A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a ‘deficit-based’ discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants’ knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants’ communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09–4.63), people with disabilities (OR: 2.43; 95% CI: 1.28–4.64), and unemployed people (OR: 2.64; 95% CI: 1.28–5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25–4.09), unemployment (OR: 4.07; 95% CI: 1.64–10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03–1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants’ knowledge, experience, and strengths has the potential to improve individuals’ diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.

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Healthcare Providers and Caregivers’ Perspectives on the Quality of Child Health Services in Urban Indonesia: A Mixed-Methods Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158047 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8047

Author(s):

Agus Setiawan ◽

Poppy Fitriyani ◽

Rizkiyani Istifada ◽

Shefaly Shorey

Keyword(s):

Mixed Methods ◽

Child Health ◽

Healthcare Providers ◽

Healthcare Services ◽

Mixed Methods Study ◽

Child Health Services ◽

Structured Interviews ◽

Mortality And Morbidity ◽

Factors Affecting

Although Indonesia’s child mortality rate has decreased in tandem with the global trend, healthcare services can be further improved for children. This study aims to explore the perceptions of healthcare providers and caregivers of children aged below five years to improve child health in urban Indonesia. A mixed-methods study design was adopted. Quantitative data were collected via questionnaires from the caregivers. Qualitative data were collected via semi-structured interviews from the healthcare providers. Analysis of 540 caregiver questionnaires regarding the care provided to their child revealed that the majority of them were very satisfied (46.1%) and satisfied (52.2%) with the care received. Analysis of 12 interviews with healthcare providers derived three major themes: (1) importance of one’s role as a healthcare provider; (2) factors affecting the delivery of healthcare; and (3) the way forward in caring for young children. Although caregivers were very satisfied with the care received for their children, the perception of healthcare providers regarding their responsibility in delivering care to children under five years old provides insights into improving the quality of services for children in Indonesia. Our findings suggest that mortality and morbidity of children aged below five years can be best reduced by optimizing primary and secondary preventive measures.

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Factors affecting retention in the Philippine National Rural Physician Deployment Program from 2012 to 2019: a mixed methods study

BMC Health Services Research ◽

10.1186/s12913-021-07219-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Erika Louise L. Flores ◽

Edric Matthew R. Manahan ◽

Miguel Paulo B. Lacanilao ◽

Isabella Ma. Beatriz T. Ladaw ◽

Mico Martin B. Mallillin ◽

...

Keyword(s):

Mixed Methods ◽

Healthcare Providers ◽

Well Being ◽

The Philippines ◽

Social Needs ◽

Factors Affecting ◽

Work Related ◽

Universal Healthcare ◽

The Individual ◽

Rural Physician

Abstract Background To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Philippine National Rural Physician Deployment Program, or more commonly known as the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment. Methods A descriptive, mixed-methods, explanatory design was used. For the quantitative part, the modified and updated Stayers Questionnaire was given to all current DTTBs present in a Continuing Medical Education session in the Development Academy of the Philippines. Descriptive statistics were then presented. For the qualitative part, individual, semi-structured key informant interviews were conducted in-person or via phone with current and alumni DTTBs from 2012 to 2019. Proceedings of the interviews were transcribed, translated, and analyzed thematically. Results 102 current DTTBs participated in the quantitative part of our study, while 10 current and former DTTBs participated in the interviews. Demographic factors and location, personal beliefs, well-being, friends and family dynamics, and perceptions about work were the individual factors identified to affect retention. Social working conditions, career development, and infrastructure, medical equipment, and supplies were among the work factors identified to affect retention. Geography, living conditions, local social needs, and technology were among the local factors identified to affect retention. Compensation, the recently signed Universal Healthcare Law, and Safety and Security were identified as national factors that could affect retention. International factors did not seem to discourage DTTBs from staying in their communities. Conclusions A host of individual, work-related, local, national, and international factors influence the DTTB’s decision to be retained in different, complex, interconnected, and dynamic ways. We also identified implementation issues in the DTTB program and suggested interventions to encourage retention.

