Convergent Parallel Mixed Methods Approach Research Articles

Feasibility of Group Telerehabilitation for Older Adults: A Quality Improvement Project

A growing body of evidence suggests group rehabilitation may empower patients to achieve functional goals by leveraging social connectivity. From previous work, we adapted an in-person group for older Veterans to a telerehabilitation group called Fit for Life. The current quality improvement project aimed to evaluate the feasibility of implementing Fit for Life. Eligible Veterans lived in the community and were at risk for falls or hospitalization per functional performance measures. We used convergent parallel mixed methods approach in the evaluation. Eighteen Veterans ≥55 years old (all male, mean 77 years, 39% rural) received a referral to Fit for Life, two did not participate. We analyzed and integrated adaptations posed by clinicians and Veterans in real-time to enhance access to and participation in Fit for Life. Future work will explore clinical effectiveness, tools to identify patients most likely to benefit, and care delivery structures that integrate telerehabilitation groups for older Veterans.

Undergraduate Nursing Students' Perceptions of Geriatric Care and Nursing Curriculum.

The geriatric population in the United States is growing rapidly with an expected increase of 22% by 2040. Nursing students, however, consistently report negative attitudes toward caring for geriatric patients. The purpose was to assess undergraduate nursing student perceptions of care for the geriatric population, how their nursing curriculum influenced these perceptions, and any perceived curricular changes, didactic or clinical, that could potentially improve students' preparedness and desire to seek a career in geriatric nursing. Using a convergent parallel mixed methods approach, senior prelicensure nursing students completed a Likert-scale survey with additional open-ended questions to assess perceptions of geriatric care and how the current nursing curriculum relates to those perceptions. Quantitative data identified that most students believed the didactic curriculum prepared them for geriatric care but did not increase their desire to work with geriatric patients. Qualitative data identified negative stereotypes and clinical experiences and revealed a lack of desire for geriatric care. Lack of desire for geriatric care was the norm for participants. Geriatric care should be more heavily weighted in academics, and educators should develop innovative methods that increase the desire of prelicensure students to commit to care for the geriatric population.

Examining COVID-19 Sources of Information, Vaccine Hesitancy, and Uptake Behaviors Among Diverse Underserved Latinx Communities: A Convergent Parallel Mixed Methods Approach

At 63.7 million, Latinxs constitute the largest racial/ethnic minority in the United States (US). Early during the COVID-19 pandemic, Latinxs were disproportionately impacted and exhibited lower vaccine uptake. Widespread infodemics contributed to confusion, eroded trust, and fostered vaccine hesitancy among this population. This study used a convergent parallel mixed-methods approach to analyze, integrate, and interpret concurrently collected data gathered as part of the Community Engaged Alliance (CEAL) Against COVID-19 Disparities project, initiated by the National Institutes of Health (NIH) in response to the COVID-19 pandemic in the US. Target populations were three underserved Latinx communities of Miami-Dade County (MDC), Florida, during the pandemic’s peak. Qualitative findings show six themes and subthemes that integrate with quantitative survey data (N = 451). Themes included a “wait-and-see” approach to vaccine uptake; concerns about infodemics; attitudes about science, education, healthcare providers; and personal sources of information. Our findings highlight cultural significance, trusted sources, and reasons for hesitancy before vaccination decisions as corroborated by quantitative results. However, divergence was found regarding media sources. Consistent with the literature, although participants report concerns about infodemics and media bias, they still rely on media for updates, particularly with established television networks and trusted personalities. The value placed on education throughout the study (quantitative and qualitative) highlights the importance of culturally appropriate educational interventions. Moreover, the complex nature of the impact that media has on health-related information and vaccine uptake in this population underscores the need for media literacy interventions alongside health education.

