Client Perceptions Research Articles

What Drives Financing Decisions of SMEs? A Survey of German Bank Advisers

This study explores companies’ financing decisions from a new perspective, those of the bank advisers, who are deeply involved in the decision processes, but are nevertheless outsiders. In our survey, corporate advisers of a large German bank report their perception of clients’ decisions. The survey covers both large companies and many SMEs. It confirms the relevance of company size, but also indicates strong heterogeneity within the SMEs. While some SMEs seem to resemble large companies, others differ noticeably. Our results confirm the relevance of strategy, management experience and decision makers’ personalities, but give little support for capital structure theories. The current change in German companies’ financing behavior towards more market-oriented instruments is clearly visible in the responses. The core motivations seem to be a desire for financial stability and flexibility. To secure this, companies tend to combine traditional bank financing with new instruments.

The Intricate Relationship Between Client Perceptions of Physician Empathy and Physician Self-Assessment: Lessons for Reforming Clinical Practice.

Objectives: Clinical empathy is an important predictor of patient outcomes. Several factors affect physician’s empathy and client perceptions. We aimed to assess the association between physician and client perception of clinical empathy, accounting for client, physician, and health system factors. Methods: We conducted a hospital-based cross-sectional study in 3 departments (family medicine, internal medicine, and surgery) of King Saud Medical City in Riyadh, Saudi Arabia. We interviewed 30 physicians and 390 clients from 3 departments. Physicians completed the Jefferson Scale of Empathy (JSE) and the clients responded to the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). We used a hierarchical multilevel generalized structural equation approach to model factors associated with JSE and JSPPPE and their inter-relationship. Results: Mean (SD) score of client-rated physician empathy was 26.6 (6) and that of physician self-rated was 111 (12.8). We found no association between the 2 (b = 0.06; 95% confidence intervals CI: −0.1, 0.21), even after adjusting for client, physician, and health system factors. Physician's nationality (0.49; 0.12, 0.85), adequate consultation time (1.05; 0.72, 1.38), and trust (1.33; 0.9, 1.75) were positively associated whereas chronic disease (−0.32; −0.56, −0.07) and higher waiting times (−0.26; −0.47, −0.05) were negatively associated. Conclusion: A physician's self-assessed empathy does not correlate with clients’ perception. We recommend training and monitoring to enhance clinical empathy.

Better than expected: client and clinician experiences of videoconferencing therapy (VT) during the COVID-19 pandemic

Abstract Videoconferencing therapy (VT) has been an emerging medium of psychological therapy, and during the COVID-19 pandemic there has been substantial growth in its usage as a result of home working. However, there is a paucity of research into client and clinician perceptions of VT. This study sought to assess client and staff experiences of VT. This mixed methods study produced both quantitative and qualitative data. Seven clients who had previously received VT and 11 psychotherapists who had previously delivered VT were recruited from two NHS sites. Clients and psychotherapists took part in qualitative interviews which were analysed using thematic analysis. Quantitative surveys were developed based on themes generated from the interviews and were completed by 172 clients and 117 psychotherapists. These were analysed using simple percentages. VT often exceeded client and psychotherapist expectations and overall experiences of VT were generally positive, although there were mixed findings regarding the therapeutic alliance. Several barriers to VT were cited, such as IT issues, and challenges identified in conducting behavioural experiments, and potential exclusion of certain populations were also cited. The medium of VT was received well by both clients and clinicians, with advantages around convenience seemingly outweighing losses in quality of therapeutic relationship. Future research should focus on overcoming barriers to accessing VT in populations prone to digital exclusion. NHS services not currently employing VT may wish to reconsider their stance, expanding choice of therapy delivery and improving accessibility. Key learning aims (1) To gain insight into client and clinician experiences of VT during the COVID-19 pandemic. (2) To assess the acceptability and feasibility of VT within two NHS short-term psychological support services. (3) To identify barriers and facilitators to the implementation of VT within two NHS short-term psychological support services.

