Cross-sectional Mixed Methods Study Research Articles

The Diagnostic Pathway Experiences of People Living with Rare Dementia and Their Family Caregivers: A Cross-Sectional Mixed Methods Study Using Qualitative and Economic Analyses.

The pathways for receiving a diagnosis of a rare type of dementia are poorly understood. Diagnostic challenges decrease access to relevant health promotion activities and post-diagnostic support. This study was focused on pathways experienced by people affected by rare dementia in Wales, United Kingdom (UK), considering the practical, emotional, and economic consequences. Semi-structured interviews were completed with 10 people affected by rare dementia across Wales, UK (nine family caregivers and one person living with rare dementia). The interview data were subject to a thematic analysis and a bottom-up costing approach was used to cost the pathway journeys. Five transitional points occurred across the diagnostic pathway (initial contact, initial referral, further referrals-provider, further referrals-private, and diagnosis) alongside two further themes (i.e., involved in the diagnostic process and disputes between stakeholders). The timeliness of the diagnosis was perceived to often be subject to 'luck', with access to private healthcare a personal finance option to expedite the process. Higher economic costs were observed when, in retrospect, inappropriate referrals were made, or multiple referrals were required. The confusion and disputes relating to individual diagnostic pathways led to further emotional burdens, suggesting that higher economic costs and emotional consequences are interlinked. Clearer diagnostic pathways for rare dementia may prevent unnecessary service contacts, waiting times, and associated distress. Prioritising appropriate and timely service contacts leads to diagnosis and support to families and enables people to increase control over their health. Appropriate diagnostic pathways may be less costly and reduce costs for families.

Assessment of care-arrangement of people with dementia in Karachi by 10/66 protocol

Background and Objective:
 Pakistan is a low middle-income country (LMIC) in South Asia with a rising aging population. This study aimed to understand care-arrangement and resources of people with dementia (PWD) in Karachi, Pakistan.
 Methods:
 This cross-sectional mixed-method (qualitative and quantitative) study was carried out using 10/66 protocol for dementia patients. Data collection for the study was done from September 2016 till August 2017.This assessed characteristics of patients and caregivers, the economic impact of caregiving, and resources available to care for people with dementia (PWD).
 Results:
 One-hundred-twenty-eight PWD and their caregivers were included in the study. The average gross national product (GNP) per PWD per capita was $140. Majority of the caregivers were married women, family members, and full-time housewives. Three quarters of the caregivers were patients’ children or spouse residing with the patient, in a 2-to-3-bedroom house. Majority of the time of the caregivers’ day was spent with the PWD.
 Conclusion:
 In Pakistan majority of PWD are dependent on female family members for care. Caregiver roles are full-time responsibilities with little to no burden shared by others. There is low monthly GNP per PWD with a high cost of medical needs of PWD.

Evaluation of the malaria case surveillance system in KwaZulu-Natal Province, South Africa, 2022: a focus on DHIS2

BackgroundSouth Africa set a target to eliminate malaria by 2023, with KwaZulu-Natal (KZN) Province the malaria-endemic province closest to achieving this goal. Objective two of the National Malaria Elimination Strategic Plan (NMESP) focused on strengthening surveillance systems to support the country’s elimination efforts. Regular evaluations of the malaria surveillance systems against the targets of the NMESP objective are crucial in improving their performance and impact. This study aimed to assess whether the malaria surveillance system in KwaZulu-Natal Province meets the NMESP surveillance objective and goals.MethodsA mixed-methods cross-sectional study design was used to evaluate the malaria surveillance system, focusing on the District Health Information System 2 (DHIS2). The study assessed the data quality, timeliness, simplicity, and acceptability of the system. Key personnel from KZN’s Provincial malaria control programme were interviewed using self-administered questionnaires to evaluate their perception of the system's simplicity and acceptability. Malaria case data from January 2016 to December 2020 were extracted from the DHIS2 and evaluated for data quality and timeliness.ResultsThe survey respondents generally found the DHIS2-based surveillance system acceptable (79%, 11/14) and easy to use (71%, 10/14), stating that they could readily find, extract, and share data (64%, 9/14). Overall data quality was good (88.9%), although some variables needed for case classification had low completeness and data availability. However, case notifications were not timely, with only 61% (2 622/4 329) of cases notified within 24 h of diagnosis. During the 5-year study period, the DHIS2 captured 4 333 malaria cases. The majority of cases (81%, 3 489/4 330) were categorized as imported, and predominately in males (67%, 2 914/4 333).ConclusionWhile the malaria surveillance system in KZN Province largely met the NMESP surveillance strategic goals, it failed to achieve the overarching surveillance objective of 100% notification of cases within 24 h of diagnosis. The majority of reported cases in KZN Province were classified as imported, emphasizing the importance of complete data for accurate case classification. Engaging with healthcare professionals responsible for case notification and disseminating aggregated data back to them is needed to encourage and improve notification timeliness.

