Determinants of Long Immunization Clinic Wait Times in a Sub-Saharan African Country

The wait time clients spend during immunization clinic visits in low- and middle-income countries is a not well-understood reported barrier to vaccine completion. We used a prospective, observational design to document the total time from client arrival-to-discharge and all sequential provider-client activities in 1 urban, semi-urban, and rural immunization clinic in Nigeria. We also conducted caregiver and provider focus group discussions to identify perceived determinants of long clinic wait times. Our findings show that the time from arrival-to-discharge varied significantly by the clinic and ranged between 57 and 235 minutes, as did arrival-to-all providers-client activities. Focus group data attributed workflow delays to clinic staff waiting for a critical mass of clients to arrive for their immunization appointment before starting the essential health education talk or opening specific vaccine vials. Additionally, respondents indicated that complex documentation processes caused system delays. Research on clinic workflow transformation and simplification of immunization documentation is needed.

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What Influences Saturation? Estimating Sample Sizes in Focus Group Research

Qualitative Health Research ◽

10.1177/1049732318821692 ◽

2019 ◽

Vol 29 (10) ◽

pp. 1483-1496 ◽

Cited By ~ 37

Author(s):

Monique M. Hennink ◽

Bonnie N. Kaiser ◽

Mary Beth Weber

Keyword(s):

Focus Group ◽

Degree Of Saturation ◽

Sample Sizes ◽

Focus Group Discussions ◽

Group Discussions ◽

Focus Group Research ◽

Group Research ◽

Group Data ◽

Focus Group Data ◽

Group Stratification

Saturation is commonly used to determine sample sizes in qualitative research, yet there is little guidance on what influences saturation. We aimed to assess saturation and identify parameters to estimate sample sizes for focus group studies in advance of data collection. We used two approaches to assess saturation in data from 10 focus group discussions. Four focus groups were sufficient to identify a range of new issues (code saturation), but more groups were needed to fully understand these issues (meaning saturation). Group stratification influenced meaning saturation, whereby one focus group per stratum was needed to identify issues; two groups per stratum provided a more comprehensive understanding of issues, but more groups per stratum provided little additional benefit. We identify six parameters influencing saturation in focus group data: study purpose, type of codes, group stratification, number of groups per stratum, and type and degree of saturation.

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Education for Citizenship as a Permanent Laboratory

Handbook of Research on Education for Participative Citizenship and Global Prosperity - Advances in Educational Marketing, Administration, and Leadership ◽

10.4018/978-1-5225-7110-0.ch023 ◽

2019 ◽

pp. 517-536 ◽

Cited By ~ 1

Author(s):

Barbara Balconi ◽

Elisabetta Nigris ◽

Luisa Zecca

Keyword(s):

Focus Group ◽

Teacher Professional Development ◽

Curriculum Design ◽

Local Community ◽

Development Project ◽

Group Discussions ◽

Group Data ◽

Focus Group Data ◽

Teacher Professional

In this chapter, the authors discuss the results of three focus group discussions conducted in the context of the teacher professional development project STEP (school territory environment pedagogy) undertaken by researchers and teachers from three EU Countries—France, Spain, Italy—and one non-EU country, Switzerland. Specifically, they present findings regarding changes in how the teachers in the Milano Bicocca case study represented citizenship education practices. The focus group data was subjected to content analysis, using a set of categories drawn from the national reference documents on curriculum design and the transnational curriculum defined in the STEP project. The changes in the teachers' representations concerned three main aspects: dialogue with the local community and territorial context, the gap between teachers declared intentions and actual educational actions, and the adoption of a complex perspective in the choice of knowledge to be mobilized.

