Explanatory Sequential Mixed Methods Research Articles

Psychological Well-Being, Curiosity and Perfectionism among Filipino Young Professionals with Quarter Life Crisis: Basis for Existential Positive Psychology Wellness Plan

Quarter Life Crisis is a difficult encounter in the life transition from adolescence to early adulthood. This crisis revolves around social comparison, work satisfaction, intimate relationships, career consolidation, preoccupations and fears, struggle from transition, social isolation, and frustration and disappointments. This study examined the psychological well-being, curiosity, and perfectionism among young professionals with a quarter-life crisis. There were 318 participants in this study from two different cities in one province of Region IV-A in the Philippines. The study used a sequential explanatory mixed method design that combines qualitative and quantitative research. Based on the result, the research found that young professionals with quarter-life crises have low psychological well-being, low curiosity, and high perfectionism. The themes, low disposition, poor mindset, and weak personality were extracted from the texts to fully support the respective variables. Furthermore, the research proposed a psychological intervention plan for young professionals experiencing the crisis: the existential positive psychology wellness plan.

Untangling purpose: examining the nuanced influence of personal meaning and beyond-the-self orientation on youth mental health in unprecedented times

ABSTRACT This modified sequential explanatory mixed methods study explores how the components of purpose (personal meaningfulness and a beyond-the-self orientation) impact youth mental health outcomes (depressive and anxiety symptoms) in the context of COVID-19. We hypothesized that youth with higher scores on the components of purpose (goal-directedness, personal meaningfulness, and beyond-the-self orientation) would be less likely to experience anxiety and depressive symptoms during COVID-19. We also explored in what ways youths’ descriptions of their own prosocial behavior align with the relation between purpose and mental health. Data are from two waves of the Boy Scouts of America (BSA) Building Evidence in Scouting Together study. Quantitative data are from 4,896 youth and a subsample of 94 youth completed qualitative personal communication Results indicate the personal meaning component of purpose is protective against depressive and anxiety symptoms. However, the beyond-the-self orientation of purpose is associated with higher levels of depressive and anxiety symptoms. In addition, differences were found between youth who reported higher and lower levels of depressive and anxiety symptoms, and personal meaning and a beyond-the-self orientation for the following themes: 1) Empathy for others, 2) Desire to change the situation, 3) Solutions to change the situation, 4) Helping at home, 5) Following health advice, and 6) Scouting-specific examples. Taken together, this study provides useful insights into how each component of purpose can uniquely promote or provide a buffer for depression and anxiety among youth.

Satisfaction of chronic patients with community-based health insurance schemes and related factors: Explanatory sequential mixed methods study.

Chronic disease poses a serious threat to accessible, high-quality healthcare. Community-based health insurance (CBHI) schemes provide the poor with financial security. However, there is no evidence in Ethiopia on how satisfied chronic patients are with the schemes. The objective of the current study was to evaluate the satisfaction of chronic patients with the schemes and identify contributing factors. A hospital-based explanatory sequential mixed methods study on 632 chronic patients and 12 key informants was carried out between February 28 and May 31, 2022, in the hospitals of East Gojjam, Northwest Ethiopia. Hospitals and study participants were selected using multistage sampling methods. Quantitative data was entered using Epi Data 3.1 and exported to SPSS version 25 for analysis. P value <0.05 was used to consider significant association in multivariable binary logistic regression. Thematic analysis was a method to manually review qualitative data. A narrative approach was used for integrating the two data. The mean age of study participants was 46.1 (46.1± 5.2, range: 25-82). Patients aged 45 to 64 made up the majority of the population (60.6%). Rheumatoid arthritis affected the preponderance of individuals (36.4%). The overall level of satisfaction of chronic patients with the CBHI scheme was 31% (95% CI; 27-35%). Respect and friendliness (AOR = 7.05; CI: 3.71-13.36), knowledge of benefits packages (AOR = 2.02; CI: 1.24-3.27), partial or non-availability of drugs (AOR = 0.24, AOR = 0.21, respectively), waiting times (AOR = 1.84; CI: 1.12-3.0), and availability of laboratory tests (AOR = 1.59; CI: 1.01-2.48) were significantly associated with participants' satisfaction with the schemes. Our study revealed that the overall satisfaction of chronic patients was quite low and affected by the availability of drugs and laboratory tests, caregivers' respect and friendliness, waiting times, and participant knowledge. Therefore, stakeholders must concentrate on reducing waiting times, improving the availability of drugs and laboratory tests at each hospital, opening back up community pharmacies, and promoting awareness about benefits packages primarily through health education. The main focus of researchers needs to be on nationally representative studies that include more important factors.

