scholarly journals A qualitative study of autism services and supports in Singapore: Perspectives of service providers, autistic adults and caregivers

Autism ◽  
2021 ◽  
pp. 136236132110161
Author(s):  
Emeline Han ◽  
Melisa Mei Jin Tan ◽  
Laura Crane ◽  
Helena Legido-Quigley
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Complex Nature ◽  
Structured Interviews ◽  
Related Services ◽  
Collective Effort ◽  
Autistic People ◽  
Flexible Supports ◽  
Autistic Adults ◽  
Services And Supports

The lifelong and complex nature of autism necessitates an array of services and supports spanning across different sectors and providers at different life stages of an autistic individual. However, research has shown that autistic individuals and their families often experience barriers accessing the autism-related services and supports that they need. This is the first qualitative study to explore the provision and coordination of autism services and supports in Singapore from the perspectives of service providers, autistic adults and caregivers. Semi-structured interviews with 21 participants revealed three main themes: (1) improving access to autism-specific services, (2) creating flexible supports in an inclusive environment and (3) addressing stigma and changing societal attitudes. Our findings suggest that Singapore may have achieved rapid growth in autism services, but broader social structures may be slower to change. To better support autistic individuals in society, autistic voices need to be amplified and a collective effort is needed to achieve a paradigm shift from impairment to capability. Lay abstract Because autism is a lifelong and complex condition, autistic people may need a range of supports cutting across different sectors (e.g. health, education and social care) at different stages of their lives. Studies in some countries have shown that autistic people and their families face difficulties accessing the services they need, but no research has been done on this topic in Singapore. To start addressing this gap, we interviewed 21 service providers, autistic adults and caregivers/parents of autistic children to find out their perceptions and experiences of autism services and supports in Singapore. Our participants told us that beyond improving access to autism-specific services, they also hoped to see more flexible supports in an inclusive environment and a broader change in societal attitudes. This study highlights that autism service provision should be informed by autistic voices and not only focus on impairment but also recognise the strengths of autistic people alongside their very real needs. The whole of society – including policymakers, professionals, employers, educators, families and autistic people themselves – needs to work together to fight autism stigma and discrimination.

What makes an optimal delivery for PrEP against HIV: A qualitative study in MSM

2022 ◽  
pp. 095646242110608
Author(s):  
Janice Y. C. Lau ◽  
Ngai-Sze Wong ◽  
Krystal C. K. Lee ◽  
Tsz-Ho Kwan ◽  
Grace C. Y. Lui ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Effective Means ◽  
Qualitative Assessment ◽  
Theory Approach ◽  
Service Model ◽  
Structured Interviews ◽  
Sexually Transmitted ◽  
Ethnic Chinese ◽  
Sex With Men

Background Pre-exposure prophylaxis (PrEP) is an effective means of HIV prevention for men who have sex with men (MSM), a key population whose engagement is crucial for achieving effective public health outcomes. An optimal service model would be important in planning the implementation of PrEP in places where such service has not been established. Methods A qualitative study was conducted to delineate the attributes of an optimal PrEP service model for MSM in Hong Kong, a city where no formal PrEP programs existed. Twenty purposively sampled MSM who were enrollees of two pilot PrEP projects participated in the semi-structured interviews promoting story-telling. The coded data were thematically analyzed following Grounded Theory approach, focusing on uncovering a typology of the essential attributes of an optimal PrEP service model, and the reasons for such preferences. Results Participating MSM were all ethnic Chinese and aged 26 to 52 years. All had received PrEP from pilot projects in conjunction with periodic screening of sexually transmitted infections (STI), HIV antibody, and plasma creatinine. Four major themes emerged as regards the attributes of a preferred PrEP service: (i) comprehensiveness of HIV/STI and safety monitoring; (ii) convenient unitary service; (iii) stigma-free PrEP access and protecting confidentiality; and (iv) affordable price. Whereas regular provision of PrEP was acceptable to MSM, unaffordability and related stigma were the anticipated challenges for potential service providers. Conclusions The qualitative assessment of MSM’s preference for PrEP service delivery has yielded important information on the many facets of a desirable service model.