MCH Services in Delhi in Terms of Beneficiaries’ Awareness, Coverage and Satisfaction

Maternal and child health (MCH) services have seen many changes, the recent one being introduction of a trained female community health activist under NRHM - 'ASHA' (i.e. Accredited Social Health Activist) to actas a link worker in MCH programmes. But any programme, no matter how relevant its components are, is likely to fail unless it succeeds in improving the coverage, knowledge and imparting satisfaction to its clients. Literature and anecdotes reported a mismatch between the people's need and the services delivered. People have a right to be involved in the decision making. Clients' (beneficiaries') perception and satisfaction will help to understand the gaps and adopting a bottom-up approach i.e. the understanding of the ground realities from the mothers so as to throw light on quality, need and sustainability of the MCH-related programmes. In this descriptive study conducted in Delhi from September to December 2012 to analyse MCH services in Delhi in terms of beneficiaries' awareness, coverage and satisfaction, a multi stage sampling technique was used and a sample size of 1000 beneficiaries was selected randomly from the list of mothers obtained from the conveniently selected Primary Health Centre. Data were analysed by descriptive and inferential statistics in SPSS. The study findings showed that 92.65 percent mothers received their first ante-natal check-up in the first trimester but 48.3 percent of mothers only received three ante natal check-ups. Home visits were found to be performed by health worker both in ante natal and post natal period during 3rd month of pregnancy and within 6 week after delivery. Among the health workers who visited beneficiaries, ASHA visited mothers the most during ante natal and post-natal period and ANM visited less during ante-natal period and somewhat nil (0.1%) within first 6 weeks after delivery (post-natal). Also, 99.6percent of mothers received IFA tablets and there was 100 percent coverage of TT immunisation. Most deliveries (96%) were indicated to be institutional and 40 mothers (4%) delivered at home. The reason for home delivery was that they did not feel institutional delivery as necessary; 92.2 percent mothers were given breastfeeding within first two hours of delivery; 99.6 percent of mothers were aware about various components of MCH services and the major source of information regarding MCH services was found to be ASHA followed by ANM. Majority of beneficiaries (86%) were found to be fully satisfied with the MCH services and there was no rating below average satisfaction. No significant difference in satisfaction based on their age & educational qualification was observed; however significant difference was observed in the satisfaction based on the number of children as the mothers with more than one child were more satisfied than mothers with one child which may be due to high expectations level of mothers during first child birth than the second.

Barriers and enablers to hepatitis C treatment among clients of Aboriginal Community Controlled Health Services in South East Queensland, Australia: a qualitative enquiry.

Aboriginal and Torres Strait Islander Australians have disproportionately high rates of hepatitis C infection. Aboriginal Community Controlled Health Services play an important role in promoting hepatitis C treatment, but uptake is variable. This study explores the service-level barriers and enablers to hepatitis C screening and treatment among clients of Aboriginal Community Controlled Health Services in South East Queensland. This qualitative study involved yarns with 16 clients and 40 healthcare providers. Thematic analysis was used to identify common barriers and enablers to hepatitis C screening and treatment. Common barriers included healthcare providers' knowledge deficits and inaccurate perceptions of clients' ability to complete treatment, whereas clients described stigma that resulted in distrust of health care, and experiences of poor relationships and connections with healthcare providers. Enablers included Aboriginal governance of Aboriginal Community Controlled Health Services and the ease of direct-acting antiviral treatment. This study's findings point to the need for healthcare worker training focussing on client autonomy, reduced hepatitis C-related stigma, and consideration of clinicians' roles in increasing service engagement. Addressing the barriers to hepatitis C treatment through client-focussed service improvement may promote increased hepatitis C screening and treatment among Aboriginal and Torres Strait Islander Australians.

