scholarly journals Protocol for a prospective, longitudinal mixed-methods case study: supporting a Model of Care for Healthier Adolescents (The MoCHA study)

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025098 ◽  
Author(s):  
Claire Hayes ◽  
Victoria J Palmer ◽  
Magenta Simmons ◽  
Bridget Hamilton ◽  
Christine Simons ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Depressive Symptomatology ◽  
Emotional Dysregulation ◽  
Self Report ◽  
Structured Interviews ◽  
Post Discharge ◽  
Mixed Methods Case Study ◽  
Distress Scale ◽  
Prospective Longitudinal

IntroductionImproving mental healthcare for adolescents is a global policy priority. Despite demands for community-based services, many adolescents require more intensive interventions, such as an inpatient admission. This is typically at a point of crisis, often accompanied by intense emotional dysregulation, impairment of coping function and impulsivity. However, limited evidence exists on how best to support this group while they are in inpatient care, aside from pharmacological treatments which have a limited role in adolescents. Little is known about the models of care (MoC) offered in inpatient units, whether adolescents perceive these as helpful and the perspectives of caregivers and clinicians. Here, we describe a protocol which aims to explore and evaluate an inpatient MoC.Methods and analysisWe designed a longitudinal, mixed-methods, case study. The population consists of adolescents, caregivers and clinicians at a single inpatient unit in Melbourne, Australia. Standardised outcome measures, including semi- structured interviews, will be administered to adolescents at three time-points, T1 (admission), T2 (discharge) and T3 (6 months post discharge). Caregivers will also be interviewed at T1, T2 and T3. Clinicians will be interviewed once. The measures include: Life Problems Inventory, Quick Inventory of Depressive Symptomatology, Kessler Psychological Distress Scale and the Youth Self-Report. Health of the Nation Outcome Scales for Children and Adolescents will be collected at T1 and T2. Quantitative analysis will include descriptive statistics and paired t-tests summarising adolescents admitted to the unit, clinical characteristics and longitudinal data on symptomatology. Qualitative data will be analysed using both thematic and trajectory analysis. Data collection began in May 2017 and will cease with T3 interviews by October 2018.Ethics and dissemination

scholarly journals Why do stroke survivors not receive recommended amounts of active therapy? Findings from the ReAcT study, a mixed-methods case-study evaluation in eight stroke units

2018 ◽  
Vol 32 (8) ◽  
pp. 1119-1132 ◽  
Author(s):  
David J Clarke ◽  
Louisa-Jane Burton ◽  
Sarah F Tyson ◽  
Helen Rodgers ◽  
Avril Drummond ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Information Exchange ◽  
Patient Specific ◽  
Guideline Recommendation ◽  
Structured Interviews ◽  
Stroke Units ◽  
Mixed Methods Case Study ◽  
Documentary Analysis ◽  
Study Evaluation

Objective: To identify why the National Clinical Guideline recommendation of 45 minutes of each appropriate therapy daily is not met in many English stroke units. Design: Mixed-methods case-study evaluation, including modified process mapping, non-participant observations of service organisation and therapy delivery, documentary analysis and semi-structured interviews. Setting: Eight stroke units in four English regions. Subjects: Seventy-seven patients with stroke, 53 carers and 197 stroke unit staff were observed; 49 patients, 50 carers and 131 staff participants were interviewed. Results: Over 1000 hours of non-participant observations and 433 patient-specific therapy observations were undertaken. The most significant factor influencing amount and frequency of therapy provided was the time therapists routinely spent, individually and collectively, in information exchange. Patient factors, including fatigue and tolerance influenced therapists’ decisions about frequency and intensity, typically resulting in adaptation of therapy rather than no provision. Limited use of individual patient therapy timetables was evident. Therapist staffing levels were associated with differences in therapy provision but were not the main determinant of intensity and frequency. Few therapists demonstrated understanding of the evidence underpinning recommendations for increased therapy frequency and intensity. Units delivering more therapy had undertaken patient-focused reorganisation of therapists’ working practices, enabling them to provide therapy consistent with guideline recommendations. Conclusion: Time spent in information exchange impacted on therapy provision in stroke units. Reorganisation of therapists’ work improved alignment with guidelines.