Experiences of Racism and Racial Tensions Among African American Women Impacted by Commercial Sexual Exploitation in Practice: A Qualitative Study

2019 ◽  
Vol 26 (5) ◽  
pp. 438-457
Author(s):  
Lara B. Gerassi
Keyword(s):  
Black Women ◽  
Qualitative Study ◽  
African American Women ◽  
White Women ◽  
Service Providers ◽  
Sexual Exploitation ◽  
Commercial Sexual Exploitation ◽  
Adult Women ◽  
Related Services ◽  
Related Service

Barriers faced by Black women when navigating commercial sexual exploitation (CSE)-related services remain understudied. This qualitative study explores (a) Black women’s experiences of racism when accessing services in CSE-related organizations and (b) the existence and manifestation of racial tensions in practice. In-depth interviews were conducted with 30 adult women who traded sex as adults and 20 CSE-related service providers. Findings suggest that Black women perceive preferential treatment given to White women. Racial tensions between women accessing programs were identified, as well as a promising practice of intergroup dialogue groups addressing racism, privilege, and oppression. Implications are discussed.

scholarly journals ‘I never realised everybody felt as happy as I do when I am around autistic people’: A thematic analysis of autistic adults’ relationships with autistic and neurotypical friends and family

Autism ◽  
2020 ◽  
Vol 24 (6) ◽  
pp. 1438-1448 ◽  
Author(s):  
Catherine J Crompton ◽  
Sonny Hallett ◽  
Danielle Ropar ◽  
Emma Flynn ◽  
Sue Fletcher-Watson
Keyword(s):  
Social Relationships ◽  
Thematic Analysis ◽  
Social Life ◽  
Minority Status ◽  
Structured Interviews ◽  
Social Time ◽  
Autistic People ◽  
Social Opportunities ◽  
Autistic Adults ◽  
Close Family

Many autistic people are motivated to have friends, relationships and close family bonds, despite the clinical characterisation of autism as a condition negatively affecting social interaction. Many first-hand accounts of autistic people describe feelings of comfort and ease specifically with other autistic people. This qualitative research explored and contrasted autistic experiences of spending social time with neurotypical and autistic friends and family. In total, 12 autistic adults (10 females, aged 21–51) completed semi-structured interviews focused on time spent with friends and family; positive and negative aspects of time spent with neurotypical and autistic friends and family; and feelings during and after spending time together. Three themes were identified: cross-neurotype understanding, minority status and belonging. Investigation of these themes reveals the benefits of autistic people creating and maintaining social relationships with other autistic people, in a more systematic way than previous individual reports. They highlight the need for autistic-led social opportunities and indicate benefits of informal peer support for autistic adults. Lay abstract Although autistic people may struggle to interact with others, many autistic people have said they find interacting with other autistic people more comfortable. To find out whether this was a common experience, we did hour-long interviews with 12 autistic adults. We asked them questions about how it feels when spending time with their friends and family, and whether it felt different depending on whether the friends and family were autistic or neurotypical. We analysed the interviews and found three common themes in what our participants said. First, they found spending with other autistic people easier and more comfortable than spending time with neurotypical people, and felt they were better understood by other autistic people. Second, autistic people often felt they were in a social minority, and in order to spend time with neurotypical friends and family, they had to conform with what the neurotypical people wanted and were used to. Third, autistic people felt like they belonged with other autistic people and that they could be themselves around them. These findings show that having time with autistic friends and family can be very beneficial for autistic people and played an important role in a happy social life.

Challenges of the Relative Value Unit Experience in Iran: A Qualitative Study

2021 ◽  
Vol 15 (5) ◽  
pp. 1249-1255
Author(s):  
S. Forootan ◽  
S. Hajebrahimi ◽  
B. Najafi ◽  
A. Janati
Keyword(s):  
Qualitative Study ◽  
Service Providers ◽  
Health Sector ◽  
Active Role ◽  
Structured Interviews ◽  
Group Discussions ◽  
Provider Behavior ◽  
Income Disparities ◽  
Relative Value ◽  
Data Content

