Perceptions and acceptability of mHealth interventions for improving patient care at a community-based HIV/AIDS clinic in Uganda: A mixed methods study

BackgroundUK general practice faces a workforce crisis, with general practitioner (GP) shortages, organisational change, substantial pressures across the whole health-care system and an ageing population with increasingly complex health needs. GPs require lengthy training, so retaining the existing workforce is urgent and important.Objectives(1) To identify the key policies and strategies that might (i) facilitate the retention of experienced GPs in direct patient care or (ii) support the return of GPs following a career break. (2) To consider the feasibility of potentially implementing those policies and strategies.DesignThis was a comprehensive, mixed-methods study.SettingThis study took place in primary care in England.ParticipantsGeneral practitioners registered in south-west England were surveyed. Interviews were with purposively selected GPs and primary care stakeholders. A RAND/UCLA Appropriateness Method (RAM) panel comprised GP partners and GPs working in national stakeholder organisations. Stakeholder consultations included representatives from regional and national groups.Main outcome measuresSystematic review – factors affecting GPs’ decisions to quit and to take career breaks. Survey – proportion of GPs likely to quit, to take career breaks or to reduce hours spent in patient care within 5 years of being surveyed. Interviews – themes relating to GPs’ decision-making. RAM – a set of policies and strategies to support retention, assessed as ‘appropriate’ and ‘feasible’. Predictive risk modelling – predictive model to identify practices in south-west England at risk of workforce undersupply within 5 years. Stakeholder consultation – comments and key actions regarding implementing emergent policies and strategies from the research.ResultsPast research identified four job-related ‘push’ factors associated with leaving general practice: (1) workload, (2) job dissatisfaction, (3) work-related stress and (4) work–life balance. The survey, returned by 2248 out of 3370 GPs (67%) in the south-west of England, identified a high likelihood of quitting (37%), taking a career break (36%) or reducing hours (57%) within 5 years. Interviews highlighted three drivers of leaving general practice: (1) professional identity and value of the GP role, (2) fear and risk associated with service delivery and (3) career choices. The RAM panel deemed 24 out of 54 retention policies and strategies to be ‘appropriate’, with most also considered ‘feasible’, including identification of and targeted support for practices ‘at risk’ of workforce undersupply and the provision of formal career options for GPs wishing to undertake portfolio roles. Practices at highest risk of workforce undersupply within 5 years are those that have larger patient list sizes, employ more nurses, serve more deprived and younger populations, or have poor patient experience ratings. Actions for national organisations with an interest in workforce planning were identified. These included collection of data on the current scope of GPs’ portfolio roles, and the need for formal career pathways for key primary care professionals, such as practice managers.LimitationsThe survey, qualitative research and modelling were conducted in one UK region. The research took place within a rapidly changing policy environment, providing a challenge in informing emergent policy and practice.ConclusionsThis research identifies the basis for current concerns regarding UK GP workforce capacity, drawing on experiences in south-west England. Policies and strategies identified by expert stakeholders after considering these findings are likely to be of relevance in addressing GP retention in the UK. Collaborative, multidisciplinary research partnerships should investigate the effects of rolling out some of the policies and strategies described in this report.Study registrationThis study is registered as PROSPERO CRD42016033876 and UKCRN ID number 20700.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Nurse–Physician Communication in Patient Care and Associated Factors in Public Hospitals of Harari Regional State and Dire-Dawa City Administration, Eastern Ethiopia: A Multicenter-Mixed Methods Study

Journal of Multidisciplinary Healthcare ◽

10.2147/jmdh.s320721 ◽

2021 ◽

Vol Volume 14 ◽

pp. 2315-2331

Author(s):

Mehammedamin Jemal ◽

Mohammed Abdurke Kure ◽

Tesfaye Gobena ◽

Biftu Geda

Keyword(s):

Mixed Methods ◽

Patient Care ◽

Associated Factors ◽

Public Hospitals ◽

Mixed Methods Study ◽

Physician Communication ◽

Eastern Ethiopia ◽

City Administration ◽

Regional State ◽

Dire Dawa

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HIV Testing and Care in Canadian Aboriginal Youth: A community based mixed methods study

BMC Infectious Diseases ◽

10.1186/1471-2334-8-132 ◽

2008 ◽

Vol 8 (1) ◽

Cited By ~ 25

Author(s):

Judy E Mill ◽

Randy C Jackson ◽

Catherine A Worthington ◽

Chris P Archibald ◽

Tom Wong ◽

...