Clear Masks Do Not Prevent Gains During Dynamic Temporal and Tactile Cueing Treatment: An Explanatory Sequential Mixed Methods Pilot Study

Purpose: This study aimed to determine the outcomes and impact of Dynamic Temporal and Tactile Cueing (DTTC) treatment when clear vinyl masks were worn. DTTC is one of the few evidence-based treatments for children with childhood apraxia of speech (CAS). Given that DTTC relies on visual, auditory, and tactile cues, it was unknown if treatment gains would be demonstrated when masks were worn and how masking would impact the therapy experience for clinicians and caregivers. Method: A sequential mixed methods design was used to study the efficacy of DTTC treatment in children with CAS when clear masks were worn. The quantitative phase used a multiple-baseline across-participants design. Four children (each 4 years of age) participated in the treatment protocol in which 24 sessions of DTTC were provided over 8 weeks while clear vinyl face masks were worn by participants and clinicians. Whole word accuracy on treated items and generalization to easy and hard untreated items were assessed during baseline, treatment, and follow-up. Semistructured interviews were conducted with clinicians and caregivers following treatment to explore the experience of masks being worn during treatment. Qualitative data were analyzed using descriptive thematic analysis. Results: Three children completed the treatment protocol. Visual and statistical analyses revealed that two participants demonstrated significant treatment effects, with one also demonstrating generalization. The remaining participant demonstrated marginal treatment gains. Qualitative findings revealed two main themes: “mask wearing was inconvenient but did not prevent therapy gains” and “in-person therapy with face masks was preferable to teletherapy.” Conclusions: Masks did not prohibit treatment gains during DTTC therapy, with treatment effects of varying degrees shown for the three participants who completed the protocol. Together, quantitative and qualitative results indicate that mask wearing was, for most, a minor inconvenience that did not substantially interfere with the efficacy of DTTC treatment. Supplemental Material: https://doi.org/10.23641/asha.26408854

Evaluating the Impact of the Language Mindset Toolkit among Thai Undergraduate Students

This study reports the impact of a language mindset toolkit in influencing the language mindsets of Thai undergraduate students. An explanatory sequential mixed method design was used to determine how language mindset changes and know the students’ language learning insights through a focused mindset intervention. Data from 67 students chosen from convenience sampling completed language mindset surveys, journal entries, and semi-structured interviews were analyzed. Descriptive statistics was used to analyze the survey data, while thematic and content analyses were utilized for journal entries and interview data. Key findings revealed a notable shift from a fixed to a growth mindset, particularly in language learning abilities. While mindsets related to intelligence and age sensitivity remained relatively stable, there was a marked change in participants’ belief in the malleability of their language learning abilities, underpinned by the principles of effort and persistence. Thematic analysis of journals supports these findings, with themes such as knowing about language mindset in learning, putting effort into language learning, setting goals in language learning, using strategies in language learning, and regulating emotions in language learning. Meanwhile, the content analysis of individual interviews revealed insights such as appreciating self, motivating self in language learning, and gaining self-efficacy. Growth mindset-oriented interventions could transform the students’ beliefs in language learning.