Background: The Relative Value Unit (RVU) is a value scale and plays a key role in the physician reimbursement system. The health sector has faced challenges such as providers’ dissatisfaction, income disparities, and reduced service quality which is said to be due to improper RVUs. Always there are debates about it. This study aims to identify the challenges of the RVU experience in Iran from the perspective of the service providers, payers and, policymakers. Methods: This qualitative study was conducted in 2020. Data were collected from November 2019 to February 2020. Thirty experts participated in the study and were categorized into four groups: insurance organizations’ managers, surgeons, health economists, and health policymakers. Focus Group Discussions and semi-structured interviews were held to collect data. Content analysis was conducted to analyze data. Results: According to the expert, the challenges of RVU in Iran are classified into five scopes. Financial, payment, macro-organization, regulation, and persuasion scope. Each scope’s result was categorized into main themes and relevant sub-themes. Conclusions: The RVU has an important impact on the health system, provider behavior, and even patients. Paying attention to required infrastructures, decision- makers’ conflict of interests, decrease the Ministry of Health and Medical Education’s authority, and expanding the active role of involved organizations to increase their commitment to the successful implantation of RVU is necessary. Keywords: Relative Value Unit, Challenge, Expert opinion, Qualitative study, Iran.

Perceived Needs of Students with Low-Incidence Disabilities in Rural Areas

2005 ◽  
Vol 24 (3) ◽  
pp. 3-14 ◽  
Author(s):  
Harvey Rude ◽  
Lewis Jackson ◽  
Silvia Correa ◽  
John Luckner ◽  
Sheryl Muir ◽  
...  
Keyword(s):  
Special Education ◽  
Rural Areas ◽  
Service Providers ◽  
Information Provision ◽  
The United States ◽  
Professional Organizations ◽  
Highly Qualified ◽  
Related Services ◽  
Low Incidence ◽  
Services And Supports

We examined the current perspectives of service providers, administrators, and parents who are linked to the provision of special education and related services to learners with low-incidence disabilities in the United States. The purposes of the investigation were to gain information from the various respondents concerning the adequacy and availability of appropriate educational services for students with low-incidence disabilities and provide information regarding the need for additional services and supports. A detailed survey instrument that included a variety of open-ended response items was developed and mailed to the membership of two professional organizations with strong connections to rural special education. Responses indicated that the biggest areas of need were for highly qualified personnel with the necessary skills and knowledge to meet the needs of learners with low-incidence disabilities and for timely information that would support the education of these learners. Implications for how these concerns can be addressed are provided within the framework of four major functions including: information provision, teacher preparation, local school support, and research.

scholarly journals Healthcare inequities and barriers to access for homeless individuals: a qualitative study in Barcelona (Spain)

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrés Cernadas ◽  
Ángela Fernández
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Healthcare Workers ◽  
Service Providers ◽  
Universal Access ◽  
Healthcare Services ◽  
Medical Professional ◽  
Homeless Population ◽  
Public Health Services ◽  
Structured Interviews

Abstract Background In Spain, homeless individuals have lower perceived quality of health than the rest of the population and their life expectancy is 30 years lower than the national average. While the Spanish health system provides universal access and coverage, homeless individuals do not access or use public care enough to maintain their health. The objective of this study is to determine if homeless individuals can access public health services in conditions of equality with the rest of the population, as established in healthcare legislation, and to better understand the causes of observed inequalities or inequities of access. Methods A detailed qualitative study was carried out in the city of Barcelona (Spain) from October 2019 to February 2020. A total of nine open and in-depth interviews were done with homeless individuals along with seven semi-structured interviews with key informants and two focus groups. One group was composed of eight individuals who were living on the street at the time and the other consisted of eight individuals working in healthcare and social assistance. Results The participants indicated that homeless individuals tend to only access healthcare services when they are seriously ill or have suffered some kind of injury. Once there, they tend to encounter significant barriers that might be 1) administrative; 2) personal, based on belief that that will be poorly attended, discriminated against, or unable to afford treatment; or 3) medical-professional, when health professionals, who understand the lifestyle of this population and their low follow-through with treatments, tend towards minimalist interventions that lack the dedication they would apply to other groups of patients. Conclusions The conclusions derived from this study convey the infrequent use of health services by homeless individuals for reasons attributable to the population itself, to healthcare workers and to the entire healthcare system. Accordingly, to reduce inequities of access to these services, recommendations to healthcare service providers include adapting facilities to provide more adequate care for this population; increasing sensitivity/awareness among healthcare workers; developing in situ care systems in places where the homeless population is most concentrated; and establishing healthcare collaboration agreements with entities that work with this population.

