Convergent Approach Research Articles

Factors influencing nurse manager retention, intent to stay or leave and turnover: A systematic review update.

To understand factors influencing nurse manager retention or intention to leave, develop a preliminary theoretical model and identify strategies and interventions for workforce planning. Systematic review update of literature with integrated design of mixed research synthesis. We included peer-reviewed articles examining factors influencing retention or intention to leave for front-line, middle or patient care nurse managers. Authors independently screened articles for inclusion and assessed included articles for quality. We adhered to a convergent synthesis approach. Nine databases included MEDLINE, EMBASE, PsychINFO, CINAHL Plus with Full Text, ERIC, Health Source Nursing/Academic Edition, Scopus, ProQuest Dissertations and Theses and LILACS in January 2023. Thirty-five studies published between 1990 and 2022, 22 quantitative and 13 qualitative or mixed methods, were included. 155 factors influencing nurse manager retention, intention to stay, or turnover were reported. Job satisfaction was most frequently examined (n = 7), followed by factors such as empowerment (n = 3), decision-making (n = 3) and resilience (n = 2). We developed a preliminary theoretical model demonstrating staff relations and leadership, organizational and job characteristics, socio-demographics, personal characteristics, well-being and nurse manager relationship with work influence managers' intention to stay or to leave. Nurse managers who were empowered, satisfied with their work, received constructive feedback and found meaning in their roles showed greater intent to stay. Nurse administrators can ensure managers are provided with authority to make decisions that promote autonomy. Work cultures that allow for regular meaningful constructive feedback from staff and leaders may contribute to nurse managers feeling valued. Understanding factors that influence job retention or intention to leave may help nurse managers and their supervisors identify areas for strategy and intervention design to ensure sustainability of this workforce. PRISMA 2020 Guidelines. No patient or public contribution.

Extensiveness of Continuous Assessment Practice on Improving Students’ Academic Performance in Monduli District Public Secondary Schools, Tanzania

This study assesses the extensiveness of continuous assessment practices in improving students' academic performance in public secondary schools in Monduli District, Tanzania. The study employed a convergent design and mixed-methods research approach guided by the Social Learning Theory by Albert Bandura (1977). The target population in this study includes 12 public secondary schools, 12 heads of schools, 399 teachers, 1823 students, and 1 DSEO. The study sample size comprised 253 respondents, of which 40 teachers were sampled through the stratified random sampling technique; 208 students were selected using the stratified random technique; 4 heads of schools and 1 DSEO were purposively sampled (total population sampling technique) based on the virtue of their position. A questionnaire, interview guide, and document analysis schedule were used to collect the required information. The validity of quantitative instruments was achieved by two research experts in the area of educational assessment and evaluation from Mwenge Catholic University. The reliability of the questionnaires was estimated by Cronbach Alpha technique of which the output was 0.799 which means the instrument was reliable for data collection. The trustworthiness of the qualitative data was ensured by the triangulation of instruments and peer debriefing methods. Quantitative data was analysed using descriptive statistics and presented in tables with the aid of Statistical Package for Social Science (SPSS) version 23. Qualitative data were analysed thematically and presented in words by verbatim quotations. The study found that continuous assessment was practised to a high extent to improve students' academic performance in Monduli District. The study concluded that continuous assessment practices have successively achieved their goal of improving students' academic performance in national examinations to a high extent. The study recommended that there should be monitoring and evaluation of the effectiveness of continuous assessment practices regularly to identify areas for improvement and ensure they continue to be effective in improving student academic performance.

Enhancing the Creative Arts Skill of Generalist Teachers in the Ga East Municipality, Ghana

The objective-based curriculum previously in use was replaced by a standards-based curriculum for the 2019–2020 school year, bringing a fresh approach to the fundamental study of visual arts. However, the current curriculum places greater emphasis on art history and cultural practices, presenting challenges for generalist teachers in the Ga East Municipality who lack significant training or experience in creative arts. This study aimed to explore the impact of different levels of educational leadership on enhancing the teaching skills of generalist teachers in creative arts education. Employing a convergent parallel mixed methods approach, both qualitative and quantitative data were analysed. The study collected a total of 210 questionnaire responses and conducted interviews with 3 participants. The respondents included 185 generalist teachers, 25 headteachers, and 3 municipal education officers, selected through purposive sampling. The study held importance for the practical ability of generalist teachers to navigate complex artistic concepts through adaptability and flexibility in their teaching methods. The findings demonstrated that implementing innovative intervention strategies, such as collaborative projects, professional development training, integration of online resources, and pre-service education into the curriculum, while equipping generalist teachers with enhanced skills, can effectively inspire and engage students. Additionally, it highlighted the necessity for generalist teachers to exhibit passion, enthusiasm, instructional prowess, and imaginative skills to foster creativity, critical thinking, and self-expression in students through creative arts, ultimately influencing the quality of future art education.

