scholarly journals Study protocol: building an evidence base for epidemiology emergency response, a mixed-methods study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e037326
Author(s):  
Amy Elizabeth Parry ◽  
Martyn D Kirk ◽  
David N Durrheim ◽  
Babatunde Olowokure ◽  
Tambri Housen
Keyword(s):  
Mixed Methods ◽  
Emergency Response ◽  
Evidence Base ◽  
Mixed Methods Study ◽  
Local Context ◽  
Integrated Analysis ◽  
Displaced Populations ◽  
National University ◽  
New Thinking ◽  
The Right

IntroductionDeterminants and drivers for emergencies, such as political instability, weak health systems, climate change and forcibly displaced populations, are increasing the severity, complexity and frequency of public health emergencies. As emergencies become more complex, it is increasingly important that the required skillset of the emergency response workforce is clearly defined. To enable essential epidemiological activities to be implemented and managed during an emergency, a workforce is required with the right mix of skills, knowledge, experience and local context awareness. This study aims to provide local and international responders with an opportunity to actively contribute to the development of new thinking around emergency response roles and required competencies. In this study, we will develop recommendations using a broad range of evidence to address identified lessons and challenges so that future major emergency responses are culturally and contextually appropriate, and less reliant on long-term international deployments.Method and analysisWe will conduct a mixed-methods study using an exploratory sequential study design. The integration of four data sources, including key informant interviews, a scoping literature review, survey and semistructured interviews will allow the research questions to be examined in a flexible, semistructured way, from a range of perspectives. The study is unequally weighted, with a qualitative emphasis. We will analyse all activities as individual components, and then together in an integrated analysis. Thematic analysis will be conducted in NVivo V.11 and quantitative analysis will be conducted in Stata V.15.Ethics and disseminationAll activities have been approved by the Science and Medical Delegated Ethics Review Committee at the Australian National University (protocol numbers 2018–521, 2018–641, 2019–068). Findings will be disseminated through international and local deployment partners, peer-reviewed publication, presentation at international conferences and through social media such as Twitter and Facebook.

scholarly journals An Exploratory Mixed Methods Study of Experiences of Interprofessional Teams Who Received Coaching to Simultaneously Redesign Primary Care Education and Clinical Practice

2021 ◽  
Vol 12 ◽  
pp. 215013272110237
Author(s):  
Patricia A. Carney ◽  
W. Perry Dickinson ◽  
Jay Fetter ◽  
Eric J. Warm ◽  
Brenda Zierler ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Mixed Methods Study ◽  
Local Context ◽  
Primary Care Residency ◽  
Interprofessional Teams ◽  
Coaching Relationship ◽  
Team Coaching ◽  
Primary Care Education ◽  
Health Coaches

Introduction/Objectives: Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice. Methods: This three-year exploratory mixed methods study included transformational assistance from 9 interprofessional coaches, one assigned to each of 9 interprofessional primary care teams that included family medicine, internal medicine, pediatrics, nursing, pharmacy and behavioral health. Coaches interacted with teams during 2 in-person training sessions, an in-person site visit, and then as requested by their teams. Surveys administered at 1 year and end study assessed the coaching relationship and process. Results: The majority of participants (82% at end of Year 1 and 76.6% at end study) agreed or strongly agreed that their coach developed a positive working relationship with their team. Participants indicated coaches helped them: (1) develop as teams, (2) stay on task, and (3) respond to local context issues, with between 54.3% and 69.2% agreeing or strongly agreeing that their coaches were helpful in these areas. Cronbach’s alpha for the 15 coaching survey items was 0.965. Challenges included aligning the coach’s expertise with the team’s needs. Conclusions: While team coaching was well received by interprofessional teams of primary care professionals undertaking educational and clinical redesign, the 3 primary care disciplines have much to learn from each other regarding how to improve inter- and intra-professional collaborative practice among clinicians and staff as well as with interprofessional learners rotating through their outpatient clinics.

scholarly journals P009: Violence against health care professionals in Karachi: results from a mixed methods study

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S81-S81
Author(s):  
S. Arif ◽  
L.A. Baig
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Professionals ◽  
Deductive Reasoning ◽  
Group Discussion ◽  
Mixed Methods Study ◽  
General Situation ◽  
Human Right ◽  
The Right ◽  
The City