Contribution of Biometric Fingerprint in Reducing Prevalence of Unauthorized Absenteeism among Employees in Public Organizations in Moshi Municipality

This study investigated the contribution of biometric fingerprint technology in reducing unauthorized absences among employees in public organizations within Moshi Municipality, Tanzania. Grounded in the Social Control Theory, the research utilized a convergent parallel mixed-methods approach. The target population consisted of 3,218 public employees from 45 organizations, with a sample of 356 respondents. The study collected qualitative and quantitative data, ensuring validity and reliability through content, face validity, and Cronbach's alpha. Quantitative data was analyzed using descriptive statistics in SPSS, while qualitative data underwent context analysis. Ethical guidelines were strictly adhered to. The findings revealed that public servants in Moshi Municipality perceived biometric fingerprint technology as a reliable solution for addressing unauthorized absences in the workplace. Implementation of this biometric has created a secure and accountable work environment. The study concludes that the use of biometric fingerprint technology has positive contributions to attendance management, accountability, and productivity of public organization employees. Further, it was recommended that public organizations prioritize clear communication with employees about the purpose, benefits, and safeguards of biometric fingerprint technology. Additionally, further research is suggested to explore the challenges faced by employees in utilizing this technology, with the aim of contributing to the existing knowledge base on biometric fingerprints in public organizations.

Perceived structural empowerment, resilience, and intent to stay among midwives and registered nurses in Saudi Arabia: a convergent parallel mixed methods study

BackgroundRetaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It’s a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses’ and midwives’sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization.MethodsThis study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023.ResultsThe study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p < 0.000) to intent to stay if compared to resilience (β = 0.215, p < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational.ConclusionThe study’s findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates.

Black college women's preventive health behaviors: Applications of a Black Feminist-Womanist research paradigm

ObjectiveThe researchers applied Lindsay-Dennis' Black Feminist-Womanist research paradigm to Andersen's Behavioral Model for Health Service Use to guide initial research about Black American women's preventive health behaviors. MethodsThis article highlights this application, using interpretive phenomenological analysis for qualitative questions assessing how 40 Black college women define health and their experiences in health care. This was part of a larger convergent parallel mixed-methods approach in a 2022 cross-sectional online survey. ResultsParticipants defined health as a concept involving health literacy, physical and mental health, and being free from health conditions or disease. Regarding health-related lived experiences, negative experiences were more frequently reported than positive experiences. However, many participants reported both positive and negative health care related experiences. Predisposing, enabling, and need factors were all present in qualitative responses. ConclusionsThis article highlights the fit of a Black Feminist-Womanist research paradigm to Andersen's model to better understand Black women's health experiences and illustrates ways that medical mistrust, health literacy, and past experiences with health care can influence health service use. Areas for future research on barriers and facilitators to preventive care and implications for reducing health disparities are also discussed.

Assessing Cultural Intelligence in PharmD Education Through Art

ObjectiveThis study, conducted in collaboration with the University of North Carolina (UNC)–Chapel Hill’s Ackland Art Museum, assessed student experiences in a facilitated visual art experience designed to foster cultural intelligence among 143 first-year Doctor of Pharmacy students at the UNC Eshelman School of Pharmacy. MethodsA post-event survey was used to collect data on student perceptions of this experience and its implications. Quantitative items were analyzed using descriptive statistics. Qualitative items were deductively coded using the 4 domains of the Cultural Intelligence Framework: cultural awareness, cultural knowledge, cultural practice, and cultural desire. A convergent parallel mixed-methods approach was used to gain a deeper understanding of the data. ResultsOf the 143 students who completed the survey (response rate = 99%), nearly all agreed (n = 60, 42%) or strongly agreed (n = 70, 49%) that the art experience was valuable. Students indicated that it increased their confidence in having open dialogue concerning equity, inclusivity, and race, expanded their perspectives about the implications of inequities, and provided knowledge they can apply in their careers as health science professionals. Findings revealed students’ acknowledgment of their own backgrounds, enhanced understanding of bias and historical contexts, recognition of relevance to pharmacy practice, and expressed a desire for further cultural understanding. ConclusionThis research underscores the potential of visual art and museum partnerships in fostering positive perceptions and beliefs about cultural intelligence among aspiring pharmacists.

Health-related quality of life in ethnically diverse Black prostate cancer survivors: a convergent parallel mixed-methods approach.