The perceived relevance, utility and retention of basic sciences in general practice

BackgroundBasic sciences are crucial for clinical medicine, yet studies focusing on their perceived utility among general practitioners (GPs) are sparse. Considering the broad scope of GPs’ practice, an in-depth understanding of basic sciences is fundamental for making informed clinical decisions. This study evaluated GP registrars’ retention and perceptions of the utility of basic sciences in clinical practice.MethodsUsing sequential explanatory mixed methods study design, knowledge retention was assessed by a multiple-choice question (MCQ) examination followed by interviews on the perception of the relevance and utility of basic sciences among GP registrars at James Cook University's (JCU) General Practice Training (GPT) program. Descriptive and inferential statistical analyses were conducted on the MCQ exam data, while thematic analysis was employed for the qualitative interview data.ResultsSixty-one GP registrars participated in the MCQ exam, while 11 of them were involved in the interviews. The highest mean score was obtained in biochemistry (75.1 ± 2.23) while the lowest mean score was in anatomy (56.07 ± 3.16). Key performance predictors included the formative clinical examination scores (β = 0.83, 95% CI: 0.45 to 1.2, p < 0.001) and gender (β = -9.7, 95% CI: -17 to -2.3, p = 0.011). The qualitative data analysis revealed five themes, including the backbone of clinical medicine, varying utility over time and by specialty, clinical synthesis integrates encapsulated knowledge, professional pressures hinder revisitation of knowledge and knowledge renewal enhances updates.ConclusionBasic sciences were considered relevant in clinical practice. Development of continuing professional development (CPDs) sessions and clinically relevant online resources were measures proposed to enhance the retention of knowledge. Future research could focus on innovative educational strategies for GPs.

Promoting inclusion for disabled students in healthcare education: Using research-based theatre to enhance knowledge and empathy

AimThis study explores and compares the impact of in-person and online versions of a Research-based Theatre production named "Alone in the Ring," aimed at increasing knowledge and fostering positive attitudes towards persons with disabilities in healthcare professions. The study examines changes in attitudes towards disabled persons in healthcare professions, levels of engagement in the play and knowledge about the experiences and challenges of disabled individuals in healthcare professions. It also investigates possible actions to increase inclusion for disabled persons in healthcare education and practice. BackgroundDisabled students face numerous barriers in healthcare education and practice, many of which are rooted in stigma and negative attitudes. Research-based Theatre promotes experiential learning to address these attitudes and stereotypes. The performance "Alone in the Ring" is based on a comprehensive study of the experiences of disabled students and clinicians in health professions, aiming to promote inclusion for students with disabilities in these fields. DesignThis study uses a pre-test and post-test design with two comparison groups. MethodThe study employed an explanatory sequential mixed method design to explore the impact of online versus in-person Research-based Theatre teaching in healthcare education. Participants were graduate health students (N = 198); 100 watched the in-person version and 98 watched the online version. Surveys were administered before and after the performance. Participants were also invited to share their experiences in semi-structured interviews and their responses were analyzed using thematic analysis. ResultsResults indicated that students generally felt more comfortable with disabled persons in healthcare professions in the post-survey compared to the pre-survey, with online participants reporting greater comfort and higher engagement than those in-person. Knowledge of disabled persons' experiences and challenges, as well as possible actions to increase belonging and inclusion, improved significantly for both groups from pre- to post-performance, with online participants showing a greater change. Qualitative data revealed that online theatre was perceived as authentic and beneficial for accessibility, engagement and emotional impact on students, though challenges included potential distractions and technological issues. Positive correlations were found between changes in knowledge, positive attitude and engagement, suggesting that increased engagement and a shift in attitudes can promote knowledge and awareness of the inclusion of disabled persons in healthcare professions. ConclusionThese results support the use of online theatre-based academic teaching that experientially engages students, increases empathy and can promote more inclusive healthcare educational settings for disabled persons.

Assessment of infrastructure, behaviours, and user satisfaction of guardian waiting shelters for secondary level hospitals in southern Malawi.

