Experiences with Work and Participation in Public Programs by Low-Income Medicaid Enrollees Using Qualitative Interviews

Abstract Background The North Carolina Healthy Food Small Retailer Program (NC HFSRP) was established through a policy passed by the state legislature to provide funding for small food retailers located in food deserts with the goal of increasing access to and sales of healthy foods and beverages among local residents. The purpose of this study was to qualitatively examine perceptions of the NC HFSRP among store customers. Methods Qualitative interviews were conducted with 29 customers from five NC HFSRP stores in food deserts across eastern NC. Interview questions were related to shoppers’ food and beverage purchases at NC HFSRP stores, whether they had noticed any in-store efforts to promote healthier foods and beverages, their suggestions for promoting healthier foods and beverages, their familiarity with and support of the NC HFSRP, and how their shopping and consumption habits had changed since implementation of the NC HFSRP. A codebook was developed based on deductive (from the interview guide questions) and inductive (emerged from the data) codes and operational definitions. Verbatim transcripts were double-coded and a thematic analysis was conducted based on code frequency, and depth of participant responses for each code. Results Although very few participants were aware of the NC HFSRP legislation, they recognized changes within the store. Customers noted that the provision of healthier foods and beverages in the store had encouraged them to make healthier purchase and consumption choices. When a description of the NC HFSRP was provided to them, all participants were supportive of the state-funded program. Participants discussed program benefits including improving food access in low-income and/or rural areas and making healthy choices easier for youth and for those most at risk of diet-related chronic diseases. Conclusions Findings can inform future healthy corner store initiatives in terms of framing a rationale for funding or policies by focusing on increased food access among vulnerable populations.

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“Trailer Trash” Stigma and Belonging in Florida Mobile Home Parks

Social Inclusion ◽

10.17645/si.v8i1.2391 ◽

2020 ◽

Vol 8 (1) ◽

pp. 66-75 ◽

Cited By ~ 1

Author(s):

Margarethe Kusenbach

Keyword(s):

United States ◽

Sense Of Community ◽

Low Income ◽

Qualitative Interviews ◽

The United States ◽

Mobile Home ◽

Central Florida ◽

Discursive Strategies ◽

Mobile Homes ◽

Community Belonging

<p>In the United States, residents of mobile homes and mobile home communities are faced with cultural stigmatization regarding their places of living. While common, the “trailer trash” stigma, an example of both housing and neighborhood/territorial stigma, has been understudied in contemporary research. Through a range of discursive strategies, many subgroups within this larger population manage to successfully distance themselves from the stigma and thereby render it inconsequential (Kusenbach, 2009). But what about those residents—typically white, poor, and occasionally lacking in stability—who do not have the necessary resources to accomplish this? This article examines three typical responses by low-income mobile home residents—here called resisting, downplaying, and perpetuating—leading to different outcomes regarding residents’ sense of community belonging. The article is based on the analysis of over 150 qualitative interviews with mobile home park residents conducted in West Central Florida between 2005 and 2010.</p>

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What price a welcome? Understanding structure agency in the delivery of respectful midwifery care in Uganda

International Journal of Health Governance ◽

10.1108/ijhg-11-2017-0061 ◽

2018 ◽

Vol 23 (1) ◽

pp. 46-59 ◽

Cited By ~ 1

Author(s):

Louise Ackers ◽

Hannah Webster ◽

Richard Mugahi ◽

Rachel Namiiro

Keyword(s):