Investigating consumers' experiences with community supported agriculture: Convergent parallel design methods.

Community-supported agriculture (CSA) represents a collaborative model where local farms and community members form partnerships to facilitate the direct delivery of fresh produce from farms to consumers. This study primarily investigates the experiences of current CSA members, focusing on the key factors influencing their retention intentions. Employing a convergent parallel mixed methods approach, this study gathers and analyzes both quantitative data (such as factors affecting members' retention intentions) and qualitative data (derived from interviews reflecting members' perceptions of their CSA experiences). The integration of these datasets provides a comprehensive understanding of the factors that shape CSA membership dynamics. The research findings underscore that Convenience, Product Quality, and Positive Interactions are pivotal factors that contribute to members' Intentions to continue their CSA memberships. These insights are crucial for enhancing the services provided to CSA members and hold significant implications for the broader scope of CSA membership research. This study not only fills a critical gap in understanding the Chinese CSA context but also contributes to the global discourse on sustainable agriculture practices and community engagement.

Effects of elastic band resistance training on the physical and mental health of elderly individuals: A mixed methods systematic review.

Elastic band resistance training in elderly individuals can improve physical fitness and promote mental health in addition to other benefits. This systematic review aimed to review, summarize, and evaluate quantitative, qualitative, and mixed methodological studies on the use of elastic band resistance training in elderly individuals, and to investigate the influence of elastic band resistance training on the physical and mental health of elderly individuals, as well as their preferences and obstacles in training. A convergent separation approach was used to synthesize and integrate the results, specifically the mixed systematic review approach recommended by the Joanna Briggs Institute. The extensive search strategy included electronic database searches in the Cochrane Library, PubMed, Embase, Web of Science, Google Scholar, MEDLINE, and CINAHL. The researchers rigorously screened the literature, extracted and analyzed the data, and evaluated the quality of the included studies using the Mixed Methods Appraisal Tool (MMAT). Twenty-eight studies were included, of which 25 were quantitative studies, 2 were qualitative studies, and 1 was a mixed-methods study. A total of 1,697 subjects were investigated across all studies. Quantitative evidence supports the notion that elastic band resistance training can improve upper and lower limb flexibility, endurance, upper strength, physical balance, and cardiopulmonary function and enhance the mental health of elderly individuals. Participants in the qualitative study reported some preferences and obstacles with band resistance training, but most participants reported physical benefits. Despite the heterogeneity between studies, this review is the first systematic review to comprehensively evaluate the effectiveness of elastic band resistance training in older adults. It not only shows the influence of elastic band resistance training on the physical and mental health of the elderly, but also emphasizes the preference and obstacles of elderly individuals face.

Translation competence between industry and academia in Saudi Arabia: job descriptions vs students’ perceptions

ABSTRACT Given the constant changes in the translation job market, translator training (TT) programmes need ongoing adaptation to continue training students to meet market requirements. This study aimed to explore the extent to which undergraduates of Arabic/English TT programmes in Saudi Arabia (SA) perceive their ability to help students acquire knowledge and skills related to translation (sub)competences required in the Saudi translation market. To this end, two empirical studies were designed using a convergent parallel mixed methods approach. The first analysed 91 translation-related job descriptions published in SA during 2020 to identify the knowledge and skills required in the market. The second analysed the perceptions of final-year students of the Saudi undergraduate Arabic/English TT programmes regarding the extent to which their programmes helped them acquire these skills. The findings indicate the need to explore why students perceived programmes as ‘not effective enough’, as well as the need to propose ways to develop them. This study will contribute to improving Saudi undergraduate TT programmes to provide highly qualified, competent translators to satisfy current Saudi translation market demands.