Guardian Waiting Shelters (GWSs) are an essential component of the Malawi's health care system as they serve as a temporary home for patient guardians while taking care of their relatives admitted to the hospital, and expectant mothers. Although GWSs play a crucial role in Malawi's healthcare system, past studies have primarily concentrated on maternity waiting homes, neglecting the role and importance of GWSs. The study examines GWS management structures and conditions, as well as guardian satisfaction and perception of health risks related to GWS use. In this explanatory sequential mixed methods design, we assessed 12 GWSs from southern region of Malawi. Qualitative data included interviews (n = 149) and focus group discussions with patient guardians (n = 72), interviews with GWS caretakers (n = 5), representatives from Hospital Management (n = 12) and Hospital Advisory Committees (n = 11). Lack of guidelines and standards for GWSs resulted in creating a customized facility checklist to quantitatively assess infrastructure present at GWSs (n = 12). Descriptive statistics and qualitative thematic analysis were utilized for data analysis, and a problem tree analysis was used to triangulate and summarize the findings. A total of 249 participants participated in the study. Each GWS had an average of 100 users daily, primarily adult females (71%). No one was accountable for GWS operation and maintenance due to the lack of a management hierarchy. GWS infrastructure conditions were poor, with inadequate functional sleeping rooms, insufficient access to water, sanitation and hygiene facilities. Notably, 50% of the GWSs lacked water access, and a quarter had non-functional toilets. Guardians felt unsafe and at risk of disease transmission when staying within GWS. Study findings highlight lack of clear, consistent GWS ownership as a root cause of challenges in GWSs. Clear policy and operational standards must be established for effective management and smooth functioning of GWSs.

Efficacy of Specialized Security Agencies in Curbing Cattle Rustling in Sotik and Borabu Sub-Counties in Kenya

Kenya has faced a wide scale threat of cattle rustling. The menace has been occurring mainly in counties populated by pastoralist groups including the Turkana, Samburu, Maasai, Pokot as well as Kipsigis and Kisii among others. People have been killed, their property lost; some mutilated, injured, and displaced. Security organizations such as the General Service Unit (GSU) and the Anti-Stock Theft Unit (ASTU) among others were mobilized to help curb the danger of cattle rustling yet it has continued to occur in Kenya including Sotik and Borabu Sub counties. The purpose of this study was thus to investigate how effective security agencies were in curbing cattle rustling in the counties of Bomet and Nyamira, Kenya. This study therefore investigated the effectiveness of specialized security agencies in curbing cattle rustling in the Sotik and Borabu Sub-Counties in Bomet and Nyamira Counties in Kenya. A sequential exploratory mixed methods design was used. The target population was all the residents of Sotik and Borabu Sub-Counties (18 years and above) who had information regarding the topic under discourse. They were 284,379 in number. A total of 156 respondents participated. The respondents were drawn through purposive sampling. A questionnaire was used to gather quantitative information while key informant interview guides were used to gather qualitative information from the respondents. The hypothesis was tested using Pearson’s Correlation Coefficient (r) at α =0.05 level of significance. The results obtained from the two sub-counties determined that the deployment of specialized security agencies had a statistically significant effect on curbing cattle rustling. This means that before the deployment of security agencies, the frequency of cattle rustling was relatively high as compared to the periods after their deployment. The reduction was therefore attributed to the constant pursuit and deployment of specialized units such as the ASTU, GSU and Administration Police in the region. The study recommends that the national government should expand the presence and activities of specialized security agencies in regions with a history of high cattle rustling rates, focusing on areas with the highest correlation between agency presence and rustling reduction. The government should also implement targeted training programs for specialized security personnel to equip them with the necessary skills and knowledge for addressing the unique challenges associated with cattle rustling.

