Convergence Study Research Articles

Prevalence, correlates, and reasons for substance use among adolescents aged 10–17 in Ghana: a cross-sectional convergent parallel mixed-method study

BackgroundSubstance use among adolescents poses significant risks to their health, wellbeing, and development, particularly in low- and middle-income countries, including Ghana. However, little is known about the outlets and reasons for substance use among Ghanaian adolescents. This study examined the prevalence, correlates, reasons for substance use, and outlets of these substances among adolescents aged 10–17 in Ghana.MethodsData were obtained from the Department of Children, Ministry of Gender, Children, and Social Protection, Ghana, which employed a cross-sectional convergent parallel mixed-methods technique to collect quantitative and qualitative data from children aged 8–17, parents or legal guardians and officials of state institutions responsible for the promotion and protection of children’s rights and wellbeing. Overall, 4144 adolescents aged 10–17 were interviewed for the quantitative data, while 92 adolescents participated in 10 focus group discussions. Descriptive statistics, Pearson’s chi-square test, and multivariable binary logistic regression were used to analyse the quantitative data, while the qualitative data was analysed thematically.ResultsThe prevalence of substance use was 12.3%. Regarding the types of substance use, alcohol (56.9%) and cigarettes (26.4%) were the most common substances. Being a male and currently working are significant risk factors, whereas being aged 10–13, and residing in the Middle- and Northern-ecological belts of Ghana are significant protective factors of substance use. Peers, household members who use substances, drug stores, and drug peddlers are the major outlets. The reasons for substance use were fun, substance as an aphrodisiac, boosting self-confidence, dealing with anxiety, and improved social status.ConclusionsThere is a relatively high substance use among adolescents in Ghana, and this calls for a multi-sectoral approach to addressing substance use by providing risk-behaviour counselling, parental control, and effective implementation of substance use laws and regulations.

Bioelectrical impedance vector analysis as an indicator of malnutrition in children under five years with and without pneumonia in Mchinji District, Malawi: An exploratory mixed-methods analysis

Background Bioelectrical impedance vector analysis (BIVA) is a non-invasive approach to assessing body composition and cellular health, which may improve the assessment of nutritional status in sick children. We explored the reliability, clinical utility, and acceptability of BIVA, as an indicator of nutritional status for children under five years with and without pneumonia, in Malawi. Methods We conducted a parallel convergent mixed-methods exploratory study in Mchinji District Hospital, Malawi, in 2017. We recruited a convenience sample of children aged 0–59 months with clinical pneumonia, and without an acute illness. Children had duplicate anthropometric and BIVA measurements taken. BIVA measurements of phase angle were taken of the whole body, and trunk and arm segments. Reliability was assessed by comparing the variability in the two measures, and clinical utility by estimating the association between anthropometry and phase angle using linear regression. Focus group discussions with healthcare workers who had not previously used BIVA instrumentation were conducted to explore acceptability. Results A total of 52 children (24 with pneumonia and 28 healthy) were analysed. The reliability of sequential phase angle measurements was lower than anthropometric measurements, but trunk and arm segments performed better. The largest associations with phase angle were a negative relationship with weight-for-age z-score (WAZ) in children with pneumonia in the trunk segment, and a positive association with WAZ in the full body measurement in healthy children. Healthcare workers in focus group discussions expressed trust in BIVA technology and that it would enable more accurate diagnosis of malnutrition; however, they raised concerns about the sustainability and necessary resources to implement BIVA. Conclusions While healthcare workers were positive towards BIVA as a novel technology, implementation challenges should be expected. The differential direction of association between anthropometry and phase angle for children with pneumonia warrants further investigation.

Entrepreneurial engagement of business graduates in Region XI with entrepreneurial motivation and entrepreneurial education as determinants: A convergent mixed methods study

Entrepreneurial engagement of business graduates in Region XI with entrepreneurial motivation and entrepreneurial education as determinants: A convergent mixed methods study

Study on the Fundamental Frequency and Dynamic Mode of Traveling Wave Vibration of Rotating PJCS