ПСИХОСЕМАНТИЧНА РЕКОНСТРУКЦІЯ ГЕНЕРАЛІЗОВАНОГО-ТРИВОЖНОГО РОЗЛАДУ В КОГНІТИВНОМУ КЛЮЧІ

The basic aspects of the importance of personal and semantic factors in the formation of generalized anxiety disorder are highlighted in the article. The model of understanding and psychotherapy of excessive worries, based on the reconstruction of the value system is proposed. Such reconstruction is possible due to the "rewriting" of the personal narrative, which in external manifestation functions as the equivalent of a speech act. It is through the psychosemantic aspect that the way to the field of meanings and understanding of "excessive worries" is opened and the access to the subjective world of a person in his/her own system of semantic and linguistic coordinates is provided. The cognitivebehavioral methodology of recognition of generalized anxiety disorder, Penn State Worry Questionnaire (PSWQ), WWS-II (worry scale), author's questionnaire and psychotherapeutic interventions were used, which stand for the main tool for reconstruction of semantic spaces and individual value system. The study involved 150 people aged 19-24. The results show that significant aspects of personal and semantic factors in the formation of generalized anxiety disorder can be considered as follows: client perception of worries as those that help to solve problems, motivate to action and can prevent negative results. Such positive beliefs about the worries can significantly affect the dynamics of psychotherapeutic work. The article presents a clinical case and demonstrates the effectiveness of psychotherapeutic interventions. An algorithm for dealing with clients is suggested, which is grounded on a current technique for the cure of generalized anxiety disorder and includes: qualified examination; reevaluation of the effectiveness of the worries; assistance in a realistic perception of ambiguous situations that are not necessarily threatening; reconsidering of attitudes to situations of uncertainty; use of exposures technique aimed at profound coping with the stimulus in a nonverbal way; skills of overcoming negative emotions without escaping from them. Such psychotherapy is also based on the provisions of psychosemantic analysis on the possibility of reconstructing the semantic space of algorithms of emotional-cognitive response. The article attempts to combine the clinical paradigm and the scientific position, the cognitive-behavioral model of psychotherapy and the position of psycholinguistics on cognitive processing of information on the basis of mental representations formed by the individual. The applied psycholinguistics has meaningful prospects for applied cognitive research.

Client Versus Clinicians’ Standards of Clinically Meaningful Change and the Effects of Treatment Expectations on Therapeutic Outcomes in Individuals With Posttraumatic Stress Disorder

There is limited research on the concordance between client perceptions and clinician standards of the degree of symptom change required to achieve meaningful therapeutic improvement. This was investigated in an adult sample (N = 147) who received trauma-focused cognitive-behavioral therapies for posttraumatic stress disorder (PTSD). We examined whether clients’ benchmarks of change were related to actual outcomes and the relationship between client expectations and their treatment outcomes. Clients completed measures indexing the level of symptom reduction required (in their view) to reflect a benefit or recovery from treatment and treatment expectations. Actual PTSD severity was indexed pre- and posttreatment via self-report and clinician-administered interview. Results demonstrated that the amount of change clients said they required to experience a benefit or recovery was significantly larger than typical clinical research standards. Nonetheless, the majority of client benchmarks of change (79.7–81.8%) were consistent with clinical research standards of what constitutes benefit or recovery. Client benchmarks were generally positively correlated with their actual outcomes. Clients’ belief that treatment would be successful was associated with greater reductions in PTSD symptoms. These findings provide preliminary evidence that the standards used to determine clinically significant change are somewhat consistent with clients’ own perceptions of required symptom change.

Goals, Tasks, and Bonds: Toward the Computational Assessment of Therapist Versus Client Perception of Working Alliance.

Early client dropout is one of the most significant challenges facing psychotherapy: recent studies suggest that at least one in five clients will leave treatment prematurely. Clients may terminate therapy for various reasons, but one of the most common causes is the lack of a strong working alliance. The concept of working alliance captures the collaborative relationship between a client and their therapist when working toward the progress and recovery of the client seeking treatment. Unfortunately, clients are often unwilling to directly express dissatisfaction in care until they have already decided to terminate therapy. On the other side, therapists may miss subtle signs of client discontent during treatment before it is too late. In this work, we demonstrate that nonverbal behavior analysis may aid in bridging this gap. The present study focuses primarily on the head gestures of both the client and therapist, contextualized within conversational turn-taking actions between the pair during psychotherapy sessions. We identify multiple behavior patterns suggestive of an individual's perspective on the working alliance; interestingly, these patterns also differ between the client and the therapist. These patterns inform the development of predictive models for self-reported ratings of working alliance, which demonstrate significant predictive power for both client and therapist ratings. Future applications of such models may stimulate preemptive intervention to strengthen a weak working alliance, whether explicitly attempting to repair the existing alliance or establishing a more suitable client-therapist pairing, to ensure that clients encounter fewer barriers to receiving the treatment they need.

