprehensive bibliography is included, technical assistance programsmore » are listed and described, and a methodology for evaluating potential or actual savings from projects is delineated.« less

  6. Development and validation of safety climate scales for mobile remote workers using utility/electrical workers as exemplar.

    PubMed

    Huang, Yueng-Hsiang; Zohar, Dov; Robertson, Michelle M; Garabet, Angela; Murphy, Lauren A; Lee, Jin

    2013-10-01

    The objective of this study was to develop and test the reliability and validity of a new scale designed for measuring safety climate among mobile remote workers, using utility/electrical workers as exemplar. The new scale employs perceived safety priority as the metric of safety climate and a multi-level framework, separating the measurement of organization- and group-level safety climate items into two sub-scales. The question of the emergence of shared perceptions among remote workers was also examined. For the initial survey development, several items were adopted from a generic safety climate scale and new industry-specific items were generated based on an extensive literature review, expert judgment, 15-day field observations, and 38 in-depth individual interviews with subject matter experts (i.e., utility industry electrical workers, trainers and supervisors of electrical workers). The items were revised after 45 cognitive interviews and a pre-test with 139 additional utility/electrical workers. The revised scale was subsequently implemented with a total of 2421 workers at two large US electric utility companies (1560 participants for the pilot company and 861 for the second company). Both exploratory (EFA) and confirmatory factor analyses (CFA) were adopted to finalize the items and to ensure construct validity. Reliability of the scale was tested based on Cronbach's α. Homogeneity tests examined whether utility/electrical workers' safety climate perceptions were shared within the same supervisor group. This was followed by an analysis of the criterion-related validity, which linked the safety climate scores to self-reports of safety behavior and injury outcomes (i.e., recordable incidents, missing days due to work-related injuries, vehicle accidents, and near misses). Six dimensions (Safety pro-activity, General training, Trucks and equipment, Field orientation, Financial Investment, and Schedule flexibility) with 29 items were extracted from the EFA to measure the organization-level safety climate. Three dimensions (Supervisory care, Participation encouragement, and Safety straight talk) with 19 items were extracted to measure the group-level safety climate. Acceptable ranges of internal consistency statistics for the sub-scales were observed. Whether or not to aggregate these multi-dimensions of safety climate into a single higher-order construct (overall safety climate) was discussed. CFAs confirmed the construct validity of the developed safety climate scale for utility/electrical workers. Homogeneity tests showed that utility/electrical workers' safety climate perceptions were shared within the same supervisor group. Both the organization- and group-level safety climate scores showed a statistically significant relationship with workers' self-reported safety behaviors and injury outcomes. A valid and reliable instrument to measure the essential elements of safety climate for utility/electrical workers in the remote working situation has been introduced. The scale can provide an in-depth understanding of safety climate based on its key dimensions and show where improvements can be made at both group and organization levels. As such, it may also offer a valuable starting point for future safety interventions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. A loss of moral experience: understanding HIV-related stigma in the New York City House and Ball Community.

    PubMed

    Galindo, Gabriel R

    2013-02-01

    I incorporated qualitative methods to explore how HIV-related stigma functions in New York City's House and Ball Community (HBC). From January through March 2009, I conducted 20 in-depth 1-on-1 interviews with a diverse sample of New York City HBC members. Interviews addressed perceptions of HIV-related stigma, the treatment of HIV-positive members in the community, and the potential impact of HIV-related stigma on risk behaviors. HIV-related stigma contributes to a loss of moral experience for HBC members. Moral experience (i.e., threats to what really matters in a community) disrupts established social connections and hinders the attainment of "ball status" (i.e., amassing social recognition) in the local world of these individuals. My recommendations address HIV-related stigma in the New York City HBC from the vantage of moral experience and highlight the need for longitudinal studies of individual house members and for the implementation of stigma-focused interventions in the community that utilize the unique ball status hierarchy and HBC network to influence social norms surrounding the treatment of HIV-positive community members.

  8. Managing volunteers: FEMA's Urban Search and Rescue programme and interactions with unaffiliated responders in disaster response.

    PubMed

    Barsky, Lauren E; Trainor, Joseph E; Torres, Manuel R; Aguirre, Benigno E

    2007-12-01

    In the aftermath of disasters it is not uncommon for a large number of individuals, ranging from professional technical responders to untrained, albeit well meaning, volunteers, to converge on site of a disaster in order to offer to help victims or other responders. Because volunteers can be both a help and a hindrance in disaster response, they pose a paradox to professional responders at the scene. Through focus group interviews and in-depth structured interviews, this paper presents an extended example of how Urban Search and Rescue (US&R) task forces, a type of professional technical-responder organisation, interact with and utilise volunteers. Findings show that US&R task forces evaluate the volunteers in terms of their presumed legitimacy, utility, and potential liability or danger posed during the disaster response. Other responses to volunteers such as a feeling of powerlessness or the use of volunteers in non-technical ways are also explored. This paper demonstrates some key aspects of the relationship between volunteers and formal response organisations in disasters.

  9. Disparities in Water and Sewer Services in North Carolina: An Analysis of the Decision-Making Process

    PubMed Central

    Gibson, Jacqueline MacDonald

    2015-01-01

    Objectives. We examined the factors that affect access to municipal water and sewer service for unincorporated communities relying on wells and septic tanks. Methods. Using a multisite case study design, we conducted in-depth, semistructured interviews with 25 key informants from 3 unincorporated communities in Hoke, New Hanover, and Transylvania counties, North Carolina, July through September 2013. Interviewees included elected officials, health officials, utility providers, and community members. We coded the interviews in ATLAS.ti to identify common themes. Results. Financing for water and sewer service emerged as the predominant factor that influenced decisions to extend these services. Improved health emerged as a minor factor, suggesting that local officials may not place a high emphasis on the health benefits of extending public water and sewer services. Awareness of failed septic systems in communities can prompt city officials to extend sewer service to these areas; however, failed systems are often underreported. Conclusions. Understanding the health costs and benefits of water and sewer extension and integrating these findings into the local decision-making process may help address disparities in access to municipal services. PMID:26270307

  10. The MaBwana Black men's study: community and belonging in the lives of African, Caribbean and other Black gay men in Toronto.

    PubMed

    George, Clemon; Adam, Barry A; Read, Stanley E; Husbands, Winston C; Remis, Robert S; Makoroka, Lydia; Rourke, Sean B

    2012-01-01

    In Canada, there is a paucity of research aimed at understanding Black gay men and the antecedents to risk factors for HIV. This study is an attempt to move beyond risk factor analysis and explore the role of sexual and ethnic communities in the lives of these men. The study utilized a community-based research and critical race theory approach. Semi-structured interviews were conducted with eight key informants to augment our understanding of Black gay men and to facilitate recruitment of participants. In-depth interviews were done with 24 Black gay men. Our data showed that the construction of community for Black gay men is challenged by their social and cultural environment. However, these men use their resilience to navigate gay social networks. Black gay men expressed a sense of abjuration from both gay and Black communities because of homophobia and racism. It is essential for health and social programmers to understand how Black gay men interact with Black and gay communities and the complexities of their interactions in creating outreach educational, preventive and support services.

  11. Utilization of maternal health-care services by tribal women in Kerala

    PubMed Central

    Jose, Jinu Annie; Sarkar, Sonali; Kumar, S. Ganesh; Kar, Sitanshu Sekhar

    2014-01-01

    Background: The coverage of maternal care services among the tribal women in Kerala is better as compared to other states in India. Aim: This study was done to identify the factors contributing to better coverage of maternal care services among the tribal women in Kerala and to study the reasons for remaining differences that exists in utilization of services between tribal and non-tribal pregnant women. Settings and Design: This was a descriptive cum qualitative study conducted in Thariode Gramapanchayat in the Wayanad district of Kerala. Materials and Methods: Among all women who had registered their pregnancies in the 5 sub-centres under CHC Thariode and had delivered between September 2009 and October 2010, equal numbers of tribal and non-tribal ante-natal women, 35 each were interviewed in-depth using a semi-structured questionnaire. Statistical Analysis Used: Quantitative data was analysed using SPSS Version 16.0. Content analysis was done for qualitative data. Results: The determinants of utilization in tribal women were general awareness, affordability, accessibility and quality of services along with motivation by health workers. Among tribal antenatal women, 85% utilized maternal health care facilities fully compared to 100% among non-tribal women. Lower levels of education and lack of transport facilities were prime factors contributing to under utilization by tribal women. Conclusions: Affordable, accessible and good quality of services in the public health system in Kerala and motivation by health workers were important contributing factors for better utilization of maternal care services. PMID:24678214

  12. How is Shared Decision-Making Defined among African-Americans with Diabetes?

    PubMed Central

    Peek, Monica E.; Quinn, Michael T.; Gorawara-Bhat, Rita; Odoms-Young, Angela; Wilson, Shannon C.; Chin, Marshall H.

    2011-01-01

    Objective This study investigates how shared decision-making (SDM) is defined by African-American patients with diabetes, and compares patients’ conceptualization of SDM with the Charles model. Methods We utilized race-concordant interviewers/moderators to conduct in-depth interviews and focus groups among a purposeful sample of African-American patients with diabetes. Each interview/focus group was audio-taped, transcribed verbatim and imported into Atlas.ti software. Coding was done using an iterative process and each transcription was independently coded by two members of the research team. Results Although the conceptual domains were similar, patient definitions of what it means to “share” in the decision-making process differed significantly from the Charles model of SDM. Patients stressed the value of being able to “tell their story and be heard” by physicians, emphasized the importance of information sharing rather than decision-making sharing, and included an acceptable role for non-adherence as a mechanism to express control and act on treatment preferences. Conclusion Current instruments may not accurately measure decision-making preferences of African-American patients with diabetes. Practice Implications Future research should develop instruments to effectively measure decision-making preferences within this population. Emphasizing information-sharing that validates patients’ experiences may be particularly meaningful to African-Americans with diabetes. PMID:18684581

  13. Impact of decentralization on health services in Uganda: a look at facility utilization, prescribing and availability of essential drugs.

    PubMed

    Anokbonggo, W W; Ogwal-Okeng, J W; Obua, C; Aupont, O; Ross-Degnan, D

    2004-02-01

    Uganda began implementation of a structural adjustment programme (SAP) in July 1994 in order to improve social services. The decentralization of health services administration to district level was intended to improve the quality of health services and pharmaceutical supplies in the hospitals, with resultant increase in the level of utilization of health facilities. This study evaluated the impact of the decentralization policy on health facility utilization; availability of essential drugs, and prescribing patterns for acute respiratory infections (ARI), diarrhoea, and malaria in two district hospitals in Uganda. Mixed method evaluation design, involving both quantitative and qualitative methods. Time series analyses of data from utilization, pharmacy stock, and prescription records before and after the policy change. Key informant interviews and focus group discussions to obtain information on perceptions and attitude of stakeholders on the process of the policy implementation. STUDY SETTING AND POPULATION: The study was conducted in two district hospitals in northern Uganda. A total of seven years of utilization and pharmacy stock data including 5040 patient records from the hospitals were analysed retrospectively. In-depth interviews were conducted among 11 politicians from each district; 100 open-ended questionnaires were administered to patients in each hospital; 86 health care workers were interviewed using semi-structured questionnaires; and focus group discussions were conducted with 23 health care providers. Facility utilization was evaluated by average monthly attendance in the outpatient department and paediatric ward admissions. Availability was assessed as average number of drugs per month. Prescribing indicator outcomes included: for malaria, percent chloroquine tablets and percent chloroquine injection; for ARI, percent receiving antibiotics or injections; for diarrhoea, use of oral rehydration salts (ORS), antidiarrhoeal mixtures, and antibiotics. The average number of drugs prescribed assessed polypharmacy. There was a general increase in patient attendance in both hospitals, although the initial increase later declined in Apac. Drug availability was erratic and not always adequate. The situation was better in Lira where funding for drug procurement was more accessible. Prescribing patterns varied, with improvement in some indicators, while others showed no change or even worsened. The decentralization policy led to increased utilization of health facilities. The perception was that the policy was good because it "empowered the community in terms of creating a sense of responsibility in the stakeholders, and a sense of ownership that facilitated sustainability" of public institutions. In spite of the views expressed by the stakeholders, the policy failed to improve drug shortages, inefficient utilization of resources, and low morale among hospital staff. Staff should be re-trained and better remunerated in order to cope with the implementation of the policy. Local politicians should clearly understand their roles and responsibility under the new policy. Efficient utilization of funds at all levels of the district administrative structures should be ensured.

  14. [Factors determining the selection of treatment options of complementary and alternative medicine].

    PubMed

    Zörgő, Szilvia; Purebl, György; Zana, Ágnes

    2016-04-10

    Complementary and alternative medicine have undoubtedly been gaining ground on the healthcare market, thus the vital question arises why patients choose these treatments, oftentimes at the cost of discontinuing the Western medical therapy. The aim of the authors was to investigate and scrutinize factors leading to the utilization of various alternative medical services. The basis of this qualitative research was medical anthropological fieldwork conducted at a clinic of Traditional Chinese Medicine including participant observation (355 hours), unstructured interviews with patients (n = 93) and in-depth interviews (n = 14). Patients of alternative medical systems often do not receive a diagnosis, explanation or cure for their illness from Western medicine, or they do not agree with what they are offered. In other instances, patients choose alternative medicine because it exhibits a philosophical congruence with their already existing explanatory model, that is, previous concepts of world, man or illness. A particular therapy is always part of a cultural system and it is embedded in a specific psycho-social context, hence choice of therapy must be interpreted in accordance with this perspective.

  15. Perceptions of Child Sexual Abuse--A Qualitative Interview Study with Representatives of the Socio-Legal System in Urban Tanzania

    ERIC Educational Resources Information Center

    Kisanga, Felix; Mbwambo, Jessie; Hogan, Norah; Nystrom, Lennarth; Emmelin, Maria; Lindmark, Gunilla

    2010-01-01

    Through in-depth interviews, this study explored perceptions and experiences of key players handling child sexual offense cases in Dar es Salaam, Tanzania. The informants included public police investigators, magistrates, legal workers, and social workers working with nongovernmental organizations. The interviews were recorded, transcribed…

  16. Responses to and Resources for Intimate Partner Violence: Qualitative Findings from Women, Men, and Service Providers in Rural Kenya

    PubMed Central

    Odero, Merab; Hatcher, Abigail M; Bryant, Chenoia; Onono, Maricianah; Romito, Patrizia; Bukusi, Elizabeth A.; Turan, Janet M.

    2014-01-01

    Intimate partner violence (IPV) is reported by one in five women globally, but the prevalence is much higher in East Africa. Though some formal and informal resources do exist for women experiencing IPV, data suggest that disclosure, help seeking, and subsequent utilization of these resources are often hindered by socio-cultural, economic, and institutional factors. This paper explores actions taken by victims, available support services, and barriers to utilization of available IPV resources by pregnant women in rural Nyanza, Kenya. Qualitative data were collected through 9 focus group discussions and 20 in-depth interviews with pregnant women, partners or male relatives of pregnant women, and service providers. Data were managed in NVivo 8 using a descriptive analytical approach that harnessed thematic content coding and in-depth grounded analysis. We found that while formal resources for IPV were scarce, women utilized many informal resources (family, pastors, local leaders) as well as the health facility. In rare occasions, women escalated their response to formal services (police, judiciary). The community was sometimes responsive to women experiencing IPV, but often viewed it as a “normal” part of local culture. Further barriers to women accessing services included logistical challenges and providers who were under-trained or uncommitted to responding to IPV appropriately. Moreover, the very sanctions meant to address violence (such as fines or jail) were often inhibiting for women who depended on their partners for financial resources. The results suggest that future IPV interventions should address community views around IPV and build upon locally available resources – including the health clinic - to address violence among women of child-bearing age. PMID:24255067

  17. Responses to and resources for intimate partner violence: qualitative findings from women, men, and service providers in rural Kenya.

    PubMed

    Odero, Merab; Hatcher, Abigail M; Bryant, Chenoia; Onono, Maricianah; Romito, Patrizia; Bukusi, Elizabeth A; Turan, Janet M

    2014-03-01

    Intimate partner violence (IPV) is reported by one in three women globally, but the prevalence is much higher in East Africa. Though some formal and informal resources do exist for women experiencing IPV, data suggest that disclosure, help seeking, and subsequent utilization of these resources are often hindered by sociocultural, economic, and institutional factors. This article explores actions taken by victims, available support services, and barriers to the utilization of available IPV resources by pregnant women in rural Nyanza, Kenya. Qualitative data were collected through nine focus group discussions and 20 in-depth interviews with pregnant women, partners or male relatives of pregnant women, and service providers. Data were managed in NVivo 8 using a descriptive analytical approach that harnessed thematic content coding and in-depth grounded analysis. We found that while formal resources for IPV were scarce, women utilized many informal resources (family, pastors, local leaders) as well as the health facility. In rare occasions, women escalated their response to formal services (police, judiciary). The community was sometimes responsive to women experiencing IPV but often viewed it as a "normal" part of local culture. Further barriers to women accessing services included logistical challenges and providers who were undertrained or uncommitted to responding to IPV appropriately. Moreover, the very sanctions meant to address violence (such as fines or jail) were often inhibiting for women who depended on their partners for financial resources. The results suggest that future IPV interventions should address community views around IPV and build upon locally available resources-including the health clinic-to address violence among women of childbearing age.

  18. The Science ELF: Assessing the enquiry levels framework as a heuristic for professional development

    NASA Astrophysics Data System (ADS)

    Wheeler, Lindsay B.; Bell, Randy L.; Whitworth, Brooke A.; Maeng, Jennifer L.

    2015-01-01

    This study utilized an explanatory sequential mixed methods approach to explore randomly assigned treatment and control participants' frequency of inquiry instruction in secondary science classrooms. Eleven treatment participants received professional development (PD) that emphasized a structured approach to inquiry instruction, while 10 control participants received no PD. Two representative treatment participants were interviewed and observed to provide an in-depth understanding of inquiry instruction and factors affecting implementation. Paired t-tests were used to analyze quantitative data from observation forms, and a constant comparative approach was used to analyze qualitative data from surveys, interviews, purposeful observations and artifacts. Results indicated that treatment participants implemented inquiry significantly more frequently than control participants (p < .01). Two treatment participants' instruction revealed that both used a similar structure of inquiry but employed different types of interactions and emphasized different scientific practices. These differences may be explained by the participants' understandings of and beliefs about inquiry and structuring inquiry. The present study has the potential to inform how methods of structuring inquiry instruction and teaching scientific practices are addressed in teacher preparation.

  19. Links between social environment and health care utilization and costs.

    PubMed

    Brault, Marie A; Brewster, Amanda L; Bradley, Elizabeth H; Keene, Danya; Tan, Annabel X; Curry, Leslie A

    2018-01-01

    The social environment influences health outcomes for older adults and could be an important target for interventions to reduce costly medical care. We sought to understand which elements of the social environment distinguish communities that achieve lower health care utilization and costs from communities that experience higher health care utilization and costs for older adults with complex needs. We used a sequential explanatory mixed methods approach. We classified community performance based on three outcomes: rate of hospitalizations for ambulatory care sensitive conditions, all-cause risk-standardized hospital readmission rates, and Medicare spending per beneficiary. We conducted in-depth interviews with key informants (N = 245) from organizations providing health or social services. Higher performing communities were distinguished by several aspects of social environment, and these features were lacking in lower performing communities: 1) strong informal support networks; 2) partnerships between faith-based organizations and health care and social service organizations; and 3) grassroots organizing and advocacy efforts. Higher performing communities share similar social environmental features that complement the work of health care and social service organizations. Many of the supportive features and programs identified in the higher performing communities were developed locally and with limited governmental funding, providing opportunities for improvement.

  20. 75 FR 46899 - Agency Information Collection Activities: Proposed Collection; Comment Request-In-Depth Case...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-04

    ... conduct interviews of SNAP staff at all levels, visit multiple local offices, hold focus groups with... vendors that contract with State SNAP agencies. Tailored protocols will be used for the interviews... States will receive remuneration of $75,000 to offset the costs of participating in the study. Interview...

  1. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hosptal

    PubMed Central

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M.

    2015-01-01

    Health service delivery is a key pillar of the health system management .The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014 .The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused group discussion. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0. Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education and adolescent awareness about existence of friendly health services offered were significantly associated with utilization at p<0.05. Long queues, unfavorable working hours and lack of money negatively affected consumption of AFHS.The study concluded that the utilization of health services among the adolescents was low largely due to unfriendliness of the health care providers at health facilities and lack of awareness of AFHS services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of AFHS and ensure that the recommendations of Adolescent Package of care is implemented fully with good evaluation strategies in place. Laborious awareness drives to sensitize the adolescents about the available services through rigorous health education and increased involvement of both parents/guardians and teachers to scale up implementation are also recommended. PMID:26153176

  2. Preparedness of County Referral Health Facilities in Implementing Adolescent Friendly Health Services: A Case Study of Mama Lucy Kibaki Hospital.

    PubMed

    Owuondo, Pacific Akinyi; Mwaura-Tenembergen, Wanja; Adoyo, Maureen; Kiilu, Elizabeth M

    2015-03-25

    Health service delivery is a key pillar of the health system management. The World Health Organization recently emphasized the need to develop adolescent -friendly health services to improve the care provided to young people throughout the world. However, there is limited peer reviewed literature on this subject therefore necessitating assessment of whether the existing health facilities are prepared to implement the adolescent friendly health services. Adolescent friendly health services remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services. After International Conference on Population and Development in 1994, countries started implementing adolescent friendly health services. The Government of Kenya together with partners in an attempt to address the health challenges came up with the Adolescent package of care (APOC) in 2013 whose guidelines were finalized in November 2014 and released for use by service providers . Despite this package of care, there is still ineffective staff capacity in relation to skills and knowledge gap of health professionals, training needs, health resources as well as health system factors that can affect implementation of AFHS. The study explored ways of mitigating or addressing the barriers to implementation of these services. The study used both quantitative and qualitative approaches to collect data. The study utilized survey research adapting descriptive cross sectional design and semi-structured questionnaire to interview 348 health care providers and 472 adolescents in Mam Lucy Kibaki Hospital from 3rd May 2014 to 16 June 2014. The key informants were mainly nurses, clinical officers and Medical doctors who were working at the health service delivery area at the time of study and were interviewed using an interview guide. The managers at the hospital were interviewed using an in-depth interview guide while the adolescents were interviewed through interview guide and focused group discussion. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) Version 18.0. Descriptive statistics and chi-square tests were performed to determine significant associations. The study established that sex, age, level of education and adolescent awareness about existence of friendly health services offered were significantly associated with utilization at p<0.05. Long queues, unfavorable working hours and lack of money negatively affected consumption of AFHS. The study concluded that the utilization of health services among the adolescents was low largely due to unfriendliness of the health care providers at health facilities and lack of awareness of AFHS services. In view of the findings, this study recommends need for the Government through the Ministry of Health and partners in health service provision to increase the number of AFHS and ensure that the recommendations of Adolescent Package of care is implemented fully with good evaluation strategies in place. Laborious awareness drives to sensitize the adolescents about the available services through rigorous health education and increased involvement of both parents/guardians and teachers to scale up implementation are also recommended.

  3. 78 FR 45254 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ..., through focus groups with youth and in-depth interviews with health care providers, to improve tobacco use... youth and vulnerable populations. The focus groups and interviews are an integral [[Page 45255

  4. 78 FR 58325 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-23

    ..., through focus groups with youth and in-depth interviews with health care providers, to improve tobacco use... youth and vulnerable populations. The focus groups and interviews are an integral part of the process to... interview health care professionals who treat youth with these conditions. The screen will be administered...

  5. Exploring Culture from a Distance: The Utility of Telephone Interviews in Qualitative Research

    ERIC Educational Resources Information Center

    Lechuga, Vicente M.

    2012-01-01

    Qualitative studies that utilize telephone interviews, as a primary data collection mode, often are not discussed in the qualitative research literature. Data excerpts from a study that sought to understand the culture of for-profit universities are used to illustrate the types of data that can be garnered through telephone interviews. In…

  6. Children's traditional ecological knowledge of wild food resources: a case study in a rural village in Northeast Thailand

    PubMed Central

    Setalaphruk, Chantita; Price, Lisa Leimar

    2007-01-01

    Consuming wild foods is part of the food ways of people in many societies, including farming populations throughout the world. Knowledge of non-domesticated food resources is part of traditional and tacit ecological knowledge, and is largely transmitted through socialization within cultural and household contexts. The context of this study, a small village in Northeast Thailand, is one where the community has experienced changes due to the migration of the parental generation, with the children being left behind in the village to be raised by their grandparents. A case study approach was used in order to gain holistic in-depth insight into children's traditional ecological knowledge as well as patterns of how children acquire their knowledge regarding wild food resources. Techniques used during field data collection are free-listing conducted with 30 village children and the use of a sub-sample of children for more in-depth research. For the sub-sample part of the study, wild food items consisted of a selection of 20 wild food species consisting of 10 species of plants and 10 species of animals. Semi-structured interviews with photo identification, informal interviews and participatory observation were utilized, and both theoretical and practical knowledge scored. The sub-sample covers eight households with boys and girls aged between 10–12 years old from both migrant families and non-migrant families. The knowledge of children was compared and the transmission process was observed. The result of our study shows that there is no observable difference among children who are being raised by grandparents and those being raised by their parents, as there are different channels of knowledge transmission to be taken into consideration, particularly grandparents and peers. The basic ability (knowledge) for naming wild food species remains among village children. However, the practical in-depth knowledge, especially about wild food plants, shows some potential eroding. PMID:17937791

  7. Public health interventions, barriers, and opportunities for improving maternal nutrition in India.

    PubMed

    Ramakrishnan, Usha; Lowe, Alyssa; Vir, Sheila; Kumar, Shuba; Mohanraj, Rani; Chaturvedi, Anuraag; Noznesky, Elizabeth A; Martorell, Reynaldo; Mason, John B

    2012-06-01

    Inadequate nutrient intake, early and multiple pregnancies, poverty, caste discrimination, and gender inequality contribute to poor maternal nutrition in India. While malnutrition is seen throughout the life cycle, it is most acute during childhood, adolescence, pregnancy, and lactation. Although nutrition policies are on the books and interventions are in place, child malnutrition and maternal undernutrition persist as severe public health problems. To evaluate the implementation of maternal nutrition programs in India. The research was conducted in two phases. Phase 1 consisted of a desk review of national and state policies pertinent to maternal nutrition and national-level key informant interviews with respondents who have a working knowledge of relevant organizations and interventions. Phase 2 utilized in-depth interviews and focus group discussions at the state, district, and community levels in eight districts of two states: Tamil Nadu and Uttar Pradesh. All data were analyzed thematically. India has a rich portfolio of programs and policies that address maternal health and nutrition; however, systematic weaknesses, logistical gaps, resource scarcity, and poor utilization continue to hamper progress. Elevating the priority given to maternal nutrition in government health programs and implementing strategies to improve women's status will help to address many of the challenges facing India's nutrition programs. Programs can be strengthened by promoting integration of services, ensuring effective procurement mechanisms for micronutrient and food supplements, establishing regional training facilities for improved program implementation, and strengthening program monitoring and evaluation.

  8. Receiving Video-Based Feedback in Elite Ice-Hockey: A Player's Perspective

    ERIC Educational Resources Information Center

    Nelson, Lee J.; Potrac, Paul; Groom, Ryan

    2014-01-01

    The aim of this paper was to provide some rich insights into how an elite ice-hockey player responded to his coaches' pedagogical delivery of video-based feedback sessions. Data for this study were gathered through a series of in-depth, semi-structured interviews and a reflective log relating to those interviews. The interviews were transcribed…

  9. Development of a disease-specific quality of life questionnaire in Addison's disease.

    PubMed

    Løvås, Kristian; Curran, Suzanne; Oksnes, Marianne; Husebye, Eystein S; Huppert, Felicia A; Chatterjee, V Krishna K

    2010-02-01

    Patients with Addison's disease reproducibly self-report impairment in specific dimensions of general well-being questionnaires, suggesting particular deficiencies in health-related quality-of-life (HRQoL). We sought to develop an Addison's disease-specific questionnaire (AddiQoL) that could better quantify altered well-being and treatment effects. Design, Setting, Patients, Intervention, and Outcomes: We reviewed the literature to identify HRQoL issues in Addison's disease and interviewed patients and their partners in-depth to explore various symptom domains. A list of items was generated, and nine expert clinicians and five expert patients assessed the list for impact and clarity. A preliminary questionnaire was presented to 100 Addison's outpatients; the number of items was reduced after analysis of the distribution of the responses. The final questionnaire responses were assessed by Cronbach's alpha and Rasch analysis. Published studies of HRQoL in Addison's disease indicated reduced vitality and general health perception and limitations in physical and emotional functioning. In-depth interviews of 14 patients and seven partners emphasized the impact of the disease on the emotional domain. Seventy HRQoL items were generated; after the expert consultation process and pretesting in 100 patients, the number of items was reduced to 36. Eighty-six patients completed the final questionnaire; the responses showed high internal consistency with Cronbach's alpha 0.95 and Person Separation Index 0.94 (Rasch analysis). We envisage AddiQoL having utility in trials of hormone replacement and management of patients with Addison's disease, analogous to similar questionnaires in GH deficiency (AGHDA) and acromegaly (AcroQoL).

  10. Exploring health facilities' experiences in implementing the free health-care policy (FHCP) in Nepal: how did organizational factors influence the implementation of the user-fee abolition policy?

    PubMed

    Sato, Midori; Gilson, Lucy

    2015-12-01

    This article presents an Asian experience of abolishing health-care user fees: Nepal's universal free health-care policy, implemented in 2008. Based on doctoral fieldwork between August 2008 and April 2009, the paper analyses primary-care facilities' and central and district health systems' experiences with the policy. It makes a unique contribution to existing evidence because it explicitly applies organizational theory within a carefully designed, rigorous, multiple case-study analysis to deepen our understanding of the organizational and 'people' factors in the successful removal of user fees. The cases were two pairs of primary-care facilities in one district, paired for comparison of the facilities' experiences with the policy in relation to its effects on health care utilization. Data collection methods included document reviews; key informant interviews at district and central levels; in-depth, semi-structured interviews and group interviews at case facilities. (Data on indicators of utilization and quality changes over time were also collected and will be published separately). Using key elements of Nadler and Tushman's 'Organizational Congruence' model, a degree-of-fit analysis tested the study's initial propositions and yielded generalizations for contexts in and outside Nepal. The study found that Nepal's key implementation challenges were similar to Africa's: insufficient or delayed inputs of drugs and compensation; insufficient workforce and the resulting reduced quality of services that hampered facilities' relationships with their clients and health providers' attitudes. However, the Nepalese case facilities with (1) good intra- and inter-facility relationships, (2) adequate staffing, (3) well-oriented providers and (4) previously trained, better-informed and skilled health management committees experienced higher utilization and better-quality indicators over time. Through its detailed analysis of Nepal's experience in removing user fees, the study highlights the importance of addressing the 'people' and 'organizational' factors in health-policy development and implementation. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

  11. The fuzzy world of precision medicine: deliberations of a precision medicine tumor board

    PubMed Central

    McGraw, Sarah A; Garber, Judy; Jänne, Pasi A; Lindeman, Neal; Oliver, Nelly; Sholl, Lynette M; Van Allen, Eliezer M; Wagle, Nikhil; Garraway, Levi A; Joffe, Steven; Gray, Stacy W

    2017-01-01

    Aim: To understand how a cancer precision medicine tumor board (CPM-TB) made choices about return of results. Materials & methods: Observed CPM-TB deliberations and completed in-depth interviews with committee members. Results: Responding to complex evidence of ambiguous significance, deliberations of the CPM-TB were predicated on analytic validity and clinical utility. Members had concerns both about potential harms due to returning results based on weak evidence and about withholding potentially meaningful results. Group dynamics and the clinical experiences of individual committee members shaped their work. Conclusion: Both scientific evidence and the social context surrounding deliberations of a CPM-TB influenced decisions about return of results. Subjective elements, while present in any scientific endeavor, may carry more weight in the face of ambiguous findings. PMID:28757884

  12. Optimizing Implementation of Obesity Prevention Programs: A Qualitative Investigation Within a Large-Scale Randomized Controlled Trial.

    PubMed

    Kozica, Samantha L; Teede, Helena J; Harrison, Cheryce L; Klein, Ruth; Lombard, Catherine B

    2016-01-01

    The prevalence of obesity in rural and remote areas is elevated in comparison to urban populations, highlighting the need for interventions targeting obesity prevention in these settings. Implementing evidence-based obesity prevention programs is challenging. This study aimed to investigate factors influencing the implementation of obesity prevention programs, including adoption, program delivery, community uptake, and continuation, specifically within rural settings. Nested within a large-scale randomized controlled trial, a qualitative exploratory approach was adopted, with purposive sampling techniques utilized, to recruit stakeholders from 41 small rural towns in Australia. In-depth semistructured interviews were conducted with clinical health professionals, health service managers, and local government employees. Open coding was completed independently by 2 investigators and thematic analysis undertaken. In-depth interviews revealed that obesity prevention programs were valued by the rural workforce. Program implementation is influenced by interrelated factors across: (1) contextual factors and (2) organizational capacity. Key recommendations to manage the challenges of implementing evidence-based programs focused on reducing program delivery costs, aided by the provision of a suite of implementation and evaluation resources. Informing the scale-up of future prevention programs, stakeholders highlighted the need to build local rural capacity through developing supportive university partnerships, generating local program ownership and promoting active feedback to all program partners. We demonstrate that the rural workforce places a high value on obesity prevention programs. Our results inform the future scale-up of obesity prevention programs, providing an improved understanding of strategies to optimize implementation of evidence-based prevention programs. © 2015 National Rural Health Association.

  13. Appraising longitudinal trends in the strategic risks cited by risk managers in the international water utility sector, 2005-2015.

    PubMed

    Chalker, Rosemary T C; Pollard, Simon J T; Leinster, Paul; Jude, Simon

    2018-03-15

    We report dynamic changes in the priorities for strategic risks faced by international water utilities over a 10year period, as cited by managers responsible for managing them. A content analysis of interviews with three cohorts of risk managers in the water sector was undertaken. Interviews probed the focus risk managers' were giving to strategic risks within utilities, as well as specific questions on risk analysis tools (2005); risk management cultures (2011) and the integration of risk management with corporate decision-making (2015). The coding frequency of strategic (business, enterprise, corporate) risk terms from 18 structured interviews (2005) and 28 semi-structured interviews (12 in 2011; 16 in 2015) was used to appraise changes in the perceived importance of strategic risks within the sector. The aggregated coding frequency across the study period, and changes in the frequency of strategic risks cited at three interview periods identified infrastructure assets as the most significant risk over the period and suggests an emergence of extrinsic risk over time. Extended interviews with three utility risk managers (2016) from the UK, Canada and the US were then used to contextualise the findings. This research supports the ongoing focus on infrastructure resilience and the increasing prevalence of extrinsic risk within the water sector, as reported by the insurance sector and by water research organisations. The extended interviews provided insight into how strategic risks are now driving the implementation agenda within utilities, and into how utilities can secure tangible business value from proactive risk governance. Strategic external risks affecting the sector are on the rise, involve more players and are less controllable from within a utility's own organisational boundaries. Proportionate risk management processes and structures provide oversight and assurance, whilst allowing a focus on the tangible business value that comes from managing strategic risks well. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Many Ways of Telling: Expanding Conceptualizations of Child Sexual Abuse Disclosure

    ERIC Educational Resources Information Center

    Alaggia, R.

    2004-01-01

    Objective:: The aim of this study was to explore influences that inhibit or promote child sexual abuse (CSA) disclosure. Method:: Face-to-face in-depth interviews of 24 female and male survivors of CSA were conducted, using the Long-Interview method to trace disclosure processes. Verbatim transcriptions of the interviews were analyzed by hand and…

  15. Imaginal Coping and Childhood Illness: How Children Relate to Treatments for Chronic Illness.

    ERIC Educational Resources Information Center

    Clark, Cindy Dell

    This ethnographic study used multiple approaches to try to determine the emotional experience of young children (ages 5 to 8) with chronic illnesses. Forty-six children with severe asthma and diabetes were interviewed on two separate occasions using child-centered in-depth interviews that included play-based interviewing. The study also employed…

  16. "Everything Just Going Down the Drain." Interviews with Female Delinquents in Hawaii. Report No. 319.

    ERIC Educational Resources Information Center

    Koroki, Jan; Chesney-Lind, Meda

    Findings of in-depth interviews with ten delinquent girls in Hawaii are presented and analyzed in this report. The girls interviewed were participants in a short-term residential treatment program or students at an alternative school for boys and girls who have been adjudicated and who have had school difficulties. Following a brief introduction,…

  17. "Set in Stone" or "Ray of Hope": Parents' Beliefs About Cause and Prognosis After Genomic Testing of Children Diagnosed with ASD.

    PubMed

    Reiff, Marian; Bugos, Eva; Giarelli, Ellen; Bernhardt, Barbara A; Spinner, Nancy B; Sankar, Pamela L; Mulchandani, Surabhi

    2017-05-01

    Despite increasing utilization of chromosomal microarray analysis (CMA) for autism spectrum disorders (ASD), limited information exists about how results influence parents' beliefs about etiology and prognosis. We conducted in-depth interviews and surveys with 57 parents of children with ASD who received CMA results categorized as pathogenic, negative or variant of uncertain significance. Parents tended to incorporate their child's CMA results within their existing beliefs about the etiology of ASD, regardless of CMA result. However, parents' expectations for the future tended to differ depending on results; those who received genetic confirmation for their children's ASD expressed a sense of concreteness, acceptance and permanence of the condition. Some parents expressed hope for future biomedical treatments as a result of genetic research.

  18. Barriers to utilization of postnatal care at village level in Klaten district, central Java Province, Indonesia.

    PubMed

    Probandari, Ari; Arcita, Akhda; Kothijah, Kothijah; Pamungkasari, Eti Poncorini

    2017-08-07

    Maternal health remains a persisting public health challenge in Indonesia. Postnatal complications, in particular, are considered as maternal health problems priority that should be addressed. Conducting adequate care for postnatal complications will improve the quality of life of mothers and babies. With the universal health coverage implementation, the Indonesian government provides free maternal and child health services close to clients at the village level, which include postnatal care. Our study aimed to explore barriers to utilization of postnatal care at the village level in Klaten district, Central Java Province, Indonesia. A qualitative study was conducted in March 2015 - June 2016 in Klaten district, Central Java, Indonesia. We selected a total of 19 study participants, including eight mothers with postnatal complications, six family members, and five village midwives for in-depth interviews. We conducted a content analysis technique on verbatim transcripts of the interviews using open code software. This study found three categories of barriers to postnatal care utilization in villages: mother and family members' health literacy on postnatal care, sociocultural beliefs and practices, and health service responses. Most mothers did not have adequate knowledge and skills regarding postnatal care that reflected how they lacked awareness and practice of postnatal care. Inter-generational norms and myths hindered mothers from utilizing postnatal care and from having adequate nutritional intake during the postnatal period. Mothers and family members conducted unsafe self-treatment to address perceived minor postnatal complication. Furthermore, social power from extended family influenced the postnatal care health literacy for mother and family members. Postnatal care in the village lacked patient-centered care practices. Additionally, midwives' workloads and capacities to conduct postnatal information, education and counseling were also issues. Despite the government's efforts to provide free postnatal care closer to mothers' homes, other barriers to postnatal care utilization remained. Specifically, among mothers, community, and health services. An innovative approach to increase the health literacy on postnatal care is required. In particular, improving the capacity of midwives to conduct patient-centered care. In addition, village midwives' tasks should be evaluated and reoriented.

  19. Individual and structural environmental influences on utilization of iron and folic acid supplementation among pregnant women in Harare, Zimbabwe.

    PubMed

    Tinago, Chiwoneso B; Annang Ingram, Lucy; Blake, Christine E; Frongillo, Edward A

    2017-07-01

    Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to a lack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Care established a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant women receiving daily iron and folic acid (IFA) at their first antenatal care visit and throughout pregnancy. Despite these efforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand the experiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare, Zimbabwe, and the influence of health-service and social environments on utilization. Semi-structured in-depth interviews were conducted in Shona and English, with pregnant women (n = 24) and healthcare workers (n = 14) providing direct antenatal care services to pregnant women in two high-density community clinics. Data were analysed thematically using NVivo 10. Influences on utilization were at the individual and structural environmental levels. Reasons for low utilization of IFA supplementation included forgetting to take IFA, side effects, misconceptions about IFA, limited access to nutrition information, delayed entry or non-uptake of antenatal care and social norms of pregnant women for IFA supplementation. Utilization was enhanced by knowledge of risks and benefits of supplementation, fear of negative health complications with non-utilization, family support and healthcare worker recommendation for supplementation. Study findings can inform approaches to strengthen micronutrient supplementation utilization to improve the micronutrient status of pregnant women to decrease maternal mortality and improve overall maternal and child health in Zimbabwe. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

  20. Compatibility of the Relationship of Early Recollections and Life Style with Parent Schemas Obtained through Adlerian Interviews

    ERIC Educational Resources Information Center

    Canel, Azize Nilgün

    2016-01-01

    In this study, the Adlerian Interview Form has been used as a semi-structured, in-depth interview method to identify the experiences of six participants regarding Adler's concepts of early recollections and life style. Subsequent to transcribing the obtained information, recollections to be included in the analysis were subjected to the criterion…

  1. Older adults' perspectives on key domains of childhood social and economic experiences and opportunities: a first step to creating a multidimensional measure

    PubMed Central

    Yen, Irene H; Stewart, Anita L; Scherzer, Teresa; Pérez-Stable, Eliseo J

    2007-01-01

    Objectives Although research has found that childhood socioeconomic status (SES) is associated with physical and mental health in mid- and later life, most of these studies used conventional, single dimension SES measures for the childhood period such as household income or educational attainment of parents. Life course and health disparities research would benefit from identification and measurement of a variety of childhood social and economic experiences and opportunities that might affect health in later life. Design This study utilized qualitative research methods to identify key dimensions of childhood experiences related to SES. We conducted in-depth interviews with 25 adults age 55 to 80 years from diverse economic and ethnic backgrounds. Topics included home, neighborhood, school, and work experiences during early childhood and adolescence. Interviews were audio-taped and transcripts were coded to identify thematic domains. Results We identified eight thematic domains, many of which had clear subdomains: home and family circumstances, neighborhood, work and money, potential for advancement through schooling, school quality and content, discrimination, influence and support of adults, and leisure activities. These domains highlight individual characteristics and experiences and also economic and educational opportunities. Conclusion These domains of childhood social and economic circumstances add breadth and depth to conventional conceptualization of childhood SES. When the domains are translated into a measurement tool, it will allow for the possibility of classifying people along multiple dimensions, such as from a low economic circumstance with high levels of adult support. PMID:17986341

  2. Finding the Little 'c' in Physics: A Multiple Case Study Examining the Development of Creative Activities in the Physics Classroom

    NASA Astrophysics Data System (ADS)

    Wheeler, Christopher

    This study focused on how physics teachers develop and implement activities that promote creative thinking strategies in the standards based physics classroom. A particular focus was placed on every day or little "c", creativity, which can be taught in the high school classroom. The study utilized a multiple case study design, which allows for in-depth study in a variety of settings. Four participants from various high schools were identified utilizing administrator recommendations. Data were then collected via interviews, observations, and documents. The data were coded and analyzed for emerging themes. The themes were then merged to determine findings to the stated research questions. The research demonstrated the importance of modifying activities for student interest and understanding through effective use of scientific inquiry. The past experiences and professional development of the participants served as a vital piece to the development of their educational pedagogy especially concerning inquiry and questioning strategies. It was also established that an unstructured, positive classroom environment is a vital aspect of teaching while supporting creative thinking skills.

  3. Experiences of time: a qualitative inquiry into experiences of time as described by palliative care inpatients.

    PubMed

    Robertson, Matra

    2015-02-01

    In palliative care, health professionals provide support and care for patients for the duration of the unknown time toward death. While the experiences of patients diagnosed with a life limiting illness in palliative care have received some scholarly attention, little research has explored these experiences as described by palliative inpatients themselves. The purpose of this article is to explore how patients describe their lived experiences of time while in a palliative inpatient facility. This study used a qualitative phenomenological method and nine inpatients were recruited. They were interviewed utilizing in-depth semi-structured interviews, which were audio taped and transcribed. These interview transcripts of their descriptions were the data sources for this inquiry. Their description is part of a broader phenomenological inquiry on the experience of living with a life limiting illness described by palliative inpatients. Data were analyzed to identify essential themes within and across cases. Three essential themes were revealed: "brief time"; "waiting time," and "transcendental horizon: future time." These themes were not mutually exclusive and participant's experiences of time approaching death were described as a time of living toward death. The findings suggest that patients diagnosed with a life limiting illness have multi-dimensional experiences of time. Understanding the experiences of temporality for patients close to the gravity of death, from the patients' own words, can provide direction for patient informed interventions in clinical practice.

  4. Interventions to improve utilization of cataract surgical services by girls: Case studies from Asia and Africa.

    PubMed

    Adhisesha Reddy, Priya; Kishiki, Elizabeth A; Thapa, Hari Bahadur; Demers, Lisa; Geneau, Robert; Bassett, Ken

    2018-06-01

    Gender and blindness initiatives continue to make eye care personnel aware of the service utilization inequity strongly favouring men, yet interventions to reduce that inequity, particularly for girls, are under developed. This descriptive study gathered quantitative data on the degree of gender equity at five Child Eye Health Tertiary Facilities (CEHTFs) in Asia and Africa and conducted in-depth interviews with eye care personnel to assess their strategies and capacity to reduce gender inequity. Cataract surgery was utilized to assess the degree of inequity and success of interventions to reduce inequity in case finding, service utilization, and follow-up. CEHTF administrative data showed significant gender inequity in cataract surgical services favouring boys in all settings. CEHTFs actively seek children through community and school-based outreach, yet do not have initiatives to reduce gender inequity. Little gender inequity was found among children receiving surgical and follow-up care, although two out of three children were boys. CEHTF staff, despite being aware, offered no effective means to reduce gender inequity involving cataract surgical services. Interventions that successfully increased service utilization by girls came from individual cases, involving extraordinary effort by a single eye care programme person. Community-based case finders such as Anganwadi workers in India, Female Community Health Volunteers (FCHVs) in Nepal, and Key Informants (KIs) in Africa are necessary to identify children in need of cataract services, but insufficient to increase service utilization by girls. Secondary, often extra-ordinary community-based interventions by eye care personnel are needed in all settings.