Perceptions of Safe Staffing, Self-Reported Mental Well-being and Intentions to Leave the Profession among UK Social Workers: A Mixed Methods Study

Abstract The purpose of this study was to examine social workers’ perceptions of safe staffing levels and correlate these perceptions with standardised measurements of well-being in the UK. This cross-sectional mixed-methods study analysed data from 406 social workers from November 2022 until late January 2023. Data were collected using anonymous online surveys including both qualitative and quantitative methods examining mental well-being, burnout and intentions to leave the profession post-coronavirus disease 2019. Findings revealed that only one-third of social workers responding perceived that they work in an environment of safe staffing. There were also significant differences in well-being and an increase in personal, work-related and client-related burnout in social workers who believed their service did not operate a safe staff-to-service user ratio. Likewise, compared to those who perceived their service to operate within a safe staff-to-service-user ratio, those who perceived unsafe ratios were more likely to communicate their intention to leave the profession. Qualitative findings helped contextualise the quantitative results. These findings suggest that increased demand for social work services, shortage of qualified social workers, high workloads, inadequate resources and retention problems, contribute to additional pressure on existing staff and have implications for policy, practice and research in social work.

Community perspectives on the magnitude of Xeroderma pigmentosum and care-seeking practices in Micheweni district, Pemba: a mixed-methods cross-sectional study

ObjectivesTo determine the community’s perception on the magnitude of Xeroderma pigmentosum (XP) disease and healthcare-seeking practices in Micheweni, Pemba in response to the public widespread information on the increased burden...

Acceptability to donate human milk among postnatal mothers at St. Francis hospital Nsambya, Uganda: a mixed method study

BackgroundThe World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN).MethodsA cross-sectional sequential explanatory mixed method study was conducted between October 2018 and March 2019. A questionnaire on sociodemography, awareness and likely acceptability to donate HM was administered to 410 postnatal mothers at SFHN. Multivariate logistic regression analysis was undertaken to determine factors associated with acceptance of HM donation. Focus Group Discussions (4) and Key Informants Interviews (4) were used to explore factors influencing behaviours to donate human milk. Qualitative data were analysed using a content thematic approach.ResultsOverall acceptance of donating the HM was 77.6%, and the significant factors were: willingness to express the HM (AOR 7.5; 95% CI 3.01, 18.68); wet-nursing knowledge (AOR 2.3; 95% CI 1.1, 5.0) and visit to under-5 years’ clinic (AOR 21.3; 95% CI 2.3, 196.9). The major themes in relation to accepting to donate HM were wet nursing experience, and confidence in donating the HM, and its perceived effectiveness. There were concerns about the safety and adequacy of HM and fear of transmitting criminal behaviours and mental illness through human milk.ConclusionsAcceptance to donate HM among postnatal mothers at St. Francis Hospital Nsambya was very high. Willingness to express and store human milk, prior knowledge about wet nursing and a visit to an under-five outpatient clinic were associated with acceptance. Thus, establishing a human milk bank is feasible in the study setting.

Exploring rural households’ knowledge and perception of acute kidney injury in the southern region of The Gambia: a mixed-method community-based cross-sectional study design

BackgroundThe Acute Kidney Injury (AKI) outbreak in The Gambia is a national tragedy attracting international concern, linked to nearly 100 deaths in children. This situation arose due to the use...

