Qualitative Comparative Case Study Research Articles

Delivering Blue-Green Infrastructure: Innovation Pathways for Integrating Multiple Values

Realizing a multifunctional blue-green infrastructure (BGI) as a nature-based solution for the urban water system and built environment within crowded city areas is seen as a promising route for the process of climate adaptation. BGI projects like rain gardens, green roofs, and water squares can be combined to achieve a variety of technical (drainage), environmental (biodiversity), economic (property development) and social (health and wellbeing) goals and values at a local neighborhood level. As integrating such values within local governments' existing fragmented structures and procedures has proved to be challenging, urban governments are increasingly experimenting with innovative governance approaches at different levels to capitalize on the multiple benefits of BGI. Nevertheless, policy actors who try to justify their choices in the face of value conflicts are both constrained and enabled by the institutions they can call on. Using a qualitative comparative case study, this article therefore aims to gain insight into different ways of, or approaches to, organizing value integration. In particular, we compare: (1) a top-down case of programmatic steering to translate value integration into a neighborhood approach; (2) a market-oriented innovative procurement approach to local public-private partnership projects; and (3) a case of invitational governance for a future-proof neighborhood that is striving for a sense of citizen ownership. Our findings demonstrate the conditions, drivers, and barriers to the value integration of different governance innovations in relation to time-related issues, the types of support available, organizational embedding, and stakeholder involvement. Our specific focus is on understanding how social and sustainability and spatial and technical values are integrated. This paper thus helps us to get to grips with different pathways to value integration in the context of urban infrastructures, as well as their applicability and the conditions for success. These insights will enable the further strengthening of our capacity to build climate-proof cities in a value-driven and integrative manner.

Muslim consumers’ brand-switching behavior in Lahore and Kuala Lumpur: a qualitative comparative case study

PurposeThe purpose of this qualitative comparative study was to explore the brand-switching behavior of Muslim consumers in selected cities from Pakistan and Malaysia.Design/methodology/approachData were collected through interviews which were conducted with 30 participants including universities (5), shopping malls (5) and restaurant locations (5) of each country. The constant comparative analysis was used to analyze the data.FindingsResults revealed that a demonstration of awareness of American brands, their image and perceived quality causes Muslim consumers to switch away from American brands to non-American brands. In addition, this study also showed that the certain reasons compel consumers to stay with American brands.Practical implicationsThe findings are helpful for American brands in reconsidering their strategies while segmenting the Muslim consumers as target market.Originality/valueThis is the first paper of its kind to explore Muslim consumer brand-switching behavior by using a qualitative method.

Perceptions of factors that facilitate and impede learning among twice-exceptional college students with autism spectrum disorder

This qualitative comparative case study explored the personal perceptions and institutional factors that facilitated academic success, as well as challenges, in college among a sample of 40 academically talented students with autism spectrum disorder (2e/ASD) who were enrolled in highly competitive colleges and universities in the United States. Findings from the study included that the majority had excellent reading and writing skills, but struggled with mathematics. The personal trait that most enabled them to be successful in college, described by 26 of the 40 students, was a driving passion for learning. Half of the participants were motivated to succeed academically by the independence college offers, as well the flexibility to take advantage of a range of opportunities, and the development of their personal autonomy. The majority of the participants indicated that faculty members’ instructional practices were their greatest barriers to learning.

Understanding the wider social and economic context of post-earthquake cordons: A comparative case study between Christchurch, Aotearoa (New Zealand) and L’Aquila, Italy