  5. Improving transgender health by building safe clinical environments that promote existing resilience: Results from a qualitative analysis of providers.

    PubMed

    Torres, Carlos G; Renfrew, Megan; Kenst, Karey; Tan-McGrory, Aswita; Betancourt, Joseph R; López, Lenny

    2015-11-18

    Transgender (TG) individuals experience discordance between their sex at birth and their gender identity. To better understand the health care needs and characteristics of TG youth that contribute to resilience, we conducted a qualitative study with clinical and non-clinical providers. In-depth interviews were conducted of providers (n = 11) of TG youth (ages 13-21). Convenience and purposive sampling were used to recruit participants in the Boston area. All interviews were audio-recorded and transcribed verbatim. An interview guide of 14 open-ended questions was used to guide the discussion. A grounded theory approach was utilized to code and analyze the data, including double-coding to address issues of inter-rater reliability. Five primary themes emerged: 1) resilience of TG youth 2) lack of access to services that influence health, 3) the critical role of social support, 4) challenges in navigating the health care system, and 5) the need for trans-affirming competency training for providers and frontline staff. The findings of this study show that providers recognize multiple barriers and challenges in the care of TG youth. However, they also identify the resilience exhibited by many youth. We propose that providers can further enhance the resilience of TG youth and help them flourish by offering them necessary resources via the creation of safe and welcoming clinical environments.

  6. Barriers and facilitators related to implementation of regulated midwifery in Manitoba: a case study.

    PubMed

    Thiessen, Kellie; Heaman, Maureen; Mignone, Javier; Martens, Patricia; Robinson, Kristine

    2016-03-15

    In 2000, midwifery was regulated in the Canadian Province of Manitoba. Since the establishment of the midwifery program, little formal research has analyzed the utilization of regulated midwifery services. In Manitoba, the demand for midwifery services has exceeded the number of midwives in practice. The specific objective of this study was to explore factors influencing the implementation and utilization of regulated midwifery services in Manitoba. The case study design incorporated qualitative exploratory descriptive methods, using data derived from two sources: interviews and public documents. Twenty-four key informants were purposefully selected to participate in semi-structured in-depth interviews. All documents analyzed were in the public domain. Content analysis was employed to analyze the documents and transcripts of the interviews. The results of the study were informed by the Behavioral Model of Health Services Use. Three main topic areas were explored: facilitators, barriers, and future strategies and recommendations. The most common themes arising under facilitators were funding of midwifery services and strategies to integrate the profession. Power and conflict, and lack of a productive education program emerged as the most prominent themes under barriers. Finally, future strategies for sustaining the midwifery profession focused on ensuring avenues for registration and education, improving management strategies and accountability frameworks within the employment model, enhancing the work environment, and evaluating both the practice and employment models. Results of the document analysis supported the themes arising from the interviews. These findings on factors that influenced the implementation and integration of midwifery in Manitoba may provide useful information to key stakeholders in Manitoba, as well as other provinces as they work toward successful implementation of regulated midwifery practice. Funding for new positions and programs was consistently noted as a successful strategy. While barriers such as structures of power within Regional Health Authorities and inter and intra-professional conflict were identified, the lack of a productive midwifery education program emerged as the most prominent barrier. This new knowledge highlights issues that impact the ongoing growth and capacity of the midwifery profession and suggests directions for ensuring its sustainability.

  7. Access to primary health care for acute vascular events in rural low income settings: a mixed methods study.

    PubMed

    Ahmed, Shyfuddin; Chowdhury, Muhammad Ashique Haider; Khan, Md Alfazal; Huq, Nafisa Lira; Naheed, Aliya

    2017-01-18

    Cardiovascular diseases (CVDs) are the leading cause of global mortality. Among the CVDs, acute vascular events (AVE) mainly ischemic heart diseases and stroke are the largest contributors. To achieve 25% reduction in preventable deaths from CVDs by 2025, health systems need to be equipped with extended service coverage in order to provide person-centered care. The overall goal of this proposed study is to assess access to health care in-terms of service availability, care seeking patterns and barriers to access care after AVE in rural Bangladesh. We will consider myocardial infarction (MI) and stroke as acute vascular events. We will conduct a mixed methods study in rural Matlab, Bangladesh. This study will comprise of a) health facility survey, b) structured questionnaire interview and c) qualitative study. We will assess service availabilities by creating an inventory of public and private health facilities. Readiness of the facilities to deliver services for AVE will be assessed through a health facility survey using 'service availability and readiness assessment' (SARA) tools of the World Health Organization (WHO). We will interview survivors of AVE and caregivers (present and accompanied the person during the event) of person who died from AVE for exploring patterns of care seeking during an AVE. For exploring barriers to access care for AVE, we will conduct in-depth interview with survivors of AVE and caregivers of the person who died from AVE. We will also conduct key informant interviews with the service providers at primary health care (PHC) facilities and government high level officials at central health administration of Bangladesh. This study will provide a comprehensive picture of access to primary health care services during acute cardiovascular events as stroke & MI in rural context of Bangladesh. It will explore available service facilities in rural area for management, utilization of services and barriers to access care during an acute emergency. This study will help to generate hypothesis, develop programs and policies for better access to care for AVE in similar rural settings considering barriers of access and improving utilization.

  8. Deaf Adults' Emic Views on Deaf Education in South Africa: Looking Back To Improve the Future.

    ERIC Educational Resources Information Center

    Storbeck, Claudine

    In-depth interviews were conducted with 23 deaf adults (ages 17 to 56) who had been educated in South Africa, to determine their impressions about the education system there. Ten of those interviewed had moved to the U.S. while the remaining 13 were still living in South Africa . The interviews were administered in sign language, with video…

  9. UTILIZATION OF MATERNAL HEALTH SERVICES AMONG INTERNAL MIGRANTS IN MUMBAI, INDIA.

    PubMed

    Gawde, Nilesh C; Sivakami, Muthusamy; Babu, Bontha V

    2016-11-01

    This study aimed to understand access to maternal health care and the factors shaping it amongst poor migrants in Mumbai, India. A cross-sectional mixed methods approach was used. It included multistage cluster sampling and face-to-face interviews, through structured interview schedules, of 234 migrant women who had delivered in the two years previous to the date they were interviewed. Qualitative in-depth interviews of migrant women, health care providers and health officials were also conducted to understand community and provider perspectives. The results showed that access to antenatal care was poor among migrants with less than a third of them receiving basic antenatal care and a quarter delivering at home. Multivariate analysis highlighted that amongst migrant women those who stayed in Mumbai during pregnancy and delivery had better access to maternal health care than those who went back to their home towns. Poor maternal health care was also due to weaker demand for health care as a result of the lack of felt-need among migrants due to socio-cultural factors and lack of social support for, and knowledge of, health facilities in the city. Supply-side factors such as inadequate health infrastructure at primary and secondary levels, lack of specific strategies to improve access to health care for migrants and cumbersome administrative procedures that exclude migrants from certain government programmes all need to be addressed. Migrants should be integral to the urban development process and policies should aim at preventing their exclusion from basic amenities and their entitlements as citizens.

  10. Comparing appropriateness and equivalence of email interviews to phone interviews in qualitative research on reproductive decisions.

    PubMed

    Hershberger, Patricia E; Kavanaugh, Karen

    2017-10-01

    Despite an increasing use of qualitative email interviews by nurse researchers, there is little understanding about the appropriateness and equivalence of email interviews to other qualitative data collection methods, especially on sensitive topics research. The purpose is to describe our procedures for completing asynchronous, email interviews and to evaluate the appropriateness and equivalency of email interviews to phone interviews in two qualitative research studies that examined reproductive decisions. Content analysis guided the methodological appraisal of appropriateness and equivalency of in-depth, asynchronous email interviews to single phone interviews. Appropriateness was determined by: (a) participants' willingness to engage in email or phone interviews, (b) completing data collection in a timely period, and (c) participants' satisfaction with the interview. Equivalency was evaluated by: (a) completeness of the interview data, and (b) insight obtained from the data. Of the combined sample in the two studies (N=71), 31% of participants chose to participate via an email interview over a phone interview. The time needed to complete the email interviews averaged 27 to 28days and the number of investigator probe-participant response interchanges was 4 to 5cycles on average. In contrast, the phone interviews averaged 59 to 61min in duration. Most participants in both the email and phone interviews reported they were satisfied or very satisfied with their ability to express their true feelings throughout the interview. Regarding equivalence, 100% of the email and phone interviews provided insight into decision processes. Although insightful, two of the email and one phone interview had short answers or, at times, underdeveloped responses. Participants' quotes and behaviors cited within four published articles, a novel evaluation of equivalency, revealed that 20% to 37.5% of the citations about decision processes were from email participants, which is consistent with the percent of email participants. In-depth, asynchronous email interviews were appropriate and garnered rich, insightful data that augmented the phone interviews. Awareness of the procedures, appropriateness, and nuances when carrying out email interviews on sensitive topics may provide nurse researchers with the ability to obtain thick, rich data that can best advance clinical practice and direct future research. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. In-depth interviews of patients with primary immunodeficiency who have experienced pump and rapid push subcutaneous infusions of immunoglobulins reveal new insights on their preference and expectations.

    PubMed

    Cozon, Grégoire Jacques Noël; Clerson, Pierre; Dokhan, Annaïk; Fardini, Yann; Sala, Taylor Pindi; Crave, Jean-Charles

    2018-01-01

    Patients with primary immunodeficiency (PID) often receive immunoglobulin replacement therapy (IgRT). Physicians and patients have the choice between various methods of administration. For subcutaneous immunoglobulin infusions, patients may use an automated pump (P) or push the plunger of a syringe (rapid push [RP]). P infusions are performed once a week and last around 1 hour. RP decreases the duration of administration, but requires more frequent infusions. Eight out of 30 patients (coming from a single center) who had participated in the cross-over, randomized, open-label trial comparing P and RP participated in a focus group or underwent in-depth interviews. Patients had a long history of home-based subcutaneous immunoglobulin using P. The trial suggested that RP had slightly greater interference on daily life than P, but similar efficacy and better cost-effectiveness. When asked about the delivery method they had preferred, around one-third of patients pointed out RP rather than P. In-depth interviews may reveal unforeseen reasons for patients' preferences. Interviews underlined the complexity of the relationship that the patients maintain with their disease and IgRT. Even if they recognized the genetic nature of the disease and claimed PID was a part of them, patients tried not to be overwhelmed by the disease. IgRT by P was well integrated in patients' routine. By contrast, RP too frequently reminded the patients of their disease. In addition, some patients pointed out the difficulty of pushing the plunger due to the viscosity of the product. Coming back too frequently, RP was not perceived as time saving over a week. Long-lasting use of P could partly explain patients' reasonable reluctance to change to RP. In-depth interviews of PID patients highlighted unforeseen reasons for patients' preference that the physician needs to explore during the shared medical decision-making process.

  12. 'In some ways it all helps but in some ways it doesn't': The complexities of service users' experiences of inpatient mental health care in Australia.

    PubMed

    Isobel, Sophie

    2018-06-13

    Recovery-oriented mental health care requires active involvement of service users in the evaluation of care. While experience of care surveys is routinely given out upon discharge, capturing the depth and detail of service users' experiences in such a way to meaningfully improve services may require more in-depth and targeted approaches. This study aimed to gather voluntary and involuntary service users' experiences of care during hospitalization in two acute adult mental health inpatient units, through the collaborative completion of a purpose designed tool. The purpose of the study was to examine broad experiences of care and to identify the utility of proactive approaches to ongoing service evaluation. Overall, 67 participants were interviewed. Findings highlight the complexity of experiences of care including how an admission can seemingly facilitate clinical recovery while not being recovery-oriented. The findings also detail areas for improvement in the way that care is delivered and evaluated. The implications are particularly pertinent for mental health nurses to consider how, within the existing constraints of their roles, they can provide therapeutic care to all service users. © 2018 Australian College of Mental Health Nurses Inc.

  13. Caring for patients with cancer in non-specialist wards: the nurse experience.

    PubMed

    Mohan, S; Wilkes, L M; Ogunsiji, O; Walker, A

    2005-07-01

    This study aims to describe the experiences of nurses caring for cancer patients in non-specialist wards. The study was conducted in a large (420 beds) and small (32 beds) hospital in an area health service with urban and rural populations in the west of Sydney. A qualitative descriptive approach was utilized to collect data from the nurses. Data were collected using a survey and in-depth interviews of nurses working in non-specialist cancer wards. Transcribed data were managed with Nudist Vivo software and analysed for common themes using process of constant comparison and contrast. Twenty-five surveys were returned and five nurses volunteered to be interviewed. The six major themes that emerged from analysis of data were: emotional nature of care, lack of time, lack of knowledge of cancer treatment, family support, environment not conducive to proper care and dealing with patient's non-acceptance of cancer diagnosis. The nurses in this study wished to provide quality supportive care for cancer patients and their families but the inconducive environment and inadequate relevant training hindered the nurses' efforts. This then presents further need of relevant training for nurses in cancer care and time management, to meet up with these challenges.

  14. Exploring Older Adults' Health Information Seeking Behaviors

    ERIC Educational Resources Information Center

    Manafo, Elizabeth; Wong, Sharon

    2012-01-01

    Objective: To explore older adults' (55-70 years) health information-seeking behaviors. Methods: Using a qualitative methodology, based on grounded theory, data were collected using in-depth interviews. Participants were community-living, older adults in Toronto, Canada who independently seek nutrition and health information. Interview transcripts…

  15. Interviewing with or without the partner present?--an underexposed dilemma between ethics and methodology in nursing research.

    PubMed

    Norlyk, Annelise; Haahr, Anita; Hall, Elisabeth

    2016-04-01

    To discuss ethical and methodological challenges related to in-depth interviews with patients and partners when interviewed together or separately. Increased interest in exploring illness phenomena from both patients' and partners' perspectives has emerged. The decision about how to collect data is challenging. Patients and partners can be interviewed separately or together; in both scenarios researchers face complex questions of methodology and ethics. This paper contributes to the ongoing debate on individual or joint interviewing and the effect of absence/presence of the partner on data collection. Discussion paper that draws on data from three phenomenological studies. Referring to three cases from our phenomenological studies, we discuss the different types of ethical and methodological dilemmas faced when undertaking joint and separate interviews with couples. Furthermore, we discuss how the unexpected presence of the partner potentially influences the data gathered from the patient. The cases demonstrate the interrelatedness of ethics and methodology in studies based on in-depth interviews with couples. Nurse researchers may be caught up in a dilemma between ethical concerns and methodological considerations. We argue that the presence of the partner during an interview session might influence the data and favour expressions of shared rather than individual experiences of the phenomenon studied. Furthermore, we argue that ethical concerns must be given higher priority than methodology when interviewing couples. An increased awareness of the tension between ethical and methodological challenges in joint or individual interviewing with patients and partners is necessary, as this issue is underexposed. © 2015 John Wiley & Sons Ltd.

  16. The promise and the reality: a mental health workforce perspective on technology-enhanced youth mental health service delivery.

    PubMed

    Orlowski, Simone; Lawn, Sharon; Matthews, Ben; Venning, Anthony; Wyld, Kaisha; Jones, Gabrielle; Winsall, Megan; Antezana, Gaston; Schrader, Geoffrey; Bidargaddi, Niranjan

    2016-10-10

    Digital technologies show promise for reversing poor engagement of youth (16-24 years) with mental health services. In particular, mobile and internet based applications with communication capabilities can augment face-to-face mental health service provision. The literature in this field, however, fails to adequately capture the perspectives of the youth mental health workforce regarding utility and acceptability of technology for this purpose. This paper describes results of in-depth qualitative data drawn from various stakeholders involved in provision of youth mental health services in one Australian rural region. Data were obtained using focus groups and semi-structured interviews with regional youth mental health clinicians, youth workers and support/management staff (n = 4 focus groups; n = 8 interviews) and analysed via inductive thematic analysis. Results question the acceptability of technology to engage clients within youth mental health services. Six main themes were identified: young people in a digital age, personal connection, power and vulnerability, professional identity, individual factors and organisational legitimacy. These findings deepen the understanding of risks and challenges faced when adopting new technologies in mental healthcare. Recommendations for technology design and implementation in mental health services are made.

  17. Stigma, deforming metaphors and patients' moral experience of multibacillary leprosy in Sobral, Ceará State, Brazil.

    PubMed

    Nations, Marilyn K; Lira, Geison Vasconcelos; Catrib, Ana Maria Fontenelle

    2009-06-01

    In response to the call for a new Science of Stigma, this anthropological study investigates the moral experience of patients diagnosed with severe multibacillary leprosy. From 2003 to 2006, fieldwork was conducted in the so-called 'United-States-of-Sobral', in Ceará State, Northeast Brazil. Sobral is highly endemic for leprosy, despite intensified eradication efforts and a 30% increase in primary care coverage since 1999. Of 329 active leprosy cases at two public clinics, 279 multibacillary patients were identified and six information-rich cases selected for in-depth ethnographic analysis, utilizing illness narratives, key-informant interviews, home visits, participant-observation of clinical consultations and semi-structured interviews with physicians. A 'contextualized semantic interpretation' revealed four leprosy metaphors: a repulsive rat's disease, a racist skin rash, a biblical curse and lethal leukemia. Far from value-free pathology, the disease is imbued with moral significance. Patients' multivocalic illness constructions contest physicians' disease discourse. 'Skin Spot Day' discriminates more than educates. Patients' 'non-compliance' with effective multi-drug therapy is due to demoralizing stigma more than a rejection of care. 'Social leprosy' in Northeast Brazil deforms patients' moral reputations and personal dignity.

  18. Development of culturally tailored educational brochures on HPV and pap tests for American Indian women.

    PubMed

    Sharpe, Patricia A; Brandt, Heather M; McCree, Donna H; Owl-Myers, Elizabeth; Taylor, Betty; Mullins, Glenda

    2013-07-01

    Participatory formative research guided the creation of a culturally tailored educational brochure about human papillomavirus (HPV) at an American Indian women's clinic. A review of existing educational materials and in-depth interviews were conducted. Nine steps for creating health communications messages that were patterned after National Cancer Institute guidelines guided the brochure development process. Of 95 women tested for HPV, 41% were positive, 32 (34%) agreed to the in-depth interview, and 9 agreed to the pretesting interview. Mean age was 41 years. Interviews revealed key themes concerning emotional reactions to abnormal Pap test results and HPV; need for basic information about HPV, Pap tests, and results; concerns about HPV stigma, sexual transmission, and communication with sexual partner; and the preferred source and format for HPV educational materials. A literature review revealed 12 areas of basic HPV content. A participatory process successfully engaged nursing staff and patients in creating culturally appropriate brochures for clinic use. This article provides specific steps for creating culturally tailored patient education materials.

  19. Parents’ and Professionals’ Perceptions on Causes and Treatment Options for Autism Spectrum Disorders (ASD) in a Multicultural Context on the Kenyan Coast

    PubMed Central

    Gona, Joseph K.; Rimba, Kenneth; Mapenzi, Rachel; Kihara, Michael

    2015-01-01

    Objective To explore parents’ and professionals’ perceived causes and treatment of Autism Spectrum Disorders (ASD) on the Kenyan Coast. Methods In-depth interviews and focus group discussions using guiding questions were utilized in data collection. One hundred and three participants, who included parents of children with ASD, special needs teachers, clinicians, and social workers from diverse cultural background, participated in this study. The interviews and focus groups were recorded, transcribed verbatim and then translated to English. Themes were generated using content analysis. Results Preternatural causes were mentioned and included evil spirits, witchcraft, and curses. Biomedical causes comprised infections, drug abuse, birth complications, malnutrition, and genetic related problems. Treatment varied from traditional and spiritual healing to modern treatment in health facilities, and included consultations with traditional healers, offering prayers to God, and visits to hospitals. Conclusions The results suggest that regardless of cultural backgrounds, people on the Kenyan Coast have similar views on perceived causes and treatment of ASD. These findings provide valuable conceptual understanding for professionals when planning and implementing community based rehabilitation interventions targeting children with ASD within a local context. PMID:26267668

  20. Evaluating a policing strategy intended to disrupt an illicit street-level drug market.

    PubMed

    Corsaro, Nicholas; Brunson, Rod K; McGarrell, Edmund F

    2010-12-01

    The authors examined a strategic policing initiative that was implemented in a high crime Nashville, Tennessee neighborhood by utilizing a mixed-methodological evaluation approach in order to provide (a) a descriptive process assessment of program fidelity; (b) an interrupted time-series analysis relying upon generalized linear models; (c) in-depth resident interviews. Results revealed that the initiative corresponded with a statistically significant reduction in drug and narcotics incidents as well as perceived changes in neighborhood disorder within the target community. There was less-clear evidence, however, of a significant impact on other outcomes examined. The implications that an intensive crime prevention strategy corresponded with a reduction in specific forms of neighborhood crime illustrates the complex considerations that law enforcement officials face when deciding to implement this type of crime prevention initiative.

  1. [The experience of adult Korean children caring for parents institutionalized with dementia].

    PubMed

    Kwon, Suhye; Tae, Young Sook

    2014-02-01

    The purpose of the study was to explore and describe the experience of adult Korean children who are caregivers for parents institutionalized with dementia. Participants were fourteen adult children caregivers of elders institutionalized with dementia. Data were collected through in-depth unstructured interviews with individual participants from August to November, 2012. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Strauss and Corbin's Grounded Theory Method. From open coding, 67 concepts, 29 sub-categories, and 14 categories were identified. Analysis revealed that the core category of the experience of adult children caring for their parents institutionalized with dementia was 'enduring the role of a prop' consisting of four phases: initial turmoil, exploration, role adjustment, and acclimation. To manage the role of a prop, participants utilized various action/interactional strategies such as overcoming the unfamiliarity, overseeing the nursing home care, and counterbalancing the caring roles. As a result, participants experienced ambivalence towards the existence of parents with dementia, changes in family relationships, altered viewpoint towards nursing homes, and restructuring of life. In-depth understanding of the experience will guide nurses to promote effective interventions in order to better support the Korean family caregivers of parents institutionalized with dementia.

  2. 'Questerviews': using questionnaires in qualitative interviews as a method of integrating qualitative and quantitative health services research.

    PubMed

    Adamson, Joy; Gooberman-Hill, Rachael; Woolhead, Gillian; Donovan, Jenny

    2004-07-01

    Multi-method approaches are increasingly advocated in health services research (HSR). This paper examines the use of standardised self-completion questionnaires and questions, during in-depth interviews, a technique termed 'questerviews'. 'Questerview' techniques were used in four empirical studies of health perceptions conducted by the authors. The studies included both standardised self-completion questions or questionnaires and in-depth interviews. Respondents were tape-recorded while they completed the standardised questionnaires and were encouraged to discuss their definitions of terms and responses to items in-depth. In all studies, 'questerviews' were fully transcribed and data analysis involved the scrutinising of transcripts to identify emergent themes. Responses to the standardised items led to rich sources of qualitative data. They proved to be useful triggers as respondents discussed their understanding and definitions of terms, often explaining their responses with stories from their own experiences. The items triggered detailed exploration of the complex factors that comprise health, illness and healthcare seeking, and gave considerable insight into the ways in which people respond to standardised questions. Apparently simple questions and response categories conceal considerable complexity. Inclusion of standardised survey questions in qualitative interviews can provide an easy and fruitful method to explore research issues and provide triggers to difficult or contested topics. Well designed and validated questionnaires produce data of immense value to HSR, and this value could be further enhanced by their use within a qualitative interview. We suggest that the technique of 'questerviews' is a tangible and pragmatic way of doing this.

  3. Patient perspective on quality of geriatric care and rehabilitation--development and psychometric testing of a questionnaire.

    PubMed

    Wressle, Ewa; Eriksson, Lennart; Fahlander, Amie; Rasmusson, Ing-Marie; Tedemalm, Ulla; Tängmark, Karin

    2006-06-01

    The aim was to develop and test a questionnaire for use in telephone interviews concerning patient evaluation of geriatric care and rehabilitation. Instrument development was performed comprising qualitative interviews, construction of items, content validation, pilot study and data collection for evaluation of care and rehabilitation, clinical utility, reliability and construct validity. Qualitative interviews were performed with 12 elderly participants. The qualitative interviews formed the basis for the construction of 45 items. An expert panel performed a content validation of the questionnaire resulting in a revised version. A pilot study comprised 29 participants recently discharged from geriatric wards and the main data collection comprised 221 participants. Inclusion criteria were being able to perform a telephone interview and willingness to participate. Clinical utility was examined through questions to the interviewers, answered in writing. Cronbach's alpha coefficient was 0.79. According to a factor analysis and the evaluation of clinical utility, the underlying dimensions of the final revised questionnaire concern 'Respect and safety', 'Information and participation' and 'Rehabilitation interventions', scored in 18 items. In addition, one global item concerns satisfaction with care, resulting in 19 items in total. The revised questionnaire was named PaPeR, Patient Perspective on care and Rehabilitation. The questionnaire is considered valid, reliable and judged to have good clinical utility. The time consumption for the telephone interview is about 10-20 minutes. The questionnaire is useful in defining areas for potential quality improvement in geriatric wards.

  4. Aspiration for Global Cultural Capital in the Stratified Realm of Global Higher Education: Why Do Korean Students Go to US Graduate Schools?

    ERIC Educational Resources Information Center

    Kim, Jongyoung

    2011-01-01

    This study aims to understand Korean students' motivations for studying in US graduate schools. For this purpose, I conducted in-depth interviews with 50 Korean graduate students who were enrolled in a research-centered US university at the time of the interview. In these interviews, I sought to understand how their motivations are connected not…

  5. Why Breast Cancer Patients Seek Traditional Healers

    PubMed Central

    Muhamad, Mazanah; Merriam, Sharan; Suhami, Norhasmilia

    2012-01-01

    Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or “bomoh” at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities. PMID:22295249

  6. The benefits of discussing suicide with Alaska native college students: qualitative analysis of in-depth interviews.

    PubMed

    DeCou, Christopher R; Skewes, Monica C; López, Ellen D S; Skanis, Marie L

    2013-01-01

    Suicide represents a significant health disparity for communities in rural Alaska, and has implications for mental health among people who have lost loved ones from suicide. A qualitative interview study was conducted to examine the ways in which suicide has affected the lives of college students who have migrated from rural villages to an urban university (N = 25). The present research represents a secondary aim of the study-specifically, we examined the affective responses of Alaska Native college students from rural villages after completing in-depth semistructured interviews about their experiences related to suicide. Debriefing questions posed at the conclusion of the interviews revealed that the majority of participants (n 16) stated they felt "better" after completing the interview, and no participants reported feeling "worse." No participant required the use of the safety plan developed in case of severe emotional distress. All participants indicated they would be interested in participating in future research. Analysis of questions pertaining to the interview experience revealed the salience of foundation (the participant's prior experience discussing issues like suicide), process (the interview questions and questioning style), and outcomes (the challenges and benefits of participation described by the respondent). Findings provided important insights concerning the experience of discussing past trauma, perceived importance of research addressing coping with suicide, and the influence of past experiences in the process of talking about suicide.

  7. Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool.

    PubMed

    Jessani, Nasreen; Lewy, Daniela; Ekirapa-Kiracho, Elizabeth; Bennett, Sara

    2014-06-02

    Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans. Between June and November 2011, seven SPHs across the Democratic Republic of Congo, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda implemented this co-created tool. The objectives of the institutional assessments were to assess existing capacities for HSR and to develop capacity development plans to address prioritized gaps. A mixed-method approach was employed consisting of document analysis, self-assessment questionnaires, in-depth interviews, and institutional dialogues aimed at capturing individual perceptions of institutional leadership, collective HSR skills, knowledge translation, and faculty incentives to engage in HSR. Implementation strategies for the capacity assessment varied across the SPHs. This paper reports findings from semi-structured interviews with focal persons from each SPH, to reflect on the process used at each SPH to execute the institutional assessments as well as the perceived strengths and weaknesses of the assessment process. The assessment tool was robust enough to be utilized in its entirety across all seven SPHs resulting in a thorough HSR capacity assessment and a capacity development plan for each SPH. Successful implementation of the capacity assessment exercises depended on four factors: (i) support from senior leadership and collaborators, (ii) a common understanding of HSR, (iii) adequate human and financial resources for the exercise, and (iv) availability of data. Methods of extracting information from the results of the assessments, however, were tailored to the unique objectives of each SPH. This institutional HSR capacity assessment tool and the process for its utilization may be valuable for any SPH. The self-assessments, as well as interviews with external stakeholders, provided diverse sources of input and galvanized interest around HSR at multiple levels.

  8. Applying the theory of planned behavior to explore HAART adherence among HIV-positive immigrant Latinos: elicitation interview results.

    PubMed

    Vissman, Aaron T; Hergenrather, Kenneth C; Rojas, Gabriela; Langdon, Sarah E; Wilkin, Aimee M; Rhodes, Scott D

    2011-12-01

    This study explored influences on intention to adhere to highly active antiretroviral therapy (HAART) among immigrant Latinos living with HIV/AIDS in the southeastern USA. Our community-based participatory research (CBPR) partnership completed individual in-depth interviews with 25 immigrant Latinos, based on the theory of planned behavior (TPB), to explore beliefs toward HAART adherence and HIV testing. Participants identified (a) seven outcomes of treatment adherence (e.g., "feeling good" and "controlling the virus"), (b) six groups of persons influencing adherence (e.g., family, partner/spouse), and (c) nine impediments to adherence (e.g., appointment scheduling, side effects of treatment). Fear of deportation, perceived costs of services, and barriers to communication emerged as impediments to both HAART adherence and HIV testing. The findings suggest the utility of TPB in identifying factors to enhance HAART adherence among immigrant Latinos. Future research should explore the extent to which these identified TPB components quantitatively influence adherence intention and immunological and virological outcomes. Culturally congruent interventions for immigrant Latinos may need to focus on facilitators of adherence, influential referent groups, and destigmatizing HIV/AIDS. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Systems theory as a framework for examining a college campus-based support program for the former foster youth.

    PubMed

    Schelbe, Lisa; Randolph, Karen A; Yelick, Anna; Cheatham, Leah P; Groton, Danielle B

    2018-01-01

    Increased attention to former foster youth pursuing post-secondary education has resulted in the creation of college campus based support programs to address their need. However, limited empirical evidence and theoretical knowledge exist about these programs. This study seeks to describe the application of systems theory as a framework for examining a college campus based support program for former foster youth. In-depth semi-structured interviews were conducted with 32 program stakeholders including students, mentors, collaborative members, and independent living program staff. Using qualitative data analysis software, holistic coding techniques were employed to analyze interview transcripts. Then applying principles of extended case method using systems theory, data were analyzed. Findings suggest systems theory serves as a framework for understanding the functioning of a college campus based support program. The theory's concepts help delineate program components and roles of stakeholders; outline boundaries between and interactions among stakeholders; and identify program strengths and weakness. Systems theory plays an important role in identifying intervention components and providing a structure through which to identify and understand program elements as a part of the planning process. This study highlights the utility of systems theory as a framework for program planning and evaluation.

  10. Individual and Social Network Sexual Behavior Norms of Homeless Youth at High Risk for HIV Infection

    PubMed Central

    Tyler, Kimberly A.; Melander, Lisa A.

    2012-01-01

    Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner’s risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual history, availability, pregnancy, and the prevention of sexually transmitted infections (STIs). Sixteen homeless youth indicate that they do not discuss safe sex practices with their partners or social network members. PMID:23162182

  11. Individual and Social Network Sexual Behavior Norms of Homeless Youth at High Risk for HIV Infection.

    PubMed

    Tyler, Kimberly A; Melander, Lisa A

    2012-12-01

    Although previous research shows that homeless youth engage in numerous risky sexual behaviors, little is known about whether or not specific rules govern this conduct within their social networks and how group norms influence subsequent sexual actions. The current study utilizes 19 in-depth interviews with homeless youth to investigate different elements of their sexual behavior. Findings reveal that their decision to have sex generally depends on chemistry and physical appearance whereas a potential partner's risky sexual history and heavy substance use discourages youth from engaging in sex. Both males and females discuss condom usage as it relates to unknown sexual history, availability, pregnancy, and the prevention of sexually transmitted infections (STIs). Sixteen homeless youth indicate that they do not discuss safe sex practices with their partners or social network members.

  12. What's Not Being Said? Recollections of Nondisclosure in Clinical Supervision While in Training

    ERIC Educational Resources Information Center

    Sweeney, Jennifer; Creaner, Mary

    2014-01-01

    The aim of this qualitative study was to retrospectively examine nondisclosure in individual supervision while in training. Interviews were conducted with supervisees two years post-qualification. Specific nondisclosures were examined and reasons for these nondisclosures were explored. Six in-depth semi-structured interviews were conducted and…

  13. Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study.

    PubMed

    Stöckl, Heidi; Hertlein, Linda; Himsl, Isabelle; Ditsch, Nina; Blume, Carolin; Hasbargen, Uwe; Friese, Klaus; Stöckl, Doris

    2013-03-26

    The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital's maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women's experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy.

  14. Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study

    PubMed Central

    2013-01-01

    Background The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. Methods A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital’s maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Results Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women’s experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Conclusions Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy. PMID:23531127

  15. Electric utility companies and geothermal power

    NASA Technical Reports Server (NTRS)

    Pivirotto, D. S.

    1976-01-01

    The requirements of the electric utility industry as the primary potential market for geothermal energy are analyzed, based on a series of structured interviews with utility companies and financial institution executives. The interviews were designed to determine what information and technologies would be required before utilities would make investment decisions in favor of geothermal energy, the time frame in which the information and technologies would have to be available, and the influence of the governmental politics. The paper describes the geothermal resources, electric utility industry, its structure, the forces influencing utility companies, and their relationship to geothermal energy. A strategy for federal stimulation of utility investment in geothermal energy is suggested. Possibilities are discussed for stimulating utility investment through financial incentives, amelioration of institutional barriers, and technological improvements.

  16. Pediatric Patient and Caregiver Preferences in the Development of a Mobile Health Application for Management of Surgical Colorectal Conditions.

    PubMed

    Raval, Mehul V; Taylor, Natalie; Piper, Kaitlin; Thakore, Mitali; Hoff, Kathleen; Owens, Shane; Durham, Megan M

    2017-07-01

    Patient-centered frameworks are an effective way to engage patients in treatment plans, strengthen adherence behaviors, and improve disease outcomes. These frameworks can also be applied in the design of mobile technology disease management applications. However, the utilization of these frameworks is rare and frequently overlooked in existing colorectal mobile health (mHealth) applications. The purpose of this study was to utilize a patient-centered framework to facilitate the development of a valid, appropriate, and feasible mHealth tool for pediatric patients and their caregivers. To inform application design and production, in-depth interviews were conducted with pediatric patients and their caregivers to capture management experiences, application preferences, and barriers and facilitators to application use. Patient ages ranged from 3 to 16. Six caregivers and 2 adolescent patients participated in the interviews. Patients and caregivers reported various management styles and desired an application that is not only user-friendly and customizable, but also able to facilitate communication and information sharing with other patients, caregivers, and providers. Older patients also wanted the application to give them more independence in managing their disease. Employing patient-centered frameworks is context-specific, but holds much promise at the intersection of mobile technology and healthcare. By incorporating pediatric patient experiences and viewpoints, we identified important components for inclusion in a mHealth surgical colorectal disease management application. Patients and caregivers wanted a mHealth application that was unique to their needs and easy to use. They suggested that the application include treatment tracking, note taking, and provider communication features.

  17. Factors related to tooth loss due to dental caries among workers in an industrial estates in Thailand.

    PubMed

    Chatrchaiwiwatana, Supaporn; Ratanasiri, Amornrat; Jaidee, Jeeratip; Soontorn, Surasak

    2012-11-01

    The present study aimed to evaluate the prevalence and factors related to tooth loss due to dental caries among workers in industrial estates in Pathumthani and Phranakhorn Si Ayutthaya provinces in central Thailand. The present study utilized quantitative and qualitative methodologies. A quantitative study was done using a cross-sectional analytic method with a sample group of 457 adults (283 males; 174 females) between 19 and 53 years. Data were obtained through an oral examination and oral health behavior questionnaire. Data analyses were done using descriptive, bivariate and multivariable logistic regression statistics. In-depth interviews were used to collect qualitative data from 11 subjects. Most (62.2%) participants had tooth loss due to caries and findings from the final multivariable logistic regression model revealed that such loss was associated with education, residency, use of social security welfare, decayed teeth and filled teeth. Relatedly, the in-depth interview confirmed that tooth loss due to dental caries was related to (1) lack of time to visit a dentist (2) have a negative attitude toward or a phobia regarding dental treatment (3) inability to afford the high cast of dental treatment (4) lack of knowledge in regarding dental caries prevention, root canal treatment and the harmful effects of losing teeth (5) choosing to get an extraction upon having caries exposed pulp and (6) lack of oral health promotion programs provided by either the government or private sectors. The government and non-government organizations should promote oral health in an industrial estates and provide services and welfare for dental health of workers in an industrial estate appropriate to their socio-economic needs.

  18. Using decision tree models to depict primary care physicians CRC screening decision heuristics.

    PubMed

    Wackerbarth, Sarah B; Tarasenko, Yelena N; Curtis, Laurel A; Joyce, Jennifer M; Haist, Steven A

    2007-10-01

    The purpose of this study was to identify decision heuristics utilized by primary care physicians in formulating colorectal cancer screening recommendations. Qualitative research using in-depth semi-structured interviews. We interviewed 66 primary care internists and family physicians evenly drawn from academic and community practices. A majority of physicians were male, and almost all were white, non-Hispanic. Three researchers independently reviewed each transcript to determine the physician's decision criteria and developed decision trees. Final trees were developed by consensus. The constant comparative methodology was used to define the categories. Physicians were found to use 1 of 4 heuristics ("age 50," "age 50, if family history, then earlier," "age 50, if family history, then screen at age 40," or "age 50, if family history, then adjust relative to reference case") for the timing recommendation and 5 heuristics ["fecal occult blood test" (FOBT), "colonoscopy," "if not colonoscopy, then...," "FOBT and another test," and "a choice between options"] for the type decision. No connection was found between timing and screening type heuristics. We found evidence of heuristic use. Further research is needed to determine the potential impact on quality of care.

  19. The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS

    PubMed Central

    Nevedal, Andrea; Sankar, Andrea

    2016-01-01

    Purpose of the Study: Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker’s (1997) life course disruption theory, we explored older African Americans’ experiences of living with HIV/AIDS. Design and Methods: A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Results: Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Implications: Older African Americans’ discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. PMID:26035889

  20. Youth Apprenticeship Experiences in Wisconsin: A Stakeholder-Based Evaluation.

    ERIC Educational Resources Information Center

    Scribner, Jay Paredes; Wakelyn, David

    The experiences of stakeholders in Wisconsin's youth apprenticeship programs are used to provide insights for other policy-makers and educators contemplating or currently implementing youth apprenticeship programs. In-depth interviews, focus group interviews, and surveys with more than 100 students, parents, employers, and instructors were used to…

  1. What Are We Educating Towards? Socialization, Acculturization, and Individualization as Reflected in Home Education

    ERIC Educational Resources Information Center

    Neuman, Ari; Guterman, Oz

    2017-01-01

    This article examines the educational objectives of parents who homeschool (or practice home education) in terms of the widely accepted division of primary educational objectives, namely, socialisation, acculturation, and individualization. Using qualitative methodology and in-depth interviews, 30 homeschooling mothers were interviewed about their…

  2. Emerging Conceptions of ICT-Enhanced Teaching: Australian TAFE Context

    ERIC Educational Resources Information Center

    Khan, Shahadat Hossain

    2015-01-01

    This article presents the results of a study, undertaken from a phenomenographic perspective, which examines technical and further education (TAFE) teachers' conceptions of ICT-enhanced teaching. A cohort of 23 teachers from three TAFE institutions in Australia, participated in semi-structured, in-depth interviews. These interviews were used to…

  3. Preliminary assessment of facial soft tissue thickness utilizing three-dimensional computed tomography models of living individuals.

    PubMed

    Parks, Connie L; Richard, Adam H; Monson, Keith L

    2014-04-01

    Facial approximation is the technique of developing a representation of the face from the skull of an unknown individual. Facial approximation relies heavily on average craniofacial soft tissue depths. For more than a century, researchers have employed a broad array of tissue depth collection methodologies, a practice which has resulted in a lack of standardization in craniofacial soft tissue depth research. To combat such methodological inconsistencies, Stephan and Simpson 2008 [15] examined and synthesized a large number of previously published soft tissue depth studies. Their comprehensive meta-analysis produced a pooled dataset of averaged tissue depths and a simplified methodology, which the researchers suggest be utilized as a minimum standard protocol for future craniofacial soft tissue depth research. The authors of the present paper collected craniofacial soft tissue depths using three-dimensional models generated from computed tomography scans of living males and females of four self-identified ancestry groups from the United States ranging in age from 18 to 62 years. This paper assesses the differences between: (i) the pooled mean tissue depth values from the sample utilized in this paper and those published by Stephan 2012 [21] and (ii) the mean tissue depth values of two demographically similar subsets of the sample utilized in this paper and those published by Rhine and Moore 1984 [16]. Statistical test results indicate that the tissue depths collected from the sample evaluated in this paper are significantly and consistently larger than those published by Stephan 2012 [21]. Although a lack of published variance data by Rhine and Moore 1984 [16] precluded a direct statistical assessment, a substantive difference was also concluded. Further, the dataset presented in this study is representative of modern American adults and is, therefore, appropriate for use in constructing contemporary facial approximations. Published by Elsevier Ireland Ltd.

  4. Science Teachers’ Pedagogical Content Knowledge and Integrated Approach

    NASA Astrophysics Data System (ADS)

    Adi Putra, M. J.; Widodo, A.; Sopandi, W.

    2017-09-01

    The integrated approach refers to the stages of pupils’ psychological development. Unfortunately, the competences which are designed into the curriculum is not appropriate with the child development. This Manuscript presents PCK (pedagogical content knowledge) of teachers who teach science content utilizing an integrated approach. The data has been collected by using CoRe, PaP-eR, and interviews from six elementary teachers who teach science. The paper informs that high and stable teacher PCKs have an impact on how teachers present integrated teaching. Because it is influenced by the selection of important content that must be submitted to the students, the depth of the content, the reasons for choosing the teaching procedures and some other things. So for teachers to be able to integrate teaching, they should have a balanced PCK.

  5. The Nature of Mathematics Anxiety.

    ERIC Educational Resources Information Center

    Cemen, Pamala Byrd

    This paper attempts to generate a comprehensive description of the nature of mathematics anxiety through a synthesis of: (1) the general and test anxiety literatures applied to mathematics anxiety; (2) the mathematics anxiety literature, and (3) case studies developed through in-depth interviews. The indepth interviews were conducted with seven…

  6. Development, Content Validity, and User Review of a Web-based Multidimensional Pain Diary for Adolescent and Young Adults With Sickle Cell Disease.

    PubMed

    Bakshi, Nitya; Stinson, Jennifer N; Ross, Diana; Lukombo, Ines; Mittal, Nonita; Joshi, Saumya V; Belfer, Inna; Krishnamurti, Lakshmanan

    2015-06-01

    Vaso-occlusive pain, the hallmark of sickle cell disease (SCD), is a major contributor to morbidity, poor health-related quality of life, and health care utilization associated with this disease. There is wide variation in the burden, frequency, and severity of pain experienced by patients with SCD. As compared with health care utilization for pain, a daily pain diary captures the breadth of the pain experience and is a superior measure of pain burden and its impact on patients. Electronic pain diaries based on real-time data capture methods overcome methodological barriers and limitations of paper pain diaries, but their psychometric properties have not been formally established in patients with SCD. To develop and establish the content validity of a web-based multidimensional pain diary for adolescents and young adults with SCD and conduct an end-user review to refine the prototype. Following identification of items, a conceptual model was developed. Interviews with adolescents and young adults with SCD were conducted. Subsequently, end-user review with use of the electronic pain diary prototype was conducted. Two iterative cycles of in-depth cognitive interviews in adolescents and young adults with SCD informed the design and guided the addition, removal, and modification of items in the multidimensional pain diary. Potential end-users provided positive feedback on the design and prototype of the electronic diary. A multidimensional web-based electronic pain diary for adolescents and young adults with SCD has been developed and content validity and initial end-user reviews have been completed.

  7. Making the Connection between Prayer, Faith, and Forgiveness in Roman Catholic Families

    ERIC Educational Resources Information Center

    Batson, Mindi; Marks, Loren

    2008-01-01

    This study examines meanings and processes associated with religious practices of prayer, building faith, and forgiving through in-depth, qualitative interviews with six highly religious Roman Catholic families with children. Families were interviewed using a narrative approach that asked participants to share experiences and challenges related to…

  8. Coping Constructs Related to College Students with Chronic Pain

    ERIC Educational Resources Information Center

    Firmin, Michael W.; Burger, Amanda J.; Sherman, Amanda L.; Grigsby, Megan E.; Croft, Jennifer N.

    2011-01-01

    This phenomenological, qualitative research study involved in-depth interviews with 22 participants enrolled in a private Midwestern university. Each participant reported living with a respective chronic pain syndrome while also being a full-time student. Our semi-structured, interviews centered around the constructs of physical, social,…

  9. [Effects of phosphorus application rates and depths on P utilization and loss risk in a maize-soybean intercropping system].

