Mixed-methods research to assess care coordination experiences among NCORP clinical trial participants.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 168-168
Author(s):  
Izumi Okado ◽  
Ian Pagano ◽  
Anamalia Su'esu'e ◽  
Kevin Cassel ◽  
Jessica Rhee ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Mixed Methods ◽  
Focus Group ◽  
Care Coordination ◽  
Cancer Care ◽  
Additional Benefit ◽  
Cancer Clinical Trial ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Trial Participants

168 Background: According to the Institute of Medicine, care coordination (CC) is a critical component of high-quality cancer care; however, many patients with cancer continue to experience fragmented care. CC experiences among cancer clinical trial (CT) participants are relatively unknown. Using mixed methods, we examined perceptions of CC among patients enrolled on therapeutic CTs conducted through the Hawaii Minority/Underserved NCI Community Oncology Research Program (NCORP). Methods: Forty-five CT participants completed the validated Care Coordination Instrument (CCI). The CCI assesses cancer patients’ perceptions of CC overall and across Communication, Navigation, and Operational domains. Data from 45 non-CT participants matched by age, gender, cancer type (breast, GI, other), and clinical stage from our prior studies served as a control group. Paired t-tests were used to compare the CCI scores between the two groups. Three semi-structured focus group interviews were conducted with 14 CT participants in 2020 and 2021. Results: The mean age of CT participants was 61.7 ( SD = 9.4), with the majority being female (67%) and Asian (56%). The most common cancer disease sites were breast (27%) and GI (16%). CT participants reported significantly higher total CC scores than non-participants ( p =.0008). Similar trends were found for Navigation ( p =.007) and Operational ( p =.001) domain scores. 56% of CT participants reported receiving moderate to high-intensity CC assistance from their clinical research professionals (CRPs). Content analysis of focus group discussions revealed that the majority of CT participants’ comments aligned with CC domains; 42% Communication, 30% Navigation, and 28% Operational. Nearly half of focus group discussions centered on CRPs (47%), including CC support provided by CRPs (26%). Other key themes that emerged from the focus groups included general CT experiences (22%) and CRP involvement as an additional benefit to CT participation (15%). Conclusions: Clinical trial participants perceive better CC than non-CT participants, partly attributed to CC support provided by CRPs. Our findings highlight a generally unrecognized yet integral role of CRPs as part of a cancer clinical trial care team. CRP involvement may be an additional benefit of CT participation and contribute to improved quality and value for patient-centered cancer care.

Mixed-methods research to evaluate a novel patient-centered cancer care coordination instrument.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 280-280
Author(s):  
Izumi Okado ◽  
Kevin Cassel ◽  
Ian Pagano ◽  
Randall F. Holcombe
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Cancer Patients ◽  
Care Coordination ◽  
Cancer Care ◽  
Mixed Methods Research ◽  
Patient Navigator ◽  
Focus Group Discussions ◽  
Patient Centered ◽  
Group Discussions

280 Background: Effective care coordination (CC) is a critical component of high-quality cancer care; however, efforts to improve cancer care coordination are hampered by limited patient-centered measures. This mixed-methods research reports on patients’ feedback and the utility of a novel care coordination instrument (CCI) designed to assess cancer care coordination. Methods: 7 focus group discussions were conducted with 68 cancer patients receiving active therapy to evaluate validity of the CCI. Subsequently, the CCI was modified and administered to additional 200 cancer patients derived from community-based private and hospital clinics. The CCI is a 29-item, multiple-choice questionnaire and includes subscales that evaluate CC in 3 domains (Communication, Navigation, Operational) across 4 areas of CC (patient-physician; between providers; during inpatient-to-ambulatory care transitions; during transitions across phases of care). Results: Qualitative analysis of focus group discussions demonstrated that the CCI has good face and content validity. Content analysis identified the following themes: Survey, Education/Knowledge, Navigator, Communication, Support, Access, Providers, and Team. Questions with unclear wording or high proportions of not applicable or missing responses were refined or removed. Results of the revised survey indicated that the CCI is able to distinguish patient- and practice characteristics associated with optimal/poor CC. Specifically, cancer types (leukemia, myeloma) and having a patient navigator predicted high overall patients’ ratings of CC ( p < .05). Marginally significant differences were found for practice setting ( p = .085). A multiple regression model with all predictors entered simultaneously revealed that the presence of a family/friend caregiver significantly predicted better CC ( p < .001); however, the benefits of a patient navigator were no longer significant. Conclusions: This study demonstrates the utility of the CCI for assessing patients’ perspectives of cancer CC. Use and integration of this instrument in oncology practices/clinics can identify areas of potential interventions for CC improvement and lead to a better quality of care.

