Moving forward: Barriers and enablers to failure to fail – A mixed methods meta-integration

2020 ◽  
pp. 104666
Author(s):  
Lynda J. Hughes ◽  
Marion L. Mitchell ◽  
Amy N.B. Johnston
Keyword(s):  
Mixed Methods ◽  
Barriers And Enablers

scholarly journals Barriers, enablers and strategies for the treatment and control of hypertension in Nepal: a mixed-methods systematic review

2020 ◽  
Author(s):  
Raja Ram Dhungana ◽  
Zeljko Pedisic ◽  
Achyut Raj Pandey ◽  
Nipun Shrestha ◽  
Maximilian de Courten
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Health System ◽  
Family Support ◽  
Quantitative Methods ◽  
Illness Perception ◽  
Hypertension Treatment ◽  
Barriers And Enablers ◽  
Adherence To Medication ◽  
And Control

Abstract Background: The challenge of achieving effective treatment and control of blood pressure is linked to various barriers to hypertension care at different layers of health system (HS). Evidence is emerging globally on the effectiveness of multi-pronged hypertension control strategies. However, no systematic review of strategies of and factors associated with hypertension treatment and control in Nepal is available. Understanding country-specific factors influencing hypertension care is critical to address the gaps in the management of hypertension. This study aimed to systematically review published literature and synthesise the findings on barriers, enablers and strategies for hypertension treatment and control in Nepal. Methods: Six databases namely Embase, PubMed, Web of Science, CINAHL, ProQuest and WorldCat, Nepali journals and Nepal government websites were systematically searched for qualitative, quantitative and mixed-methods studies investigating the factors or strategies in relation to hypertension treatment and control in Nepal. The methodological quality of selected articles was assessed using Mixed Methods Appraisal Tool. Themes on barriers and enablers were generated and framed under “health system” , “provider” and “patient” domains, according to the framework synthesis approach. Findings on hypertension strategies were narratively synthesised. Results: We identified 14 published studies; one with mixed, three with qualitative and 10 with quantitative methods. Eight were related to barriers and enablers and six of hypertension strategies. The identified barriers associated with the HS were: lack of affordable services and lack of resources. The barriers at the provider’s level were: communication gaps and long waiting hours for appointments. Poor help-seeking behaviour, non-adherence to medication, perceived side-effects of drugs, financial hardship and lack of family support were barriers identified at patient level. The following enablers were identified: positive illness perception, free essential healthcare services and family support. Strategies implemented across the HS, provider and patient were: establishing digital health records at health centres, health worker’s capacity development, health education and yoga practice. Conclusion: There is a range of barriers for hypertension treatment and control in Nepal pertaining to the HS, providers, and patients. Comprehensive interventions are needed at all three levels to further improve management and control of hypertension in Nepal.Registration: The protocol is registered in PROSPERO (registration number: CRD42020145823)

Building Oral Health Research Capacity in India: Identifying Barriers and Enablers Using Mixed Methods

2017 ◽  
Vol 2 (2) ◽  
pp. 106-108
Author(s):  
M. Masood ◽  
T. Newton ◽  
O.P. Kharbanda ◽  
Y. Masood ◽  
J. Feine ◽  
...  
Keyword(s):  
Developing Countries ◽  
Mixed Methods ◽  
Oral Health ◽  
Knowledge Transfer ◽  
Health Research ◽  
Research Capacity ◽  
Mixed Methods Approach ◽  
Barriers And Enablers

Knowledge Transfer Statement: This article will provide a brief overview of the methods in finding barriers and enablers in doing oral health research in India. This mixed-methods approach can be used by researchers in finding barriers and enablers in doing oral health research in other developing countries and building oral health research capacities.

scholarly journals Facilitators and barriers to behaviour change within a lifestyle program for women with obesity to prevent excess gestational weight gain: a mixed methods evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca F. Goldstein ◽  
Jacqueline A. Boyle ◽  
Clement Lo ◽  
Helena J. Teede ◽  
Cheryce L. Harrison
Keyword(s):  
Mixed Methods ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Behaviour Change ◽  
Healthy Lifestyle ◽  
Scale Up ◽  
Motivation To Change ◽  
Gestational Weight ◽  
Barriers And Enablers ◽  
Healthy Pregnancy

Abstract Background Maternal obesity is associated with health risks for women and their babies and is exacerbated by excess gestational weight gain. The aim of this study was to describe women’s experiences and perspectives in attending a Healthy Pregnancy Service designed to optimise healthy lifestyle and support recommended gestational weight gain for women with obesity. Methods An explanatory sequential mixed methods study design utilised two questionnaires (completed in early and late pregnancy) to quantify feelings, motivation and satisfaction with the service, followed by semi-structured interviews that explored barriers and enablers of behaviour change. Data were analysed separately and then interpreted together. Results Overall, 49 women attending the service completed either questionnaire 1, 2 or both and were included in the analysis. Fourteen women were interviewed. Prior to pregnancy, many women had gained weight and attempted to lose weight independently, and reported they were highly motivated to achieve a healthy lifestyle. During pregnancy, diet changes were reported as easier to make and sustain than exercise changes. Satisfaction with the service was high. Key factors identified in qualitative analysis were: service support enabled change; motivation to change behaviour, social support, barriers to making change (intrinsic, extrinsic and clinic-related), post-partum lifestyle and needs. On integration of data, qualitative and quantitative findings aligned. Conclusions The Healthy Pregnancy service was valued by women. Barriers and enablers to the delivery of an integrated model of maternity care that supported healthy lifestyle and recommended gestational weight gain were identified. These findings have informed and improved implementation and further scale up of this successful service model, integrating healthy lifestyle into routine antenatal care of women with obesity. Trial registration This trial is registered with the Australian New Zealand Clinical Trials Registry (no.12620000985987). Registration date 30/09/2020, retrospectively registered. http://www.anzctr.org.au/

scholarly journals A mixed methods study of seasonal influenza vaccine hesitancy in adults with chronic respiratory conditions