Public Health ◽

Low Income ◽

Quality Care ◽

Qualitative Interviews ◽

Health Facilities ◽

Content Type ◽

Mortality And Morbidity ◽

Private Care ◽

Willingness To Disclose ◽

Respectful Care

Purpose The purpose of this paper is to present the findings of research on mothers and midwives’ understanding of the concept of respectful care in the Ugandan public health settings. It focusses on one aspect of respect; namely communication that is perhaps least resource-dependent. The research found endemic levels of disrespect and tries to understand the reasons behind these organisational cultures and the role that governance could play in improving respect. Design/methodology/approach The study involved a combination of in-depth qualitative interviews with mothers and midwives together with focus groups with a cohort of midwives registered for a degree. Findings The findings highlight an alarming level of verbal abuse and poor communication that both deter women from attending public health facilities and, when they have to attend, reduces their willingness to disclose information about their health status. Respect is a major factor reducing the engagement of those women unable to afford private care, with health facilities in Uganda. Research limitations/implications Access to quality care provided by skilled birth attendants (midwives) is known to be the major factor preventing improvements in maternal mortality and morbidity in low income settings. Although communication lies at the agency end of the structure-agency continuum, important aspects of governance contribute to high levels of disrespect. Originality/value Whilst there is a lot of research on the concept of respectful care in high income settings applying this to the care environment in low resource settings is highly problematic. The findings presented here generate a more contextualised analysis generating important new insights which we hope will improve the quality of care in Uganda health facilities.

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Do institutions matter?

Journal of Enterprising Communities People and Places in the Global Economy ◽

10.1108/jec-04-2018-0027 ◽

2019 ◽

Vol 13 (3) ◽

pp. 319-332

Author(s):

Habiba Ibrahim

Keyword(s):

Social Networks ◽

Low Income ◽

Qualitative Interviews ◽

Community Support ◽

Institutional Perspective ◽

Content Type ◽

Credit Line ◽

Institutional Determinants ◽

The Usa ◽

Nationally Representative

Purpose Guided by the institutional theory of savings, the purpose of this study is to assess the institutional elements of rotating, savings and credit associations (ROSCAs) that enable participants to save. Design/methodology/approach The study used data from in-depth qualitative interviews (N = 10) conducted among the ROSCA group leaders from African immigrant communities in the USA. Findings The primary goal for joining the ROSCA group among participants is to achieve economic stability. The results of the study postulate that, through institutional mechanisms and social networks, ROSCAs create an environment for families to save and invest. The emphasis on the concept of “you cannot save alone” underscores the importance of supportive structures to enable low-income households to save. Although “alternative savings programs” such as ROSCAs are imagined as something that less well-to-do persons use, the findings from this study demonstrate that such strategies also appeal to some people with higher socioeconomic status. This appeal and utility speaks to the importance of ROSCAs as an institutional response, rather than just an informal arrangement among persons known to each other. Research limitations/implications It is prudent to bear in mind that the study sample is not nationally representative, and therefore, the results presented cannot be generalized to immigrants across the country. However, as one of the few ROSCA studies in the USA, the findings from this study make generous contributions to the immigrants’ savings and ROSCA practices literature. Practical implications ROSCAs could be used as a bridge to the formal financial institutions. Non-profit agencies working with these communities could work with these groups to report ROSCA payments to the major credit bureaus, to help them build a credit line in their new country. Originality/value Previous studies of ROSCAs have assessed ROSCAs as community support systems and social networks. The current study has analyzed ROSCAs from an institutional perspective by examining the institutional characteristics of ROSCAs comparable to the institutional determinants of savings that enable savings among the participants.

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Qualitative research study on addressing barriers to healthy diet among low-income individuals at an urban, safety-net hospital

BMJ Nutrition, Prevention & Health ◽

10.1136/bmjnph-2020-000064 ◽

2020 ◽

pp. bmjnph-2020-000064

Author(s):

Erin Cahill ◽

Stacie R Schmidt ◽

Tracey L Henry ◽

Gayathri Kumar ◽

Sara Berney ◽

...

Keyword(s):

Behaviour Change ◽

Healthy Eating ◽

Low Income ◽

Dietary Habits ◽

Qualitative Interviews ◽

Safety Net ◽

Nutritional Knowledge ◽

Adequate Food ◽

Safety Net Hospital ◽

Urban Safety

BackgroundSome American households experience food insecurity, where access to adequate food is limited by lack of money and other resources. As such, we implemented a free 6-month Fruit and Vegetable Prescription Program within a large urban safety-net hospital .Methods32 participants completed a baseline and postintervention qualitative evaluation about food-related behaviour 6 months after study completion. Deductive codes were developed based on the key topics addressed in the interviews; inductive codes were identified from analytically reading the transcripts. Transcripts were coded in MAXQDA V.12 (Release 12.3.2).ResultsThe information collected in the qualitative interviews highlights the many factors that affect dietary habits, including the environmental and individual influences that play a role in food choices people make. Participants expressed very positive sentiments overall about their programme participation.ConclusionsA multifaceted intervention that targets individual behaviour change, enhances nutritional knowledge and skills, and reduces socioeconomic barriers to accessing fresh produce may enhance participant knowledge and self-efficacy around healthy eating. However, socioeconomic factors remain as continual barriers to sustaining healthy eating over the long term. Ongoing efforts that address social determinants of health may be necessary to promote sustainability of behaviour change.