Introduction: The right to live is the supreme human right and according to Article 3 of the Universal declaration of human rights everyone has a right to life, liberty and security. In Karachi, Pakistan huge numbers of health care professionals (HCP) have been subjected to violence inclusive of money extortion, kidnapping, mental & physical torture, murders etc. A recent study from Karachi’s four major hospitals reported that 72.5% of HCP have experienced abuse (verbal and physical) in the past 12 months. The goal of this study was to develop strategies for preventing violence against health care after collecting baseline data. The objectives of the study were to: Identify the magnitude, threshold and impact of violence against HCPs. Methods: This was a mixed methods study design with a QUAN-QUAL approach. Structured questionnaire was used after pilot testing and filled by the surveyors. Focus group discussion and In-depth interviews were conducted with HCPs, NGOs, Law enforcement agencies, ambulance services, hospital administrators and LHW programs. Frequencies and proportions were compared for different cadres of HCPs for the quantitative data analysis. Thematic content analysis with inductive and deductive reasoning was used for analysing qualitative data. Results: Data on 822 HCPs revealed that 33% had faced violence and 49 % had experienced it, 89% was verbal and 43% was physical abuse, 2% had died and 22% were injured. Ambulance services and physicians were the most common victims of violence. The main reasons were grouped as institutional, behavioral (victims and perpetrators) and general situation of the city. There is high acceptance of violence among HCPs and lack of training in dealing with it was the most common reason given. Sequlae included effects on victim, family, institution and the reporting agencies. The final paper will have complete details on the baseline and the recommendations proposed by the stakeholders. Conclusion: Violence faced by HCP’s is a multifactorial complex issue. There is a dire need to design interventions which can help in addressing the behavioral, Institutional and sociopolitical factors promoting violence among HCP’s. The interventions based on recommendations by the respondents have been developed and implementation has started as a pilot in the city of Karachi.

Doing the Right Thing: A Mixed-Methods Study Focused on Generosity and Positive Well-Being

2014 ◽  
Vol 9 (3) ◽  
pp. 318-331 ◽  
Author(s):  
Mei-Chuan Wang ◽  
Kimberly K. Tran ◽  
Pius N. Nyutu ◽  
Elise Fleming
Keyword(s):  
Mixed Methods ◽  
Well Being ◽  
Mixed Methods Study ◽  
The Right

scholarly journals Countermeasures against COVID-19: how to navigate medical practice through a nascent, evolving evidence base — a European multicentre mixed methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043015 ◽  
Author(s):  
Fabian Eibensteiner ◽  
Valentin Ritschl ◽  
Tanja Stamm ◽  
Asil Cetin ◽  
Claus Peter Schmitt ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Expert Opinion ◽  
Tertiary Care ◽  
Rapid Change ◽  
Evidence Base ◽  
Routine Care ◽  
Resource Dependency ◽  
Mixed Methods Study ◽  
European Countries ◽  
Factors Affecting

ObjectivesIn a previously published Delphi exercise the European Pediatric Dialysis Working Group (EPDWG) reported widely variable counteractive responses to COVID-19 during the first week of statutory public curfews in 12 European countries with case loads of 4–680 infected patients per million. To better understand these wide variations, we assessed different factors affecting countermeasure implementation rates and applied the capability, opportunity, motivation model of behaviour to describe their determinants.DesignWe undertook this international mixed methods study of increased depth and breadth to obtain more complete data and to better understand the resulting complex evidence.SettingThis study was conducted in 14 paediatric nephrology centres across 12 European countries during the COVID-19 pandemic.ParticipantsThe 14 participants were paediatric nephrologists and EPDWG members from 12 European centres.Main outcome measures52 countermeasures clustered into eight response domains (access control, patient testing, personnel testing, personal protective equipment policy, patient cohorting, personnel cohorting, suspension of routine care, remote work) were categorised by implementation status, drivers (expert opinion, hospital regulations) and resource dependency. Governmental strictness and media attitude were independently assessed for each country and correlated with relevant countermeasure implementation factors.ResultsImplementation rates varied widely among response domains (median 49.5%, range 20%–71%) and centres (median 46%, range 31%–62%). Case loads were insufficient to explain response rate variability. Increasing case loads resulted in shifts from expert opinion-based to hospital regulation-based decisions to implement additional countermeasures despite increased resource dependency. Higher governmental strictness and positive media attitude towards countermeasure implementation were associated with higher implementation rates.ConclusionsCOVID-19 countermeasure implementation by paediatric tertiary care centres did not reflect case loads but rather reflected heterogeneity of local rules and of perceived resources. These data highlight the need of ongoing reassessment of current practices, facilitating rapid change in ‘institutional behavior’ in response to emerging evidence of countermeasure efficacy.