The vibrations of rotating joined conical–conical shells with classical supported conditions have been studied extensively. As a matter of fact, in some cases, these classical boundary conditions cannot exactly model actual situations. Moreover, theoretical frameworks on them are still limited. This research aims to investigate the fundamental frequencies and dynamic mode shapes of the traveling wave of the rotating porous metal material joined conical–conical thin shells (PJCS) with elastic supports. By utilizing artificial spring technology, arbitrary elastic supported boundary conditions and classical boundary conditions are achieved efficiently. A new dynamic model has been formulated with the help of the first-order shear deformation theory (FSDT) and Hamilton’s principle. By employing the generalized differential quadrature (GDQ) method along with stress boundary conditions and generalized eigenvalues, various factors such as porosity, semi-vertex angles and stiffness are analyzed for their impact on the fundamental frequencies of forward wave (FW), backward wave (BW) and mode shapes. The presented results are validated through the convergence and comparison studies from literatures. The interesting and novel results indicate that the in-plane displacement constraints have the most significant impact on the critical speed, while the lateral displacement constraint has the least effect. The vibrations are more easily excited for the part with a larger half vertex angle. Rotating PJCS with Type 1 has the biggest critical rotating speed.

Chinese Providers' Perspectives on Early Integration of Palliative Care in Pediatric Oncology: A Mixed-Methods Study.

Internationally, early integration of palliative care in pediatric oncology has been widely recognized. However, little is known about the perspective of Chinese providers in this regard. The aim of this study was to explore the perspective of Chinese providers on the early integration of palliative care in pediatric oncology. This was a convergent mixed-methods study with a survey among 141 Chinese providers (101 nurses, 38 oncologists, and 2 social workers) and 12 individual interviews (5 oncologists, 5 nurses, and 2 social workers). Three categories existed by comparison and merging of quantitative and qualitative findings: (1) attitudes toward early integration of pediatric palliative care: 75% of the participants endorsed early integration because it would bring benefits to patients and their families-participants had concerns about misunderstandings of palliative care among other stakeholders; (2) patient-provider interactions relating to early integration: participants held contradictory views toward the impact on and influencers of early integration regarding patient-provider interactions; and (3) participants suggested a system to support early integration by addressing parents' misconceptions and providers' training, and institutional facilitation. Chinese pediatric oncology providers generally exhibit a reserved willingness toward the early integration of palliative care. They agree that palliative care would be beneficial but have concerns about providing structural support and addressing cultural influencers. Findings of this study emphasize the significance of convening stakeholders and establishing a pediatric palliative care-friendly system in a developing country, particularly by addressing structural support, resource allocation, clarified responsibilities, and capacity building.

Uncertainty quantification of the flexural strengthening of RC beams with UHPC using improved metaheuristic algorithm

This study presents an artificial intelligence-based model to predict the flexural strengthening of RC beam/slab strengthened with UHPC (RC-UHPC) and perform uncertainty quantification of such values. Improved eliminate particle swamp optimization hybridized artificial neural network (IEPANN) was a model developed on artificial neural network (ANN) optimized by improved-eliminate-particle-swamp optimization (IEPSO). Experimental datasets were used to establish the hybrid ML model. The efficiency of IEPANN was compared against support vector regression (SVR) and multiple linear regression (MLR). The IEPANN demonstrates outstanding performance over MLR and SVR. The flexural strengthening of RC-UHPC depends on materials and geometrical configurations, which have stochastic characteristics. Convergence studies, sensitivity, and probabilistic analyses were conducted on each random parameter. Simulation results indicated that strengthening configuration is the most sensitive to flexural strengthening. Systematic assessment of uncertainties in flexural strengthening may lead to a higher confidence level in model outcomes, and RC-UHPC is examined and designed. It enhances construction reliability.

Examining Parental Stress and Autism in the Early Days of the Pandemic: A Mixed-Methods Study

In this convergent parallel mixed-methods study, we investigated the early impact of the COVID-19 stay-at-home mandate in Illinois on 16 caregivers of children with autism. Our goal was to understand contributors to caregivers’ stress by integrating qualitative and quantitative data. Through a joint display, we explored the intricate relationship between caregivers’ perceptions of their child’s needs, the loss of essential services, and stress levels. The caregivers’ reported needs, wishes, barriers, and coping strategies informed and corroborated final quantitative results on stress levels. Significant associations were found between stress levels and caregivers’ agreement with statements on child supervision, service loss, and perceived level of their child’s independence. These findings underscore the importance for robust support systems that enhance family resilience and validate prior research during exceptional circumstances. They offer insights for policymakers and service providers seeking to improve the well-being of families raising children with autism, particularly in times of crisis.