Keyword(s):

Mixed Methods ◽

Hiv Testing ◽

Mixed Methods Study ◽

Community Based ◽

Aboriginal Youth

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Integrated decision-making model for community-based rehabilitation service utilisation among persons with severe mental illness in China: protocol for a cross-sectional, mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2018-021528 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021528 ◽

Cited By ~ 2

Author(s):

Ruoxi Wang ◽

Shangfeng Tang ◽

Ian Shaw ◽

Zhanchun Feng ◽

Zhuo Chen ◽

...

Keyword(s):

Decision Making ◽

Mental Illness ◽

Mixed Methods ◽

Mixed Methods Study ◽

Service Utilisation ◽

Community Based ◽

Cross Sectional ◽

Community Based Rehabilitation ◽

Integrated Decision Making ◽

Different Levels

IntroductionA common problem low-income and middle-income countries face is the scarcity of community-based rehabilitation (CBR) resources and low service utilisation among persons with severe mental illness (SMI). Despite this problem, the factors and pathways followed influencing one’s decision on service utilisation in China have not been fully comprehended. This study aims to develop a theory-based model that systematically describes the integrated decision-making process of mental health CBR utilisation among persons with SMI in China.Methods/DesignThis cross-sectional, mixed-methods study involves three main stages and is expected to last 3 years, from January 2018 to December 2020. In stage 1, the Social Exchange Theory is deployed as an analytical framework to comprehensively capture factors associated with tendency to use CBR services in China using semistructured interview methodology involving patients with SMI, their primary caregivers and CBR service providers. In stage 2, interpretive structural modelling will be applied to analyse the relationships between factors in different dimensions, at different levels and with different levels of impact. Stage 3 involves a multiregion survey among at least 300 family decision-makers (either the patient or their caregivers) in six communities in three cities to statistically validate the initial model derived in stage 2 using a further structural equation modelling.Ethics and disseminationEthical approval was granted by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology (No 2017S319). All interviewees will be provided with written information about the study, and a signed consent will be retrieved prior to the interview. Rules on confidentiality and anonymity of data will be strictly followed. The findings of this study will be disseminated via international and domestic peer-reviewed journals, reports, conference presentations and symposium discussions. Reports will be submitted to the National Natural Science Foundation of China.

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Integrating Community-based Research into a Senior Capstone Seminar: Lessons Learned from a Mixed-methods Study

Teaching Sociology ◽

10.1177/0092055x19841667 ◽

2019 ◽

Vol 47 (3) ◽

pp. 191-203 ◽

Cited By ~ 1

Author(s):

Sara Shostak ◽

Margarita Corral ◽

Ann G. Ward ◽

Alex Willett

Keyword(s):

Mixed Methods ◽

Research Methods ◽

Social Processes ◽

Lessons Learned ◽

Mixed Methods Study ◽

Important Work ◽

Community Based ◽

Community Based Research ◽

Community Based Organizations ◽

Sociology Departments

This article describes a senior capstone, Neighborhoods and Health, which used community-based research (CBR) as its primary pedagogy. Students in the course drew upon multiple research methods and forms of data to provide our partner, the Urban Farming Institute of Boston, with an array of research products in support of the revitalization of a historic farm in the Boston neighborhood of Mattapan. Based on pre- and posttest assessment and analysis of students’ reflections in their journals, we identify how a multimethods approach—combined with a commitment to producing usable research products—simultaneously contributed to students’ research methods proficiency and their understanding of complex social processes. For both sociology departments and interdisciplinary majors that draw on sociological perspectives, CBR offers a compelling means of providing seniors with meaningful capstone experiences while adding capacity to the important work of community-based organizations.

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