Convergent Mixed Methods Approach Research Articles

Evaluation of daily environmental cleaning and disinfection practices in veterans affairs acute and long-term care facilities: A mixed methods study

To describe daily environmental cleaning and disinfection practices and their associations with cleaning rates while exploring contextual factors experienced by healthcare workers involved in the cleaning process. A convergent mixed methods approach using quantitative observations (ie, direct observation of environmental service staff performing environmental cleaning using a standardized observation form) and qualitative interviews (ie, semistructured interviews of key healthcare workers) across 3 Veterans Affairs acute and long-term care facilities. Between December 2018 and May 2019 a total of sixty-two room observations (N=3602 surfaces) were conducted. The average observed surface cleaning rate during daily cleaning in patient rooms was 33.6% for all environmental surfaces and 60.0% for high-touch surfaces (HTS). Higher cleaning rates were observed with bathroom surfaces (Odds Ratio OR=3.23), HTSs (OR=1.57), and reusable medical equipment (RME) (OR=1.40). Lower cleaning rates were observed when cleaning semiprivate rooms (OR=0.71) and rooms in AC (OR=0.56). In analysis stratified by patient presence (ie, present, or absent) in the room during cleaning, patient absence was associated with higher cleaning rates for HTSs (OR=1.71). In addition, the odds that bathroom surfaces being cleaned more frequently than bedroom surfaces decreased (OR=1.97) as well as the odds that private rooms being cleaned more frequently than semi-private rooms also decreased (OR=0.26; 0.07-0.93). Between January and June 2019 eighteen qualitative interviews were conducted and found key themes (ie, patient presence and semiprivate rooms) as potential barriers to cleaning; this supports findings from the quantitative analysis. Overall observed rates of daily cleaning of environmental surfaces in both acute and long-term care was low. Standardized environmental cleaning practices to address known barriers, specifically cleaning practices when patients are present in rooms and semi-private rooms are needed to achieve improvements in cleaning rates.

Medical Students' Socialization Tactics When Entering a New Clinical Clerkship: A Mixed Methods Study of Proactivity.

PurposeSocialization into clinical clerkships is difficult in part due to ambiguity around students’ new roles and expected behaviors. Being proactive reduces ambiguity and is essential to socialization. Proactive behavior can be taught and goes beyond having a proactive personality. Among students entering new undergraduate clinical clerkships, this study aimed to investigate (1) reported proactive behaviors and their association with social integration and (2) enabling and inhibiting factors for proactive behavior.MethodThis study was conducted at the 5-year MBBS program at Western Sydney University during academic year 2019–2020. Using a convergent mixed methods approach, survey and interview data from third-, fourth-, and fifth-year students were collected. Surveys explored 5 proactive behaviors: feedback seeking, information seeking, task negotiation, positive framing, and relationship building. Interviews elicited descriptions of how students described their proactivity and what influenced students to be proactive when entering a new clerkship. Data were integrated using the following the thread and mixed methods matrix techniques.ResultsStudents exhibited all 5 proactive behaviors. Survey data showed positive framing and task negotiation had the highest and lowest scores, respectively. Only positive framing correlated significantly with social integration scores (r = 0.27; P < .01), but this contrasted to interviews, in which students described how other proactive behaviors also led to social integration. Proactive behavior scores decreased across academic years. Integrated data showed 3 linked antecedents to whether students exhibited proactive behavior: feeling capable of being proactive, individual intention to be proactive, and the immediate environment and system-level factors.ConclusionsStudents who framed the experience positively were more likely to report increased social integration. Initiating task negotiation was challenging for most students. The authors propose a conceptual model for proactivity and social integration to support socialization and learning during clinical transitions for future research and interventional design.

Healthcare workers use of psychological support resources during COVID-19; a mixed methods approach utilising Pillar Integration Analysis.