Informed consent practice and associated factors among healthcare professionals in public hospitals of Southern Ethiopia, 2023: a mixed-method study

BackgroundPatients may sign a consent form before the specific treatment is offered for a variety of reasons, including during an outpatient appointment. Healthcare professionals must obtain consent from patients or other legal persons before providing any treatment or performing any procedures. But, little attention has been given to the informed consent process in Ethiopia.ObjectiveTo assess informed consent practice and associated factors among healthcare professionals in Wolaita Zone, Southern Ethiopia public hospitals from January, 2023.MethodsAn institutional-based cross-sectional mixed-method study was conducted among 399 healthcare professionals. Simple random sampling and purposive sampling techniques were used to select healthcare professionals for quantitative and qualitative studies respectively. Data for both studies were collected using self-administered questionnaire and key informant interview respectively. EpiDataV4.6 and the Statistical Package for the Social Science was used for entry and analysis of quantitative data. OpenCode software was used for thematic analysis for qualitative data.Results339 respondents were included in the study, with a response rate of 94.3%. The good practice of informed consent among the healthcare professionals is 53.1%. There was a significant association between the good practice of informed consent and being male [AOR: 0.003 (95% CI: 0.000–0.017)], working in a comprehensive specialized hospital [AOR: 4.775 (95% CI: 1.45–15.74)] and in-service training [AOR: 0.038 (95% CI: 0.013–0.114)].Conclusion and recommendationsMore than half of healthcare professionals had good practices for informed consent. However, it is critical to plan and intervene various strategies with the goal of improving knowledge and attitude toward informed consent.

Oral manifestations of long COVID and the views of healthcare professionals

Introduction Oral manifestations have been observed with this condition; however, little is known about their impact on the healthcare professionals routinely managing these patients.Aims To investigate the prevalence of the oral manifestations of long COVID and the healthcare professionals' views, experiences and practices for managing these conditions.Materials and methods A cross-sectional mixed-methods study, including a self-reported online questionnaire (n = 104) and healthcare professionals' (n = 7) semi-structured interviews, was conducted. Descriptive statistics and reflexive thematic analysis were used to analyse the data.Results In total, 78% of respondents reported one or more oral conditions associated with COVID-19. Changes in the sense of taste and/or smell (58%), dry mouth (48.1%) and mouth sores (45.7%) were frequently reported. Themes identified from healthcare professionals' interviews were areas for research, management and interdisciplinary collaboration.Discussion Allied healthcare professionals may assist dental professionals with managing oral manifestations of long COVID. Inadequate access to NHS dentistry is deterring patients worried about their oral symptoms and the limited oral knowledge of healthcare professionals affects their ability to manage patients.Conclusion Healthcare professionals have observed oral manifestations in individuals diagnosed with long COVID; however, further information and training on this topic would assist them with managing patients and increasing awareness among clinicians.

Quality of Life in Ugandan Children and Young Adults After Surgery for Congenital Heart Disease: Mixed Methods Approach.

Health-related quality of life (HRQOL) is a critical issue for patients undergoing surgery for congenital heart disease (CHD) but has never been assessed in a low-income country. We conducted a cross-sectional mixed methods study with age-matched healthy siblings serving as controls at the Uganda Heart Institute. One-hundred fifteen CHD pediatric and young adult patients and sibling control participants were recruited. Health-related quality of life was assessed using the Pediatric Quality of Life Inventory Version 4.0 in participants ages 5-17 and 36-Item Short Form Survey for young adults aged 18-25. A subset of 27 participants completed face-to-face interviews to supplement quantitative findings. Eighty-six pediatric (age 5-17) sibling and parent pairs completed Peds QOL surveys, and 29 young adult (age 18-25) sibling pairs completed SF-36 surveys. One third of patients had surgery in Uganda. Ventricular septal defects and tetralogy of Fallot were the most common diagnoses. Health-related quality of life scores in patients were lower across all domains compared to control participants in children. Reductions in physical and emotional domains of HRQOL were also statistically significant for young adults. Variables associated with lower HRQOL score on multivariate analysis in pediatric patients were younger age in the physical and emotional domains, greater number of surgeries in the physical domain and surgery outside Uganda in the school domain. The only predictor of lower HRQOL score in young adults was surgery outside Uganda in the social domain. Qualitative interviews identified a number of themes that correlated with survey results including abandonment by family, isolation from peers and community, financial hardship and social stigmatization. Health-related quality of life was lower in Ugandan patients after CHD surgery than siblings. Younger patients and those who had surgery outside of Uganda had lower HRQOL. These data have important implications for patients undergoing CHD surgery in LMIC and have potential to inform interventions.