Soul work: Black practitioners’ perceptions of Black clients’ mental health needs

AbstractMost empirical investigations with Black clients have focused on the multicultural competence of practitioners who work with them. Little attention has been given to the needs of Black clients. This phenomenological inquiry explored Black practitioners’ perceptions of Black clients’ mental health needs and identified five common themes: (a) mental health literacy, (b) family and parenting counseling, (c) advocacy, (d) trauma and grief work, and (e) self‐efficacy enhancement. Implications for counseling and future research are discussed.

Service Quality, a Correlation of Customer Expectation and Customer Perception of Services Received Responsiveness and Empathy in Shisong Hospital

Although Universal Health Coverage (UHC) is of the expectation that health services whether promotive, preventive, curative, rehabilitative or palliative, are of sufficient quality to be effective (WHO, 2010), there has been a common phenomenon in most health communities to find patients moving from one health service facility to another in search for better quality of services, which is defined by their expectation from the health institution and the perception after receiving the health services. Shisong hospital in Kumbo East Health District, Bui Division of the Northwest Region of Cameroon is no exception to these experiences, given that it competes with other health instructions in, around and away from Kumbo. While some patients perceive that the quality of services of Shisong hospital meet their expectations, some perceive that they are yet to receive a commensurate quality of services from Shisong hospital. It was important to find out if the ways employees of Shisong hospital respond and empathise with clients relate the expectations and perception of clients. And investigation was done by administering a unique close ended questionnaire to 425 clients who have used the services of Shisong hospital to test the relationship between their expectation and satisfaction with these two facets of service quality, Responsiveness and Empathy in this hospital through some sub derivatives. Correlation analysis showed that there is a moderate significant relationship between employee responsiveness with clients and customer satisfaction, and a strong significant relationship between employee empathy with clients and customer satisfaction. Based on responsiveness and empathy, service quality in Shisong hospital has been described as ‘satisfactory’. The study recommends that the hospital should improve on these facets of service quality (responsiveness and empathy), given that customer satisfaction falls below their expectations, especially by raising customer perception to be ‘very satisfactory’, in match with the common expectation that has been ‘very good’

Development and Initial Evaluation of a Nurse-Led Healthcare Clinic for Homeless and At-Risk Populations in Tasmania, Australia: A Collaborative Initiative.

People who are homeless experience significantly poorer health than the general population and often face multifaceted challenges engaging with public healthcare services. Mission Health Nurse-led Clinic (MHNC) was established in 2019 to meet the healthcare needs of this marginalised population in Launceston, Tasmania. This study examines barriers to healthcare access amongst individuals who experience homelessness, client and staff perceptions of the MHNC services and explored opportunities for service expansion. Descriptive statistics were drawn from administrative data, and all interviews were thematically analysed. A total of 426 presentations were reported for 174 individuals experiencing homelessness over 26 months. The median client age was 42 years and 60.9% were male; A total of 38.5% were homeless or lived in a supported accommodation. The predominant reasons for clinic visits included prescription requests (25.3%) and immunisations (20.1%). A total of 10 clients and 5 City Mission staff were interviewed with three themes emerging from the findings: personal vulnerability, disconnectedness and acceptability of the MHNC. The MHNC services were reported to be highly appreciated by all clients. Mental health and allied health, extra operating hours and maintaining the flexibility of walk-in appointments were suggested as expansion areas for the service and were highlighted as ways to increase engagement for improved health outcomes. Continued partnerships with interprofessional primary healthcare providers would contribute to addressing unmet healthcare needs in this vulnerable population.