    PubMed

    Zhao, Wei; Song, Chun; Zhou, Pan; Wang, Jia Yu; Xui, Feng; Ye, Fang; Wang, Xiao Chun; Yang, Wen Yu

    2018-04-01

    In order to explore the advantage of intercropping on phosphorus (P) efficient utilization and the reduction of soil P loss, a field experiment in a maize-soybean intercropping system, which included three P application (P 2 O 5 ) rates (CP: 168 kg·hm -2 ; RP 1 : 135 kg·hm -2 ; RP 2 : 101 kg·hm -2 ) and three P application depths (D 1 : applied in 5 cm depth; D 2 : applied in 15 cm depth; D 3 : 1/2 of P fertilizer applied in 5 cm depth and another 1/2 in 15 cm depth) was carried out to analyze the effects of P application rates and depth on crop aboveground biomass, grain yield, crop P uptake, soil total and available P contents, and soil P adsorption-desorption characteristics. Compared with control treatment, the aboveground biomass, grain yield, crop P uptake, soil total P, and available P content were increased significantly by P application, regardless of P rate and application depth. Under the same application depth, RP 1 had similar grain yield but higher crop P uptake compared with CP, and thus higher P apparent utilization efficiency. Under the same P application rate, the application depth of D 2 had the highest crop aboveground biomass, grain yield, P uptake, soil total P, and available P. According to the characteristic of soil P adsorption-desorption, the treatment with the rate of RP 1 and the depth of D 2 had the strongest soil P retention capacity, which had advantage in alleviating P loss. These results suggested that reducing application rate but increasing application depth of P fertilizer could improve P use efficiency and reduce soil P loss without sacrifice in crop production in maize-soybean relay intercropping system.

  10. Standardized Patients versus Volunteer Patients for Physical Therapy Students' Interviewing Practice: A Pilot Study.

    PubMed

    Murphy, Sue; Imam, Bita; MacIntyre, Donna L

    2015-01-01

    To compare the use of standardized patients (SPs) and volunteer patients (VPs) for physical therapy students' interviewing practice in terms of students' perception and overall costs. Students in the Master of Physical Therapy programme (n=80) at a Canadian university were divided into 20 groups of 4 and were randomly assigned to interview either an SP (10 groups) or a VP (10 groups). Students completed a survey about their perception of the usefulness of the activity and the ease and depth of information extraction. Survey responses as well as costs of the interview exercise were compared between SP and VP groups. No statistically significant between-groups difference was found for the majority of survey items. The cost of using an SP was $148, versus $50 for a VP. Students' perceptions of the usefulness of the activity in helping them to develop their interview skills and of the ease and depth of extracting information were similar for both SPs and VPs. Because the cost of using an SP is about three times that of using a VP, using VPs seem to be a more cost-effective option.

  11. Field Trial Results of a 14-channel GPR Integrated with a U.S. Program for 3-D Utility Mapping

    NASA Astrophysics Data System (ADS)

    Anspach, James H.

    2013-04-01

    Existing underground utilities continue to be a leading cause of highway construction delay claims in the United States. Although 80-90% of existing utilities can typically be discovered and mapped using a wide range of geophysical tools, there is a recognizable need to improve the process. Existing shortcomings to the utility mapping process include a lack of viable depth attributes, long field occupation times, low experience level of the field technicians, and separate survey / geophysics functions. The U.S. National Academies and its Transportation Research Board recently concluded a project on alleviating the existing utility mapping shortcomings through the development of enhanced GPR. An existing commercial 400MHz 14-channel towed array was enhanced with positioning and interpretation hardware and software over a 3-year US 2M program. Field trials for effectiveness were conducted in a city suburb commercialized environment where the relative permittivity values averaged 9.4. The effectiveness of enhanced GPR was compared to traditional utility mapping techniques (Single Channel GPR, FDEM, Acoustic, Sondes, Gradiometric Magnetometers) during the project. The project area utilities included natural gas, water, electric, telephone, cable, storm, sanitary, traffic control, and several unknown function lines. Depths for these utilities were mostly unknown. 81% of known (from records and field appurtenance visual observation) utilities were detected via traditional geophysical means. These traditional geophysical means also detected 14% additional and previously "unknown" utilities. The enhanced GPR detected approximately 40% of the known and unknown utilities, and found an additional 6% of utilities that were previously undetected. These additional utilities were subsequently determined to be small diameter abandoned water and gas systems in very poor and broken condition. Although it did well with metallic water and gas lines, communication and electric utilities were mostly undetectable. Through a ground-truthing program of test holes to expose utilities, the depth values derived from the enhanced GPR were fairly consistent and within 15 cm of actual depth. The incomplete underground picture determined by the enhanced GPR reinforces previous studies that show that the mapping of existing underground utilities is a multi-tool effort that takes highly trained and skilled field technicians and data interpreters. The addition of a new GPR tool is valuable in determining continuous depth profiles of imaged utilities. A second and significant benefit is the interpretation of other geotechnical data that benefit project designers. This might include showing geometry, location, intensity, and depths of either areas of anomalies, or of known structures, such as paving thickness, substrate thickness, voids, water table, soil lenses, boulders, bedrock, and so forth. The Florida Department of Transportation has decided to take advantage of this new technology and has entered into an experimental contract with Cardno TBE to incorporate several enhanced GPR arrays with traditional utility detection tools. The goal of this contract will be to provide a 3-D model of existing underground utilities for use in automated construction. The GPR 3-D data model will be melded with conventional subsurface utility engineering and mapping practices and will be required to follow the ASCE 38 standard for utility data reliability.

  12. HIV-related needs for safety among male-to-female transsexuals (mak nyah) in Malaysia.

    PubMed

    Koon Teh, Yik

    2008-12-01

    This research, commissioned by the Malaysian AIDS Council in 2007, is qualitative and descriptive in nature. In depth face-to-face interviews were carried out with 15 mak nyah respondents from five major towns. The interviews were guided by an interview schedule that had seven main topics: brief background; hormone-taking behaviour; safe sex; health care; substance abuse; harassment from authorities; and HIV prevention. The HIV problem among the mak nyah, mak nyah sex workers and their clients is critical. Many do not have in-depth HIV/AIDS knowledge and do not practise safe sex. The problem gets worse when most mak nyah do not consider HIV/AIDS as a primary concern because of other pressing problems like employment and discrimination. There are also no HIV prevention activities in many parts of Malaysia. Mak nyah also face constant harassment from enforcement authorities for prostitution. This hampers HIV prevention work.

  13. Response to Trauma in Haitian Youth at Risk

    PubMed Central

    Douyon, Richard; Marcelin, Louis Herns; Jean-Gilles, Michèle; Page, J. Bryan

    2006-01-01

    SUMMARY In order to characterize undesirable behavior (drug use, fighting, criminal activity) among Haitian youth at risk and determine the relationship between traumatic experience and that kind of behavior, investigators recruited 291 Haitian youths via networks of informal social relations in two zones of Miami/Dade County strongly idenitified with Haitian ethnicity. Each recruit responded to an interview schedule eliciting sociodemographic information and self-reported activities, including involvement in youth-dominated groups. They also reported traumatic experience. Clinicians administered CAPS to a subset of those respondents who self-reported traumatic experience. Staff ethnographers selected respondents for in-depth interviews and family studies to provide contextual depth for findings of the interview schedule and the CAPS assessments. Although traumatic experience may still play a role in mental health outcomes among children, childhood victimization among Haitian children does not appear to be related to the drug use and undesirable behaviors associated with unsupervised youth, including formation of gangs. PMID:16275637

  14. Learning at Work: Organisational Affordances and Individual Engagement

    ERIC Educational Resources Information Center

    Bryson, Jane; Pajo, Karl; Ward, Robyn; Mallon, Mary

    2006-01-01

    Purpose: The purpose of this research is to explore the interaction between organisational affordances for the development of individuals' capability, and the engagement of workers at various levels with those opportunities. Design/methodology/approach: A case study of a large New Zealand wine company, using in-depth interviews. Interviews were…

  15. Social Influences on Sorority and Fraternity Member Smoking

    ERIC Educational Resources Information Center

    Cheney, Marshall K.; Maness, Sarah; Huber, J. Kathleen; Burt, Taylor; Eggleston, Landon; Naberhaus, Bryce; Nichols, Brooklyn

    2017-01-01

    Objective: To understand how the Greek system uniquely influences smoking attitudes, beliefs, and behaviors among college students who belong to a social sorority or fraternity. Participants: Active members of sororities (n = 16) and fraternities (n = 17) were interviewed between February 2013 and October 2015. Methods: In-depth interviews were…

  16. 24-Hour Academic Libraries: Adjusting to Change

    ERIC Educational Resources Information Center

    Bowman, Adam C.

    2013-01-01

    The purpose of this study was to explore the adaptive measures that academic libraries perform when implementing and operating a 24-hour schedule. Five in-depth interviews were conducted with current managerial-level librarians at 24-hour academic libraries. The exploratory interviews revealed similar measures for security, budgeting, employee…

  17. Perceived Challenges in Dementia Care by Vietnamese Family Caregivers and Care Workers in South Australia.

    PubMed

    Xiao, Lily Dongxia; Habel, Lesley; De Bellis, Anita

    2015-09-01

    The majority of Vietnamese Australians migrated to Australia as refugees to escape a war and this unique migration background may affect their ability to access and utilize healthcare services in Australia. Inability to utilize dementia services is associated with higher levels of caregiver burden, higher rates of morbidities and mortality and hospitalization. The aim of the study was to explore the perceived challenges of dementia care from Vietnamese family caregivers and Vietnamese care workers. Gadamer's philosophical hermeneutics was used to interpret and describe the experiences of the participants. Data were collected from in-depth interviews with six Vietnamese family caregivers and a focus group with Vietnamese care workers using purposive sampling. Participants were recruited from a Vietnamese community care organization in South Australia. Five themes were identified from the data analysis namely: (1) a need for culturally and linguistically appropriate dementia education programs; (2) a willingness and unwillingness to seek help; (3) poor knowledge of health care service availability related to dementia; (4) the effect of language barrier in accessing services; and (5) the main sources of services utilized. The study revealed that Vietnamese family caregivers and Vietnamese care workers held different views on the association of stigma with dementia. Findings also revealed factors that impacted accessing and utilizing dementia services. These findings facilitate a more comprehensive understanding of Vietnamese family caregivers' needs and have implications for developing individualized support for family caregivers and for consumer-directed dementia services in Australia.

  18. Beliefs about Using Technology in the Mathematics Classroom: Interviews with Pre-Service Elementary Teachers

    ERIC Educational Resources Information Center

    Lin, Cheng-Yao

    2008-01-01

    This study explored the efficacy of web-based workshops in topics in elementary school mathematics in fostering teachers' confidence and competence in using instructional technology, and thereby promoting more positive attitudes toward using computers and Internet resources in the mathematics classroom. It consisted of in-depth interviews of…

  19. Patterns and determinants of small-quantity LNS utilization in rural Malawi and Mozambique: considerations for interventions with specialized nutritious foods.

    PubMed

    Kodish, Stephen R; Aburto, Nancy J; Nseluke Hambayi, Mutinta; Dibari, Filippo; Gittelsohn, Joel

    2017-01-01

    Small-quantity, lipid-based nutrient supplements (SQ-LNS) show promise to improve the quality of maternal and child diets, particularly during the first 1000 days of life. The potential of SQ-LNS to impact positively upon nutritional status relies on numerous factors, including complementary dietary intake, disease prevalence and dynamics of household utilization, including sharing practices. Therefore, this study sought to elucidate the patterns and determinants of SQ-LNS utilization among children 6-23 months and potential sharing practices of other household members prior to intervention development. In Ntchisi, Malawi and Cabo Delgado, Mozambique, both rural, agricultural settings, we conducted two home-feeding trials of 8 and 6 weeks, respectively, nested within a larger multi-phase, emergent formative research design. Multiple methods, including in-depth interviews (n = 38), direct meal observations (n = 80), full-day child observations (n = 38) and spot checks of SQ-LNS supply (n = 23), were conducted with households (n = 35 in Malawi; n = 24 in Mozambique). Overall, the SQ-LNS was utilized contrary to its recommended use, with 50% of households in Malawi reporting running out of stock too early and 87% of households in Mozambique either overusing or underusing the product. Utilization of SQ-LNS was manifested in four patterns of overuse and two of underuse and was determined by factors at multiple levels of influence. Maternal and child health efforts need to consider the reasons behind choices by households to overuse or underuse SQ-LNS and design intervention strategies to increase the likelihood of its appropriate utilization. © 2016 John Wiley & Sons Ltd.

  20. Determinants of Utilization and Community Experiences with Community Health Volunteers for Treatment of Childhood Illnesses in Rural Sierra Leone.

    PubMed

    Yansaneh, Aisha I; George, Asha S; Sharkey, Alyssa; Brieger, William R; Moulton, Lawrence H; Yumkella, Fatu; Bangura, Peter; Kabano, Augustin; Diaz, Theresa

    2016-04-01

    In 2010, at the same time as the national roll out of the Free Health Care Initiative (FHCI), which removed user fees for facility based health care, trained community health volunteers (CHVs) were deployed to provide integrated community case management of diarrhea, malaria and pneumonia to children under 5 years of age (U5) in Kambia and Pujehun districts, Sierra Leone. After 2 years of implementation and in the context of FHCI, CHV utilization rate was 14.0 %. In this study, we examine the factors associated with this level of CHV utilization. A cross-sectional household-cluster survey of 1590 caregivers of 2279 children U5 was conducted in 2012; with CHV utilization assessed using a multiple logistic regression model. Focus groups and in-depth interviews were also conducted to understand communities' experiences with CHVs. Children with diarrhea (OR = 3.17, 95 % CI: 1.17-8.60), from female-headed households (OR = 4.55, 95 % CI: 1.88-11.00), and whose caregivers reported poor quality of care as a barrier to facility care-seeking (OR = 8.53, 95 % CI: 3.13-23.16) were more likely to receive treatment from a CHV. Despite low utilization, caregivers were highly familiar and appreciative of CHVs, but were concerned about the lack of financial remuneration for CHVs. CHVs remained an important source of care for children from female-headed households and whose caregivers reported poor quality of care at health facilities. CHVs are an important strategy for certain populations even when facility utilization is high or when facility services are compromised, as has happened with the recent Ebola epidemic in Sierra Leone.

  1. ADHD and Health Services Utilization in the National Health Interview Survey

    ERIC Educational Resources Information Center

    Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert

    2009-01-01

    Objective: Describe the general health, comorbidities and health service use among U.S. children with ADHD. Method: The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization. Results: Asthma…

  2. Interviewer as Instrument: Accounting for Human Factors in Evaluation Research

    ERIC Educational Resources Information Center

    Brown, Joel H.

    2006-01-01

    This methodological study examines an original data collection model designed to incorporate human factors and enhance data richness in qualitative and evaluation research. Evidence supporting this model is drawn from in-depth youth and adult interviews in one of the largest policy/program evaluations undertaken in the United States, the Drug,…

  3. Patients' perspectives of a multifaceted intervention with a focus on technology: a qualitative analysis.

    PubMed

    Lambert-Kerzner, Anne; Havranek, Edward P; Plomondon, Mary E; Albright, Karen; Moore, Ashley; Gryniewicz, Kelsey; Magid, David; Ho, P Michael

    2010-11-01

    Few studies have investigated the effectiveness of multifaceted interventions from the study participants' perspective. We conducted qualitative interviews to understand patients' experiences with a multifaceted blood pressure (BP) control intervention involving interactive voice response technology, home BP monitoring, and pharmacist-led BP management. In the randomized study, the intervention resulted in clinically significant decreases in BP. We used insights generated from in-depth interviews from all study participants randomly assigned to the multifaceted intervention or usual care (n=146) to create a model explaining the observed improvements in health behavior and clinical outcomes. The data were analyzed using qualitative content analysis methods and consultative and reflexive team analysis. Six explanatory factors emerged from the patients' interviews: (1) improved relationships with medical personnel; (2) increased knowledge of hypertension; (3) increased participation in their health care and personal empowerment; (4) greater understanding of the impact of health behavior on BP; (5) high satisfaction with technology used in the intervention; and, for some patients, (6) increased health care utilization. Eighty-six percent of the intervention patients and 62% of the usual care patients stated that study participation had a positive effect on them. Of those expressing a positive effect, 68% (intervention) and 55% (usual care) reached their systolic BP goal. Establishing bidirectional conversations between patients and providers is a key element of successful hypertension management. Home BP monitoring coupled with interactive voice response technology reporting facilitates such conversations.

  4. Who Gets the Best Grades at Top Universities? An Exploratory Analysis of Institution-Wide Interviews with the Highest Achievers at a Top Korean University

    ERIC Educational Resources Information Center

    Lee, Hye-Jung; Lee, Jihyun

    2012-01-01

    This study explores what makes high achievement at a top university in order to gain insights into college learning. For this purpose, institution-wide in-depth interviews were conducted with the 45 highest achievers (GPA of 4.0/4.3 or higher) at a top Korean university, and the interview data were primarily analyzed qualitatively to investigate…

  5. Communication in Young Children with Fragile X Syndrome: A Qualitative Study of Mothers' Perspectives

    ERIC Educational Resources Information Center

    Brady, Nancy; Skinner, Debra; Roberts, Joanne; Hennon, Elizabeth

    2006-01-01

    Purpose: To provide descriptive and qualitative information about communication in young children with fragile X syndrome (FXS) and about how families react to and accommodate communication differences in their children. Method: In-depth interviews were conducted with 55 mothers of young children with FXS. Interviewers asked mothers to describe…

  6. Understanding the Support Systems of Hispanic Teacher Candidates: A Study through In-Depth Interviews.

    ERIC Educational Resources Information Center

    Martinez, Raul R.; O'Donnell, James

    This study explores the background of minority teacher education candidates; their experience in teacher education courses and how the program met student goals and expectations; cultural conflicts they experienced in participating in teacher education; and the mentoring and support systems that the participants used or needed. Interviews held…

  7. Relational Inquiries and the Research Interview: Mentoring Future Researchers

    ERIC Educational Resources Information Center

    Hoskins, Marie L.; White, Jennifer

    2013-01-01

    In this article we describe some of the challenges and constraints that students face when they engage in qualitative research interviews. We borrow extensively from Ron Pelias' in-depth description of "leaning in" during everyday life encounters. Although he refers to other kinds of relationships, we believe that the similarities…

  8. A Phenomenological Study: Teachers' Experiences of Using Digital Storytelling in Early Childhood Education

    ERIC Educational Resources Information Center

    Yuksel-Arslan, Pelin; Yildirim, Soner; Robin, Bernard Ross

    2016-01-01

    This study investigates how early childhood education (ECE) teachers incorporated digital storytelling in their classrooms and the challenges and successes that they faced in the process. After the teachers attended a digital storytelling workshop, in-depth phenomenological interview, observation and focus group interviews were used to collect…

  9. “You Know You Are Sick, Why Do You Carry A Pregnancy Again?” Applying the Socio-Ecological Model to Understand Barriers to PMTCT Service Utilization in Western Kenya

    PubMed Central

    Onono, Maricianah; Kwena, Zachary; Turan, Janet; Bukusi, Elizabeth A; Cohen, Craig R; Gray, Glenda E

    2015-01-01

    Objective Throughout most of sub-Saharan Africa (SSA), prevention of mother-to-child transmission (PMTCT) services are readily available. However, PMTCT programs in SSA have had suboptimal performance compared to other regions of the world. The main objective of this study is to explore the socio-ecological and individual factors influencing the utilization of PMTCT services among HIV-positive pregnant women in western Kenya using a social ecological model as our analytical lens. Methods Data were collected using in-depth interviews with 33 HIV-infected women attending government health facilities in rural western Kenya. Women with HIV-infected infants aged between 6 weeks to 6 months with a definitive diagnosis of HIV in the infant, as well as those with an HIV-negative test result in the infant were interviewed between November 2012 and June 2013. Coding and analysis of the transcripts followed grounded theory tenets. Coding reports were discussed in a series of meetings held among the authors. We then employed constant comparative analysis to discover dominant individual, family, society and structural determinants of PMTCT use. Results Barriers to women’s utilization of PMTCT services fell within the broad constructs of the socio-ecological model of individual, family, society and structural determinants. Several themes cut across the different steps of PMTCT cascade and relate to different constructs of the socio-ecological model. These themes include: self-motivation, confidence and resilience, family support, absence or reduced stigma, right provider attitude and quality of health services provided. We also found out that these factors ensured enhanced maternal health and HIV negative children. Conclusion The findings of this study suggest that a woman’s social environment is an important determinant of MTCT. PMTCT Interventions must comprehensively address multiple factors across the different ecological levels. More research is however required for the development of multi-component interventions that combine strategies at different ecological levels. PMID:26457229

  10. Physicians' Perspectives on Caring for Cognitively Impaired Elders.(author Abstract)

    ERIC Educational Resources Information Center

    Adams, Wendy L.; McIlvain, Helen E.; Geske, Jenenne A.; Porter, Judy L.

    2005-01-01

    Purpose: This study aims to develop ah in-depth understanding of the issues important to primary care physicians in providing care to cognitively impaired elders. Design and Methods: In-depth interviews were conducted with 20 primary care physicians. Text coded as "cognitive impairment" was retrieved and analyzed by use of grounded theory analysis…

  11. Sure start: voices of the 'hard-to-reach'.

    PubMed

    Coe, C; Gibson, A; Spencer, N; Stuttaford, M

    2008-07-01

    This research aimed to look in depth at the factors affecting the ability of four Sure Start local programmes, based in a multicultural Midlands city, to engage with 'hard-to-reach' populations. A variety of research strategies and methods were employed. Geographical information systems, participatory research methods and interviews were used in order to understand the extent of the challenge, and hear first hand, why parents may not get involved with Sure Start. The mapping exercise involved collation and mapping of postcode data with respect to boundaries and potential and actual users of Sure Start services. This made possible the identification of any geographical patterning in the distribution of service users and non-users. Participatory research methods were used with parents, enabling them to conduct short interviews within their own communities and make sense of the data collected. Interviews were also conducted with 70 parents across the city, recruited through local schools. The results indicate that parental decisions regarding Sure Start are the product of a complex interaction between numerous factors which may act as either barriers or facilitators to service utilization. The results suggest that a multi-method approach to data collection is useful and appropriate in gaining access to those parents who are non-users of the Sure Start services and enabling their voices to be heard. These findings offer some explanations and insight into the apparent ambivalent attitudes of some families toward Sure Start services. Implications for future practice are discussed.

  12. 'I do the best I can': an in-depth exploration of the aphasia management pathway in the acute hospital setting.

    PubMed

    Foster, Abby M; Worrall, Linda E; Rose, Miranda L; O'Halloran, Robyn

    2016-09-01

    While research has begun to explore the management of aphasia across the continuum of care, to date there is little in-depth, context specific knowledge relating to the speech pathology aphasia management pathway. This research aimed to provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting, from the perspective of speech pathologists. Underpinned by a social constructivist paradigm, the researchers implemented an interpretive phenomenological method when conducting in-depth interviews with 14 Australian speech pathologists working in the acute hospital setting. Interview transcripts and interviewer field notes were subjected to a qualitative content analysis. Analysis identified a single guiding construct and five main categories to describe the management of aphasia in the acute hospital setting. The guiding construct, First contact with the profession, informed the entire management pathway. Five additional main categories were identified: Referral processes; Screening and assessment; Therapeutic intervention; Educational and affective counselling; and Advocacy. Findings suggest significant diversity in the pathways of care for people with aphasia and their families in the acute hospital setting. Additional support mechanisms are required in order to support speech pathologists to minimise the evidence-practice gap. Implications for Rehabilitation Significant diversity exists in the current aphasia management pathway for people with acute post-stroke aphasia and their families in the acute hospital setting. Mechanisms that support speech pathologists to minimise the evidence-practice gap, and consequently reduce their sense of professional dissonance, are required.

  13. Critical Contexts for Biomedical Research in a Native American Community: Health Care, History, and Community Survival

    ERIC Educational Resources Information Center

    Sahota, Puneet Chawla

    2012-01-01

    Native Americans have been underrepresented in previous studies of biomedical research participants. This paper reports a qualitative interview study of Native Americans' perspectives on biomedical research. In-depth interviews were conducted with 53 members of a Southwest tribal community. Many interviewees viewed biomedical research studies as a…

  14. Applying to Higher Education: Comparisons of Independent and State Schools

    ERIC Educational Resources Information Center

    Dunne, Máiréad; King, Russell; Ahrens, Jill

    2014-01-01

    This paper reports on research into the ways that schools engage in university application processes. Questionnaire and interview data were collected from 1400 Year 13 students from 18 independent and state schools in England and 15 in-depth interviews were carried out with school teacher higher education (HE) advisors. The analysis compares…

  15. Teaching the Poor in Turkey: A Phenomenological Insight

    ERIC Educational Resources Information Center

    Ömür, Yunus Emre

    2018-01-01

    The purpose of this study was to analyze how primary school classroom teachers experienced teaching poor students. This study was designed in a phenomenological approach. To fulfill the aim of the study, in-depth and focus group interviews were held as well as classroom observations. The data gathered through interviews and observations was…

  16. Why don't dentists talk to patients about oral cancer?

    PubMed

    Awojobi, O; Newton, J T; Scott, S E

    2015-05-08

    Up to half of oral cancer patients are diagnosed with advanced lesions. One route to early diagnosis could involve dentists raising awareness of oral cancer through discussions with patients, emphasising prompt help-seeking. This study explores opinions and practices of dentists regarding discussing oral cancer with patients including views on barriers and facilitators. Qualitative in-depth interviews.Setting Dentists working in general dental practices in the United Kingdom were interviewed in 2013. In-depth interviews with dentists (n = 16) were conducted. Interviews were audio-recorded and transcribed. Data was analysed using framework analysis. Dentists recognised the importance of raising awareness but identified several barriers to discussions including system factors (for example, time constraints and a lack of financial incentive), patient factors (for example, fear of invoking undue anxiety) and dentist factors (for example, a lack of sufficient knowledge, training and self-confidence). Facilitators included developing practice standards and good dentist-patient relationships. Identified barriers may hold back efforts to raise awareness of oral cancer and could be targeted in future initiatives to encourage early detection.

  17. "What has it been like for you to talk with me today?": the impact of participating in interview research on rape survivors.

    PubMed

    Campbell, Rebecca; Adams, Adrienne E; Wasco, Sharon M; Ahrens, Courtney E; Sefl, Tracy

    2010-01-01

    The purpose of this project was to conduct a qualitative study of how participating in in-depth interviews impacted rape survivors. These interviews contained both open-ended, free response section and closed-ended, standardized assessments. The implementation of the interviews was informed by principles of feminist interviewing, which emphasized reducing hierarchy between the interviewer and interviewee, providing information and resources, and creating an emotionally supportive and compassionate setting. Narrative data were analyzed from rape survivors (N = 92) regarding how they were affected by participating in these interviews. Results suggested that the overwhelming majority of survivors found the interview to be a helpful, supportive, and insightful experience. Additional analyses revealed that the feminist interviewing principles were noticed and appreciated by the participants and contributed to their overall positive participation outcomes.

  18. Dimensions of social capital of families with thalassemia in an indigenous population in Tamil Nadu, India - a qualitative study.

    PubMed

    Palanisamy, Bharathi; Kosalram, Kalpana; Gopichandran, Vijayaprasad

    2017-06-24

    Studies have shown that social capital is positively associated with health, and the association is context-based. Indigenous populations with poor access to health care largely depend on social capital for their health care needs. This study was conducted to explore the dimensions and types of social capital and its utilization by families with thalassemia for their health and well-being in an indigenous population in Tamil Nadu, India. The participants in the study were parents who had children with thalassemia, belonged to an indigenous community in Tamil Nadu, were poor and marginalized, and had poor access to health care. Different dimensions and types of social capital were examined with the help of qualitative in-depth interviews using a phenomenological approach. A total of 8 in-depth interviews were conducted and transcribed. Thematic analysis of the data was performed. The social capital identified through the in-depth interviews consisted of various levels of family support, financial support from relatives and neighbors, the provision of information from formal and informal networks, and trust in the physician. Indigenous communities are close-knit due to their geographical remoteness and limited accessibility. Family ties were a form of social capital that encouraged bonding, and provided support and care to the children affected by thalassemia. The bonding also helped to meet the regular requirement of blood donation for the children. Relatives and neighbors were an asset that served as a bridge for the families affected, helping them in times of immediate and urgent financial need, making it easier to sustain long-term treatment and providing emotional support. There were informal networks that bridged parents belonging to indigenous and non-indigenous communities, with the latter providing the former with information to help them choose better health care at an affordable cost. The other formal links were the ties between the parents and nongovernmental organizations, such as the local thalassemia association, which connected members belonging to different areas. It was these ties that were of the greatest assistance to the families affected in coping with the disease, enabling them to sustain the treatment, and assisting them to choose and carry out the complicated bone marrow transplantation, which is the definitive treatment for this condition. The bonding, bridging, and linking dimensions of social capital help communities cope with thalassemia, the more so in indigenous and marginalized communities.

  19. Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study

    PubMed Central

    Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

    2015-01-01

    This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported intentions to use conventional methods of family planning without the knowledge of their spouses. PMID:29546129

  20. Factors Affecting Utilization of Family Planning Services in a Post-Conflict Setting, South Sudan: A Qualitative Study.

    PubMed

    Ahmed, Waled Amen Mohammed; Shokai, Sara Boutros; Abduelkhair, Insaf Hassan; Boshra, Amira Yahia

    2015-01-01

    This study aims to explore and examine the conjectures surrounding the utilization of family planning services among currently married couples of childbearing age in Renk County. This study has adopted a qualitative method to collect data on factors affecting the utilization of family planning services through focus group discussions and in-depth interviews, in rural and urban areas of Renk County. It targeted married women, men as well as unmarried men and women. The researchers conducted nine focus group discussions and nine interviews at both Jelhak (rural setting) and Renk (urban setting). The results suggested that the people of Renk County prefer to have large families and therefore choose not to use family planning methods. The data collected was analyzed by means of thematic analysis. This included the construction of a thematic framework, coding, editing and categorization of available data as well as the creation of sub-themes. The result also suggested that perception is a main factor that affects utilization of family planning services with a majority of the people in Renk and Jelhak preferring to have many children in order to increase the family size for some reasons. These are linked to religion, social stigma and taboo that are attached to childless people or users of family planning methods for birth control purposes. The responses revealed some variation in perception between rural (Jelhak) and urban (Renk) areas. Respondents from Renk area reported that some people use family planning services for economic reasons that involve alleviation of financial difficulties and provision of better education when the family size is small. On the other hand, rural people from Jelhak perceive family planning to be socially un-acceptable. Furthermore, men and women of Jelhak reported that after each birth of a child, married couples avoid sexual relationship for a period of two years as means of family planning. Women of both Urban and Rural settings reported intentions to use conventional methods of family planning without the knowledge of their spouses.

  1. Primary School Teachers' Understanding of Environmental Issues: An Interview Study.

    ERIC Educational Resources Information Center

    Summers, Mike; Kruger, Colin; Childs, Ann; Mant, Jenny

    2000-01-01

    Uses in-depth interviews to explore the understanding of a non-random sample of 12 practicing primary school teachers in four areas: (1) biodiversity; (2) the carbon cycle; (3) ozone; and (4) global warming. Identifies those underpinning science concepts that were well understood, and those which were not so well understood. (Author/SAH)

  2. "Different People Have Different Priorities": Work-Family Balance, Gender, and the Discourse of Choice

    ERIC Educational Resources Information Center

    Beddoes, Kacey; Pawley, Alice L.

    2014-01-01

    This paper contributes new perspectives on the underrepresentation of female faculty in science, technology, engineering and mathematics (STEM) disciplines by identifying how faculty themselves conceptualize or make sense of the problem. We conducted in-depth interviews with 19 STEM faculty members. The interviews were employed to identify…

  3. Attitudinal Outcomes of a Multicultural Learning Community Experience: A Qualitative Analysis

    ERIC Educational Resources Information Center

    Firmin, Michael W.; Warner, Susan C.; Firmin, Ruth L.; Johnson, Courtney B.; Firebaugh, Stephanie D.

    2013-01-01

    Research investigating the long-term effects of learning communities on students is scarce. This qualitative study focuses on the results of 24 in-depth interviews with students three years after participating in a first year learning community at a private, selective Midwestern university. Interview questions were designed to probe students'…

  4. Differences between Adolescent Mothers and Nonmothers: An Interview Study.

    ERIC Educational Resources Information Center

    Garrett, Susan Corona; Tidwell, Romeria

    1999-01-01

    Reports on in-depth interviews conducted with nine adolescent females, all residing in a licensed care institution. Four of them were already mothers, four were not mothers, and one was pregnant. Abuse, neglect, and family dysfunction were found to be more pronounced among the mothers and the pregnant adolescent. (Author/GCP)

  5. Mainstream Teachers' Experiences of Communicating with Students with Multiple and Severe Disabilities

    ERIC Educational Resources Information Center

    De Bortoli, Tania; Balandin, Susan; Foreman, Phil; Arthur-Kelly, Michael; Mathisen, Bernice

    2012-01-01

    The aim of this study was to explore regular teachers' perceptions and experiences of supports and obstacles to communicative interactions for students with multiple and severe disabilities (MSD). Five teachers of students with MSD participated in two in-depth interviews. Interview transcripts were analysed using content analysis. Transcripts were…

  6. Trading Skills for Sales Assistants. IES Report 323.

    ERIC Educational Resources Information Center

    Dench, S.; And Others

    A study examined changing skill requirements for the occupation of sales assistant in the United Kingdom. Data were collected from four sources: a review of the existing literature; exploratory interviews with key contacts concerned with sales assistants' skills/training; in-depth interviews of 19 employers; and a seminar at which the study…

  7. Building physician resilience.

    PubMed

    Jensen, Phyllis Marie; Trollope-Kumar, Karen; Waters, Heather; Everson, Jennifer

    2008-05-01

    To explore the dimensions of family physician resilience. Qualitative study using in-depth interviews with family physician peers. Hamilton, Ont. Purposive sample of 17 family physicians. An iterative process of face-to-face, in-depth interviews that were audiotaped and transcribed. The research team independently reviewed each interview for emergent themes with consensus reached through discussion and comparison. Themes were grouped into conceptual categories. Four main aspects of physician resilience were identified: 1) attitudes and perspectives, which include valuing the physician role, maintaining interest, developing self-awareness, and accepting personal limitations; 2) balance and prioritization, which include setting limits, taking effective approaches to continuing professional development, and honouring the self;3) practice management style, which includes sound business management, having good staff, and using effective practice arrangements; and 4) supportive relations, which include positive personal relationships, effective professional relationships, and good communication. Resilience is a dynamic, evolving process of positive attitudes and effective strategies.

  8. Health services for reproductive tract infections among female migrant workers in industrial zones in Ha Noi, Viet Nam: an in-depth assessment

    PubMed Central

    2012-01-01

    Background Rural-to-urban migration involves a high proportion of females because job opportunities for female migrants have increased in urban industrial areas. Those who migrate may be healthier than those staying in the village and they may benefit from better health care services at destination, but the 'healthy' effect can be reversed at destination due to migration-related health risk factors. The study aimed to explore the need for health care services for reproductive tract infections (RTIs) among female migrants working in the Sai Dong industrial zone as well as their services utilization. Methods The cross sectional study employed a mixed method approach. A cohort of 300 female migrants was interviewed to collect quantitative data. Two focus groups and 20 in-depth interviews were conducted to collect qualitative data. We have used frequency and cross-tabulation techniques to analyze the quantitative data and the qualitative data was used to triangulate and to provide more in-depth information. Results The needs for health care services for RTI were high as 25% of participants had RTI syndromes. Only 21.6% of female migrants having RTI syndromes ever seek helps for health care services. Barriers preventing migrants to access services were traditional values, long working hours, lack of information, and high cost of services. Employers had limited interests in reproductive health of female migrants, and there was ineffective collaboration between the local health system and enterprises. These barriers were partly caused by lack of health promotion programs suitable for migrants. Most respondents needed more information on RTIs and preferred to receive these from their employers since they commonly work shifts - and spend most of their day time at work. Conclusion While RTIs are a common health problem among female migrant workers in industrial zones, female migrants had many obstacles in accessing RTI care services. The findings from this study will help to design intervention models for RTI among this vulnerable group such as communication for behavioural impact of RTI health care, fostered collaboration between local health care services and employer enterprises, and on-site service (e.g. local or enterprise health clinics) strengthening. PMID:22369718

  9. Ethical budgets: a critical success factor in implementing new public management accountability in health care.

    PubMed

    Bosa, Iris M

    2010-05-01

    New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the critical role played by the novel concept of an 'ethical budget' in engaging the willing cooperation of the medical profession in implementing change. Utilizing a qualitative research design, with in-depth interviews with GPs, hospital doctors and managers, along with archival analysis, the present study finds that management accounting can be successfully implemented among medical professionals provided there is alignment between the management imperative and the ethical framework in which doctors practise their profession. The concept of an 'ethical budget' has been shown to be an innovative and effective tool in achieving this alignment.

  10. Regulation and Mindful Resident Care in Nursing Homes

    PubMed Central

    Colón-Emeric, Cathleen S.; Plowman, Donde; Bailey, Donald; Corazzini, Kirsten; Utley-Smith, Queen; Ammarell, Natalie; Toles, Mark; Anderson, Ruth

    2009-01-01

    Regulatory oversight is intended to improve the health outcomes of nursing home residents, yet evidence suggests that regulations can inhibit mindful staff behaviors that are associated with effective care. We explored the influence of regulations on mindful staff behavior as it relates to resident health outcomes, and offer a theoretical explanation of why regulations sometimes enhance mindfulness and other times inhibit it. We analyzed data from an in-depth, multiple case study including field notes, interviews, and documents collected in 8 nursing homes. We completed a conceptual/thematic description using the concept of mindfulness to reframe the observations. Shared facility mission strongly impacted staff perceptions of the purpose and utility of regulations. In facilities with a resident-centered culture, regulations increased mindful behavior, whereas in facilities with a cost-focused culture, regulations reduced mindful care practices. When managers emphasized the punitive aspects of regulation we observed a decrease in mindful practices in all facilities. PMID:20479137

  11. Perceptions of family caregivers of cancer patients about the challenges of caregiving: a qualitative study.

    PubMed

    Nemati, Shahnaz; Rassouli, Maryam; Ilkhani, Mahnaz; Baghestani, Ahmad Reza

    2018-03-01

    The experience of caring for a family member with cancer is associated with several care-related problems and challenges for the caregiver. The comprehensive and in-depth understanding of the trials and tribulations of caregiving can be a step towards resolving the problems faced by family caregivers of these patients. The present study aimed to explore challenges faced by Iranian family caregivers of cancer patients. The present qualitative study was conducted through in-depth semi-structured interviews held with 21 family caregivers of cancer patients selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analysed through conventional content analysis. The codes extracted from interviews produced four main themes, including 'confusion', 'uncertainty', 'disintegration' and 'setback', which collectively caused suffering for family caregivers. Care provided in an atmosphere of suffering and discontent diminishes caregiver's quality of life and quality of patient care. Health planners should therefore consider the challenges and sufferings faced by family caregivers and should seek to obviate them through appropriate plans. © 2017 Nordic College of Caring Science.

  12. Endorsing the declining indigenous ethnobotanical knowledge system of seabuckthorn in Central Himalaya, India.

    PubMed

    Dhyani, D; Maikhuri, R K; Misra, S; Rao, K S

    2010-02-03

    Based on research findings this study is aimed to generate database on ethnobotanical aspects, sustainable utilization by value addition and awareness generation through outreach programme related to Hippophae salicifolia D. Don. (Elaeagnaceae) in the higher Himalayan zone of Uttarakhand in Central Himalaya, India. An in-depth survey from June 2004 to July 2006 followed by 480 interviews with the help of semi-structured questionnaires was carried out in 24 Hippophae growing locations in 12 different valleys of Uttarakhand. Plant has immense multipurpose properties and is traditionally utilized for food (20(Min)-90%(Max)), medicine (10(Min)-60%(Max)), veterinary (20(Min)-100%(Max)), fuel (10(Min)-80%(Max)), fencing (20(Min)-80%(Max)), agricultural tools (20(Min)-50%(Max)) and dye mordant (60%). Besides, awareness programmes and value added product demonstration resulted in economical upliftment of local inhabitants of Central Himalaya. The present manuscript will certainly provide an ethnobotanical statistics' impact on the modern scientific societies regarding conservation, cultivation and popularization of this underutilized wild edible species at mass scale. Simultaneously, these findings have important connotations in light of upcoming organic food and nutraceutical industries in the country. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  13. Fumando la piedra: emerging patterns of crack use among Latino immigrant day laborers in New Orleans.

    PubMed

    Valdez, Avelardo; Cepeda, Alice; Negi, Nalini Junko; Kaplan, Charles

    2010-10-01

    The devastating effects of Hurricane Katrina have contributed to a dynamic demographic shift in the Latino composition of New Orleans. This article focuses on a particularly deleterious pattern of crack cocaine smoking associated with numerous social and health consequences. Utilizing a rapid assessment methodology, in-depth qualitative interviews were conducted with 52 Latino immigrant day laborers in New Orleans. Findings reveal that the presence of a flourishing drug market has facilitated and maintained patterns of crack use including initiation and periods of daily use. Moreover, feelings of isolation and constant exposure to victimization due to day laborers' marginal status are described as contributing to this use. This qualitative analysis reveals how social processes and contextual factors contribute to crack use among Latino day laborers in a post-disaster context. This study has important public health implications in the spread of HIV and other blood borne pathogens.

  14. Working Conditions, Occupational Injuries, and Health Among Filipino Fish Processing Workers in Dutch Harbor, Alaska

    PubMed Central

    Garcia, Gabriel Macasiray; de Castro, Butch

    2017-01-01

    This study explored how unique environmental conditions in Alaska influenced occupational health and safety for Filipino fish processing workers, many of whom migrated from warm locations (e.g., the Philippines, California, and Nevada). In-depth interviews were conducted with 26 Filipino workers in one commercial fish processing company in Dutch Harbor. Results indicated that cold weather interferes with workers’ job performance, increasing their risk for injury and illness, whereas the community’s isolation and rural nature causes loneliness and boredom, resulting in more high-risk behaviors. Other non-environmental factors affecting worker health include roommate and supervisor concerns and culture-specific practices. Findings suggest the importance of job rotation to avoid long exposures to cold temperatures, the value of a designated individual to inform workers about company and community resources that promote healthy lifestyles, and the possible utility of a joint worker–management safety committee. PMID:27729501

  15. Working Conditions, Occupational Injuries, and Health Among Filipino Fish Processing Workers in Dutch Harbor, Alaska.

    PubMed

    Garcia, Gabriel Macasiray; de Castro, Butch

    2017-05-01

    This study explored how unique environmental conditions in Alaska influenced occupational health and safety for Filipino fish processing workers, many of whom migrated from warm locations (e.g., the Philippines, California, and Nevada). In-depth interviews were conducted with 26 Filipino workers in one commercial fish processing company in Dutch Harbor. Results indicated that cold weather interferes with workers' job performance, increasing their risk for injury and illness, whereas the community's isolation and rural nature causes loneliness and boredom, resulting in more high-risk behaviors. Other non-environmental factors affecting worker health include roommate and supervisor concerns and culture-specific practices. Findings suggest the importance of job rotation to avoid long exposures to cold temperatures, the value of a designated individual to inform workers about company and community resources that promote healthy lifestyles, and the possible utility of a joint worker-management safety committee.

  16. Developing an Unguided Internet-Delivered Intervention for Emotional Distress in Primary Care Patients: Applying Common Factor and Person-Based Approaches

    PubMed Central

    Muñoz, Ricardo F; Yardley, Lucy; Mc Sharry, Jennifer; Little, Paul; Moore, Michael

    2016-01-01

    Background Developing effective, unguided Internet interventions for mental health represents a challenge. Without structured human guidance, engagement with these interventions is often limited and the effectiveness reduced. If their effectiveness can be increased, they have great potential for broad, low-cost dissemination. Improving unguided Internet interventions for mental health requires a renewed focus on the proposed underlying mechanisms of symptom improvement and the involvement of target users from the outset. Objective The aim of our study was to develop an unguided e-mental health intervention for distress in primary care patients, drawing on meta-theory of psychotherapeutic change and utilizing the person-based approach (PBA) to guide iterative qualitative piloting with patients. Methods Common factors meta-theory informed the selection and structure of therapeutic content, enabling flexibility whilst retaining the proposed necessary ingredients for effectiveness. A logic model was designed outlining intervention components and proposed mechanisms underlying improvement. The PBA provided a framework for systematically incorporating target-user perspective into the intervention development. Primary care patients (N=20) who had consulted with emotional distress in the last 12 months took part in exploratory qualitative interviews, and a subsample (n=13) undertook think-aloud interviews with a prototype of the intervention. Results A flexible intervention was developed, to be used as and when patients need, diverting from a more traditional, linear approach. Based on the in-depth qualitative findings, disorder terms such as “depression” were avoided, and discussions of psychological symptoms were placed in the context of stressful life events. Think-aloud interviews showed that patients were positive about the design and structure of the intervention. On the basis of patient feedback, modifications were made to increase immediate access to all therapeutic techniques. Conclusions Detailing theoretical assumptions underlying Internet interventions for mental health, and integrating this approach with systematic in-depth qualitative research with target patients is important. These strategies may provide novel ways for addressing the challenges of unguided delivery. The resulting intervention, Healthy Paths, will be evaluated in primary care-based randomized controlled trials, and deployed as a massive open online intervention (MOOI). PMID:27998878

  17. Men who have sex with transgender women: challenges to category-based HIV prevention.

    PubMed

    Operario, Don; Burton, Jennifer; Underhill, Kristen; Sevelius, Jae

    2008-01-01

    Although transgender women are acknowledged as a priority population for HIV prevention, there is little knowledge on men who have sex with transgender women (MSTGWs). MSTGWs challenge conventional sexual orientation categories in public health and HIV prevention research, and warrant increased attention from the public health community. This paper used qualitative techniques to analyze how MSTGWs describe their sexual orientation identities, and to explore the correspondence between men's identities and sexual behaviors with transgender women. We conducted in-depth semi-structured individual interviews with 46 MSTGWs in San Francisco. We observed a diversity in the ways participants identified and explained their sexual orientation, and found no consistent patterns between how men described their sexual orientation identity versus their sexual behavior and attraction to transgender women. Findings from this qualitative study question the utility of category-based approaches to HIV prevention with MSTGWs and offer insights into developing HIV interventions for these men.