This study examined the health-related quality of life (HRQoL) among ethnically diverse Black men (BM) with prostate cancer (CaP) in the United States. A convergent parallel mixed-methods design, employing both qualitative and quantitative research, involved recruiting Black CaP survivors through multiple channels. The target population was native-born BM (NBBM), African-born BM (ABBM), and Caribbean-born BM (CBBM). QoL for all men was assessed using The Functional Assessment Cancer Therapy-Prostate (FACT-P) measure, which includes five domains: physical- (PWB), emotional- (EWB), social-(SWB), and functional-wellbeing (FWB), and a CaP subscale (PCS). A subset of men completed qualitative interviews. Demographic and clinical characteristics were also collected. Black CaP survivors aged 49-85 participated in the study (n = 108), with a subset (n = 31) completing a qualitative interview. Participants were mainly NBBM (72.2%) and treated with radiotherapy (51.9%). The FACT-P scale total mean score (± SD) was 114 ± 24.1 (theoretical range 0-156), with lower scores reported on the SWB, FWB, and EWB domains. The mixed-methods findings approach included meta-inferences derived from integrating the corresponding quantitative and qualitative data, covering all the domains within the FACT-P. Black CaP survivors experienced significant burdens that impacted their overall HRQoL. The analysis revealed impacts on physical, social, and emotional well-being, with variations among ethnic groups suggesting the need for culturally tailored interventions. EWB was also profoundly impacted by CaP treatment, with universal emotional burdens emphasized across all groups. Healthcare providers must recognize and address these multifaceted needs to promote better outcomes and HRQoL for Black CaP survivors.

Psychological distress among healthcare professionals in Mbarara, following the 2022 Ebola Virus Disease outbreak in Uganda: a mixed methods study

BackgroundThe 2022 Ebola Virus Disease (EVD) outbreak occurred at a time when Uganda was still battling the social and psychological challenges of the COVID-19 pandemic; placing health care professionals (HCPs) at a much higher risk of developing psychological distress. Psychological distress among HCPs can cause decreased workplace productivity and ineffective management of their patients. The current study aimed to investigate and understand psychological distress among HCPS in Mbarara city in Southwestern Uganda following the 2022 EVD outbreak.MethodWe enrolled 200 HCPs through convenient sampling from one private and one public health facility in Mbarara city in Southwestern Uganda, in a cross-sectional convergent parallel mixed method approach where qualitative and quantitative data were collected concurrently. Quantitative data, utilizing the Kessler Psychological Distress (K10) Scale, provided us with a quantitative measure of the prevalence of psychological distress among HCPs, and were analyzed using STATA version 16. Qualitative data, on the other hand, offered deeper insights into the nature, perceptions, and contextual factors influencing this distress, and were analyzed using emergent theme analysis.ResultsThe prevalence of psychological distress was 59.5% and it was higher among females (63.9%) compared to males (36.1%). HCPs vividly expressed distress and anxiety, with heightened suspicion that every patient might be an EVD carrier, creating a pervasive sense of unsafety in the workplace. However, the outbreak had an educational affect where concerns about the announcement of another EVD outbreak were diverse, with HCPs expressing anxiety, despair, and dissatisfaction with the country’s management of potential outbreaks.ConclusionHigh levels of psychological distress were experienced by HCPs in Southwestern Uganda as a result of the 2022 EVD pandemic. HCPs express a wide range of feelings, such as dread, anxiety, despair, pessimism, and discontent with the way the outbreaks are handled throughout the nation. We recommend implementation of comprehensive psychosocial support programs tailored to the unique needs of HCPs, including counseling services, stress management workshops, and peer support networks.

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.

Exploring the Association Between Loneliness, Subjective Cognitive Decline, and Quality of Life Among Older Thai Adults: A Convergent Parallel Mixed-Method Study.

Examining the rising prevalence of subjective cognitive decline as an early indicator of dementia in adults, this study investigates its complex interaction with loneliness and quality of life in individuals with preclinical dementia. Using a convergent parallel mixed-method approach, we employed Structural Equation Modeling on a cohort of 149 older adults. Qualitative insights were derived from focused group discussions and in-depth semi-structured interviews with a cohort of 23 older adults. Loneliness emerges as a pivotal contributor, exerting a discernible partial indirect effect on quality of life through subjective cognitive decline (indirect effect = -0.145, p = .006). Noteworthy differentials surfaced, with the impact of subjective cognitive decline on quality of life heightened in those with chronic diseases (△χ2 = 6.139, p = .013). Loneliness, wielding a palpable impact, intricately interlaces with quality of life, the nexus of which is intricately mediated by subjective cognitive decline.

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.

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.

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.