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An investigation of the perspectives of low-income Latina mothers with preschoolers transitioning to kindergarten

Journal of Early Childhood Literacy ◽

10.1177/1468798420901822 ◽

2020 ◽

pp. 146879842090182 ◽

Cited By ~ 1

Author(s):

Sarai Coba-Rodriguez ◽

Robin L Jarrett

Keyword(s):

Emergent Literacy ◽

Low Income ◽

Literacy Development ◽

Qualitative Interviews ◽

Family Members ◽

Literacy Skills ◽

Latina Mothers ◽

Quantitative Studies ◽

Demographic Risk ◽

Demographic Risk Factors

Research in the United States (U.S.) documents that young Latino children whose families are characterized by demographic risk factors disproportionately lack the early literacy skills needed to successfully transition to kindergarten. Quantitative studies using comparative samples have found lower quality home learning environments and lower scores on a child outcome assessments among Latino children compared to their Black and White peers. A small body of qualitative, non-comparative studies that focus on Latino families in their own right provides descriptive accounts of the positive ways that Latina mothers and other family members promote child literacy development, despite being characterized by demographic risk factors. However, the social address variables utilized in quantitative studies limit our understanding of the family processes affecting child literacy development, and most qualitative studies focus on older, school-aged children with very few studies focusing on the early transitional period before kindergarten, especially for Latinos. Addressing current gaps in the literature on preschool-aged children, we conducted in-depth qualitative interviews and photo-elicitation interviews with 17 low-income Latina mothers of Head Start preschoolers in a northern Chicago suburb in the U.S. Privileging mothers’ voices and experiences, we explored their in-home emergent literacy practices and the role of other family members in promoting children’s literacy development. Informed by a family resilience framework, we accessed intimate family worlds that reveal highly engaged and resilient parents. Specifically, we identified numerous child literacy skills that families supported through an array of family instructional practices and tools. We further identified the role of various available family members, particularly fathers and siblings. These findings add to substantive discussions of emergent literacy, resilience and familismo. Insights from the qualitative interviews lead to recommendations for how early childhood educators can capitalize on families’ funds of knowledge, and view them as valued collaborators.

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Moral Identity Among Low–Socioeconomic Status Adolescents: Stressful Events and Family Relationships Considered

Journal of Adolescent Research ◽

10.1177/0743558417713136 ◽

2017 ◽

Vol 33 (4) ◽

pp. 395-415

Author(s):

Alexandra N. Davis ◽

Cara Streit

Keyword(s):

Low Socioeconomic Status ◽

Low Income ◽

Family Relationships ◽

Conceptual Models ◽

Moral Identity ◽

Qualitative Interviews ◽

The United States ◽

Family Processes ◽

Stressful Events ◽

Low Socioeconomic

The current study aimed to examine themes surrounding the moral identity of adolescents from two low-income communities in the United States using qualitative interviews. Based on previous conceptual models, the authors aimed to examine the co-occurrence of themes of morality, stressors, and family processes. Participants were adolescents from the Northeast and Midwest ( n = 38; mean age = 15.64; 73.7% female; 23.7% Black, 30.6% Latino, and 47.4% White). The results demonstrated that morality was a salient theme among adolescents. In addition, a subset of adolescents discussed stressors and family processes in conjunction with morality. The discussion will focus on the resiliency of youth living in low-income communities.

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Understanding Participation in Social Programs: Why Don't Households Pick up the Lifeline?