  18. Violence, addiction, recovery: An anthropological study of Mexico's anexos.

    PubMed

    Garcia, Angela; Anderson, Brian

    2016-08-01

    Informal, coercive residential centers for the treatment of addiction are widespread and growing throughout Latin America. In Mexico these centers are called "anexos" and they are run and utilized by low-income individuals and families with problems related to drugs and alcohol. This article draws on findings from a 3-year anthropological study of anexos in Mexico City. Participant observation and in-depth interviews were used to describe and analyze anexos, their therapeutic practices, and residents' own accounts of addiction and recovery. Our findings indicate that poverty, addiction, and drug-related violence have fueled the proliferation of anexos They also suggest that anexos offer valuable health, social, and practical support, but risk exacerbating the suffering of residents through coercive rehabilitation techniques. Emphasizing this tension, this article considers the complex relationship between coercion and care, and poses fundamental questions about what drug recovery consists of in settings of poverty and violence. © The Author(s) 2016.

  19. Violence, addiction, recovery: An anthropological study of Mexico’s anexos

    PubMed Central

    Garcia, Angela; Anderson, Brian

    2017-01-01

    Informal, coercive residential centers for the treatment of addiction are widespread and growing throughout Latin America. In Mexico these centers are called “anexos” and they are run and utilized by low-income individuals and families with problems related to drugs and alcohol. This article draws on findings from a 3-year anthropological study of anexos in Mexico City. Participant observation and in-depth interviews were used to describe and analyze anexos, their therapeutic practices, and residents’ own accounts of addiction and recovery. Our findings indicate that poverty, addiction, and drug-related violence have fueled the proliferation of anexos. They also suggest that anexos offer valuable health, social, and practical support, but risk exacerbating the suffering of residents through coercive rehabilitation techniques. Emphasizing this tension, this article considers the complex relationship between coercion and care, and poses fundamental questions about what drug recovery consists of in settings of poverty and violence. PMID:27535824

  20. Co-Parenting Relationship Experiences of Black Adolescent Mothers in Active Romantic Partnerships With the Fathers of Their Children.

    PubMed

    Nelson, LaRon E; Thach, Chia T; Shelton, Melissa M; Boyer, Cherrie B

    2015-08-01

    We conducted an interpretive description of co-parenting relationship experiences of romantically involved Black adolescent mothers and fathers with shared biological children. The study was conducted in Brooklyn, New York, using data from individual in-depth interviews with adolescent mothers and fathers (n = 10). Four themes were identified: (a) putting our heads together; (b) balancing childhood and parenthood; (c) less money, more problems; and (d) if we use condoms, it is for contraception. The co-parenting couples managed very complex relationships, but their mutual interest in the welfare of their children was a relational asset. Co-parents had sparse financial resources but used a moral economy strategy to provide mutual support. Future research is needed that focuses on identifying other co-parent relationship assets and integrating and evaluating their utility for enhancing interventions for adolescent families. © The Author(s) 2014.

  1. A qualitative assessment of decisions affecting contraceptive utilization and fertility intentions among HIV-positive women in Soweto, South Africa.

    PubMed

    Laher, Fatima; Todd, Catherine S; Stibich, Mark A; Phofa, Rebecca; Behane, Xoliswa; Mohapi, Lerato; Gray, Glenda

    2009-06-01

    The HIV epidemic in sub-Saharan Africa disproportionately affects women of reproductive age. The increasing provision of Highly Active Anti-Retroviral Therapy (HAART) with improved prognosis and maternal-fetal outcomes calls for an understanding of fertility planning for HIV-positive women. We describe the effect of HIV and HAART on pregnancy desires and contraceptive use among HIV-positive women in Soweto, South Africa. Focus group discussions and in-depth interviews were conducted with 42 HIV-positive women of reproductive age. Analysis was performed using ATLAS-ti (ATLAS-ti Center, Berlin). Emergent themes were impact of HIV diagnosis on pregnancy intentions; factors affecting contraceptive uptake including real and normative side effects, body image, and perceived vaginal wetness; and the mitigating influence of partnership on both pregnancy intentions and contraceptive use. Routine counseling about pregnancy desires and contraception should be offered to HIV-positive women.

  2. Abnormal pap tests among women living in a Hispanic migrant farmworker community: A narrative of health literacy.

    PubMed

    Vamos, Cheryl A; Lockhart, Elizabeth; Vázquez-Otero, Coralia; Thompson, Erika L; Proctor, Sara; Wells, Kristen J; Daley, Ellen M

    2016-08-01

    This study explored narrative responses following abnormal Pap tests among Hispanic migrant farmworkers ( N = 18; ages 22-50 years) via in-depth interviews in Florida. Qualitative analyses utilized health literacy domains (obtain/process/understand/communicate) as a conceptual framework. Participants described how they (1) obtained information about getting a Pap test, (2) processed positive and negative reactions following results, (3) understood results and recommended health-promoting behaviors, and (4) communicated and received social support. Women had disparate reactions and understanding following an abnormal Pap result. Health literacy was a meaningful conceptual framework to understand assets and gaps among women receiving an abnormal Pap test result. Future interventions should incorporate health literacy domains and facilitate patient-provider communications and social support to assist women in decision-making and health-promoting behaviors, ultimately decreasing cancer disparities.

  3. Measuring the Value of Succession Planning and Management: A Qualitative Study of Multinational Companies

    ERIC Educational Resources Information Center

    Kim, Yeonsoo

    2010-01-01

    This article proposes a model for planning and operating an effective succession planning and management (SP&M) program and measuring its value. The nature of the research is exploratory, following a qualitative approach using in-depth interviews. Representatives of multinational companies interviewed for this study revealed that succession…

  4. Japanese Nursery and Kindergarten Teachers' Beliefs and Practices Regarding Developmentally Appropriate Practices

    ERIC Educational Resources Information Center

    Hegde, Archana V.; Sugita, Chisato; Crane-Mitchell, Linda; Averett, Paige

    2014-01-01

    This study explored Japanese day nursery and kindergarten teachers' beliefs and practices regarding developmentally appropriate practices. Data were collected using in-depth interviews. Teacher interviews provided insights into the merger of the childcare and education systems of Japan. Six themes emerged from the analysis of the day nursery and…

  5. Household Response to Inadequate Sewerage and Garbage Collection Services in Abuja, Nigeria

    PubMed Central

    2017-01-01

    Provision of sanitation and garbage collection services is an important and yet challenging issue in the rapidly growing cities of developing countries, with significant human health and environmental sustainability implications. Although a growing number of studies have investigated the consequences of inadequate delivery of basic urban services in developing countries, few studies have examined how households cope with the problems. Using the Exit, Voice, Loyalty, and Neglect (EVLN) model, this article explores how households respond to inadequate sewerage and garbage collection services in Abuja, Nigeria. Based on a qualitative study, data were gathered from in-depth interviews with sixty households, complemented with personal observation. The findings from grounded analysis indicated that majority (62%) and about half (55%) of the respondents have utilized the informal sector for sewerage services and garbage collection, respectively, to supplement the services provided by the city. While 68% of the respondents reported investing their personal resources to improve the delivery of existing sewerage services, half (53%) have collectively complained to the utility agency and few (22%) have neglected the problems. The paper concludes by discussing the public health and environmental sustainability implications of the findings. PMID:28634496

  6. Therapeutic Change in Colombian Families Dealing with Violence: Therapists, Clients, and Referring Systems in Conversation

    ERIC Educational Resources Information Center

    Ripoll-Nunez, Karen; Villar-Guhl, Carlos Felipe; Villar-Concha, Eduardo

    2012-01-01

    There is a gap in the Marriage and Family Therapy literature regarding clients', therapists', and family judges' theories of change in relational therapy for family violence. We conducted in-depth interviews with eleven court-referred families, their therapists, and two family judges in Bogota, Colombia. Interviews focused on their expectations of…

  7. Making Sense of Social Justice in Education: Jewish and Arab Leaders' Perspectives in Israel

    ERIC Educational Resources Information Center

    Arar, Khalid Husny; Oplatka, Izhar

    2016-01-01

    The research aimed to understand the way in which high school principals' perceptions of social justice (SJ) are implemented in their daily educational work. A qualitative study employed in-depth semi-structured interviews to collect the narratives of two high school principals in Israel--one Arab-Muslim and one Jewish. The interview transcripts…

  8. Recruiting Underserved Mothers to Medical Research: Findings from North Carolina

    PubMed Central

    Spears, Chaya R.; Sandberg, Joanne C.; O’Neill, Jenna L.; Grzywacz, Joseph G.; Howard, Timothy D.; Feldman, Steven R.; Arcury, Thomas A.

    2014-01-01

    Representative samples are required for ethical, valid, and useful health research. Yet, recruiting participants, especially from historically underserved communities, can be challenging. This paper presents findings from in-depth interviews with 40 mothers about factors that might influence their willingness to participate or allow their children to participate in medical research. Saliency analysis organizes the findings. Frequent and important salient themes about research participation included concerns that it might cause participants harm, hope that participants might gain a health benefit, and recognition that time and transportation resources could limit participation. Ultimately, we propose that a theoretical model, such as the Theory of Planned Behavior (TPB), will facilitate more systematic evaluation of effective methods for recruitment and retention of participants in medical research. Future research should explore the utility of such a model for development of effective recruitment and retention strategies. PMID:24185171

  9. "That's What 'College Experience' is": Exploring Cultural Narratives and Descriptive Norms College Students Construct for Legitimizing Alcohol Use.

    PubMed

    Russell, Laura D; Arthur, Tabytha

    2016-08-01

    Among the many health issues relevant to college students, overconsumption of alcohol remains a prevalent concern. Circumscribing the drinking habits occurring on campuses are innumerable social norms furthering popular beliefs that alcohol is an inherent part of college life. This case study examines how students encounter, interpret and express the social norms they conceive as constituting their campus culture. Through triangulating ethnographic practices with in-depth interviews, we utilize a narrative lens to explore how students construct meanings and values for alcohol's roles in campus life. Our findings demonstrate how students validate uses of alcohol by coupling its presence with stress, social enhancement, peer responsibility and identity. Moreover, interviewees expressed there being subcultural differences between younger and older students' discourse around alcohol use. We draw from these observations to offer suggestions for engaging students actively in campus interventions that give rise to voices excluded from commonly construed social norms.

  10. Budgeting for Solar PV Plant Operations & Maintenance: Practices and Pricing.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Enbar, Nadav; Weng, Dean; Klise, Geoffrey Taylor

    2016-01-01

    With rising grid interconnections of solar photovoltaic (PV) systems, greater attention is being trained on lifecycle performance, reliability, and project economics. Expected to meet production thresholds over a 20-30 year timeframe, PV plants require a steady diet of operations and maintenance (O&M) oversight to meet contractual terms. However, industry best practices are only just beginning to emerge, and O&M budgets—given the arrangement of the solar project value chain—appear to vary widely. Based on insights from in-depth interviews and survey research, this paper presents an overview of the utility-scale PV O&M budgeting process along with guiding rationales, before detailing perspectives onmore » current plant upkeep activities and price points largely in the U.S. It concludes by pondering potential opportunities for improving upon existing O&M budgeting approaches in ways that can benefit the industry at-large.« less

  11. Budgeting for Solar PV Plant Operations & Maintenance: Practices and Pricing.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Enbar, Nadav; Weng, Dean; Klise, Geoffrey Taylor

    2015-12-01

    With rising grid interconnections of solar photovoltaic (PV) systems, greater attention is being trained on lifecycle performance, reliability, and project economics. Expected to meet production thresholds over a 20-30 year timeframe, PV plants require a steady diet of operations and maintenance (O&M) oversight to meet contractual terms. However, industry best practices are only just beginning to emerge, and O&M budgets—given the arrangement of the solar project value chain—appear to vary widely. Based on insights from in-depth interviews and survey research, this paper presents an overview of the utility-scale PV O&M budgeting process along with guiding rationales, before detailing perspectives onmore » current plant upkeep activities and price points largely in the U.S. It concludes by pondering potential opportunities for improving upon existing O&M budgeting approaches in ways that can benefi t the industry at-large.« less

  12. Exploring the usefulness of comprehensive care plans for children with medical complexity (CMC): a qualitative study.

    PubMed

    Adams, Sherri; Cohen, Eyal; Mahant, Sanjay; Friedman, Jeremy N; Macculloch, Radha; Nicholas, David B

    2013-01-19

    The Medical Home model recommends that Children with Special Health Care Needs (CSHCN) receive a medical care plan, outlining the child's major medical issues and care needs to assist with care coordination. While care plans are a primary component of effective care coordination, the creation and maintenance of care plans is time, labor, and cost intensive, and the desired content of the care plan has not been studied. The purpose of this qualitative study was to understand the usefulness and desired content of comprehensive care plans by exploring the perceptions of parents and health care providers (HCPs) of children with medical complexity (CMC). This qualitative study utilized in-depth semi-structured interviews and focus groups. HCPs (n = 15) and parents (n = 15) of CMC who had all used a comprehensive care plan were recruited from a tertiary pediatric academic health sciences center. Themes were identified through grounded theory analysis of interview and focus group data. A multi-dimensional model of perceived care plan usefulness emerged. The model highlights three integral aspects of the care plan: care plan characteristics, activating factors and perceived outcomes of using a care plan. Care plans were perceived as a useful tool that centralized and focused the care of the child. Care plans were reported to flatten the hierarchical relationship between HCPs and parents, resulting in enhanced reciprocal information exchange and strengthened relationships. Participants expressed that a standardized template that is family-centered and includes content relevant to both the medical and social needs of the child is beneficial when integrated into overall care planning and delivery for CMC. Care plans are perceived to be a useful tool to both health care providers and parents of CMC. These findings inform the utility and development of a comprehensive care plan template as well as a model of how and when to best utilize care plans within family-centered models of care.

  13. Application of remote sensing techniques to hydrography with emphasis on bathymetry. M.S. Thesis

    NASA Technical Reports Server (NTRS)

    Dejesusparada, N. (Principal Investigator); Meireles, D. S.

    1980-01-01

    Remote sensing techniques are utilized for the determination of hydrographic characteristics, with emphasis in bathymetry. Two sensor systems were utilized: the Metric Camera Wild RC-10 and the Multispectral Scanner of LANDSAT Satellite (MSS-LANDSAT). From photographs of the metric camera, data of photographic density of points with known depth are obtained. A correlation between the variables density x depth is calculated through a regression straight line. From this line, the depth of points with known photographic density is determined. The LANDSAT MSS images are interpreted automatically in the Iterative Multispectral Analysis System (I-100) with the obtention of point subareas with the same gray level. With some simplifications done, it is assumed that the depth of a point is directly related with its gray level. Subareas with points of the same depth are then determined and isobathymetric curves are drawn. The coast line is obtained through the sensor systems already mentioned. Advantages and limitations of the techniques and of the sensor systems utilized are discussed and the results are compared with ground truth.

  14. Exploring family environment characteristics and multiple abuse experiences among homeless youth.

    PubMed

    Ferguson, Kristin M

    2009-11-01

    This qualitative study used data from the Social Enterprise Intervention (SEI) pilot study, a comprehensive vocational training program with integrated clinical services for homeless youth. In-depth interviews were conducted with 28 homeless youth participating in the SEI study to explore their perceptions of family environment characteristics and abuse experiences. The constant comparative method was used to analyze transcripts from in-depth interviews with the youth participants. Emergent themes related to family characteristics include home instability, abandonment, and caregiver substance abuse. Abuse-related subthemes include intrafamilial abuse, caregiver abuse, rejection, and deprecation by caregivers. Grounded theory is used to interpret findings and develop working hypotheses to guide future studies of multitype maltreatment among homeless youth.

  15. Disclosure of Child Sexual Abuse by Adolescents: A Qualitative In-Depth Study

    ERIC Educational Resources Information Center

    Schonbucher, Verena; Maier, Thomas; Mohler-Kuo, Meichun; Schnyder, Ulrich; Landolt, Markus A.

    2012-01-01

    This qualitative study aimed to study the process of disclosure by examining adolescents from the general population who had experienced child sexual abuse (CSA). Twenty-six sexually victimized adolescents (23 girls, 3 boys; age: 15-18 years) participated in a qualitative face-to-face in-depth interview on different aspects of disclosure. A…

  16. Technology, Identity, and Community: The Role of Electronic Teaching Portfolios in Becoming a Teacher

    ERIC Educational Resources Information Center

    Trent, John; Shroff, Ronnie H.

    2013-01-01

    This article reports on an exploratory qualitative investigation of an initiative to use an electronic teaching portfolio at a teacher education institution in Hong Kong. Using in-depth interviews, this initiative is examined from the perspective of preservice teachers themselves. Interviews sought to gain an understanding of how the construction…

  17. 78 FR 27406 - Agency Information Collection Activities; Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... groups will be conducted with up to eight participants in each for a total sample size of 32. The second... determine eligibility for the pilot study to recruit a sample of 500 participants (50 from each clinical... participate in an in-depth, qualitative telephone interview for a total of 100 interviews. Finally, up to...

  18. Preserving the Higher Education Legacy: A Conversation with California Leaders. Report No. 95-3.

    ERIC Educational Resources Information Center

    Immerwahr, John; Boese, Jill

    This study reports the results of confidential, in-depth interviews with 29 business, education, and community leaders in California to determine their attitudes toward the higher education needs of the state. The interviews examined areas of consensus and controversy in many facets of higher education policy. The most important findings included:…

  19. Constructing Self as Leader: Case Studies of Women Who Are Change Agents in South Africa

    ERIC Educational Resources Information Center

    Mogadime, Dolana; Mentz, P. J.; Armstrong, Denise E.; Holtam, Beryl

    2010-01-01

    The present article draws from the biographical narratives of three South African high school female principals which are part of a larger research study in which 26 aspiring and practicing women school leaders were interviewed. Narratives were constructed from in-depth interviews with each participant and analyzed for themes that provided…

  20. Coping, crowding and satisfaction: a study of Adirondack wilderness hikers

    Treesearch

    Andrew K. Johnson; Chad Dawson

    2002-01-01

    Hikers in the wilderness areas of New York's Adirondack Park use a combination of physical and cognitive coping behaviors to maintain satisfaction with their wilderness experience. A total of 102 hikers in 16 Adirondack wilderness areas were interviewed and asked to complete a single-page survey. The in-depth interviews and surveys of hikers' importance and...

  1. Stacking the Odds: A Phenomenological Study of Non-Problem Gambling in Later Life

    ERIC Educational Resources Information Center

    Hagen, Brad; Nixon, Gary; Solowoniuk, Jason

    2005-01-01

    The purpose of this exploratory, phenomenological-hermeneutic study was to explore the experience of non-problem gambling by older adults. Twelve older gamblers were identified as non-problem gamblers using two gambling screens and participated in in-depth interviews about their experience of gambling. Two major themes emerged from the interviews:…

  2. Postpartum weight loss: weight struggles, eating, exercise, and breast-feeding.

    PubMed

    Montgomery, Kristen S; Best, Melissa; Aniello, Tracy B; Phillips, Jennifer D; Hatmaker-Flanigan, Elizabeth

    2013-06-01

    Twenty-four women with children 5 years old or younger were interviewed regarding their experiences in losing weight during the postpartum period. Phenomenological interviews were conducted according to Husserl's perspective. Women who participated in the study revealed the issues related to postpartum weight loss: weight struggles, exercise, breast-feeding, eating, and pregnancy contributions to weight gain. The overall theme that resulted from these in-depth interviews was that women struggle to balance their successes and setbacks in losing weight during the postpartum period.

  3. The balancing act: Exploring stigma, economic need and disclosure among male sex workers in Ho Chi Minh City, Vietnam

    PubMed Central

    Closson, Elizabeth F.; Colby, Donn J.; Nguyen, Thi; Cohen, Samuel S.; Biello, Katie; Mimiaga, Matthew J.

    2014-01-01

    In Vietnam, there is an emerging HIV epidemic among men who have sex with men (MSM). Male sex workers (MSWs) engage in high-risk sexual behaviours that make them particularly vulnerable to HIV infection. In 2010, 23 MSM in Ho Chi Minh City (HCMC) who recently received payment for sex with another man completed in-depth qualitative interviews exploring motivations for sex work, patterns of sex work disclosure and experiences of social stigma. Interviews were recorded, transcribed and translated into English and analysed using a qualitative descriptive approach. Low wages, unstable employment, and family remittances were motivating factors for MSM in HCMC to sell sex. Participants described experiences of enacted and felt social stigma related to their involvement in sex work. In response, they utilized stigma management techniques aimed at concealment of involvement in sex work. Such strategies restricted sexual communication with non-paying sex partners and potentially limited their ability to seek social support from family and friends. Departing from decontextualized depictions of sex work disclosure, our findings describe how decisions to reveal involvement in sex work are shaped by social and structural factors such as social stigma, techniques to minimize exposure to stigma, economic imperatives and familial responsibilities. PMID:25555192

  4. Recovery-Promoting Care as Experienced by Persons with Severe Mental Illness and Substance Misuse

    ERIC Educational Resources Information Center

    Cruce, Gunilla; Ojehagen, Agneta; Nordstrom, Monica

    2012-01-01

    This paper explores recovery-promoting care as experienced by persons with concomitant severe mental illness and substance misuse. Sixteen in-depth interviews, based on an interview guide concerning their experiences of health, life situation and care, were held with eight participants in an outpatient treatment programme. The analysis aimed to…

  5. The Mismatch between Children's Health Needs and School Resources

    ERIC Educational Resources Information Center

    Knauer, Heather; Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda

    2015-01-01

    There are increasing numbers of children with special health care needs (CSHCN) who require various levels of care each school day. The purpose of this study was to examine the role of public schools in supporting CSHCN through in-depth key informant interviews. For this qualitative study, the authors interviewed 17 key informants to identify key…

  6. The Link between the Emotional Consequences of Child Sexual Abuse and School Experiences

    ERIC Educational Resources Information Center

    Phasha, Tlakale Nareadi

    2008-01-01

    The present paper presents findings drawn from a qualitative study that investigated the impact of childhood sexual abuse on school functioning among young adult survivors in South Africa. Data were obtained by means of in-depth individual interviews with 22 young adults. Analyzing the interviews following procedures aligned to a grounded theory…

  7. Supporting the Educational Career of Children from Divorced Families: Parents' Experiences and the Role of the School

    ERIC Educational Resources Information Center

    Colpin, H.; Vandemeulebroecke, L.; Ghesquiere, P.

    2004-01-01

    This study investigated experiences and needs concerning (supporting) children's school career among parents in divorced lone-parent and stepfamilies. Forty custodial parents from a variety of divorced family situations responded to an in-depth interview. The interview data were analysed using qualitative methods. The results show a variety of…

  8. Knowledge Restructuring in the Development of Children's Cosmologies

    ERIC Educational Resources Information Center

    Blown, E. J.; Bryce, T. G. K.

    2006-01-01

    The development of children's cosmologies was investigated over a 13-year period, using multi-modal, in-depth interviews with 686 children (217 boys, 227 girls from New Zealand and 129 boys, 113 girls from China), aged 2-18. Children were interviewed while they "observed" the apparent motion of the Sun and Moon, and other features of the…

  9. Leading by Interviewing

    ERIC Educational Resources Information Center

    Sorenson, Richard D.

    2007-01-01

    While the interview remains the most relevant process by which information about an applicant can be obtained, the effective school administrator must recognize that the interview process is much more than exploring an applicant's qualifications, skills, and experiences. The interview must also be utilized as a means of leading. In other words,…

  10. Older teen attitudes toward birth control access in pharmacies: a qualitative study.

    PubMed

    Wilkinson, Tracey A; Miller, Courtney; Rafie, Samantha; Landau, Sharon Cohen; Rafie, Sally

    2018-03-01

    To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are interested in this additional method of contraceptive access and understanding their perspectives can help guide implementation by states and in individual pharmacies. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The impact of persistent visually disabling vitreous floaters on health status utility values.

    PubMed

    Zou, Haidong; Liu, Haiyun; Xu, Xun; Zhang, Xi

    2013-08-01

    To assess the time trade-off (TTO) utility values in patients with persistent visually disabling vitreous floaters (DVF) and to determine the reliability and validity of TTO methods in DVF patients. Prospective cross-sectional questionnaire survey: Eligible patients with persistent DVF referred to the Shanghai First People's Hospital outpatient service between January 2006 and February 2010, and randomly selected normal vision general population residents, were enrolled. All participants underwent TTO utility value evaluation. After 4-5 weeks, the patients were asked to undergo second TTO utility value evaluation during the follow-up interview. The mean initial utility values of the 107 persistent DVF patients were 0.904 ± 0.054. Regression analyses revealed that length of education, visual acuity in the poorer-vision eye and employment status were associated with utility values (all P < 0.01). All patients took part in the follow-up interview; the intra-class correlation coefficient for TTO utility values at the initial and follow-up interviews was 0.855. In the 91 general population residents, the mean utility value was 0.923 ± 0.032, which was statistically higher than that of active study patients (t = 3.01, P < 0.01). Persistent DVF can substantially diminish the patients' perception of their life, and can be measured by TTO utility values with high reliability and construct validity.

  12. Lay versus expert understandings of workplace risk in the food service industry: a multi-dimensional model with implications for participatory ergonomics.

    PubMed

    Cann, Adam P; MacEachen, Ellen; Vandervoort, Anthony A

    2008-01-01

    The recent trend towards cooperative management and prevention of workplace injuries has introduced numerous health and safety actors to the workplace with varying amounts and types of expertise. The purpose of this qualitative research project was to explore the understandings of risk as experienced by food service workers (FSW) and how these compare with an 'expert' in risk assessment. In total 13 FSW, selected based on age, work location, and gender, and one experienced Ergonomist participated in the study. In-depth semi-structured telephone interviews were conducted with each participant and transcripts of the interviews were analyzed using thematic analysis by drawing on methods closely related to grounded theory. The findings of this study indicated that the risks for occupational injury as experienced by FSW were multi-dimensional in nature representing not only the physical requirements of the individual's job, but also the social interactions of the FSW with their coworkers, management, and the organization. FSW were also found to be a rich source of knowledge and experience concerning occupational risk and may be under-utilized when designing interventions. The results of this study support a cooperative team approach to reduce the risks of injury in the workplace, with a specific emphasis on inclusion of the worker.

  13. Guinea worm: an in-depth study of what happens to mothers, families and communities.

    PubMed

    Watts, S J; Brieger, W R; Yacoob, M

    1989-01-01

    This paper reports on the impact of maternal morbidity due to guinea worm, dracunculiasis, on the care and health of children under 24 months old, and the way in which the mothers and the family coped with the often extended periods of disability. This qualitative study is based on observation and in-depth interviewing, supplemented by focus group discussions. Of 42 mothers with guinea worm in two hyperendemic areas of Oyo and Kwara States, 28 were either bedridden or only able to hobble short distances with the help of a stick; the average period of incapacity was almost 9 weeks. Of the four maternal roles identified (child care, self care, domestic tasks, income generation), the women gave priority to child care; 34 of the 42 mothers needed help in child care. Coping networks operated principally within the extended family, but also included women in other households, and women from beyond the community. Thus the impact of a mother's illness extended beyond her children and family to the wider community. This qualitative study thus reveals the multifaceted impact of a disease on individuals and on the community. The study stresses the need for, and availability of, effective methods for controlling guinea worm by utilizing community cooperation to provide protected water sources and other preventive measures against the disease.

  14. Discharge against Medical Advice at Neonatal Intensive Care Unit in Gujarat, India.

    PubMed

    Devpura, Bhanu; Bhadesia, Pranav; Nimbalkar, Somashekhar; Desai, Sandeep; Phatak, Ajay

    2016-01-01

    Objective . We explored reasons for discharged against medical advice (DAMA) of neonates from a neonatal intensive care unit (NICU) through in-depth interviews of the parents/guardians. Methods . Of 456 babies admitted to NICU during April 2014 to March 2015, 116 babies were DAMA. Parents of randomly selected 50 babies of these 116, residing within 50 kilometers, were approached for in-depth interviews at their homes. Audio recordings were done and manually transcribed, analyzed in detail to explore common threads leading to DAMA. Basic demographic information of the newborns was retrieved from hospital records. Results . The prevalence of DAMA was 25.4%. Of 50 parents approached, 41 in-depth interviews were completed. Nonaffordability (38.6%), no improvement (14.6%), poor prognosis (12%), and inappropriate behavior of the patient relation office personnel (10.6%) were major factors contributing to DAMA. Parents of 6.6% neonates wanted guarantee of survival and 5.3% parents reported poor behavior of nurses. No gender bias was observed related to DAMA. One-third of neonates (34.1%) were DAMA on first day of admission. Conclusions . The issue of DAMA needs attention. Besides nonaffordability and clinical characteristics of the baby, communication (breaking bad news, counseling, etc.) and lack of adequate infrastructure for relatives emerged as modifiable factors leading to DAMA.

  15. Gender identity, healthcare access, and risk reduction among Malaysia’s mak nyah community

    PubMed Central

    Gibson, Britton A.; Brown, Shan-Estelle; Rutledge, Ronnye; Wickersham, Jeffrey A.; Kamarulzaman, Adeeba; Altice, Frederick L.

    2016-01-01

    Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalize them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilization patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally-sensitive prevention and healthcare services for TGW. PMID:26824463

  16. The effectiveness of the TBA programme in reducing maternal mortality and morbidity in Malawi.

    PubMed

    Bisika, Thomas

    2008-08-01

    The main objective of this study was to assess the role of TBAs and the quality of their services in contributing to the reduction of maternal deaths in Malawi. This study used a qualitative research methodology involving key informant and in-depth interviews, observation and focus group interviews. The study found that most of the people rely on traditional birth attendants although the quality of their services is poor due to illiteracy, their ailing age, lack of supplies and equipment and general absence of supervision. The study fiuther observed that although the hospital sees many pregnant women during antenatal care, very few women actually come back to the hospital for delivery. The study also found that there was high awareness among TBAs about what they were supposed to do but that their actual practices did not reflect compliance with their roles as assigned by the formal health system. The study concludes that TBAs are an important source of maternal care especially in rural areas and that they need to be empowered to comply with the requirement of ensuring infection free deliveries. This entails adequate supervision and provision of supplies. The study further observed that the utilization levels of TBAs is far much greater that presently acknowledged suggesting severe inadequacies within the formal health system.

  17. Pregnancy, Contraception and Emergency Contraception: The Language of Urban Adolescent Young Women

    PubMed Central

    Mollen, Cynthia J.; Fernando, Melissa; Hayes, Katie L.; Barg, Frances K.

    2012-01-01

    Study Objective We sought to characterize how a group of urban adolescent females understands the domains of pregnancy, contraception and emergency contraception (EC). Design We utilized the research strategy of freelisting as part of an in-depth interview study. Setting and Participants Urban adolescent females presenting to a Pediatric Emergency Department. Participants were enrolled using a purposive sampling strategy if they were Black, English-speaking females ages 15 through 19 years old who resided in one of 11 zip codes surrounding the hospital. Main Outcome Measure Smith’s saliency score. Freelists were analyzed for the entire sample as well as for subgroups. Results Thirty adolescents completed the interview. We found that this group of adolescents uses different words to characterize the domains of pregnancy, contraception and EC. The only overlapping salient term was “abortion,” which appeared in the overall lists for pregnancy and EC and in the younger group’s list for contraception. In addition, lack of knowledge was cited as an important factor related to contraception. Conclusions Adolescent patients may not understand the concepts of contraception and EC fully. Providers should consider the potential need to provide an explanation for terms used, and should consider explicitly differentiating between routine forms of contraception and EC, as well as between EC and abortion. PMID:22840933

  18. Qualitative Methods in the Development of a Bilingual and Bicultural Quality of Life Outcomes Measure for Pediatric Patients With Craniofacial Conditions.

    PubMed

    Tapia, Viridiana Juarez; Drizin, Julia Helene; Dalle Ore, Cecilia; Nieto, Marcelo; Romero, Yajahira; Magallon, Sandra; Nayak, Rohith; Sigler, Alicia; Malcarne, Vanessa; Gosman, Amanda

    2017-05-01

    Craniofacial surgeons treat patients with diverse craniofacial conditions (CFCs). Yet, little is known about the health-related quality of life (HRQoL) impact of diverse CFCs. Currently, there are no suitable instruments that measure the HRQoL of patients with diverse CFCs from the perspective of children and parents. The objective of this study was to develop the items and support the content validity of a comprehensive patient and parent-reported outcomes measure. An iterative process consisting of a systematic literature review, expert opinion and in-depth interviews with patients and parents of patients with diverse CFCs was used. The literature review and expert opinion were used to generate in-depth interview questions. We interviewed 127 subjects: 80 parents of patients ages 0 to 18 years or older and 47 patients ages 7 to 18 years or older. English and Spanish speakers were represented in our sample. The majority of subjects originated from the United States and Mexico (83%). Craniofacial conditions included were cleft lip/palate, craniosynostosis, craniofacial microsomia, microtia, and dermatological conditions. Semistructured interviews were conducted until content saturation was achieved. Line-by-line analysis of interview transcripts identified HRQoL themes. Themes were interpreted and organized into larger domains that represent the conceptual framework of CFC-associated HRQoL. Themes were operationalized into items that represent the HRQoL issues of patients for both parent and patient versions. Six final bilingual and bicultural scales based on the domains derived from the literature review, expert opinion, and in-depth interviews were developed: (1) "Social Impact," (2) "Psychological Function," (3) "Physical Function," (4) "Family Impact," (5) "Appearance," And (6) "Finding Meaning." Some cultural differences were identified: in contrast to children from Mexico and other developing nations, families from the United States did not report public harassment or extremely negative public reactions to patients' CFC. Religion and spirituality were common themes in interviews of Spanish-speaking subjects but less common in interviews of English-speaking subjects. Qualitative methods involving pediatric patients with diverse CFCs and their parents in the item development process support the content validity for this bilingual and bicultural HRQoL instrument. The items developed in this study will now undergo psychometric testing in national multisite studies for validation.

  19. Tailoring the Interview Process for More Effective Personnel Selection.

    ERIC Educational Resources Information Center

    Saville, Anthony

    Structuring the initial teacher employment interview adds validity to selection and appropriately utilizes human resources. Five aspects of an effective interview program include: (1) developing a job analysis plan; (2) reviewing the applications; (3) planning for the interview; (4) the interview instrument; and (5) legal implications. An…

  20. Wisconsin Twin Research: early development, childhood psychopathology, autism, and sensory over-responsivity.

    PubMed

    Schmidt, Nicole L; Van Hulle, Carol A; Brooker, Rebecca J; Meyer, Lauren R; Lemery-Chalfant, Kathryn; Goldsmith, H Hill

    2013-02-01

    The Wisconsin Twin Research Program comprises multiple longitudinal studies that utilize a panel recruited from statewide birth records for the years 1989 through 2004. Our research foci are the etiology and developmental course of early emotions, temperament, childhood anxiety and impulsivity, autism, sensory over-responsivity, and related topics. A signature feature of this research program is the breadth and depth of assessment during key periods of development. The assessments include extensive home- and laboratory-based behavioral batteries, recorded sibling and caregiver interactions, structured psychiatric interviews with caregivers and adolescents, observer ratings of child behavior, child self-report, cognitive testing, neuroendocrine measures, medical records, dermatoglyphics, genotyping, and neuroimaging. Across the various studies, testing occasions occurred between 3 months and 18 years of age. Data collection for some aspects of the research program has concluded and, for other aspects, longitudinal follow-ups are in progress.

  1. Wisconsin Twin Research: Early Development, Childhood Psychopathology, Autism, and Sensory Over-responsivity

    PubMed Central

    Schmidt, Nicole L.; Van Hulle, Carol; Brooker, Rebecca J.; Meyer, Lauren R.; Lemery-Chalfant, Kathryn; Goldsmith, H. H.

    2012-01-01

    The Wisconsin Twin Research Program comprises multiple longitudinal studies that utilize a panel recruited from statewide birth records for the years 1989 through 2004. Our research foci are the etiology and developmental course of early emotions, temperament, childhood anxiety and impulsivity, autism, sensory over-responsivity, and related topics. A signature feature of this research program is the breadth and depth of assessment during key periods of development. The assessments include extensive home and laboratory-based behavioral batteries, recorded sibling and caregiver interactions, structured psychiatric interviews with caregivers and adolescents, observer ratings of child behavior, child self-report, cognitive testing, neuroendocrine measures, medical records, dermatoglyphics, genotyping, and neuroimaging. Across the various studies, testing occasions occurred between 3 months and 18 years of age. Data collection for some aspects of the research program has concluded and, for other aspects, longitudinal follow-ups are in progress. PMID:23200241

  2. Health care administrators' perspectives on the role of absorptive capacity for strategic change initiatives: a qualitative study.

    PubMed

    Kash, Bita A; Spaulding, Aaron; Gamm, Larry; Johnson, Christopher E

    2013-01-01

    The dimensions of absorptive capacity (ACAP) are defined, and the importance of ACAP is established in the management literature, but the concept has not been applied to health care organizations attempting to implement multiple strategic initiatives. The aim of this study was to test the utility of ACAP by analyzing health care administrators' experiences with multiple strategic initiatives within two health systems. Results are drawn from administrators' assessments of multiple initiatives within two health systems using in-depth personal interviews with a total of 61 health care administrators. Data analysis was performed following deductive qualitative analysis guidelines. Interview transcripts were coded based on the four dimensions of ACAP: acquiring, assimilating, internalizing/transforming, and exploiting knowledge. Furthermore, we link results related to utilization of management resources, including number of key personnel involved and time consumption, to dimensions of ACAP. Participants' description of multiple strategic change initiatives confirmed the importance of the four ACAP dimensions. ACAP can be a useful framework to assess organizational capacity with respect to the organization's ability to concurrently implement multiple strategic initiatives. This capacity specifically revolves around human capital requirements from upper management based on the initiatives' location or stage within the ACAP framework. Strategic change initiatives in health care can be usefully viewed from an ACAP perspective. There is a tendency for those strategic initiatives ranking higher in priority and time consumption to reflect more advanced dimensions of ACAP (assimilate and transform), whereas few initiatives were identified in the ACAP "exploit" dimension. This may suggest that health care leaders tend to no longer identify as strategic initiatives those innovations that have moved to the exploitation stage or that less attention is given to the exploitation elements of a strategic initiative than to the earlier stages.

  3. An Interview with Ira Shor--Part II.

    ERIC Educational Resources Information Center

    Tinberg, Howard

    1999-01-01

    Presents Part II of an interview with Ira Shor reflecting on the state of community colleges since the 1960s. Discusses how the most important thing to teach is critical inquiry and critical literacy, to study something in a methodical way and to communicate knowledge gained with articulate depth to a real audience. Outlines 13 goals for schooling…

  4. Qualitative Inquiry with Women in Poverty in Mexico City: Reflections on the Emotional Responses of a Research Team

    ERIC Educational Resources Information Center

    Martinez-Salgado, Carolina

    2009-01-01

    While conducting a qualitative inquiry involving in-depth interviews on the perceptions of health risks within a group of profoundly poor urban families in the southern part of Mexico City, Martinez-Salgado and her interdisciplinary team of women interviewers got involved in emotionally complex situations with the women participants in the study.…

  5. Extension for Organic Agriculture: A Comparative Study between Baden-Württemberg, Germany and Crete, Greece

    ERIC Educational Resources Information Center

    Österle, Nina; Koutsouris, Alex; Livieratos, Yannis; Kabourakis, Emmanuil

    2016-01-01

    Purpose: The aim of this paper is to compare the extension services offered in the field of organic agriculture (OA) in Baden-Württemberg (BW), Germany and Crete, Greece. Design/methodology approach: 16 in-depth interviews, 10 in BW and 6 in Crete, were carried out with representatives of OA extension providers; interviews were qualitatively…

  6. Identity, Empathy and "Otherness": Asian Women, Education and Dowries in the UK

    ERIC Educational Resources Information Center

    Bhopal, Kalwant

    2009-01-01

    This article will examine Asian women's views on the practice of dowries in the UK. The research is based on 20 in-depth interviews with Asian women studying for a Social Sciences degree in a "new" (post-1992) university in the southeast of England. All of the interviews were tape-recorded and the data transcribed. The data was analysed…

  7. [Dealing with sensitive interview topics--insights into the research project "Everyday life of people with urinary incontinence"].

    PubMed

    Hayder, Daniela; Cintron, Alexa; Schnell, Martin W; Schnepp, Wilfried

    2009-10-01

    This article has been written as part of a research project investigating the experiences of people with urinary incontinence. In this article a systematic literature analysis combined with excerpts from the study was used to describe and reflect on the best way to conduct interviews on sensitive topics. Ethical aspects are emphasised. These include informed and process consent, different types, places, and phases of such an interview, and reasons for people to participate in such interviews. It is shown that grappling with sensitive and shameful topics can promote recruitment of potential candidates and add depth to qualitative research. As such, sensitive interview topics constitute important quality indicators for qualitative research.

  8. Gender and Health Lifestyle: An In-Depth Exploration of Self-Care Activities in Later Life

    ERIC Educational Resources Information Center

    Grzywacz, Joseph G.; Stoller, Eleanor Palo; Brewer-Lowry, A. Nichol; Bell, Ronny A.; Quandt, Sara A.; Arcury, Thomas A.

    2012-01-01

    Objective: Evaluate similarities and differences in the self-care domain of health lifestyle among older, rural-dwelling women and men. Method: Qualitative analysis of in-depth interview data from 62 community-dwelling older (M = 74.3 years) African and European American women and men. Results: Both older women and men rely heavily on…

  9. The Status of Career Guidance in Michigan Schools. An Opinion Research Study of Career Guidance Professionals.

    ERIC Educational Resources Information Center

    Michigan State Dept. of Education, Lansing.

    Project Outreach, the opinion research division of the Michigan State Board of Education, conducted a study on the current status of career guidance in Michigan public schools, using in-depth telephone interviews with career guidance professionals (N=445) in November and December of 1989. The interview questionnaire, developed with the advice of…

  10. "What We Might Become": The Lives, Aspirations, and Education of Young Migrants in the London Area

    ERIC Educational Resources Information Center

    Cooke, Melanie

    2008-01-01

    This article draws on three in-depth interviews with teenage migrants, two asylum seekers and one from Portugal. The interviews reveal experiences particular to young new arrivals attempting to find ways of being in a global city where they find themselves living in multicultural localities that are occasionally the sites of conflict as well as…

  11. The Salience of Family Worldview in Mourning an Elderly Husband and Father

    ERIC Educational Resources Information Center

    Black, Helen K.; Santanello, Holly R.

    2012-01-01

    Objective: The purpose of this study was to qualitatively explore family reaction to the death of the elderly husband and father in the family. Methods: We qualitatively interviewed 34 families (a family included a widow and 2 adult biological children) approximately 6-15 months after the death. In private, one-on-one in-depth interviews, we…

  12. Factors shaping effective utilization of health information technology in urban safety-net clinics.

    PubMed

    George, Sheba; Garth, Belinda; Fish, Allison; Baker, Richard

    2013-09-01

    Urban safety-net clinics are considered prime targets for the adoption of health information technology innovations; however, little is known about their utilization in such safety-net settings. Current scholarship provides limited guidance on the implementation of health information technology into safety-net settings as it typically assumes that adopting institutions have sufficient basic resources. This study addresses this gap by exploring the unique challenges urban resource-poor safety-net clinics must consider when adopting and utilizing health information technology. In-depth interviews (N = 15) were used with key stakeholders (clinic chief executive officers, medical directors, nursing directors, chief financial officers, and information technology directors) from staff at four clinics to explore (a) nonhealth information technology-related clinic needs, (b) how health information technology may provide solutions, and (c) perceptions of and experiences with health information technology. Participants identified several challenges, some of which appear amenable to health information technology solutions. Also identified were requirements for effective utilization of health information technology including physical infrastructural improvements, funding for equipment/training, creation of user groups to share health information technology knowledge/experiences, and specially tailored electronic billing guidelines. We found that despite the potential benefit that can be derived from health information technologies, the unplanned and uninformed introduction of these tools into these settings might actually create more problems than are solved. From these data, we were able to identify a set of factors that should be considered when integrating health information technology into the existing workflows of low-resourced urban safety-net clinics in order to maximize their utilization and enhance the quality of health care in such settings.

  13. The Search for an Explanation: Breast Cancer in the Context of Genetic Inheritance

    ERIC Educational Resources Information Center

    Maheu, Christine

    2009-01-01

    This case study is an in-depth examination of how Erika (a pseudonym) interpreted and understood her genetic test results for breast cancer susceptibility. Her experience is presented in the form of a biography, which was built from key passages retrieved from the semi structured interview the author conducted at Erika's home. The interview data…

  14. 78 FR 54659 - Agency Information Collection Activities: Submission to OMB for Review and Approval; Public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-05

    ... groups will be conducted with up to eight participants in each for a total sample size of 32. The second... determine eligibility for the pilot study to recruit a sample of 500 participants (50 from each clinical... to participate in an in-depth, qualitative telephone interview for a total of 100 interviews. Finally...

