Stress and family relationships among college student parents: A mixed methods study

2020 ◽  
pp. 026540752097519
Author(s):  
Aryn M. Dotterer ◽  
Audrey C. Juhasz ◽  
Kristin N. Murphy ◽  
SuJung Park ◽  
Lisa K. Boyce
Keyword(s):  
Mixed Methods ◽  
College Student ◽  
Low Income ◽  
Family Relationships ◽  
Online Survey ◽  
Qualitative Interviews ◽  
Multiple Roles ◽  
Structured Interviews ◽  
External Resources ◽  
Student Parents

College student parents represent a unique population because they are typically low-income, accrue more debt than traditional students, and must balance the role of student and parent. Using a mixed methods design, this study examined the relation between college student parents’ stress and distress in their relationships with their children and examined how parents managed their multiple roles. Parent participants ( n = 80; 54 mothers, 26 fathers; M age = 28.74 years, SD = 4.72) completed an online survey and a subsample ( n = 14) participated in semi-structured interviews. Results revealed that college student parents experience a variety of stressors that spillover into their relationships with their children and these associations appear more detrimental for father-child relationships. However, in-depth qualitative interviews not only highlighted the various sources of stress (e.g., time demands, multiple roles), but also revealed internal and external resources that college student parents draw on to help cope with stressors. Findings suggest that program efforts to strengthen the co-parenting relationship and to help college student parents more effectively manage their stress may be beneficial for improved parent-child relationships.

Bureaucratic organization and innovation : a mixed-methods study of U.S. State Department of Transportation website adoption

2017 ◽  
Author(s):  
◽  
A. J. Million
Keyword(s):  
Mixed Methods ◽  
Online Survey ◽  
State Level ◽  
State Department ◽  
Third Parties ◽  
Department Of Transportation ◽  
Structured Interviews ◽  
University Of Missouri ◽  
Bureaucratic Organization ◽  
Barriers To Change

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] This study explores bureaucratic organization and innovation in U.S. state department of transportation (DOT) websites. To determine if working with third parties fosters change in state DOT websites, it employs a two-part, explanatory sequential mixed-methods design. In phase one, an online survey was disseminated to IT managers and communications officers in all 50 states to collect data regarding agency demographics, bureaucratic models, and Web infrastructure. In total, 45 valid responses (or 90 percent) were received from DOTs indicating that most built, hosted, and managed their websites in-house, but that state-level IT consolidations required many to pool resources with third parties. In research phase two, 12 semi-structured interviews were conducted of a maximum variation sample of survey respondents. These interviews were conducted to explain why DOTs built and operated their websites with the support of third parties. Employing a grounded theoretical approach, analysis revealed 6 themes explaining website adoption and showed that working with third parties can foster innovation; however, not all change is positive. Therefore, a need exists for governments to selectively work with others, ascertain future barriers to change, and ensure that adopted innovations meet desired ends. Finally, five best practices informed by study findings are presented that may help decision-makers and civil servants provide e-government services in a flexible manner.

scholarly journals Development of a tool for identifying and addressing prioritised determinants of quality improvement projects led by healthcare professionals: a mixed-methods study

2020 ◽  
Author(s):  
Anne van Tuijl ◽  
Hub C. Wollersheim ◽  
Cornelia R.M.G. Fluit ◽  
Petra. J. van Gurp ◽  
Hiske Calsbeek
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Learning By Doing ◽  
Mixed Methods Study ◽  
Quality Improvement Initiative ◽  
Structured Interviews ◽  
Priority Score ◽  
A Priority