2021 ◽  
Author(s):  
Lynn Williams ◽  
Karen Deakin ◽  
Allyson Gallant ◽  
Susan Rasmussen ◽  
David Young ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Side Effects ◽  
Influenza Vaccination ◽  
Thematic Analysis ◽  
Psychological Factors ◽  
Seasonal Influenza ◽  
Collective Responsibility ◽  
Mixed Methods Study ◽  
Barriers And Enablers ◽  
Respiratory Conditions

AbstractBackgroundSeasonal influenza vaccination is recommended for patients with chronic respiratory conditions, but uptake is suboptimal. We undertook a comprehensive mixed methods study in order to examine the barriers and enablers to influenza vaccination in patients with chronic respiratory conditions.MethodsMixed methods including a survey (n=429) which assessed socio-demographics and the psychological factors associated with vaccine uptake (i.e. confidence, complacency, constraints, calculation and collective responsibility) with binary logistic regression analysis. We also undertook focus groups and interviews (n=59) to further explore barriers and enablers to uptake using thematic analysis.ResultsThe survey analysis identified that older participants were more likely to accept the vaccine, as were those with higher perceptions of collective responsibility around vaccination, lower levels of complacency, and lower levels of constraints. Thematic analysis showed that concerns over vaccine side effects, lack of tailored information and knowledge, and a lack of trust and rapport with healthcare professionals were key barriers. In contrast, the importance of feeling protected, acceptance of being part of an at-risk group, and feeling a reduced sense of vulnerability after vaccination were seen as key enablers.ConclusionsOur findings showed that the decision to accept a vaccine against influenza is influenced by multiple sociodemographic and psychological factors. Future interventions should provide clear and transparent information about side effects and be tailored to patients with chronic respiratory conditions. Interactions between patients and their healthcare providers have a particularly important role to play in helping patients address their concerns and feel confident in vaccination.

scholarly journals Barriers and Enablers to Physical Activity in Patients during Hospital Stay: A Scoping Review

2021 ◽  
Author(s):  
Sven Jacobus Gertruda Geelen ◽  
Hanneke Corine van Dijk - Huisman ◽  
Robert Adriaan de Bie ◽  
Cindy Veenhof ◽  
Raoul Engelbert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Healthcare Professional ◽  
Hospital Stay ◽  
Acute Care ◽  
Scoping Review ◽  
Healthcare Professionals ◽  
Social Influences ◽  
Comprehensive Overview ◽  
Barriers And Enablers

Abstract Background: Low levels of physical activity are common during hospital stay and have been associated with negative health outcomes. Understanding barriers and enablers to physical activity during hospital stay can improve the development and implementation of tailored interventions aimed at improving physical activity. Previous studies have identified many barriers and enablers, but a comprehensive overview is lacking. This study aimed to identify and categorize all published patient- and healthcare professional-reported barriers and enablers to physical activity during hospital stay for acute care, using the Theoretical Domains Framework (TDF). Methods: We conducted a scoping review of Dutch and English articles using MEDLINE, CINAHL Plus, EMBASE, PsycINFO and Cochrane library (inception to September 2020), which included quantitative, qualitative and mixed-methods studies reporting barriers and enablers to physical activity during hospital stay for acute care, as perceived by patients or healthcare professionals. Two reviewers systematically extracted, coded and categorized all barriers and enablers into TDF domains.Results: Fifty-six articles were included in this review (32 qualitative, 7 quantitative, and 17 mixed-methods). In total, 264 barriers and 228 enablers were reported by patients, and 415 barriers and 409 enablers by healthcare professionals. Patient-reported barriers were most frequently assigned to the TDF domains Environmental Context & Resources (ECR, n = 148), Social Influences (n = 32), and Beliefs about Consequences (n = 25), while most enablers were assigned to ECR (n = 67), Social Influences (n = 54), and Goals (n = 32). Barriers reported by healthcare professionals were most frequently assigned to ECR (n = 210), Memory, Attention and Decision Process (n = 45), and Social/Professional Role & Identity (n = 31), while most healthcare professional-reported enablers were assigned to the TDF domains ECR (n = 143), Social Influences (n = 76), and Behavioural Regulation (n = 54).Conclusions: Our scoping review presents a comprehensive overview of all barriers and enablers to physical activity during hospital stay, and highlights the prominent role of the TDF domains ECR and Social Influences in hospitalized patients’ physical activity behaviour. This TDF-based overview provides a theoretical foundation to guide clinicians and researchers in future intervention development and implementation.Registration: No protocol was registered for this review.

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