Post-earthquake cordons have been used after seismic events around the world. However, there is limited understanding of cordons and how contextual information such as geography, sociocultural characteristics, economy, and institutional and governance structures affects decisions and operational procedures, including aspects related to spatial and temporal attributes of cordon establishment. This research aims to fill the gap in cordon knowledge through a qualitative comparative case study of two cities: Christchurch, New Zealand (Mw 6.2 earthquake, February 2011) and L’Aquila, Italy (Mw 6.3 earthquake, 2009). Both cities suffered comprehensive damage to their city centers and had cordons established for extended periods of time. Data collection was done through purposive and snowball sampling whereby 23 key informants were interviewed in total. Research participants held expert knowledge in their roles and responsibilities, that is, council members, emergency managers, politicians, business/insurance representatives, academics, and police. Results illustrate that cordons were primarily established to ensure safety of people and to maintain security. The extent and duration of the cordons were affected by the recovery approaches taken in respective cities, that is, in Christchurch demolition was widely undertaken which supported recovery and allowed for faster removal of cordons. In contrast, authorities in L’Aquila placed high value on heritage buildings which led to recovery strategy based on preserving and restoring most of the buildings which extended the duration of cordon. Extended cordons have many similarities but evolve overtime. This evolution of cordons is affected by site-specific needs; thus, cordons should be understood and planned based on contextual realities.

Children’s participation in practice: comparing the views of managers and practitioners in an early intervention and prevention programme

PurposeParticipation is the active involvement of children and young people in decision-making regarding issues that affect their lives. It is crucial in the context of child protection and welfare systems and how they respond to the needs of children and young people. The purpose of this paper is to report on the evaluation of child and family participation in an early intervention and prevention programme implemented by the Irish Child and Family Agency. It provides an analysis of a comprehensive, “whole organization” approach to understand how participation is embedded in policy and practice.Design/methodology/approachThis paper reports on a comparative qualitative case study of the perspectives of managers and practitioners about participation practice, identifying the facilitators and barriers, as well as their perspectives of the sustainability of participation within the agency and its partners. The authors draw on two complementary, theoretically informed studies evaluating participatory practice within the Agency using qualitative interviews with participants.FindingsOverall, managers and practitioners had a positive attitude towards participation and identified examples of best practices. Facilitators included training, access to resources and the quality of relationships. Challenges for meaningful participation remain, such as the need to engage, hard to reach populations. Differences were identified regarding how embedded and sustainable participation was.Originality/valueThis paper provides a critical understanding of participation in practice and how to embed a culture of participation in child protection and welfare.

Assessing the Integrative Framework for the Implementation of Change in Nursing Practice: Comparative Case Studies in French Hospitals.

The implementation of healthcare policies in healthcare organizations is a pivotal issue for managers. They generally require a change in professional practices. In previous work, we developed the Integrative Framework for Implementation of change in Nursing Practices (IFINP) to support implementation initiatives for such change in nursing practices. We aimed to assess the generalizability of IFINP in other organizational settings and explore links between strategic and socio-material factors during implementation. We used a comparative qualitative case study at three French hospitals to assess the implementation of certification procedures. Data were collected from 33 semi-structured interviews with managers and nurses. Narratives reflecting actions and interactions were extracted and deductively analyzed using IFINP components. The results showed that the framework was flexible and captured the different aspects of implementation actions and interactions at the three hospitals. Strong interferences were identified between mobilization mechanisms and strategic elements. Interferences were observed mostly between ‘reflexive monitoring and work articulation’, and ‘reflexive monitoring and sense-making’ mechanisms. Leadership was integrated into the different mechanisms, especially the ‘translation’ mechanism. The IFINP facilitated a greater understanding of strategic elements and associated relationships with social and material factors during implementation. It helps to provide a clear definition of the managers’ role when implementing new nurse practices.

Are there reasons behind high Handrub consumption? A French National in-depth qualitative assessment

BackgroundHand hygiene (HH) is the most important measure for preventing healthcare-associated infections. A significant correlation between alcohol-based handrub consumption (AHRC) and observed HH compliance rates has been established. In France, publicly reported AHRC displayed a large heterogeneity across healthcare facilities (HCFs). We aimed to describe programmes for promoting HH in the top and medium AHRC scorers and to assess factors and drivers leading to a high AHRC score in a panel of French HCFs.MethodsWe performed a nationwide qualitative comparative case study based on in-depth semi-structured interviews in 16 HCFs with high, 4-year AHRC scores, and a sample of seven university hospitals (UHs) with medium AHRC scores. Infection Prevention and Control Team (IPC) members (n = 62), quality managers/chief executive officers (n = 23) and frontline workers (n = 6) were interviewed, using a grounded theory approach and an iterative thematic approach.ResultsNinety-one interviews were performed. There was a large heterogeneity in IPC structures and objectives, with specific patterns associated with high AHRC that were more organisational than technical. Four areas emerged: (1) strong cohesive team structure with supportive and outcome-oriented work attitude, (2) IPC structure within the organization, (3) active support from the institution, (4) leadership and role model. Among high AHRC scorers, a good core IPC organisation, a proactive and flexible management, a frequent presence in the clinical wards, and working in a constructive safety climate were prominent.ConclusionWe highlighted that IPC structure and activity is heterogeneous, with organisational and behavioural characteristics associated with high AHRC score. Beyond technical challenge, our work underlines the importance of strong structure of the IPC and behavioural approaches in implementing key IPC programmes.