Leadership in the Modern Academe: Knowledge Management and Curriculum Delivery in Multigenerational Professional Learning Communities

This study was conducted to look into the different perceptions and assessments of multigenerational professional learning communities as regards to knowledge management and curriculum delivery among their school leaders. The study follows a sequential explanatory mixed methods design. The study was done in two phases. In the first phase, a survey was conducted to gather quantitative data to assess the extent of knowledge management and the level of observance of curriculum delivery in multigenerational professional learning communities among their school leaders. A test of difference was then carried out to see if there is a difference between the perceptions multigenerational professional learning communities as regards to knowledge management and curriculum delivery. The result showed that there is no significant difference between the assessments of multigenerational professional learning communities. In the second phase, interviews were conducted to gather qualitative data and then themes were exposed. The qualitative results build on the initial quantitative results wherein the quantitative results inform the secondary qualitative results. The respondents of the study were the 14 Baby Boomer teachers, 61 generation Xs and 65 millennial teachers from the elementary schools in East 2. The co-researchers of the study were 2 teachers from each generations. In conclusion, this thesis has exposed that there is no difference in the assessment of multigenerational professional learning communities as regards to knowledge management and curriculum delivery among school leaders. Their perspectives also the same quantitatively and qualitatively. Meanwhile, the themes that emerged after gathering the data were: Principals’ Own Knowledge Management, Principals’ Personal Curriculum Delivery Initiatives, Generational Edge as to Experience, Technology, Discipline, Flexibility, Willingness to Learn and Exposure, and lastly, Positive Reaction to Principals’ Leadership. For the output of the study, a compendium of best practices for knowledge management and curriculum delivery was provided in the study for the school leaders to further enhance their capabilities in leading the modern academe in multigenerational professional learning communities.

Improving Argument-Based Explanation Writing in Inclusive High School Science Class for Students with and without Exceptionalities

ABSTRACT There have been many calls for the development of discipline-specific argument writing interventions to integrate science-specific and general literacy standards and goals. Yet, adolescents with and without exceptionalities struggle to meet existing writing demands. This explanatory sequential mixed methods design draws from the strengths of multiple baseline design and integrates rich qualitative data, from a student perspective, to better understand the elements that contribute to effective discipline-specific writing instruction. The study examined the effects of implementing Self-Regulated Strategy Development (SRSD) through a writing-to-learn sensemaking framework adapting the DEFEND strategy to improve students’ written argument-based explanations across inclusive science classrooms and focus learners with exceptionalities. A ninth-grade science teacher delivered science and writing instruction and collected quick writes before, during, and after SRSD implementation. Results indicated that students’ argument-based explanations improved in discipline-specific components (i.e. claim, evidence, reasoning, knowledge) and general components (i.e. organization and writing quality). Students discussed the challenges of using their developing knowledge to write argument-based explanations using the DEFEND strategy, with particular difficulties in expressing reasoning and an appropriate counterclaim. Issues of feasibility and usability are discussed.

The development of a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of cardiac sarcoidosis on health-related quality of life

Abstract Introduction Sarcoidosis is a rare inflammatory condition caused by the formation of lumps (granulomas) of abnormal tissue in any organ, and can affect physical, functional, mental, social and economic aspects of life. People living with cardiac sarcoidosis (CS) are likely to have worse clinical outcomes and greater impairment on health-related quality of life (HRQoL) than other sarcoidosis manifestations. HRQoL is the main concern for people living with sarcoidosis. However, measuring HRQoL in people with CS is difficult as existing tools focus on other forms of sarcoidosis (for example, lung, eye or skin involvement) or for specific cardiac symptoms (for example, atrial fibrillation, angina or heart failure), but not specifically for CS. Purpose To develop a disease-specific patient-reported outcome measure (CARD-SARC) to assess the impact of CS on HRQoL. Methods A sequential exploratory mixed-method, multicentre observational cohort study using a clinimetric approach was conducted. The McMaster Framework for evaluative instruments was combined with the consensus-based standards for the selection of health measurement instruments (COSMIN) recommendations, involving three steps: item selection, item scaling and item reduction. The item-generation process used simultaneous triangulation (QUAN+qual) method, connecting quantitative data (theory, research findings and systematic review) with complementary qualitative components (interviews, clinical observations and experts’ opinion). The formatting of items was guided by patient and public involvement (PPI). The item reduction strategy was led by PPI and an international multidisciplinary clinical CS-experts. Results 740 potential items were generated by converging all the different sources and techniques. After removal of duplicates and simultaneous triangulation, a preliminary list with 111 items was reviewed by the CS-expert panel (including 11 pulmonologists, 7 cardiologists, 5 CS-patients and 3 specialist-nurses). After a consensus meeting, the CARD-SARC included 61 relevant items in six sections for pilot-testing: "functioning", "social, leisure and occupation", "emotional", psychological", "physical" and "healthcare/self-care". Conclusions This study used a robust methodology and active PPI involvement to develop the first disease-specific HRQoL tool for CS. The engagement and contributions of the PPI group in each step of the framework enhanced the content validity of the CARD-SARC. The CARD-SARC has the potential to influence clinical management and treatment options, future research and health-economic stakeholders’ decisions for CS.