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Companion Animal Type and Level of Engagement Matter: A Mixed-Methods Study Examining Links between Companion Animal Guardianship, Loneliness and Well-Being during the COVID-19 Pandemic

Animals ◽

10.3390/ani11082349 ◽

2021 ◽

Vol 11 (8) ◽

pp. 2349

Author(s):

Heather Clements ◽

Stephanie Valentin ◽

Nicholas Jenkins ◽

Jean Rankin ◽

Nancy R. Gee ◽

...

Keyword(s):

Mixed Methods ◽

Quantitative Data ◽

Online Survey ◽

Qualitative Data ◽

Companion Animals ◽

Well Being ◽

Companion Animal ◽

Mixed Methods Study ◽

The Impact ◽

Mental Well Being

To reduce the spread of COVID-19, countries worldwide placed limitations on social interaction, which is anticipated to have severe psychological consequences. Although findings are inconsistent, prior research has suggested that companion animals may positively influence human well-being and reduce loneliness. In the context of COVID-19, this has important implications, as companion animal guardians may be less negatively affected by the pandemic. The primary aim of this research was to investigate the influence of companion animals on mental well-being and loneliness during the pandemic, with specific interest in the role of ornamental fishes. A mixed-methods study was conducted, using an international sample. Quantitative data were collected via an online survey (n = 1199) and analysed using robust hierarchical multiple regression analyses; the influence of level of engagement with companion animals was examined for dogs, cats and ornamental fishes. There was no evidence that companion animal guardianship was associated with loneliness and mental well-being during the pandemic but spending more time engaging physically or socially with dogs (and to a lesser extent cats) was generally associated with poorer outcomes. Qualitative data were collected through open-ended survey responses (n = 757) and semi-structured interviews (n = 25) and analysed using reflexive thematic analysis. Two themes were developed—one related to companion animals as providers of social and emotional support, and the other to companion animals as providers of purpose and perspective. Concerns regarding the impact of the pandemic on animal welfare were also identified. Compared to other animal types, more participants expressed indifference regarding the impact of their fishes on their well-being during the pandemic, possibly because fishes cannot provide comfort via physical touch. The findings of this study reflect the wider field of human–animal interaction; although qualitative data suggest guardians believe their companion animals are a positive influence in their lives, there is little convincing quantitative data to support these beliefs. This highlights the need to refine theories regarding which aspects of companion animal guardianship may influence human well-being; the findings from this research may be useful in the refinement of such theories.

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Occupational stress and well-being among Early Head Start home visitors: A mixed methods study

Early Childhood Research Quarterly ◽

10.1016/j.ecresq.2017.11.003 ◽

2018 ◽

Vol 44 ◽

pp. 288-303 ◽

Cited By ~ 10

Author(s):

Allison L. West ◽

Lisa J. Berlin ◽

Brenda Jones Harden

Keyword(s):

Mixed Methods ◽

Head Start ◽

Occupational Stress ◽

Early Head Start ◽

Well Being ◽

Mixed Methods Study ◽

Home Visitors

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“Shoot! Can We Restart the Interview?”: Lessons From Practicing “Uncomfortable Reflexivity”

International Journal of Qualitative Methods ◽

10.1177/1609406920963810 ◽

2020 ◽

Vol 19 ◽

pp. 160940692096381

Author(s):

Judith Eckert

Keyword(s):

Qualitative Research ◽

Mixed Methods ◽

Well Being ◽

Research Process ◽

Mixed Methods Study ◽

Close Analysis ◽

Growing Body ◽

Typical Experience ◽

Process Gain ◽

Intellectual Challenge

Failure is a typical experience in research, but it is largely taboo in published studies. In recent years, however, we can observe a small yet growing body of literature on failure in qualitative research to address this gap. In this article, I contribute my experiences of failed interviews in a mixed-methods study in Germany to this body of literature and highlight some aspects of failure that have not yet received enough attention. First, in my example, it was not only one interview or a few interviews that failed; rather, it seemed that the whole study failed in design due to particular methodical decisions. Second, failed research presents an intellectual challenge, but it also produces emotional and social trouble because failed research might be attributed to a failed researcher. This may be one reason failure is so damaging for one’s well-being and so difficult to share. Nevertheless, practicing some form of “uncomfortable reflexivity” (Pillow, 2003) via qualitative, close analysis helped me navigate the research process, gain methodical insights and substantive results. Third, I share lessons that might be useful for other researchers: reading literature on failure, the search for a safe and supportive space, and analyzing failure as closely and early as possible.