ObjectivesWe sought to examine healthcare workers (HCWs) utilisation of formal and informal psychological support resources in the workplace during the first and third waves of the COVID-19 pandemic in Ireland.MethodsA convergent mixed methods approach was undertaken. Four hundred and thirty HCWs in the Mid West and South of Ireland responded to an online survey in terms of their use of psychological support resources during Wave 1 (April/May 2020) of COVID-19. Thirty-nine HCWs undertook in depth interviews at Wave 3 (January/February 2021), and a further quantitative survey was distributed and completed by 278 HCWs at this time. Quantitative data arising at Wave 1 and Wave 3, were synthesised with Qualitative data collected at Wave 3. A Pillar Integration Process (PIP) was utilised in the analysis of the quantitative and qualitative data.ResultsFive pillars were identified from the integration of results. These were: a) the primacy of peer support, b) the importance of psychologically informed management, c) a need to develop the organisational well-being ethos, d) support for all HCWs, and e) HCWs ideas for developing the well-being path. These pillars encapsulated a strong emphasis on collegial support, an emphasis on the need to support managers, a questioning of the current supports provided within the healthcare organisations and critical reflections on what HCWs viewed as most helpful for their future support needs.ConclusionsHCWs who utilised supportive resources indicated ‘in house’ supports, primarily collegial resources, were the most frequently used and perceived as most helpful. While formal psychological supports were important, the mechanism by which such psychological support is made available, through utilising peer support structures and moving towards psychologically informed supervisors and workplaces is likely to be more sustainable and perceived more positively by HCWs.

Why do people avoid and postpone the use of voice assistants for transactional purposes? A perspective from decision avoidance theory

Consumers increasingly adopt artificial intelligence (AI) enabled voice assistants (VAs) for transactional and non-transactional uses due to these devices’ inherent affordances, such as their ease of use and convenience. Despite the widespread adoption of VAs in recent times, consumers continue to avoid using VAs for transactional purposes. Currently, we have a limited understanding of the various antecedents and consequences of consumer decision avoidance in the context of VAs. This study aims to bridge this gap by adopting the decision avoidance theory as a theoretical lens and a convergent mixed-methods approach to identify the antecedents (i.e. cognitive biases and nudging) and consequences (i.e. rejection of VAs for transactional purposes and intention to adopt VAs for transactional purposes) of consumer decision avoidance (i.e. consumer inertia and procrastination). The study findings suggest a positive association of cognitive biases with consumer inertia, procrastination and rejection. While nudging is positively associated with procrastination and intentions, it shares a negative association with rejection. Consumer inertia is positively associated with rejection and negatively associated with intentions. Meanwhile, procrastination shares a positive association with intention and a negative association with rejection. Technology comfort has a significant moderating (negative) influence on the association between cognitive biases and intentions.

A mixed-methods exploration of virtual reality as a tool to promote green exercise

The salutogenic effects of green exercise are widely recognised, yet many individuals do not engage in this health-related behaviour. Using a convergent mixed methods approach, this study explored the impact of experiencing nature through Virtual Reality (VR) on the decision-making process relating to green exercise. Three experimental trials were conducted (overall n = 136), in which healthy adults were exposed to different VR scenarios reproducing a virtual walk in an existing urban green area. Participants reported medium–high rating of intent to visit the location. Significant pre-to-post increments in future green exercise intention were observed after the VR exposure, though a significance difference was not achieved in comparison with a control condition. Qualitative analysis revealed the impact of the VR experience on behaviour regulation, and highlighted the pivotal role of anticipated emotional benefits. Despite scepticism, the VR experience was effective in arousing curiosity to explore natural environments, which was associated with environmental perceptions as well as nostalgic and socio-cultural perspectives.

Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care \u2013 a mixed-method study on patient perspectives

BackgroundProcess evaluations are useful in clarifying results obtained from randomised controlled trials (RCTs). Traditionally, the degree of intervention usage in process evaluations is monitored by measuring dose or evaluating implementation fidelity. From a person-centred perspective, such evaluations should be supplemented with patients’ experiences of meaningful use, given that intervention use should be agreed upon between interested parties and tailored to each patient. This study aimed to elucidate patients’ experiences of a remote person-centred care (PCC) intervention by deepening the understanding of, if, how and for whom the intervention contributed to meaningful use.MethodsPatients (n = 86) were recruited from the RCT PROTECT intervention group. A convergent mixed-method approach was implemented. Data were collected in parallel with the ongoing RCT via a survey, including ratings and written comments on meaningful or non-meaningful use. Also, interviews were performed with twelve purposefully selected participants. Descriptive statistics, logistic regression and content analysis were employed. Data sources were integrated in the results.ResultsMost participants rated the overall intervention as meaningful to use, with the telephone support rated as most meaningful. Interviews and written comments showed that patient ratings on meaningful use were explained by four categories: Not in need, Communication deficiency, Benefits in everyday life and A personal boost. Meaningful use of rating symptoms on the digital platform was predicted by living alone (adjusted odds ratio [aOR] = 2.8 P = .044). A diagnosis of chronic obstructive pulmonary disease (COPD) predicted meaningful use of digital platform direct messaging (aOR = 3.5, P = .045). Moreover, having access to direct-dial telephone contact explained meaningful use among participants with low ratings of technical competence (aOR = 3.6, P = .014).ConclusionsThe combined digital platform and structured telephone support could be helpful in identifying preventive actions to maintain health for people diagnosed with COPD and chronic heart failure but tends to be more meaningful for those diagnosed with COPD. Overall, lower adoption of the digital platform was seen compared to telephone support. Shortcomings were noted in the digital platform’s implementation that negatively influences experiences of meaningful use. When used, the intervention proved to be an easily applicable and valued tool to support preventive actions in a person-centred manner.