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P019: Understanding patient perceptions of emergency department wait time publication: a mixed-methods needs assessment

CJEM ◽

10.1017/cem.2016.195 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S84-S84

Author(s):

S.M. Calder-Sprackman ◽

E.S. Kwok ◽

R. Bradley ◽

J. Landreville ◽

L.A. Calder

Keyword(s):

Mixed Methods ◽

Focus Group ◽

Tertiary Care ◽

Patient Empowerment ◽

Wait Time ◽

Patient Survey ◽

Wait Times ◽

Focus Group Discussions ◽

Group Discussions ◽

Waiting Room

Introduction: Many emergency departments (EDs) have begun publishing wait times. This study seeks to develop an understanding of patients’ needs with respect to publishing ED wait times, which, to our knowledge, has not been described in the literature. Methods: We conducted a two-stage mixed methods study at a dual campus tertiary care academic center. First, we held focus group discussions comprising of 7 patient advocacy hospital committee members. Themes generated from focus group discussions were then utilized to create a patient survey. Focus groups were analyzed using content theme analysis. Hospital sites for survey administration were randomized and pre-assigned shifts were established to ensure a balance of weekdays, weekends, days, evenings, and overnights. All adult patients (age >18) in the waiting room were eligible, but excluded if they were directly referred to a specialty service or did not speak French or English. Survey data was analyzed using descriptive statistics. Results: We found 9 dominant focus group themes: definition of wait time, wait time posting, lack of communication, education in waiting room, patient expectations, utilization of the ED, patient behavior, physical comfort, and patient empowerment. Of the 240 patient questionnaires administered, 81.3% (195) wanted to know ED wait times before arrival to hospital and 90.8% (217) wanted ED wait times posted in the ED waiting room. The most popular choice for publishing wait times outside the ED was a website (46.7%) whereas, within the ED, patients were not particular about the specific display modality as long as times were displayed (39.6%). Overall, 76.7% (184) stated their satisfaction with the ED would be improved if wait times were posted. Conclusion: ED patients we surveyed strongly supported both the idea of having access to wait time information prior to arrival, as well as physical display of wait times in the waiting room.

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Problems and Practice of Management on Menstruation by Adolescents Girls of Basic Schools of Chitwan, Nepal

Journal of Health Promotion ◽

10.3126/jhp.v8i0.32988 ◽

2020 ◽

Vol 8 ◽

pp. 85-94

Author(s):

Sudha Ghimire

Keyword(s):

Current Practice ◽

Quantitative Information ◽

Community Schools ◽

Mixed Method Research ◽

Participatory Action ◽

Group Discussions ◽

Middle Income ◽

Middle Income Countries ◽

Field Notes ◽

Sanitary Pads

Managing menstruation in a hygienic way is a challenge in most of the low and middle-income countries (LMIC) including Nepal, where normal and natural physiological process of menstruation is considered as girls’ problem which is viewed as sinful, unholy and matter of shame. This paper explores the current practice and existing difficulties that adolescents girls encounter hygienic management of menstruation (MHM) especially during school days. The study was conducted on five purposively selected community schools of Chitwan district. The study adopted Participatory Action Research (PAR) as an approach, that is encapsulated with mixed method research design. For qualitative information observation, focus group discussions (FGD) and field notes were used, whereas for quantitative data self-administrative questionnaires were used. Quantitative information was collected from 205 girls students who were present at schools on the day of data collection. The finding shows that majority of the girls (93.7%) who encounter hygienic management of menstruation were of 10-14 years old age, whereas nearly one third of them were (29%) from grade eight. Similarly, among the total 205 girls, only 79 girls have already started their menstruation; among those who have started menstruation majority (78%) had heard about menstruation form their mothers. Likewise, 35% girls used homemade cotton pads and 40.5% of them changed pad three times a day. During FGD, adolescents girls shared that lack of water and soap in toilets, stress and lack of concentration during menstruation are the major difficulties which they encounter during days of menstruation. They suggested the concerned authorities to manage pad bank, make soap and water available, and develop skills for proper disposing of used sanitary pads for MHM at schools.