Delayed opportunities for patient-provider communication about medication overuse headache: Mixed methods perspectives from patients and neurologists

ObjectivesMedication overuse headache (MOH) is a common, debilitating condition occurring when migraine patients overuse pain relief medications. We conducted a convergent mixed methods study examining patient-provider communication on MOH. MethodsMigraine patients were identified from one academic health center via electronic health records. Research staff recruited patients and administered a remote survey on MOH awareness, knowledge, and communication; descriptive and bivariate analyses were conducted. Neurologists from the same health center were invited to participate in qualitative interviews; analysis drew from the Rapid Identification of Themes from Audio Recordings procedures. A side-by-side comparison of results followed. ResultsParticipants included 200 patients and 13 neurologists. More than one third of patients (39.5 %) had never heard of ‘medication overuse headache.’ Among those who had, 38.4 % learned about MOH ≥ 5 years after their migraine diagnosis. Neurologists similarly reported limited patient awareness of MOH and suggested communication was provider-initiated, reactive to patient-reported symptoms and behaviors. Participants agreed MOH was described as a ‘consequence’ of frequent medication taking, though specific terminology varied with neurologists suggesting they choose terms they perceive to be easier to understand and less stigmatizing to patients. Neurologists felt they lacked effective patient education resources. ConclusionsFindings reveal delayed opportunities to inform patients about MOH. Standardized education supporting early preventive communication is needed, perhaps in primary care where many patients seek initial care for migraine symptoms.

Dynamic Analysis of Shape-Memory-Alloy-Reinforced Damaged Layered Panel: Reversal of Structural Stiffness

This research investigates the dynamic analysis of a shape-memory-alloy-reinforced laminated composite shell panel (SMARLCSP) with and without damage. The potential of SMA reinforcement against the internally defected composite structural panel has been explored by enhancing the parent structural stiffness and the corresponding dynamic responses. To ensure the accuracy of the proposed model, convergence studies, experimental tests, and numerical validations are performed. The theoretical and mathematical modeling of the study employs the higher-order shear deformation theory, offering improved accuracy for modeling the complex behavior of the SMARLCSP. The transient responses are determined using Newmark’s average acceleration steps via MATLAB computer code. The functional material effect has been included in this analysis via the marching technique to compute the numerical outcomes presented in detail. The study comprehensively evaluates geometric and SMA-relevant parameters for intact and damaged Laminated Composite Spherical Shell Panel (LCSSP) cases. The findings exhibit positive results, highlighting significant enhancements in structural stiffness and improved dynamic responses when SMA reinforcement is incorporated into the composite shell panel.

Numerical Integration of Some Arbitrary Functions over an Ellipsoid by Discretizing into Hexahedral Elements for Biomaterial Studies

This study mathematically examines chemical and biomaterial models by employing the finite element method. Unshaped biomaterials’ complex structures have been numerically analyzed using Gaussian quadrature rules. It has been analyzed for commercial benefits of chemical engineering and biomaterials as well as biorefinery fields. For the computational work, the ellipsoid has been taken as a model, and it has been transformed by subdividing it into six tetrahedral elements with one curved face. Each curved tetrahedral element is considered a quadratic and cubic tetrahedral element and transformed into standard tetrahedral elements with straight faces. Each standard tetrahedral element is further decomposed into four hexahedral elements. Numerical tests are presented that verify the derived transformations and the quadrature rules. Convergence studies are performed for the integration of rational, weakly singular, and trigonometric test functions over an ellipsoid by using Gaussian quadrature rules and compared with the generalized Gaussian quadrature rules. The new transformations are derived to compute numerical integration over curved tetrahedral elements for all tests, and it has been observed that the integral outcomes converge to accurate values with lower computation duration.

Exploring quality of life post sudden onset hearing loss: A convergent parallel approach.

Sudden onset hearing loss (SOHL) is rare and presents differently to individuals; hence, it is complex to diagnose. The impact on the quality of life (QoL) varies for individuals and their support structure. However, the exploration of research designs is warranted. This study explored the lived experiences of adults post-SOHL diagnosis and the impact on the QoL. Facilitators of emotional and social aspects of counselling provided by audiologists post-SOHL diagnosis were established. This was a convergent parallel research study. Data were collected from the two primary participants and three secondary participants, face-to-face and telephonically. The Hearing Handicap Inventory for Adults (HHIA) screening tool and the semi-structured interviews were used for data collection. The data sets were analysed independently,viz. descriptive analysis and thematic analysis, to confirm the impact on the QoL post-SOHL diagnosis. The HHIA scores obtained were 84% and 50% for P1 and P2, respectively. Key themes that emerged from the interviews revealed that communication difficulties mostly impacted the QoL, which in turn influenced their mental and social well-being. Aural rehabilitation was perceived as ineffective support, thus the inability to reduce the impact on the QoL post-SOHL diagnosis. The integrated findings indicated the impact on the QoL post-SOHL diagnosis. Convergent parallel methods should be considered by researchers to understand rare auditory pathologies and their impact on the QoL.Contribution:Person-centred care (PCC) and family-centred care (FCC) are facilitators of counselling that audiologists can employ as QoL management strategies post-SOHL diagnosis.