Sustainable tourism policy in practice: A comparative case study of Argentina and Costa Rica

Argentina and Costa Rica are two Latin American countries rich in natural attractions that make up most of their tourism attractiveness for visitors. However, Costa Rica has managed to establish itself as a successful example and leader in the Sustainable Tourism sector, while Argentina could not. The aim of the present work is to explore what can account for such differences: more specifically, why Argentina has been unable to establish healthy sustainable tourism development. To examine the research question, the present study sets to describe the Tourism Development Policy of Argentina and Costa Rica, analyse their sustainability, and compare both countries by using a comparative qualitative and interpretative case study method. Comparisons will be made concerning three different governance levels: international, national, and local. The results of the present study show a close resemblance of both countries’ international policy with a stark difference at the national level, with two main consequences. Firstly, it suggests a greater importance of the National Tourism Development guiding plan when it comes to setting directions of the sustainability of the sector. Secondly, the biggest contrast that can be identified between the two countries is found on the environmental component of sustainability. Thirdly, it is observed that the application of National Tourism Policy at a local level has a high impact on the sustainability of the touristic activity, especially in terms of the involvement and inclusion of local communities. Finally, suggestions and easily applicable modifications are formulated based on the Costa Rican example to improve the country’s tourism Development in the years to come.

Desettling History: Non-Indigenous Teachers’ Practices and Tensions Engaging Indigenous Knowledges

Background/Context: For educators committed to unraveling racism and colonial bias in world history courses, challenges persist—particularly with Indigenous peoples and knowledges. Typical history curriculum, standards, and instructional tools misrepresent Indigenous peoples and knowledges in damaging and inaccurate ways. In cities, where Indigenous peoples and the natural world are often presumed distant, teachers may especially struggle to disrupt these patterns. Purpose/Objective/Research Question/Focus of Study: This study explores the efforts of two experienced urban secondary teachers nominated by local Indigenous educators, asking: How do teachers craft globally-oriented history instruction that engages Indigenous knowledges in historical inquiry? Population/Participants/Subjects: Both participants were experienced social studies teachers in or near West Coast cities, in public schools with strong racial, ethnic, and socioeconomic diversity. Julie (a white woman in her late 50s) taught in a small alternative middle school, while Teacher X (a Xicano/Latino man in his early 40s) taught in a large comprehensive high school. Research Design: This qualitative comparative case study relied on teacher interviews, class observations, and document analysis. Student and colleague interviews supported triangulation. Findings/Results: Findings indicate three teaching practices for desettling expectations (Bang et al., 2012) in historical inquiry: (1) strengthening context for Indigenous knowledges and sovereignty to counter colonial patterns of erasure; (2) using historiographical counter-narratives to show how interpretations of history are situated in colonial power relations; and (3) offering experiential and place-based learning with Indigenous knowledges beyond the classroom. Although both teachers worked to desettle expectations in these ways, only one showed consistency with centering Indigenous knowledges in observed practice. Conclusions/Recommendations: Personal resonance with relational and place-based learning appears crucial for teaching Indigenous historical perspectives meaningfully, which may prove challenging for teachers who identify as “urban” in ways perceived as distant from the natural world. Combined with the three practices above, teachers’ ongoing, reciprocal relationships with Indigenous peoples and homelands shaped their effectiveness in engaging Indigenous knowledges as valid and generative for historical inquiry, offering implications for practitioners and scholars in global historical inquiry and teacher education.

