Level Of Engagement Research Articles

Female top managers, female owners and corporate financial sustainability: new evidence from a panel smooth transition regression model

This study investigates the nonlinear link between gender diversity at various levels and business financial sustainability for a large sample of 54759 enterprises in 80 developing countries from 2015 to 2022. Previous studies have shown that female participation may bring both advantages and costs to businesses. The empirical evidence on whether it improves or degrades company results is inconclusive. This research attempts to improve our knowledge of the complicated link between gender diversity and company financial sustainability. It explains how female managers’ and female owners’ effects on business sustainability is dependent on their different levels of engagement in the firm. Results of the Panel Smooth Transition Regression model (PSTR) demonstrate a nonlinear relationship between gender diversity and firm sustainability. Depending on the measure of female participation, the model contains one threshold at 39% of female senior managers and 34% of female owners, as well as two extreme regimes. The results reveal that below these thresholds the relationship is negative. Misunderstandings and a lack of coherence between groups of different genders may affect decision-making and the capacity to come up with the best responses. However, increasing gender diversity has a favourable influence on firm sustainability above the projected thresholds. This research supports the theory that a critical mass condition is required before a minority group begins to alter organisational functioning. Our findings demonstrate that diversity has an influence on collective decision making and, hence, sustainability only when a critical mass is reached. These findings offer numerous managerial insights and policy recommendations for developing-country enterprises looking to improve their financial sustainability.

Characteristics and urbanization of agricultural migrants in the Yangtze River Delta based on new-type urbanization perspective

ABSTRACT Investigating the characteristics of the agricultural floating population stands as a fundamental prerequisite for fostering human urbanization and constitutes a pivotal aspect within the framework of people-centered New-type urbanization. Drawing upon data from the 2017 China Migrants Dynamic Survey (CMDS), this study delves into the age distribution, educational attainment, and other mobility traits of the agricultural migrant populace residing in the urban agglomeration of the Yangtze River Delta, alongside examining the patterns concerning their places of origin and settlement convergence. Furthermore, utilizing questionnaire data sourced from the CMDS, this paper proceeds to evaluate the urbanization level of the agricultural floating population. The findings of this research are threefold: Firstly, the age composition of the agricultural migrant cohort predominantly comprises youthful and middle-aged laborers, characterized by limited educational attainment and chiefly inter-provincial mobility. Secondly, within urban agglomerations, the agricultural migrant influx predominantly originates from Anhui Province, while beyond these urban centers, migrants predominantly hail from provinces noted for substantial labor outflows. Thirdly, a notable proportion, one-third to be precise, of the surveyed agricultural migrants express a willingness to settle in urban locales, thereby underscoring the imperative to enhance their integration into urban societal fabric and elevate their level of civic engagement.

Burnout, Engagement, and Resilience During the COVID-19 Lockdown: Keys to a Model for Teachers' Self-Efficacy.

Social isolation measures by the COVID-19 pandemic have impacted teaching work. In an "Emergency Remote Teaching" (ERT) context, it is relevant to investigate the factors that affect teachers' self-efficacy. A total of 289 teachers from schools in southern Spain have participated in this study. They have been asked about their levels of burnout, engagement, and resilience. Comparisons were made by groups in accordance with sex, type of center they belonged to, school social context, and educational level in which the teacher taught. Using a Structural Equations Model, the multivariate relationships between the variables related to burnout, engagement, and resilience were described. During the ERT, teachers' self-efficacy was influenced by the 3 factors: burnout-exhaustion and cynicism-engagement, and resilience. During the ERT, the teachers in semi-private and private centers showed greater self-efficacy. In turn, the teachers in childhood and primary education showed a significantly higher level of work engagement than the teachers in compulsory and post-compulsory secondary education. The results in relation to ERT are discussed in the context of the exceptionality and universal globality of the pandemic phenomenon and the complex self-perception of the social value of the teaching function.