Development and Implementation of an Elementary School-Based Indigenous Knowledge Pedagogical Model on Native Tree Species for Environmental Sustainability Education in Ghana

Environmental education across countries is seen as the surest means of nurturing pro-environmental behaviours in children so that the conservation of biodiversity in the environment can be guaranteed. Unfortunately in Ghana, there is no indigenous-knowledge inspired pedagogical model that would aid elementary school teachers in carrying out such education. This convergent parallel mixed method study was aimed at developing, implementing and evaluating an indigenous knowledge inspired pedagogical model for native tree education among elementary school learners in Ghana. The indigenous-knowledge inspired pedagogical model was developed by the researchers under the expert guidance of some curriculum planners in Ghana with inputs from elementary school teachers and in tandem with the elementary school curriculum strand on environmental education. It was implemented in classroom and off-classroom contexts and finally evaluated for its potential in inciting elementary school learners in engaging in helpful native tree conservation activities. The quantitative results show high viability scores (100%) of the ESBIK pedagogical model’s capability of impacting significantly on the sustainability consciousness and competence of elementary school learners (Very Important-72.2%, Extremely Important-27.7%). On the other hand, the qualitative findings indicated the model’s capability of imparting knowledge on the essential roles that native tree species play in their lives and the broader benefits to ecosystem. Elementary school learners demonstrated care for native trees through tree planting, making of nurseries and gardens, and engaging in native tree conservation campaigns. The study recommends that the Ministry of Education should adopt, improve and widely disseminate the pedagogical model. Future studies should consider using a larger sample size comprising elementary schools from several regions out of the sixteen (16) regions and engage in scholarly regional comparison of the results after the implementation of the ESBIK pedagogical model.

Energy-conserving physics for nonhydrostatic dynamics in mass coordinate models

Abstract. Motivated by reducing errors in the energy budget related to enthalpy fluxes within the Energy Exascale Earth System Model (E3SM), we study several physics–dynamics coupling approaches. Using idealized physics, a moist rising bubble test case, and the E3SM's nonhydrostatic dynamical core, we consider unapproximated and approximated thermodynamics applied at constant pressure or constant volume. With the standard dynamics and physics time-split implementation, we describe how the constant-pressure and constant-volume approaches use different mechanisms to transform physics tendencies into dynamical motion and show that only the constant-volume approach is consistent with the underlying equations. Using time step convergence studies, we show that the two approaches both converge but to slightly different solutions. We reproduce the large inconsistencies between the energy flux internal to the model and the energy flux of precipitation when using approximate thermodynamics, which can only be removed by considering variable latent heats, both when computing the latent heating from phase change and when applying this heating to update the temperature. Finally, we show that in the nonhydrostatic case, for physics applied at constant pressure, the general relation that enthalpy is locally conserved no longer holds. In this case, the conserved quantity is enthalpy plus an additional term proportional to the difference between hydrostatic pressure and full pressure.

Development of an App for Symptom Management in Women With Breast Cancer Receiving Maintenance Aromatase Inhibitors: Protocol for a Mixed Methods Feasibility Study.

Patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer often experience a reduced quality of life after primary treatment. The disease and treatment trajectory consists of surgery followed by chemotherapy or radiation therapy. Upon this, maintenance hormone therapy with an aromatase inhibitor can result in several physical and psychosocial symptoms. Optimal symptom control during maintenance therapy is central to maintaining the patient's quality of life. This study aims to (1) develop an electronic symptom management tool for patients with postmenopausal early breast cancer receiving maintenance aromatase inhibitors with an endocrine aspect and (2) assess the feasibility, acceptability, and usability of the pilot version of the Bone@BC app. Furthermore, longitudinally, symptom prevalence and quality of life for patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will be explored. This study follows a multistage research plan. In stage 1, a systematic literature review to establish an overview of aromatase inhibitor-related symptoms reported by postmenopausal women with nonmetastatic estrogen receptor-positive breast cancer will be completed. In stage 2, a comprehensive overview of symptoms related to aromatase inhibitors (letrozole, exemestane, and anastrozole) will be performed (eg, by reviewing medical leaflets and guidelines). In stage 3, an electronic app with a user-friendly Patient Concern Inventory list to comprise symptoms and concerns will be developed. Last, in stage 4, a convergent mixed methods feasibility study of the pilot version of the Bone@BC app will be conducted. A total of 45 patients with postmenopausal nonmetastatic estrogen receptor-positive breast cancer will use the app daily for symptom identification and respond to 6 serial patient-reported outcome measurements for 12 weeks. Finally, semistructured interviews will be performed. The primary outcome includes consent rate, attrition rate, retention rates, technical issues, and adherence, assessed using preestablished criteria on feasibility and a mixed methods approach for exploring acceptability. A patient advisory board consisting of 5 women with breast cancer is recruited to include their perspectives and experiences in the planning, organization, implementation, and dissemination of the research throughout the project. At the time of submitting this paper (January 2024), a total of 23 patients have been included in the stage 2 medical audit over the recruitment period of 3 months (November 2022 to February 2023), and 19 patients have been enrolled in stage 2, the semistructured patient interviews. This protocol describes a study investigating the feasibility, acceptability, and usability of the symptom management tool Bone@BC developed for patients with breast cancer with an endocrine aspect. ClinicalTrails.gov NCT05367830; https://clinicaltrials.gov/ct2/show/NCT05367830. DERR1-10.2196/49549.

Generative adversarial reduced order modelling

In this work, we present GAROM, a new approach for reduced order modeling (ROM) based on generative adversarial networks (GANs). GANs attempt to learn to generate data with the same statistics of the underlying distribution of a dataset, using two neural networks, namely discriminator and generator. While widely applied in many areas of deep learning, little research is done on their application for ROM, i.e. approximating a high-fidelity model with a simpler one. In this work, we combine the GAN and ROM framework, introducing a data-driven generative adversarial model able to learn solutions to parametric differential equations. In the presented methodology, the discriminator is modeled as an autoencoder, extracting relevant features of the input, and a conditioning mechanism is applied to the generator and discriminator networks specifying the differential equation parameters. We show how to apply our methodology for inference, provide experimental evidence of the model generalization, and perform a convergence study of the method.

Inventors emerging in-school and out-of-school: six iterations of educational design to promote equitable student engagement

Invention education is an emerging field that shows promise for fostering equitable student engagement, especially related to disciplines of science, technology, engineering, arts, and mathematics (STEAM), in both classroom and informal learning. A central concept for practitioners, researchers, and evaluators, student engagement connects with academic, socioemotional, career, and civic success. Nonetheless, more work is needed to ensure more equitable approaches to educational design for student engagement, especially with youth of one or more minoritized identity markers (e.g., Black, Brown, or Indigenous youth; female or non-binary youth; youth from lower socioeconomic statuses; etc.). This Curriculum, Instruction, and Pedagogy article describes six iterations of educational designs for invention education with grades 6–8 classes and camps. Three of the iterations revised the same curriculum for grade 7 classes (N ~ 160 students/year), and the other three iterations involved similar yet distinct curricula for grades 6–8 camps (N ~ 25 students/year). Taking a cultural psychology approach to design-based research, we conducted a phenomenological mixed-methods study for convergence. That is, we iteratively refined educational designs within given microcultures, and we sought to better understand participants’ lived experiences. We share evidence of high affective, behavioral, and cognitive engagement, within and between both individual and social levels, alongside development of self-efficacy with respect to ability beliefs and anxiety management. With a few exceptions, our findings suggest equitable participation of youth. These findings we connect with educational design considerations, including individual vs. social supports, explicit attention to youths’ hobbies and peer-inventors, and formative assessment that broadens response scales and gradations of challenge. Our work supports a more nuanced and socially-situated six-dimensional framework for student engagement, expanding upon commonly-used three-and four-dimensional models. We conclude with local and transferrable implications, towards the main goal of fostering equitable student engagement in science and engineering through invention education.

A hemodynamic study of blood flow models on various stent graft configurations during aorto-iliac reconstruction.