Implementing Coordinated Care Networks: The Interplay of Individual and Distributed Leadership Practices.

How does leadership emerge and function when multiple health care organizations come together to form a network? In this qualitative comparative case study, we draw on distributed leadership theory to examine the leadership practices that manifested during the implementation of three coordinated care networks. Thirty leaders and care providers participated in semistructured interviews. Interview data were inductively analyzed using thematic analysis. Although established in response to the same policy initiative, each case differed in its leadership approach and implementation strategy. We found that manifestation of distributed leadership was contingent on the presence of an individual leader who acted as a unifying force across their respective network. Our findings suggest that policies to encourage the development of interorganizational networks should include sufficient resources to support an individual leader who enables distributed leadership.

What’s behind the barriers? Uncovering structural conditions working against urban nature-based solutions

Nature-based solutions (NBS) are a promising and innovative approach to address multiple sustainability challenges faced by cities. Yet, NBS are not integrated into mainstream urban development practices. Based on a qualitative comparative case study of Germany, Hungary, the Netherlands, Spain, Sweden, and the United Kingdom, this study shows how barriers to mainstreaming urban NBS are shaped by the structural conditions in urban infrastructure regimes, which offers an improved, context-sensitive understanding of why such barriers persist. We identify underlying structural conditions shaping seven key barriers to urban NBS: limited collaborative governance, knowledge, data and awareness challenges, low private sector engagement, competition over urban space, insufficient policy development, implementation and enforcement, insufficient public resources, and challenging citizen engagement. This study also advances an understanding of urban infrastructure regimes as complex, heterogeneous systems, made up of different functional domains that define the space available for sustainability innovations. Importantly, our case comparison reveals that similar barriers to NBS mainstreaming in planning processes are caused by different structural conditions across countries. For example, perceived causes of limited citizen engagement are low environmental awareness in Spain, a lack of resources to support participation in Hungary, and NIMBY-ism in the Netherlands. Our findings stress the importance of moving beyond ‘silver bullet’-type approaches to addressing NBS mainstreaming barriers, towards systemic but context-sensitive responses, tailored to specific urban infrastructure regimes. This systematic understanding of barriers and their underlying structural conditions can help both scholars and practitioners identify promising pathways for the mainstreaming of NBS as an urban sustainability innovation.

Becoming Job-Ready? Narratives of Local Welfare-to-Work Programs and Client Experiences Across Differing Economic Contexts in California

Previous research on welfare-to-work exits has focused on individual client characteristics rather than local economic contexts. Drawing on a qualitative comparative case study design, this study enhances our understanding on how welfare-to-work organizational narratives and client experiences of becoming job-ready are shaped across two different economic contexts. In the disadvantaged economic context, a punitive welfare-to-work narrative is operational resulting in clients accepting precarious work. In the more privileged economic context, the individual responsibility narrative dominates as clients struggle to make ends meet. Our findings highlight how regional economic factors shape organizational narratives and impel clients to accept precarious low wage working conditions and unstable housing. Thus, there is a need for alternatives to welfare-to-work, such as unconditional, Universal Basic Income.

Experiences of peer workers and mental health service users with a peer support intervention: applying and critiquing a behaviour change techniques taxonomy

ABSTRACT Objective There is growing evidence for the benefits of peer support in mental health services. Less is known about the specific mechanisms whereby peer support brings about change. The aim of this study was to explore the experiences of adults using mental health services and peer workers to investigate whether the contents of an intentionally provided one-to-one peer support intervention can be adequately described using a standard taxonomy of behaviour change techniques (BCTs). Method This qualitative comparative case study involved semi-structured interviews with 11 peer workers and 10 people they supported, in 2017–2018. They participated in a randomised controlled trial of a peer support intervention. Data were coded using both an analytical framework, derived from Michie and colleague’s taxonomy of BCTs, and inductive thematic analysis. Results The findings revealed that the intervention included BCTs from all 16 BCT groupings in the taxonomy, with the emphasis on the groupings of ‘social support’, ‘comparison of behaviour’, ‘comparison of outcomes’, ‘regulation’ ‘shaping knowledge’, ‘identity’ and ‘covert learning’. Thematic analysis revealed a new group, ‘relational aspects’, consisting of five new BCTs: sharing of the peer worker’s experiential knowledge; promoting reciprocity, autonomy, and confidentiality; and validation of a safe and trusting relationship. Discussion A standard taxonomy of BCTs was shown to be broadly applicable to describing the contents of an intentional one-to-one peer support intervention for adults using mental health services. The taxonomy may need to be extended to consider additional BCTs related to encouraging the therapeutic relationship.