Abstract Background: Several frameworks have been developed to identify essential determinants for healthcare improvement. These frameworks aim to be comprehensive, leading to the creation of long lists of determinants that are not prioritised based on being experienced as most important. Furthermore, most existing frameworks do not describe the methods or actions used to identify and address the determinants, limiting their practical value. The aim of this study is to describe the development of a tool with prioritised facilitators and barriers supplemented with methods to identify and address each determinant. The tool can be used by those performing quality improvement initiatives in healthcare practice. Methods: A mixed-methods study design was used to develop the tool. First, an online survey was used to ask healthcare professionals about the determinants they experienced as most facilitating and most hindering during the performance of their quality improvement initiative . A priority score was calculated for every named determinant, and those with a priority score ≥ 20 were incorporated into the tool. Semi-structured interviews with implementation experts were performed to gain insight on how to analyse and address the determinants in our tool Results: The 25 healthcare professionals in this study experienced 64 facilitators and 66 barriers when performing their improvement initiatives. Of these, 12 facilitators and nine barriers were incorporated into the tool. Sufficient support from management of the department was identified as the most important facilitator, while having limited time to perform the initiative was considered the most important barrier. The interviews with 16 experts in implementation science led to various inputs for identifying and addressing each determinant. Important themes included maintaining adequate communication with stakeholders, keeping the initiative at a manageable size, learning by doing and being able to influence determinants. Conclusions: This paper describes the development of a tool with prioritized determinants for performing quality improvement initiatives with suggestions for analysing and addressing these determinants. The tool is developed for those engaged in quality improvement initiatives in practice, so in this ways it helps to bridging the research to practice gap of determinants frameworks. More research is needed to validate and develop the tool further.

scholarly journals P.024 Educational needs in migraine care: results from a mixed-methods study among Canadian primary care providers and specialists

2018 ◽  
Vol 45 (s2) ◽  
pp. S22-S22
Author(s):  
S Peloquin ◽  
E Leroux ◽  
G Shapero ◽  
S Labbe ◽  
S Murray ◽  
...  
Keyword(s):  
Mixed Methods ◽  
General Practitioners ◽  
Online Survey ◽  
Medical Training ◽  
Phase 1 ◽  
Primary Care Providers ◽  
Educational Needs ◽  
Phase 2 ◽  
Care Providers ◽  
Structured Interviews

Background: Migraines are sub-optimally treated, affect millions of Canadians, and are underrepresented in medical training. A study was conducted to identify the needs of Canadian Healthcare Providers (HCPs) for migraine education, with the aim to inform the development of learning activities. Methods: This ethics-approved study was deployed in two consecutive phases using a mixed-methods approach. Phase 1 (qualitative) explored the causes of challenges to migraine care via a literature review, input from an expert working group, and semi-structured interviews with multiple stakeholders. Phase 2 (quantitative) validated these causes using an online survey. Results: The study included 103 participants (28 in phase 1; 75 in phase 2): general practitioners=37; neurologists=24; nurses=14; pharmacists=20; administrators, policy influencers and payers=8. Four areas of sub-optimal knowledge were identified: (1) Canadian guidelines, (2) diagnostic criteria, (3) preventive treatment, and (4) non-pharmacological therapies. Attitudinal issues related to the management of migraine patients were also identified. Detailed data including the frequencies of knowledge gaps among general practitioners and general neurologists will be presented along with qualitative findings. Conclusions: Educational activities for general practitioners and general neurologists who treat patients with migraines should be designed to address the four educational needs described in this study.

Exploring the factors motivating continued Lay First Responder participation in Uganda: a mixed-methods, 3-year follow-up

2020 ◽  
Vol 38 (1) ◽  
pp. 40-46
Author(s):  
Peter G Delaney ◽  
Zachary J Eisner ◽  
T Scott Blackwell ◽  
Ibrahim Ssekalo ◽  
Rauben Kazungu ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Low Income ◽  
First Responders ◽  
Prehospital Emergency Care ◽  
Structured Interviews ◽  
Economic Implications ◽  
Taxi Drivers ◽  
Financial Benefits ◽  
Motorcycle Taxi