  15. The Lost Boys of Sudan: Ambiguous Loss, Search for Family, and Reestablishing Relationships with Family Members

    ERIC Educational Resources Information Center

    Luster, Tom; Qin, Desiree B.; Bates, Laura; Johnson, Deborah J.; Rana, Meenal

    2008-01-01

    The "Lost Boys of Sudan" were separated from their families by civil war and subsequently lived in 3 other countries--Ethiopia, Kenya, and the United States. In-depth interviews were conducted with 10 refugees who located surviving family members in Sudan after an average separation of 13.7 years. The interviews probed their experiences…

  16. School Kids/Street Kids: Identity Development in Latino Students. Sociology of Education Series.

    ERIC Educational Resources Information Center

    Flores-Gonzalez, Nilda

    Based on a year-long study and in-depth interviews with Latino high school students, this book focuses on why some develop a school kid identity that enables them to succeed in school, while others develop a street kid" identity and drop out. Interviews were conducted with approximately 10 stayers, 10 leavers, and 10 returners. The book…

  17. "Yes, but Suppose Everyone Turned Gay?": The Structure of Attitudes toward Gay and Lesbian Rights among Islamic Youth in Belgium

    ERIC Educational Resources Information Center

    Hooghe, Marc; Dejaeghere, Yves; Claes, Ellen; Quintelier, Ellen

    2010-01-01

    Various quantitative studies have suggested the occurrence of hostile feelings toward LGBT rights among Islamic communities in Western societies. We know less, however, about the structure of these attitudes among Belgian Islamic youth. Based on focus groups and in-depth interviews, we try to disentangle these elements. The interviews suggest that…

  18. An Examination of Second Graders' Construction and Interpretation of Questions Used during Social Studies Interviews

    ERIC Educational Resources Information Center

    Kelley, Lynn Allyson

    2009-01-01

    An investigation was conducted to determine whether the level of social studies interview questions second graders formulate and use can be increased with questioning instruction in terms of quality, which is defined as depth of response, and in terms of quantity. This was a quantitative study using both qualitative and quantitative data in which…

  19. Increasing Consumer Engagement by Tailoring a Public Reporting Website on the Quality of Diabetes Care: A Qualitative Study

    PubMed Central

    Bednarz, Lauren; Nordby, Peter A; Fink, Jennifer; Greenlee, Robert T; Bolt, Daniel; Magnan, Elizabeth M

    2016-01-01

    Background The majority of health care utilization decisions in the United States are made by persons with multiple chronic conditions. Existing public reports of health system quality do not distinguish care for these persons and are often not used by the consumers they aim to reach. Objective Our goal was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care. Methods We adapted an existing consumer-focused public reporting website using adult learning theory to display diabetes quality reports tailored to the user’s chronic condition profile. We conducted in-depth cognitive interviews with 20 individuals who either had diabetes and/or cared for someone with diabetes to assess the website. Interviews were audiotaped and transcribed, then analyzed using thematic content analysis. Results Three themes emerged that suggested increased engagement from tailoring the site to a user’s chronic conditions: ability to interact, relevance, and feeling empowered to act. Conclusions We conclude that tailoring can be used to improve public reporting sites for individuals with chronic conditions, ultimately allowing consumers to make more informed health care decisions. PMID:28003173

  20. The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS.

    PubMed

    Nevedal, Andrea; Sankar, Andrea

    2016-08-01

    Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker's (1997) life course disruption theory, we explored older African Americans' experiences of living with HIV/AIDS. A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. Older African Americans' discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Ideas and enhancements related to mobile applications to support type 1 diabetes.

    PubMed

    Pulman, Andy; Taylor, Jacqui; Galvin, Kathleen; Masding, Mike

    2013-07-25

    Mobile devices have become increasingly important to young people who now use them to access a wide variety of health-related information. Research and policy related to the integration of health information and support with this technology do not effectively consider the viewpoint of a younger patient. Views of young people with type 1 diabetes are vital in developing quality services and improving their own health-related quality of life (HRQOL), yet research on their lifestyle and use of Web and mobile technology to support their condition and in non-health-related areas is sparse. To develop insight into young people with type 1 diabetes and their current use of Web and mobile technology and its potential impact on HRQOL. This can be achieved by constructing an in-depth picture of their day-to-day experiences from qualitative interviewing and exploring how they make use of technology in their lives and in relation to their condition and treatment. The goal was then to build something to help them, using the researcher's technical expertise and seeking users' opinions during the design and build, utilizing sociotechnical design principles. Data were collected by semistructured, in-depth qualitative interviews (N=9) of young people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto NVivo for theme identification. Data analysis was undertaken during initial interviews (n=4) to locate potential ideas and enhancements for technical development. Latter interviews (n=5) assisted in the iterative sociotechnical design process of the development and provided additional developmental ideas. Six themes were identified providing an understanding of how participants lived with and experienced their condition and how they used technology. Four technological suggestions for improvement were taken forward for prototyping. One prototype was developed as a clinically approved app. A number of ideas for new mobile apps and enhancements to currently existing apps that did not satisfactorily cater to this age group's requirements for use in terms of design and functionality were suggested by interviewees but were not prototyped. This paper outlines the nonprototyped suggestions from interviewees and argues that young people with type 1 diabetes have a key role to play in the design and implementation of new technology to support them and improve HRQOL. It is vital to include and reflect on their suggestions as they have a radically different view of technology than either their parents or practitioners. We need to consider the relationship to technology that young people with type 1 diabetes have, and then reflect on how this might make a difference to them and when it might not be a suitable mechanism to use.

  2. "I'm a Natural and I Do It for Love!": Exploring Students' Accounts of Studying Mathematics

    ERIC Educational Resources Information Center

    Bartholomew, Hannah; Darragh, Lisa; Ell, Fiona; Saunders, Jeanette

    2011-01-01

    Drawing on in-depth interviews with the third year students at a New Zealand university, we explore the ways in which students speak about studying mathematics, their relationship with the subject and how this has developed over time. These interviews were conducted as part of a project looking at undergraduate mathematics from the perspective of…

  3. Family members' narratives of lifespace: Mapping changes before and after a brain injury causing driving disruption.

    PubMed

    Liang, Phyllis; Liddle, Jacki; Fleming, Jennifer; Gustafsson, Louise

    2016-06-01

    Family members of a person with an acquired brain injury often provide transport assistance during driving disruption with potential impacts on their own travel and participation within the community. The geographic area in which people travel and conduct their activities is known as lifespace. This study aimed to describe the quantitative changes in family members' lifespace after brain injury and understand their subjective experiences through interacting with maps during narratives. Mapping was embedded within in-depth semi-structured interviews with 15 family members. Two sets of maps were generated per participant showing the number of travel locations before and after brain injury. In the interviews, participants reflected on the perceived meaning of lifespace change. Qualitative data were analysed using a narrative approach. Quantitative data from the mapping revealed an increase in travel locations for nine participants, a decrease for five, and no change for one participant. Data analysis revealed four typologies which complemented and enriched the quantitative data: (i) I will do everything for him or her; (ii) Trying to fit all in; (iii) We spend all our time together now; (iv) I need to also care for myself. The findings describe the change in family members' lifespace after taking on the driver role following acquired brain injury. This study highlights the importance of understanding both quantitative and qualitative aspects of lifespace. The subjective experiences and consequences of lifespace changes are different from the impact on individuals with health conditions. Mapping in an interview as a tool has potential clinical utility. © 2016 Occupational Therapy Australia.

  4. It's not about pager replacement: an in-depth look at the interprofessional nature of communication in healthcare.

    PubMed

    Quan, Sherman D; Wu, Robert C; Rossos, Peter G; Arany, Teri; Groe, Silvi; Morra, Dante; Wong, Brian M; Cavalcanti, Rodrigo; Coke, William; Lau, Francis Y

    2013-03-01

    Institutions have tried to replace the use of numeric pagers for clinical communication by implementing health information technology (HIT) solutions. However, failing to account for the sociotechnical aspects of HIT or the interplay of technology with existing clinical workflow, culture, and social interactions may create other unintended consequences. To evaluate a Web-based messaging system that allows asynchronous communication between health providers and identify the unintended consequences associated with implementing such technology. Intervention-a Web-based messaging system at the University Health Network to replace numeric paging practices in May 2010. The system facilitated clinical communication on the medical wards for coordinating patient care. Study design-pre-post mixed methods utilizing both quantitative and qualitative measures. Five residents, 8 nurses, 2 pharmacists, and 2 social workers were interviewed. Pre-post interruption-15 residents from 5 clinical teams in both periods. The study compared the type of messages sent to physicians before and after implementation of the Web-based messaging system; a constant comparative analysis of semistructured interviews was used to generate key themes related to unintended consequences. Interruptions increased 233%, from 3 pages received per resident per day pre-implementation to 10 messages received per resident per day post-implementation. Key themes relating to unintended consequences that emerged from the interviews included increase in interruptions, accountability, and tactics to improve personal productivity. Meaningful improvements in clinical communication can occur but require more than just replacing pagers. Introducing HIT without addressing the sociotechnical aspects of HIT that underlie clinical communication can lead to unintended consequences. Copyright © 2013 Society of Hospital Medicine.

  5. Interviewing in Virtual Worlds: A Phenomenological Study Exploring the Success Factors of Job Applicants Utilizing Second Life to Gain Employment

    ERIC Educational Resources Information Center

    Koufoudakis-Whittington, Stefania

    2014-01-01

    This study explored the phenomenon of success factors of job applicants utilizing Second Life to gain employment. The study focused on identifying the perception of what qualified as a successful interview through the lived common experiences of 16 employment recruiters. The research problem was that a gap existed in scholarly research on…

  6. The role of men in induced abortion decision making in an urban area of the Philippines.

    PubMed

    Hirz, Alanna E; Avila, Josephine L; Gipson, Jessica D

    2017-09-01

    To understand beliefs about unintended pregnancy and abortion, and perceptions about male roles related to pregnancy decision-making among men in the Philippines. Qualitative data were collected during in-depth interviews and focus group discussions with men in an urban area of the Philippines between October 2007 and July 2008. Interview participants were purposively sampled from a local survey based on their having reported being "afraid or troubled" or "afraid and planned to terminate" in response to a recent pregnancy. Focus group participants were selected from the same communities. Data were analyzed using the constant comparative method. In-depth interview data from 15 men-each interviewed twice-and five focus group discussions were included. Male interview participants reported feeling morally responsible for the pregnancy and as wanting to avoid the "sin" of induced abortion; however, they were concerned about being able to support a family financially. Participants expressed resentment towards partners who attempted or completed an induced abortion without their knowledge. In such cases, men would disparage their partner and cease interacting with them to avoid the "sin" of induced abortion. Participants described negative feelings towards women seeking induced abortions, and their own desire to avoid associated "sin". This highlights the effects of unintended pregnancy and induced abortion on young Filipino men, including their own experience of abortion stigma. © 2017 International Federation of Gynecology and Obstetrics.

  7. Preferences for infant delivery site among pregnant women and new mothers in Northern Karnataka, India.

    PubMed

    Bruce, Sharon G; Blanchard, Andrea K; Gurav, Kaveri; Roy, Anuradha; Jayanna, Krishnamurthy; Mohan, Haranahalli L; Ramesh, Banadakoppa M; Blanchard, James F; Moses, Stephen; Avery, Lisa

    2015-02-27

    The National Rural Health Mission (NRHM) of India aims to increase the uptake of safe and institutional delivery among rural communities to improve maternal, neonatal and child health (MNCH) outcomes. Previous studies in India have found that while there have been increasing numbers of institutional deliveries there are still considerable barriers to utilization and quality of services, particularly in rural areas, that may mitigate improvements achieved by MNCH interventions. This paper aims to explore the factors influencing preference for home, public or private hospital delivery among rural pregnant and new mothers in three northern districts of Karnataka state, South India. In-depth qualitative interviews were conducted in 2010 among 110 pregnant women, new mothers (infants born within past 3 months), their husbands and mothers-in-law. Interviews were conducted in the local language (Kannada) and then translated to English for analysis. The interviews of pregnant women and new mothers were used for analysis to ultimately develop broader themes around definitions of quality care from the perspective of service users, and the influence this had on their delivery site preferences. Geographical and financial access were important barriers to accessing institutional delivery services in all districts, and among those both above and below the poverty line. Access issues of greatest concern were high costs at private institutions, continuing fees at public hospitals and the inconsistent receipt of government incentives. However, views on quality of care that shaped delivery site preferences were deeply rooted in socio-cultural expectations for comfortable, respectful and safe care that must ultimately be addressed to change negative perceptions about institutional, and particularly public hospital, care at delivery. In the literature, quality of care beyond access has largely been overlooked in favour of support for incentives on the demand side, and more trained doctors, facilities and equipment on the supply side. Taking a comprehensive approach to quality of care in line with cultural values and community needs is imperative for improving experiences, utilization, and ultimately maternal and neonatal health outcomes at the time of delivery.

  8. Analysis of an Online Match Discussion Board: Improving the Otolaryngology—Head and Neck Surgery Match

    PubMed Central

    Kozin, Elliott D.; Sethi, Rosh; Lehmann, Ashton; Remenschneider, Aaron K.; Golub, Justin S.; Reyes, Samuel A.; Emerick, Kevin; Lee, Daniel J.; Gray, Stacey T.

    2015-01-01

    Introduction “The Match” has become the accepted selection process for graduate medical education. Otomatch.com has provided an online forum for Otolaryngology-Head and Neck Surgery (OHNS) Match-related questions for over a decade. Herein, we aim to 1) delineate the types of posts on Otomatch to better understand the perspective of medical students applying for residency and 2) provide recommendations to potentially improve the Match process. Methods Discussion forum posts on Otomatch between December 2001 and April 2014 were reviewed. The title of each thread and total number of views were recorded for quantitative analysis. Each thread was organized into one of six major categories and one of eighteen subcategories, based on chronology within the application cycle and topic. National Resident Matching Program (NRMP) data were utilized for comparison. Results We identified 1,921 threads corresponding to over 2 million page views. Over 40% of threads related to questions about specific programs, and 27% were discussions about interviews. Views, a surrogate measure for popularity, reflected different trends. The majority of individuals viewed posts on interviews (42%), program specific questions (20%) and how to rank programs (11%). Increase in viewership tracked with a rise in applicant numbers based on NRMP data. Conclusions Our study provides an in depth analysis of a popular discussion forum for medical students interested in the OHNS Match. The most viewed posts are about interview dates and questions regarding specific programs. We provide suggestions to address unmet needs for medical students and potentially improve the Match process. PMID:25550223

  9. Best Technology Practices of Conflict Resolution Specialists: A Case Study of Online Dispute Resolution at United States Universities

    ERIC Educational Resources Information Center

    Law, Kimberli Marie

    2013-01-01

    The purpose of this study was to remedy the paucity of knowledge about higher education's conflict resolution practice of online dispute resolution by providing an in-depth description of mediator and instructor online practices. Telephone interviews were used as the primary data collection method. Eleven interview questions were relied upon to…

  10. The Experience of Adult Children of Mothers with Intellectual Disability: A Qualitative Retrospective Study from Poland

    ERIC Educational Resources Information Center

    Wolowicz-Ruszkowska, Agnieszka; McConnell, David

    2017-01-01

    Background: Little is known about the experience of growing up with a mother with intellectual disability. The aim of this study was to explore this experience from the perspective of adult children. Method: In-depth interviews with 23 adult children brought up by mothers with moderate-to-severe intellectual disability. The interview data were…

  11. Meaningful Solutions for the Unemployed or Their Counsellors? The Role of Case Managers' Conceptions of Their Work

    ERIC Educational Resources Information Center

    Värk, Aare; Reino, Anne

    2018-01-01

    This article reports the outcomes of a phenomenographical study of case managers' conceptions of case management work and its influence on the process and performance of the work of counselling the unemployed. A heterogeneous sample of 11 Estonian case managers was selected for in-depth interviews. Analysis of the interviews revealed three…

  12. EXTENSION ADMINISTRATION AND STATE LEGISLATIVE PROCESS--A CASE STUDY OF THE 71ST MISSOURI GENERAL ASSEMBLY.

    ERIC Educational Resources Information Center

    KYD, STIRLING

    TO GAIN UNDERSTANDING OF MISSOURI'S LEGISLATIVE PROCESS AND AID ADMINISTRATORS OF THE EXTENSION DIVISION, THE AUTHOR INVESTIGATED THE 71ST GENERAL ASSEMBLY. HE READ PUBLICATIONS, INTERVIEWED LOBBYISTS, AND CONDUCTED OPEN ENDED DEPTH INTERVIEWS WITH LEGISLATORS SELECTED TO COMPRISE THE LEADERSHIP OF THE ASSEMBLY. HIS DISSERTATION PRESENTS THE…

  13. Prescription opioid abuse and diversion in an urban community: the results of an ultrarapid assessment.

    PubMed

    Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Beard, Ronald A

    2009-04-01

    Prescription-drug diversion is a topic about which comparatively little is known, and systematic information garnered from prescription-drug abusers and dealers on the specific mechanisms of diversion is extremely limited. A pilot ultrarapid assessment was carried out in Wilmington, Delaware, during December 2006 to better understand the scope and dynamics of prescription-drug abuse and diversion. This involved focus groups with prescription-drug abusers and key informant interviews with police, regulatory officials, prescription-drug dealers, and pill brokers. The research team recruited focus group participants from the two residential substance abuse treatment programs in Wilmington reporting the highest proportions of prescription drug abusing clients. A total of six focus groups were conducted with 32 patients in these two programs. Dealers were recruited from the same treatment facilities, and three in-depth interviews were completed. In-depth interviews were also conducted with two prescription pill brokers recruited through the authors' existing contacts in the drug abusing community. Six in-depth interviews were conducted with representatives from a number of Delaware agencies-the Attorney General's Office, the Department of Professional Regulation, the State Police; the Wilmington Police Department, and the Newark Police Department. In-depth interview and focus group guides were developed for each of the target populations. The in-depth interviews with police and regulatory officials focused on the extent of prescription drug abuse and diversion in the community, the types of drugs most commonly diverted, and mechanisms being used to channel the drugs to the illicit market. The focus group areas of inquiry with prescription drug abusers included general perceptions of the prescription drug problem in Delaware, sources and mechanisms of access to prescription drugs, popularity and prices of prescription medications on the street, as well as the initiation and progression of prescription and illicit drug abuse. The primary sources of prescription drugs on the street were the elderly, patients with pain, and doctor shoppers, as well as pill brokers and dealers who work with all of the former. The popularity of prescription drugs in the street market was rooted in the abusers' perceptions of these drugs as 1) less stigmatizing; 2) less dangerous; and, 3) less subject to legal consequences than illicit drugs. For many, the abuse of prescription opioids also appeared to serve as a gateway to heroin use. The diversion of prescription opioids might be reduced through physician education focusing on 1) recognizing that a patient is misusing and/or diverting prescribed medications; 2) considering a patient's risk for opioid misuse before initiating opioid therapy; and 3) understanding the variation in the abuse potential of different opioid medications currently on the market. Patient education also appears appropriate in the areas of safeguarding medications, disposal of unused medications, and understanding the consequences of manipulating physicians and selling their medications.

  14. Methodological Reflections on Researching Lesbian, Gay, Bisexual and Transgender University Students in Hong Kong: To What Extent Are They Vulnerable Interview Subjects?

    ERIC Educational Resources Information Center

    Suen, Yiu Tung

    2015-01-01

    Increasingly, the importance of reflexivity has been acknowledged in higher education research. In this paper, I reflect on my experience of researching lesbian, gay, bisexual and transgender (LGBT) university students in Hong Kong. The focus is not on the findings that emerge from the in-depth interviews conducted per se, but on the…

  15. Using GIS and perceived distance to understand the unequal geographies of healthcare in lower-income urban neighbourhoods.

    PubMed

    Hawthorne, Timothy L; Kwan, Mei-Po

    2012-01-01

    Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.

  16. "And You're Telling Me Not to Stress?" A Grounded Theory Study of Postpartum Depression Symptoms among Low-Income Mothers

    ERIC Educational Resources Information Center

    Abrams, Laura S.; Curran, Laura

    2009-01-01

    Low-income mothers in the U.S. are more likely to experience postpartum depression (PPD) and less likely to seek treatment than their middle-class counterparts. Despite this knowledge, prior research has not provided an in-depth understanding of PPD symptoms as they are experienced by low-income mothers. Through in-depth interviews, this study…

  17. "Disruptive Technologies", "Pedagogical Innovation": What's New? Findings from an In-Depth Study of Students' Use and Perception of Technology

    ERIC Educational Resources Information Center

    Conole, Grainne; de Laat, Maarten; Dillon, Teresa; Darby, Jonathan

    2008-01-01

    The paper describes the findings from a study of students' use and experience of technologies. A series of in-depth case studies were carried out across four subject disciplines, with data collected via survey, audio logs and interviews. The findings suggest that students are immersed in a rich, technology-enhanced learning environment and that…

  18. Reliability of Using Piaget's Logic of Meanings to Analyze Pre-Service Teachers' Understanding of Conceptual Problems in Earth Science

    ERIC Educational Resources Information Center

    Wavering, Michael; Mangione, Katherine; McBride, Craig

    2013-01-01

    A dissertation study looking at preservice teachers' alternative conceptions in earth science was completed by one of the authors. The data used for this study from the dissertation were a series of eleven interviews. (Purpose) The authors of this manuscript wanted to provide more in-depth analysis of these interviews, specifically to provide a…

  19. Health workers who ask about social determinants of health are more likely to report helping patients: Mixed-methods study.

    PubMed

    Naz, Anila; Rosenberg, Ellen; Andersson, Neil; Labonté, Ronald; Andermann, Anne

    2016-11-01

    To assess the feasibility of implementing a clinical decision aid called the CLEAR Toolkit that helps front-line health workers ask their patients about social determinants of health, refer to local support resources, and advocate for wider social change. A mixed-methods study using quantitative (online self-completed questionnaires) and qualitative (in-depth interviews, focus groups, and key informant interviews) methods. A large, university-affiliated family medicine teaching centre in Montreal, Que, serving one of the most ethnically diverse populations in Canada. Fifty family doctors and allied health workers responded to the online survey (response rate of 50.0%), 15 completed in-depth interviews, 14 joined 1 of 2 focus groups, and 3 senior administrators participated in key informant interviews. Our multimethod approach included an online survey of front-line health workers to assess current practices and collect feedback on the tool kit; in-depth interviews to understand why they consider certain patients to be more vulnerable and how to help such patients; focus groups to explore barriers to asking about social determinants of health; and key informant interviews with high-level administrators to identify organizational levers for changing practice. Senior administrators consider asking about social determinants to be part of the mandate of health workers. However, barriers perceived by front-line clinicians include insufficient training in social history taking, uncertainty about how to address these issues in clinical practice, and a lack of knowledge of local referral resources. Health workers with specific ways of asking patients about their social challenges were more likely to report having helped their patients as compared with those who did not know how to ask (93.8% vs 52.9%; P = .003). While health workers recognize the importance of social determinants, many are unsure how to ask about these often sensitive issues or where to refer patients. The CLEAR Toolkit can be easily adapted to local contexts to help front-line health workers initiate dialogue around social challenges and better support patients in clinical practice. Copyright© the College of Family Physicians of Canada.

  20. Medical students are afraid to include abortion in their future practices: in-depth interviews in Maharastra, India.

    PubMed

    Sjöström, Susanne; Essén, Birgitta; Gemzell-Danielsson, Kristina; Klingberg-Allvin, Marie

    2016-01-12

    Unsafe abortions are estimated to cause eight per-cent of maternal mortality in India. Lack of providers, especially in rural areas, is one reason unsafe abortions take place despite decades of legal abortion. Education and training in reproductive health services has been shown to influence attitudes and increase chances that medical students will provide abortion care services in their future practice. To further explore previous findings about poor attitudes toward abortion among medical students in Maharastra, India, we conducted in-depth interviews with medical students in their final year of education. We used a qualitative design conducting in-depth interviews with twenty-three medical students in Maharastra applying a topic guide. Data was organized using thematic analysis with an inductive approach. The participants described a fear to provide abortion in their future practice. They lacked understanding of the law and confused the legal regulation of abortion with the law governing gender biased sex selection, and concluded that abortion is illegal in Maharastra. The interviewed medical students' attitudes were supported by their experiences and perceptions from the clinical setting as well as traditions and norms in society. Medical abortion using mifepristone and misoprostol was believed to be unsafe and prohibited in Maharastra. The students perceived that nurse-midwives were knowledgeable in Sexual and Reproductive Health and many found that they could be trained to perform abortions in the future. To increase chances that medical students in Maharastra will perform abortion care services in their future practice, it is important to strengthen their confidence and knowledge through improved medical education including value clarification and clinical training.

  1. The Health Seeking Behaviors and Perceptions of Iranian Patient with Osteoarthritis about Pain Management: A Qualitative Study

    PubMed Central

    Zamanzadeh, Vahid; Ahmadi, Fazlollah; Foolady, Marjaneh; Behshid, Mozhgan; Irajpoor, Alireza

    2017-01-01

    Introduction: Pain is the main reason for patients with osteoarthritis (OA) to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Methods: Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and out-patient clinics, and physicians’ offices. Data saturation was reached after 31 in-depth and semi-structured interviews (five second interviews). Data were analyzed by qualitative content analysis, using comparison, reflection and interpretation techniques. The criteria used to enhance rigor included credibility, transferability, dependability, and confirmability. Results: Two main categories and six subcategories emerged from data analysis. The first main category included "adapting to the reality" which had three subcategories: Facing OA pain, seeking health care, and accepting pain as a part of life. The second main category included "behavior fluctuation" with three subcategory of role conflict, responsibility for self-care and, adherence to prescribed treatment versus self-treatment. Conclusion: Care seeking behaviors for chronic pain sufferers are void of cultural, emotional, social and financial situation and patient expectations. Some misconceptions emerged about the health problem and its management, which may lead to negative attitudes toward treatment and therapists and finally lead to non-adherence to treatment. Patients need for education to enhance appropriate health care utilization. PMID:28299300

  2. The Health Seeking Behaviors and Perceptions of Iranian Patient with Osteoarthritis about Pain Management: A Qualitative Study.

    PubMed

    Zamanzadeh, Vahid; Ahmadi, Fazlollah; Foolady, Marjaneh; Behshid, Mozhgan; Irajpoor, Alireza

    2017-03-01

    Introduction: Pain is the main reason for patients with osteoarthritis (OA) to visit health clinics. Health seeking behaviors indicate unmet patient needs and lack of understanding of OA pain patterns. This study aimed to describe the experiences of Iranian patients with OA and explore their health seeking behaviors and perceptions on pain management related to osteoarthritis. Methods: Using a qualitative approach, data was collected by interviewing 19 patients, 2 family members, and 5 health care providers from the in-patient and out-patient clinics, and physicians' offices. Data saturation was reached after 31 in-depth and semi-structured interviews (five second interviews). Data were analyzed by qualitative content analysis, using comparison, reflection and interpretation techniques. The criteria used to enhance rigor included credibility, transferability, dependability, and confirmability. Results: Two main categories and six subcategories emerged from data analysis. The first main category included "adapting to the reality" which had three subcategories: Facing OA pain, seeking health care, and accepting pain as a part of life. The second main category included "behavior fluctuation" with three subcategory of role conflict, responsibility for self-care and, adherence to prescribed treatment versus self-treatment. Conclusion: Care seeking behaviors for chronic pain sufferers are void of cultural, emotional, social and financial situation and patient expectations. Some misconceptions emerged about the health problem and its management, which may lead to negative attitudes toward treatment and therapists and finally lead to non-adherence to treatment. Patients need for education to enhance appropriate health care utilization.

  3. Utilizing Motivational Interviewing to Address Resistant Behaviors in Clinical Supervision

    ERIC Educational Resources Information Center

    Wahesh, Edward

    2016-01-01

    Motivational interviewing is presented as an approach to address resistant behaviors in clinical supervision. A case example is used to illustrate the process in which the relational and technical elements of motivational interviewing can be applied to supervisee resistance. Implications for supervisors and researchers are discussed.

  4. A rural shelter in Ontario adapting to address the changing needs of women who have experienced intimate partner violence: a qualitative case study.

    PubMed

    Mantler, Tara; Wolfe, Barat

    2017-01-01

    Intimate partner violence is a significant public health problem, with shelters offering the predominant community-based solution. Shelters in Canada are mandated to provide a safe place, protection planning, advocacy and counseling among other services. Recently it has been noted the role of the shelter was shifting from an inpatient to outpatient model with a focus on increased integration of health and social services. This changing role of the shelter is amplified within the rural context where resources and cultural norms may be limited or incompatible with help-seeking behaviors. Women's shelters located in rural settings provide services within a specific cultural context that can be at odds with the needs of women who have experienced abuse, because cultural values such as rural pride, lack of anonymity, and lack of services may inhibit access to health and social services. The purpose of this in-depth qualitative case study was to examine and explore how one rural Canadian women's shelter role was changing and how the shelter was adapting to achieve the changing role. The theoretical framework utilized was a feminist intersectional lens. Qualitative interviews (averaging 60 minutes) were conducted with shelter service providers (n=6) and women staying in the shelter or utilizing shelter services (n=4). Throughout semi-structured interviews, data-trustworthy steps were taken including member-checking and paraphrasing to ensure data were an accurate representation of participants' experiences. Inductive content analysis of all interviews and field notes was conducted independently by two researchers. Analysis revealed the shelter's role was changing to include filling gaps, case management, and system navigation. To achieve the changing role, relationship building, community mobilization (both education and empowerment), and redesigning delivery were implemented as adaptation strategies. Together both the changing role of the shelter and the adaptation strategies being implemented were found to be working toward a larger goal of transformation of cultural and structural norms related to violence against women. This study uniquely identified the specific changes to the role of one rural Canadian shelter and the adaptations strategies utilized to adapt to the changing needs of women. The changing role of the shelter and the adaptation strategies being utilized have significant implications for the health of women given the increased use of healthcare services for women who have experienced violence. Specifically, the changing role of the shelter has the potential to decrease healthcare service use while increasing the potential fit of services. Further research is required to assess the impact of the changing role of the shelter on the healthcare needs and outcomes for women who have experienced intimate partner violence.

  5. Authorship, plagiarism and conflict of interest: views and practices from low/middle-income country health researchers.

    PubMed

    Rohwer, Anke; Young, Taryn; Wager, Elizabeth; Garner, Paul

    2017-11-22

    To document low/middle-income country (LMIC) health researchers' views about authorship, redundant publication, plagiarism and conflicts of interest and how common poor practice was in their institutions. We developed a questionnaire based on scenarios about authorship, redundant publication, plagiarism and conflicts of interest. We asked participants whether the described practices were acceptable and whether these behaviours were common at their institutions. We conducted in-depth interviews with respondents who agreed to be interviewed. We invited 607 corresponding authors of Cochrane reviews working in LMICs. From the 583 emails delivered, we obtained 199 responses (34%). We carried out in-depth interviews with 15 respondents. Seventy-seven per cent reported that guest authorship occurred at their institution, 60% reported text recycling. For plagiarism, 12% of respondents reported that this occurred 'occasionally', and 24% 'rarely'. Forty per cent indicated that their colleagues had not declared conflicts of interest in the past. Respondents generally recognised poor practice in scenarios but reported that they occurred at their institutions. Themes identified from in-depth interviews were (1) authorship rules are simple in theory, but not consistently applied; (2) academic status and power underpin behaviours; (3) institutions and culture fuel bad practices and (4) researchers are uncertain about what conflict of interests means and how this may influence research. LMIC researchers report that guest authorship is widely accepted and common. While respondents report that plagiarism and undeclared conflicts of interest are unacceptable in practice, they appear common. Determinants of poor practice relate to academic status and power, fuelled by institutional norms and culture. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Authorship, plagiarism and conflict of interest: views and practices from low/middle-income country health researchers

    PubMed Central

    Young, Taryn; Garner, Paul

    2017-01-01

    Objectives To document low/middle-income country (LMIC) health researchers’ views about authorship, redundant publication, plagiarism and conflicts of interest and how common poor practice was in their institutions. Design We developed a questionnaire based on scenarios about authorship, redundant publication, plagiarism and conflicts of interest. We asked participants whether the described practices were acceptable and whether these behaviours were common at their institutions. We conducted in-depth interviews with respondents who agreed to be interviewed. Participants We invited 607 corresponding authors of Cochrane reviews working in LMICs. From the 583 emails delivered, we obtained 199 responses (34%). We carried out in-depth interviews with 15 respondents. Results Seventy-seven per cent reported that guest authorship occurred at their institution, 60% reported text recycling. For plagiarism, 12% of respondents reported that this occurred ‘occasionally’, and 24% ‘rarely’. Forty per cent indicated that their colleagues had not declared conflicts of interest in the past. Respondents generally recognised poor practice in scenarios but reported that they occurred at their institutions. Themes identified from in-depth interviews were (1) authorship rules are simple in theory, but not consistently applied; (2) academic status and power underpin behaviours; (3) institutions and culture fuel bad practices and (4) researchers are uncertain about what conflict of interests means and how this may influence research. Conclusions LMIC researchers report that guest authorship is widely accepted and common. While respondents report that plagiarism and undeclared conflicts of interest are unacceptable in practice, they appear common. Determinants of poor practice relate to academic status and power, fuelled by institutional norms and culture. PMID:29170291

  7. Local wisdom of Ngata Toro community in utilizing forest resources as a learning source of biology

    NASA Astrophysics Data System (ADS)

    Yuliana, Sriyati, Siti; Sanjaya, Yayan

    2017-08-01

    Indonesian society is a pluralistic society with different cultures and local potencies that exist in each region. Some of local community still adherethe tradition from generation to generation in managing natural resources wisely. The application of the values of local wisdom is necessary to teach back to student to be more respect the culture and local potentials in the region. There are many ways developing student character by exploring local wisdom and implementing them as a learning resources. This study aims at revealing the values of local wisdom Ngata Toro indigenous people of Central Sulawesi Province in managing forest as a source of learning biology. This research was conducted by in-depth interviews, participant non-observation, documentation studies, and field notes. The data were analyzed with triangulation techniques by using a qualitative interaction analysis that is data collection, data reduction, and data display. Ngata Toro local community manage forest by dividing the forest into several zones, those arewana ngkiki, wana, pangale, pahawa pongko, oma, and balingkea accompanied by rules in the management of result-based forest conservation and sustainable utilization. By identifying the purpose of zonation and regulation of the forest, such values as the value of environmental conservation, balance value, sustainable value, and the value of mutual cooperation. These values are implemented as a biological learning resource which derived from the competences standard of analyze the utilization and conservation of the environment.

  8. Evaluating Bang for the Buck: A Cost-Effectiveness Comparison Between Individual Interviews and Focus Groups Based on Thematic Saturation Levels

    ERIC Educational Resources Information Center

    Namey, Emily; Guest, Greg; McKenna, Kevin; Chen, Mario

    2016-01-01

    Evaluators often use qualitative research methods, yet there is little evidence on the comparative cost-effectiveness of the two most commonly employed qualitative methods--in-depth interviews (IDIs) and focus groups (FGs). We performed an inductive thematic analysis of data from 40 IDIs and 40 FGs on the health-seeking behaviors of African…

  9. A Description and Analysis of the Perspectives on Leadership Effectiveness of African-American Student Leaders at the University of New Mexico. A Qualitative Research Study.

    ERIC Educational Resources Information Center

    Kustaa, Friedrich Freddy

    This report concerns a qualitative study on African-American leadership effectiveness as perceived and defined by African-American student leaders at the University of New Mexico (Albuquerque). Six African-American student leaders (three males and three females) participated in-depth interviews. The interviews were audiorecorded and transcribed.…

  10. Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China

    PubMed Central

    Richards, Esther; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

    2017-01-01

    Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers’ perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces—Zhejiang, Hubei and Yunnan—were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources. PMID:29045434

  11. Opportunities, challenges and systems requirements for developing post-abortion family planning services: Perceptions of service stakeholders in China.

    PubMed

    Jiang, Hong; Xu, Jieshuang; Richards, Esther; Qian, Xu; Zhang, Weihong; Hu, Lina; Wu, Shangchun; Tolhurst, Rachel

    2017-01-01

    Post-abortion family planning (PAFP) has been proposed as a key strategy to decrease unintended pregnancy and repeat induced abortions. However, the accessibility and quality of PAFP services remain a challenge in many countries including China where more than 10 million unintended pregnancies occur each year. Most of these unwanted pregnancies end in repeated induced abortions. This paper aims to explore service providers' perceptions of the current situation regarding family planning and abortion service needs, provision, utilization, and the feasibility and acceptability of high quality PAFP in the future. Qualitative methods, including in-depth interviews and focus group discussions, were used with family planning policy makers, health managers, and service providers. Three provinces-Zhejiang, Hubei and Yunnan-were purposively selected, representing high, medium and relatively undeveloped areas of China. A total of fifty-three in-depth interviews and ten focus-group discussions were conducted and analysed thematically. Increased numbers of abortions among young, unmarried women were perceived as a major reason for high numbers of abortions. Participants attributed this to increasing socio-cultural acceptability of premarital sex, and simultaneously, lack of understanding or awareness of contraception among young people. The majority of service stakeholders acknowledged that free family planning services were neither targeted at, nor accessible to unmarried people. The extent of PAFP provision is variable and limited. However, service providers expressed willingness and enthusiasm towards providing PAFP services in the future. Three main considerations were expressed regarding the feasibility of developing and implementing PAFP services: policy support, human resources, and financial resources. The study indicated that key service stakeholders show demand for and perceive considerable opportunities to develop PAFP in China. However, changes are needed to enable the systematic development of high quality PAFP, including actively targeting young and unmarried people in service provision, obtaining policy support and increasing the investment of human and financial resources.

  12. Students' Communicative Resources in Relation to Their Conceptual Understanding—The Role of Non-Conventionalized Expressions in Making Sense of Visualizations of Protein Function

    NASA Astrophysics Data System (ADS)

    Rundgren, Carl-Johan; Hirsch, Richard; Chang Rundgren, Shu-Nu; Tibell, Lena A. E.

    2012-10-01

    This study examines how students explain their conceptual understanding of protein function using visualizations. Thirteen upper secondary students, four tertiary students (studying chemical biology), and two experts were interviewed in semi-structured interviews. The interviews were structured around 2D illustrations of proteins and an animated representation of water transport through a channel in the cell membrane. In the analysis of the transcripts, a score, based on the SOLO-taxonomy, was given to each student to indicate the conceptual depth achieved in their explanations. The use of scientific terms and non-conventionalized expressions in the students' explanations were investigated based upon a semiotic approach. The results indicated that there was a positive relationship between use of scientific terms and level of education. However, there was no correlation between students' use of scientific terms and conceptual depth. In the interviews, we found that non-conventionalized expressions were used by several participants to express conceptual understanding and played a role in making sense of the visualizations of protein function. Interestingly, also the experts made use of non-conventionalized expressions. The results of our study imply that more attention should be drawn to students' use of scientific and non-conventionalized terms in relation to their conceptual understanding.

  13. Assessing the Performance of Medical Personnel Involved in the Diagnostic Imaging Processes in Mulago Hospital, Kampala, Uganda

    PubMed Central

    Kawooya, Michael G.; Pariyo, George; Malwadde, Elsie Kiguli; Byanyima, Rosemary; Kisembo, Harrient

    2012-01-01

    Objectives: Uganda, has limited health resources and improving performance of personnel involved in imaging is necessary for efficiency. The objectives of the study were to develop and pilot imaging user performance indices, document non-tangible aspects of performance, and propose ways of improving performance. Materials and Methods: This was a cross-sectional survey employing triangulation methodology, conducted in Mulago National Referral Hospital over a period of 3 years from 2005 to 2008. The qualitative study used in-depth interviews, focus group discussions, and self-administered questionnaires, to explore clinicians’ and radiologists’ performancerelated views. Results: The study came up with following indices: appropriate service utilization (ASU), appropriateness of clinician's nonimaging decisions (ANID), and clinical utilization of imaging results (CUI). The ASU, ANID, and CUI were: 94%, 80%, and 97%, respectively. The clinician's requisitioning validity was high (positive likelihood ratio of 10.6) contrasting with a poor validity for detecting those patients not needing imaging (negative likelihood ratio of 0.16). Some requisitions were inappropriate and some requisition and reports lacked detail, clarity, and precision. Conclusion: Clinicians perform well at imaging requisition-decisions but there are issues in imaging requisitioning and reporting that need to be addressed to improve performance. PMID:23230543

  14. Perception of spokespersons' performance and characteristics in crisis communication: experience of the 2003 severe acute respiratory syndrome outbreak in Taiwan.

    PubMed

    Lyu, Shu-Yu; Chen, Ruey-Yu; Wang, Shih-fan Steve; Weng, Ya-Ling; Peng, Eugene Yu-Chang; Lee, Ming-Been

    2013-10-01

    To explore perception of spokespersons' performance and characteristics in response to the 2003 severe acute respiratory syndrome (SARS) outbreak. This study was conducted from March to July, 2005, using semi-structured in-depth interviews to collect data. All interviews were audio-recorded and transcribed verbatim. A qualitative content analysis was employed to analyze the transcribed data. Interviewees included media reporters, media supervisors, health and medical institution executives or spokespersons, and social observers. Altogether, 35 interviewees were recruited for in-depth interviews, and the duration of the interview ranged from 1 hour to 2 hours. Results revealed that the most important characteristics of health/medical institutions spokespersons are professional competence and good interaction with the media. In contrast, the most important behaviors they should avoid are concealing the truth and misreporting the truth. Three major flaws of spokespersons' performance were identified: they included poor understanding of media needs and landscape; blaming the media to cover up a mistake they made in an announcement; and lack of sufficient participation in decision-making or of authorization from the head of organization. Spokespersons of health and medical institutions play an important role in media relations during the crisis of a newly emerging infectious disease. Copyright © 2013. Published by Elsevier B.V.

  15. Social and Virtual Networks: Evaluating Synchronous Online Interviewing Using Instant Messenger

    ERIC Educational Resources Information Center

    Hinchcliffe, Vanessa; Gavin, Helen

    2009-01-01

    This paper describes an evaluation of the quality and utility of synchronous online interviewing for data collection in social network research. Synchronous online interviews facilitated by Instant Messenger as the communication medium, were undertaken with ten final year university students. Quantitative and qualitative content analysis of…

  16. 10 CFR 709.15 - Processing counterintelligence evaluation results.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... raise significant questions about the covered person's access to classified information or materials... in-depth interview with the covered person, may request relevant information from the covered person...

  17. 10 CFR 709.15 - Processing counterintelligence evaluation results.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... raise significant questions about the covered person's access to classified information or materials... in-depth interview with the covered person, may request relevant information from the covered person...

  18. Carbon and nitrogen utilization in two species of Red Sea corals along a depth gradient: Insights from stable isotope analysis of total organic material and lipids

    NASA Astrophysics Data System (ADS)

    Alamaru, Ada; Loya, Yossi; Brokovich, Eran; Yam, Ruth; Shemesh, Aldo

    2009-09-01

    We examined the utilization of carbon and nitrogen in two common Red Sea coral species (Stylophora pistillata and Favia favus), differing in colony morphology and polyp size, along a depth gradient down to 60 m. We describe the changes in C/N ratios and in the stable isotope composition of carbon and nitrogen of coral's tissue and algal symbionts. We also measured the carbon isotopic composition of the lipid fraction extracted from both coral tissue and algal symbionts in order to reveal the changes in the carbon source utilized by the host coral for lipid synthesis. The results show that for both species, δ13C decreases by 7-8‰ in animal tissue, algal symbionts and in the lipid fractions as depth increases. However, in contrast to previous reports, the difference between δ13C values of coral tissue and algal symbionts does not increase with depth. δ15N values of coral tissue and algal symbionts in both species do not correlate with depth suggesting that the heterotrophic capacity of these corals does not increase with depth. δ13C values of tissue lipids were depleted by an average of ˜3.5‰ compared to δ13C of the entire tissue at all depths. δ13C values of algal lipids were depleted by an average of ˜2‰ compared to δ13C of the entire zooxanthellae at all depths, indicating high efficiency of carbon recycling between the two symbiotic partners along the entire gradient. The depletion of lipids is attributed to the fractionation mechanism during lipid synthesis. In addition, for both species, δ13C values of algal lipids were enriched compared with δ13C of tissue lipids. In S. pistillata, the difference between δ13C values of tissue lipids and algal lipids increased linearly with depth, indicating a change in the sources of carbon utilized by the coral for lipid synthesis below 20 m from an autotrophic to a heterotrophic source. However, in F. favus, this average difference was ˜4 times larger compared to shallow S. pistillata and was constant along the entire depth gradient, suggesting that F. favus uses heterotrophically-acquired carbon for lipid synthesis regardless of depth. Overall, F. favus exhibited enriched δ13C and δ15N values compared to S. pistillata along the entire gradient. We attribute these differences to both morphological differences (i.e. colony morphology, tissue thickness and polyp size) between the two species and to a higher heterotrophy/autotrophy ratio in F. favus at all depths. The C/N ratio in S. pistillata tissue decreased with increasing water depth whereas in F. favus it remained constant. This reflects a higher heterotrophic capacity in the large polyped F. favus, at all depths.

  19. Environmental factors that impact the eating behaviors of low-income African American adolescents in Baltimore City.

    PubMed

    Christiansen, Karina M H; Qureshi, Farah; Schaible, Alex; Park, Sohyun; Gittelsohn, Joel

    2013-01-01

    To understand environmental factors influencing the food-related habits of low-income urban African American adolescents. Qualitative research was conducted between February and April, 2010, using in-depth interviews, focus groups, and direct observation. The study was conducted in low-income, predominantly African American neighborhoods of Baltimore City. A total of 20 adolescents were interviewed in 18 in-depth interviews (n = 13) and 2 focus groups (n = 7). Participants were recruited from Baltimore City recreation centers and were eligible if they were African American and aged 10-16 years. The food-related habits of low-income, African American, urban adolescents and reported perceptions of their food environments. Interviews were audio recorded, transcribed, coded, and analyzed for emerging themes. Six thematic categories emerged and were organized into 4 environmental contexts: the neighborhood context (accessibility of food and safety of neighborhood), the school context (school food environment), the family context (family health history, role modeling, and monitoring) and the peer context (peer behaviors). Future efforts to reduce the obesity epidemic among low-income African American adolescents should address the social environment of the family; however, positive behavior change may not be sustainable without neighborhood or school food environment modifications. Copyright © 2013 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  20. An Exploration of Decision-Making Processes on Infant Delivery Site from the Perspective of Pregnant Women, New Mothers, and Their Families in Northern Karnataka, India.

    PubMed

    Blanchard, Andrea Katryn; Bruce, Sharon Gail; Jayanna, Krishnamurthy; Gurav, Kaveri; Mohan, Haranahalli L; Avery, Lisa; Moses, Stephen; Blanchard, James Frederick; Ramesh, Banadakoppa M

    2015-09-01

    This study was conducted to explore the decision-making processes regarding sites for delivery of infants among women, their husbands, and mothers-in-law in a rural area of northern Karnataka state, south India. Qualitative semi-structured, individual in-depth interviews were conducted in 2010 among 110 pregnant women, new mothers, husbands and mothers-in-law. Interviews were conducted by trained local researchers in participants' languages and then translated into English. Decisions were made relationally, as family members weighed their collective attitudes and experiences towards a home, private or public delivery. Patterns of both concordance and discordance between women and their families' preferences for delivery site were present. The voice of pregnant women and new mothers was not always subordinate to that of other family members. Still, the involvement of husbands and mothers-in-law was important in decision-making, indicating the need to consider the influence of household gender and power dynamics. All respondent types also expressed shifts in social context and cultural attitudes towards increasing preference for hospital delivery. An appreciation of the interdependence of family members' roles in delivery site decision-making, and how they are influenced by the socio-cultural context, must be considered in frameworks used to guide the development of relevant interventions to improve the utilization and quality of maternal, neonatal and child health services.