scholarly journals Nairobi Early Childcare in Slums (NECS) Study Protocol: a mixed-methods exploration of paid early childcare in Mukuru slum, Nairobi

2020 ◽  
Vol 4 (1) ◽  
pp. e000822
Author(s):  
Robert C Hughes ◽  
Patricia Kitsao-Wekulo ◽  
Sunil Bhopal ◽  
Elizabeth W Kimani-Murage ◽  
Zelee Hill ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Early Years ◽  
Epidemiological Methods ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Early Childcare ◽  
Depth Interviews ◽  
Childcare Providers

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.

scholarly journals A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nabil Sulaiman ◽  
Youssef Rishmawy ◽  
Amal Hussein ◽  
Maha Saber-Ayad ◽  
Hamzah Alzubaidi ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Patient Care ◽  
Interprofessional Education ◽  
Health Sciences ◽  
Study Cohort ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Positive Attitudes ◽  
Health Sciences Students

Abstract Background High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students’ readiness and positive attitudes towards IPE have been reported from the Arabian context. Methods A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed. Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.

scholarly journals Poor Information Literacy Skills and Practices as Barriers to Academic Performance: A Mixed Methods Study of the University of Dar es Salaam

2016 ◽  
Vol 55 (4) ◽  
pp. 293 ◽  
Author(s):  
Tina Klomsri ◽  
Matti Tedre
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Information Literacy ◽  
Literacy Skills ◽  
Focus Group Discussions ◽  
Online Questionnaire ◽  
Group Discussions ◽  
Postgraduate Students ◽  
Knowing How ◽  
The University

Information and Communication Technology (ICT) is increasingly used in Tanzanian education. Knowing how to operate ICT alone is incomplete without knowing how to use it as a tool for organization, communication, research, and problem-solving. In recognition of this challenge, information literacy (IL) has been identified as a key attribute to students as they progress through their learning paths. Based on a mixed methods strategy, using questionnaires and focus group discussions, this study measured the level of IL skills among University of Dar es Salaam’s (UDSM) postgraduate students, to gain insights into the students’ perceptions and experiences with information problems. A total of 102 students from four institutions answered the online questionnaire and 22 students participated in six focus group discussions. The questionnaire scores of the students were poor in the majority of IL categories, suggesting ineffectiveness of the current IL training in imparting IL knowledge and skills. The study ends by discussing recommendations to improve current IL practices at the university.

Assessing determinants of programmatic performance of community management of malaria, pneumonia, and diarrhea in children in Africa: Protocol and data collection for a mixed-methods evaluation of iCCM (Preprint)

2021 ◽  
Author(s):  
Aliya Karim ◽  
Don de Savigny ◽  
Serge Ngaima ◽  
Daniel Mäusezahl ◽  
Daniel Cobos Muñoz ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Child Health ◽  
Data Collection ◽  
Intervention Effectiveness ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Middle Income ◽  
Key Informant ◽  
Low And Middle Income