Revolutionary struggle and its diffusion: A configurational analysis of the 2011 Arab Uprisings

Researchers of revolutionary waves argue that early cases diffuse mobilization to later cases which are, compared with their forerunners, disadvantaged as they have fewer favorable antecedent conditions and less strategic protagonists. Using fuzzy-set Qualitative Comparative Analysis (fsQCA) and comparative case studies, I examine the 2011 Arab Uprisings in order to ask: (1) Why does revolutionary struggle (mass mobilization to topple an existing regime) in a given region emerge in and then diffuse to some countries but not others? and (2) Why do the struggles vary in form—that is, in terms of social composition, action types, and demands? My study finds three configurations of antecedent conditions that favor the emergence of revolutionary struggle. The three “paths” follow a two-sided narrowing pattern: each successive path has fewer expected favorable conditions and yields a less expansive form of struggle. These paths account for the six national cases of “revolutionary struggle” in the region, and co-occur with one path leading to mass reformist struggle and several other paths leading to relative quiescence. Overall, the article demonstrates how specific antecedent conditions combine in causal ways amid the temporal unfolding of a revolutionary wave. Furthermore, by identifying the narrowing pattern of revolutionary diffusion, the article suggests that later struggles essentially reflect locally informed strategic rationales, not irrational emulation or externally driven emergent processes, as posited by previous studies.

A Comparative Case Study on the Challenges Encountered by Philippine Private and Public Educational Institutions with their Existing Management Information System

For the last two years, all Philippine educational institutions had to adapt flexible learning. All personnel and students underwent orientation and training to their institution’s Management Information System (MIS). These institutions are utilizing either MIS mandated by the Department of Education, subscribed to or created by the institution itself. Challenges and concerns have been noted on the use of these MIS worldwide. Hence, this study elucidated the experiences and challenges of admistrators, faculty and students with their existing MIS among public and private educational institutions in the Philippines. Using a qualitative comparative case study design, the researchers draw the experiences of the participants on their existing MIS. The findings of the study revealed three main themes on the experiences of the participants with their existing MIS: excellent way to systematize and organize, a work in progress and encompassing of all institutional services. On the resolution of concerns and challenges with their MIS, prevailing themes were: having an efficient and expert Information Technology (IT) team, continuous feedback and improvement, and unresolved due to poor internet connectivity. As to how these challenges affected their performance, themes clustered on: improved and more efficient, negatively affected output and efficiency, and unaffected. This study highlighted the importance of proper orientation and training of all personnel and students, for an effective MIS which must be managed by an expert IT team. Despite the challenges encountered, the use of the MIS led to the better performance of the participants’ duties and responsibilities.

Occupational welfare en segmentatie: een onderzoek naar variatie tussen (en binnen) sectoren in Duitsland en België

The paper uses a qualitative comparative case study design to examine across (and within) sectoral variation in occupational welfare outcomes (i.e. flexible working hours, occupational pensions and health and sickness benefits, fringe benefits complementing wages) for different groups of workers in food and chemical manufacturing in Germany and Belgium. Findings indicate that common national challenges can yield different occupational welfare outcomes across (and within) different sectors, which in turn affect workforce segmentation. The integration between local and sector-level power dynamics explains the extent to which and how negotiation on occupational welfare can entail segmentation.

Strategies and Challenges: Qualitative Lessons Learned From Georgia Produce Prescription Programs.