  1. Perceptions of leadership and student performance in science from campus leaders in selected high schools

    NASA Astrophysics Data System (ADS)

    Wilder, Sharon Mae

    This naturalistic study focused on the perceptions of leadership and student performance in science from campus leaders in three purposefully selected secondary campuses of ninth through twelfth grades. Each school had experienced an improvement in student passing rates on the science TAKS test that exceeded the state's percent improvement in passing rates for the past three years and had a record of improving science TAKS scores for the period of 2003 to 2008 exceeding fifteen percentage points. The qualitative research technique of multi-case studies design was used. Data was collected through semi-structured, in-depth interviews with four campus leaders from each of the selected schools. These campus leaders included campus administrators, science department chairs, and grade-level team leaders. A framework of transformational leadership was utilized in the analysis of the data generated from the interviews. The perception from the campus leaders was that leadership has a positive impact on student success in science. The findings indicated perceptions of leadership from the campus leaders had certain leadership practices in common. These included (a) clear vision and goals from the campus principal, (b) high performance expectations for teachers and students from administrators and science department leaders, (c) encouragement and support from campus administrators and science department leaders to develop new programs to address problem areas, (d) emphasis on collaborative teams, and (e) open door policy from administrators.

  2. Clinical nurse preceptors' perception of e-portfolio use for undergraduate students.

    PubMed

    Chang, Chi-Ping; Lee, Ting-Ting; Mills, Mary Etta

    Nursing schools and hospitals form partnerships to foster nursing education. Clinical nurse preceptors (CNPs) have a profound influence on nursing students' Last Mile practicum. Assisting preceptors to prepare students as future staff nurses has become a critical issue. E-portfolios utilize digital access and hyperlinks to integrate student knowledge, skills, and achievements with teaching assessment, process and evaluation. Based on the school-hospital partnership, preceptors require a teaching application to facilitate student learning. This descriptive qualitative study explored preceptors' perceptions regarding the use of e-portfolios. Data were collected from November 2012 to March 2013. One-on-one in-depth interviews with preceptors from different hospitals in Taiwan were examined using content analysis. Four key themes were revealed: utilizing students' learning experiences to design the CNP's teaching plan; a group-based discussion platform as a communication channel is needed; posting teaching content to facilitate student learning process; and, motivation usage factors in ease of use, sustaining use and win (student) - win (preceptor) outcomes. The use of e-portfolios allows preceptors to prepare for the learning needs of students. By considering preceptors' preferences, the design of e-portfolios may become more user friendly and useful for preceptors to expedite their teaching process and enhance student learning experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Characterizing the structure and content of nurse handoffs: A Sequential Conversational Analysis approach.

    PubMed

    Abraham, Joanna; Kannampallil, Thomas; Brenner, Corinne; Lopez, Karen D; Almoosa, Khalid F; Patel, Bela; Patel, Vimla L

    2016-02-01

    Effective communication during nurse handoffs is instrumental in ensuring safe and quality patient care. Much of the prior research on nurse handoffs has utilized retrospective methods such as interviews, surveys and questionnaires. While extremely useful, an in-depth understanding of the structure and content of conversations, and the inherent relationships within the content is paramount to designing effective nurse handoff interventions. In this paper, we present a methodological framework-Sequential Conversational Analysis (SCA)-a mixed-method approach that integrates qualitative conversational analysis with quantitative sequential pattern analysis. We describe the SCA approach and provide a detailed example as a proof of concept of its use for the analysis of nurse handoff communication in a medical intensive care unit. This novel approach allows us to characterize the conversational structure, clinical content, disruptions in the conversation, and the inherently phasic nature of nurse handoff communication. The characterization of communication patterns highlights the relationships underlying the verbal content of nurse handoffs with specific emphasis on: the interactive nature of conversation, relevance of role-based (incoming, outgoing) communication requirements, clinical content focus on critical patient-related events, and discussion of pending patient management tasks. We also discuss the applicability of the SCA approach as a method for providing in-depth understanding of the dynamics of communication in other settings and domains. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Resilience in work-related stress among female sex workers in Hong Kong.

    PubMed

    Yuen, Winnie Wing-Yan; Wong, William Chi-Wai; Holroyd, Eleanor; Tang, Catherine So-Kum

    2014-09-01

    The literature on positive psychology and resilience demonstrates that individuals utilize their personal strengths and environmental resources to facilitate positive adaptation. Using a qualitative approach, we investigated how these frameworks operated as self-protective strategies for female sex workers to maintain their psychological and physical well-being under stressful socioeconomic and work-related conditions. Twenty-three female sex workers in Hong Kong participated in in-depth interviews. We used the grounded theory approach for data analysis. The informants reported negative feelings in response to financial burden, clients' demands, threats to physical health, and stigma. Some female sex workers showed their resilience by being able to rationalize their role, believe their ability to make a change in life, and stay optimistic. They adopted strategies including emotional regulation and acceptance of their responsibility and limits to cope with stressful life events. The results help us understand the role of positive psychology and resilience in this vulnerable population. © The Author(s) 2014.

  5. Maintaining an outward image: a Korean immigrant's life with type 2 diabetes mellitus and hypertension.

    PubMed

    Pistulka, Gina M; Winch, Peter J; Park, Hyunjeong; Han, Hae-Ra; Kim, Miyong T

    2012-06-01

    Type 2 diabetes mellitus (DM) and hypertension (HTN) disproportionately affect minority populations in the United States, including Korean American immigrants (KAI). We conducted qualitative interviews with middle-aged KAI in Maryland living with DM and HTN to examine the illness experience to inform future intervention strategies. Study results show that participants utilized strategies to maintain respect and Korean identity, including an image of being healthy and in control of their behavior in the public arena. These strategies included the lack of disclosure of their illness, even to family members, and avoiding outside assistance when engaging in problem solving. Maintaining an outward image of health was a common goal that affected the self-care of KAI in this study, a finding that might prove significant in the management of other chronic illnesses affecting this population. The study findings demonstrate the importance of in-depth understanding of specific populations when treating chronic illness, and caretakers' sensitivity to each population's unique cultural issues regarding identity, image, and disclosure.

  6. From Disabled Students to Disabled Brains: The Medicalizing Power of Rhetorical Images in the Israeli Learning Disabilities Field.

    PubMed

    Katchergin, Ofer

    2017-09-01

    The neurocentric worldview that identifies the essence of the human being with the material brain has become a central paradigm in current academic discourse. Israeli researchers also seek to understand educational principles and processes via neuroscientific models. On this background, the article uncovers the central role that visual brain images play in the learning-disabilities field in Israel. It examines the place brain images have in the professional imagination of didactic-diagnosticians as well as their influence on the diagnosticians' clinical attitudes. It relies on two theoretical fields: sociology and anthropology of the body and sociology of neuromedical knowledge. The research consists of three methodologies: ethnographic observations, in-depth interviews, and rhetorical analysis of visual and verbal texts. It uncovers the various rhetorical and ideological functions of brain images in the field. It also charts the repertoire of rhetorical devices which are utilized to strengthen the neuroreducionist messages contained in the images.

  7. Incorporating elements of social franchising in government health services improves the quality of infant and young child feeding counselling services at commune health centres in Vietnam.

    PubMed

    Nguyen, Phuong H; Kim, Sunny S; Keithly, Sarah C; Hajeebhoy, Nemat; Tran, Lan M; Ruel, Marie T; Rawat, Rahul; Menon, Purnima

    2014-12-01

    Although social franchising has been shown to enhance the quality of reproductive health services in developing countries, its effect on nutrition services remains unexamined. This study assessed the effects of incorporating elements of social franchising on shaping the quality of infant and young child feeding (IYCF) counselling facilities and services in Vietnam. Process-related data collected 12 months after the launch of the first franchises were used to compare randomly assigned Alive & Thrive-supported health facilities (AT-F, n = 20) with standard facilities (SF, n = 12) across three dimensions of service quality: 'structure', 'process' and 'outcome' that capture the quality of facilities, service delivery, and client perceptions and use, respectively. Data collection included facility assessments (n = 32), staff surveys (n = 96), counselling observations (n = 137), client exit interviews (n = 137) and in-depth interviews with mothers (n = 48). Structure: AT-F were more likely to have an unshared, well-equipped room for nutrition counselling than SF (65.0% vs 10.0%). Compared with SF providers, AT-F staff had better IYCF knowledge (mean score 9.9 vs 8.8, range 0-11 for breastfeeding; mean score 3.6 vs 3.2, range 0-4 for complementary feeding). AT-F providers also demonstrated significantly better interpersonal communication skills (score 9.6 vs 5.1, range 0-13) and offered more comprehensive counselling sessions. Overall utilization of franchises was low (10%). A higher proportion of pregnant women utilized franchise services (48.9%), compared with mothers with children 6-23.9 months (1.4%). There was no quantitative difference in client satisfaction with counselling services between AT-F and SF, but franchise users praised the AT-F for problem solving related to child feeding. Incorporating elements of social franchising significantly enhances the quality of IYCF counselling services within government primary healthcare facilities, particularly their structural and process attributes. Provided that service utilization is improved through demand generation, this model has the potential to impact IYCF practices and child nutrition. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  8. Minimizing Confusion and Disorientation: Cognitive Support Work in Informal Dementia Caregiving

    PubMed Central

    Berry, Brandon

    2015-01-01

    Drawing from ethnographic fieldwork and in-depth interviews, I explain how informal dementia caregivers attempt to reduce the affected individual’s moments of confusion and disorientation through cognitive support work. I identify three stages through which such support takes shape and then gradually declines in usage. In a first stage, family members collaborate with affected individuals to first identify and then to avoid “triggers” that elicit sudden bouts of confusion. In a second stage, caregivers lose the effective collaboration of the affected individual and begin unilateral attempts to minimize confused states through pre-emptive conversational techniques, third-party interactional support, and social-environment shifts. In a third stage, caregivers learn that the affected individual has reached a level of impairment that does not respond well to efforts at reduction and begin abandoning strategies. I identify the motivations driving cognitive support work and discuss the role of lay health knowledge in dementia caregiving. I conclude by considering the utility of cognitive support as a concept within dementia caregiving. PMID:24984915

  9. A qualitative analysis of parental decision making for childhood immunisation.

    PubMed

    Marshall, S; Swerissen, H

    1999-10-01

    Achieving high rates of childhood immunisation is an important public health aim. Currently, however, immunisation uptake in Australia is disappointing. This qualitative study investigated the factors that influence parental decision making for childhood immunisation, and whether parents' experiences were better conceptualised in terms of static subjective expected utility models or in terms of a more dynamic process. Semi-structured in-depth interviews were conducted with 20 predominantly middle-class mothers--17 immunizers and three non-immunizers, in Melbourne, Victoria, in 1997. The data were then examined using thematic analysis. The results suggested that for these participants the decision regarding childhood immunization was better conceptualized as a dynamic process. The decision required initial consideration, implementation then maintenance. If a better understanding of immunization decision making is to be achieved, future studies must look beyond static frameworks. Clearer insight into the dynamic nature of immunization decision making should assist in the identification of more effective methods of promoting childhood immunization to groups at risk of non-compliance.

  10. Rural patients' experiences of the open disclosure of adverse events.

    PubMed

    Piper, Donella; Iedema, Rick; Bower, Kate

    2014-08-01

    To analyse rural patients' and their families' experiences of open disclosure and offer recommendations to improve disclosure in rural areas. Retrospective qualitative study based on a subset of 13 semistructured, in-depth interviews with rural patients from a larger dataset. The larger data set form a nationwide, multisite, retrospective-qualitative study that included 100 semistructured, in-depth interviews with 119 patients and family members who were involved in high-severity health care incidents and incident disclosure. The larger study is known as the '100 Patient Stories' study. Interviews were transcribed verbatim and analysed by one analyst (D.P.) for recurrent experiences and concerns. Acute care. A sub-set of 13 of the 100 participants from the '100 Patient Stories' study who identified as experiencing an adverse incident in a rural or regional area. Patients' and family members' perceptions and experiences of health care incident disclosure, as expressed in interviews. Rural patients and clinicians experience additional challenges to metropolitan patients and clinicians in their experiences of health care incidents. These additional barriers include: a lack of resources at small hospitals; delays in diagnosis and transfer; distance between services; and a lack of communication between providers. These challenges impact not only upon how patients and their families experience incidents, but also how open disclosure is implemented. This analysis of 13 of the 100 Patient Stories interviews provides guidance to rural health services on how to conduct open disclosure. © 2014 National Rural Health Alliance Inc.

  11. Changes in methanogenic substrate utilization and communities with depth in a salt-marsh, creek sediment in southern England

    NASA Astrophysics Data System (ADS)

    John Parkes, R.; Brock, Fiona; Banning, Natasha; Hornibrook, Edward R. C.; Roussel, Erwan G.; Weightman, Andrew J.; Fry, John C.

    2012-01-01

    A combined biogeochemical and molecular genetic study of creek sediments (down to 65 cm depth) from Arne Peninsula salt-marsh (Dorset, UK) determined the substrates used for methanogenesis and the distribution of the common methanogens, Methanosarcinales and Methanomicrobiales capable of metabolising these substrates. Methane concentrations increased by 11 cm, despite pore water sulphate not being removed until 45 cm. Neither upward methane diffusion or anaerobic oxidation of methane seemed to be important in this zone. In the near-surface sulphate-reduction zone (5-25 cm) turnover time to methane for the non-competitive methanogenic substrate trimethylamine was most rapid (80 days), and were much longer for acetate (7900 days), methanol (40,500 days) and bicarbonate (361,600 days). Methylamine-utilizing Methanosarcinales were the dominant (60-95%) methanogens in this zone. In deeper sediments rates of methanogenesis from competitive substrates increased substantially, with acetate methanogenic rates becoming ˜100 times greater than H 2/CO 2 methanogenesis below 50 cm. In addition, there was a dramatic change in methanogen diversity with obligate acetate-utilizing, Methanosaeta related sequences being dominant. At a similar depth methanol turnover to methane increased to its most rapid (1700 days). This activity pattern is consistent with deeper methanogen populations (55 cm) being dominated by acetate-utilizing Methanosaeta with H 2/CO 2 and alcohol-utilizing Methanomicrobiales also present. Hence, there is close relationship between the depth distribution of methanogenic substrate utilization and specific methanogens that can utilize these compounds. It is unusual for acetate to be the dominant methanogenic substrate in coastal sediments and δ13C-CH 4 values (-74 to -71‰) were atypical for acetate methanogenesis, suggesting that common stable isotope proxy models may not apply well in this type of dynamic anoxic sediment, with multiple methanogenic substrates.

  12. Developing an Unguided Internet-Delivered Intervention for Emotional Distress in Primary Care Patients: Applying Common Factor and Person-Based Approaches.

    PubMed

    Geraghty, Adam Wa; Muñoz, Ricardo F; Yardley, Lucy; Mc Sharry, Jennifer; Little, Paul; Moore, Michael

    2016-12-20

    Developing effective, unguided Internet interventions for mental health represents a challenge. Without structured human guidance, engagement with these interventions is often limited and the effectiveness reduced. If their effectiveness can be increased, they have great potential for broad, low-cost dissemination. Improving unguided Internet interventions for mental health requires a renewed focus on the proposed underlying mechanisms of symptom improvement and the involvement of target users from the outset. The aim of our study was to develop an unguided e-mental health intervention for distress in primary care patients, drawing on meta-theory of psychotherapeutic change and utilizing the person-based approach (PBA) to guide iterative qualitative piloting with patients. Common factors meta-theory informed the selection and structure of therapeutic content, enabling flexibility whilst retaining the proposed necessary ingredients for effectiveness. A logic model was designed outlining intervention components and proposed mechanisms underlying improvement. The PBA provided a framework for systematically incorporating target-user perspective into the intervention development. Primary care patients (N=20) who had consulted with emotional distress in the last 12 months took part in exploratory qualitative interviews, and a subsample (n=13) undertook think-aloud interviews with a prototype of the intervention. A flexible intervention was developed, to be used as and when patients need, diverting from a more traditional, linear approach. Based on the in-depth qualitative findings, disorder terms such as "depression" were avoided, and discussions of psychological symptoms were placed in the context of stressful life events. Think-aloud interviews showed that patients were positive about the design and structure of the intervention. On the basis of patient feedback, modifications were made to increase immediate access to all therapeutic techniques. Detailing theoretical assumptions underlying Internet interventions for mental health, and integrating this approach with systematic in-depth qualitative research with target patients is important. These strategies may provide novel ways for addressing the challenges of unguided delivery. The resulting intervention, Healthy Paths, will be evaluated in primary care-based randomized controlled trials, and deployed as a massive open online intervention (MOOI). ©Adam WA Geraghty, Ricardo F Muñoz, Lucy Yardley, Jennifer Mc Sharry, Paul Little, Michael Moore. Originally published in JMIR Mental Health (http://mental.jmir.org), 20.12.2016.

  13. The Interactive Candidate Assessment Tool: A New Way to Interview Residents.

    PubMed

    Platt, Michael P; Akhtar-Khavari, Vafa; Ortega, Rafael; Schneider, Jeffrey I; Fineberg, Tabitha; Grundfast, Kenneth M

    2017-06-01

    The purpose of the residency interview is to determine the extent to which a well-qualified applicant is a good fit with a residency program. However, questions asked during residency interviews tend to be standard and repetitive, and they may not elicit information that best differentiates one applicant from another. The iCAT (interactive Candidate Assessment Tool) is a novel interview instrument that allows both interviewers and interviewees to learn about each other in a meaningful way. The iCAT uses a tablet computer to enable the candidate to select questions from an array of video and nonvideo vignettes. Vignettes include recorded videos regarding some aspect of the program, while other icons include questions within recognizable categories. Postinterview surveys demonstrated advantages over traditional interview methods, with 93% agreeing that it was an innovative and effective tool for conducting residency program interviews. The iCAT for residency interviews is a technological advancement that facilitates in-depth candidate assessment.

  14. The Significance of Privacy and Trust in Providing Health-Related Services to Behaviorally Bisexual Men in the United States

    PubMed Central

    Dodge, Brian; Schnarrs, Phillip W.; Goncalves, Gabriel; Malebranche, David; Martinez, Omar; Reece, Michael; Rhodes, Scott D.; Van Der Pol, Barbara; Nix, Ryan; Fortenberry, J. Dennis

    2012-01-01

    Previous research suggests that bisexual men face unique health concerns in comparison to their exclusively homosexual and heterosexual counterparts. However, little is known about behaviorally bisexual men’s experiences with health services, including ways of providing services that would be most appropriate to meet the health needs of this population. This study sought to understand preferences for health-related services among behaviorally bisexual men in the Midwestern United States. Using a community-based research approach, a diverse sample of 75 behaviorally bisexual men was recruited for in-depth interviews. Qualitative data were analyzed utilizing inductive coding through established team-based protocols to ensure reliability. Themes emerged involving the importance of privacy and trust when reaching, recruiting, and engaging behaviorally bisexual men in health services. Findings suggest that multifaceted approaches are needed, including those that provide relevant and confidential services while allowing for the development and ongoing maintenance of trust. PMID:22676463

  15. Multiple Family Groups for Child Behavior Difficulties Retention Among Child Welfare–Involved Caregivers

    PubMed Central

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P.

    2013-01-01

    Among children who remain at home with their permanent caregivers following a child welfare investigation, few who manifest emotional and behavioral difficulties actually engage in mental health treatment. The Multiple Family Group service delivery model to reduce childhood disruptive behavior disorders (MFG) has shown promise in engaging child welfare-involved families. This qualitative study examines caregiver perceptions of factors that influence retention in MFGs among child welfare-involved families. Methods Twenty-five predominantly Black and Hispanic adult (ages 26–57) female caregivers with child welfare services involvement participated in individual, in-depth interviews about their experience with MFGs. Transcribed interview data were thematically coded guided by grounded theory methodology. Emergent themes were subsequently organized into a conceptual framework. Results Within the overarching influence of child welfare services involvement, specific components of MFGs influencing retention included the quality of interaction among group members, group facilitators’ attentive approach with caregivers, supports designed to overcome logistical barriers (i.e., child care, transportation expenses, meals), and perceptions of MFG content and activities as fun and helpful. Caregiver factors, including their mental health and personal characteristics, as well as children’s behavior, (i.e., observed changes in behavioral difficulties) were also associated with retention. Conclusions High acceptability suggest utility for implementing MFGs within settings serving child welfare involved families, with additional modifications to tailor to setting and client features. PMID:26527856

  16. Sea Water Characterization at Ujung Kulon Coastal Depth as Raw Water Source for Desalination and Potential Energy

    NASA Astrophysics Data System (ADS)

    Mugisidi, Dan; Heriyani, Okatrina

    2018-02-01

    Fresh water is basic need for life while the source is limited. Therefore, sea water is used as fresh water through desalination process. Sea water has different physical and chemical properties ranging from the surface to the seabed. The energy potential that can be obtained from the hydrostatic pressure also changes according to the depth. As part of the research of the utilization of sea water into fresh water, the aim of this study is to know the characteristics of sea water in the depth that can be utilized as source of fresh water. The sea water samples were taken at 11km from Ujung Kulon beach with depth of 0m, 20m, 40m, 60m, 80m, and 100m under the surface. The results showed that the physical properties at every depth were below the maximum allowable drinking water except for the amount of dissolved solids. Chemical characteristics at any depth above allowable level were fluoride, hardness (CaCo3), chloride, sodium, sulphate, and (KMnO4). In addition to the properties, pressure is one of the considerations in this study to determine the depth of sea water as sources for desalination. Pressure increased by 36.11% as the depth of the sea increased.

  17. Interrelations between siblings and parents in families living with children with cancer.

    PubMed

    Kobayashi, Kyoko; Hayakawa, Akira; Hohashi, Naohiro

    2015-02-01

    Having a child diagnosed with cancer is a stressful event for the family. This exploratory multimethod study utilized both quantitative and qualitative multiinformant methodologies to investigate the relationships between parental family functioning and siblings' health-related quality of life (HRQOL) and to describe interrelations between the experiences of parents and siblings of children with childhood cancer. A total of 14 Japanese families participated in the quantitative study, and 4 families of the 14 participated in the qualitative study. In-depth, semistructured interviews revealed three family-unit stages during the time course of the ill child's treatment that included particular parent-sibling interrelations. We also found strong correlation between parental family functioning and siblings' HRQOL in the quantitative study. The results suggest the importance of family nursing interventions directed to individual family members and the family unit that focus on strengthening the parent-sibling relationship and supporting families who are experiencing childhood cancer. © The Author(s) 2014.

  18. Acceptability and Feasibility of HIV Self-Testing Among Transgender Women in San Francisco: A Mixed Methods Pilot Study.

    PubMed

    Lippman, Sheri A; Moran, Lissa; Sevelius, Jae; Castillo, Leslie S; Ventura, Angel; Treves-Kagan, Sarah; Buchbinder, Susan

    2016-04-01

    An estimated one in four transgender women (trans women) in the U.S. are infected with HIV. Rates of HIV testing are not commensurate with their risk, necessitating alternative strategies for early detection and care. We explored the feasibility and acceptability of HIV self-testing (HIVST) with 50 HIV-negative adult trans women in San Francisco. Participants received three self-test kits to perform once a month. Acceptability and behavioral surveys were collected as were 11 in-depth interviews (IDIs). Among 50 participants, 44 reported utilizing HIVST at least once; 94 % reported the test easy to use; 93 % said results were easy to read; and 91 % would recommend it to others. Most participants (68 %) preferred HIVST to clinic-based testing, although price was a key barrier to uptake. IDIs revealed a tension between desires for privacy versus support found at testing sites. HIVST for trans women was acceptable and feasible and requires careful consideration of linkage to support services.

  19. Factors influencing palliative care. Qualitative study of family physicians' practices.

    PubMed Central

    Brown, J. B.; Sangster, M.; Swift, J.

    1998-01-01

    OBJECTIVE: To examine factors that influence family physicians' decisions to practise palliative care. DESIGN: Qualitative method of in-depth interviews. SETTING: Southwestern Ontario. PARTICIPANTS: Family physicians who practise palliative care on a full-time basis, who practise on a part-time basis, or who have retired from active involvement in palliative care. METHOD: Eleven in-depth interviews were conducted to explore factors that influence family physicians' decisions to practise palliative care and factors that sustain their interest in palliative care. All interviews were audiotaped and transcribed verbatim. The analysis strategy used a phenomenological approach and occurred concurrently rather than sequentially. All interview transcriptions were read independently by the researchers, who then compared and combined their analyses. Final analysis involved examining all interviews collectively, thus permitting relationships between and among central themes to emerge. MAIN OUTCOME FINDINGS: The overriding theme was a common philosophy of palliative care focusing on acceptance of death, whole person care, compassion, communication, and teamwork. Participants' philosophies were shaped by their education and by professional and personal experiences. In addition, participants articulated personal and systemic factors currently affecting their practice of palliative care. CONCLUSIONS: Participants observed that primary care physicians should be responsible for their patients' palliative care within the context of interdisciplinary teams. For medical students to be knowledgeable and sensitive to the needs of dying patients, palliative care should be given higher priority in the curriculum. Finally, participants argued compellingly for transferring the philosophy of palliative care to the overall practice of medicine. PMID:9612588

  20. Frailty and its prediction of disability and health care utilization: the added value of interviews and physical measures following a self-report questionnaire.

    PubMed

    Gobbens, Robbert J J; van Assen, Marcel A L M

    2012-01-01

    To establish whether the prediction of the adverse outcomes disability and six indicators of health care utilization one and two years later by the three frailty domains (physical, psychological, social) of the Tilburg Frailty Indicator (TFI) is improved by adding interview and physical measures of frailty. A representative sample of 245 Dutch community-dwelling persons aged 75 years and older (response rate 53%) participated in 2008, one year later in 2009 (n=179, 73%) and again two years later in 2010 (n=141, 58%). Frailty was assessed with the TFI, an easy to administer self-report measure. Disability was measured using the Groningen Activity Restriction Scale (GARS). Indicators of health care utilization were: visit to a general practitioner (gp), contacts with health care professionals (hcps), hospital admission, receiving personal care, receiving nursing care, and receiving informal care. After controlling for background characteristics, the TFI predicted disability and the indicators of health care utilization. Interviews and physical measures of frailty improved the prediction of disability. The Hospital Anxiety and Depression Scale (HADS-A) improved the prediction of contacts with hcps, but the interview and physical measures of frailty did not improve the predictions of the other indicators of health care utilization. Assessment by the self-report TFI is sufficient for predicting six indicators of health care utilization, but for predicting disability the use of both the TFI and the Timed Up & Go (TUG) test is recommended. It is advisable assessing all three frailty domains when examining frailty and its prediction of adverse outcomes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Feasibility, acceptability and clinical utility of the Cultural Formulation Interview: mixed-methods results from the DSM-5 international field trial.

    PubMed

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan; Lam, Peter C; Galfalvy, Hanga; Weiss, Mitchell G; Kirmayer, Laurence J; Paralikar, Vasudeo; Deshpande, Smita N; Díaz, Esperanza; Nicasio, Andel V; Boiler, Marit; Alarcón, Renato D; Rohlof, Hans; Groen, Simon; van Dijk, Rob C J; Jadhav, Sushrut; Sarmukaddam, Sanjeev; Ndetei, David; Scalco, Monica Z; Bassiri, Kavoos; Aguilar-Gaxiola, Sergio; Ton, Hendry; Westermeyer, Joseph; Vega-Dienstmaier, Johann M

    2017-04-01

    Background There is a need for clinical tools to identify cultural issues in diagnostic assessment. Aims To assess the feasibility, acceptability and clinical utility of the DSM-5 Cultural Formulation Interview (CFI) in routine clinical practice. Method Mixed-methods evaluation of field trial data from six countries. The CFI was administered to diagnostically diverse psychiatric out-patients during a diagnostic interview. In post-evaluation sessions, patients and clinicians completed debriefing qualitative interviews and Likert-scale questionnaires. The duration of CFI administration and the full diagnostic session were monitored. Results Mixed-methods data from 318 patients and 75 clinicians found the CFI feasible, acceptable and useful. Clinician feasibility ratings were significantly lower than patient ratings and other clinician-assessed outcomes. After administering one CFI, however, clinician feasibility ratings improved significantly and subsequent interviews required less time. Conclusions The CFI was included in DSM-5 as a feasible, acceptable and useful cultural assessment tool. © The Royal College of Psychiatrists 2017.

  2. Pathways of the association between maternal employment and weight status among women and children: Qualitative findings from Guatemala.

    PubMed

    Oddo, Vanessa M; Surkan, Pamela J; Hurley, Kristen M; Lowery, Caitlin; de Ponce, Silvia; Jones-Smith, Jessica C

    2018-01-01

    The double burden of malnutrition, defined by the coexistence of undernutrition and overweight, is well documented in low- and middle-income countries. However, the mechanisms by which employment may be related to maternal and child weight status in low- and middle-income countries are not well understood. We conducted in-depth interviews among 20 mothers who participated in Project MIEL, a contemporary trial which evaluated the effects of an integrated micronutrient supplement and parenting intervention in rural Guatemala. We utilized semi-structured interviews to explore the pathways by which maternal employment might influence bodyweight. Interviews were structured to explore the factors that mothers considered when deciding whether or not to participate in the labor force and how mothers perceived the influence of employment on determinants of their own bodyweight and that of their children. Themes were used to develop a conceptual framework. Mothers described four pathways through which employment could lead to changes in weight status: changes in food purchasing; improved household well-being; changes in time allocation; and psychological effects. Mothers described purchasing increased quantities and more varied types of food, as well as the purchase of energy-dense foods. Less time to devote to food preparation resulted in mothers preparing quicker meals and relying on substitute childcare. Mothers also expressed feelings of worry and neglect in relation to being employed, and perceived that these feelings would affect weight. A better understanding of these mechanisms is important for developing policies and programs to support women in the workplace and also reducing maternal and child overweight in Guatemala. © 2017 John Wiley & Sons Ltd.

  3. Bayesian Bigot? Statistical Discrimination, Stereotypes, and Employer Decision Making

    PubMed Central

    Pager, Devah; Karafin, Diana

    2010-01-01

    Much of the debate over the underlying causes of discrimination centers on the rationality of employer decision making. Economic models of statistical discrimination emphasize the cognitive utility of group estimates as a means of dealing with the problems of uncertainty. Sociological and social-psychological models, by contrast, question the accuracy of group-level attributions. Although mean differences may exist between groups on productivity-related characteristics, these differences are often inflated in their application, leading to much larger differences in individual evaluations than would be warranted by actual group-level trait distributions. In this study, the authors examine the nature of employer attitudes about black and white workers and the extent to which these views are calibrated against their direct experiences with workers from each group. They use data from fifty-five in-depth interviews with hiring managers to explore employers’ group-level attributions and their direct observations to develop a model of attitude formation and employer learning. PMID:20686633

  4. Assessing culture via the Internet: methods and techniques for psychological research.

    PubMed

    Barry, D T

    2001-02-01

    This study examines the acculturation experiences of Arabic immigrants and assesses the utility of the Internet as a data collection tool. Based on in-depth pilot interview data from 10 male Arabic immigrants and items selected from pre-existing measures, the Male Arabic Ethnic Identity Measure (MAEIM) was developed. Male Arab immigrants (115 males) were solicited through traditional methods in addition to the Internet. Satisfactory reliability and validity were reported for the MAEIM. No significant differences emerged between the Internet and Midwestern samples. The Internet proved to be an effective method for soliciting a relatively large, geographically dispersed sample of Arabic immigrants. The use of the Internet as a research tool is examined in the context of anonymity, networking, low-cost, perceived interactive control, methodological rigor, and external validity. The Internet was an effective vehicle for addressing concerns raised by prospective participants. It is suggested that the Internet may be an important method to assess culture-relevant variables in further research on Arab and other immigrant populations.

  5. Adolescent survivors after suicide: Australian young people’s bereavement narratives.

    PubMed

    Bartik, Warren; Maple, Myfanwy; Edwards, Helen; Kiernan, Michael

    2013-01-01

    While the research literature exploring suicide bereavement has expanded in recent years, this has been primarily quantitative and has focused more on the bereavement experience of parents and siblings. The bereavement experience of young people affected through the suicide death of a friend remains under-conceptualized and not well understood. To develop an understanding of the experiences of young people bereaved by the suicide of a friend. Ten young people participated in a pilot study with in-depth interviews to explore their suicide bereavement experiences. Narrative inquiry methodology was utilized to analyze the qualitative data. The findings indicated multiple grief experiences caused by suicide. Four themes reported are meaning making, feeling guilt, risky coping behavior, and relating to friends following suicide loss. Implications include the need for increased awareness that friends of young people who die by suicide may have significant health and well-being challenges associated with bereavement, and that friends in these circumstances may not readily present at services for assistance.

  6. Health Access Livelihood Framework Reveals Potential Barriers in the Control of Schistosomiasis in the Dongting Lake Area of Hunan Province, China

    PubMed Central

    McManus, Donald P.; Raso, Giovanna; Utzinger, Jürg; Xiao, Shui-Yuan; Yu, Dong-Bao; Zhao, Zheng-Yuan; Li, Yue-Sheng

    2013-01-01

    Background Access to health care is a major requirement in improving health and fostering socioeconomic development. In the People's Republic of China (P.R. China), considerable changes have occurred in the social, economic, and health systems with a shift from a centrally planned to a socialist market economy. This brought about great benefits and new challenges, particularly for vertical disease control programs, including schistosomiasis. We explored systemic barriers in access to equitable and effective control of schistosomiasis. Methodology Between August 2002 and February 2003, 66 interviews with staff from anti-schistosomiasis control stations and six focus group discussions with health personnel were conducted in the Dongting Lake area, Hunan Province. Additionally, 79 patients with advanced schistosomiasis japonica were interviewed. The health access livelihood framework was utilized to examine availability, accessibility, affordability, adequacy, and acceptability of schistosomiasis-related health care. Principal Findings We found sufficient availability of infrastructure and human resources at most control stations. Many patients with advanced schistosomiasis resided in non-endemic or moderately endemic areas, however, with poor accessibility to disease-specific knowledge and specialized health services. Moreover, none of the patients interviewed had any form of health insurance, resulting in high out-of-pocket expenditure or unaffordable care. Reports on the adequacy and acceptability of care were mixed. Conclusions/Significance There is a need to strengthen health awareness and schistosomiasis surveillance in post-transmission control settings, as well as to reduce diagnostic and treatment costs. Further studies are needed to gain a multi-layered, in-depth understanding of remaining barriers, so that the ultimate goal of schistosomiasis elimination in P.R. China can be reached. PMID:23936580

  7. The motivators and barriers to a smoke-free home among disadvantaged caregivers: identifying the positive levers for change.

    PubMed

    Jones, Laura L; Atkinson, Olesya; Longman, Jo; Coleman, Tim; McNeill, Ann; Lewis, Sarah A

    2011-06-01

    The aims of this study were to explore home smoking behaviors and the motivators and barriers to smoke-free homes among a group of disadvantaged caregivers for young children and to identify the positive levers that health care professionals can utilize when supporting smoking behavior change. In-depth qualitative interviews were conducted between July and September 2009, with 22 disadvantaged smoking caregivers, accessing Children's Centre Services in Nottingham, UK. Interviews were audiorecorded and transcribed verbatim. Data were coded and analyzed thematically to identify emergent main and subthemes. Caregivers had some general understanding of the dangers of secondhand smoke (SHS), but their knowledge appeared incomplete and confused. All interviewees described rules around smoking in the home; however, these tended to be transient and fluid and unlikely to be effective. Caregivers were often living in difficult and complex circumstances and experienced significant barriers to creating a smoke-free home. The motivators for change were more strongly linked to house decor and smell than children's health, suggesting that visible evidence of the harm done by SHS to children might help promote smoke-free homes. Findings suggest that further tailored information on the effect of SHS is required, but to instigate caregiver behavior change, providing demonstrable evidence of the impact that their smoking is having on their children's health is more likely to be effective.

  8. Factors influencing antibiotic prescribing in long-term care facilities: a qualitative in-depth study.

    PubMed

    van Buul, Laura W; van der Steen, Jenny T; Doncker, Sarah M M M; Achterberg, Wilco P; Schellevis, François G; Veenhuizen, Ruth B; Hertogh, Cees M P M

    2014-12-16

    Insight into factors that influence antibiotic prescribing is crucial when developing interventions aimed at a more rational use of antibiotics. We examined factors that influence antibiotic prescribing in long-term care facilities, and present a conceptual model that integrates these factors. Semi-structured qualitative interviews were conducted with physicians (n = 13) and nursing staff (n = 13) in five nursing homes and two residential care homes in the central-west region of the Netherlands. An iterative analysis was applied to interviews with physicians to identify and categorize factors that influence antibiotic prescribing, and to integrate these into a conceptual model. This conceptual model was triangulated with the perspectives of nursing staff. The analysis resulted in the identification of six categories of factors that can influence the antibiotic prescribing decision: the clinical situation, advance care plans, utilization of diagnostic resources, physicians' perceived risks, influence of others, and influence of the environment. Each category comprises several factors that may influence the decision to prescribe or not prescribe antibiotics directly (e.g. pressure of patients' family leading to antibiotic prescribing) or indirectly via influence on other factors (e.g. unfamiliarity with patients resulting in a higher physician perceived risk of non-treatment, in turn resulting in a higher tendency to prescribe antibiotics). Our interview study shows that several non-rational factors may affect antibiotic prescribing decision making in long-term care facilities, suggesting opportunities to reduce inappropriate antibiotic use. We developed a conceptual model that integrates the identified categories of influencing factors and shows the relationships between those categories. This model may be used as a practical tool in long-term care facilities to identify local factors potentially leading to inappropriate prescribing, and to subsequently intervene at the level of those factors to promote appropriate antibiotic prescribing.

  9. Retention and sustainability of community-based health volunteers' activities: A qualitative study in rural Northern Ghana.

    PubMed

    Chatio, Samuel; Akweongo, Patricia

    2017-01-01

    The shortage of formal health workers has led to the utilization of Community-Based Health Volunteers (CBHV) to provide health care services to people especially in rural and neglected communities. Community-based health volunteers have been effective partners in health care delivery at the community level for many years. The challenge is how to retain these volunteers and also sustain their activities. This study explored factors affecting retention and sustainability of community-based health volunteers' activities in a rural setting in Northern Ghana. This was a qualitative study comprising thirty-two in-depth interviews (IDIs) with health volunteers and health workers in-charge of health volunteers' activities. Purposive sampling technique was used to select study participants for the interviews. The interviews were transcribed and coded into themes using Nvivo 10 software. The thematic analysis framework was used to analyze the data. Study participants reported that the desire to help community members, prestige and recognition as doctors in community mainly motivated them to work as health volunteers. Lack of incentives and logistical supplies such as raincoats, torch lights, wellington boots and transportation in the form of bicycles to facilitate the movement of health volunteers affected the work. They suggested that lack of these things discouraged them from working as health volunteers. Most of the dropout volunteers said lack of support and respect from community members made them to stop working as health volunteers. They recommended that community support, incentives and logistical supplies such as raincoats, torch light, wellington boots, bicycles, awards to hard working volunteers are mechanisms that can help retain community-based health volunteers and also sustain their activities. Providing means of transport and non-monetary incentives would help to retain community-based health volunteers and also sustain their activities at the community level.

  10. The role of culture in breast health practices among Chinese-Australian women.

    PubMed

    Kwok, Cannas; Sullivan, Gerard; Cant, Rosemary

    2006-12-01

    Exploring how cultural meanings of the breast impact on perceived images of breast cancer and breast health practices. In-depth interviews were conducted with 20 Chinese-Australian women in their native language (Cantonese). The findings revealed that the meanings of the breast are constructed within the women's social and cultural context where breasts are associated with sex; and talking about, being concerned with or expressing curiosity about breasts is considered inappropriate. These views have a significant impact on (1) the way the informants viewed breast cancer; (2) perceptions of breast health practices; and (3) the explanations of breast cancer and associated risk perception. Understanding the nature of culturally-based barriers to utilization of breast cancer screening is the first step to discovering solutions for making screening tests more acceptable to women from other cultures. This study provides insight about obstacles for breast health promotion practices and for developing culturally appropriate health education programs and counselling strategies.

  11. "It Can Promote an Existential Crisis": Factors Influencing Pap Test Acceptability and Utilization Among Transmasculine Individuals.

    PubMed

    Peitzmeier, Sarah M; Agénor, Madina; Bernstein, Ida M; McDowell, Michal; Alizaga, Natalie M; Reisner, Sari L; Pardee, Dana J; Potter, Jennifer

    2017-12-01

    Transmasculine (i.e., female-to-male transgender) individuals have lower rates of cervical cancer screening than nontransgender women and often report negative experiences with the Pap test. Deciding to undergo screening and the test experience itself are characterized by the following processes: negotiating identity as the patient, provider, and insurance company wrestle with the degree of (in)congruence between a patient's masculine gender identity and their conception of the Pap test as feminine; bargaining for health as a Pap test may be required to obtain medical transition services or avoid undesired health outcomes; withstanding acute challenges during the Pap test to body, identity, and privacy; or reframing challenges as affirmation. The degree of distress triggered by the Pap test varied from "routine" to traumatic. Participants affirmed that a trusted, trans-competent health care provider could significantly reduce barriers to regular and satisfactory cervical cancer screening. Data are from 32 in-depth interviews conducted in Boston, Massachusetts, with transmasculine individuals; a modified grounded theory approach informed the analysis.

  12. The Relationship Quality Interview: Evidence of Reliability, Convergent and Divergent Validity, and Incremental Utility

    ERIC Educational Resources Information Center

    Lawrence, Erika; Barry, Robin A.; Brock, Rebecca L.; Bunde, Mali; Langer, Amie; Ro, Eunyoe; Fazio, Emily; Mulryan, Lorin; Hunt, Sara; Madsen, Lisa; Dzankovic, Sandra

    2011-01-01

    Relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention has been paid to the assessment of relationship quality. The present study introduces the Relationship Quality Interview (RQI), a semistructured, behaviorally anchored individual interview.…

  13. Utilizing the Walking Interview to Explore Campus Climate for Students of Color

    ERIC Educational Resources Information Center

    Harris, Jessica

    2016-01-01

    This article explores the walking interview as a qualitative tool to assess campus climate. Using examples from a study that employed the walking interview, the author elucidates how this method of data collection allows for in situ understandings of participants' perceptions, spatial practices, biographies, social architecture, and social realms…

  14. Palliative care clients' and caregivers' notion of fear and their strategies for overcoming it.

    PubMed

    Penman, Joy; Ellis, Bronwyn

    2015-06-01

    This paper aims to clarify our understanding of fear and explore the strategies employed by people with life-limiting conditions and their caregivers in addressing the emotion of fear as they journey through the dying process. The role of fear is discussed: different kinds of fear, the tangible and intangible measures by which people manage their fear, and the ways of transcending fear. The findings of a larger research project funded by the Australian Department of Health and Ageing are drawn upon. In-depth interviews were conducted with clients and caregivers relating to the psychosocial and emotional issues in palliative care. Secondary analysis was utilized to examine the perceptions of fear in this cohort. While there were many other findings, the results highlighted in this paper relate to the notion of fear among interview participants. Interview data showed that people with life-limiting conditions and their caregivers had different types of fear and employed a variety of strategies to deal with fear. Four themes emerged embodying these strategies: calling on their own resilience and inner resources, maintaining human relationships, gaining the ability to "keep one step ahead" in the dying process, and engaging in spirituality and religion. The implications of the findings for healthcare professionals are highlighted. The recognition of emotions is embedded in palliative care; healthcare professionals should view the management of emotions as an integral part of professional practice. Addressing fear is essential because unresolved fear can impinge on one's ability to cope. Our paper brings together different perspectives on fear and how vulnerable individuals attempt to cope with it while at the same time providing a view of the challenges confronting healthcare professionals who are engaged with them and committed to optimizing health outcomes for palliative care clients and their caregivers.

  15. An evaluation of students' perceptions of a college-based programme that involves patients, carers and service users in physiotherapy education.

    PubMed

    Thomson, Di; Hilton, Ros

    2012-03-01

    There is little evidence of the integration of UK physiotherapy university education into clinical practice, and some students say that they are not adequately prepared for professional life. This was addressed by a college-based programme involving patients, carers and service users as facilitators of learning to enhance the partnership between health professionals and patients. This programme has been running for 2 years, and this paper is an evaluation of the students' perceptions of it, appraising the outcomes of their learning in order to discover the ways in which it can be enhanced, improved or changed. A grounded theory approach utilizing focus groups and semi-structured interviews was conducted. Three focus groups representing the higher educational levels 4-6 in pre-registration physiotherapy were carried out. Following the analysis of the focus groups, seven interviews reflecting the three educational levels were conducted in order to explore in greater depth the findings from the focus groups. The analysis of the focus groups and the subsequent interviews were carried out in accordance with a grounded theory framework. The students perceived the programme as a context in which to think how their learning needs could be met within a 'real' framework but on their own territory. Equally, it created feelings of anxiety at being given such an open forum that created a challenge to their communication skills. Many expressed a wish for a more explicit mentoring-learning environment. They also perceived a tension between the technical-rational demands of academia and social practice and a need to view this as a basis for critical appraisal and self-awareness. This programme appeared to be integral to the students' development as future physiotherapists. Copyright © 2011 John Wiley & Sons, Ltd.

  16. Increasing Consumer Engagement by Tailoring a Public Reporting Website on the Quality of Diabetes Care: A Qualitative Study.