“Was it useful? Like, really?”: Client and Consultant Perceptions of Post-Session Satisfaction Surveys

Client satisfaction surveys have long been a cornerstone of writing center assessment, but to date, research on satisfaction surveys has largely focused on analyzing client responses from the survey and their administrative uses. Research rarely investigates why clients provide the responses they do and how consultants process these responses. This study, therefore, involved conducting separate client and consultant focus groups to learn about each population’s interactions with one writing center’s optional post-session satisfaction survey and the survey results. The findings revealed that while client participants used the survey to communicate high levels of satisfaction, client participants also thought about the survey in multifaceted ways that took into account complex factors, such as their relationship with the writing center and care for consultants’ feelings. The study also showed that consultant participants valued positive feedback from clients but that consultants found their survey responses to have limited utility for professional growth and that they craved more specific and constructive feedback. This article offers considerations for how writing center professionals can better communicate the purpose of surveys to both clients and consultants, and it proposes additional forms of assessment that could allow consultants and administrators to hear the nuanced feedback clients can offer.

Veterinarians' perceptions of COVID-19 pandemic-related influences on veterinary telehealth and on pet owners' attitudes toward cats and dogs.

To gather and evaluate veterinarians' perspectives about the impacts of the COVID-19 pandemic on the use of veterinary telehealth and on cat owners' versus dog owners' attitudes toward transmission of the SARS-CoV-2 virus from their pets. 93 respondent veterinarians (47 in primary care practice and 46 in specialty practice). An online survey was conducted between June 15 and July 15, 2020, and included 21 questions concerning demographics, use of telehealth before and after the onset of the pandemic (before March 15, 2020, and between March 15 and June 15, 2020, respectively), changes in caseloads, and perception of clients' concerns about potential for transmission of the SARS-CoV-2 virus from pets. Reported zip codes informed the collection of census data. The level of poverty was significantly lower in zip code areas for respondents who reported telehealth services were (vs were not) offered before the pandemic. The percentage of respondents who reported their practice offered telehealth services increased from 12% (11/93) before the pandemic to 38% (35/93) between March 15 and June 15, 2020. Although most respondents reported owner-expressed concerns over SARS-CoV-2 virus transmission from their pets, most also reported increased caseloads, seeing newly adopted pets, and few discussions of surrender of pets for reasons related to the SARS-CoV-2 virus. Findings indicated that caseloads increased and telehealth services expanded during the pandemic but that there was no evidence of differences in respondent-reported owner concern for SARS-CoV-2 virus transmission from cats versus dogs.

The 4MOTHERS trial of the impact of a mobile money-based intervention on maternal and neonatal health outcomes in Madagascar: study protocol of a cluster-randomized hybrid effectiveness-implementation trial

BackgroundMobile money—a service enabling users to receive, store, and send electronic money using mobile phones—has been widely adopted across low- and middle-income economies to pay for a variety of services, including healthcare. However, evidence on its effects on healthcare access and health outcomes are scarce and the possible implications of using mobile money for financing and payment of maternal healthcare services—which generally require large one-time out-of-pocket payments—have not yet been systematically assessed in low-resource settings. The aim of this study is to determine the impact on health outcomes, cost-effectiveness, feasibility, acceptability, and usefulness of mobile phone-based savings and payment service, the Mobile Maternal Health Wallet (MMHW), for skilled healthcare during pregnancy and delivery among women in Madagascar.MethodsThis is a hybrid effectiveness-implementation type-1 trial, determining the effectiveness of the intervention while evaluating the context of its implementation in Madagascar’s Analamanga region, containing the capital, Antananarivo. Using a stratified cluster randomized design, 61 public-sector primary-care health facilities were randomized within 6 strata to either receive the intervention or not (29 intervention vs. 32 control facilities). The strata were defined by a health facility’s antenatal care visit volume and its capacity to offer facility-based deliveries. The registered pre-specified primary outcomes are (i) delivery at a health facility, (ii) antenatal care visits, and (iii) total healthcare expenditure during pregnancy, delivery, and neonatal period. The registered pre-specified secondary outcomes include additional health outcomes, economic outcomes, and measurements of user experience and satisfaction. Our estimated enrolment number is 4600 women, who completed their pregnancy between July 1, 2020, and December 31, 2021. A series of nested mixed-methods studies will elucidate client and provider perceptions on feasibility, acceptability, and usefulness of the intervention to inform future implementation efforts.DiscussionA cluster-randomized, hybrid effectiveness-implementation design allows for a robust approach to determine whether the MMHW is a feasible and beneficial intervention in a resource-restricted public healthcare environment. We expect the results of our study to guide future initiatives and health policy decisions related to maternal and neonatal health and universal healthcare coverage through technology in Madagascar and other countries in sub-Saharan Africa.Trial registrationThis trial was registered on March 12, 2021: Deutsches Register Klinischer Studien (German Clinical Trials Register), identifier: DRKS00014928. For World Health Organization Trial Registration Data Set see Additional file 1.