An Assessment of Knowledge of Health Workers in Hospitals of Southern Province of Zambia, towards Marketing of Breastmilk Substitutes Regulations

Background: Optimal breastfeeding practices have been undermined by unregulated marketing of breastmilk substitutes worldwide, resulting in about 820, 000 preventable deaths per year among children under five years globally. The International Code (thereafter called the Code) of Marketing breastmilk substitutes was developed by the World Health Organization, the United Nations Children's Emergency Fund, and stakeholders to protect, promote and support breastfeeding. Member states are expected to domesticate the Code. Zambia enacted Statutory Instrument No. 48 of 2006, Regulations on marketing of breastmilk substitutes. Successful implementation calls for a good level of knowledge among health workers. However, we found no study, in Zambia on marketing of breastmilk substitutes Regulations. Objective: To assess the level of knowledge of health workers on Zambia’s Regulations on marketing breastmilk substitutes. Study design and methods: A mixed-method cross-sectional study. Data was collected online and in person. Probability proportional to size calculation yielded an estimated sample size of 384. A sample size of 410 after adjusting upwards assumed non-response rate, 401 participants responded. Quantitative data were analyzed using the Social Statistical Package for Social Sciences. Knowledge results were described by frequencies and percentages. Tests were conducted using univariable linear and multivariable regression analysis. A p-value of <0.05 was considered statistically significant. Thematic analysis was used for qualitative data analysis. Results: The mean overall level of good knowledge of health workers was 0.339 or 34% [SE: 0.0221; 95%CI: (0.2959, 0.3828)]. Conclusion: The level of knowledge among health workers in hospitals of Southern Province, Zambia was poor. Keywords: Breastmilk substitute Regulations, Health worker, Knowledge.

Addressing patients' unmet needs related to multidrug-resistant tuberculosis (MDR-TB) care: A qualitative research study from Pune city, India.

We aimed to identify and describe the unmet needs of patients with multidrug-resistant tuberculosis (MDR-TB). As a part of larger cross-sectional mixed-methods (qualitative and quantitative data) study on pathways to MDR-TB care, here we present the qualitative component. We interviewed 128 (56 men and 72 women) individuals who had MDR-TB, aged > = 15 years, registered and treated under the National TB Elimination Program (NTEP) in Pune city of India. We carried out thematic analysis of participants' narratives. We found that delays in diagnosis, lack of counseling, late referral to the NTEP and unwarranted expenditure were the main barriers to care that study participants experienced in the private sector. Provider dismissal of symptoms, non-courteous behavior, lack of hygiene in the referral centers, forced stay with other patients and lack of support for psychological/psychiatric problems were identified as a few additional challenges that participants faced at the NTEP care centers. Using qualitative data from experiences of participants with MDR-TB, we identify patients' several unmet needs, attention to which can improve MDR-TB care. Educating private providers about MDR-TB risk and available rapid molecular assays can help the timely diagnosis of MDR-TB and reduce patients' out of pocket costs. At the RNTCP/NTEP, measures such as training health workers to build rapport with patients, maintaining hygienic environments in the health centers with adequate isolation of participants with MDR from other serious cases, referral of patients with psychiatric symptoms to mental health specialists and monitoring drug shortages can help in improving care delivery.

Consumer risk perception towards pesticide-stained tomatoes in Uganda

Background Tomatoes are consumed daily. Unfortunately, abuse of pesticide application by vegetable growers in Uganda increases risks of pesticide residue exposure among consumers, as they may be above Maximum Residue Limits (European Union Maximum Residue Limits used as a standard in Uganda). This study aimed to determine consumer attitudes and risk perceptions towards pesticide-stained tomatoes in Uganda to support interventions that could be used to reduce pesticide residue exposures in food. Methods A mixed methods cross-sectional study sampled 468 household consumers in four regions of Uganda, selecting one district (interventional project area) per region. In each district, about 60 household members were randomly selected from a total of three Sub Counties and interviewed. In addition, 9 tomato handlers (three tomato farmers, three tomato retailers, and three tomato wholesalers) participated in Focus Group Discussions (FGDs) per district. Collected data were entered into MS-Excel 13 and exported into Stata version 14.0 for cleaning and analysis at a 5% level of significance and 95% Confidence Intervals (CI). The proportion of risk perceptions and attitudes were computed and presented as percentages, while factors associated with risk perception were determined using Fisher exact test. Qualitative data collected under a traditional theory were analyzed using thematic content analysis. Results More than half, 54.2% (253/468), of the respondents were females, mean age was 37 years (SD = 13.13, ranging from 18 to 88 years). Half of the respondents, 50.9% (238/467), were farmers by occupation, and 40.3% (188/468) had completed upper primary education. Only 5.0% (20/396) of consumers reported a high-risk perception towards tomatoes stained with pesticide residues, the rest, 95.0% (376/396), were buying pesticide-stained tomatoes despite their awareness of the possible health effects. The main reason for buying the pesticide-stained tomatoes was that a majority, 59.0% (230/390), lacked an alternative to stained tomatoes like organically grown tomatoes. However, consumers generally had a negative attitude towards pesticide-stained tomatoes, with 67.0% (313/468) of the consumers disagreeing with the statement that tomatoes sold on the market are safe. Consumer risk perception was significantly associated with their awareness about residues in the tomatoes; where the proportion of consumers who were aware of the risk of pesticide-stained tomatoes was 42.8 times more likely not to buy stained tomatoes compared to the proportion of those who were not aware. OR, 42.8 (95% CI: 10.76–170.28). However, after Fisher-Exact tests analysis, level of education P(0.975), gender P(0.581), and age group P(0.680) were not associated with consumer risk perception (95% CI and 5% level of significance). Conclusion Although the consumers had a negative attitude towards the pesticide-stained tomatoes, their risk perception towards them ranked low, with most consumers buying tomatoes stained with pesticide residues due to a lack of an alternative. Ministry of Agriculture extension service efforts should promote and emphasize community to start household-based organic kitchen gardens as the efforts for the establishment of a national pesticide residue monitoring center awaits.