Produce prescription programs (PPPs) have grown in numbers in the past decade, empowering health care providers to promote health by issuing subsidies for produce to vulnerable patients. However, little research has been conducted on the facilitators that make it easier for PPPs to succeed or the barriers that programs face, which could provide guidance on how to improve future PPP design and implementation. The study sought to identify the facilitators and barriers affecting positive outcomes in Georgia PPPs called Fruit and Vegetable Prescription (FVRx) Programs. A process evaluation with a qualitative comparative case study approach was conducted. Fifteen FVRx providers, ranging from nutrition educators to farmers market managers, were interviewed in a focus group interview or on the phone between 2016 and 2017. Two nutrition education classes and an FVRx best practices meeting were observed, and program documents were collected. Interview transcripts, field notes from observations, and documents were then thematically analyzed. Four overall themes were determined regarding facilitators and barriers experienced by FVRx programs: (1) creating accessible programming may encourage FVRx participation, (2) provider dedication to the program is important, (3) participants' challenging life circumstances can make participation difficult, and (4) the sustainability of the program is a concern. The findings of this study suggest helpful strategies and challenges for providers to consider when developing and implementing PPPs in Georgia and beyond. Research on the long-term program impact is needed, and policy options for sustainable, scaling up of PPPs should be explored.

Improving Decision-Making for Population Health in Nonhealth Sectors in Urban Environments: the Example of the Transportation Sector in Three Megacities—the 3-D Commission

Noncommunicable diseases (NCDs) represent a significant global public health burden. As more countries experience both epidemiologic transition and increasing urbanization, it is clear that we need approaches to mitigate the growing burden of NCDs. Large and growing urban environments play an important role in shaping risk factors that influence NCDs, pointing to the ineluctable need to engage sectors beyond the health sector in these settings if we are to improve health. By way of one example, the transportation sector plays a critical role in building and sustaining health outcomes in urban environments in general and in megacities in particular. We conducted a qualitative comparative case study design. We compared Bus Rapid Transit (BRT) policies in 3 megacities-Lagos (Africa), Bogotá (South America), and Beijing (Asia). We examined the extent to which data on the social determinants of health, equity considerations, and multisectoral approaches were incorporated into local politics and the decision-making processes surrounding BRT. We found that all three megacities paid inadequate attention to health in their agenda-setting, despite having considerable healthy transportation policies in principle. BRT system policies have the opportunity to improve lifestyle choices for NCDs through a focus on safe, affordable, and effective forms of transportation. There are opportunities to improve decision-making for health by involving more available data for health, building on existing infrastructures, building stronger political leadership and commitments, and establishing formal frameworks to improve multisectoral collaborations within megacities. Future research will benefit from addressing the political and bureaucratic processes of using health data when designing public transportation services, the political and social obstacles involved, and the cross-national lessons that can be learned from other megacities.

Recasting Sustainable Collaborations through Postcolonial Perspectives

This study examines from a postcolonial perspective the drivers of sustainability that underpin successful diaspora-induced organizational collaborations. Our qualitative comparative case study of ...

Pro-judge study: Nurses' professional judgement in nurse staffing systems.

Aim of this study is to better understand the role of nurses' professional judgment in nurse staffing systems. Qualitative comparative case study design of nurse staffing systems in England and Wales. Data will be collected through a variety of sources: individual interviews, observations of relevant meetings and analysis of key documents. Ethical approval for the study was granted in August 2020 from The Healthcare Research Ethics Committee (SREC reference: REC741). Data generation will be informed by science and technology studies and practice theories. Ensuring adequate numbers of nurses are available to care for patients in response to shifting demand is an international policy priority. Emerging evidence on the use of formal workforce planning methodologies across the developed world highlights both the centrality of nurses' professional judgement in nurse staffing methodologies and the urgent need for theoretically informed research to better understand and conceptualise its contribution to decision-making. This study is designed to address this gap in understanding. It takes advantage of nurses' experiences of managing the service and staffing impacts of the Covid-19 pandemic and differences in strategic approaches to nurse staffing systems between England and Wales. The research will: make visible the knowledge and skills that underpin professional judgement in nurse staffing decisions and provide a conceptual language with which to articulate this; lay the foundations for evidence-based programmes of nurse education and continuing professional development; furnish the evidence to inform the development of nurse-led decision support tools to augment professional judgement; and generate wider insights into the effectiveness of nurse staffing systems in practice.