scholarly journals Advancing engagement and capacity for rural cancer control: a mixed-methods case study of a Community-Academic Advisory Board in the Appalachia region of Southwest Virginia

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jamie M. Zoellner ◽  
Kathleen J. Porter ◽  
Donna-Jean P. Brock ◽  
Emma Mc Kim Mitchell ◽  
Howard Chapman ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Cancer Screening ◽  
Cancer Control ◽  
Value Added ◽  
Advisory Board ◽  
Comprehensive Cancer Control ◽  
Structured Interviews ◽  
Human Papillomavirus Vaccination ◽  
Time Points

Abstract Background The objectives are to: 1) describe engagement processes used to prioritize and address regional comprehensive cancer control needs among a Community-Academic Advisory Board (CAB) in the medically-underserved, rural Appalachian region, and 2) detail longitudinal CAB evaluation findings. Methods This three-year case study (2017–2020) used a convergent parallel, mixed-methods design. The approach was guided by community-based participatory research (CBPR) principles, the Comprehensive Participatory Planning and Evaluation process, and Nine Habits of Successful Comprehensive Cancer Control Coalitions. Meeting artifacts were tracked and evaluated. CAB members completed quantitative surveys at three time points and semi-structured interviews at two time points. Quantitative data were analyzed using analysis of variance tests. Interviews were audio recorded, transcribed, and analyzed via an inductive-deductive process. Results Through 13 meetings, Prevention and Early Detection Action Teams created causal models and prioritized four cancer control needs: human papillomavirus vaccination, tobacco control, colorectal cancer screening, and lung cancer screening. These sub-groups also began advancing into planning and intervention proposal development phases. As rated by 49 involved CAB members, all habits significantly improved from Time 1 to Time 2 (i.e., communication, priority work plans, roles/accountability, shared decision making, value-added collaboration, empowered leadership, diversified funding, trust, satisfaction; all p < .05), and most remained significantly higher at Time 3. CAB members also identified specific challenges (e.g., fully utilizing member expertise), strengths (e.g., diverse membership), and recommendations across habits. Conclusion This project’s equity-based CBPR approach used a CPPE process in conjunction with internal evaluation of cancer coalition best practices to advance CAB efforts to address cancer disparities in rural Appalachia. This approach encouraged CAB buy-in and identified key strengths, weaknesses, and opportunities that will lay the foundation for continued involvement in cancer control projects. These engagement processes may serve as a template for similar coalitions in rural, underserved areas.

scholarly journals THE EPILEPSY SPECIALIST NURSE: A MIXED-METHODS CASE STUDY ON THE ROLE AND ACTIVITIES

Seizure ◽  
2021 ◽  
Author(s):  
G. Locatelli ◽  
D. Ausili ◽  
V. Stubbings ◽  
S. Di Mauro ◽  
M. Luciani
Keyword(s):  
Mixed Methods ◽  
Specialist Nurse ◽  
Mixed Methods Case Study

scholarly journals Influences on the Diffusion of Environmental Programmes in Small Businesses in the Greening of an Industry for Sustainability: The Case of Golf

2018 ◽  
Vol 8 (2) ◽  
pp. 1
Author(s):  
Dino M. Minoli
Keyword(s):  
Mixed Methods ◽  
Government Policy ◽  
Environmental Performance ◽  
Small Businesses ◽  
Industry Sector ◽  
Mixed Methods Case Study ◽  
Golf Clubs ◽  
Empirical Framework ◽  
Social And Environmental Impacts

Globally there are around 34,000 golf facilities including very many small golf clubs that collectively generate significant economic, social and environmental impacts. Thus, small golf clubs have an important role to play in the greening of golf in support of sustainability. Environmental programmes (EPs) were developed to improve the environmental performance of all types and sizes of golf facilities. However, EPs are rarely employed in small golf clubs and no research until now has explored the reasons for this. Data from an in-depth mixed methods case study found several internal and external influences on the level of implementation of EPs in small golf clubs. Interventions are suggested to stimulate the uptake of EPs in smaller golf clubs. The study is of value to the golf sector, government policy and organisations concerned with the greening of small businesses in the greening of an industry sector for sustainability. The study also provides a conceptual/empirical framework for further studies in this under-researched yet noteworthy field.

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