The Landscape of Health Technology for Equity Deserving Groups in Rural Communities: A Systematic Review.

Equity-deserving groups face well-known health disparities that are exacerbated by rural residence. Health technologies have shown promise in reducing disparities among these groups, but there has been no comprehensive evidence synthesis of outcomes. The purpose of this systematic review was to examine the patient, healthcare, and economic outcomes of health technology applications with rural living equity-deserving groups. The databases searched included Medline and Embase. Articles were assessed for bias using the McGill mixed methods appraisal tool. Data were synthesized narratively using a convergent integrated approach for qualitative and quantitative findings. This evidence synthesis includes papers (n = 21) that reported on health technologies targeting rural equity-deserving groups. Overall, patient outcomes - knowledge, self-efficacy, weight loss, and clinical indicators - improved. Healthcare access improved with greater convenience, flexibility, time and travel savings, though travel was still occasionally necessary. All studies reported satisfaction with health technologies. Technology challenges reported related to connectivity and infrastructure issues influencing appointment quality and modality options. While some studies reported additional costs, overall, studies indicated cost savings for patients. There is a paucity of research on health technologies targeting rural equity-deserving groups, and the available research has primarily focused on women. While current evidence was primarily of high quality, research is needed inclusive of equity-deserving groups and interventions co-designed with users that integrate culturally sensitive approaches. Review registered with Prospero ID = CRD42021285994.

Feasibility Verification and Upper Bound Computation in Global Minimization Using Approximate Active Index Sets

We propose a new upper bounding procedure for global minimization problems with continuous variables and possibly nonconvex inequality and equality constraints. Upper bounds are crucial for standard termination criteria of spatial branch-and-bound (SBB) algorithms to ensure that they can enclose globally minimal values sufficiently well. However, whereas for most lower bounding procedures from the literature, convergence on smaller boxes is established, this does not hold for several methods to compute upper bounds even though they often perform well in practice. In contrast, our emphasis is on the convergence. We present a new approach to verify the existence of feasible points on boxes, on which upper bounds can then be determined. To this end, we resort to existing convergent feasibility verification approaches for purely equality and box constrained problems. By considering carefully designed modifications of subproblems based on the approximation of active index sets, we enhance such methods to problems with additional inequality constraints. We prove that our new upper bounding procedure finds sufficiently good upper bounds so that termination of SBB algorithms is guaranteed after a finite number of iterations. Our theoretical findings are illustrated by computational results on a large number of standard test problems. These results show that compared with interval Newton methods from the literature, our proposed method is more successful in feasibility verification for both, a full SBB implementation (42 instead of 26 test problems) and exhaustive sequences of boxes around known feasible points (120 instead of 29 test problems). History: Accepted by Antonio Frangioni, Area Editor for Design & Analysis of Algorithms–Continuous. Supplemental Material: The software that supports the findings of this study is available within the paper and its Supplemental Information ( https://pubsonline.informs.org/doi/suppl/10.1287/ijoc.2023.0162 ) as well as from the IJOC GitHub software repository ( https://github.com/INFORMSJoC/2023.0162 ). The complete IJOC Software and Data Repository is available at https://informsjoc.github.io/ .

Quality of work life for health professions in Colombia’s adult critical care: An integrative analysis

BackgroundHealth professionals in Colombian and many parts of the world, in some cases, work in precarious conditions and intend to migrate to other countries in search of better living conditions for themselves and their families, which results in inadequate distribution worldwide and in the quality of care throughout the health system, which can ultimately influence the quality of life of patients in their health-disease processes.PurposeDescribe in depth what quality of life at work is like for the health workforce in adult critical care (ACC).MethodsThis is an investigation of convergent parallel mixed methods approach that are integrated by means of a matrix in terms of convergence, divergence, and complementarity. Two methods are used: a transversal analytical method in which three instruments were applied to 209 participants to study the relationship between Quality of Life at Work, exposure to psychosocial risks, compassion fatigue and the intention to rotate; other than from the experiences narrated by 10 Human Talent in Health explore organizational practices in critical care.ResultsThe dimension of quality of work life with the greatest dissatisfied was the management of free time (77%), the most compromised psychosocial risk was the pace of work (84%). They have high compassion satisfaction (67%) and there is an intention to migrate to another country (66%). The narrative results in discrimination/harassment as normalized practices and faceless spirituality. The integration of mixed methods shows convergence between the use of the instrument that measures quality of life at work and the narratives of the participants, complementarity with the other instruments, and divergence regarding the intention to rotate to another health institution.ConclusionThe positive trend that converges with the two approaches is that of safety at work and well-being achieved through work, embodied in the constant updating of technology and care protocols, experience time, balance between salary and work effort, staffing and supplies, and disconnection with work.