scholarly journals Exploring Autistic Adults’ Psychosocial Experiences Affecting Beginnings, Continuity, and Change in Camouflaging Over Time- A Qualitative Study

2021 ◽  
Author(s):  
Beatrice Loo ◽  
Truman Teo ◽  
Melanie Liang ◽  
Dawn-Joy Leong ◽  
Diana Weiting Tan ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Sense Of Self ◽  
Self Identity ◽  
Psychosocial Experiences ◽  
Continuity And Change ◽  
Autistic People ◽  
Psychosocial Influences ◽  
Societal Level ◽  
Autistic Adults ◽  
Over Time

Many autistic people develop camouflaging strategies to mask or compensate for their underlying autism-related differences in order to get by in predominantly non-autistic societies. Autistic adults have described camouflaging as a “lifetime of conditioning to act normal”, suggesting that camouflaging develops over the autistic person’s lifespan. Yet, very little is so far known about the course of camouflaging motivations and behaviours over time or the psychosocial factors that may influence autistic people’s camouflaging trajectories. In an exploratory qualitative study within an Asian sociocultural context, we interviewed 11 Singaporean autistic adults in depth about their camouflaging experiences throughout their lives. We aimed to better understand the beginnings, continuity and changes in their camouflaging motivations and strategies over time, and related psychosocial influences. Interviews were transcribed verbatim and thematically analysed. Twenty-six themes were identified, and were organised across four phases - pre-camouflaging, beginnings, continuity, and change over time. The earliest camouflaging motivations were predominantly relational, linked to a negative self-identity shaped by adverse social experiences. Strategies were increasingly complex and better integrated into one’s sense of self over time, or more selectively engaged in. Our findings highlight the role of psychosocial pressures precipitating camouflaging. They also emphasise the need for both individual psychological and societal-level changes to move from pathologizing autistic differences to acceptance, understanding, and inclusion, so as to reduce psychosocial pressures on autistic people of all ages to camouflage.

scholarly journals Cultivating social occupations, spaces, and networks: service providers’ perspectives on enabling immigrants’ social participation

2021 ◽  
Vol 29 ◽  
Author(s):  
Suzanne Huot ◽  
Jaqueline Brower ◽  
Alex Tham ◽  
Atieh Razavi Yekta
Keyword(s):  
Qualitative Study ◽  
Economic Integration ◽  
Thematic Analysis ◽  
Social Participation ◽  
Service Providers ◽  
Community Organizations ◽  
Occupational Therapists ◽  
Social Identities ◽  
Canadian Society ◽  
Structured Interviews

Abstract Introduction Immigrants may experience many barriers to social participation within host societies. Immigrants’ integration into Canadian society is supported through government-funded services. Objective In the present study, we explored the perspectives of service providers working in community organizations regarding their role in enabling immigrants’ social participation through occupations in British Columbia, Canada. Method Representatives from twenty different organizations providing services to the community participated in a constructivist qualitative study aiming to uncover aspects shaping opportunities for occupational participation provided for immigrants. Results Drawing on semi-structured interviews and using thematic analysis, we identified three main themes relating to cultivating social occupations, spaces, and networks. Findings illustrate that service providers’ cultivation of these opportunities can support immigrants’ desired social roles and social identities, further enabling their participation in receiving societies. Conclusion Emphasis upon supporting socio-economic integration into society appears to limit a client-centred approach to developing opportunities for social participation through occupation. Implications for occupational therapists and scientists are discussed.

scholarly journals A Family-Focused Intervention for Parental Mental Illness: A Practitioner Perspective