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Quantified Nostalgia: Social Media, Metrics, and Memory

Social Media + Society ◽

10.1177/20563051211008822 ◽

2021 ◽

Vol 7 (2) ◽

pp. 205630512110088

Author(s):

Benjamin N. Jacobsen ◽

David Beer

Keyword(s):

Social Media ◽

Focus Group ◽

Qualitative Interviews ◽

The Past ◽

Group Data ◽

Focus Group Data ◽

Social Media Platforms ◽

Memory Practices ◽

The Relationship

As social media platforms have developed over the past decade, they are no longer simply sites for interactions and networked sociality; they also now facilitate backwards glances to previous times, moments, and events. Users’ past content is turned into definable objects that can be scored, rated, and resurfaced as “memories.” There is, then, a need to understand how metrics have come to shape digital and social media memory practices, and how the relationship between memory, data, and metrics can be further understood. This article seeks to outline some of the relations between social media, metrics, and memory. It examines how metrics shape remembrance of the past within social media. Drawing on qualitative interviews as well as focus group data, the article examines the ways in which metrics are implicated in memory making and memory practices. This article explores the effect of social media “likes” on people’s memory attachments and emotional associations with the past. The article then examines how memory features incentivize users to keep remembering through accumulation. It also examines how numerating engagements leads to a sense of competition in how the digital past is approached and experienced. Finally, the article explores the tensions that arise in quantifying people’s engagements with their memories. This article proposes the notion of quantified nostalgia in order to examine how metrics are variously performative in memory making, and how regimes of ordinary measures can figure in the engagement and reconstruction of the digital past in multiple ways.

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Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

BMJ Global Health ◽

10.1136/bmjgh-2020-003423 ◽

2020 ◽

Vol 5 (11) ◽

pp. e003423

Author(s):

Dongqing Wang ◽

Molin Wang ◽

Anne Marie Darling ◽

Nandita Perumal ◽

Enju Liu ◽

...

Keyword(s):

Weight Gain ◽

North Africa ◽

Low Income ◽

Sub Saharan Africa ◽

Middle Income ◽

Middle Income Countries ◽

Gestational Weight ◽

Latin America And Caribbean ◽

Nationally Representative ◽

Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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User-centered Requirements for Patient Fluid Intake Monitoring Support

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641170 ◽

2020 ◽

Vol 64 (1) ◽

pp. 736-740

Author(s):

Ellen J. Bass ◽

Andrew J. Abbate ◽

Yaman Noaiseh ◽

Rose Ann DiMaria-Ghalili

Keyword(s):

Data Analysis ◽

Focus Group ◽

Focus Groups ◽

Real Time ◽

Information Needs ◽

Fluid Intake ◽

Fluid Consumption ◽

Registered Dietitians ◽

Group Data ◽

Focus Group Data

There is a need to support patients with monitoring liquid intake. This work addresses development of requirements for real-time and historical displays and reports with respect to fluid consumption as well as alerts based on critical clinical thresholds. We conducted focus groups with registered nurses and registered dietitians in order to identify the information needs and alerting criteria to support fluid consumption measurement. This paper presents results of the focus group data analysis and the related requirements resulting from the analysis.

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Development of a theory-based HPV vaccine promotion comic book for East African adolescents in the US

BMC Public Health ◽

10.1186/s12889-021-11005-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Isabelle Celentano ◽

Rachel L. Winer ◽

Sou Hyun Jang ◽

Anisa Ibrahim ◽

Farah Bille Mohamed ◽

...

Keyword(s):

Focus Group ◽

Hpv Vaccine ◽

Information Needs ◽

Cultural Beliefs ◽

Comic Book ◽

East African ◽

Step Process ◽

Group Data ◽

The Us ◽

Focus Group Data

Abstract Background Human Papillomavirus (HPV) vaccine uptake is low among East African adolescents in the US. Adolescents’ preferences influence HPV vaccine decisions, yet few interventions exist that address East African adolescents’ beliefs about HPV vaccines. We describe a multi-step process on how to create a theory-based comic book by integrating empirical findings, theory and focus group data from East African parents in the US. Methods Our multi-methods process included conducting focus groups with Somali, Ethiopian, and Eritrean mothers (n = 30) to understand mothers and adolescents socio-cultural beliefs and information needs about the HPV vaccine, creating comic book messages integrating the focus group findings, and assessing the acceptability of the finalized comic book among Somali, Ethiopian, and Eritrean adolescents (n = 134). Results We identified categories around socio-cultural beliefs (such ethnic representation and concerns about pork gelatin in vaccines), HPV vaccine information needs, and diffusion of information. We then mapped the categories to theoretical constructs and operationalized them into the comic book. Finally, we describe the overall acceptability of the comic book and specifics on comic book structure, appeal of characters, and message relevance. Conclusions A rigorous multi-step process that integrates theory and focus group data can help create culturally appropriate health messages that can educate and appeal to the community.