‘We’re not all into death and doom … it’s more an appreciation of the macabre.’ Exploring brand success at dark tourism festivals

ABSTRACT Festivals with dark and Gothic themes and their implications for local economies, cultural appropriation and consumer experience have attracted increased attention in recent years. Dark tourism festivals are popular with festival goers, economically and culturally valuable, and often represent important shoulder-season assets. However, the role of festival goers in the marketing mix is currently poorly understood. This paper focuses on the role festival goers play in experiential marketing at dark tourism festivals. This paper utilises a comparative case study approach, examining two examples of dark tourism festivals with a gothic and dark focus: the Whitby Goth Weekend (UK) and the Bram Stoker Festival (Ireland). The paper adopts an inductive approach, and qualitative methodology, drawing on semi-structured interviews’ primary data. Thematic analysis is used to analyse data. Interviewees (n = 30) include festival management, festival marketers and festival participants. Our findings propose a model for dark tourism festival marketing, positing that a co-created approach, with high levels of participant engagement, is required for brand success. This paper presents implications for the practical promotion of niche festivals, including practical tips for marketing, societal need/ attraction to ‘unusual’ festivals, economic impacts and creating a more resilient festival design.

Strategic Human Resource Management and Employee Engagement in Australia

Purpose: The aim of the study was to investigate the strategic human resource management and employee engagement in Australia. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: In Australia, Strategic Human Resource Management (SHRM) practices have shown significant impact on employee engagement across various sectors. Studies consistently highlight that organizations implementing effective SHRM strategies, such as performance management systems and supportive leadership styles, experience higher levels of engagement among employees. Leadership, especially through transformational styles, plays a crucial role in inspiring teams and fostering a positive work environment. Aligning SHRM practices with a supportive organizational culture further enhances their effectiveness in promoting employee commitment and productivity. Unique Contribution to Theory, Practice and Policy: Resource-based view (RBV) theory, social exchange theory (SET) & high-involvement management (HIM) theory may be used to anchor future studies on strategic human resource management and employee engagement in Australia. Organizations should tailor their SHRM strategies to align with their unique organizational goals, culture, and employee demographics. Governments can support SHRM and employee engagement initiatives through regulatory frameworks that encourage investment in employee development, fair labor practices, and work-life balance.

Engagement With Stop Smoking Services After Referral or Signposting: A Mixed Methods Study.

Screening for smoking when people interact with healthcare services and referral of those who smoke to stop smoking services (SSSs) is a key component of efforts to tackle tobacco use. However, little is known about what happens after someone is referred or signposted to SSSs. As part of the Cessation of Smoking Trial in the Emergency Department (NCT04854616), those randomised to intervention (n= 505) were referred to local SSSs (along with receiving brief advice and an e-cigarette starter kit) and those randomised to control (n= 502) were given contact details for the same services (signposted). SSS engagement data was collected: 1) directly from participants and 2) from SSS, additional qualitative data came from 33 participant interviews. Engagement with SSSs was very low. 3.2% (n=16) of those in the intervention group and 2.4% (n=12) in the control group reported attending a one-to-one support session. From SSS data, engagement was also low with 8.9% (n=43) of those referred engaging and 3.1% (n=15) going on to quit with SSS support. The majority of the 24 intervention participants interviewed did not recall being contacted by an SSS. Referral or signposting to stop smoking services within an Emergency Department based trial resulted in very low levels of engagement. Barriers to engagement identified included participants not being contacted by SSSs and the support offered not meeting their needs. Referral or signposting of those who smoke to Stop smoking services from the Emergency Department resulted in low rates of engagement in this large multi-centre randomised controlled trial. In order to better support those who smoke it may be more effective for smoking cessation advice to be offered 'in the moment' within clinical settings, and follow-up to be proactively offered rather than relying on people being motivated to contact the services themselves or engaging when contacted.