BACKGROUND Integrated community case management (iCCM) is a child health program designed to provide integrated, community-based care for pneumonia, malaria and diarrhea for children in hard-to-reach areas of low- and middle-income countries (LMICs). The foundation of the intervention is service-delivery by community health workers (CHWs) who depend on reliable provision of drugs and supplies, consistent supervision, comprehensive training, and community acceptance and participation to perform optimally. The effectiveness of the program may also depend on a number of other elements, including an enabling policy environment, financing mechanisms from the national to the local level, data transmission systems, and appropriate monitoring and evaluation. The extent to which these factors act upon each other to influence the effectiveness and viability of iCCM is both variable and challenging to assess, especially across different implementation contexts. OBJECTIVE In this paper, we describe a mixed-methods systems-based study protocol to assess the programmatic components of iCCM which are associated with intervention effectiveness, and report preliminary results of data collection. METHODS This protocol employs a mixed qualitative and quantitative study design based on a Systems Thinking approach within four iCCM programs in Malawi, Democratic Republic of the Congo, Niger State, and Abia State, Nigeria. Routine monitoring data is collected to determine intervention effectiveness, namely testing, treatment and referral outcomes. Surveys with CHWs, supervisors, and caregivers are performed to collect quantitative data on their demographics, activities, and experiences within the program, and how these relate to the areas of intervention effectiveness. Focus group discussions are conducted with these stakeholders as well as local traditional leaders to contextualize this data. Key informant interviews are undertaken with national and district-level program stakeholders and officers knowledgeable in critical program processes. RESULTS We performed 3,836 surveys and 45 focus group discussions with CHWs, supervisors, and caregivers, and traditional leaders; 120 key informant interviews with district and national-level program managers, health officers, and ministry officials. Policy and program documents were additionally collected for review. CONCLUSIONS Evidence from this study will inform child health programs and practice in low- and middle-income settings, and future policy development within the iCCM intervention.

scholarly journals Social-ecological influences on unhealthy dietary behaviours among Moroccan adolescents: a mixed-methods study

2020 ◽  
Vol 23 (6) ◽  
pp. 996-1008
Author(s):  
Abdelghaffar El-Ammari ◽  
Hicham El Kazdouh ◽  
Siham Bouftini ◽  
Samira El Fakir ◽  
Youness El Achhab
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Snack Food ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Dietary Behaviours ◽  
Social Ecological ◽  
Modifiable Factors

AbstractObjective:To identify the prevalence of unhealthy dietary behaviours and their social-ecological influences in adolescents.Design:The study used a sequential explanatory mixed-methods design, which begins with the collection of quantitative data, followed by the collection of qualitative data to explain and enrich the quantitative findings. Quantitative data were collected via a global school-based student health survey and were analysed using quantitative approaches. Qualitative data were obtained via focus group discussions and were analysed thematically.Setting:Middle and high secondary schools in Taza city, Morocco.Participants:Our quantitative analyses included 764 students (14–19 years). For the qualitative part, seventeen focus group discussions were conducted with 100 participants (fifty-six adolescents, twenty-six parents and eighteen teachers).Results:Of total student participants, 46·1 % skipped breakfast, 60·6 % had inadequate intake of fruits and vegetables (F&V), 39·4 % consumed soft drinks and 28·0 % consumed fast foods. All of these dietary behaviours could coexist in the same person except for inadequate intake of F&V. Gender, academic performance, age, perceived family income and education level of mother were associated with unhealthy dietary behaviours. Qualitative findings identified seven themes regarding social-ecological influences on adolescents’ dietary behaviours: cognitive, affective/biological, lifestyle, outcome expectation, social network, accessibility/availability and macro-level influences.Conclusions:The prevalence of unhealthy dietary behaviours in our study group is a concern. Dietary behaviours are the result of inseparable interactions among social-ecological influences. Modifiable factors identified may be useful when designing a future intervention aimed at improving breakfast and F&V consumption and reducing fast/snack-food consumption among adolescents.

Supporting in an existential crisis: A mixed-methods evaluation of a training model in palliative care

2017 ◽  
Vol 16 (4) ◽  
pp. 470-478
Author(s):  
Lisa Sand ◽  
Mariann Olsson ◽  
Peter Strang
Keyword(s):  
Palliative Care ◽  
Mixed Methods ◽  
Focus Group ◽  
Mixed Methods Research ◽  
Qualitative Content Analysis ◽  
Training Model ◽  
Care Staff ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Existential Crisis