The B E Journal of Economic Analysis & Policy ◽

10.2202/1935-1682.1583 ◽

2007 ◽

Vol 7 (1) ◽

Cited By ~ 14

Author(s):

Mark Burton ◽

Jeffrey Macher ◽

John W Mayo

Keyword(s):

Low Income ◽

Information Dissemination ◽

State Level ◽

Social Programs ◽

Participation Rates ◽

Public Programs ◽

Assistance Program ◽

Assistance Programs ◽

Program Characteristics ◽

The Individual

Abstract In this study, we draw upon data from the low-income Lifeline Assistance Program (Lifeline) for telephone service to examine the participation of eligible households in social programs designed to alleviate financial hardship. Utilizing panel data on participation levels in 1997 and 2003 and the associated variation in state-level policies, we are able to identify program characteristics that significantly affect participation rates. In particular, we find that participation rates are significantly negatively influenced by limitations that some states place on the ability of Lifeline subscribers to utilize optional calling features such as three-way calling or call forwarding. We also find that program participation is positively influenced by the longevity of the individual state's Lifeline program. While no direct test of state-level advertising is feasible, this result is suggestive of an inter-temporal pattern of information dissemination that grows with program longevity. Because eligibility for the Lifeline service is conditional upon participation in other low-income public programs, we also find that: (1) the larger the number of "portals" (i.e., low income public programs that states identify as creating Lifeline eligibility), the higher is participation; and (2) higher financial benefits of these portal programs attract greater participation in Lifeline programs. These results suggest important linkages that may be exploited through coordination of low-income assistance programs. Finally, we test for, and find that variations in Lifeline benefits significantly influence participation rates.

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DEVELOPMENT COMMUNICATION AND PERFORMANCE IN THE PROJECTS OF LOW-INCOME COUNTRIES: THE CASE OF THE REGIONAL SUPPORT PROJECT FOR PASTORALISM IN THE SAHEL (PRAPS) IN NIGER

International Journal of Management & Entrepreneurship Research ◽

10.51594/ijmer.v2i5.180 ◽

2020 ◽

Vol 2 (5) ◽

pp. 380-390

Author(s):

Régina Soutongo Bande ◽

Dr. Théophile Bindeouè Nassè

Keyword(s):

Low Income ◽

Qualitative Interviews ◽

Small Ruminants ◽

Low Income Countries ◽

Development Communication ◽

Pastoral Systems ◽

Efficient Communication ◽

And Performance ◽

State Of Affairs ◽

Effective Development

In West Africa, pastoral systems provide more than 80% of income to rural households and are a vital food source for urban populations. The six Sahelian countries (Burkina Faso, Chad, Mali, Mauritania, Niger, and Senegal) have around 20 million pastoralists who raise a population of 60 million cattle and 160 million small ruminants. However, projects in pastoral systems sometimes experience communication-related failures. Development communication is very important within the Regional Support Project for Pastoralism in the Sahel (PRAPS). Still, it must be recognized that some of the objectives are not achieved because of certain factors related to communication which are not taken into account. This state of affairs raises a question: How can the objectives set by PRAPS be achieved with an efficient communication? The approach used here is inductive, and the research is conducted through qualitative interviews carried out with focus groups. Data is collected using a digital recorder, then, the data is hand-transcribed and analyzed. The results show not only that development communication has effects on project results, but also that development communication has effects on the performance of projects of the Regional Support Project for Pastoralism in the Sahel (PRAPS). It is recommended that project supervisors should put an emphasis on an effective development communication in order to achieve the objectives of the Regional Support Project for Pastoralism in the Sahel (PRAPS).

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Understanding demand for, and feasibility of, centre-based child-care for poor urban households: A mixed methods study in Dhaka, Bangladesh.

10.21203/rs.3.rs-54081/v2 ◽

2020 ◽

Author(s):

Helen Elsey ◽

Fariza Fieroze ◽

Riffat Ara Shawon ◽

Shammi Nasreen ◽

Joseph Paul Hicks ◽

...

Keyword(s):

Early Childhood ◽

Child Care ◽

Mixed Methods ◽

Urban Environment ◽

Low Income ◽

Early Childhood Development ◽

Qualitative Interviews ◽

Childhood Development ◽

Urban Households ◽

Care Givers

Abstract Background: Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care. Methods: We used sequential mixed methods including a household survey (n=222) and qualitative interviews with care-givers (n=16), community leaders (n=5) and policy-makers (n=5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n=5), non-users (n=3), ex-users (n=3) and staff (2) were used to refine the model and identify implementation issues. Results: We found 24% (95% CI: 16%,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74%, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need.Conclusion: Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.

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