Barriers, enablers, benefits, and drawbacks to point-of-care testing: a survey of the general practice out-of-hours service in Scotland.

The general practice out-of-hours (GPOOH) service is under pressure to treat more patients in less time, while reducing referrals and minimising diagnostic errors. Point-of-care (POC) testing involves rapid clinical tests that can be used to generate results during the consultation, and has the potential to facilitate managing these competing demands safely. To describe current availability of POC tests in GPOOH in Scotland, and identify barriers, enablers, benefits, and drawbacks to its use. Cross-sectional mixed-methods study, which surveyed opinions of clinicians working in the GPOOH service in NHS Scotland. An electronic questionnaire was developed, designed, piloted, and distributed to clinicians, which had closed questions and areas for free text. In total, 142 responses were received. Urine dipstick testing (99.2%), pregnancy tests (98.5%), oxygen saturation (97.7%), and blood glucose testing (93.9%), were the only POC tests commonly available in GPOOH in NHS Scotland. There was strongest support for the provision of POC tests, particularly C-reactive protein (CRP; 79.4%), strep A (76.0%), and D-dimer (75.2%). Responders felt that POC tests would improve confidence (92.3%) and safety (89.8%) surrounding clinical decision making, improve patient satisfaction (80.6%), and reduce hospital and secondary care referrals (77.5%). Barriers to POC test use were availability of the test kits and machines (94.5%), training requirements on how to use the machine (71.1%) and interpret results (56.3%), and time to do the test (62.0%). Few POC tests are in regular use in GPOOH in Scotland. GPOOH clinicians are supportive of using POC testing. They identified a number of benefits to its use, with very few drawbacks. Increased provision of POC testing in GPOOH in NHS Scotland should be considered urgently.

Young Men's Attitudes and Understanding of Menstruation

PurposeTo identify sources of information, perceptions, and potential misinformation about menstruation among college-aged men in the United States. MethodsThis is a mixed-methods cross-sectional survey study of students in the United States. Inclusion criteria included participants aged 17–29 years, male gender identity, enrolled as an undergraduate or graduate student, and no personal history of menstruation. ResultsThis study included 70 participants. Almost half of all participants (42.9%) first learned about menstruation from family members. More than two-thirds of respondents felt that menstrual education was essential or very important for all genders. The most common symptoms noted to be associated with periods included cramping (93.6%), mood changes (80.9%), and vague “hormonal” changes (36.2%). When asked how a menstrual period might affect someone's ability to perform daily activities, one-third reported debilitating or very burdensome symptoms, whereas one-fifth felt periods do not have much impact. DiscussionComprehensive education and accurate reproductive health knowledge are critical in combating gender bias and stigma. Most males surveyed agree that education on menstruation is important, yet the majority do not have or do not remember formal education on this topic, instead relying on family members and friends as learning tools and resources. Most participants identified negative symptoms associated with menstrual periods, especially mental health concerns including mood changes and irritability. This association with mood changes, as well as vague “hormonal fluctuations,” contributes to the societal bias against people who menstruate by marking them as prone to emotional instability, thereby exacerbating gender prejudices. It is therefore critical that accurate menstrual education be widely available for everyone, regardless of gender.