Pain Management for Older Adults Living with Dementia: Perspectives from African American Family Caregivers

African American older adults living with dementia are at increased risk for under-assessed and under-treated pain. This risk is even greater for those of lower socioeconomic status. The purpose of this study is to characterize family caregivers’ perspectives on pain assessment and management in the context of advance care planning for their loved one living with dementia. A convergent mixed methods approach will be used to gather descriptive, cross-sectional data within a community-based participatory design process with the impetus to develop targeted interventions.

Delays in Cryptococcal Meningitis Diagnosis and Care: A Mixed Methods Study in Rural Uganda.

Background:Cryptococcal meningitis (CM) remains a major cause of mortality for HIV-infected persons in sub-Saharan Africa, despite widespread access to antiretroviral therapy. Delays in CM diagnosis and treatment contribute to high mortality, with patients often arriving “too late” for treatment to be effective. Little is known about patient-related delays and their experiences with CM.Objectives:This study seeks to identify the factors related to delays in diagnosis and care among patients with cryptococcal meningitis.Methods:A convergent mixed-methods approach was used to understand delays related to diagnosis and treatment of CM among patients admitted to Lira Regional Referral Hospital in rural northern Uganda. We collected data from February to March 2020 using surveys followed by semi-structured interviews from 20 CM patients who survived hospitalization and 20 family members of deceased patients during February 2017–November 2019. Interviews were audio-recorded, transcribed, and thematically coded for analysis.Findings:Delays to CM care were related to 1) self-medication, 2) lack of CM education, 3) seeking treatment multiple times at health centers with 4) missed/misdiagnosis, and 5) cultural factors. Among patients who died, 70% sought care ≥3 times, while those who survived, 35% of sought care ≥3 times before CM diagnosis. Only 10% of patients and 40% of family members knew what caused CM, indicating a lack of knowledge.Conclusions:Patients sought medical care for CM symptoms, but several factors contributed to CM diagnosis and care delays. Many of these factors relate to a lack of CM education and knowledge among patients and providers. A CM awareness campaign for the general public, targeted education for HIV patients, and continuing medical education for healthcare providers can decrease delays and improve outcomes.

Postpartum Depressive Symptoms and Experiences During COVID-19.

Purpose:To identify postpartum depression risk and describe experiences of women in the first 6 weeks after giving birth during the COVID-19 pandemic.Study Design and Methods:Using a convergent mixed-methods approach, we recruited a convenience sample of women living in the United States who gave birth March 1, 2020 or later from social media Web sites. Participants completed the Postpartum Depression Screening Scale-Short Form and provided written answers to open-ended questions regarding their experiences at home with their new infant.Results:Our 262 participants were on average 32.6 years of age, the majority were White (82%), married or partnered (91.9%), and college educated (87.4%). Mean postpartum depression score was 17.7 (SD = 5.9) with 75% scoring ≥14, indicating significant postpartum depressive symptoms. Qualitative content analysis revealed five themes: Isolation and seclusion continue; Fear, anxiety, and stress filled the days; Grieving the loss of normal: It's just so sad; Complicated by postpartum depression: A dark time; and There is a silver lining. Quantitative and qualitative findings provided a holistic view of women's depressive symptoms and experiences at home with their infants during the COVID-19 pandemic.Clinical Implications:Although policies that reduce risk of COVID-19 exposure and infection for patients and the health care team must continue to be implemented, the adverse effects of depressive symptoms on maternal–infant wellbeing within the context of increased isolation due to the pandemic need to be kept at the forefront. Nurses need to be aware of the consequences of women sheltering in place and social distancing on maternal–infant outcomes, particularly on depression and likelihood of breastfeeding.