scholarly journals Living labs for patient engagement and knowledge exchange: an exploratory sequential mixed methods study to develop a living lab in paediatric rehabilitation

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e041530
Author(s):  
Mandy M Archibald ◽  
Kristy Wittmeier ◽  
Matthew Gale ◽  
Florencia Ricci ◽  
Kelly Russell ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Patient Engagement ◽  
Knowledge Exchange ◽  
Mixed Methods Study ◽  
Integrated Analysis ◽  
Prototype Development ◽  
Sequential Mixed Methods ◽  
Living Lab ◽  
Living Labs ◽  
Paediatric Rehabilitation

IntroductionDespite recognition of the importance of patient engagement in research and knowledge translation, systematic approaches to engagement and co-ideation remain limited. Living labs are collaborative knowledge sharing systems that use multimethod, user-centred approaches that hold potential to catalyse these aims. However, their use in healthcare is limited, and no living lab has been developed in paediatric rehabilitation. In response to this gap and to propel innovative knowledge exchange, we propose a mixed methods study to co-develop a living lab prototype (ie, preliminary infrastructure with opportunity for scale up) in paediatric rehabilitation, with relevance to other healthcare contexts.MethodsAn exploratory sequential mixed methods study will be undertaken to determine research and knowledge exchange priorities and to inform the development of the living lab prototype. Stage 1: we will use a multipronged approach to sample 18–21 youth with developmental differences or rehabilitation needs, their youth siblings and parents/guardians from a provincial paediatric rehabilitation centre, to participate in qualitative and arts-based data collection. Data will provide insight into desirable features of the living lab. Stage 2: E-surveys to youth, siblings, parents/guardians and clinicians who receive or provide services at this same centre will expand on priorities and living lab features. Stage 3: integrated analysis will inform the living lab prototype development.AnalysisInductive thematic analysis using interpretive description, integrated analysis of visual data and descriptive and content analysis of e-survey data will be undertaken. Joint displays will facilitate data integration. Priorities will be identified using a modified rank-order method for each key living lab domain.Ethics and disseminationInstitutional ethics and site approval have been granted. A parent advisory group and rehabilitation engineering partners will confer on data and inform the development of the living lab prototype. User engagement with the prototype will occur during an online or in-person event, and findings shared through non-technical research summaries, journal articles and academic presentations.

scholarly journals Emergencies in Long-Term Care Services for the Elderly in Korea: A Mixed-Methods Study

2019 ◽  
Vol 17 (1) ◽  
pp. 66
Author(s):  
Soon Ok Kim ◽  
Sun Hee Bae
Keyword(s):  
Mixed Methods ◽  
Emergency Response ◽  
Long Term Care ◽  
The Elderly ◽  
Home Care Services ◽  
Mixed Methods Study ◽  
Term Care ◽  
Emergency Situations ◽  
Care Services

This mixed-methods study explored ways to enhance the emergency response abilities of workers in long-term care services for the elderly. Based on different service types, we identify emergency situations and the response abilities of workers in long-term care services. Results indicated that there are more emergency situations in care facilities than in home care services. However, 71.3% of respondents in facilities said emergency response abilities were low compared to 44.2% of workers in home care services. Qualitative research identified six categories and 16 themes based on emotions experienced during emergencies and the challenges in determining solutions. The study confirms that there is a difference in emergency incidences and the coping abilities of workers in facilities and home services with high emergency incidence rates. Developing and applying guidelines for emergency response management by service type is recommended.

scholarly journals Activating Partnership Assets to Produce Synergy in Primary Health Care: A Mixed Methods Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1060
Author(s):  
Ekaterina Loban ◽  
Catherine Scott ◽  
Virginia Lewis ◽  
Susan Law ◽  
Jeannie Haggerty
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Mixed Methods ◽  
Assessment Tool ◽  
Evidence Base ◽  
Mixed Methods Study ◽  
Management Decision ◽  
Structured Interviews ◽  
Primary Health ◽  
Intermediate Outcomes