Investigating Mixed Methods Research in Applied Linguistics: Methodological Avoidance and Possible Barriers in the Field

The field of applied linguistics is becoming increasingly transdisciplinary as recognition for the need to approach empirical questions from a variety of epistemological and theoretical perspectives grows (Douglas Fir Group, 2016). One methodological approach that holds promise for advancing sophisticated inquiry into complex issues of applied linguistics is mixed methods research (MMR); however, studies adopting MMR to its fullest potential remain infrequent. Employing an exploratory sequential mixed methods design that includes a focus group and survey questionnaire, this empirical study investigates the internal and external factors that may lead applied linguistics researchers to avoid conducting and/or publishing MMR. Integrated analyses revealed that participants’ methodological and publishing decisions were influenced by factors such as their socialization into research practices in graduate school, the pressure to publish, and the considerations of the research journal industry. Implications for future applied linguistics researcher education programs and the impact of the publishing industry on research agendas are discussed.

To Improve Motivational Barriers to Retention in High Resolution Anoscopy, Patients and Providers Recommend Social and Environmental Changes: A Sequential Explanatory Mixed-Methods Pilot Study in a Federally Qualified Health Center.

Loss to follow-up (LTFU) in high-resolution anoscopy (HRA) programs jeopardizes the procedure's potential to help prevent anal cancer. We explored quality improvement factors to understand how to address this LTFU. Using the transtheoretical COM-B Model (Capability, Opportunity, Motivation, and Behavior) and a sequential explanatory mixed-methods design, we surveyed and interviewed 13 patients who remained engaged in HIV care but who delayed their HRA monitoring or treatment visits in the same community clinic, and 6 HRA clinicians and medical assistants. Analyses involved descriptive statistics and rapid qualitative analysis. Patients were racially, ethnically, and economically representative of the LTFU population, and were generally experienced with HRA (Mean HRA visits = 4.6, SD = 2.8, mdn = 3). Providers were experienced clinicians and medical assistants (Mean years providing HRA = 6.0, SD = 2.2). Analyses revealed two primary, related barriers: (A) motivational barriers such as physical pain, discomfort, embarrassment, and anxiety; which were largely borne from (B) opportunity barriers such as difficulties with scheduling, inconsistent after-care (particularly for pain and discomfort), anxiety-inducing exam rooms and equipment, and internalized and anticipated stigma. Capability barriers, such as limited health literacy about HRA, were less common and, like motivational barriers, linked to opportunity barriers. Participants recommended potential facilitators, including easier scheduling, standardization of pain management and after-care services, and examination room modifications to reduce anxiety. To retain HRA patients in community settings, interventions should address social and physical opportunity barriers that strongly determine motivational and capability barriers. Improving convenience, standardizing pain management, and introducing stigma interventions specific to HRA, could alleviate both motivational and capability barriers.