The impact of the acoustic environment on human emotion and experience: A case study of worship spaces

People’s interactions with the environment shape their experiences. Thus, understanding these interactions is critical to enhancing human well-being. Aural attributes play a significant role in shaping the perception of space in addition to visual attributes. It is well known that sounds evoke an emotional response, but less is known about how the acoustic characteristics of environments reinforce such an emotional impact. By adopting virtual reality as a platform for recreating 3D sounds and 360° visuals of built environments of worship spaces as case studies, this study aims to investigate the influence of the acoustic environment considering audiovisual congruency on enhancing the human experience through self-report and physiological response analysis. It also examines the role of cultural background in terms of familiarity with the acoustic environment. The convergent mixed-methods approach, merging both quantitative and qualitative analysis, provides a deep understanding of the role of the acoustic environment in enhancing the auditory experience. The results show that the acoustic environment and audiovisual congruency amplify the intensity of the emotional impact, and the amplification of the impact can vary depending on the acoustic environment of the building. They also reveal that familiarity with sound and acoustic characteristics can increase this impact.

Interviewing preschool children in Greece about their usage of mobile devices at home

The time children spend with mobile devices has increased in recent years. Preschoolers’ home usage of mobile devices has mainly been investigated through parents’ perceptions. Listening to the children’s voices can help us understand this matter more directly. Therefore, in this study, a convergent mixed methods approach was employed to help us investigate the home usage of mobile devices by young children, focusing on children’s comments. The participants were 55 Greek children aged 4–6, attending two public kindergartens in Patras. Children described in detail their activities on mobile devices, through semi-structured interviews. The results indicated that the most popular activity for the children was playing digital games. The children were able to demonstrate and describe activities for educational purposes (letters, numbers, digital puzzles, documentaries, etc.) during the home usage of mobile devices. The circumstances in which they are allowed to use their mobile devices is when their parents want to keep them calm during quiet hours or in public places. Implications for introducing mobile learning activities in Greek education are discussed.

Explicit vocabulary instruction for fifth graders’ vocabulary knowledge and reading comprehension: An action research study

This action research aimed to evaluate the impact that explicit vocabulary instruction delivered through Schoology had on the vocabulary knowledge and reading comprehension of fifth graders at an urban elementary school in the southeastern United States. A convergent mixed-method approach was applied. The vocabulary and reading comprehension scores and the learner experience survey accounted for the quantitative data. Furthermore, qualitative data gathered from semi-structured interviews were analyzed inductively. Findings show that students' vocabulary knowledge and reading comprehension significantly increased after receiving explicit vocabulary instruction, and results marked instruction regarding Latin and Greek roots as areas needing attention. For elementary educators, the study's practical implications highlight the importance of teaching explicit vocabulary strategies, including morphology and context clues, to students.

The Role of Non-Governmental Organisations (NGOs) in Community-based Mental Health Services in Northern Nigeria: Prospects and Challenges

Despite the role of non-governmental organisations (NGOs) in many health issues, their role in community mental health services in parts of northern Nigeria is unknown. This study explored the availability and role of NGOs in community-mental health care services, with a view to identifying the prospects and challenges. Using the convergent mixed methods approach, a self-constructed questionnaire and in-depth interviews were used to collect data from 205 conveniently and purposively selected study participants. Descriptive and thematic analyses were done and then triangulated to meet research objectives. There is a scarcity of mental health-related NGOs in the study areas; only one NGO engaged in the mental health activities was identified (13.4%). Surprisingly attempts by the only available NGO at providing the needed community-based mental health care were “frustrated” by certain government policy directions, which appear to paralyse activities and intentions of the only existing one. NGOs for mental health care are lacking. There is a dire need for NGO activities in mental health care. Efforts should be made to attract NGOs to the study areas in view of the increasing burden of mental health issues in the communities in the setting. Governments at all levels, community-based organisations and traditional institutions can be instrumental to this. NGOs within and outside the study areas focusing on community health in general and mental health care, in particular, may also interrogate this situation further for urgent intervention.

An Exploration of Gender Bias Affecting Women in Medicine.