BackgroundThe WHO recommends training lay first responders (LFRs) as the first step towards establishing emergency medical services (EMS) in low-income and middle-income countries. Understanding social and financial benefits associated with responder involvement is essential for LFR programme continuity and may inform sustainable development.MethodsA mixed-methods follow-up study was conducted in July 2019 with 239 motorcycle taxi drivers, including 115 (75%) of 154 initial participants in a Ugandan LFR course from July 2016, to evaluate LFR training on participants. Semi-structured interviews and surveys were administered to samples of initial participants to assess social and economic implications of training, and non-trained motorcycle taxi drivers to gauge interest in LFR training. Themes were determined on a per-question basis and coded by extracting keywords from each response until thematic saturation was achieved.ResultsThree years post-course, initial participants reported new knowledge and skills, the ability to help others, and confidence gain as the main benefits motivating continued programme involvement. Participant outlook was unanimously positive and 96.5% (111/115) of initial participants surveyed used skills since training. Many reported sensing an identity change, now identifying as first responders in addition to motorcycle taxi drivers. Drivers reported they believe this led to greater respect from the Ugandan public and a prevailing belief that they are responsible transportation providers, increasing subsequent customer acquisition. Motorcycle taxi drivers who participated in the course reported a median weekly income value that is 24.39% higher than non-trained motorcycle taxi counterparts (p<0.0001).ConclusionsA simultaneous delivery of sustained social and perceived financial benefits to LFRs are likely to motivate continued voluntary participation. These benefits appear to be a potential mechanism that may be leveraged to contribute to the sustainability of future LFR programmes to deliver basic prehospital emergency care in resource-limited settings.

scholarly journals Engagement with and delivery of the ‘parkrun practice initiative’ in general practice: a mixed methods study

2020 ◽  
Vol 70 (697) ◽  
pp. e573-e580
Author(s):  
Joanna Fleming ◽  
Carol Bryce ◽  
Joanne Parsons ◽  
Chrissie Wellington ◽  
Jeremy Dale
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Focus Group ◽  
Online Survey ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Practice Staff ◽  
Health And Wellbeing ◽  
Positive Effects ◽  
Improve Patient

BackgroundThe parkrun practice initiative, a joint collaboration between parkrun and the Royal College of General Practitioners, was launched to encourage general practices to improve the health and wellbeing of patients and staff through participating in local 5 km parkrun events. Why and how practices engage with the initiative is unknown.AimTo investigate engagement with and delivery of the parkrun practice initiative in general practice.Design and settingMixed methods study conducted from April–July 2019 comprising an online survey of all registered parkrun practices, and interviews and a focus group with practice staff in the West Midlands.MethodThe designated contacts at 780 registered parkrun practices were invited to complete an online survey. A purposive sample of parkrun practice staff and non-registered practice staff took part either in semi-structured interviews or a focus group, with transcripts analysed thematically.ResultsOf the total number of parkrun practices, 306 (39.2%) completed the survey. Sixteen practice staff (from nine parkrun practices and four non-registered practices) took part in either semi-structured interviews (n = 12) or a focus group (n = 4). Key motivators for becoming a parkrun practice were: to improve patient and staff health and wellbeing, and to become more engaged with the community and enhance practice image. Practices most commonly encouraged patients, carers, and staff to take part in parkrun and displayed parkrun flyers and posters. Challenges in implementing activities included lack of time (both personal and during consultations) and getting staff involved. Where staff did engage there were positive effects on morale and participation. Non-registered practices were receptive to the initiative, but had apprehensions about the commitment involved.ConclusionPractices were keen to improve patient and staff health. Addressing time constraints and staff support needs to be considered when implementing the initiative.

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

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.

scholarly journals Effects of training podiatrists to use imagery-based motivational interviewing when treating people with diabetes-related foot disease: a mixed-methods pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Tracey Kaczmarek ◽  
Jaap J. Van Netten ◽  
Peter A. Lazzarini ◽  
David Kavanagh
Keyword(s):  
Job Satisfaction ◽  
Mixed Methods ◽  
Pilot Study ◽  
Motivational Interviewing ◽  
Qualitative Interviews ◽  
Self Care ◽  
Substantial Effect ◽  
Subjective Experiences ◽  
Structured Interviews ◽  
Foot Disease