Does the education system matter? Exploring in-depth joint school attendance, hazardous and non-hazardous activities in artisanal and small-scale mining in the Democratic Republic of the Congo

PurposeThis paper explores the deconstruction of child labour in artisanal and small-scale mining (ASM) sites, highlighting different perspectives. Despite the economic benefits to the Democratic Republic of the Congo (DRC), ASM poses challenges, particularly where children are concerned. Methodology: Our study uses a convergent parallel mixed methods approach to interpret qualitative and qualitative data based on the conceptual framework of human capital. Trivariate probit and Tobit models were used for quantitative data and content analysis was employed for qualitative data. We collected primary data by interviewing children involved in artisanal mining activities. Interviews were conducted with consent from the children and their parents or guardians. We adopt snowball sampling due to the lack of a database. The Centre of Expertise on Mining Governance (CEGEMI) developed the data collection instruments in collaboration with Inner City Fund (ICF) International and validated by the United States Department of Labour. FindingsWe found that limited access to education leads to decreased school attendance rates among children, pushing them towards engaging in hazardous and non-hazardous economic activities within the DRC's mining areas. Moreover, excessive working hours negatively impact children's academic performance. Consequently, there is a trade-off between attending school and engaging in child labour at ASM sites in the DRC. LimitationsThis study did not consider domestic activities carried out by children. This could give even more detailed results. Public policy implicationsGovernments and partners must prioritise creating a comprehensive list of hazardous activities for children in the ASM context. Careful conceptualisation is necessary to ensure the clarity and effectiveness of this list. Raising awareness about the merits of removing children from activities related to mining is important for households living in and around ASM sites. Interventions aiming to reduce child labour and increase school attendance in ASM zones must remain mindful of the socio-economic and school infrastructure needs.

Effect of interventions to improve safety culture on healthcare workers in hospital settings: a systematic review of the international literature

BackgroundIn an era of safety systems, hospital interventions to build a culture of safety deliver organisational learning methodologies for staff. Their benefits to hospital staff are unknown. We examined the...

PERSEPSI PEMERINTAH DAN MASYARAKAT DALAM PELESTARIAN CAGAR BUDAYA: STUDI KASUS KAWASAN CAGAR BUDAYA PUSAT PEMERINTAHAN KESULTANAN SIAK SRI INDRAPURA

This study discusses the interpretation of the importance of government versus community in the preservation and potential use of the Siak Sri Indrapura Cultural Heritage Area. Efforts for preservation in accordance with the law are not easy, since in practice various problems arise, especially those related to their use. The purpose of this study is to combine the interpretation of important values of government and society in the preservation of cultural heritage areas and their potential use by taking into account socio-cultural and economic values. This study was designed using a convergent qualitative and quantitative approach (convergent mixed methods approach), where data collected through qualitative and quantitative approaches are analyzed separately, then the results of the analysis are compared whether the findings of the data in the form of mutual information become normalized, or vice versa do not normalize each other. The result of study found the need for community participation in compiling significant values and the similarity between government interpretation and public perception in aspects of sosio-cultural and economic values.

Parameters for selecting biological features in multifunctional bio-inspired design: a convergent evolution approach

Combining different biological features exhibiting different functions is necessary to generate uncommon and unique multifunctional bio-inspired conceptual designs. Different biological features independently evolve characteristics to solve the same need/necessity. This phenomenon is called convergent evolution. Without parameters, selecting a suitable feature from those that exhibit the same function and have the same geometric relevance becomes quite difficult. This research investigates and identifies the parameters that have the potential to support choosing the suitable biological feature and to support the multifunctional design concept generation. In this paper, parameters are hypothesized by studying the mechanisms of tissue formation responsible for generating structural features in a biological system. These parameters are used in the Expandable Domain Integrated Design ideation model to aid designers in choosing and combining suitable biological features for multifunctional concepts. A case study is presented to validate the effectiveness of the parameters in the selection process.