Rural parents’ adherence to infant feeding guidelines to prevent allergy: a cross sectional study in New South Wales

BackgroundResponding to international research showing that early introduction of common food allergens can reduce the chance of developing allergies, in 2016 the Australasian Society of Clinical Immunology and Allergy (ASCIA) revised allergen introduction guidelines, recommending earlier introduction of allergens to infants in their first year. Australia has high food allergy rates, and limited understanding of adherence to allergen introduction guidelines, especially in rural areas. This project explored rural parent adherence to ASCIA guidelines.MethodsThis was a mixed method cross sectional study using an online survey including multiple-choice and qualitative short answer responses. The sample were 336 women from two rural health districts in New South Wales. All were aged 18 or over, and either pregnant or had delivered a baby since July 2018. Descriptive statistics were used to measure behavioural alignment with the recommended guidelines, thematic analysis was used to analyse attitudes and explanations.ResultsIn 84.3% of children, feeding adhered to all four guidelines studied, including no elimination of allergens during pregnancy (98%), age of introduction of solids (97.7%), continuation of breast milk/cow’s milk formula during introduction of solids (95%), and age of introduction of allergens (92.9%). Adherence was not significantly correlated with the education (X2 = 17.9, P = .056), prior history of allergy [neither mother (X2 = 0.945,P = .623) nor previous children (X2 = 0.401,P = .818)], or primary care received during pregnancy. More than 90% of participants agreed or strongly agreed that the guidelines are realistic, trustworthy, and important for the health of their child. However, thematic analysis revealed that parents’ perceptions of a child’s individual progress, and medical conditions or other circumstances, such as challenges with breastfeeding, will often take precedence over adherence to specific guideline recommendations.ConclusionsHigh rates of adherence with ASCIA guidelines found here are comparable with findings from metropolitan studies and encouraging for future population health. Participant comments on the guidelines imply to rural policymakers that there are multiple influences on parent decisions about infant feeding, often including parents’ own intuition and experiences. Further studies to improve understanding of the role of information, carers, and other influences on parent decision-making concerning feeding attitudes and behaviours will be necessary to optimise adherence in rural areas.

Outsciencing the scientists: a cross-sectional mixed-methods investigation of public trust in scientists in seven European countries

BackgroundIn this era of global health crises, public trust in scientists is a crucial determinant of adherence to public health recommendations. Studies of trust in scientists often link sociodemographic and...

A prospective cross-sectional mixed-methods study evaluating dietary modifications in children with Inflammatory Bowel Disease (IBD)

A prospective cross-sectional mixed-methods study evaluating dietary modifications in children with Inflammatory Bowel Disease (IBD)

Assessment of patient satisfaction level in the State University of Haiti Hospital and responsible factors: a cross-sectional mixed-methods study protocol

IntroductionOver the past few years, the healthcare industry has undergone a significant transformation where patients’ perceptions of healthcare have gained a huge importance in assessing quality. Considering that it is...

Formative research on parenting practices and community support for early childhood development among caregivers in Telangana

Background: Early Childhood Development refers to the overall development of children from conception until 5 years of age across various domains such as physical, emotional, social and cognitive development. Empowering caregivers by providing information regarding ECD and early stimulation, play and communication activities from birth will help ensure all-round child development and reduce risk of developmental delays. Methods: A cross-sectional mixed methods study was conducted in May-July 2022 in two districts of Telangana, India. A semi-structured questionnaire was administered to assess KAP among 218 primary caregivers of children aged 0 to 5 years. Two focused group discussions among secondary caregivers and 18 In-Depth Interviews among frontline workers (AWWs and ASHAs) were conducted to study about current ECD practices, sources of information and communication channels. Results: More than 80% parents had good knowledge regarding brain development, but 15 to 25% did not know that activities like talking or playing with their child could improve intelligence. Less than 50% parents associated routine activities like telling stories, being sensitive to the child, playing and protecting the child with their child’s cognitive or emotional development. Even though fathers engaged their children in play and learning activities, most felt the mother was the primary caregiver. Most participants received information regarding Health and Nutrition from Anganwadi workers, but topics like sanitation, child rearing and early stimulation were not regularly covered. Conclusions: Empowering caregivers on early learning and stimulation activities by frontline workers is crucial for ensuring overall growth and development of children into productive adults.