Abstract Background Self-care in diabetes related foot disease (DFD) is challenging and contributes to poor outcomes. Motivational Interviewing (MI) can engage people in self-care and modifying it by integrating imagery may further improve its outcomes. No previous studies have trained podiatrists in using MI to address DFD self-care. This was the first study on training podiatrists to conduct imagery-based motivational interviewing (MI) when treating people with DFD, and to examine impacts on MI related skills, job satisfaction and subjective experiences in a mixed-methods pilot study. Methods Eleven recruited podiatrists (median age: 35 years, 9 female and 2 male) received two 4-h training sessions, and three received subsequent mentoring. MI and imagery skills were rated using validated tools during two clinical sessions per participant at baseline, and 2- and 12-weeks post-training. Job satisfaction was assessed at baseline and 12 weeks. Semi-structured interviews at 12 weeks were analysed using the framework approach. Results Significant improvements over time (p = .006–.044) with substantial effect sizes (η2 = .50–.67) were found in three of four global MI related communication skills and two of four MI behaviours. However, effects on these indices were not sustained to 12 weeks, and imagery was rarely used. Job satisfaction was high at baseline and unchanged at follow-up (p = 0.34, η2 = .100). In qualitative interviews, MI training and skills were valued, but significant challenges in using MI when treating people with DFD were reported. Conclusion Training podiatrists in MI may have potential but more training, observation and mentoring appear needed to obtain sustained communication changes in practice.

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

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.

scholarly journals Process evaluation of integrated early child development care at private clinics in poor urban Pakistan: a mixed methods study

BJGP Open ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. bjgpopen17X101073 ◽  
Author(s):  
Muhammad Amir Khan ◽  
Syeda Somyyah Owais ◽  
Sehrish Ishaq ◽  
John Walley ◽  
Haroon Jehangir Khan ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Child Development ◽  
Qualitative Interviews ◽  
Public Health Care ◽  
Early Child Development ◽  
Care Providers ◽  
Structured Interviews ◽  
District Health ◽  
Healthcare Facilities ◽  
Early Child

BackgroundIn poor urban Pakistan, private GP clinics lack adequate services to promote early child development (ECD) care. A clinic-based contextualised ECD intervention was developed for quarterly tool-assisted counselling of mothers.AimTo explore the experience and implementation of ECD intervention by the private care providers and clients, for further adaptation for scaling of quality ECD care, at primary level private healthcare facilities in Pakistan.Design & settingA mixed methods approach using quantitative records review and qualitative interviews at poor urban clinics in Rawalpindi and Lahore, Pakistan.MethodQuantitative data from study-specific records were reviewed for 1242 mother–child pairs registered in the intervention. A total of 18 semi-structured interviews with clinic staff, mothers, and research staff were conducted at four clinics. The interviews were audiorecorded and transcribed verbatim.ResultsDistrict Health Office (DHO) support allowed transparent and effective selection and training of clinic providers. Public endorsement of ECD care at private clinics and the addition of community advocates promoted ECD care uptake. Clinic settings were found feasible for clinic assistants, and acceptable to mothers, for counselling sessions. Mothers found ECD counselling methods more engaging compared to the usual care provided.ConclusionIn poor urban settings where public health care is scarce, minimal programme investment on staff training and provision of minor equipment can engage private clinics effectively in delivering ECD care.

scholarly journals Understanding Demand for, and Feasibility of, Centre-based Child-care for Poor Urban Households: A Mixed Methods Study in Dhaka, Bangladesh.

2020 ◽  
Author(s):  
Helen Elsey ◽  
Fariza Fieroze ◽  
Riffat Shawon ◽  
Shammi Nasreen ◽  
Joseph Paul Hicks ◽  
...  
Keyword(s):  
Child Care ◽  
Mixed Methods ◽  
Urban Environment ◽  
Low Income ◽  
Qualitative Interviews ◽  
Childhood Development ◽  
Child Care Centre ◽  
Urban Households ◽  
Care Givers ◽  
The Impact

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 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.

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