Resilience Development of Swiss Adolescents: A Convergent Mixed-Methods Approach

Introduction: We applied a convergent mixed-methods research design, focusing on data from Swiss students to identify patterns of resilience development in high school. Method: The study consisted of an online longitudinal survey conducted in two waves, in autumn 2019 (n = 377 grade seven) and spring 2021 (n = 257 grade eight). By combining latent transition analysis (LTA), a person-oriented quantitative method, and qualitative content analysis, we detected four resilience patterns. Results: The longitudinal survey revealed a decrease in the “blooming” pattern (students who displayed high levels of individual and social support indicators as well as satisfaction with their grades and academic success measures) over time and, on the other hand, an increase in the “challenged” pattern, suggesting larger numbers of students with low levels of social support and academic success. Additionally, qualitative interviews were conducted with four students from the sample. These interviews provided insights into the stressors; coping experiences, skills, processes, and resources; and outcomes related to resilience. Discussion: The analysis revealed key factors contributing to resilience, including empowering experiences, supportive individuals, self-help as a prioritized resource, and a positive school environment. Merging the data has elicited various claims such as improving both home and school environments, along with focusing on elaborating their interplay, is the most efficacious approach to bolstering resilience.

A mixed methods evaluation of the impact of ECHO® telementoring model for capacity building of community health workers in India

IntroductionIndia has the largest cohort of community health workers with one million Accredited Social Health Activists (ASHAs). ASHAs play vital role in providing health education and promoting accessible health care services in the community. Despite their potential to improve the health status of people, they remain largely underutilized because of their limited knowledge and skills. Considering this gap, Extension for Community Healthcare Outcomes (ECHO)® India, in collaboration with the National Health System Resource Centre (NHSRC), implemented a 15-h (over 6 months) refresher training for ASHAs using a telementoring interface. The present study intends to assess the impact of the training program for improving the knowledge and skills of ASHA workers.MethodsWe conducted a pre–post quasi-experimental study using a convergent parallel mixed-method approach. The quantitative survey (n = 490) assessed learning competence, performance, and satisfaction of the ASHAs. In addition to the above, in-depth interviews with ASHAs (n = 12) and key informant interviews with other stakeholders (n = 9) examined the experience and practical applications of the training. Inferences from the quantitative and qualitative approaches were integrated during the reporting stage and presented using an adapted Moore’s Expanded Outcomes Framework.ResultsThere was a statistically significant improvement in learning (p = 0.038) and competence (p = 0.01) after attending the training. Participants were satisfied with the opportunity provided by the teleECHO™ sessions to upgrade their knowledge. However, internet connectivity, duration and number of participants in the sessions were identified as areas that needed improvement for future training programs. An improvement in confidence to communicate more effectively with the community was reported. Positive changes in the attitudes of ASHAs towards patient and community members were also reported after attending the training. The peer-to-peer learning through case-based discussion approach helped ensure that the training was relevant to the needs and work of the ASHAs.ConclusionsThe ECHO Model ™ was found effective in improving and updating the knowledge and skills of ASHAs across different geographies in India. Efforts directed towards knowledge upgradation of ASHAs are crucial for strengthening the health system at the community level. The findings of this study can be used to guide future training programs.Trial registration The study has been registered at the Clinical Trials Registry, India (CTRI/2021/10/037189) dated 08/10/2021.

Methodology for forming a digital farming management system

The paper presents methodological approaches for the creation of a digital farming management system (DFMS). A convergent approach, based on cognitive (conceptual) analysis methods, is employed in the research and applied to the formation of adaptive landscape farming systems. The fundamental principles of organizing DFMS include crop and environmental monitoring (in situ, remote sensing); the formation of farming system archetypes based on the analysis of long-term field experiments; spatial object modeling and land typology using GIS; planning and support for agrotechnologies to adapt to natural and economic conditions; modeling ecosystem services and biodiversity; assessing the impact on the sustainability and economics of crop production. The system is implemented using geoinformation models in a specific geographic coordinate. DFMS involves conducting a "inventory" of natural and production resources, as well as identifying limits of climatic, soil, and agrolandscape parameters at different levels of land use intensity. At each stage of organizing system blocks, methods of intelligent data analysis and machine learning are used, with the core of the system relying on the use of knowledge bases and logical rules of the subject area. A key element of the system is the scaling of the results of long-term field experiments and accumulated knowledge in different management areas based on the parameterization of the multi-level variability of farming systems and the formation of their archetypes. The practical implementation of the main provisions of DFMS allows approaching the solution of key issues related to reducing the level of uncertainty and associated risks in agriculture. This is achieved through scientifically justified organization of rational land use, increasing the resilience of crop production in different land use conditions, and providing information support to rural producers.