Understanding the capacity development of faculty development programs: a sequential explanatory mixed methods study

BackgroundFaculty development programs can bring about both individual and organizational capacity development by enhancing individuals’ attitudes, values, and skillsto enable them to implement organizational change. Understanding how faculty development programs produce capacity development, and the influencing factors, requires further understanding. This study aimed to explore the perceptions of the participants of a faculty development program about the capacity development features of the program and the influencing factors.MethodsA sequential explanatory mixed methods design was used. Faculty members were surveyed about their perspectives on capacity development of faculty development. Subsequently, 22 interviews were conducted with the respondents to deepem understanding of the survey results. Interview transcripts underwent conventional content analysis.ResultsA total of 203 completed the questionnaire. Most of the faculty highly agreed that the faculty development programs had produced capacity development. The combined data identified (a) “quality of faculty development programs”, underscoring the significance of robust and comprehensive initiatives, (b) “development in instruction”, emphasizing the importance of continuous improvement in pedagogical approaches (c) “development in professionalism”, highlighting the necessity for cultivating a culture of professionalism among faculty members, (d) “development in attitude towards education”, emphasizing the role of mindset in fostering effective teaching practices, and (e) “supporting faculty development programs”, with fostering organizational growth and innovation. Important barriers and facilitators of the capacity development process included several organizational, interpersonal, and individual factors.ConclusionThe study identified specific features of the capacity development process in the context of a faculty development program and highlighted the importance of these programs in producing changes in both individuals and within the wider organizational system. Several factors that enabled and constrained the capacity development process were also identified. The findings of the study can inform future implementation of faculty development programs for capacity development.

Sustaining Undergraduate Students’ Metacognitive Regulatory Actions During Online Flipped Programming Course

This research explores how metacognitive strategies influence the metacognitive awareness of undergraduate students enrolled in an online flipped programming course. It specifically focuses on regulatory actions crucial for success in programming instruction and distance education settings. The primary objective is to contribute to the existing literature by investigating the implementation of online flipped programming courses that integrate metacognitive-oriented approaches to support students' metacognitive regulatory actions. The study employed an explanatory sequential mixed methods design. A total of 29 university students enrolled in programming courses participated in the study, engaging with instructional videos provided before each 10-week lesson. They were administered the Metacognitive Awareness Scale and supplementary forms designed to assess their metacognitive awareness and regulatory actions. A detailed coding scheme was developed to analyze students' metacognitive regulation activities during programming lessons. The study also evaluated the impact of supportive activities on students' metacognitive awareness. While no statistically significant difference was found in the students' metacognitive awareness through quantitative analysis, qualitative data revealed that activities supporting metacognition significantly enhanced students' comprehension of the programming content.

Protocol to develop strategies to improve the effectiveness and efficiency of Village Health Workers in service delivery in a selected district of Zimbabwe

Village Health Workers (VHWs) in Zimbabwe complement the healthcare staff in primary health care delivery. In 2015 the Ministry of Health streamlined services offered by the VHWs with the VHW Strengthening Plan to improve the effectiveness of the program. However, these continue to offer services not addressing the current and emerging health problems. This three-phased study seeks to develop strategies to improve the effectiveness and efficiency of VHWs in service delivery. Systematic literature review shall be used to develop a conceptual framework to guide the development of VHWs service delivery strategies. Exploratory sequential mixed methods design shall explore VHWs roles in primary health care. A survey in the first stage shall collect qualitative data from 45 purposely selected healthcare workers and VHWs using interviews and then thematically analyzed with MAXQDA. The variables generated will have a cross-sectional survey used to collect quantitative data from 134 VHWs and analyzed on SPSS. The SWOT and basic logic models shall be used to develop strategies validated by the Delphi Technique and Key Stakeholders. Informed consent will be maintained in the study with findings published in journals and presentation symposiums. This protocol was approved by the University of Venda Research Ethics Committee (Registration FHS/23/pH/11/0709).