Apartment purchase under Shirkah-ul Milk and shariah compliance in Islamic banks: the perception of bankers and clients in Bangladesh

PurposeApartment purchase is an increasing investment trend in Islamic banks as clients trusted to eradicate the interest from financial dealings to capture the Islamic Principles. The paper aims to investigate the Shariah compliance in the investment of apartment purchases under Shirkah-ul milk in Bangladesh Islamic banks.Design/Methodology/ApproachThis study examined the perception of 125 clients and 25 managers from five key Islamic banks on the investment practices of apartment purchases. This study applied two data analysis methods: reflective measurement model was operated for examining the consistency, reliability, multicollinearity problems and validity; and Smart PLS-SEM (structural equation model) was used to investigate the direct impact of each explanatory variable on Shari’ah compliance in Islamic banks.FindingsThe results indicated that Islamic banks could not strictly maintain the Shariah compliance in apartment purchase. Such Shari’ah non-compliance is due to lack of knowledge and understanding with regard to bank’s objectives and philosophy, weak Shariah board, audit, weak regulatory body and supervision problem. These findings also firmly match clients’ and managers’ perceptions.Research Limitations/ImplicationsA limited size of clients and bankers were involved in this study. The study focuses only on perceptions of Islamic banks’ clients and managers and avoids Muslim clients who involved conventional banks.Originality/ValueThis study provides Shariah-compliant alternatives in investment avenue for apartment purchases. These Shariah modes include Apartment Purchase Musharakah Mutanaqasa; Bai-Muajjal; and Apartment Purchases under Shirkah-ul Milk, which captures various limitations against current apartment purchase practices as well as to develop clients’ trust in Islamic banks.

CLIENTS’ EMPIRICISM TOWARDS UPI PLATFORMS

The purpose of the study is to examine the awareness, perception and satisfaction level of clients of popular UPI platforms. Satisfied clients are the biggest promoters in today’s fast-changing competitive market. Their favourable word-of-mouth provides legitimacy, appeal, and aids in the acquisition of new clients to the business. The Unified Payment System (UPI) is designed to build a platform for cashless and transparent financial transactions by using the advantages of mobile technology. So, this study is based mostly on primary data collected from 100 samples from UPI clients in Kerala through structured questionnaire and the secondary data used only for theocratical frame. The key tools for data analysis is statistical tool like One-way ANOVA and weighted averages. Study result reveals the significant influence of educational status of the clients in their awareness of UPI platforms and its services. The study also observes the age and gender effect on the satisfaction and perception of clients. KEYWORDS: Unified Payment Interface (UPI), UPI Platforms, Client satisfaction, Client Perception, Digital inclusion.

The Impacts of Service Quality on Client Satisfaction: An Empirical Study on Private Commercial Banks in Bangladesh

Bangladesh's financial industry is supported by banking institutions. Because the banking sector's existence is reliant on the quality of services it offers and the satisfaction of its clients, service quality is critical for measuring the banking sector's success. The purpose of this research is to assess the impact of service quality on customer satisfaction by examining the numerous factors that influence those outcomes. It investigates useful and objective input about a client's perceptions and expectations and then improves different aspects of the company to achieve those goals. A standardized questionnaire was utilized to obtain data from a group of 300 people. The data was analyzed and conclusions were drawn using descriptive statistics. As a result, the SERVQUAL dimensions have been used to evaluate the service quality of three private commercial banks in Rangpur. To show the distinction, EXIM Bank Ltd., Dutch Bangla Bank Ltd. (DBBL), and Mercantile Bank Limited were chosen. Customers of one bank appear to be moderately satisfied, but customers of the other two banks tend to fall short of their expectations on the SERVQUAL dimension. The empathy component was shown to be a key driver of client satisfaction for both EXIM Bank Ltd. and Mercantile Bank Limited. Dependability, tangibility, and assurance, on the other hand, were found to have a significant influence on customer satisfaction for Dutch Bangla Bank Limited.