2021 ◽  
Vol 12 ◽  
Author(s):  
Mairead Furlong ◽  
Christine Mulligan ◽  
Sharon McGarr ◽  
Siobhan O'Connor ◽  
Sinead McGilloway
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Illness ◽  
Qualitative Study ◽  
Child Protection ◽  
Service Providers ◽  
Controlled Trial ◽  
Parental Mental Illness ◽  
Structured Interviews ◽  
Mental Health Settings

Background: Parental mental illness (PMI) is common and can lead to children developing mental disorders. Family Talk (FT) is a well-known and widely implemented intervention designed to reduce the risk of transgenerational psychopathology. However, given the research to practise “gap,” very little qualitative research, to date, has investigated practitioner experiences in implementing FT. This study aimed to explore the practitioner-perceived barriers and facilitators to the implementation and sustainability of FT within mainstream mental health settings.Methods: This qualitative study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] within 15 adult (AMHS), child (CAMHS), primary care mental health, and child protection sites in Ireland. Semi-structured interviews and focus groups were undertaken with a purposive sample of clinicians (n = 31) and managers (n = 10), based on their experiences of implementing FT. Interview data were transcribed verbatim, analysed using constructivist grounded theory, and informed by Fixsen's implementation science framework.Results: Service providers highlighted a number of benefits for approximately two thirds of families across different diagnoses and mental health settings (AMHS/CAMHS/primary care). Sites varied in their capacity to embed FT, with key enablers identified as acquiring managerial and organisational support, building clinician skill, and establishing interagency collaboration. Implementation challenges included: recruitment difficulties, stresses in working with multiply-disadvantaged families, disruption in delivery due to the COVID-19 global pandemic, and sustainability concerns (e.g., perceived fit of FT with organisational remit/capacity, systemic and cultural barriers to change).Conclusion: This study is only the second qualitative study ever conducted to explore practitioner experiences in implementing FT, and the first conducted within the context of an RCT and national research programme to introduce family-focused practise (FFP) for families living with PMI. The findings illuminate the successes and complexities of implementing FFP in a country without a “think family” infrastructure, whilst highlighting a number of important generalisable lessons for the implementation of FT, and other similar interventions, elsewhere.

scholarly journals Role of Financial Incentives in Family Planning Services in India: A Qualitative Study

2020 ◽  
Author(s):  
Kamlesh Lalchandani ◽  
Aditi Gupta ◽  
Ashish Srivast ◽  
Gulnoza Usmanova ◽  
Ashwarya Maadam ◽  
...  
Keyword(s):  
Family Planning ◽  
Qualitative Study ◽  
Financial Incentives ◽  
Service Providers ◽  
State Level ◽  
Multiple Stakeholders ◽  
Related Services ◽  
The Government

Abstract Background: In an effort to encourage Family Planning (FP) adoption, since 1952, the Government of India has been implementing various centrally sponsored schemes that offer financial incentives (FIs) to acceptors as well as service providers, for services related to certain FP methods. However, understanding of the role of FIs on uptake of FP services, and the quality of FP services provided, is limited and mixed. Methods: A qualitative study was conducted in Chatra and Palamu districts of Jharkhand state. A total of 64 interviews involving multiple stakeholders were conducted. The stakeholders included recent FP acceptors or clients, FP service providers of public health facilities including community health activists (ASHAs), government health officials managing FP programs at the district and state level, and members of development partners supporting FP programs in Jharkhand. Data analysis included both inductive and deductive strategies. It was done using the software Atlas ti version 8. Results: It emerged that there is a strong felt need for family planning among majority clients, and FIs may be a motivator for uptake of FP methods only among those belonging to the lower socio economic strata. For ASHAs, FI is the primary motivator for providing FP related services. There may be a tendency among them and nurses to promote methods which have more financial incentives linked with them. There are mixed opinions on discontinuing FIs for clients or replacing them with non-financial incentives. Delays in payment of FIs to both clients and the ASHAs is a common issue and adversely effects the program.Conclusion: FIs for clients have limited influence on their decision to take up a FP method while different amounts of FIs for ASHAs and nurses, linked with different FP methods, may be influencing their service provision. More research is needed to determine the effect of discontinuing FP related FIs for clients.

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