Enhancing teaching and learning of evidence-based practice via game-based learning

Introduction: The Singapore Institute of Technology-University of Glasgow (SIT-UofG) Nursing Programme has traditionally taken a didactic teaching approach in the delivery of the Evidence-Based Practice (EBP) module. A hybrid approach was introduced using Game-Based Learning (GBL) to encourage active learning through gameplay. Methods: A Randomised Controlled Trial (RCT) was undertaken encompassing a cohort of 100 Nursing students taking the EBP module in their first year at the Singapore Institute of Technology (SIT) in the 2021/22 academic year. The experimental group (n=27) worked through the online GBL intervention and the EBP module, while the control group (n=27) took the EBP module alone. The GBL included five Learning Quests and three case studies. Results: High levels of satisfaction were reported by both the experimental group (n=22) and the control group (n=15) on the traditional content and delivery of the EBP module. High levels of engagement were reported by the experimental group on the GBL intervention; a one-sample statistics analysis confirming a significant level of engagement (p<0.001). A Mann-Whitney U Test, however, found no significant difference in the Continuous Assessment (CA) scores of the two groups (p=0.507 and 0.461). Conclusion: The introduction of GBL designed to deliver educational content directly associated with the learning outcomes increased the nursing student engagement in the EBP module. These findings and discoveries can be utilised to improve the GBL intervention to the EBP module to have a more positive impact the student CA scores and therefore on student learning. Keywords: Evidence-Based Teaching, Evidence-Based Practice (EBP), Nursing Education, Game-Based Learning (GBL), Teaching and Learning EBP, Nursing Students, Gamification

“Just got diagnosed; what worked for you?”: A Mixed-Methods Analysis of Treatment Experiences in the Prolactinoma Subreddit

ABSTRACT INTRODUCTION With improvement in complication and remission rates, recent studies have suggested the viability of transsphenoidal surgery as first-line management for prolactinomas. Reddit, an online forum, allows posters to interact with one another, discuss symptoms, treatments, and disease courses through specialized forums known as “subreddits”. Given the lack of research comparing patient experience on pharmacotherapy versus surgery, we sought to assess the sentiment of treatment within the “r/Prolactinoma subreddit” community. METHODS A search was done by filtering the r/Prolactinoma subreddit. Posts were sorted by “top” of “all time,” meaning entries with the most engagement throughout the site's history. Welch’s t-test was used to analyze treatment type, while sentiment regarding treatment was analyzed using grounded theory qualitative methods. RESULTS From 189 total entries, 82 were included; 33% (n=27/82) were posts. Of posters disclosing their treatment, 11% underwent surgery (n=9/79), while 76% received medication (n=60/79). The proportion of positive: negative sentiment and level of engagement on posts regarding pharmacotherapy vs surgical treatments were not significantly different (p>0.05). Qualitative analysis showed themes of changes after medical treatment, immediate changes post-surgery, and online community. CONCLUSION Our mixed-methods study found statistically non-significant differences in sentiment when comparing Reddit posts from patients who underwent medical and surgical management. Qualitative analysis revealed several themes regarding patients’ perceptions of medical and surgical management and the benefits of an online community. The qualitative themes brought to light by this study may serve to inform future studies examining the patient experience with prolactinoma care.

A mixed methods evaluation of patient perspectives on the implementation of an electronic health record-integrated patient-reported symptom and needs monitoring program in cancer care