Women in medicine face barriers that hinder progress toward top leadership roles, and the industry remains plagued by the grand challenge of gender inequality. The purpose of this study was to explore how subtle and overt gender biases affect women physicians, physician leaders, researchers, and faculty working in academic health sciences environments and to further examine the association of these biases with workplace satisfaction. The study used a convergent mixed methods approach. Sampling from a list of medical schools in the United States, in conjunction with a list of each state's medical society, the authors analyzed the quantitative survey responses of 293 women in medicine. The authors conducted ordinary least squares multiple regression to assess the relationship of gender barriers on workplace satisfaction. Additionally, 132 of the 293 participants provided written open-ended responses that were explored using a qualitative content analysis methodology. The survey results showed that male culture, lack of sponsorship, lack of mentoring, and queen bee syndrome were associated with lower workplace satisfaction. The qualitative results provided illustrations of how participants experienced these biases. These results emphasize the obstacles that women face and highlight the detrimental nature of gender bias in medicine. The authors conclude by presenting concrete recommendations for managers endeavoring to improve the culture of gender equity and inclusivity.

“Slowed for several months”: A mixed methods comparison of minor, moderate, and extreme speeders

Speeding remains a major and consistent contributor to motor vehicle fatalities in the U.S. Using a parallel convergent mixed methods approach, we compared minor, moderate, and extreme U.S. speeder types (N = 293) to gain a better understanding of why U.S. drivers speed to the degree that they do. An online survey collected quantitative data on self-reported characteristics, speeding behaviors, and roadway behaviors after key events (collisions, speeding tickets) and given passenger presence. Analysis of qualitative data from participants explaining their roadway behaviors and beliefs identified several speeding-related themes. Themes shared to the same extent by all speeder types include not typically citing speeding a cause of a collision and good drivers not needing to change speeding behaviors (i.e., perceived mastery). However, the permanence and extent of speed reductions after key events and with passengers did vary by speeder type, with minor speeders making more extensive and permanent changes. Qualitative and quantitative data both underscore the perception that speeding is not a high priority threat to roadway safety. Findings suggest continued research using conservative and nuanced definitions of speeding is warranted to understand how similar perceptions result in a spectrum of speeding behaviors.

Abstract 10933: Informal Caregivers’ Burden and Its Predictors in Heart Failure: A Mixed Methods Study

Introduction: Caring for relatives with heart failure is emotionally and physically intensive for informal caregivers leading to caregiver burden. Evidence also suggests that caregiver burden affects the quality of life of both components of the patient-caregiver dyad. Previous research provides a limited understanding of the nature of caregiver burden and its influencing factors from a dyadic perspective. Hypothesis: To develop a comprehensive understanding of caregiver burden, and to identify its predictors with a dyadic perspective Methods: A convergent mixed-method approach was used. In total, 184 patients with heart failure and their informal caregivers completed validated scales to measure burden, care dependency, quality of life, and social support and 50 caregivers participated also to a semi-structured interviews to better understand the caregiver experience. Multiple regression analysis was conducted to identify the predictors and qualitative content analysis was performed on qualitative data. The results were merged using joint displays. Results: Caregiver burden was predicted by patient worse cognitive impairment, lower physical quality of life, and a higher care dependency perceived by the caregivers. Qualitative and mixed analysis demonstrated that caregiver burden has a physical, emotional, and social nature. In particular time constraints, anticipated concerns about personal future, and generalized fatigue and exhaustion were significant predictors of caregiver burden, thereby affecting their caregiving. Conclusions: Caregiver burden can affect the capability of informal caregivers to support and care for their relatives with heart failure. There is a dire need for development and evaluation of individual and community-based strategies to address caregiver burden so as to enhance the quality of life of both caregivers and their relatives with heart failure.

Science communication skills as an asset across disciplines: A 10-year case study of students' motivation patterns at Université Laval.

As the demand for science communication proficiency is growing and post-secondary science communication courses and programs are launched or redesigned, it is paramount to understand who takes these courses and why. Based on a convergent mixed methods approach, this article explores the characteristics and self-reported motivations of students enrolled in an online science communication course at Université Laval, Canada, from 2009 to 2018. Results show that the typical science communication student is a woman with a career-orientated motivation pattern, mostly seeing science communication skills as an asset for a career in communication, science, or health. Be it career-driven, interest-driven, or online education-driven, motivation pattern differences emerge depending on the students’ gender or field of study. Those patterns offer new paths of research, such as exploring the impact of science communication program design or of advertising strategies on enrollment.