Young Adults’ Essential Food Skills and Cooking Perceptions: A mixed method study

Our purpose in this research study was to examine perceptions of food and nutrition educators (FNEs, i.e., Registered Dietitians Nutritionists and Family and Consumer Science teachers) and young adults (ages 18–25) on the status of cooking and food skills among young adults. Using a cross-sectional survey design, FNEs (<em>n</em> = 93) and college-attending young adults (<em>n</em> = 270) in the United States completed electronic surveys. The qualitative and quantitative data were collected and analyzed using a convergent mixed-methods approach. The qualitative data from open-ended survey responses collected from young adults and FNEs were analyzed using <em>coding reliability thematic analysis</em>. The quantitative data used Fisher’s Exact Test to compare the importance of food skills between FNEs and young adults. In the quantitative data, young adults and FNE reported the top five food skills essential for young adults with slight variations between the two groups. For young adults, “cooking meat and poultry” was their top skill while FNEs chose “reading and following a recipe” as the top food skill. Three themes were constructed through coding reliability thematic analysis: (1) definition of cooking, (2) perceptions of the purpose of cooking, and (3) young adults’ autonomy in cooking. We concluded that young adults understood the benefits of cooking and eating healthily, but many felt overwhelmed by it. While educational food skill interventions should focus on foundational skills, cooking should be taught with consideration of young adults in mind (e.g., time and money limitations) to make the skills practical and enduring.

Genome-wide association analyses identify 95 risk loci and provide insights into the neurobiology of post-traumatic stress disorder.

Post-traumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 new). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (for example, GRIA1, GRM8 and CACNA1E), developmental, axon guidance and transcription factors (for example, FOXP2, EFNA5 and DCC), synaptic structure and function genes (for example, PCLO, NCAM1 and PDE4B) and endocrine or immune regulators (for example, ESR1, TRAF3 and TANK). Additional top genes influence stress, immune, fear and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation.

Lactation support in neonatal intensive care units in Germany from the mothers’ perspective – a mixed-method study of the current status and needs

BackgroundEstablishing successful lactation in mothers of very low birth weight (VLBW, <1500g) infants requires structured lactation support. Little is known about mothers’ perspectives on lactation support in German neonatal intensive care units (NICUs).MethodsThis paper features a convergent mixed-method approach that includes a retrospective, cross-sectional questionnaire and interview data to showcase mothers’ perceptions of lactation support in NICUs. Content analysis of the interviews (n = 12) and a descriptive analysis of quantitative data (n = 533) were performed to illustrate the current status and need for lactation support in German NICUs.ResultsThe results show that lactation support in German NICUs is often inadequate and does not comply with recommendations based on the existing literature to encourage pumping and breastfeeding in mothers. The data imply that even if lactation is successfully initiated in most cases, it is often not maintained over time, which may be due to a lack of personal support and consistent information.ConclusionThe overall structures and institutional guidelines for lactation support should be encouraged to promote nutrition with mother´s own milk in German NICUs.

Occupational exposures among women beedi workers in Mysore District, India: A mixed-methods study protocol.

Beedi is the most common smoking form of tobacco used in India. The rolling of beedis is performed primarily by women in settings that lack occupational safeguards. The aims of this protocol are to establish methods for the study of occupational exposures among women beedi workers and their experiences and challenges working with unburnt tobacco. This protocol employs a convergent parallel mixed-methods approach. Qualitatively, we plan to explore the experiences and challenges faced by women beedi workers using photovoice, a community based participatory method. Occupational exposures to pesticides will be assessed through the use of silicone wristbands worn for seven days by workers, and exposure to toxic metals and metalloids will be assessed in dust samples collected in the homes of workers. The outcomes will be analyzed to form policy recommendations to improve the occupational health of women beedi workers.