An Explanatory Sequential Study of Public Elementary School Teachers on Deped Computerization Program (DCP)

The purpose of the study was to determine what personal information need further explanation on the utilization of DepEd computerization program in terms of; (1) purpose of computer usage, (2) indicated computer skills, (3) type of software for teaching and learning, (4) educational software by subject, (5) types of peripherals, (6) teaching and learning activities by subject and (7) internet usage of teachers and students. Further, to find out the significant difference between the utilization of DepEd computerization program when they are grouped according to their personal information variables. A total of 30 EPP/TLE teachers of Binugao District are the respondents were identified through purposive sampling technique. The study utilized explanatory sequential mixed method design. Two methods in collecting the data were utilized, for the quantitative phase the researcher used survey questionnaire in determining the personal information and utilization of DCP. Furthermore, in the qualitative phase the researcher used in-depth interview in gathering the data to identify what school program should be enhanced in utilizing DCP efficiently. On the quantitative analysis, there is no significant difference between the utilization of DepEd computerization program when they are grouped according to their personal information variables. In addition, the quantitative findings were follow-up by the qualitative findings. Thus, it was found that the school program to enhance the utilization of DCP efficiently of teachers revealed four major themes namely: (1) resiliency, (2) results-focus, (3) innovation and (4) receptiveness.

Designing a Midwife-Led Birth Center Program Based on the MAP-IT Model: A Sequential Explanatory Mixed-Methods Study

BackgroundIn recent decades, medical supervision of the labor and delivery process has expanded beyond its boundaries to the extent that in many settings, childbirth has become a medical event. This situation has influenced midwifery care. One of the significant barriers to midwives providing care to pregnant women is the medicalization of childbirth. So far, the policies and programs of the Ministry of Health to reduce medical interventions and cesarean section rates have not been successful. Therefore, the current study aims to be conducted with the purpose of “Designing a Midwife-Led Birth Center Program Based on the MAP-IT Model”.Methods/designThe current study is a mixed-methods sequential explanatory design by using the MAP-IT model includes 5 steps: Mobilize, Assess, Plan, Implement, and Track, providing a framework for planning and evaluating public health interventions in a community. It will be implemented in three stages: The first phase of the research will be a cross-sectional descriptive study to determine the attitudes and preferences towards establishing a midwifery-led birthing center focusing on midwives and women of childbearing age by using two researcher-made questionnaires to assess the participants’ attitudes and preferences toward establishing a midwifery-led birthing center. Subsequently, extreme cases will be selected based on the participants’ average attitude scores toward establishing a midwifery-led birthing center in the quantitative section. In the second stage of the study, qualitative in-depth interviews will be conducted with the identified extreme cases from the first quantitative phase and other stakeholders (the first and second steps of the MAP-IT model, namely identifying and forming a stakeholder coalition, and assessing community resources and real needs). In this stage, the conventional qualitative content analysis approach will be used. Subsequently, based on the quantitative and qualitative data obtained up to this stage, a midwifery-led birthing center program based on the third step of the MAP-IT model, namely Plan, will be developed and validated using the Delphi method.DiscussionThis is the first study that uses a mixed-method approach for designing a midwife-led maternity care program based on the MAP-IT model. This study will fill the research gap in the field of improving midwife-led maternity care and designing a program based on the needs of a large group of pregnant mothers. We hope this program facilitates improved eligibility of midwifery to continue care to manage and improve their health easily and affordably.Ethical codeIR.MUMS.NURSE.REC. 1403. 014.

Profil Habits of Mind Siswa SMA dalam Pemecahan Masalah Matematika

This study aims to describe the habits of mind possessed by high, medium, and low class XI high school students in solving mathematical problems on linear program material studied from persisting, thinking flexibly, applying past knowledge to new situations, and metacognition. Habits of mind that are the focus of this study consist of four indicators, namely persisting, thinking flexibly, applying past knowledge to new situations, and metacognition. The research subjects were students of class XI MIPA 4 SMAS Mujahidin Pontianak and the object of research was habits of mind in mathematics problem solving. Explanatory sequential mixed method design is the method of this research with its instruments, namely math problem solving test questions, habits of mind questionnaire, and interview guidelines. The results of the discussion show that the habits of mind possessed by high category students in solving mathematics are persisting, thinking flexibly, applying past knowledge to new situations, and metacognition. Habits of mind owned by medium category students are persisting, thinking flexibly, and applying past knowledge to new situations. Habits of mind possessed by low category students are persisting.