Partnerships are an important mechanism to tackle complex problems that extend beyond traditional organizational divides. Partnerships are widely endorsed, but there is a need to strengthen the evidence base relating to claims of their effectiveness. This article presents findings from a mixed methods study conducted with the aim of understanding partnership processes and how various partnership factors contribute to partnership effectiveness. The study involved five multi-stakeholder partnerships in Canada and Australia working towards improving accessibility to primary health care for vulnerable populations. Qualitative data were collected through the observation of 14 partnership meetings and individual semi-structured interviews (n = 16) and informed the adaptation of an existing Partnership Self-Assessment Tool. The instrument was administered to five partnerships (n = 54). The results highlight partnership complexity and the dynamic and contingent nature of partnership processes. Synergistic action among multiple stakeholders was achieved through enabling processes at the interpersonal, operational and system levels. Synergy was associated with partnership leadership, administration and management, decision-making, the ability of partnerships to optimize the involvement of partners and the sufficiency of non-financial resources. The Partnership Synergy framework was useful in assessing the intermediate outcomes of ongoing partnerships when it was too early to assess the achievement of long-term intended outcomes.

The New Food Truck in Town: Geographic Communities and Authenticity-Based Entrepreneurship

2020 ◽  
Author(s):  
Todd Schifeling ◽  
Daphne Demetry
Keyword(s):  
United States ◽  
Mixed Methods ◽  
The United States ◽  
Craft Production ◽  
Mixed Methods Study ◽  
Local Context ◽  
Small Scale ◽  
Food Trucks ◽  
Industrial Manufacturing ◽  
Hands On

Authenticity is a valuable attribution for organizations, but one that raises a challenge of audience acceptance for innovative entrepreneurs. In particular, organizations that depart from an established type risk being judged as inauthentic. However, entrepreneurs may be able to overcome this challenge by basing their authenticity on notions of craft—such as skilled hands-on techniques, sophisticated ingredients, and small-scale artistry rather than mass industrial manufacturing—that better support innovation. We propose that communities vary in the extent to which they embrace craft production as an evolved understanding of authenticity that is less concerned with conformity to type. This local context, in turn, conditions the likelihood of entrepreneurs creating innovative ventures that rely on perceptions of craft authenticity. We develop this argument through a mixed-methods study of the spatially uneven emergence of gourmet food trucks across the United States. Our findings contribute to research on authenticity and the geography of entrepreneurship and innovation.

Determining Emotional Tone and Verbal Behavior in Patients With Tinnitus and Hyperacusis: An Exploratory Mixed-Methods Study

2019 ◽  
Vol 28 (3) ◽  
pp. 660-672
Author(s):  
Suzanne H. Kimball ◽  
Toby Hamilton ◽  
Erin Benear ◽  
Jonathan Baldwin
Keyword(s):  
Mixed Methods ◽  
Verbal Behavior ◽  
Coping Strategies ◽  
Mixed Methods Study ◽  
Self Report ◽  
Anxiety And Depression ◽  
Negative Consequences ◽  
Emotional Tone ◽  
Explanatory Mixed Methods ◽  
Quantitative Results

Purpose The purpose of this study was to evaluate the emotional tone and verbal behavior of social media users who self-identified as having tinnitus and/or hyperacusis that caused self-described negative consequences on daily life or health. Research Design and Method An explanatory mixed-methods design was utilized. Two hundred “initial” and 200 “reply” Facebook posts were collected from members of a tinnitus group and a hyperacusis group. Data were analyzed via the LIWC 2015 software program and compared to typical bloggers. As this was an explanatory mixed-methods study, we used qualitative thematic analyses to explain, interpret, and illustrate the quantitative results. Results Overall, quantitative results indicated lower overall emotional tone for all categories (tinnitus and hyperacusis, initial and reply), which was mostly influenced by higher negative emotion. Higher levels of authenticity or truth were found in the hyperacusis sample but not in the tinnitus sample. Lower levels of clout (social standing) were indicated in all groups, and a lower level of analytical thinking style (concepts and complex categories rather than narratives) was found in the hyperacusis sample. Additional analysis of the language indicated higher levels of sadness and anxiety in all groups and lower levels of anger, particularly for initial replies. These data support prior findings indicating higher levels of anxiety and depression in this patient population based on the actual words in blog posts and not from self-report questionnaires. Qualitative results identified 3 major themes from both the tinnitus and hyperacusis texts: suffering, negative emotional tone, and coping strategies. Conclusions Results from this study suggest support for the predominant clinical view that patients with tinnitus and hyperacusis have higher levels of anxiety and depression than the general population. The extent of the suffering described and patterns of coping strategies suggest clinical practice patterns and the need for research in implementing improved practice plans.

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