Inequity in water distribution and quality: A study of mid‐hill town of Nepal

AbstractHimalayan cities are highly vulnerable to climate change and increasingly exposed to water insecurity. Given the complexities of water usage within society, developing, allocating, and managing water resources equitably is a serious emerging challenge. This paper adopts a convergent mixed method approach to explore water inequity issues in water distribution and water quality among the core and peripheral wards of Dhulikhel, a mid‐hill town of Nepal. In doing so, the paper analyzes the determinants of inequitable water distribution in core and periphery wards, perception of water quality, and underlying causes of inequity in water quality in core and peripheral wards. The paper found that various socioeconomic, environmental, technological, and governance‐related factors are causing inequity in water distribution. Our analysis showed that climate change is adding on top of these existing challenges, exacerbating inequity in access to water. This paper also found that while core wards benefit from donor schemes that ensure good water quality, the peripheral wards do not enjoy the reach of such schemes, and given climate change impacts on rainfall patterns, seasonal availability of water is likely to be unpredictable in the future.

Feasibility of a two-part person-centred care initiative for people living with dementia in acute hospitals: A mixed methods study.

The personal profile offers a potentially useful tool to support person-centred care of people living with dementia in hospital. To date, how profiles can be implemented into nurses' work practices is not established. The aim is to establish the feasibility of a Person-Centred Care package, including a personal profile and staff education program to enhance implementation. Exploratory convergent mixed methods approach. Four units of a tertiary health service, two intervention units and two comparison units set in southeast Queensland, Australia. Person living with dementia and family carer dyads and staff. Practicality was determined using participation logs, audit and review of meeting minutes. Acceptability was determined using interviews with family carers and nursing staff. Efficacy was evaluated using pre-post comparison survey design, assessing staff knowledge using the Dementia Knowledge Assessment Scale and person-centred care using the Person-centredness of Older People with cognitive impairment in Acute Care-revised scale. Practically, the personal profile was distributed to 95 and 73% of patients in the two intervention units. Of the 18 people living with dementia who consented to participate, only 6 (33%) had a This is Me form completed. The three-part education program was well attended (n=190 participants). In terms of acceptability, carers' (n=5) experienced variable quality of engagement from nurses. In interviews, nurses (n=18) experienced increased confidence to engage carers, in part attributed to local leadership, but attitudes towards care appeared to be influenced by perceived time constraints. For efficacy, completion of both surveys at all time points and in all units was 50% and higher. Dementia knowledge significantly improved in the intervention group (p<.01) however there was no difference in self-ratings of person-centred care. The feasibility of a Person-Centred Care package, including a personal profile and a focused program of staff education was partially achieved, with the education component adopted into the organisation's continuing education program. Implementation research is required to enhance the element of coherence, how completing the personal profile is an investment in person-centred care rather than simply completing another form.

Benchmarking for accountability on obesity prevention: evaluation of the Healthy Food Environment Policy Index (Food-EPI) in Australia (2016-2020).

Despite broad agreement on the need for comprehensive policy action to improve the healthiness of food environments, implementation of recommended policies has been slow and fragmented. Benchmarking is increasingly being used to strengthen accountability for action. However, there have been few evaluations of benchmarking and accountability initiatives to understand their contribution to policy change. This study aimed to evaluate the impact of the Healthy Food Environment Policy Index (Food-EPI) Australia initiative (2016-2020) that assessed Australian governments on their progress in implementing recommended policies for improving food environments. A convergent mixed methods approach was employed incorporating data from online surveys (conducted in 2017 and 2020) and in-depth semi-structured interviews (conducted in 2020). Data were analysed against a pre-defined logic model. Australia. Interviews: twenty stakeholders (sixteen government, four non-government). Online surveys: fifty-three non-government stakeholders (52 % response rate) in 2017; thirty-four non-government stakeholders (36 % response rate) in 2020. The Food-EPI process involved extensive engagement with government officials and the broader public health community across Australia. Food-EPI Australia was found to support policy processes, including as a tool to increase knowledge of good practice, as a process for collaboration and as an authoritative reference to support policy decisions and advocacy strategies. Key stakeholders involved in the Food-EPI Australia process viewed it as a valuable initiative that should be repeated to maximise its value as an accountability mechanism. The highly collaborative nature of the initiative was seen as a key strength that could inform design of other benchmarking processes.