    PubMed

    Smith, Maureen A; Bednarz, Lauren; Nordby, Peter A; Fink, Jennifer; Greenlee, Robert T; Bolt, Daniel; Magnan, Elizabeth M

    2016-12-21

    The majority of health care utilization decisions in the United States are made by persons with multiple chronic conditions. Existing public reports of health system quality do not distinguish care for these persons and are often not used by the consumers they aim to reach. Our goal was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care. We adapted an existing consumer-focused public reporting website using adult learning theory to display diabetes quality reports tailored to the user's chronic condition profile. We conducted in-depth cognitive interviews with 20 individuals who either had diabetes and/or cared for someone with diabetes to assess the website. Interviews were audiotaped and transcribed, then analyzed using thematic content analysis. Three themes emerged that suggested increased engagement from tailoring the site to a user's chronic conditions: ability to interact, relevance, and feeling empowered to act. We conclude that tailoring can be used to improve public reporting sites for individuals with chronic conditions, ultimately allowing consumers to make more informed health care decisions. ©Maureen A Smith, Lauren Bednarz, Peter A Nordby, Jennifer Fink, Robert T Greenlee, Daniel Bolt, Elizabeth M Magnan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.12.2016.

  17. Pregnancy and Mental Health of Young Homeless Women

    PubMed Central

    Crawford, Devan M.; Trotter, Emily C.; Hartshorn, Kelley J. Sittner; Whitbeck, Les B.

    2012-01-01

    Pregnancy rates among women in the U.S. who are homeless are much higher than rates among women who are housed (Greene & Ringwalt, 1998). Yet little research has addressed mental health, risk and resilience among young mothers who are homeless. This study utilizes a sample of women from the Midwest Longitudinal Study of Homeless Adolescents (MLSHA) to investigate pregnancy and motherhood over three years among unaccompanied homeless young mothers. Our data are supplemented by in-depth interviews with a subset of these women. Results show that almost half of sexually active young women (n = 222, µ age = 17.2) had been pregnant at baseline (46.4%), and among the longitudinal subsample of 171 women (µ age = 17.2), almost 70.0% had been pregnant by the end of the study. Among young mothers who are homeless, only half reported that they helped to care for their children consistently over time, and one-fifth of the women reported never seeing their children. Of the young women with children in their care at the last interview of the study (Wave 13), almost one-third met criteria for lifetime major depressive episode (MDE), lifetime posttraumatic stress disorder (PTSD), and lifetime drug abuse, and one-half met criteria for lifetime antisocial personality disorder (APD). Twelve-month diagnoses are also reported. The impacts of homelessness on maternal and child outcomes are discussed, including the implications for practice, policy, and research. PMID:21486259

  18. A descriptive phenomenology study of newcomers’ experience of maternity care services: Chinese women’s perspectives

    PubMed Central

    2014-01-01

    Background Maternity health care available in Canada is based on the needs of women born in Canada and often lacks the flexibility to meet the needs of immigrant women. The purpose of this study was to explore immigrant Chinese women’s experiences in accessing maternity care, the utilization of maternity health services, and the obstacles they perceived in Canada. Methods This descriptive phenomenology study used in-depth semi-structured interviews to examine immigrant Chinese women’s experiences. Fifteen participants were recruited from the Chinese community in Toronto, Canada by using purposive sampling. The interviews were digitally recorded and transcribed verbatim into written Chinese. The transcripts were analyzed using Colaizzi’s (1978) phenomenological method. Results Six themes were extracted from the interviews: (1) preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, (2) strategies to deal with the inconvenience of the Canadian healthcare system (3) multiple resources to obtain pregnancy information, (4) the merits of the Canadian healthcare system, (5) the need for culturally sensitive care, and (6) the emergence of alternative supports and the use of private services. Conclusions The findings provide new knowledge and understanding of immigrant Chinese women’s experiences in accessing maternity health services within a large metropolitan Canadian city. Participants described two unique experiences within the themes: preference for linguistically and culturally competent healthcare providers, with obstetricians over midwives, and the emergence of alternative supports and the use of private services. Few studies of immigrant maternity service access have identified these experiences which may be linked to cultural difference. Further investigation with women from different cultural backgrounds is needed to develop a comprehensive understanding of immigrant women’s experiences with maternity care. PMID:24602231

  19. Qualitative studies using in-depth interviews with older people from multiple language groups: methodological systematic review.

    PubMed

    Fryer, Caroline; Mackintosh, Shylie; Stanley, Mandy; Crichton, Jonathan

    2012-01-01

    This paper is a report of a methodological review of language appropriate practice in qualitative research, when language groups were not determined prior to participant recruitment. When older people from multiple language groups participate in research using in-depth interviews, additional challenges are posed for the trustworthiness of findings. This raises the question of how such challenges are addressed. The Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, Ageline, PsycINFO, Sociological abstracts, Google Scholar and Allied and Complementary Medicine databases were systematically searched for the period 1840 to September 2009. The combined search terms of 'ethnic', 'cultural', 'aged', 'health' and 'qualitative' were used. In this methodological review, studies were independently appraised by two authors using a quality appraisal tool developed for the review, based on a protocol from the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Nine studies were included. Consideration of language diversity within research process was poor for all studies. The role of language assistants was largely absent from study methods. Only one study reported using participants' preferred languages for informed consent. More examples are needed of how to conduct rigorous in-depth interviews with older people from multiple language groups, when languages are not determined before recruitment. This will require both researchers and funding bodies to recognize the importance to contemporary healthcare of including linguistically diverse people in participant samples. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  20. Using health information technology to manage a patient population in accountable care organizations.

    PubMed

    Wu, Frances M; Rundall, Thomas G; Shortell, Stephen M; Bloom, Joan R

    2016-06-20

    Purpose - The purpose of this paper is to describe the current landscape of health information technology (HIT) in early accountable care organizations (ACOs), the different strategies ACOs are using to develop HIT-based capabilities, and how ACOs are using these capabilities within their care management processes to advance health outcomes for their patient population. Design/methodology/approach - Mixed methods study pairing data from a cross-sectional National Survey of ACOs with in-depth, semi-structured interviews with leaders from 11 ACOs (both completed in 2013). Findings - Early ACOs vary widely in their electronic health record, data integration, and analytic capabilities. The most common HIT capability was drug-drug and drug-allergy interaction checks, with 53.2 percent of respondents reporting that the ACO possessed the capability to a high degree. Outpatient and inpatient data integration was the least common HIT capability (8.1 percent). In the interviews, ACO leaders commented on different HIT development strategies to gain a more comprehensive picture of patient needs and service utilization. ACOs realize the necessity for robust data analytics, and are exploring a variety of approaches to achieve it. Research limitations/implications - Data are self-reported. The qualitative portion was based on interviews with 11 ACOs, limiting generalizability to the universe of ACOs but allowing for a range of responses. Practical implications - ACOs are challenged with the development of sophisticated HIT infrastructure. They may benefit from targeted assistance and incentives to implement health information exchanges with other providers to promote more coordinated care management for their patient population. Originality/value - Using new empirical data, this study increases understanding of the extent of ACOs' current and developing HIT capabilities to support ongoing care management.

  1. What is the experience of national quality campaigns? Views from the field.

    PubMed

    Bradley, Elizabeth H; Nembhard, Ingrid M; Yuan, Christina T; Stern, Amy F; Curtis, Jeptha P; Nallamothu, Brahmajee K; Brush, John E; Krumholz, Harlan M

    2010-12-01

    To identify key characteristics of a national quality campaign that participants viewed as effective, to understand mechanisms by which the campaign influenced hospital practices, and to elucidate contextual factors that modified the perceived influence of the campaign on hospital improvements. In-depth interviews, hospital surveys, and Health Quality Alliance data. We conducted a qualitative study using in-depth interviews with clinical and administrative staff (N = 99) at hospitals reporting strong influence (n = 6) as well as hospitals reporting limited influence (n = 6) of the Door-to-Balloon (D2B) Alliance, a national quality campaign to improve heart attack care. We analyzed these qualitative data as well as changes in hospital use of recommended strategies reported through a hospital survey and changes in treatment times using Health Quality Alliance data. In-depth, open-ended interviews; hospital survey. Key characteristics of the national quality campaign viewed as enhancing its effectiveness were as follows: credibility of the recommendations, perceived simplicity of the recommendations, alignment with hospitals' strategic goals, practical implementation tools, and breadth of the network of peer hospitals in the D2B Alliance. Perceived mechanisms of the campaign's influence included raising awareness and influencing goals, fostering strategy adoption, and influencing aspects of organizational culture. Modifying contextual factors included perceptions about current performance and internal championship for the recommended changes. The impact of national quality campaigns may depend on both campaign design features and on the internal environment of participating hospitals. © Health Research and Educational Trust.

  2. Evaluating User Experiences of the Secure Messaging Tool on the Veterans Affairs’ Patient Portal System

    PubMed Central

    Lind, Jason D; Shimada, Stephanie L; Martin, Tracey L; Gosline, Robert M; Antinori, Nicole; Stewart, Max; Simon, Steven R

    2014-01-01

    Background The United States Department of Veterans Affairs has implemented an electronic asynchronous “Secure Messaging” tool within a Web-based patient portal (ie, My HealtheVet) to support patient-provider communication. This electronic resource promotes continuous and coordinated patient-centered care, but to date little research has evaluated patients’ experiences and preferences for using Secure Messaging. Objective The objectives of this mixed-methods study were to (1) characterize veterans’ experiences using Secure Messaging in the My HealtheVet portal over a 3-month period, including system usability, (2) identify barriers to and facilitators of use, and (3) describe strategies to support veterans’ use of Secure Messaging. Methods We recruited 33 veterans who had access to and had previously used the portal’s Secure Messaging tool. We used a combination of in-depth interviews, face-to-face user-testing, review of transmitted secure messages between veterans and staff, and telephone interviews three months following initial contact. We assessed participants’ computer and health literacy during initial and follow-up interviews. We used a content-analysis approach to identify dominant themes in the qualitative data. We compared inferences from each of the data sources (interviews, user-testing, and message review) to identify convergent and divergent data trends. Results The majority of veterans (27/33, 82%) reported being satisfied with Secure Messaging at initial interview; satisfaction ratings increased to 97% (31/32, 1 missing) during follow-up interviews. Veterans noted Secure Messaging to be useful for communicating with their primary care team to manage health care needs (eg, health-related questions, test requests and results, medication refills and questions, managing appointments). Four domains emerged from interviews: (1) perceived benefits of using Secure Messaging, (2) barriers to using Secure Messaging, (3) facilitators for using Secure Messaging, and (4) suggestions for improving Secure Messaging. Veterans identified and demonstrated impediments to successful system usage that can be addressed with education, skill building, and system modifications. Analysis of secure message content data provided insights to reasons for use that were not disclosed by participants during interviews, specifically sensitive health topics such as erectile dysfunction and sexually transmitted disease inquiries. Conclusions Veterans perceive Secure Messaging in the My HealtheVet patient portal as a useful tool for communicating with health care teams. However, to maximize sustained utilization of Secure Messaging, marketing, education, skill building, and system modifications are needed. Data from this study can inform a large-scale quantitative assessment of Secure Messaging users’ experiences in a representative sample to validate qualitative findings. PMID:24610454

  3. Evaluating user experiences of the secure messaging tool on the Veterans Affairs' patient portal system.

    PubMed

    Haun, Jolie N; Lind, Jason D; Shimada, Stephanie L; Martin, Tracey L; Gosline, Robert M; Antinori, Nicole; Stewart, Max; Simon, Steven R

    2014-03-06

    The United States Department of Veterans Affairs has implemented an electronic asynchronous "Secure Messaging" tool within a Web-based patient portal (ie, My HealtheVet) to support patient-provider communication. This electronic resource promotes continuous and coordinated patient-centered care, but to date little research has evaluated patients' experiences and preferences for using Secure Messaging. The objectives of this mixed-methods study were to (1) characterize veterans' experiences using Secure Messaging in the My HealtheVet portal over a 3-month period, including system usability, (2) identify barriers to and facilitators of use, and (3) describe strategies to support veterans' use of Secure Messaging. We recruited 33 veterans who had access to and had previously used the portal's Secure Messaging tool. We used a combination of in-depth interviews, face-to-face user-testing, review of transmitted secure messages between veterans and staff, and telephone interviews three months following initial contact. We assessed participants' computer and health literacy during initial and follow-up interviews. We used a content-analysis approach to identify dominant themes in the qualitative data. We compared inferences from each of the data sources (interviews, user-testing, and message review) to identify convergent and divergent data trends. The majority of veterans (27/33, 82%) reported being satisfied with Secure Messaging at initial interview; satisfaction ratings increased to 97% (31/32, 1 missing) during follow-up interviews. Veterans noted Secure Messaging to be useful for communicating with their primary care team to manage health care needs (eg, health-related questions, test requests and results, medication refills and questions, managing appointments). Four domains emerged from interviews: (1) perceived benefits of using Secure Messaging, (2) barriers to using Secure Messaging, (3) facilitators for using Secure Messaging, and (4) suggestions for improving Secure Messaging. Veterans identified and demonstrated impediments to successful system usage that can be addressed with education, skill building, and system modifications. Analysis of secure message content data provided insights to reasons for use that were not disclosed by participants during interviews, specifically sensitive health topics such as erectile dysfunction and sexually transmitted disease inquiries. Veterans perceive Secure Messaging in the My HealtheVet patient portal as a useful tool for communicating with health care teams. However, to maximize sustained utilization of Secure Messaging, marketing, education, skill building, and system modifications are needed. Data from this study can inform a large-scale quantitative assessment of Secure Messaging users' experiences in a representative sample to validate qualitative findings.

  4. Interview from anywhere: feasibility and utility of web-based videoconference interviews in the gastroenterology fellowship selection process.

    PubMed

    Daram, Sumanth R; Wu, Ruonan; Tang, Shou-Jiang

    2014-02-01

    Traditional personal interviews are subject to limitations imposed by geographic, financial, and scheduling constraints. Web-based videoconferencing (WVC) has the potential to simplify the interview process. This study was intended to evaluate the feasibility and utility of WVC using standard tablets/computers with videoconferencing capability in gastroenterology (GI) fellowship interviews. At a single institution, 16 GI fellowship applicants participated in WVC with one interviewer, who was present at a remote location 750 miles away. In addition, each of the candidates underwent traditional interviews with four faculty members at the program site. All study interviewees used an iPad2 (Apple, iOS 5.1; Apple) with a videoconferencing application (Facetime). The interviewer (SRD) used Facetime on a MacBook Pro (Apple, Mac OS X 10.7.3). Each candidate completed a voluntary paper survey after completion of all assigned faculty interviews. The average age of the candidates was 30 years (range, 27-37 years). Fourteen candidates were native English speakers. Candidates expressed a high level of satisfaction, with 13 candidates (81%) stating that their WVC experience met or exceeded their expectations, and 87% of candidates stating that WVC should be an option in fellowship interviews. In addition, 25% of candidates felt that their WVC experience was equivalent to or better than their traditional interview experience on the same day. WVC can be an effective and useful tool in the fellowship interview process. It affords candidates increased flexibility, cost saving, convenience, and provides an option for participating in the selection process at more programs. For the programs and faculty, WVC has a potential to be an effective screening tool, can help minimize loss of clinical revenue and can also be an acceptable alternative to in-person interviews.

  5. Comparative analysis of respiratory motion tracking using Microsoft Kinect v2 sensor.

    PubMed

    Silverstein, Evan; Snyder, Michael

    2018-05-01

    To present and evaluate a straightforward implementation of a marker-less, respiratory motion-tracking process utilizing Kinect v2 camera as a gating tool during 4DCT or during radiotherapy treatments. Utilizing the depth sensor on the Kinect as well as author written C# code, respiratory motion of a subject was tracked by recording depth values obtained at user selected points on the subject, with each point representing one pixel on the depth image. As a patient breathes, specific anatomical points on the chest/abdomen will move slightly within the depth image across pixels. By tracking how depth values change for a specific pixel, instead of how the anatomical point moves throughout the image, a respiratory trace can be obtained based on changing depth values of the selected pixel. Tracking these values was implemented via marker-less setup. Varian's RPM system and the Anzai belt system were used in tandem with the Kinect to compare respiratory traces obtained by each using two different subjects. Analysis of the depth information from the Kinect for purposes of phase- and amplitude-based binning correlated well with the RPM and Anzai systems. Interquartile Range (IQR) values were obtained comparing times correlated with specific amplitude and phase percentages against each product. The IQR time spans indicated the Kinect would measure specific percentage values within 0.077 s for Subject 1 and 0.164 s for Subject 2 when compared to values obtained with RPM or Anzai. For 4DCT scans, these times correlate to less than 1 mm of couch movement and would create an offset of 1/2 an acquired slice. By tracking depth values of user selected pixels within the depth image, rather than tracking specific anatomical locations, respiratory motion can be tracked and visualized utilizing the Kinect with results comparable to that of the Varian RPM and Anzai belt. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  6. Perspectives of Egyptian research ethics committees regarding their effective functioning.

    PubMed

    Matar, Amal; Silverman, Henry

    2013-02-01

    The recent increase in research in the Middle East has been associated with the establishment of research ethics committees (RECs). Our aim was to obtain perspectives of RECs regarding the challenges that impede their effective functioning. We conducted in-depth interviews using a semi-structured interview guide. We transcribed and analyzed the interviews to uncover major themes and subthemes. We identified the following themes: membership composition; training needs of members; availability of human and capital resources; role of the national government; concerns with the informed consent process; government scrutiny of research; investigator-related issues; and concerns with transfer of biological samples to other countries. Our interview study revealed several barriers that need to be considered by appropriate stakeholders to enhance adequate functioning of RECs.

  7. Non use of health information kiosks examined in an information needs context.

    PubMed

    Williams, Peter; Nicholas, David; Huntington, Paul

    2003-06-01

    Whilst great emphasis has rightly been placed on the increased availability and use of health information, little research has been undertaken into the non use of such material, particularly with regard to electronic sources. Computer transactional log data from health information touch screen kiosks, collected as part of an ongoing Department of Health-funded study being carried out by City University, showed that females in the 55-74 age group were particularly under-represented as users. To explore reasons for this, in-depth interviews were carried out with 13 non-kiosk-using, primary-care out-patients fitting this profile, at a surgery which had a kiosk that was being monitored. Subjects were interviewed at length about their information needs and information-seeking behaviour, to determine reasons (if any) they might have had for non-kiosk use. The study utilized an interview schedule and technique loosely based on the 'Sense-Making' methodology of Brenda Dervin (Talk Presented at the International Communication Association Annual Meeting, May 1983, Dallas, Texas, USA. Available from: http://communicationsbsohio-stateedu/sense-making/art/artdervin83html.). Findings elicited many factors accounting for non use of the system. The first and major source of information remained the doctor, with written or other sources only being consulted where recommended or provided. There was evidence that patients wanted little more than the minimum information or instructions required to deal with their condition. Many appeared unaware of the presence of the kiosk and others assumed either that it was not for patient use or that it would not serve their needs. The methodology proved itself, with certain caveats, to be an appropriate vehicle for this kind of exploratory work.

  8. Perceptions of quality across the maternal care continuum in the context of a health financing intervention: Evidence from a mixed methods study in rural Malawi.

    PubMed

    Kambala, Christabel; Lohmann, Julia; Mazalale, Jacob; Brenner, Stephan; Sarker, Malabika; Muula, Adamson S; De Allegri, Manuela

    2017-06-08

    In 2013, Malawi with its development partners introduced a Results-Based Financing for Maternal and Newborn Health (RBF4MNH) intervention to improve the quality of maternal and newborn health-care services. Financial incentives are awarded to health facilities conditional on their performance and to women for delivering in the health facility. We assessed the effect of the RBF4MNH on quality of care from women's perspectives. We used a mixed-method prospective sequential controlled pre- and post-test design. We conducted 3060 structured client exit interviews, 36 in-depth interviews and 29 focus group discussions (FGDs) with women and 24 in-depth interviews with health service providers between 2013 and 2015. We used difference-in-differences regression models to measure the effect of the RBF4MNH on experiences and perceived quality of care. We used qualitative data to explore the matter more in depth. We did not observe a statistically significant effect of the intervention on women's perceptions of technical care, quality of amenities and interpersonal relations. However, in the qualitative interviews, most women reported improved health service provision as a result of the intervention. RBF4MNH increased the proportion of women reporting to have received medications/treatment during childbirth. Participants in interviews expressed that drugs, equipment and supplies were readily available due to the RBF4MNH. However, women also reported instances of neglect, disrespect and verbal abuse during the process of care. Providers attributed these negative instances to an increased workload resulting from an increased number of women seeking services at RBF4MNH facilities. Our qualitative findings suggest improvements in the availability of drugs and supplies due to RBF4MNH. Despite the intervention, challenges in the provision of quality care persisted, especially with regard to interpersonal relations. RBF interventions may need to consider including indicators that specifically target the provision of respectful maternity care as a means to foster providers' positive attitudes towards women in labour. In parallel, governments should consider enhancing staff and infrastructural capacity before implementing RBF.

  9. Medication use in Australian children with asthma: user's perspective.

    PubMed

    Grover, Charu; Armour, Carol; Van Asperen, Peter Paul; Moles, Rebekah Jane; Saini, Bandana

    2013-04-01

    Medication use-related issues remain problematic in childhood asthma despite effective treatment strategies and public investment into improved asthma management strategies in industrialized countries. This study aimed to carry out an in-depth exploration of the views of parents/carers and children with asthma on medication use. Semi-structured qualitative interviews were conducted with a purposive convenience sample of children with asthma and their parents recruited from general practices in Sydney. Interviews were tape-recorded, transcribed verbatim, and thematically analyzed. A total of 52 interviews (26 parents/carers and 26 children with asthma) were conducted. Major themes which emerged from the children's interviews included issues such as self-image, resistance to medication use, and lack of responsibility in medication taking. Parental or carer issues included lack of clear understanding of how medications worked, as well as administration difficulties, cost constraints, and beliefs about medications contrary to quality use. This is one of the few research studies exploring the viewpoint of children with asthma about their medications in Australia. Despite investment in dissemination of professional, targeted evidence-based asthma management strategies in healthcare, there seems to be a lack of depth in terms of what parents understand about their child's asthma. Effective communication about medication usage, especially the inclusion of the child in the consultation to empower them to be involved in their own asthma care, may be the answer.

  10. Does the Cultural Formulation Interview for the fifth revision of the diagnostic and statistical manual of mental disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site.

    PubMed

    Aggarwal, Neil K; Desilva, Ravi; Nicasio, Andel V; Boiler, Marit; Lewis-Fernández, Roberto

    2015-01-01

    Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n = 64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Despite racial, ethnical, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient's perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but two codes fell under the implementation outcome of clinical utility, two fell under acceptability, and none fell under feasibility. Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes such as medication adherence, appointment retention, and health condition.

  11. Does the Cultural Formulation Interview (CFI) for the Fifth Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site

    PubMed Central

    Aggarwal, Neil K.; DeSilva, Ravi; Nicasio, Andel V.; Boiler, Marit; Lewis-Fernández, Roberto

    2014-01-01

    Objectives Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. Design We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n=64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Results Despite racial, ethnic, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient’s perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but 2 codes fell under the implementation outcome of clinical utility, 2 fell under acceptability, and none fell under feasibility. Conclusion Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes such as medication adherence, appointment retention, and health condition. PMID:25372242

  12. Developing a Behavioral Model for Mobile Phone-Based Diabetes Interventions

    PubMed Central

    Nundy, Shantanu; Dick, Jonathan J.; Solomon, Marla C.; Peek, Monica E.

    2013-01-01

    Objectives Behavioral models for mobile phone-based diabetes interventions are lacking. This study explores the potential mechanisms by which a text message-based diabetes program affected self-management among African-Americans. Methods We conducted in-depth, individual interviews among 18 African-American patients with type 2 diabetes who completed a 4-week text message-based diabetes program. Each interview was audio- taped, transcribed verbatim, and imported into Atlas.ti software. Coding was done iteratively. Emergent themes were mapped onto existing behavioral constructs and then used to develop a novel behavioral model for mobile phone-based diabetes self-management programs. Results The effects of the text message-based program went beyond automated reminders. The constant, daily communications reduced denial of diabetes and reinforced the importance of self-management (Rosenstock Health Belief Model). Responding positively to questions about self-management increased mastery experience (Bandura Self-Efficacy). Most surprisingly, participants perceived the automated program as a “friend” and “support group” that monitored and supported their self-management behaviors (Barrera Social Support). Conclusions A mobile phone-based diabetes program affected self-management through multiple behavioral constructs including health beliefs, self-efficacy, and social support. Practice implications: Disease management programs that utilize mobile technologies should be designed to leverage existing models of behavior change and can address barriers to self-management associated with health disparities. PMID:23063349

  13. Assessing the impact of a web-based comprehensive somatic and mental health screening tool in pediatric primary care.

    PubMed

    Fothergill, Kate E; Gadomski, Anne; Solomon, Barry S; Olson, Ardis L; Gaffney, Cecelia A; Dosreis, Susan; Wissow, Lawrence S

    2013-01-01

    To evaluate how parents and physicians perceive the utility of a comprehensive, electronic previsit screener, and to assess its impact on the visit. A mixed methods design was used. English-speaking parents were recruited from 3 primary care systems (urban MD and rural NY and VT) when they presented for a well-child visit with a child 4 to 10 years of age. Parents completed an electronic previsit screen, which included somatic concerns, health risks, and 4 mental health tools (SCARED5, PHQ-2, SDQ Impact, and PSC-17). Parents completed an exit survey, and a subset were interviewed. All primary care providers (PCPs) were interviewed. A total of 120 parents and 16 PCPs participated. The exit surveys showed that nearly 90% of parents agreed or strongly agreed that the screener was easy to use and maintained confidentiality. During interviews, parents noted that the screener helped with recall, validated concerns, reframed issues they thought might not be appropriate for primary care, and raised new questions. PCPs thought that the screener enabled them to normalize sensitive issues, and it permitted them to simultaneously focus and be comprehensive during the visit. Parents and PCPs agreed that the screener helped guide discussion, promoted in-depth exchange, and increased efficiency. Findings were consistent across quantitative and qualitative methods and between parents and PCPs. A comprehensive electronic previsit screening tool is an acceptable and practical strategy to facilitate well-child visits. It may help with problem identification as well as with setting agendas, engaging the family, and balancing attention between somatic and psychosocial concerns. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  14. Aged women, witchcraft, and social relations among the Igbo in South-Eastern Nigeria.

    PubMed

    Atata, Scholastica Ngozi

    2018-02-13

    Belief in the existence of witchcraft has remained a social phenomenon in Igbo society, especially with aged women who are often labeled witches. This study is exploratory and explains the implication of labeling an aged woman a witch and social relations in Igbo society in South-Eastern Nigeria. Twenty interviews were conducted with aged women who are victims of the witchcraft label and their relatives using qualitative methods of data collection, key informant interviews, and in-depth interviews. Data collected were analyzed using ethnographic content analysis. Findings reveal different social views attached to witchcraft and how it relates to aged women.

  15. Positive psychological states and health behaviors in acute coronary syndrome patients: A qualitative study.

    PubMed

    Huffman, Jeff C; DuBois, Christina M; Mastromauro, Carol A; Moore, Shannon V; Suarez, Laura; Park, Elyse R

    2016-06-01

    Positive psychological states are linked to superior cardiac outcomes, possibly mediated through increased participation in health behaviors. Trained study staff conducted in-depth semi-structured interviews in the hospital and 3 months later for 34 patients diagnosed with an acute coronary syndrome. These interviews focused on positive psychological states, cardiac health behaviors, and their connection; the interviews were transcribed and independently coded using directed content analysis. Both optimism and positive affect were associated with completion of physical activity and healthy eating in a bidirectional manner. In contrast, gratitude, while common, was infrequently linked to completion of health behaviors. © The Author(s) 2014.

  16. Fast depth decision for HEVC inter prediction based on spatial and temporal correlation

    NASA Astrophysics Data System (ADS)

    Chen, Gaoxing; Liu, Zhenyu; Ikenaga, Takeshi

    2016-07-01

    High efficiency video coding (HEVC) is a video compression standard that outperforms the predecessor H.264/AVC by doubling the compression efficiency. To enhance the compression accuracy, the partition sizes ranging is from 4x4 to 64x64 in HEVC. However, the manifold partition sizes dramatically increase the encoding complexity. This paper proposes a fast depth decision based on spatial and temporal correlation. Spatial correlation utilize the code tree unit (CTU) Splitting information and temporal correlation utilize the motion vector predictor represented CTU in inter prediction to determine the maximum depth in each CTU. Experimental results show that the proposed method saves about 29.1% of the original processing time with 0.9% of BD-bitrate increase on average.

  17. Psychotherapy research in developing countries: the case of Latin America.

    PubMed

    de la Parra, Guillermo

    2013-01-01

    This article describes the state of psychotherapy research in Latin America, a developing region, by means of its scientific production as reflected in international and Latin American publications, as well as through a survey and in-depth interviews with clinicians and researchers from the region. The Latin American publication rate is still low in international journals, which stands in contrast with the high level of publication within the region. The survey reveals an interest in research as well as a limited use of research in clinical practice, while exposing the difficulties of researching and publishing. The in-depth interviews, which cover most of the region, specify Latin America's shortcomings and obstacles to researching, as well as its facilitating factors and comparative advantages. The results are discussed within the framework of the colonizer-colonized relationship, Latin American identity, and the creative integration of developed and developing regions.

  18. Ethnobotany of utilization, role, and philosopical meaning of parijoto (Medinilla, spp) on Mount Muria in Kudus Regency, Central Java

    NASA Astrophysics Data System (ADS)

    Hanum, Alima Saida; Prihastanti, Erma; Jumari

    2017-08-01

    One of Indonesian plant species which has not been fully explored in terms of pharmacology is parijoto plant (Medinilla,spp). Medinilla,spp can be found on Mount Muria in Kudus regency, Central Java. This plant can be used as a traditional medicine which is derived from plants as a manifestation of active community participation in solving the healthy problems. Medinilla,spp is closely associated with the ethnic-majority area of mount Muria. Its utilization is still limited as the fruit to be consumed by pregnant women. It is necessary to do in-depth research as part of an effort in the utilization and conservation for the future. The purposes of this study were to determine the utilization, role, and philosophical meaning of Medinilla,spp. This research took place in three villages, they were Japan, Colo, and Pandak. Questionnaire and semi-structured interviews with community and key informants were used in this research. It was found out that Medinilla, spp majority were utilized as the fruit to be consumed by pregnant women and also used as medicine for diarrhea, mouth sores, anti inflammatory, anti-cancer, and anti-bacterial. The preparations process of traditional medical plants were by boiling (70%), way of brewing (15%), and consuming it freshly (15%). The composition of the ingredients were 90% used single material in the form of Medinilla,spp and 10% used addition ingredients such as ginger and turmeric. The philosophical meaning of Medinilla,spp for the people in Mount Muria region was that Medinilla, spp was not merely the fruit to be consumed by pregnant women, but Medinilla, spp was also considered as the fruit to heal various diseases. It referred to a belief that after salah prayer before hand by Sunan Muria, all diseases can be cured.

  19. The role of community mental health nurses caring for people with schizophrenia in Taiwan: a substantive grounded theory.

    PubMed

    Huang, Xuan-Yi; Yen, Wen-Jiuan; Liu, Shwu-Jiuan; Lin, Chouh-Jiuan

    2008-03-01

    The aim was to develop a practice theory that can be used to guide the direction of community nursing practice to help clients with schizophrenia and those who care for them. Substantive grounded theory was developed through use of grounded theory method of Strauss and Corbin. Two groups of participants in Taiwan were selected using theoretical sampling: one group consisted of community mental health nurses and the other group was clients with schizophrenia and those who cared for them. The number of participants in each group was determined by theoretical saturation. Semi-structured one-to-one in-depth interviews and unstructured non-participant observation were utilized for data collection. Data analysis involved three stages: open, axial and selective coding. During the process of coding and analysis, both inductive and deductive thinking were utilized and the constant comparative analysis process continued until data saturation occurred. To establish trustworthiness, the four criteria of credibility, transferability, dependability and confirmability were followed along with field trial, audit trial, member check and peer debriefing for reliability and validity. A substantive grounded theory, the role of community mental health nurses caring for people with schizophrenia in Taiwan, was developed through utilization of grounded theory method of Strauss and Corbin. In this paper, results and discussion focus on causal conditions, context, intervening conditions, consequences and phenomenon. The theory is the first to contribute knowledge about the field of mental health home visiting services in Taiwan to provide guidance for the delivery of quality care to assist people in the community with schizophrenia and their carers.

  20. The Availability and Utility of Services to Address Risk Factors for Recidivism among Justice-Involved Veterans

    PubMed Central

    Blonigen, Daniel M.; Rodriguez, Allison L.; Manfredi, Luisa; Britt, Jessica; Nevedal, Andrea; Finlay, Andrea K.; Rosenthal, Joel; Smelson, David; Timko, Christine

    2016-01-01

    The availability and utility of services to address recidivism risk factors among justice-involved veterans is unknown. We explored these issues through qualitative interviews with 63 Specialists from the Department of Veterans Affairs’ (VA) Veterans Justice Programs. To guide the interviews, we utilized the Risk-Need-Responsivity (RNR) model of offender rehabilitation. Specialists reported that justice-involved veterans generally have access to services to address most RNR-based risk factors (substance abuse; lack of positive school/work involvement; family/marital dysfunction; lack of prosocial activities/interests), but have less access to services targeting risk factors of antisocial tendencies and associates and empirically-based treatments for recidivism in VA. Peer-based services, motivational interviewing/cognitive-behavioral therapy, and Veterans Treatment Courts were perceived as useful to address multiple risk factors. These findings highlight potential gaps in provision of evidence-based care to address recidivism among justice-involved veterans, as well as promising policy-based solutions that may have widespread impact on reducing recidivism in this population. PMID:26924887

  1. QMHC interview: Peter R. Scholtes [by Marie E. Sinioris].

    PubMed

    Scholtes, P R

    1993-01-01

    Peter R. Scholtes has a unique perspective on what it takes to build a world-class quality organization: A transformation of the relationships, environment, and dynamics within and between individuals and groups throughout an organization. He brings an organizational development perspective to quality management and, in particular, to the approach and practices advocated by W. Edwards Deming. This interview explores Mr. Scholtes' in-depth understanding and sometimes controversial views on quality improvement teams, team training, and performance appraisal.

  2. Teaching primary care obstetrics: insights and recruitment recommendations from family physicians.

    PubMed

    Koppula, Sudha; Brown, Judith B; Jordan, John M

    2014-03-01

    To explore the experiences and recommendations for recruitment of family physicians who practise and teach primary care obstetrics. Qualitative study using in-depth interviews. Six primary care obstetrics groups in Edmonton, Alta, that were involved in teaching family medicine residents in the Department of Family Medicine at the University of Alberta. Twelve family physicians who practised obstetrics in groups. All participants were women, which was reasonably representative of primary care obstetrics providers in Edmonton. Each participant underwent an in-depth interview. The interviews were audiotaped and transcribed verbatim. The investigators independently reviewed the transcripts and then analyzed the transcripts together in an iterative and interpretive manner. Themes identified in this study include lack of confidence in teaching, challenges of having learners, benefits of having learners, and recommendations for recruiting learners to primary care obstetrics. While participants described insecurity and challenges related to teaching, they also identified positive aspects, and offered suggestions for recruiting learners to primary care obstetrics. Despite describing poor confidence as teachers and having challenges with learners, the participants identified positive experiences that sustained their interest in teaching. Supporting these teachers and recruiting more such role models is important to encourage family medicine learners to enter careers such as primary care obstetrics.

  3. Interviewer as instrument: accounting for human factors in evaluation research.

    PubMed

    Brown, Joel H

    2006-04-01

    This methodological study examines an original data collection model designed to incorporate human factors and enhance data richness in qualitative and evaluation research. Evidence supporting this model is drawn from in-depth youth and adult interviews in one of the largest policy/program evaluations undertaken in the United States, the Drug, Alcohol, and Tobacco Education evaluation (77 districts, 118 schools). When applying the explicit observation technique (EOT)--the strategic and nonjudgmental disclosure of nonverbal human factor cues by the interviewer to the respondent during interview--data revealed the observation disclosure pattern. Here, respondents linked perceptions with policy or program implementation or effectiveness evidence. Although more research is needed, it is concluded that the EOT yields richer data when compared with traditional semistructured interviews and, thus, holds promise to enhance qualitative and evaluation research methods. Validity and reliability as well as qualitative and evaluation research considerations are discussed.

  4. Why do women prefer home births in Ethiopia?

    PubMed

    Shiferaw, Solomon; Spigt, Mark; Godefrooij, Merijn; Melkamu, Yilma; Tekie, Michael

    2013-01-16

    Skilled attendants during labor, delivery, and in the early postpartum period, can prevent up to 75% or more of maternal death. However, in many developing countries, very few mothers make at least one antenatal visit and even less receive delivery care from skilled professionals. The present study reports findings from a region where key challenges related to transportation and availability of obstetric services were addressed by an ongoing project, giving a unique opportunity to understand why women might continue to prefer home delivery even when facility based delivery is available at minimal cost. The study took place in Ethiopia using a mixed study design employing a cross sectional household survey among 15-49 year old women combined with in-depth interviews and focus group discussions. Seventy one percent of mothers received antenatal care from a health professional (doctor, health officer, nurse, or midwife) for their most recent birth in the one year preceding the survey. Overall only 16% of deliveries were assisted by health professionals, while a significant majority (78%) was attended by traditional birth attendants. The most important reasons for not seeking institutional delivery were the belief that it is not necessary (42%) and not customary (36%), followed by high cost (22%) and distance or lack of transportation (8%). The group discussions and interviews identified several reasons for the preference of traditional birth attendants over health facilities. Traditional birth attendants were seen as culturally acceptable and competent health workers. Women reported poor quality of care and previous negative experiences with health facilities. In addition, women's low awareness on the advantages of skilled attendance at delivery, little role in making decisions (even when they want), and economic constraints during referral contribute to the low level of service utilization. The study indicated the crucial role of proper health care provider-client communication and providing a more client centered and culturally sensitive care if utilization of existing health facilities is to be maximized. Implications of findings for maternal health programs and further research are discussed.

  5. Value-based design for the elderly: An application in the field of mobility aids.

    PubMed

    Boerema, Simone T; van Velsen, Lex; Vollenbroek-Hutten, Miriam M R; Hermens, Hermie J

    2017-01-01

    In the aging society, the need for the elderly to remain mobile and independent is higher than ever. However, many aids supporting mobility often fail to target real needs and lack acceptance. The aim of this study is to demonstrate how value-based design can contribute to the design of mobility aids that address real needs and thus, lead to high acceptance. We elicited values, facilitators, and barriers of mobility of older adults via ten in-depth interviews. Next, we held co-creation sessions, resulting in several designs of innovative mobility aids, which were evaluated for acceptance via nine in-depth interviews. The interviews resulted in a myriad of key values, such as "independence from family" and "doing their own groceries." Design sessions resulted in three designs for a wheeled walker. Their acceptance was rather low. Current mobility device users were more eager to accept the designs than non-users. The value-based approach offers designers a close look into the lives of the elderly, thereby opening up a wide range of innovation possibilities that better fit their actual needs. Product service systems seem to be a promising focus for targeting human needs in mobility device design.

  6. The eye-tracking computer device for communication in amyotrophic lateral sclerosis.

    PubMed

    Spataro, R; Ciriacono, M; Manno, C; La Bella, V

    2014-07-01

    To explore the effectiveness of communication and the variables affecting the eye-tracking computer system (ETCS) utilization in patients with late-stage amyotrophic lateral sclerosis (ALS). We performed a telephone survey on 30 patients with advanced non-demented ALS that were provisioned an ECTS device. Median age at interview was 55 years (IQR = 48-62), with a relatively high education (13 years, IQR = 8-13). A one-off interview was made and answers were later provided with the help of the caregiver. The interview included items about demographic and clinical variables affecting the daily ETCS utilization. The median time of ETCS device possession was 15 months (IQR = 9-20). The actual daily utilization was 300 min (IQR = 100-720), mainly for the communication with relatives/caregiver, internet surfing, e-mailing, and social networking. 23.3% of patients with ALS (n = 7) had a low daily ETCS utilization; most reported causes were eye-gaze tiredness and oculomotor dysfunction. Eye-tracking computer system is a valuable device for AAC in patients with ALS, and it can be operated with a good performance. The development of oculomotor impairment may limit its functional use. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. The hidden cost of 'free' maternity care in Dhaka, Bangladesh.

    PubMed

    Nahar, S; Costello, A

    1998-12-01

    We studied the cost and affordability of 'free' maternity services at government facilities in Dhaka, Bangladesh, to assess whether economic factors may contribute to low utilization. We conducted a questionnaire survey and in-depth interviews among 220 post-partum mothers and their husbands, selected from four government maternity facilities (three referral hospitals and one Mother and Child Health hospital) in Dhaka. Mothers with serious complications were excluded. Information was collected on the costs of maternity care, household income, the sources of finance used to cover the costs, and the family's willingness to pay for maternity services. The mean cost for normal delivery was 1275 taka (US$31.9) and for caesarean section 4703 taka (US$117.5). Average monthly household income was 4933 taka (US$123). Twenty-one per cent of families were spending 51-100% of monthly income, and 27% of families 2-8 times their monthly income for maternity care. Overall, 51% of the families (and 74% of those having a caesarean delivery) did not have enough money to pay; of these, 79% had to borrow from a money lender or relative. Surprisingly, 72% of the families said they were willing to pay a government-levied user charge, though this was less popular among low-income families (61%). 'Free' maternity care in Bangladesh involves considerable hidden costs which may be a major contributor to low utilization of maternity services, especially among low-income groups. To increase utilization of safer motherhood services, policy-makers might consider introducing fixed user charges with clear exemption guidelines, or greater subsidies for existing services, especially caesarean section.

  8. Conducting qualitative interviews by telephone: Lessons learned from a study of alcohol use among sexual minority and heterosexual women.

    PubMed

    Drabble, Laurie; Trocki, Karen F; Salcedo, Brenda; Walker, Patricia C; Korcha, Rachael A

    2016-01-01

    This study explored effective interviewer strategies and lessons-learned based on collection of narrative data by telephone with a sub-sample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009-2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: 1) cultivating rapport and maintaining connection, 2) demonstrating responsiveness to interviewee content, concerns, and 3) communicating regard for the interviewee and her contribution. Findings underscore both the viability and value of telephone interviews as a method for collecting rich narrative data on sensitive subjects among women, including women who may be marginalized.

  9. Conducting qualitative interviews by telephone: Lessons learned from a study of alcohol use among sexual minority and heterosexual women

    PubMed Central

    Trocki, Karen F.; Salcedo, Brenda; Walker, Patricia C.; Korcha, Rachael A.

    2015-01-01

    This study explored effective interviewer strategies and lessons-learned based on collection of narrative data by telephone with a sub-sample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: 1) cultivating rapport and maintaining connection, 2) demonstrating responsiveness to interviewee content, concerns, and 3) communicating regard for the interviewee and her contribution. Findings underscore both the viability and value of telephone interviews as a method for collecting rich narrative data on sensitive subjects among women, including women who may be marginalized. PMID:26811696

  10. Coping With Preclinical Disability: Older Women’s Experiences of Everyday Activities

    PubMed Central

    Lorenz, Rebecca Ann

    2010-01-01

    Purpose The purpose of this paper is to describe coping practices used by older women during preclinical disability. Design This paper was derived from qualitative data gathered during a larger multimethod longitudinal study. Twelve women (60 to 80 years of age) participated in baseline functional performance measures and then repeated in-depth interviews and participant observations over 18 months. Methods A hermeneutic approach was used to interpret the in-depth interviews, participant observations, and field notes using three interrelated processes of thematic, exemplar, and identification of paradigm cases to identify coping practices. Findings Women coped with functional decline, such as difficulty getting up from the floor, in many different ways. Coping practices were grouped into five themes: resist, adapt, substitute, endure, and eliminate. Clinical Relevance These findings suggest that nurses need to realize outward appearances may mask the level of effort required for older women to complete daily activities. PMID:21091627

  11. How the public engages with global warming: A social representations approach.

    PubMed

    Smith, Nicholas; Joffe, Helene

    2013-01-01

    The present study utilises social representations theory to explore common sense conceptualisations of global warming risk using an in-depth, qualitative methodology. Fifty-six members of a British, London-based 2008 public were initially asked to draw or write four spontaneous "first thoughts or feelings" about global warming. These were then explored via an open-ended, exploratory interview. The analysis revealed that first thoughts, either drawn or written, often mirrored the images used by the British press to depict global warming visually. Thus in terms of media framings, it was their visual rather than their textual content that was spontaneously available for their audiences. Furthermore, an in-depth exploration of interview data revealed that global warming was structured around three themata: self/other, natural/unnatural and certainty/uncertainty, reflecting the complex and often contradictory nature of common sense thinking in relation to risk issues.

  12. Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study.

    PubMed

    Atujuna, Millicent; Newman, Peter A; Wallace, Melissa; Eluhu, Megan; Rubincam, Clara; Brown, Ben; Bekker, Linda-Gail

    2018-01-01

    New biomedical prevention technologies (NPTs) may contribute to substantially reducing incident HIV infections globally. We explored acceptability and preferences for NPTs among key and other vulnerable populations in two South African townships. We conducted six focus groups and 12 in-depth interviews with adolescents, and adult heterosexual men, women, and men who have sex with men (MSM) (n = 48), and eight in-depth interviews with key informant healthcare workers. The interview guide described pre-exposure prophylaxis (PrEP), vaginal rings, rectal microbicides and HIV vaccines, and explored acceptability and product preferences. Focus groups and in-depth interviews (45-80 minutes) were conducted in Xhosa, audiotaped, and transcribed and translated into English. Data were coded and reviewed using framework analysis with NVivo software. Overall, initial enthusiasm and willingness to use NPTs evolved into concerns about how particular NPTs might affect or require alterations in one's everyday lifestyle and practices. Different product preferences and motivations emerged by population based on similarity to existing practices and contexts of vulnerability. Adult women and female adolescents preferred a vaginal ring and HIV vaccine, motivated by longer duration of protection to mitigate feared repercussions from male partners, including threats to their marriage and safety, and a context of ubiquitous rape. Male adolescents preferred an HIV vaccine, seen as protection in serodiscordant relationships and convenient in obviating the HIV stigma and cost involved in buying condoms. Adult men preferred PrEP, given familiarity with oral medications and mistrust of injections, seen as enabling serodiscordant couples to have a child. MSM preferred a rectal microbicide given familiarity with gel-based lubricants, with concerns about duration of protection in the context of unplanned consensual sex and rape. Biomedical interventions to prevent HIV transmission, rather than obviating social-structural factors that produce vulnerability, may be limited by these same factors. Implementation of NPTs should engage local communities to understand real-world constraints and strategise to deliver effective, multi-level combination prevention.