BackgroundAs cancer centers have increased focus on patient-centered, evidenced-based care, implementing efficient programs that facilitate effective patient-clinician communication remains critical. We implemented an electronic health record-integrated patient-reported symptom and needs monitoring program (‘cPRO’ for cancer patient-reported outcomes). To aid evaluation of cPRO implementation, we asked patients receiving care in one of three geographical regions of an academic healthcare system about their experiences.MethodsUsing a sequential mixed-methods approach, we collected feedback in two waves. Wave 1 included virtual focus groups and interviews with patients who had completed cPRO. In Wave 2, we administered a structured survey to systematically examine Wave 1 themes. All participants had a diagnosed malignancy and received at least 2 invitations to complete cPRO. We used rapid and traditional qualitative methods to analyze Wave 1 data and focused on identifying facilitators and barriers to cPRO implementation. Wave 2 data were analyzed descriptively.ResultsParticipants (n = 180) were on average 62.9 years old; were majority female, White, non-Hispanic, and married; and represented various cancer types and phases of treatment. Wave 1 participants (n = 37) identified facilitators, including cPRO’s perceived value and favorable usability, and barriers, including confusion about cPRO’s purpose and various considerations for responding. High levels of clinician engagement with, and patient education on, cPRO were described as facilitators while low levels were described as barriers. Wave 2 (n = 143) data demonstrated high endorsement rates of cPRO’s usability on domains such as navigability (91.6%), comprehensibility (98.7%), and relevance (82.4%). Wave 2 data also indicated low rates of understanding cPRO’s purpose (56.7%), education from care teams about cPRO (22.5%), and discussing results of cPRO with care teams (16.3%).ConclusionsWhile patients reported high value and ease of use when completing cPRO, they also reported areas of confusion, emphasizing the importance of patient education on the purpose and use of cPRO and clinician engagement to sustain participation. These results guided successful implementation changes and will inform future improvements.

RELIGIOUS IMPLICATORS OF AN INDIVIDUAL'S SENSE OF SECURITY

ABSTRACT: Aim: The aim of the study was to capture the relationship between the subjective sense of security and the religiosity of youth. The goal was to identify those areas of the sense of security that correlate with elements constituting the sense of security and to capture differences between the genders of the participants. Methods: The study used Z. Uchnast's Security Feeling Questionnaire and R. Jaworski's Personal Religiosity Scale. A total of 112 individuals aged 19 to 28 participated in the study. Statistical analyses were conducted using Statistica software, employing non-parametric tests due to the non-normality of distributions. Results: The highest average ratings by participants concerned the sense of closeness (M=2,56), while stability (M=1,99) and trust (M=2,03) were rated lower. Gender analysis showed significant differences, with women rating their overall sense of security higher than men. Overall religiosity showed low but statistically significant correlations with self-trust and other dimensions of security, indicating positive associations with higher levels of religious engagement. Conclusion: Religiosity may serve a supportive role in building a sense of security, particularly through aspects of trust and closeness in interpersonal relationships. Further research is needed to better understand these mechanisms and to explore how other demographic variables may influence these relationships. Oryginality: Dynamic changes in postmodernism, introducing chaos into the lives of young people, imply a sense of threat. Therefore, it is important to periodically conduct studies monitoring the state of personal religiosity, which is strongly stigmatized today yet simultaneously constitutes a positive predictor of the sense of security. The originality of the article is indicated by the results of scientific research and the conclusions drawn from them. Keywords: security, sense of security, closeness, stability, trust, religiosity, personal religiosity, impersonal religiosity, faith, morality.

Modeling Risk Sharing and Impact on Systemic Risk

This paper develops a simplified agent-based model to investigate the dynamics of risk transfer and its implications for systemic risk within financial networks, focusing specifically on credit default swaps (CDSs) as instruments of risk allocation among banks and firms. Unlike broader models that incorporate multiple types of economic agents, our approach explicitly targets the interactions between banks and firms across three markets: credit, interbank loans, and CDSs. This model diverges from the frameworks established by prior researchers by simplifying the agent structure, which allows for more focused calibration to empirical data—specifically, a sample of Swiss banks—and enhances interpretability for regulatory use. Our analysis centers around two control variables, CDSc and CDSn, which control the likelihood of institutions participating in covered and naked CDS transactions, respectively. This approach allows us to explore the network’s behavior under varying levels of interconnectedness and differing magnitudes of deposit shocks. Our results indicate that the network can withstand minor shocks, but higher levels of CDS engagement significantly increase variance and kurtosis in equity returns, signaling heightened instability. This effect is amplified during severe shocks, suggesting that CDSs, instead of mitigating risk, propagate systemic risk, particularly in highly interconnected networks. These findings underscore the need for regulatory oversight to manage risk concentration and ensure financial stability.