To compare the hemodynamic performance of three (Bottom Up non-ballet, Top-Down non-ballet, Top Down ballet) idealized stent graft configurations used during endovascular repair of abdominal aortic aneurysms, under the influence of various rheological models. Ten rheological models are assumed and a commercial finite volume solver is employed for the simulation of blood flow under realistic boundary conditions. An appropriate mesh convergence study is performed and five hemodynamic variables are computed: the time average wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential and displacement force (DF) for all three configurations. The choice of blood flow model may affect results, but does not constitute a significant determinant on the overall performance of the assumed stent grafts. On the contrary, stent graft geometry has a major effect. Specifically, the Bottom Up non-ballet type is characterized by the least favorable performance presenting the lowest TAWSS and the highest OSI, RRT and ECAP values. On the other hand, the Top Down ballet type presents hemodynamic advantages yielding the highest TAWSS and lowest OSI, RRT and ECAP average values. Furthermore, the ballet type is characterized by the lowest DF, although differences observed are small and their clinical relevance uncertain. The effect of the assumed rheological model on the overall performance of the grafts is not significant. It is thus relatively safe to claim that it is the type of stent graft that determines its overall performance rather than the adopted blood flow model.

Evaluating methodological enhancements to the Yes/No Angoff standard-setting method in language proficiency assessment

This study evaluated the efficacy of two proposed methods in an operational standard-setting study conducted for a high-stakes language proficiency test of the U.S. government. The goal was to seek low-cost modifications to the existing Yes/No Angoff method to increase the validity and reliability of the recommended cut scores using a convergent mixed-methods study design. The study used the Yes/No ratings as the baseline method in two rounds of ratings, while differentiating the two methods by incorporating item maps and an Ordered Item Booklet, each of which is an integral tool of the Mapmark and the Bookmark methods. The results showed that the internal validity evidence is similar across both methods, especially after Round 2 ratings. When procedural validity evidence was considered, however, a preference emerged for the method where panelists conducted the initial ratings unbeknownst to the empirical item difficulty information, and then such information was provided on an item map as part of the Round 1 feedback. The findings highlight the importance of evaluating both internal and procedural validity evidence when considering standard-setting methods.

Examining the ecology of preschool inclusion in New York City: A mixed-methods study underway

Our team was awarded a grant by a private organization in partnership with a local research network to examine disparities in the special education referrals and services provided to young children in New York City (NYC). Our convergent mixed-methods study is exploring how the NYC preschool ecology—consisting of process, people and their positionalities, and practices—influences teachers’ decisions to refer and include minoritized young children who are at risk for or have developmental delays or disabilities. In this colloquium we: (1) describe key issues in the US and the NYC contexts that led to this design; (2) present the study methodology, including its theoretical underpinnings; and (3) discuss implications for systems change in NYC.

Diffusion of medications for opioid use disorder treatment in jail settings: a convergent mixed methods study of jail staff perspectives

BackgroundImplementation of medications for opioid use disorder (MOUD) in jails varies by facility and across states. Organizational climate, including staff attitudes toward change and exposure to education, can influence perceptions of innovations like MOUD in jails. Using a mixed methods design, we aimed to understand the association between organizational climate and jail staff perceptions of MOUD.MethodsJail staff (n = 111) who operate MOUD programs in 6 Massachusetts jails completed surveys that included the Organizational Readiness for Implementing Change (ORIC) survey. Random effects logistic regression models assessed associations between organizational climate and several outcomes of perceived MOUD efficacy, acceptability, and knowledge, while controlling for covariates. Jail staff (N = 61) participated in qualitative interviews and focus groups focused on organizational climate and knowledge diffusion, which we analyzed using inductive and deductive methods.ResultsThe results indicate that organizational change readiness on the ORIC was associated with positive perceptions of MOUD, and educational resources facilitated MOUD implementation. Greater ORIC was associated with higher perception of methadone as highly acceptable for jail populations (Odds ratio [OR] 2.3, 95% Confidence Interval [CI] 1.2 to 4.4), and high knowledge of methadone (OR 2.3, 95% CI 1.1 to 4.9), with similar magnitude of effects for buprenorphine. High levels of training for jail staff on methadone and buprenorphine were also associated with higher knowledge of these medications (Methadone: OR 7.2, 95% CI 2.2 to 23.2; Buprenorphine: OR 3.4, 95% CI 1.2 to 9.5). Qualitative results point towards the importance of organizational climate and elucidate educational strategies to improve staff perceptions of MOUD.ConclusionResults underscore the importance of organizational climate for successful implementation of jail MOUD programs and provide support for medication-specific educational resources as a facilitator of successful MOUD implementation in jail settings. Findings highlight implementation strategies that may improve jail staff perceptions of MOUD.