  13. User experience of lower-limb orthosis.

    PubMed

    Yang, Bing-Shiang; Chen, Yen-Wan; Tong, Ji-Rou

    2017-06-09

    If an assistive device is not acceptable to the user, it will not achieve efficacy and would be resource-wasting. This study employed in-depth interviews to understand what users' individual activities of daily living, problems of using orthoses, and considerations for selecting orthoses are. We conducted qualitative interviews with 35 lower-limb orthosis users, and semi-structured interviews were applied in this study. We analyzed the interview data from transcripts, through coding and concepts, to theories based on grounded theory. The results showed that problems of using orthoses are mostly related to activities of daily living of the user and user's expectation. Therefore, in order to enhance its efficacy and use intention, the design and prescribing process of orthoses need to address the problems in the light of activities of daily living and user education.

  14. A Mixed Methods and Triangulation Model for Increasing the Accuracy of Adherence and Sexual Behaviour Data: The Microbicides Development Programme

    PubMed Central

    Pool, Robert; Montgomery, Catherine M.; Morar, Neetha S.; Mweemba, Oliver; Ssali, Agnes; Gafos, Mitzy; Lees, Shelley; Stadler, Jonathan; Crook, Angela; Nunn, Andrew; Hayes, Richard; McCormack, Sheena

    2010-01-01

    Background The collection of accurate data on adherence and sexual behaviour is crucial in microbicide (and other HIV-related) research. In the absence of a “gold standard” the collection of such data relies largely on participant self-reporting. After reviewing available methods, this paper describes a mixed method/triangulation model for generating more accurate data on adherence and sexual behaviour in a multi-centre vaginal microbicide clinical trial. In a companion paper some of the results from this model are presented [1]. Methodology/Principal Findings Data were collected from a random subsample of 725 women (7.7% of the trial population) using structured interviews, coital diaries, in-depth interviews, counting returned gel applicators, focus group discussions, and ethnography. The core of the model was a customised, semi-structured in-depth interview. There were two levels of triangulation: first, discrepancies between data from the questionnaires, diaries, in-depth interviews and applicator returns were identified, discussed with participants and, to a large extent, resolved; second, results from individual participants were related to more general data emerging from the focus group discussions and ethnography. A democratic and equitable collaboration between clinical trialists and qualitative social scientists facilitated the success of the model, as did the preparatory studies preceding the trial. The process revealed some of the underlying assumptions and routinised practices in “clinical trial culture” that are potentially detrimental to the collection of accurate data, as well as some of the shortcomings of large qualitative studies, and pointed to some potential solutions. Conclusions/Significance The integration of qualitative social science and the use of mixed methods and triangulation in clinical trials are feasible, and can reveal (and resolve) inaccuracies in data on adherence and sensitive behaviours, as well as illuminating aspects of “trial culture” that may also affect data accuracy. PMID:20657778

  15. Holistic Experiences and Strategies for Conducting Research With Couples.

    PubMed

    Braybrook, Debbie E; Mróz, Lawrence W; Robertson, Steve; White, Alan; Milnes, Kate

    2017-03-01

    In this article, we outline methodological considerations for conducting research interviews with couples. We draw from two qualitative men's health studies, both developed to explore social interactions between men and their partners of either sex in relation to their health practices. We utilized a combination of separate interviews and joint couple interviews. From these studies, we offer insight into our experiences of using both types of interview styles, addressing four key areas which span elements across the research project journey: (a) choosing a mode of interview, (b) ethical concerns in couple research, (c) the interview as a platform for disclosure, and (d) analyzing data from couple research.

  16. A Report on Indian Education: (A) In-Depth Study of Nine Indian Families; (B) Memory and Reasoning in Native Children: An Effort at Improvement Through the Teaching of Cognitive Strategies.

    ERIC Educational Resources Information Center

    Berger, Allen; And Others

    The purpose of this first phase of a 3-phase study was to obtain information to use as a base in developing a workable language arts curriculum. Part A of this report dealt with the techniques and results of in-depth interviews of 9 native families in Canada. Each family engaged in a sorting process to determine categories which were of immediate…

  17. Abstraction, ethics and software: Why don`t the rules work?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Warwick, S.

    1994-12-31

    A theory is presented that one of the reasons why the use of unlicensed software is so widespread and unstigmatized is that legislatures, courts and other bodies which create policy operate at a higher level of abstraction than do individuals, and that abstraction is a key factor in the divergence of societal behavior from that condoned by legal statute. This theory is explored through a pilot study consisting of medium depth interviews with two volunteers who had used unlicensed software. Their attitudes, understanding of the law, and characterization of the their use of unlicensed software as based on {open_quotes}need{close_quotes} ismore » reported. In addition, the concept of face is examined, and how it is maintained while violating law. It is suggested that further studies, using multiple methodologies, (in-depth interview, focus groups, and surveys) be conducted prior to developing further policy or legislation regarding intellectual property protection for software.« less

  18. Understanding women's experiences with medical abortion: In-depth interviews with women in two Indian clinics.

    PubMed

    Ganatra, B; Kalyanwala, S; Elul, B; Coyaji, K; Tewari, S

    2010-01-01

    We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical abortion, other factors influencing method selection were family support and distance from the facility. The degree of medicalisation that women wanted or felt was necessary also depended on the way expectations were set by their providers. Confirmation of abortion completion was a source of anxiety for many women and led to unnecessary interventions in a few cases. Ultimately, experiences depended more on women's expectations about the method, and on the level of emotional and logistic support they received rather than on inherent characteristics of the method. These findings emphasise the circumstances under which women make reproductive choices and underscore the need to tailor service delivery to meet women's needs. Women-centred counselling and care that takes into consideration individual circumstances are needed.

  19. Underdeveloped Themes in Qualitative Research: Relationship With Interviews and Analysis.

    PubMed

    Connelly, Lynne M; Peltzer, Jill N

    2016-01-01

    In this methodological article, the authors address the problem of underdeveloped themes in qualitative studies they have reviewed. Various possible reasons for underdeveloped themes are examined, and suggestions offered. Each problem area is explored, and literature support is provided. The suggestions that are offered are supported by the literature as well. The problem with underdeveloped themes in certain articles is related to 3 interconnected issues: (a) lack of clear relationship to the underlying research method, (b) an apparent lack of depth in interviewing techniques, and (c) lack of depth in the analysis. Underdeveloped themes in a qualitative study can lead to a lack of substantive findings that have meaningful implications for practice, research, and the nursing profession, as well as the rejection of articles for publication. Fully developed themes require knowledge about the paradigm of qualitative research, the methodology that is proposed, the effective techniques of interviewing that can produce rich data with examples and experiences, and analysis that goes beyond superficial reporting of what the participants have said. Analytic problem areas include premature closure, anxiety about how to analyze, and confusion about categories and themes. Effective qualitative research takes time and effort and is not as easy as is sometimes presumed. The usefulness of findings depends on researchers improving their research skills and practices. Increasingly researchers are using qualitative research to explore clinically important issues. As consumers of research or members of a research team, clinical nurse specialists need to understand the nature of this research that can provide in-depth insight and meaning.

  20. 78 FR 70059 - Agency Information Collection Activities: Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-22

    ... (as opposed to quantitative statistical methods). In consultation with research experts, we have... qualitative interviews (as opposed to quantitative statistical methods). In consultation with research experts... utilization of qualitative interviews (as opposed to quantitative statistical methods). In consultation with...

  1. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    PubMed

    Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

    2017-01-01

    Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  2. Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and RH status: Bangladesh

    PubMed Central

    2011-01-01

    Background Cost of delivering reproductive health services to low-income populations will always require total or partial subsidization by the government and/or development partners. Broadly termed "Demand-Side Financing" or "Output-Based Aid", includes a range of interventions that channel government or donor subsidies to the service user rather than the service provider. Initial findings from the few assessments of reproductive health voucher-and-accreditation programs suggest that, if implemented well, these programs have great potential for achieving the policy objectives of increasing access and use, reducing inequities and enhancing program efficiency and service quality. At this point in time, however, there is a paucity of evidence describing how the various voucher programs function in different settings, for various reproductive health services. Methods/Design Population Council-Nairobi, funded by the Bill and Melinda Gates Foundation, intends to address the lack of evidence around the pros and cons of 'voucher and accreditation' approaches to improving the reproductive health of low income women in five developing countries. In Bangladesh, the activities will be conducted in 11 accredited health facilities where Demand Side Financing program is being implemented and compared with populations drawn from areas served by similar non-accredited facilities. Facility inventories, client exit interviews and service provider interviews will be used to collect comparable data across each facility for assessing readiness and quality of care. In-depth interviews with key stakeholders will be conducted to gain a deeper understanding about the program. A population-based survey will also be carried out in two types of locations: areas where vouchers are distributed and similar locations where vouchers are not distributed. Discussion This is a quasi-experimental study which will investigate the impact of the voucher approach on improving maternal health behaviors and status and reducing inequities at the population level. We expect a significant increase in the utilization of maternal health care services by the accredited health facilities in the experimental areas compared to the control areas as a direct result of the interventions. If the voucher scheme in Bangladesh is found effective, it may help other countries to adopt this approach for improving utilization of maternity care services for reducing maternal mortality. PMID:21513528

  3. Evaluation of the impact of the voucher and accreditation approach on improving reproductive behaviors and RH status: Bangladesh.

    PubMed

    Rob, Ubaidur; Rahman, Moshiur; Bellows, Benjamin

    2011-04-22

    Cost of delivering reproductive health services to low-income populations will always require total or partial subsidization by the government and/or development partners. Broadly termed "Demand-Side Financing" or "Output-Based Aid", includes a range of interventions that channel government or donor subsidies to the service user rather than the service provider. Initial findings from the few assessments of reproductive health voucher-and-accreditation programs suggest that, if implemented well, these programs have great potential for achieving the policy objectives of increasing access and use, reducing inequities and enhancing program efficiency and service quality. At this point in time, however, there is a paucity of evidence describing how the various voucher programs function in different settings, for various reproductive health services. Population Council-Nairobi, funded by the Bill and Melinda Gates Foundation, intends to address the lack of evidence around the pros and cons of 'voucher and accreditation' approaches to improving the reproductive health of low income women in five developing countries. In Bangladesh, the activities will be conducted in 11 accredited health facilities where Demand Side Financing program is being implemented and compared with populations drawn from areas served by similar non-accredited facilities. Facility inventories, client exit interviews and service provider interviews will be used to collect comparable data across each facility for assessing readiness and quality of care. In-depth interviews with key stakeholders will be conducted to gain a deeper understanding about the program. A population-based survey will also be carried out in two types of locations: areas where vouchers are distributed and similar locations where vouchers are not distributed. This is a quasi-experimental study which will investigate the impact of the voucher approach on improving maternal health behaviors and status and reducing inequities at the population level. We expect a significant increase in the utilization of maternal health care services by the accredited health facilities in the experimental areas compared to the control areas as a direct result of the interventions. If the voucher scheme in Bangladesh is found effective, it may help other countries to adopt this approach for improving utilization of maternity care services for reducing maternal mortality.

  4. Feasibility study to determine the economic and operational benefits of utilizing unmanned aerial vehicles (UAVs).

    DOT National Transportation Integrated Search

    2014-04-01

    This project explored the feasibility of using Unmanned Aerial Systems (UASs) in Georgia : Department of Transportation (GDOT) operations. The research team conducted 24 interviews with : personnel in four GDOT divisions. Interviews focused on (1) th...

  5. The centrality of community dynamics in the socio-economic recovery of devastated communities.

    PubMed

    Gomez, A; Atallah, W; Bidaisee, S; Patel, C; Amuleru-Marshall, O

    2009-11-01

    To assess and explore the health and socio-economic outcomes of Jubilee, a community on the Caribbean island of Grenada hit by Hurricane Ivan in 2004 and to identify remaining barriers to recovery. The assessment consisted of a mixed methods approach employing observations, household surveys, in-depth interviews and focus groups. Eighty-five per cent of the residents live in a single-family home type dwelling which is occupied by multiple families. Twenty-seven per cent of the respondents depended on a river or stream for water and 83% utilized an outdoor pit latrine. Construction accounted for 28% of the employment while 16% reported having no occupation. Public and private transportation was limited and 48% of the residents lived on less than one United States of America (US) dollar per day. Access to healthcare was reported by 89% and the prevalence of diabetes and hypertension was identified by 13% and 30% of the residents respectively. Social fragmentation within the community represents a barrier that keeps the community from developing common goals leading to full economic recovery. Jubilee has not fully recovered from the effects of Hurricane Ivan, but progress has been made in the reconstruction effort. These efforts have addressed the most immediate and basic needs of the community, mainly utility service infrastructure and home repairs. However issues related to the community's economic recovery are still unresolved.

  6. Utility of the International Classification of Functioning, Disability and Health (ICF) for educational psychologists’ work

    PubMed Central

    Aljunied, Mariam; Frederickson, Norah

    2014-01-01

    Despite embracing a bio-psycho-social perspective, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) assessment framework has had limited application to date with children who have special educational needs (SEN). This study examines its utility for educational psychologists’ work with children who have Autism Spectrum Disorders (ASD). Mothers of 40 children with ASD aged eight to 12 years were interviewed using a structured protocol based on the ICF framework. The Diagnostic Interview for Social and Communication Disorder (DISCO) was completed with a subset of 19 mothers. Internal consistency and inter-rater reliability of the interview assessments were found to be acceptable and there was evidence for concurrent and discriminant validity. Despite some limitations, initial support for the utility of the ICF model suggests its potential value across educational, health and care fields. Further consideration of its relevance to educational psychologists in new areas of multi-agency working is warranted. PMID:26157197

  7. Impacts of CERCLA Release Notification Requirements on Transportation of Products Containing Hazardous Substances

    DOT National Transportation Integrated Search

    1986-08-01

    In order to determine the regulatory burden imposed by CERCLA release-notification requirements on shippers and carriers handling products containing hazardous substances, eight shippers and seven carriers were interviewed in depth during the summer ...

  8. Utility-Marketing Partnerships: An Effective Strategy for Marketing Green Power?

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Bird, L. A.; Brown, E. S.

    This paper explores whether partnerships between utilities and independent marketers are an effective strategy for marketing green power. We present case studies of voluntary and mandatory partnerships covering green power program design and implementation in both regulated and restructured electricity markets. We also include perspectives (based on interviews) from utilities, marketers, and regulators involved in developing and implementing these partnerships. From these case studies and interviews, we describe lessons learned about developing effective partnerships, including such issues as respective roles in marketing and administration, product branding, and contract and incentive structures. Based on experience to date, strategic partnerships between utilitiesmore » and marketers can be an effective approach to marketing green power. Partnerships leverage the sales and resource procurement experience of marketers and the utility?s reputation and access to customers. Further, partnerships can create greater incentives for success because marketers have a vested financial interest in maximizing customer participation and green power sales.« less

  9. Conversations: with Carl Pilcher [interview by Johan Benson].

    PubMed

    Pilcher, C

    1998-11-01

    An interview with Carl Pilcher, science program director for solar system exploration at NASA, examines NASA's past, present, and planned missions to explore the solar system. Specific questions relate to the status of current and planned missions, science results of the Pathfinder mission to Mars, cooperation with the Japanese space agency, the status of the search for extraterrestrial life in solar system meteoroids and asteroids, mission size for more in-depth exploration, reports of water on the moon, and the exploration of near-Earth objects.

  10. Integrating biomedical and herbal medicine in Ghana - experiences from the Kumasi South Hospital: a qualitative study.

    PubMed

    Boateng, Millicent Addai; Danso-Appiah, Anthony; Turkson, Bernard Kofi; Tersbøl, Britt Pinkowski

    2016-07-07

    Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants' interviews was employed to collect data. Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations.

  11. Consensus on context-specific strategies for reducing the stigma of human immunodeficiency virus/acquired immunodeficiency syndrome in Zambézia Province, Mozambique.

    PubMed

    Mukolo, Abraham; Torres, Isabel; Bechtel, Ruth M; Sidat, Mohsin; Vergara, Alfredo E

    2013-01-01

    Stigma has been implicated in poor outcomes of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) care. Reducing stigma is important for HIV prevention and long-term treatment success. Although stigma reduction interventions are conducted in Mozambique, little is known about the current nature of stigma and the efficacy and effectiveness of stigma reduction initiatives. We describe action research to generate consensus on critical characteristics of HIV stigma and anti-stigma interventions in Zambézia Province, Mozambique. Qualitative data gathering methods, including in-depth key-informant interviews, community interviews and consensus group sessions, were utilized. Delphi methods and the strategic options development analysis technique were used to synthesize qualitative data. Key findings are that stigma enacted by the general public might be declining in tandem with the HIV/AIDS epidemic in Mozambique, but there is likely excessive residual fear of HIV disease and community attitudes that sustain high levels of perceived stigma. HIV-positive women accessing maternal and child health services appear to shoulder a disproportionate burden of stigma. Unintentional biases among healthcare providers are currently the critical frontier of stigmatization, but there are few interventions designed to address them. Culturally sensitive psychotherapies are needed to address psychological distress associated with internalized stigma and these interventions should complement current supports for voluntary counseling and testing. While advantageous for defining stakeholder priorities for stigma reduction efforts, confirmatory quantitative studies of these consensus positions are needed before the launch of specific interventions.

  12. The Catch to Confidentiality: The Use of Electronic Health Records in Adolescent Health Care.

    PubMed

    Stablein, Timothy; Loud, Keith J; DiCapua, Christopher; Anthony, Denise L

    2018-05-01

    This study aims to understand pediatric health-care providers' expectations and the practices they employ to protect confidentiality in electronic health records (EHRs) and subsequently how EHRs affect the documentation and dissemination of information in the course of health-care delivery to adolescent minors. Twenty-six pediatric health-care providers participated in in-depth interviews about their experiences using EHRs to understand a broad spectrum of expectations and practices guiding the documentation and dissemination of information in the EHR. A thematic analysis of interviews was conducted to draw findings and conclusions. Two themes and several subthemes emerged centering on how EHRs affected confidentiality expectations and practices. Participants expressed confidentiality concerns due to the EHR's longevity as a legacy record, its multidimensional uses, and increased access by users (theme 1). These concerns affected practices for protecting adolescent confidentiality within the EHR (theme 2). Practices included selectively omitting or concealing information and utilizing sets of personal and collective codes designed to alert providers or teams of providers to confidential information within a patient's record. EHRs create new and unresolved challenges for pediatric health care as they alter expectations of confidentiality and the documentation and dissemination of information within the record. This is particularly relevant in the course of care to adolescent minors as EHRs may compromise the tenuous balance providers maintain between protecting confidentiality and effective documentation within the record. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. Social surveys in HIV/AIDS: telling or writing? A comparison of interview and postal methods.

    PubMed

    McEwan, R T; Harrington, B E; Bhopal, R S; Madhok, R; McCallum, A

    1992-06-01

    We compare a probability sample postal questionnaire survey and a quota controlled interview survey, and review the literature on these subjects. In contrast to other studies, where quota samples were not representative because of biased selection of respondents by interviewers, our quota sample was representative. Response rates were similar in our postal and interview surveys (74 and 77%, respectively), although many previous similar postal surveys had poor response rates. As in other comparison studies, costs were higher in our interview survey, substantive responses and the quality of responses to closed-ended questions were similar, and responses to open-ended questions were better in the interview survey. 'Socially unacceptable' responses on sexual behaviour were less likely in interviews. Quota controlled surveys are appropriate in surveys on HIV/AIDS under certain circumstances, e.g. where the population parameters are well known, and where interviewers can gain access to the entire population. Postal questionnaires are better for obtaining information on sexual behaviour, if adequate steps are taken to improve response rates, and when in-depth answers are not needed. For most surveys in the HIV/AIDS field we recommend the postal method.

  14. Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications.

    PubMed

    Alpert, Jordan M; Krist, Alex H; Aycock, Rebecca A; Kreps, Gary L

    2017-03-01

    Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology.

  15. Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications

    PubMed Central

    Krist, Alex H.; Aycock, Rebecca A.; Kreps, Gary L.

    2017-01-01

    Abstract Background: Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). Materials and Methods: In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. Results: Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). Conclusions: Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology. PMID:27333468

  16. A Preliminary Evaluation of the Potential Utility of the Surface Condition Analyzer (SCAN) System for Monitoring Runway Water Depth as Relating to Runway Traction.

    DTIC Science & Technology

    1980-01-01

    one year with the savings realized in reduced wear on arresting gear. 2.2 Evaluation of the Potential Utility of the SCAN System for Monitoring Runway...without loss of accuracy due to build-up of rubber and other contaminants on the sensor surface? 2. Can water depth be measured representatively on a...Hargett, E.R., 1974: Skid- Resistance Evaluation of Seven Antihydroplaning Surfaces, Air Force Weapons Laboratory, Kirtland AP. NM4 87117, 39 pp

  17. Use of qualitative methods to explore the quality-of-life construct from a consumer perspective.

    PubMed

    Corring, Deborah J; Cook, Joanne V

    2007-02-01

    This study explored the construct of quality of life from the perspective of adults diagnosed as having severe and persistent mental illness, such as schizophrenia. Qualitative research strategies, specifically in-depth interviews (N=18) and focus groups (N=35), were used to collect data. Interviews and focus groups took place in hospitals, community clinics, community agencies, and clients' homes. A convenience, snowball sampling strategy was utilized. Analysis using the constant comparative method resulted in the identification of two dominant themes. These themes permeated the results, crossed all domains, influenced the linkages between domains, and clearly influenced how individuals frame their expectations regarding quality of life. The first theme was the presence of stigma and its effects on everyday life and future planning, and the second was the pervasive fear of the return of major positive symptoms of psychosis, such as hallucinations, delusions, and general loss of contact with reality. In addition, four quality-of-life domains were identified-the experience of illness, relationships, occupation, and sense of self. Many persons with mental illness simply wish for the basics in life-mental and physical health, supportive relationships, meaningful occupations, and a positive sense of self-believing that acquisition of these basics will lead to a more satisfactory quality of life. Ensuring that they are able to obtain the basics requires action on their part, by those who support them, by service providers that interact with them, and by a more accepting society.

  18. Risks associated with antiretroviral treatment for human immunodeficiency virus (HIV): qualitative analysis of social media data and health state utility valuation.

    PubMed

    Matza, Louis S; Chung, Karen C; Kim, Katherine J; Paulus, Trena M; Davies, Evan W; Stewart, Katie D; McComsey, Grace A; Fordyce, Marshall W

    2017-07-01

    Despite benefits of antiretroviral therapies (ART), people with HIV infection have increased risk of cardiovascular disease, kidney disease, and low bone mineral density. Some ARTs increase risk of these events. The purpose of this study was to examine patients' perspectives of these risks and estimate health state utilities associated with these risks for use in cost-utility models. Qualitative thematic analysis was conducted to examine messages posted to the POZ/AIDSmeds Internet community forums, focusing on bone, kidney, and cardiovascular side effects and risks of HIV/AIDS medications. Then, health state vignettes were drafted based on this qualitative analysis, literature review, and clinician interviews. The health states (representing HIV, plus treatment-related risks) were valued in time trade-off interviews with general population participants in the UK. Qualitative analysis of the Internet forums documented patient concerns about ART risks, as well as treatment decisions made because of these risks. A total of 208 participants completed utility interviews (51.4% female; mean age 44.6 years). The mean utility of the HIV health state (virologically suppressed, treated with ART) was 0.86. Adding a description of risk resulted in statistically significant disutility (i.e., utility decreases): renal risk (disutility = -0.02), bone risk (-0.03), and myocardial infarction risk (-0.05). Patient concerns and treatment decisions were documented via qualitative analysis of Internet forum discussions, and the impact of these concerns was quantified in terms of health state utilities. The resulting disutilities may be useful for differentiating among ARTs in economic modeling of treatment for patients with HIV.

  19. Silence of male child sexual abuse in India: Qualitative analysis of barriers for seeking psychiatric help in a multidisciplinary unit in a general hospital

    PubMed Central

    Subramaniyan, Vyjayanthi Kanugodu Srinivasa; Reddy, Praveen; Chandra, Girish; Rao, Chandrika; Rao, T. S. Sathyanarayana

    2017-01-01

    Introduction: In 2007, Ministry of Women and Child Welfare, supported by United Nations Children's Fund, save the children and Prayas conducted a study to understand the magnitude of child abuse in India, they found that 53.22% children faced one or more forms of sexual abuse; among them, the number of boys abused was 52.94%. Aim: The aim of this study was to explore the barriers for seeking psychiatric help by qualitative analysis of stake holders of male victims of child abuse. Materials and Methods: All the statements made by the stakeholders regarding psychiatric assessment and treatment were recorded in each referral made to the psychiatrist. Semistructured interviews and in-depth interviews were conducted to explore the topic of understanding the need for psychiatric treatment to the victims. Results: Collaborative child response unit, a multidisciplinary team, to tackle child sexual abuse in a general hospital received three referrals of male child abuse among the 27 referrals in 20 months. The main theme of the barrier that was generated by interviewing the stakeholders of male child victims of abuse was the misconception of superiority of a male victim due to gender (patriarchy) an expectation that he will outgrow the experience. In-depth interviews of three cases of homosexual abuse explored the theme. Conclusion: Patriarchy is oppressing male children and acts as a barrier to seek psychiatric help in collaborative child response unit. PMID:28827868

  20. SPS market analysis

    NASA Astrophysics Data System (ADS)

    Goff, H. C.

    1980-05-01

    A market analysis task included personal interviews by GE personnel and supplemental mail surveys to acquire statistical data and to identify and measure attitudes, reactions and intentions of prospective small solar thermal power systems (SPS) users. Over 500 firms were contacted, including three ownership classes of electric utilities, industrial firms in the top SIC codes for energy consumption, and design engineering firms. A market demand model was developed which utilizes the data base developed by personal interviews and surveys, and projected energy price and consumption data to perform sensitivity analyses and estimate potential markets for SPS.

  1. A one-size-fits-all HIV prevention and education approach?: Analyzing and interpreting divergent HIV risk perceptions between African American and East African immigrant women in Washington, DC

    PubMed Central

    De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

    2015-01-01

    Background To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born Black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women’s perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the US. Methods Forty in-depth, semi-structured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semi-structured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. Results Adopting Boerma and Weir’s Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. While African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. Conclusions Study findings suggest that addressing HIV prevention and education among Black women in DC will require distinct and targeted strategies that are culturally and community-centered in order to resonate with these different audiences. PMID:26766523

  2. Current Status and Future Trends of Diversity Initiatives in the Workplace: Diversity Experts' Perspective.

    ERIC Educational Resources Information Center

    Wentling, Rose Mary; Palma-Rivas, Nilda

    1998-01-01

    In-depth interviews with 12 diversity experts identified organizational and individual barriers inhibiting development of a diverse workforce. Primary reasons for diversity initiatives included improving productivity, enhancing social responsibility, and addressing legal concerns. (SK)

  3. A One-Size-Fits-All HIV Prevention and Education Approach?: Interpreting Divergent HIV Risk Perceptions Between African American and East African Immigrant Women in Washington, DC Using the Proximate-Determinants Conceptual Framework.

    PubMed

    De Jesus, Maria; Taylor, Juanita; Maine, Cathleen; Nalls, Patricia

    2016-02-01

    To date, there are very few comparative US studies and none in DC that distinguish between US-born and foreign-born black women to examine and compare their perceptions of HIV risk. This qualitative study, therefore, analyzes African American and East African women's perceptions of HIV risk in the Washington DC Metropolitan area, which has the highest AIDS rate in the United States. Forty in-depth, semistructured interviews and 10 cognitive interviews were conducted among a sample of 25 African American women and 25 East African born women between October 2012 and March 2013 to examine perceptions regarding HIV risk. The in-depth semistructured interviews were preceded by the cognitive interviews and accompanying survey. Study protocol was reviewed and approved by the American University Institutional Review Board. Adopting Boerma and Weir's Proximate Determinants conceptual framework to interpret the data, the results of the study demonstrate that African American and East African immigrant women have divergent perceptions of HIV risk. Although African American women ascribe HIV risk to individual-level behaviors and choices such as unprotected sex, East African women attribute HIV risk to conditions of poverty and survival. Study findings suggest that addressing HIV prevention and education among black women in DC will require distinct and targeted strategies that are culturally and community-centered to resonate with these different audiences.

  4. Innovation in the safety net: integrating community health centers through accountable care.

    PubMed

    Lewis, Valerie A; Colla, Carrie H; Schoenherr, Karen E; Shortell, Stephen M; Fisher, Elliott S

    2014-11-01

    Safety net primary care providers, including as community health centers, have long been isolated from mainstream health care providers. Current delivery system reforms such as Accountable Care Organizations (ACOs) may either reinforce the isolation of these providers or may spur new integration of safety net providers. This study examines the extent of community health center involvement in ACOs, as well as how and why ACOs are partnering with these safety net primary care providers. Mixed methods study pairing the cross-sectional National Survey of ACOs (conducted 2012 to 2013), followed by in-depth, qualitative interviews with a subset of ACOs that include community health centers (conducted 2013). One hundred and seventy-three ACOs completed the National Survey of ACOs. Executives from 18 ACOs that include health centers participated in in-depth interviews, along with leadership at eight community health centers participating in ACOs. Key survey measures include ACO organizational characteristics, care management and quality improvement capabilities. Qualitative interviews used a semi-structured interview guide. Interviews were recorded and transcribed, then coded for thematic content using NVivo software. Overall, 28% of ACOs include a community health center (CHC). ACOs with CHCs are similar to those without CHCs in organizational structure, care management and quality improvement capabilities. Qualitative results showed two major themes. First, ACOs with CHCs typically represent new relationships or formal partnerships between CHCs and other local health care providers. Second, CHCs are considered valued partners brought into ACOs to expand primary care capacity and expertise. A substantial number of ACOs include CHCs. These results suggest that rather than reinforcing segmentation of safety net providers from the broader delivery system, the ACO model may lead to the integration of safety net primary care providers.

  5. Expanding the clinical role of community pharmacy: A qualitative ethnographic study of medication reviews in Ontario, Canada.

    PubMed

    Patton, Sarah J; Miller, Fiona A; Abrahamyan, Lusine; Rac, Valeria E

    2018-03-01

    Medication reviews by community pharmacists are an increasingly common strategy to improve medication management for chronic conditions, and are part of wider efforts to make more effective use of community-based health professionals. To identify opportunities to optimize the medication review program in Ontario, Canada, we explored how providers and clients interpret and operationalize medication reviews within everyday community pharmacy practice. We conducted a qualitative ethnographic study at four pharmacies in Ontario, Canada, including non-participant observation of provider and client activities and interactions with specific attention to medication reviews, as well as brief ethnographic interviews with providers and clients, and in-depth, semi-structured interviews with providers. We report on 72h of field research, observation of 178 routine pharmacist-client interactions and 29 medication reviews, 62 brief ethnographic interviews with providers and clients, and 7 in-depth, semi-structured interviews with providers. We found that medication reviews were variably conducted across the dimensions of duration, provider type, location, and interaction style, and that local contexts and system-wide developments influence their meaning and practice. Medication reviews are exemplary of policy efforts to enhance the role of community pharmacies within health systems and the scope of practice of pharmacists as healthcare professionals. Our study highlights the importance of the local structure of community pharmacy practice and the clinical aspirations of pharmacists in the delivery of medication reviews. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Implementation of the Cultural Formulation through a newly developed Brief Cultural Interview: Pilot data from the Netherlands.

    PubMed

    Groen, Simon P N; Richters, Annemiek; Laban, Cornelis J; Devillé, Walter L J M

    2017-02-01

    The Outline for a Cultural Formulation (OCF) has remained underutilized in clinical practice since its publication in the DSM-IV in 1994. In the Netherlands, a Cultural Interview (CI) was developed in 2002 as a tool to facilitate use of the OCF in clinical practice. The time needed to conduct the interview, however, prevented its systematic implementation within mental health institutions. This article presents the development of a shortened and adapted version, the Brief Cultural Interview (BCI), and a pilot study on the feasibility, acceptability, and utility of its implementation with refugee and asylum seeking patients in a Dutch centre for transcultural psychiatry. Results show that the brief version scores better on feasibility and acceptability, while utility for clinical practice remains similar to that of the original CI. These results support the systematic use of the OCF in psychiatric care for a culturally diverse patient population through the application of a relatively brief cultural interview. A secondary finding of the study is that patients' cultural identity was considered by clinicians to be more relevant in the treatment planning sessions than their illness explanations.

  7. Influence of interlocutor/reader on utterance in reflective writing and interview

    NASA Astrophysics Data System (ADS)

    Collyer, Vivian M.

    2010-03-01

    The influence of the Other on utterance is foundational to language study. This analysis contrasts this influence within two modes of communication: reflective writing and interview. The data source is derived from the reflective writings and interview transcripts of a twelfth-grade physics student. In this student's case, reflective writing includes extensive utterances, utilizing rhetorical devices to persuade and reconcile with his reader. In the interview, on-going back-and-forth utterances allow the two participants to negotiate a co-constructed meaning for religion. Implications for the classroom are briefly discussed.

  8. Nurses experiences in chemical emergency departments: Iran-Iraq war, 1980-1988.

    PubMed

    Firouzkouhi, Mohammadreza; Zargham-Boroujeni, Ali; Nouraei, Morteza; Yousefi, Hojatollah; Holmes, Colin A

    2013-04-01

    Nurses have played a major role in taking care of the wounded across the centuries. One of the most important roles of Iranian nurses in wartime has been working in chemical emergency departments. This study investigated the nature of nursing practice in chemical emergency departments created in the context of the Iran-Iraq War fought during 1980-1988. This is a history methodology design with oral history and in-depth interview to detect nurses 'actual experiences in chemical emergency departments while taking care of the chemically injured military forces. Today's nurses emphasize finding new ways to fulfill the present nursing needs and to combine theory and practice in an appropriate framework. Having a retrospective approach to utilize nurses' experience can well clarify the future way to achieve this goal. This study revealed the way the nurses prepared to take care of the chemically injured in miserable situations and their practice in chemical emergency departments. It highlighted their awareness of wartime nursing and the challenging experiences it brings. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. The role of small agribusiness in regional development: the case of Sumatera Utara province

    NASA Astrophysics Data System (ADS)

    Subhilhar

    2018-03-01

    The agribusiness is an emerging sector in Indonesia and its potential needs to be fully explored. Its development can contribute to a development of regions or correct the discrepancy in welfare benefits between groups and regions. The development of small agribusiness is important and strategic. There are more than 32 million small agribusinesses with their working capital less than Rp. 2 billion per year. In Indonesia, out of this 90 percent (about 21.30 million business units) are household businesses which run business in the agriculture sector. The aim of this study is to identify the contributions of small agribusiness to regional development in Sumatera Utara. The method that used in this study is quantitative approach by using survey and case studies through an in-depth interview. The result shows that small agribusinesses do contribute significantly towards regional development in Sumatera Utara. This study found that annual business turnover significantly contributes toward regional development. The main contribution of small agribusinesses is in the utilization of labor force and local tax revenues.

  10. Older adults' influence in family care: how do daughters and aging parents navigate differences in care goals?

    PubMed

    Heid, Allison R; Zarit, Steven H; Van Haitsma, Kimberly

    2016-01-01

    This study seeks to address how older adults influence their daily care when their preferences conflict with those of their adult daughter caregivers. Using a sample of 10 dyads (N = 20) of an older adult and adult daughter, we utilize content analysis strategies to analyze in-depth, semi-structured interview data with QSR NVIVO to investigate how older adults influence their care, how daughters respond to such efforts of influence, and how dyads navigate differences in care goals. When there is agreement in goals, dyads report tasks going well and both individuals' requests are honored. When there are differences in care goals, daughters most frequently reason with their older parents, while parents walk away or 'let go' of their requests. Daughters report making decisions for their parents for health or safety-related needs. However, all dyads discuss differences in care goals, whereby parents are perceived as insisting, resisting, or persisting in care. Findings illustrate complex patterns of responses by families when navigating differences in daily care goals that carry important implications for research and the development of dyadic-based family interventions.

  11. Disadvantaged persons' participation in health promotion projects: some structural dimensions.

    PubMed

    Boyce, W F

    2001-05-01

    A structural perspective was used in studying community participation of disadvantaged groups (poor women, street youth, and disabled persons) in health promotion projects. Five community projects in the Canadian Health Promotion Contribution Program were examined in a comparative case study utilizing in-depth interviews, documents, and secondary sources. Analysis revealed relatively low numbers and restricted range of participants, difficulties in recruiting and maintaining participants, declining rates of active participation over time, and limited target group influence and power. This paper reports on the relationship between various dimensions of structure (social-cultural, organizational, political-legal-economic) and the community participation process. Participation was influenced by structural factors such as bureaucratic rules and regulators, perceived minority group rights and relations, agency reputations and responsibilities, available resources, and organizational roles. Control of projects by target group members, rather than by service agencies, was an important overall organizational structural factor which allowed community members to achieve influence in projects. The study concludes that a conceptual model based on structural factors is useful in explaining how key factors from federal and local levels can restrict or facilitate the community participation process.

  12. Depth inpainting by tensor voting.

    PubMed

    Kulkarni, Mandar; Rajagopalan, Ambasamudram N

    2013-06-01

    Depth maps captured by range scanning devices or by using optical cameras often suffer from missing regions due to occlusions, reflectivity, limited scanning area, sensor imperfections, etc. In this paper, we propose a fast and reliable algorithm for depth map inpainting using the tensor voting (TV) framework. For less complex missing regions, local edge and depth information is utilized for synthesizing missing values. The depth variations are modeled by local planes using 3D TV, and missing values are estimated using plane equations. For large and complex missing regions, we collect and evaluate depth estimates from self-similar (training) datasets. We align the depth maps of the training set with the target (defective) depth map and evaluate the goodness of depth estimates among candidate values using 3D TV. We demonstrate the effectiveness of the proposed approaches on real as well as synthetic data.

  13. Reconsidering change and continuity in later life: toward an innovation theory of successful aging.

    PubMed

    Nimrod, Galit; Kleiber, Douglas A

    2007-01-01

    This article examines the patterns and meanings of innovation in the activities of a group of retirees with an eye toward understanding the place and value of innovation in the aging process. Starting with a consideration of continuity theory, as a perspective that simply describes typical patterns of activity, and activity theory that prescribes expansion of activities as a key to well-being, this article highlights the characteristics, meanings and perceived benefits of a wide variety of innovative activities. The study utilized in-depth semi-structured interviews with a purposive sample of 20 male and female retirees involved in a "Learning and Retirement" program. Innovations that both preserve a sense of self (internal continuity) as well as those that allow one to strike out in entirely new direction are described, and, using a process of constant comparison, their motivational dynamics are explored. Given previous arguments that activity can be indiscriminate and disintegrative in some circumstances, we nevertheless suggest that innovation can be growth producing and liberating, even in later life, while at the same time generally protecting a sense of internal continuity.

  14. Industry perspectives on Plug-& -Play Spacecraft Avionics

    NASA Astrophysics Data System (ADS)

    Franck, R.; Graven, P.; Liptak, L.

    This paper describes the methodologies and findings from an industry survey of awareness and utility of Spacecraft Plug-& -Play Avionics (SPA). The survey was conducted via interviews, in-person and teleconference, with spacecraft prime contractors and suppliers. It focuses primarily on AFRL's SPA technology development activities but also explores the broader applicability and utility of Plug-& -Play (PnP) architectures for spacecraft. Interviews include large and small suppliers as well as large and small spacecraft prime contractors. Through these “ product marketing” interviews, awareness and attitudes can be assessed, key technical and market barriers can be identified, and opportunities for improvement can be uncovered. Although this effort focuses on a high-level assessment, similar processes can be used to develop business cases and economic models which may be necessary to support investment decisions.

  15. Worker Dislocation and Its Consequences.

    ERIC Educational Resources Information Center

    Rosenbaum, Allan; Zirkin, Barbara G.

    A study examined the socioeconomic characteristcs, family and social supportive services, economic and social difficulties, education and training levels, and ways in which dislocated workers in Maryland found reemployment. Data were collected from in-depth personal interviews with 9 dislocated workers, questionnaires administered to 45 unemployed…

  16. Study of Automobile Market Dynamics : Volume 1. Description.

    DOT National Transportation Integrated Search

    1977-08-01

    To determine the effects of alternative energy conservation policies on total sales of new cars and upon the distribution by size-class and origin (foreign vs. domestic), in-depth interviews were administered to seven hundred recent new-car buyers. E...

  17. Value Tools in Managed Care Decision Making: Current Hurdles and Future Opportunities.

    PubMed

    Schafer, Jeremy; Galante, Dominic; Shafrin, Jason

    2017-06-01

    Organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Institute for Clinical and Economic Review, and Memorial Sloan Kettering have created distinct tools to help different stakeholders assess the value of oncology treatments. However, the oncology value tools were not necessarily created for payers, and it is unclear whether payers are using these tools as part of their drug management process. To understand what value tools payers are using in oncology management and what benefits and shortcomings the tools may have from the payer perspective. A survey targeting drug coverage decision makers at health plans was conducted in August 2016. Respondents attesting to using 2 or more value tools in drug management were eligible for an additional in-depth interview to understand the respondents' perceived benefits and shortcomings of current value tools. Respondents also were asked to describe desired attributes of a hypothetical payer-centric value tool. A total of 28 respondents representing approximately 160 million commercially insured medical lives completed the survey. Twenty respondents (71%) reported using at least 1 value tool in their drug management process. Twelve respondents (43%) used at least 2 tools, and 4 respondents (14%) used at least 3 tools. A total of 6 respondents were selected for in-depth interviews. Interviewees praised value tools for advancing the discussion on drug value and incorporating clinical evidence. However, interviewees felt available value tools varied on providing firm recommendations and relevant price benchmarks. Respondents most commonly recommended the following attributes of a proposed payer-centric value framework: taking a firm position on product value; product comparisons in lieu of comparative clinical trials; web-based tool access; and tool updates at least quarterly. Interview respondents also expressed some support for allowing manipulation of inputs and inclusion of quality-of-life and patient-reported outcome data. Although nearly half of payers surveyed use 2 or more value tools in the drug management process, payers identified a number of areas where the tools could be revised to increase their utility to payers. No outside funding or assistance of any kind was used for this research or in manuscript preparation. Schafer and Galante are employed by Precision for Value, a payer ad marketing agency that works exclusively with life science companies. Shafrin is employed by Precision Health Economics, a consulting company to insurance and life science industries. Shafer, along with Galante and Shafrin, contributed to study design, data collection, and manuscript preparation. The authors contributed equally to data analysis and interpretation and manuscript revision.

  18. Joint Estimation of Source Range and Depth Using a Bottom-Deployed Vertical Line Array in Deep Water

    PubMed Central

    Li, Hui; Yang, Kunde; Duan, Rui; Lei, Zhixiong

    2017-01-01

    This paper presents a joint estimation method of source range and depth using a bottom-deployed vertical line array (VLA). The method utilizes the information on the arrival angle of direct (D) path in space domain and the interference characteristic of D and surface-reflected (SR) paths in frequency domain. The former is related to a ray tracing technique to backpropagate the rays and produces an ambiguity surface of source range. The latter utilizes Lloyd’s mirror principle to obtain an ambiguity surface of source depth. The acoustic transmission duct is the well-known reliable acoustic path (RAP). The ambiguity surface of the combined estimation is a dimensionless ad hoc function. Numerical efficiency and experimental verification show that the proposed method is a good candidate for initial coarse estimation of source position. PMID:28590442

  19. Commercialization of biopharmaceutical knowledge in Iran; challenges and solutions

    PubMed Central

    2014-01-01

    Background The objective of this study was to investigate the application of the university research findings or commercialization of the biopharmaceutical knowledge in Iran and determine the challenges and propose some solutions. Results A qualitative study including 19 in-depth interviews with experts was performed in 2011 and early 2012. National Innovation System (NIS) model was employed as the study design. Thematic method was applied for the analysis. The results demonstrate that policy making, regulations and management development are considered as fundamental reasons for current commercialization practice pattern. It is suggested to establish foundation for higher level documents that would involve relating bodies and provide them operational guidelines for the implementation of commercialization incentives. Conclusions Policy, regulations and management as the most influential issue should be considered for successful commercialization. The present study, for the first time, attempts to disclose the importance of evidence input for measures in order to facilitate the commercialization process by the authorities in Iran. Overall, the NIS model should be considered and utilized as one of the effective solutions for commercialization. PMID:24568555

  20. A qualitative analysis of case managers' use of harm reduction in practice.

    PubMed

    Tiderington, Emmy; Stanhope, Victoria; Henwood, Benjamin F

    2013-01-01

    The harm reduction approach has become a viable framework within the field of addictions, yet there is limited understanding about how this approach is implemented in practice. For people who are homeless and have co-occurring psychiatric and substance use disorders, the Housing First model has shown promising results in employing such an approach. This qualitative study utilizes ethnographic methods to explore case managers' use of harm reduction within Housing First with a specific focus on the consumer-provider relationship. Analysis of observational data and in-depth interviews with providers and consumers revealed how communication between the two regarding the consumer's substance use interacted with the consumer-provider relationship. From these findings emerged a heuristic model of harm reduction practice that highlighted the profound influence of relationship quality on the paths of communication regarding substance use. This study provides valuable insight into how harm reduction is implemented in clinical practice that ultimately has public health implications in terms of more effectively addressing high rates of addiction that contribute to homelessness and health disparities. Copyright © 2013 Elsevier Inc. All rights reserved.

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