Trans Rights and Safety, Political Self-efficacy, and Well-Being

Abstract Introduction This mixed-methods study contributes to a growing body of research on trans political engagement by examining the interaction between trans political self-efficacy, political fatigue, and mental health. A total of 141 trans individuals completed an online mixed-methods survey assessing trans rights and safety concerns, political self-efficacy, and well-being. Methods Participants were asked to describe the reasons for their level of political engagement. Data was collected between June 2019 and August 2021, with a brief pause for COVID-19. Results Narrative analyses indicate that participants engaged with the political system due to concern for their trans rights and safety (35%), their sense of the personal (55%), communal relevance (26%), their mistrust of the political system (26%), and their political self-efficacy beliefs (26%). Though quantitative analyses indicate that participants’ well-being was significantly, positively correlated with both political security and political self-efficacy, some participants described their political engagement as being related to political fatigue (21%). Moreover, participants who reported political fatigue demonstrated significantly lower political self-efficacy than participants who did not report political fatigue. Conclusions These results suggest that trans political engagement can provide important benefits for well-being, via political self-efficacy, as well as risk factors for psychological harm, via political fatigue. Policy Implications Thus, it is recommended that social policy makers promote safe pathways for trans individuals to engage with the political system and reduce activists’ exposure to anti-trans stigma.

The impact of the cost-of-living crisis on online student engagement and future study plans

ABSTRACT The UK cost-of-living increases from 2022 to 2023, referred to as the cost-of-living crisis, has had a sudden and unprecedented impact on students’ ability to cope financially, leading many higher education students to take on work or increase their working or caring hours to make ends meet. Any increase in working commitments may impact on their ability to fulfil their study commitments. A survey of over 800 students enrolled on psychology online courses indicated that their studies were suffering as a result. Students reported on lower levels of engagement with study materials, an in-course reduction of the study commitments (withdrawing from a module), and potentially studying less modules than planned in the subsequent year. The impact of this unforeseen time-poverty was increased stress and study strategies which may compromise their achievement overall. The impacts to their current study plans may have longer term detrimental effects on the poorer students.

The effects of religious group engagement on anti-abortion protest participation in Poland

ABSTRACT Religious engagement can foster either democratic or illiberal views among adherents. Some religious institutions attempt to mobilize believers against abortion rights. For these believers, when does religion mobilize pro-choice protest participation? I test three pathways by which a prescriptive norm of pro-life protest participation might mobilize believers: general religiosity, hierarchical pressure from religious leaders, and pressure from fellow parishioners. Using semi-structured interviews with Polish anti-abortion organizers and an original, pre-registered survey experiment of Polish Catholics, I show that religiosity does not mobilize anti-abortion activism. Instead, religious group engagement powerfully drives pro-life protest. Hierarchical pressures from religious leaders and group pressures from fellow parishioners only increase the likelihood that believers protest against abortion for highly engaged parishioners, but not less-engaged parishioners. Further, religious group engagement levels fully mediate these relationships. Thus, hierarchical and social norms impact individuals’ protest propensity to the extent that they are deeply embedded in a tightly knit social group.

Multi-Factor Evaluation of RHL Success in Neniari Village, Indonesia

General Background: Forest and land rehabilitation (RHL) is essential for addressing critical land conditions, aiming to transform unproductive lands into areas that can enhance community living standards through increased productivity. Specific Background: In Neniari Village, the RHL program has been implemented with mixed success, utilizing agroforestry systems and involving various species, including both timber and non-timber plants. Knowledge Gap: Existing studies often lack detailed analysis of the factors influencing RHL success at a community and ecological level. Aims: This study seeks to evaluate the overall success of the RHL program in Neniari Village by considering plant survival rates, environmental factors, and community participation. Results: The survival rate of plants averaged 70%, indicating a moderate level of rehabilitation success, which did not meet the targeted benchmarks. Novelty: This research uniquely combines biotic and abiotic factor analyses with community engagement levels to assess RHL outcomes. Implications: The findings highlight the need for enhanced community involvement and improved environmental condition management to boost RHL success rates, suggesting adjustments to future rehabilitation strategies.Highlights: Community Involvement: Higher levels of community participation are directly linked to the success of rehabilitation efforts, indicating the need for more focused engagement strategies. Plant Survival: An average survival rate of 70% among various plant species underlines the challenges of RHL in achieving its goals, pointing towards the necessity for improved environmental management. Agroforestry Benefits: Utilizing agroforestry systems has shown potential benefits in enhancing ecological diversity and economic returns, suggesting its suitability for RHL practices. Keywords: Forest Rehabilitation, Community Participation, Agroforestry Systems, Plant Survival Rates, Environmental Factors