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.

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.

“You cannot stay with one person once you begin having sex at a young age”: the prevalence, correlates and effects of early sexual debut among children in Ghana

BackgroundChildren’s initiation of early sex has several negative implications on their sexual and reproductive health, growth and development. In Ghana, few studies on early sexual debut have focused on adolescents. Therefore, this study examined the prevalence, causes, correlates and effects of early sexual debut among children aged 8 to 17 in Ghana using secondary data from the Department of Children of the Ministry of Gender, Children, and Social Protection.MethodsA convergent parallel mixed-method approach guided the study. Descriptive statistics and multivariable binary logistic regression were used to analyse the quantitative data, while thematic analysis was used to analyse the qualitative data.ResultsThe study found that the prevalence of early sexual debut among children was 13.2%, which is more predominant among female children. The main causes of early sexual debut include engaging in sex after watching pornography, self-desire to have sex, and being influenced by alcohol consumption. Also, age, sex, education, marital status, religion, ecological zone, living arrangements, and access to the Internet were significant correlates of early sexual debut. Early sexual debut increases children’s risk of unwanted pregnancy, which leads to the termination of children’s education or induced abortion. Also, early sexual debut had adverse impacts on the wellbeing of pregnant children and increased children’s risk of multiple lifetime sexual partners.ConclusionsThis study demonstrated that socio-demographic characteristics of children (e.g., age, sex, education, and marital status) were significant correlates of early sexual debut. Policymakers need to design appropriate interventions, considering the socio-demographic characteristics of children, to curb its occurrence in Ghana.

Investigating the Efficacy and Sustainability of Virtual Education Courses

As teacher educators prepare for the future of teacher education, it is important to address the sustainability of virtual education courses. This study used a pre-existing model provided by the New York State Education Department as a framework to define the types of courses that may appear in an education program. Data was collected using a convergent parallel mixed methods approach to simultaneously gather qualitative and quantitative data. A total of 640 education courses from accredited education programs across the United States were analyzed. Findings indicated the type of course did not play a role in the course effectiveness during the pandemic, suggesting all education courses can be delivered effectively in a virtual modality. The delivery method of undergraduate courses was indicated by participants to be less effective during the pandemic than graduate courses. Results suggest courses that involve fieldwork (i.e., Field Experience, Student Teaching, or Practicum) were indicated by participants to be the least sustainable as virtual courses post-pandemic. Results also suggest that although virtual education courses at the graduate level are sustainable in education programs post-pandemic, undergraduate courses may not be. Advantages to virtual course delivery clustered around logistics and access while challenges clustered around engagement and hands-on-learning. This study provides curriculum guidance to those across the globe in the position of making modality decisions.

Water, Sanitation, and Hygiene (WASH) practices among residents of different slum settlements in a ward of Kolkata: A mixed-methods study.

Access to safe water, sanitation, and hygiene (WASH) is the most basic need for mankind. Poor WASH practices are associated with various waterborne diseases, especially in developing countries such as India. The aim of the study was to assess WASH practices among residents of different slum settlements in a ward of Kolkata, identify the factors associated with WASH practice, and explore the barriers faced by the families and municipal staff in providing adequate WASH services to the community. An observational study, cross-sectional in design with a convergent parallel mixed-methods approach, was conducted in different slum settlements in a ward of Kolkata. Quantitative data were collected by face-to-face interview, spot observation, and measuring the living area, door, and window spaces. Key informant interviews were conducted with the medical officer, ward vector-control coordinator, and municipal waste handlers, in addition to in-depth interviews with respondents who had unsatisfactory WASH practices. SPSS version 25.0 was used to analyze the quantitative data. Qualitative data were analyzed thematically using Atlas.ti 22. The overall WASH practices were considered satisfactory in 58.8% of the households. Education of the respondents up to the secondary level, presence of overcrowding, and inadequate ventilation in the house had statistically significantly higher odds of unsatisfactory practice. Poor living conditions, difficulty in collecting and storing water, waterlogging, blocked sewage drains, common toilets for men and women, and lack of motivation were the primary obstacles identified by the residents. Unsatisfactory WASH practices were observed among a high proportion of the slum population. Community engagement and education regarding WASH in communities is strongly recommended along with improvement of infrastructure and capacity building.