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Are low and middle-income countries prioritising high-value healthcare interventions?

BMJ Global Health ◽

10.1136/bmjgh-2019-001850 ◽

2020 ◽

Vol 5 (2) ◽

pp. e001850

Author(s):

Ashley A Leech ◽

David D Kim ◽

Joshua T Cohen ◽

Peter J Neumann

Keyword(s):

Cost Effectiveness ◽

Cost Saving ◽

National Health ◽

Sub Saharan Africa ◽

Health Plans ◽

Middle Income ◽

Middle Income Countries ◽

Health Priority ◽

Sub Saharan ◽

Low And Middle Income

IntroductionSince resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans.MethodsWe used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyses published in the last 10 years (2008–2017) of cost-saving health interventions in LMICs. To assess whether countries prioritised cost-saving interventions within their latest national health strategic plans, we identified 10 countries, all in sub-Saharan Africa, with the highest measures on the global burden of disease scale and reviewed their national health priority plans.ResultsWe identified 392 studies (63%) targeting LMICs that reported 3315 cost-per-DALY ratios, of which 207 ratios (6%) represented interventions reported to be cost saving. Over half (53%) of these targeted sub-Saharan Africa. For the 10 countries we investigated in sub-Saharan Africa, 58% (79/137) of cost-saving interventions correspond with priorities identified in country plans. Alignment ranged from 95% (21/22 prioritised cost-saving ratios) in South Africa to 17% (2/12 prioritised cost-saving ratios) in Cameroon. Human papillomavirus vaccination was a noted priority in 70% (7/10) of national health prioritisation plans, while 40% (4/10) of countries explicitly included prenatal serological screening for syphilis. HIV prevention and treatment were stated priorities in most country health plans, whereas 40% (2/5) of countries principally outlined efforts for lymphatic filariasis. From our sample of 45 unique interventions, 36% of interventions (16/45) included costs associated directly with the implementation of the intervention.ConclusionOur findings indicate substantial variation across country and disease area in incorporating economic evidence into national health priority plans in a sample of sub-Saharan African countries. To make health economic data more salient, the authors of cost-effectiveness analyses must do more to reflect implementation costs and other factors that could limit healthcare delivery.

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If You Don’t Eat Meat… You’ll Die. A Mixed-Method Survey of Health-Professionals’ Beliefs

Nutrients ◽

10.3390/nu11123028 ◽

2019 ◽

Vol 11 (12) ◽

pp. 3028

Author(s):

Patrick McHugh ◽

Morgen Smith ◽

Nicholas Wright ◽

Sarah Bush ◽

Sue Pullon

Keyword(s):

Focus Group ◽

Nutrition Education ◽

Health Professionals ◽

Common Chronic Disease ◽

Group Data ◽

Overwhelming Evidence ◽

Focus Group Data ◽

Good Nutrition ◽

Spreadsheet Software

Despite an ever-increasing burden of non-communicable diseases and overwhelming evidence that good nutrition improves outcomes it is difficult to know whether this evidence is reaching the general population. The purpose of this study was to investigate whether health professionals in Tairāwhiti have sufficient nutrition education for their roles in health education and promotion and whether nutrition beliefs held by health professionals were consistent with current literature. A particular interest was to enlist views on the harms, benefits, and possible barriers to following plant-based diets. A mixed-methods study involving health professionals completing a questionnaire and a subsequent focus group to collect data was used. Survey data were analysed using spreadsheet software, and thematic content analysis of focus group data was undertaken. Participants provided nutrition advice 2.4 times per day. Almost half of practitioners considered their nutrition knowledge to be inadequate, and most made poor use of references for provision of information. Plant-based diets were generally viewed as beneficial to health, improve quality of life, be filling, but were perceived as not as easy to follow. This study is in keeping with previous research that the health workforce would benefit from more formalised nutrition education and competencies to address common chronic disease.

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