School burnout and schoolwork engagement profiles among French high school students: Associations with perceived academic stress and social support.

Adolescents' well-being at school is positively affected by social support from parents, teachers, and peers and negatively affected by academic stress. However, little is known about how specific academic stressors are related to study-related well-being profiles. This study used a person-centered approach to identify the profiles of high school students based on their school burnout (i.e., exhaustion and cynicism) and engagement levels to examine their associated levels of perceived academic stress, social support, and sociodemographic characteristics. Using cluster analysis on a sample of 540 high school students (67.8% girls), we identified five profiles labeled "Engaged" (22.4%), "Relaxed" (18.9%), "Overextended" (25.6%), "Disengaged" (17.6%), and "Burned out" (15.4%). The "Engaged" and "Relaxed" groups experienced similar levels of perceived social support, but the "Engaged" students showed higher academic stress levels. The "Overextended" group displayed high academic stress with lower social support, while the "Disengaged" group showed low stress with low social support. Finally, the "Burned out" group displayed the highest academic stress and the lowest perceived support. Results are discussed within the demands-resources model of school burnout and clinical implications are presented for each profile.

Prefrontal Oscillatory Slowing in Early-Course Schizophrenia Is Associated With Worse Cognitive Performance and Negative Symptoms: A Transcranial Magnetic Stimulation-Electroencephalography Study

BackgroundAbnormalities in dorsolateral prefrontal cortex (DLPFC) oscillations are neurophysiological signatures of schizophrenia thought to underlie its cognitive deficits. Transcranial magnetic stimulation with electroencephalography (TMS-EEG) provides a measure of cortical oscillations unaffected by sensory relay functionality and/or patients’ level of engagement, which are important confounding factors in schizophrenia. Previous TMS–EEG work showed reduced fast, gamma-range oscillations and a slowing of the main DLPFC oscillatory frequency, or natural frequency, in chronic schizophrenia. However, it is unclear whether this DLPFC natural frequency slowing is present in early-course schizophrenia (EC-SCZ) and is associated with symptom severity and cognitive dysfunction. MethodsWe applied TMS–EEG to the left DLPFC in 30 individuals with EC-SCZ and 28 healthy control participants. Goal-directed working memory performance was assessed using the AX–Continuous Performance Task. The EEG frequency with the highest cumulative power at the stimulation site, or natural frequency, was extracted. We also calculated the local relative spectral power as the average power in each frequency band divided by the broadband power. ResultsCompared with the healthy control group, the EC-SCZ group had reduced DLPFC natural frequency (p = .0000002, Cohen’s d = −2.32) and higher DLPFC beta-range relative spectral power (p = .0003, Cohen’s d = 0.77). In the EC-SCZ group, the DLPFC natural frequency was inversely associated with negative symptoms. Across all participants, the beta band relative spectral power negatively correlated with AX–Continuous Performance Task performance. ConclusionsDLPFC oscillatory slowing is an early pathophysiological biomarker of schizophrenia that is associated with its symptom severity and cognitive impairments. Future work should assess whether noninvasive neurostimulation, including repetitive TMS, can ameliorate prefrontal oscillatory deficits and related clinical functions in patients with EC-SCZ.