AbstractBackground:Palliative care staff often report that they lack the skills and confidence to provide support during an existential crisis. Consequently, there is a definite need for a training program in this area.Objective:Our aim was to investigate whether a training model could give palliative care staff increased knowledge, awareness, and preparedness—all useful tools for providing support.Methods:A mixed-methods research design was used. Data were collected in four hospital-based palliative homecare teams in the Stockholm area. In total, 34 staff participated, representing different palliative care team professions. Before and after the intervention, a questionnaire with a 9-point Likert-type scale was completed (n = 34). Qualitative focus group discussions were conducted a month after the intervention (25 participants). These were recorded, transcribed, and analyzed using qualitative content analysis with a manifest focus.Results:In the quantitative part of our study, the participants showed significantly increased perceived knowledge, awareness, and preparedness in every aspect (p < 0.001 for all items). The focus group discussions revealed a process that made it possible to apply new knowledge and insight. The process began with theoretical knowledge and, through care-related reflection and self-reflection, the knowledge base gradually developed and provided useful skills and increased job satisfaction.Significance of results:The team-based “TrainingModel Sand/TER” can be performed without excessive effort and contribute to improved competence in providing support during an existential crisis. It is particularly useful for staff working in clinical palliative care.

scholarly journals Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

F1000Research ◽  
2020 ◽  
Vol 8 ◽  
pp. 1949
Author(s):  
Mat Lowe ◽  
Mamsamba Joof ◽  
Bomar Mendez Rojas
Keyword(s):  
Mixed Methods ◽  
Focus Group ◽  
Rural Areas ◽  
The Gambia ◽  
Early Marriage ◽  
Rural Settlements ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Cross Sectional ◽  
Key Informant

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%), however this rate is still high. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies to decrease early marriages. Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents, focus group discussions with 16 male and female parents, and eight key informant interviews with community-based decision makers. Focus group discussions and key informant interviews were transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: The study finds that ethnicity and the fear that girls may engage in premarital sex are two important factors associated with early marriage in rural Gambia. In addition, lack of meaningful alternatives to marriage including work opportunities in rural areas may also limit the options and resources available to girls, resulting in early wedlock. Conclusions: These findings suggest that in order to decrease early marriages in rural Gambia, future efforts should focus on understanding and addressing the role of ethnicity in determining marriage patterns and allaying the fear around premarital sex.The findings also suggest a need to provide girls with employment-oriented education including vocational skills which may result into more empowerment and a delay in marriage.

scholarly journals Medication adherence, self-efficacy and health literacy among patients with glaucoma: a mixed-methods study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e039788
Author(s):  
Maria Achilleos ◽  
Anastasios Merkouris ◽  
Andreas Charalambous ◽  
Evridiki Papastavrou
Keyword(s):  
Social Support ◽  
Mixed Methods ◽  
Medication Adherence ◽  
Health Literacy ◽  
Focus Group ◽  
Self Efficacy ◽  
Mixed Methods Study ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Stage 1

IntroductionAs the world population ages, glaucoma is becoming an increasingly significant cause of blindness. A key component in the management of glaucoma is the use of prescribed medications and the adherence to treatment. However, there is evidence of low adherence to prescribed medication in chronic diseases, such as glaucoma. This study aims to explore the level of medication adherence, self-efficacy, social support and health literacy among the patients with glaucoma and to determine if there are any correlations between them. The ultimate aim is to use the information to develop an educational programme for patients with glaucoma at a later stage.Methods and analysisThis is a mixed-methods study which includes two stages: a descriptive study (stage 1) and focus group discussions (stage 2). Sample: Patients with glaucoma or ocular hypertension, using at least one kind of drops, from two ophthalmology clinics. Selected measures include: The Glaucoma Treatment Compliance Assessment Tool, The European Health Literacy Survey Questionnaire, The Glaucoma Medication Self-Efficacy Questionnaire and The Multidimensional Scale of Perceived Social Support. Two focus groups will be used for the collection of qualitative data, aiming to enrich the study with the patients’ experiences. The data will be analysed with SPSS, using descriptive and inferential statistics for stage 1 whereas content analysis will be used for the data from the focus group discussions (stage 2).Ethics and disseminationPermission to conduct the study was received from the National Bioethics Committee and the board of management of the two ophthalmology clinics. All participants will be informed fully on the purpose and methods of the study. Consent forms will be signed and at any time participants will have the right to withdraw. Confidentiality and the protection of data will be respected at all times.

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