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Access to, and experiences of, healthcare services by trafficked people: findings from a mixed-methods study in England

British Journal of General Practice ◽

10.3399/bjgp16x687073 ◽

2016 ◽

Vol 66 (652) ◽

pp. e794-e801 ◽

Cited By ~ 20

Author(s):

Joanne Westwood ◽

Louise M Howard ◽

Nicky Stanley ◽

Cathy Zimmerman ◽

Clare Gerada ◽

...

Keyword(s):

Mixed Methods ◽

Healthcare Services ◽

Mixed Methods Study

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Are globals for health, well-being and quality of life interchangeable? A mixed methods study in ankylosing spondylitis patients and controls

Rheumatology ◽

10.1093/rheumatology/key129 ◽

2018 ◽

Vol 57 (9) ◽

pp. 1555-1562 ◽

Cited By ~ 1

Author(s):

Astrid van Tubergen ◽

Anouk Gulpen ◽

Robert Landewé ◽

Annelies Boonen

Keyword(s):

Quality Of Life ◽

Mixed Methods ◽

Ankylosing Spondylitis ◽

Well Being ◽

Mixed Methods Study

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Impact of legal status change on undocumented migrants’ health and well-being (Parchemins): protocol of a 4-year, prospective, mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2018-028336 ◽

2019 ◽

Vol 9 (5) ◽

pp. e028336 ◽

Cited By ~ 2

Author(s):

Yves Jackson ◽

Delphine S Courvoisier ◽

Aline Duvoisin ◽

Giovanni Ferro-Luzzi ◽

Patrick Bodenmann ◽

...

Keyword(s):

Mixed Methods ◽

Health Status ◽

Legal Status ◽

Well Being ◽

Living Conditions ◽

Mixed Methods Study ◽

Control Group ◽

Undocumented Migrants ◽

The Impact ◽

Health And Well Being

IntroductionMigrants without residency permit, known as undocumented, tend to live in precarious conditions and be exposed to an accumulation of adverse determinants of health. Only scarce evidence exists on the social, economic and living conditions-related factors influencing their health status and well-being. No study has assessed the impact of legal status regularisation. The Parchemins study is the first prospective, mixed-methods study aiming at measuring the impact on health and well-being of a regularisation policy on undocumented migrants in Europe.Methods and analysisThe Parchemins study will compare self-rated health and satisfaction with life in a group of adult undocumented migrants who qualify for applying for a residency permit (intervention group) with a group of undocumented migrants who lack one or more eligibility criteria for regularisation (control group) in Geneva Canton, Switzerland. Asylum seekers are not included in this study. The total sample will include 400 participants. Data collection will consist of standardised questionnaires complemented by semidirected interviews in a subsample (n=38) of migrants qualifying for regularisation. The baseline data will be collected just before or during the regularisation, and participants will subsequently be followed up yearly for 3 years. The quantitative part will explore variables about health (ie, health status, occupational health, health-seeking behaviours, access to care, healthcare utilisation), well-being (measured by satisfaction with different dimensions of life), living conditions (ie, employment, accommodation, social support) and economic situation (income, expenditures). Several confounders including sociodemographic characteristics and migration history will be collected. The qualitative part will explore longitudinally the experience of change in legal status at individual and family levels.Ethics and disseminationThis study was approved by the Ethics Committee of Geneva, Switzerland. All participants provided informed consent. Results will be shared with undocumented migrants and disseminated in scientific journals and conferences. Fully anonymised data will be available to researchers.

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