Use of Social Media Platforms for Citizen Journalism on Security Challenges in Nigeria among The Polytechnic Ibadan Students

The immediacy of social media gives citizens the ability to monitor real-world events and security issues and get immediate feedback that can help shape their responses and priorities, which can also be valuable in promoting security in general. Through its constant use, social media has played a significant role in fostering both positive and negative facets of insecurity. Therefore, this study investigated use of social media platforms and engagement in citizens’ journalism regarding security challenges in Nigeria among The Polytechnic Ibadan Students. The study adopted descriptive survey research design; multi-stage sampling procedure was adopted in the sample selection of 403 respondents. A validated instrument named; Citizen Journalism Social Media Questionnaire(r=0.874) was used for data collection; data was analyzed using descriptive and inferential statistics. Findings revealed that students of The Polytechnic Ibadan made use of popular social media platforms such as Facebook, Instagram, WhatsApp (weighted x̄ 1.40) respectively and engaged in online discussion of security challenges to a large extent using Facebook, WhatsApp, Instagram, Twitter, YouTube, Telegram, and others (weighted x̄ 2.11). Also, there was no significant difference (r = 0.053, p<0.05) in level of engagement in online discussion on security challenges in Nigeria. Thus, the study concluded that The Polytechnic Ibadan students’ social media use does not have any influence on security challenges in Nigeria. The study recommended that security information should be promptly disseminated virtually by security operatives to avoid spreading of fake security news through social media platforms.

Development and Implementation of a Novel Approach to Dietary Education for People With Inadequate Health Literacy and Advanced Kidney Disease

To describe the process of developing and implementing a novel approach to renal diet education by changing from a nutrient-based food list to a pictorial meal compilation approach through the skill steps: plan, select, cook, eat. The skill-based teaching method accommodates low literacy levels and respects cultural values. This teaching style aligns the complex renal diet guidelines with family living. Each meal plan is based on a balanced diet and includes family preferences. Appropriate cooking methods and food swaps that match renal diet specifications are included. The accompanying Cook for Life cookbook demonstrates how to prepare the new kidney-friendly family meal. Recipes were supplied by a local Māori elder and his whānau and tested by the dietitian. The cookbook is provided to all patients receiving renal dietetic education. The teaching method has undergone several iterations to accommodate feedback from dietitians, nurses, doctors, and patients. This included patient engagement to develop the Storybook, a pictorial representation of typical meals consumed in the community with a corresponding food substitution to illustrate how to compile kidney-friendly meals. Analysis of feedback regarding this approach indicates high levels of acceptance and engagement with this new teaching style. This practical skill-based dietary education teaching style appears to be a feasible, acceptable, culturally sensitive, and appropriate approach to dietary education for people who live with kidney disease. Patient engagement in the design of this approach supports effective learning and behavior change.

Clinician-Reported Barriers and Needs for Implementation of Continuous Glucose Monitoring.

Continuous glucose monitoring (CGM) for patients with type 1 and type 2 diabetes is associated with improved clinical, behavioral, and psychosocial patient health outcomes and is part of the American Diabetes Association's Standards of Medical Care. CGM prescription often takes place in endocrinology practices, yet 50% of adults with type 1 diabetes and 90% of all people with type 2 diabetes receive their diabetes care in primary care settings. This study examined primary care clinicians' perceptions of barriers and resources needed to support CGM use in primary care. This qualitative study used semistructured interviews with primary care clinicians to understand barriers to CGM and resources needed to prescribe. Participants were recruited through practice-based research networks. Rapid qualitative analysis was used to summarize themes from interview findings. We conducted interviews with 55 primary care clinicians across 21 states. Participants described CGM benefits for patients with varying levels of diabetes self-management and engagement. Major barriers to prescribing included lack of insurance coverage for CGM costs to patients, and time constraints. Participants identified resources needed to foster CGM prescribing, for example, clinician education, support staff, and EHR compatibility. Primary care clinicians face several challenges to prescribing CGM, but they are interested in learning more to help them offer it to their patients. This study reinforces the ongoing need for improved clinician education on CGM technology and continued expansion of insurance coverage for people with both type 1 and type 2 diabetes.