Client perceptions of Emirati innovation strategy on service quality in UAE tourism sector

ABSTRACT Quality tourism is indispensable to national economic development, given that it makes a major contribution to the economies of the most developed and developing countries. Therefore, this study examined the effect of Emirati sustainable innovation strategy on service quality in the UAE tourism sector. Using a cross-sectional survey approach, the researchers collected data from 100 clients of the UAE tourism agencies. The data were analysed. The overall result indicates that Emirati sustainable innovation strategy (management innovation, technical innovation, and sustainable innovation) has a significant positive effect on service quality, indicating that Emirati sustainable innovation strategy is a significant driver of service quality in the UAE tourism sector. It also shows that innovation is an indispensable tool in enhancing quality tourism. However, the findings of this study are not exhaustive, future research can dwell on this research area and replicate the current study in another context.

The Experience of Key Stakeholders During the Implementation and Use of Trauma Therapy via Digital Health for Military, Veteran, and Public Safety Personnel: Qualitative Thematic Analysis.

BackgroundExposure to occupational stressors and potentially psychologically traumatic events experienced by public safety personnel (eg, paramedics, police, fire, and correctional officers), military members, and veterans can lead to the development of posttraumatic stress injuries and other mental health disorders. Providing emergency services during COVID-19 has intensified the challenges. Owing to COVID-19 restrictions, mental health service providers offering support to these populations have had to rapidly pivot to use digital versus in-person methods of service delivery.ObjectiveThis paper aims to explore the experience of mental health service providers regarding digital health service delivery, including the current state of digital mental health service delivery, barriers to and facilitators of the use of digital health for mental health service delivery experienced during the pandemic, and recommendations for implementing and integrating digital health into regular mental health service delivery.MethodsThis embedded mixed-methods study included questionnaires and focus groups with key stakeholders (N=31) with knowledge and experience in providing mental health services. Data analysis included descriptive, quantitative, and qualitative thematic analyses.ResultsThe following three themes emerged: being forced into change, daring to deliver mental health services using digital health, and future possibilities offered by digital health. In each theme, participants’ responses reflected their perceptions of service providers, organizations, and clients. The findings offer considerations regarding for whom and at what point in treatment digital health delivery is appropriate; recommendations for training, support, resources, and guidelines for digitally delivering trauma therapy; and a better understanding of factors influencing mental health service providers’ perceptions and acceptance of digital health for mental health service delivery.ConclusionsThe results indicate the implementation of digital health for mental health service delivery to military members, public safety personnel, and veterans. As the COVID-19 pandemic continues, remote service delivery methods for trauma therapy are urgently needed to support the well-being of those who have served and continue to serve.

An integrated mixed methods approach to clarifying delivery, receipt and potential benefits of CHW-facilitated social support in a health promotion intervention

BackgroundSocial support plays a critical role in physical and emotional health, making it an important component of community health worker (CHW) health promotion interventions. Different types of support operate in different ways, however, and the relationship between the nature of CHW support and the subsequent health benefit for their clients is not well understood.MethodsThis paper describes an integrated mixed methods study of the emotional, informational, appraisal and tangible support CHWs provided to Latinx community members residing in three US-Mexico border communities. Using a cohort (n = 159) from a CHW community-based intervention, we identify and describe four clusters of social support in which participants are characterized by life situations that informed the types of social support provided by the CHW. We examine the association between each cluster and client perceptions of social support over the 6-month intervention.ResultsCHWs provided emotional, appraisal, informational and tangible support depending on the needs of participants. Participants who received higher levels of emotional support from the CHW experienced the greatest post intervention increase in perceived social support.ConclusionsStudy findings suggest that CHWs may be adept at providing non-directive social support based on their interaction with a client rather than a health outcome objective. Health promotion interventions should allow CHWs the flexibility to tailor provision of social support based on their assessment of client needs.